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Bléry, M., M. Bléry-Krissat, Y. Hammoudi, and L. Rocher. "Pathologie infectieuse du haut appareil urinaire." EMC - Radiologie et imagerie médicale - Génito-urinaire - Gynéco-obstétricale - Mammaire 1, no. 4 (January 2006): 1–20. http://dx.doi.org/10.1016/s1879-8543(06)70644-9.
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Astorg, P. M., A. Moroy, S. Lamy, L. Jehel, and J. M. Sigward. "Étude descriptive du profil des patients hospitalisés dans le service de psychiatrie du CHU de Martinique (syndrome métabolique, psycho-traumatisme et comorbidités). Résultats préliminaires." European Psychiatry 29, S3 (November 2014): 571. http://dx.doi.org/10.1016/j.eurpsy.2014.09.256.
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ContexteLes malades de psychiatrie meurent 25 ans plus tôt que la population générale, en particulier de maladies cardiovasculaires dont un des facteurs de risque est le syndrome métabolique. Les psychiatres sont souvent les seuls médecins à prendre en charge les patients hospitalisés dans des services psychiatriques, avec une approche somatique limitée.MéthodologieNous avons réalisé une étude observationnelle de novembre 2013 à juillet 2014 afin d’établir un profil des sujets pris en charge en psychiatrie au CHU de Martinique (CHUM).ObjectifNotre objectif principal est de décrire le profil des personnes hospitalisées dans le service de Psychiatrie du CHUM : comorbidités somatiques (dont syndrome métabolique) et psychiatrique, niveau socio-économique, histoire de vie (avec recherche de traumatisme).RésultatsCent quarante-quatre dossiers ont été documentés ; 62 % de femmes et 38 % d’homme avec une moyenne d’âge de 46 ans [18 ; 79]. 68 % de la population est créoles martiniquais et 17 % métropolitains. 85,7 % présentent des troubles somatiques (moyenne 2,2) et se répartit comme suit : 31 % problème cardiaque, 26 % endocrinologique, 16 % respiratoire, 25 % appareil locomoteur, 17 % maladie du système nerveux, 16 % appareil génito-urinaire et 28 % autres. 18 % présentent un syndrome métabolique. Nous ne retrouvons pas dans cette étude préliminaire de maladies psychiatriques prédisposantes pour développer un syndrome métabolique. Nous ne retrouvons pas non plus de lien entre l’histoire de vie traumatique avec diagnostic d’état de stress post-traumatique et la présence d’un syndrome métabolique (Chi2 et tests exact de Ficher).ConclusionsCes résultats soulignent la nécessité de sensibiliser les professionnels en psychiatrie sur la nécessité d’identifier les facteurs de risque de pathologie somatique (notamment métabolique et cardio-vasculaire) et de développer un réseau de prise en charge multidisciplinaire pour les patients hospitalisés en psychiatrie.
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Pisipati, Sailaja, Christian Bach, Datesh Daneshwar, Edward W. Rowe, and Anthony J. Koupparis. "Concurrent upper and lower urinary tract robotic surgery: A case series." Canadian Urological Association Journal 8, no. 11-12 (November 24, 2014): 853. http://dx.doi.org/10.5489/cuaj.1836.
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The da Vinci Surgical System (Intuitive Surgical Inc.) continues to develop as a platform in urological surgery. Synchronous upper and lower urinary tract tumours requiring extirpative surgery are not uncommon. We report the first case robotic series of combined complex upper and lower urinary tract surgery. Six high-risk anaesthetic patients with a median age of 71 years and apparent synchronous upper and lower urinary tract pathologies underwent concurrent robotic surgery. Five underwent robotic nephroureterectomyand robotic-assisted radical cystectomy (RARC); 1 had combined robotic nephroureterectomy and robotic-assisted radical prostatectomy (RALP). The mean length of stay was 10 days, with an average blood loss of 416.7 mL. The median console time for nephroureterectomy, RALP and RARC was 90, 90 and 210 minutes, respectively. Four patients had intra-corporeal ileal conduit urinary diversion. There were no Clavien grade 3, 4, or 5 complications. In all patients, 30- and 90-day mortality was nil. Margins were clear in the entire cohort. We concluded that combined upper and lower urinary tract robotic surgery is safe and technically feasible with acceptable complications and oncological outcomes.
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Carvajal, Cristian A., Alejandra Tapia-Castillo, Andrea Vecchiola, Rene Baudrand, and Carlos E. Fardella. "Classic and Nonclassic Apparent Mineralocorticoid Excess Syndrome." Journal of Clinical Endocrinology & Metabolism 105, no. 4 (December 31, 2019): e924-e936. http://dx.doi.org/10.1210/clinem/dgz315.
