Academic literature on the topic 'Urinary system disease'

Expert system is a computer system that can adopt human knowledge into a computer. Expert system can be used to solve problems commonly performed by experts, one of them is the diagnosis of urinary system diseases. Expert system for the diagnosis of the urinary system disease especially for the inflammation of the bladder and these pyelonephritis using the forward chaining and the dempster shafer method. Forward chaining is used to diagnose disease based on the rules and the dempster shafer is used to determine the value of confidence. The goal is to build an expert system using forward chaining and dempster shafer methods to diagnose early urinary system diseases and to determine the level of accuracy. The data used is the secondary data obtained from the UCI Machine Learning Repository as much as 120 data and 6 attributes. The result of the implementation of the forward chaining and the dempster shafer methods on this expert system of diagnosis of urinary system diseases generates an accuracy value of 87.5%.

Urinary diseases are very common in our society which system constitutes kidneys ureters urinary bladder and urethra various abnormalities occur in these organs due to many reasons like infection inflammation metabolic abnormalities neoplastic changes trauma etc. these abnormalities lead to various physical problems ending into death many times the abnormalities of urinary system can be diagnosed by hematological examination urine analysis radiological examination and histopathological examination especially radiological examination provide wide range of diagnosis of disease of urinary system of almost all origin although various radiological technique like X-ray (plain and contrast) Ultrasonography CT scan MRI and many others are available but in present study X-ray (plain and contrast ) and ultrasonography were used for diagnosis of disease of urinary system because of its easy availability and affordability the diseases of urinary system has been described under the name of Mutrakrichha and Mutraghata in ayurveda these two conditions are in fact group of clinical entities in which urination is difficult and retention is present respectively further they are divided into various subtypes these conditions resembles clinically with various types of urinary diseases early diagnosis has been the always advocated by ayurveda by virtue of this prevention and management becomes easy in the present study written informed consent has been taken from all the patients early detection of these conditions facilitates the management otherwise renal failure may complicate the condition

Urinary stone disease is among the most common medical conditions. Standard evaluation of urinary stone disease involves a metabolic workup of stone formers based on measurement of minerals and solutes excreted in 24-hour urine samples. Nevertheless, 24-hour urine testing is slow, expensive, and inconvenient for patients, which has hindered widespread adoption in clinical practice. Here, we demonstrate SLIPS-LAB (Slippery Liquid-Infused Porous Surface Laboratory), a droplet-based bioanalysis system, for rapid measurement of urinary stone–associated analytes. The ultra-repellent and antifouling properties of SLIPS, which is a biologically inspired surface technology, allow autonomous liquid handling and manipulation of physiological samples without complicated sample preparation procedures and supporting equipment. We pilot a study that examines key urinary analytes in clinical samples from patients with urinary stone. The simplicity and speed of SLIPS-LAB hold the potential to provide actionable diagnostic information for patients with urinary stone disease and rapid feedback for responses to dietary and pharmacologic treatments.

Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.

AbstractPteridines and their derivatives function as intermediates in the metabolism of several vitamins and cofactors, and their relevance to disease has inspired new efforts to study their roles as disease biomarkers. Recent analytical advances, such as the emergence of sensitive mass spectrometry techniques, new workflows for measuring pteridine derivatives in their native oxidation states and increased multiplexing capacities for the simultaneous determination of many pteridine derivatives, have enabled researchers to explore the roles of urinary pteridines as disease biomarkers at much lower levels with greater accuracy than with previous technologies or methods. As a result, urinary pteridines are being increasingly studied as putative cancer biomarkers with promising results being reported from exploratory studies. In addition, the role of urinary neopterin as a universal biomarker for immune system activation is being investigated in new diseases where it is anticipated to become a useful supplementary marker in clinical diagnostic settings. In summary, this review provides an overview of recent developments in the clinical study of urinary pteridines as disease biomarkers, covers the most promising aspects of advanced analytical techniques being developed for the determination of urinary pteridines and discusses the major challenges associated with implementing pteridine biomarkers in clinical laboratory settings.

Since its discovery in 1988 the powerful vasoconstrictor endothelin-1 (ET-1) has been widely implicated in the pathophysiology of chronic kidney disease (CKD) as well as the cardiovascular disease with which it is associated. ET receptor antagonists have favourable effects in experimental models of these conditions and orally acting antagonists are now licensed for the treatment of pulmonary arterial hypertension. However, there is a paucity of human data regarding the role of ET-1 in CKD. In this thesis, I have therefore explored the utility of ET-1 as a biomarker in CKD, and, using selective ET receptor antagonists, the beneficial renal and cardiovascular effects of ET receptor antagonism in CKD. I have shown that as glomerular filtration rate (GFR) declines plasma ET-1 increases linearly whereas urinary ET-1 shows an exponential increase. Furthermore, urinary ET-1 may be a useful marker of disease activity in patients with lupus nephritis. Its levels are high in those with biopsy-proven active renal inflammation and these fall with treatment. I have shown that in subjects with stable non-diabetic proteinuric CKD, acute selective ETA receptor antagonism reduces blood pressure and arterial stiffness and that these systemic benefits are associated with an increase in renal blood flow and reduction in proteinuria. Importantly, these effects are seen on top of those achieved with maximal therapy with angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers. Following a study confirming unchanged pharmacokinetics in CKD, I have used an oral selective ETA receptor antagonist to show that the reductions in BP, arterial stiffness and proteinuria seen in my acute studies are maintained longer term. This results of this study also suggest that the mechanism for the reduction in proteinuria is haemodynamic and relates to a reduction in GFR and filtration fraction. In summary, these studies suggest that ET-1 may act as a potential biomarker of renal inflammation, and confirm its role in the pathophysiology of the systemic and renal vasoconstriction seen in CKD. They also suggest that selective ETA receptor antagonism may provide a novel therapeutic approach in proteinuric CKD on top of standard therapies. Larger and longer term studies are now warranted to confirm this potential.