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Abstract Context Arterial hypertension (AHT) is one of the most frequent pathologies in the general population. Subtypes of essential hypertension characterized by low renin levels allowed the identification of 2 different clinical entities: aldosterone-mediated mineralocorticoid receptor (MR) activation and cortisol-mediated MR activation. Evidence Acquisition This review is based upon a search of Pubmed and Google Scholar databases, up to August 2019, for all publications relating to endocrine hypertension, apparent mineralocorticoid excess (AME) and cortisol (F) to cortisone (E) metabolism. Evidence Synthesis The spectrum of cortisol-mediated MR activation includes the classic AME syndrome to milder (nonclassic) forms of AME, the latter with a much higher prevalence (7.1%) than classic AME but different phenotype and genotype. Nonclassic AME (NC-AME) is mainly related to partial 11βHSD2 deficiency associated with genetic variations and epigenetic modifications (first hit) and potential additive actions of endogenous or exogenous inhibitors (ie, glycyrrhetinic acid-like factors [GALFS]) and other factors (ie, age, high sodium intake) (second hit). Subjects with NC-AME are characterized by a high F/E ratio, low E levels, normal to elevated blood pressure, low plasma renin and increased urinary potassium excretion. NC-AME condition should benefit from low-sodium and potassium diet recommendations and monotherapy with MR antagonists. Conclusion NC-AME has a higher prevalence and a milder phenotypical spectrum than AME. NC-AME etiology is associated to a first hit (gene and epigene level) and an additive second hit. NC-AME subjects are candidates to be treated with MR antagonists aimed to improve blood pressure, end-organ damage, and modulate the renin levels.
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Navarro, Junior J. Araiza J. Araiza, Raúl D. Lara Sánchez, Oyuki A. Morales Uscanga, María I. Tolentino Sosa, Fernando López Reyes, and Jorge A. Barbabosa Vilchis. "Refractory hyperactive bladder treated with sacral neuromodulator: case report and literature review." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 7 (June 27, 2018): 2937. http://dx.doi.org/10.18203/2320-1770.ijrcog20182910.
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The overactive bladder syndrome is a chronic medical condition that affects the quality of life of patients whether men or women, has a prevalence of 16.5%, however, it is known to increase with age, affecting up to 25% of women older than 65 years and up to 80% in the elderly. More than 90% of cases have no apparent cause. The OAB (Overactive Bladder) It is a condition with characteristic symptoms of urinary urgency, usually accompanied by frequency and nocturia, with or without urge incontinence, in the absence of urinary tract infection or other obvious pathology. The different therapeutic steps are not always sufficient to restore the quality of life.
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Panicker, Jalesh N., Sara Simeoni, Yasuo Miki, Amit Batla, Valeria Iodice, Janice L. Holton, Ryuji Sakakibara, and Thomas T. Warner. "Early presentation of urinary retention in multiple system atrophy: can the disease begin in the sacral spinal cord?" Journal of Neurology 267, no. 3 (November 12, 2019): 659–64. http://dx.doi.org/10.1007/s00415-019-09597-2.
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Abstract Lower urinary tract (LUT) dysfunction presents early in multiple system atrophy (MSA), usually initially as urinary urgency, frequency and incontinence, and voiding difficulties/urinary retention becomes apparent over time. We have observed a subset of patients who instead presented initially with urinary retention requiring catheterisation. At presentation, these patients had only subtle neurological signs that would not fulfil the diagnostic criteria of MSA; however, the anal sphincter electromyography (EMG) was abnormal and they reported bowel and sexual dysfunction, suggesting localisation at the level of the sacral spinal cord. They subsequently developed classical neurological signs, meeting the diagnostic criteria for probable MSA. One patient was confirmed to have MSA at autopsy. We postulate that in a subset of patients with MSA, the disease begins in the sacral spinal cord and then spreads to other regions resulting in the classical signs of MSA. The transmissibility of alpha-synuclein has been demonstrated in animal models and the spread of pathology from sacral cord to other regions of the central nervous system is therefore plausible. Patients presenting with urinary retention and mild neurological features would be an ideal group for experimental trials evaluating neuroprotection in MSA
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Kilinç, R., O. G. Doluoglu, B. Sakman, D. S. Ciliz, E. Yüksel, O. Adsan, and M. Cetinkaya. "The Correlation between Diffusion-Weighted Imaging and Histopathological Evaluation of 356 Prostate Biopsy Sites in Patients with Prostatic Diseases." ISRN Urology 2012 (June 26, 2012): 1–5. http://dx.doi.org/10.5402/2012/252846.
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Purpose. The aim of this study is to investigate the reliability of diffusion MRI for detection of cancer foci by comparing diffusion-weighted imaging (DWI) results and pathology results of prostate biopsy sites. Methods. Of the patients who applied with lower urinary tract symptoms, 36 patients who had suspected DRE and/or PSA ≥2.5 ng/mL were included in the study. Patients underwent DWI prior to 10 cores-prostate biopsy. 356 biopsy cores were obtained from the patients. Foci from the patients with prostate cancer were labeled as malignant or benign foci, likewise foci from the patients with benign pathology were grouped as BPH and inflammation foci. Apparent diffusion coefficients (ADCs) of biopsy groups were compared with each other in order to measure the reliability of DWI in detection of PCa foci. Results. When ADC values of adenocarcinoma foci and BPH foci were compared, a statistically significant difference was found (P<0.001). When ADC values obtained from adenocarcinoma foci and chronic inflammation foci are compared, the difference between two groups is statistically significant, too (P<0.001). Conclusions. Biopsies focused on suspected regions after formation of ADC maps by means of DWI would provide to start definitive treatment immediately as well as being beneficial to prevent morbidity related to repeated prostate biopsies.
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Kozlova, Daria, Yinon Gilboa, Chen Sade-Zalts, Yuval Gielchinsky, Shimon Shteingart, and Debora Kidron. "Fetal Urinoma Due to Circulatory Disorders in an Umbilical Artery: Case Report." Pediatric and Developmental Pathology 24, no. 4 (March 22, 2021): 383–87. http://dx.doi.org/10.1177/10935266211002730.
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Fetal urinoma is defined as an encapsulated accumulation of extravasated urine within the perirenal space or retroperitoneum. It is an uncommon finding in prenatal practice, and the vast majority of known cases are strongly associated with the existence of a urinary obstruction, such as posterior urethral valves, ureteropelvic junction obstruction, or ureterocele. We report a unique case of prenatally detected fetal bladder urinoma that occurred in the absence of an apparent obstructive uropathy, but was associated with extensive ischemic necrosis and calcifications of adjacent bladder wall, coexistent with signs of vascular supply decompensation.
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Evans, Andrew J., Jaudah Al-Maghrabi, John Tsihlias, Ginette Lajoie, Joan M. Sweet, and William B. Chapman. "Primary Large Cell Neuroendocrine Carcinoma of the Urinary Bladder." Archives of Pathology & Laboratory Medicine 126, no. 10 (October 1, 2002): 1229–32. http://dx.doi.org/10.5858/2002-126-1229-plcnco.
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Abstract Reports of primary large cell neuroendocrine carcinomas of the urinary bladder are few; we identified only 2 cases in the literature. Both of these cases involved male patients with rapid progression of disease culminating in death with widespread metastases. We report a case of primary large cell neuroendocrine carcinoma of the bladder, with an admixed minor element of adenocarcinoma, in an 82-year-old man. This solitary lesion arose in a bladder diverticulum lateral to the left ureteric orifice. Two attempts at transurethral resection were unsuccessful at achieving local control. The patient underwent a partial cystectomy with left-sided pelvic lymphadenectomy following preoperative staging investigations that found no metastatic disease. Pathologically, the tumor invaded into the deep aspect of the muscularis propria, without extension into perivesical fat. The lateral resection margin was microscopically positive for tumor, but no malignancy was found in the pelvic lymph nodes. The adenocarcinoma comprised less than 5% of total tumor volume, and areas of transition between the neuroendocrine and adenocarcinoma components were apparent. The patient developed a local recurrence 8 months postoperatively, which was managed by a combination of transurethral resection and radiation therapy. Currently, the patient has no evidence of local or metastatic disease 2 years after initial diagnosis.
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Майбородин, И. В., Г. Ю. Ярин, И. А. Вильгельми, and В. И. Майбородина. "AGE-RELATED CHANGES OF THE FEMALE URETHRA." Успехи геронтологии, no. 5 (January 22, 2021): 945–55. http://dx.doi.org/10.34922/ae.2020.33.5.017.
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Минимальные и максимальные показатели длины, ширины, площади или объема органов и структур нижних мочевых путей в норме могут различаться до 2-3 раз. С возрастом у здоровых женщин не меняются абсолютная и относительная длина мочеиспускательного канала, уретровезикальный угол и наклон уретры. И гладкая, и поперечнополосатая мышечные ткани, входящие в состав различных отделов женской уретры, подвергаются атрофии в процессе старения организма. Гладкая мышечная ткань менее изменчива с возрастом, но поперечнополосатые мышечные симпласты иногда полностью отсутствуют в биоптатах уретры пожилых пациентов. С возрастом уменьшаются васкуляризация и плотность иннервации структур мочеиспускательного канала, но возрастает содержание соединительной ткани в наружном сфинктере уретры. Мобильность мочеиспускательного канала у молодых женщин более выражена, чем у пожилых. Явная недостаточность современных работ, посвященных возрастным изменениям нижних мочевых путей, указывает на актуальность и необходимость продолжения изучения трансформации органов и тканей мочевыводящей системы при старении. Это может быть важным для определения этиологии и патогенеза некоторых патологических состояний, таких как стрессовое недержание мочи, а также для дифференциальной диагностики между возрастной нормой и патологией. The minimum and maximum indicators of the length, width, area or volume of organs and structures in the lower urinary tract can normally vary up to 2-3 times. With age, at healthy women the absolute and relative length of the urethra, the urethrovesical angle, and the inclination of the urethra do not change. Both smooth and striated muscle tissues, which are part of various departments of the female urethra, undergo atrophy during the aging process. Smooth muscle tissue is less variable with age, but striated muscle symplasts are sometimes completely absent in urethral biopsies from elderly patients. With age, the vascularization and density of the innervation decrease in the urethral structures, but the content of connective tissue in the external urethral sphincter increases. Urinary tract mobility at young women is more pronounced than at older women. The apparent insufficiency of modern investigations about age-related changes in the lower urinary tract indicates the relevance and need to continue studying of the organ and tissue transformation in the urinary system during aging, this may be important for determining the etiology and pathogenesis of some pathological conditions, such as stress urinary incontinence, as well as for differential diagnosis between age norm and pathology.
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Egner, William. "Adherence to recommended UK sampling protocols for detecting mast cell mediator release in perioperative anaphylaxis." Journal of Clinical Pathology 70, no. 1 (September 28, 2016): 85–88. http://dx.doi.org/10.1136/jclinpath-2016-204038.
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BackgroundSheffield National Adverse Reactions Consultancy Service (NARCOS) investigates and triages suspected perioperative anaesthetic reactions to allergy clinics, using serial tryptase samples, urinary methylhistamine and clinical information on a pro forma request.ObjectiveTo determine if current UK guidelines on serial tryptase samples are achieved and describe the patterns of tryptase release.MethodA retrospective review of 3455 NARCOS cases. Tryptase and clinical details were analysed. 1746 had sufficient clinical information to grade the reactions according to the Ring and Messmer scale.Results98% provided two or more acute samples, but only 60% supplied clinical information. 308 patients never dropped within the reference range over three samples.ConclusionsGood compliance with UK guidelines for tryptase measurements is achievable in this long-term cohort, but obtaining clinical details at referral remains a challenge. Sample sequence labelling and apparent timing may be misleading. Baseline tryptase may frequently need to be rechecked in allergy clinics to estimate true peak-to-trough changes.
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Safiullina, G. I., R. A. Yakupov, and A. A. Safiullina. "Neurophysiological aspects of enuresis in children." Russian Osteopathic Journal, no. 1-2 (June 6, 2020): 58–65. http://dx.doi.org/10.32885/2220-0975-2020-1-2-58-65.
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Introduction. Enuresis is a pathological condition, manifested by involuntary urination during sleep or in the wakeful state. It is believed that enuresis is associated with unformed or impaired self-control skills for emptying the bladder. The significance of the problem is determined by the widespread prevalence of pathology, social and psychological maladaptation of children with enuresis. An important role in this plays the development of their personality by an accentuated type often, difficult adaptability, and lack of ability to integrate into the team, especially into the semi or closed type. According to modern concepts, enuresis can be caused by the following reasons: delayed maturation of the nervous system, urological pathology and urinary tract infection, impaired activation reaction during sleep, impaired rhythm of secretion of antidiuretic hormone, adverse heredity, psychological factors and stress. The results of Russian and foreign scientists studies revealed the polyetiological character of enuresis and the impossibility, in most cases, of identifying its obvious cause. This explains the relatively wide variability of outcomes: from spontaneous cure to apparent resistance to all existing treatments. The significant prevalence of enuresis, the relative severity of this pathology and the lack of effective treatment methods necessitate the search for alternative methods of therapy or fundamentally new approaches to using existing ones, which is impossible without a thorough study of this disease etiopathogenesis.The goal of research — is to study the neurophysiological characteristics of enuresis in children.Materials and methods. Prospective controlled study was conducted in Kazan State Medical Academy — a branch of the RMACPE (Kazan) in the period 2003–2019 years. To study enuresis mechanisms we carried out a comprehensive clinical-electroneurophysiological examination of 93 children aged 5 to 15 years, suffering from bedwetting. The control group consisted of 40 healthy children who were comparable in age and gender to those in the main group. All patients underwent a comprehensive examination, which included the study of complaints, anamnesis, clinical and electroneurophysiological research.Results. Clinical examination of children with enuresis revealed signs of minimal cerebral dysfunction. An electrophysiological examination made it possible to determine an increase in the refl ex excitability of brain stem structures against the background of a decrease in downward inhibitory control.Conclusion. The predominance of excitation processes over inhibition in the central nervous system is mainly observed in children with enuresis. The weakness of the inhibitory mechanisms due to constitutional factors, pathology of the nervous system that took place earlier, allows making an assumption about the diffuse nature of the disorders of the nervous system in this urination disorder.
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Kapetanovic, Izet M., Thomas L. Horn, William D. Johnson, Michael J. Cwik, Carol J. Detrisac, and David L. McCormick. "Murine Oncogenicity and Pharmacokinetics Studies of 9-cis-UAB30, an RXR Agonist, for Breast Cancer Chemoprevention." International Journal of Toxicology 29, no. 2 (March 2010): 157–64. http://dx.doi.org/10.1177/1091581809360070.
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The synthetic retinoic acid analog, 9- cis-UAB30 [(2E,4E,6Z,8E)-8-(3′,4′-dihydro-1′(2′H)-naphthalen-1′-ylidene)-3,7-dimethyl-2,4,6-octatrienoic acid], is a specific ligand for the retinoid X receptor. Murine oncogenicity and pharmacokinetics studies were performed as part of the preclinical development of 9- cis-UAB30 for breast cancer chemoprevention. In the oncogenicity study, TSG-p53(+/-) (p53 knockout) mice (25 per sex per group) received daily gavage exposure to 9- cis-UAB30 doses of 0 (control), 30, 100, or 300 mg/kg/d for 6 months. Positive controls received p-cresidine (400 mg/kg/d) for 6 months. 9- cis-UAB30 had no biologically significant effects on survival, body weight, body weight gain, clinical signs, hematology, or clinical chemistry but induced dose-related hepatomegaly in both sexes and decreased thymus weights in high-dose females. Gross and microscopic pathology provided no evidence of 9- cis-UAB30 toxicity or oncogenicity; by contrast, p-cresidine induced urinary bladder neoplasms in more than 60% of male and female mice. It was concluded that 9- cis-UAB30 is not oncogenic in p53(+/-) mice. In the pharmacokinetics study, C57BL/6 mice received daily gavage exposure to 9- cis-UAB30 (100 or 300 mg/kg/d) for 1 or 7 days. Pharmacokinetic parameters were similar after 1 and 7 days of dosing. Dose-related peak plasma levels of 9- cis-UAB30 were seen between 0.25 and 3 hours; volume of distribution was comparable at both dose levels. Increases in area under the curve were less than proportional to dose and were associated with an increased rate of apparent clearance and decreased elimination half-life. These results suggest decreased absorption and/or possible induction of clearance mechanisms. Enzyme induction may underlie the hepatomegaly seen in mice treated with 9- cis-UAB30 for 6 months in the oncogenicity study.
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Adjenou, VK, K. N'dakena, S. Tetekpor, D. Hlomaschie, A. Agoda, S. Nana, K. Attipou, A. Attignon, and L. Sonhai. "Place de l'uretrocystographie dans l'exploration radiologique de la pathologie du bas appareil urinaire: A propos de 36 observations aux Chu de Lome." Journal de la Recherche Scientifique de l'Universite de Lome 7, no. 2 (January 1, 2009). http://dx.doi.org/10.4314/jrsul.v7i2.47593.
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Adjenou, VK, K. N'dakena, S. Tetekpor, D. Hlomaschie, A. Agoda, S. Nana, K. Attipou, A. Attignon, and L. Sonhai. "Place de l’uretrocystographie dans l’exploration radiologique de la pathologie du bas appareil urinaire : A propos de 36 observations aux chu de Lome." Journal de la Recherche Scientifique de l'Universite de Lome 9, no. 2 (March 8, 2010). http://dx.doi.org/10.4314/jrsul.v9i2.52460.
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Vetchinnikova, Olga, and Irina Nikol`skaya. "P0962CHRONIC KIDNEY DESEASE AND URINARY TRACT INFECTION IN PREGNANTS." Nephrology Dialysis Transplantation 35, Supplement_3 (June 1, 2020). http://dx.doi.org/10.1093/ndt/gfaa142.p0962.
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Abstract Background and Aims Pregnant women with chronic kidney disease (CKD) are at risk of developing/exacerbating urinary tract infection (UTI) due to the presence of additional (“specific”) risk factors. The aim of our study was estimation the features of UTI in women with CKD during pregnancy. Method The study included 139 women with CKD G1-G3 who had UTI during pregnancy. Most women (63) had chronic glomerulonephritis, 47 had with chronic pyelonephritis, and the rest had diabetic nephropathy (11), chronic tubulointerstitial nephritis (9), renal transplant (7) and lupus nephritis (2). An analysis of the bacteriological examination of urine, the sensitivity of pathogens to antibiotics, clinical manifestations and perinatal complications was performed. Results The following forms UTI are diagnosed: asymptomatic bacteriuria (50.4%), exacerbation of chronic pyelonephritis, including renal transplant (33.1%), acute pyelonephritis (16.5%). The true bacteriuria is determined identically at all stages of CKD, in those with chronic pyelonephritis in 70%, chronic glomerulonephritis in 45% of cases (p = 0.02). Gram-negative microorganisms become apparent in 73.6% of pregnant women with CKD, less often in patients with glomerular pathology than with chronic pyelonephritis (66% versus 81%). Escherichia coli among gram-negative microorganisms was 74.4%, a high frequency of detection of strains with the production of extended-spectrum β-lactamases was established. The course of asymptomatic bacteriuria in pregnant women with non-diabetic glomerulopathy was characterized by a moderate tendency to relapse and moderate release of resistant pathogens. The course of asymptomatic bacteriuria in patients with diabetic nephropathy and after kidney transplantation, on the contrary, had a pronounced tendency to relapse and the frequent release of resistant pathogens. Exacerbation of chronic pyelonephritis proceeded with minimal clinical manifestations, a vivid clinical picture of exacerbation of the disease was determined in one third of pregnant women. It was characterized by a high tendency to relapse and the development of systemic infection, a high frequency of release of resistant pathogens. Pregnant women with CKD who underwent UTI had a high risk of giving birth to premature babies (23% versus 11% p=0.01) who were required to carry out artificial lung ventilation and transfer to stage nursing (34% versus 16%, p=0.01). Conclusion The course of UTI in pregnant women with CKD is characterized by a high prevalence, dependence on primary renal disease, the release of resistant pathogens, and a high probability of an atypical clinical picture.
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Hu, Xiaoyan, Min Kuang, Bo Peng, Yang Yang, Wei Lin, Wenbo Li, and Yinghua Wu. "Diffusion Tensor Imaging in Rat Models of Preclinical Diabetic Nephropathy: A Preliminary Study." Frontiers in Endocrinology 12 (August 27, 2021). http://dx.doi.org/10.3389/fendo.2021.701116.
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PurposeThis study aimed to investigate the value of diffusion tensor imaging to assess renal injury in a rat model of preclinical diabetic nephropathy.MethodsTwenty-eight male Sprague Dawley rats were divided into two groups: the normal control (NC) group of 10 rats and the diabetic nephropathy (DN) group of 18 rats. Eight weeks after diabetes induction by streptozotocin, 3.0-T magnetic resonance (MR) imaging (b = 0 and 600 s/mm2, 15 diffusion directions) using a 32-channel knee coil was performed. After MR imaging, we measured serum creatinine, and collected double kidney tissues for pathology. The apparent diffusion coefficients(ADC) and fractional anisotropy(FA) values of the renal cortex and medulla were calculated for all kidneys. Physiological parameters, laboratory parameters, and imaging results were compared between the two groups.ResultsAll DN group animals developed hyperglycemia, polyuria, and emaciation. Serum creatinine was not significantly different between the groups (P > 0.05). Urinary albumin at 2, 4, and 8 weeks was higher in the DN group than in the NC group but <20 µg/min (P < 0.05). Pathologically, renal damage in the DN rats was observed. The ADC value was significantly increased in DN animals in the cortex (1.75×10-3mm2/s),medulla(1.53×10-3mm2/s)compared with NC group(cortex, 1.52×10-3mm2/s; medulla,1.35×10-3mm2/s). The FA value was significantly reduced in DN animals in the cortex (0.21),medulla(0.25)compared with NC group(cortex,0.26;medulla,0.3).ConclusionsIncreased apparent diffusion coefficients and decreased fractional anisotropy values on diffusion tensor imaging were associated with preclinical DN. Diffusion tensor imaging may be useful in early, non-invasive, quantitative detection, and therapy monitoring of DN.
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Shendge, Parshuram nivrutti, and Sateesh Belemkar. "Toxicity profiling of the ethanolic extract of Citrullus lanatus seed in rats: behavioral, biochemical & histopathological aspects." Bioscience Reports, December 8, 2020. http://dx.doi.org/10.1042/bsr20202345.
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Citrullus lanatus (Cucurbitaceae) is conventionally used for the treatment of urinary tract infection, renal stones, hypertension, diabetes and diarrhoea. Current study evaluates acute & 28 days repeated toxicity ethanolic extract of Citrullus lanatus seed (EECLS) in Wistar rats to measure its safety profile. The single dose (2000 mg/kg BW) of EECLS was administered while in 28 days repeated study 250, 500 and 1000 mg/kg BW were administered orally in rat. Parameters such as biochemical, haematology and histopathology were analysed in subacute toxicity study. During study, no apparent sign of toxicity, behavioural changes and mortality were detected in acutely exposed animals. In 28-days repeated toxicity study, rats have showed no significant changes in behaviour, gross pathology, body weight, biochemical and haematological parameters. Abridged serum glucose and cholesterol levels during the study designates its role in treatment of hyperglycaemic and hyperlipidaemic condition. No significance difference was observed in histopathology of liver and kidneys of treated rats. The current investigation demonstrated EECLS is non-toxic below 1000 mg/kg BW and provides protection on some body organs. The data propose that LD50 of EECLS was greater than 2000 mg/kg BW and the no observed adverse effect level (NOAEL) of EECLS was at dose of 1000mg/kg in rats. Taken together, our finding suggests that, EECLS is safe & provide some protection to body organ, Also, extract can be used for further preclinical & clinical evaluation for its therapeutic activity.
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Petra, Eleni, Tianlin He, Agnieszka Latosinska, Rafael Stroggilos, Harald Mischak, and Antonia Vlahou. "P0650URINE PEPTIDOME ANALYSIS IN HEART FAILURE, CHRONIC KIDNEY DISEASE AND CARDIORENAL SYNDROME TOWARDS THE DEFINITION OF DISEASE-SPECIFIC MARKERS." Nephrology Dialysis Transplantation 35, Supplement_3 (June 1, 2020). http://dx.doi.org/10.1093/ndt/gfaa143.p0650.
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Abstract Background and Aims The cardiorenal syndrome (CRS) reflects the complex interplay between kidney and heart diseases, but its molecular basis remains poorly understood. Multiple studies have demonstrated the association of urinary biomarkers with both heart and kidney diseases. However, their relevance and involvement in CRS have not been investigated yet. To address this gap, a study was designed with the aim to compare urinary biomarkers specific for heart failure (HF) and chronic kidney disease (CKD) with peptides representing CRS, with the ultimate target to connect these findings towards a better understanding of CRS pathophysiology. Method A total of 3.463 urinary peptidomic datasets from patients with HF, CKD, or with both HF and CKD (CRS) as well as patients with no apparent diseases (controls) were retrieved and analyzed from the urinary peptidomics database (Latosinska A et al., Electrophoresis 2019; 40: 2294-2308). Following the matching for age, gender, heart and kidney function, differences in the abundance of urinary peptides were investigated in a cohort comprised of 390 patients with HF, 257 patients with CKD, 392 patients with CRS and 356 controls. The non-parametric Mann-Whitney U test was applied, followed by correction for multiple testing using the Benjamini-Hochberg method. To map the peptides to the protein precursor, the alignment tool Geneious (www. geneious.com) was applied, while the PeptideRanker (http://distilldeep.ucd.ie/PeptideRanker/) was used to predict probability of peptide being bioactive. Results The multiple pair-wise comparisons resulted in the identification of numerous differentially abundant peptides (p<0.05) between the studied conditions, including among others 176 HF-specific, 146 CKD-specific and 35 CRS-specific peptides. Among the HF-specific peptides, the majority (n=94, 53.4%) originated from collagen type I, II and III. In the case of CKD-specific peptides, 24 (16.43%) originated from alpha-1-antitrypsin, 19 (13.0%) from b2-microglobulin and 15 (10.27%) from collagen type I. For the CRS specific peptides, fragments of Ig lambda-2 chain C regions (n=4, 11.42%), collagen type III (n=4, 11.42%), secreted and transmembrane protein 1 (n=3, 8.57%) and gelsolin (n=1, 2.85%) were identified (figure: 1). Of the 176 HF-specific peptides, 94 (53.40%) were predicted as bioactive, including, among others, fragments of collagen types I (n=43, 45.74%) and III (n=21, 22.34%). In the former, peptides with the higher bioactivity scores were aligned close to the N terminus of the precursor protein, whereas in the latter, peptides were in close proximity to both N and C termini. Along the same lines, 32 (21.91%) of the 146 CKD-specific peptides were predicted as bioactive, including peptides from collagen types I and III with the highest score, as well as fragments from collagen type V and the C terminus of the b2-microglobulin and alpha-1-antitrypsin proteins. No CRS-specific peptides could be predicted as bioactive. Conclusion Specific urinary peptides significantly associated with CRS, but not with HF or CKD, could be identified. These data indicate that on a molecular level, CRS is not merely the result of a combination of HF and CKD, but may represent a distinct pathology, defined via specific proteomic changes. It is expected that interpretation of these findings in the context of existing literature as well as in vitro activity assays will help to understand their biological relevance in CRS.
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Gerhardt, Louisa Maria Sophie, Lisa Sabath, Katrin Borm, Joel Capraro, and Beat Müller. "MON-LB039 Acute Paraneoplastic Cushing’s Syndrome in a Patient With Small Cell Lung Cancer and Co-Incidental Adrenal Adenoma: A Case Report." Journal of the Endocrine Society 4, Supplement_1 (April 2020). http://dx.doi.org/10.1210/jendso/bvaa046.2061.
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Abstract Background: Paraneoplastic Cushing’s syndrome is a rare cause of hypercortisolism associated with high morbidity, especially in patients with small cell lung cancer. Therefore, early diagnosis and treatment are critical. Clinical Case: Herein we present the case of a 58-year-old man who was referred to the endocrinology department, because of refractory hypokalemia (potassium 2.4 mmol/l; RI: 3.4 - 4.5 mmol/l) despite high potassium supplements and spironolactone therapy. History was remarkable for a metabolic syndrome with newly aggravated hypertension and a 60-pack-year smoking history. The patient reported a 20 kg weight gain in 6 weeks and proximal muscle weakness. On examination, he was overweight (BMI 44.8 kg/m²) with bilateral pitting edema. Other features of hypercortisolism such as striae rubrae, facial plethora or ecchymoses, respectively, were not apparent. Initial biochemical tests showed severe hypokalemia and metabolic alkalosis. Night-time salivary cortisol (205 nmol/l; RI: < 2.5 nmol/l), 24-hour urinary free cortisol (> 4357 nmol/24h; RI: 99 - 378 nmol/24h) and serum ACTH (158 ng/l; RI: < 61 ng/l) were markedly elevated. While the MRI of the head demonstrated no pituitary pathology, the CT of thorax and abdomen revealed a pulmonary mass as well as an incidental right adrenal mass. Bronchoscopic biopsy of the pulmonary mass confirmed the suspected diagnosis of ACTH-producing small cell lung cancer. The dignity of the right adrenal mass remained unclear, since the radiologic features per se could not differentiate between adrenal adenoma and metastasis. Chemotherapy with cisplatin/etoposide and inhibition of steroidogenesis with ketoconazole were initiated, which largely controlled the hypercortisolism. Imaging studies after completion of two cycles of chemotherapy showed a tumor response with regression of the pulmonary mass. The right adrenal mass remained stationary under chemotherapy. Thus, an adrenal metastasis could be excluded as potential cause of the adrenal mass, suggesting an incidental adrenal adenoma as the most likely diagnosis. Conclusion: Paraneoplastic Cushing’s syndrome requires high clinical suspicion for early diagnosis, since many of the classical clinical features of hypercortisolism may still be absent, even if the underlying cancer is already advanced. In patients suspected to have Cushing’s syndrome a three-step diagnostic approach is recommended: (1) biochemical confirmation of hypercortisolism, (2) differentiation between ACTH-dependant and -independant hypercortisolism and (3) identification of its source. This approach helps avoiding misdiagnosis in patients who have both an ACTH-producing cancer and an adrenal adenoma [1]. References: [1] Lacroix et al. Cushing’s syndrome. Lancet 2015; 386: 913-927.