A hipertensão é uma das principais causas de morbidade e mortalidade no Brasil. Os hipertensos muitas vezes apresentam perfil lipídico e glicidico desfavoráveis. A alimentação pode desempenhar um papel importante na redução da pressão arterial (PA) e no perfil lipídico e controle glicêmico desses pacientes. Avaliar o impacto de uma intervenção nutricional adaptada ao padrão alimentar brasileiro no controle dos níveis pressóricos e metabólico de pacientes hipertensos em acompanhamento em um serviço de atenção primária de saúde do município de São Luís do Maranhão. Metodologia: ensaio clínico randomizado utilizando uma dieta de baixo índice glicêmico combinada ao aumento do consumo de frutas, vegetais, grãos integrais e laticínios desnatados que são os princípios do Dietary Approach to Stop Hypertension (dieta DASH). Foram alocados randomicamente 206 pacientes hipertensos que foram acompanhados por 6 meses. O grupo controle (GC, n=101) recebeu aconselhamento padrão, focado na redução da ingestão de sal. Resultados: Dos 206 pacientes randomizados, 156 (37 homens, 119 mulheres) completaram o estudo. A idade média dos participantes foi de 60,1 (DP 12,9) anos. Após 6 meses, houve redução na média da pressão arterial sistólica (PAS) em 14,4 mmHg e na diastólica (PAD) de 9,7 mmHg no grupo experimental (GE), em comparação a 6,7 mmHg e 4,6 mmHg, respectivamente, no GC. Após o ajuste para mudança de peso corporal, PA na linha de base e idade, essas diferenças entre os grupos foram de aproximadamente 9,2 mmHg e 6,2 mmHg, respectivamente. Ocorreram tambem variações estatisticamente significantes na excreção urinária de sódio, reduzida em 43,4 mEq/24 h no GE, bem como o colesterol total (-46.6mg/dl) , LDL colesterol (-42.5mg/dl), triglicérides (-31.3mg/dl), glicemia de jejum (-9.6mg/dl ) e hemoglobina glicada (-0,1%). O consumo alimentar modificou-se no GE com aumento do consumo de vegetais, passando de 2,97 para 5,85 ; frutas (4,09-7,18); feijão (1,94-3,13) e peixes (1,80 para 2,74). Modificações importantes relacionadas à redução significativa de carboidratos, teor lipídico e carga glicêmica da dieta, foram observadas. Conclusão: Este estudo mostrou a viabilidade e a eficácia de uma abordagem dietética com base no padrão alimentar brasileiro, na redução da PA e parâmetros bioquímicos inadequados, podendo causar um grande impacto na saúde pública.
Hypertension is one of the leading causes of morbidity and mortality in Brazil. Hypertensive patients often have unfavorable lipid profile and glucose level. Nutrition may play an important role in reducing blood pressure (BP) and metabolic control of these patients. Objective: To evaluate the impact of nutritional intervention adapted to the Brazilian food in controlling blood pressure and metabolic monitoring in hypertensive patients from a primary care service in São Luís do Maranhão. Methodology: Randomized clinical trial using a low-glycemic index diet combined with increased consumption of fruits, vegetables, whole grains and nonfat dairy products which principles of the Dietary Approach to Stop Hypertension (DASH). We randomly assigned 206 patients with hypertension who were followed for 6 months. The control group (CG, n = 101) received standard counseling, focused on reducing salt intake. Results: Of the 206 patients randomized, 156 (37 men, 119 women) completed the study. The average age of participants was 60.1 (SD 12.9) years. After 6 months, a reduction in mean systolic blood pressure (SBP) by 14.4 mmHg and diastolic blood pressure (DBP) by 9.7 mmHg in the experimental group (EG), compared to 6.7 mmHg and 4.6 mmHg, respectively GC. After adjusting for change in body weight at baseline BP and age, these differences between groups were approximately 9,2 mmHg and 6,2 mmHg, respectively. There were also statistically significant variability in urinary sodium excretion, reduced by 43.4 mEq/24 h at GE, as well as total cholesterol (-46.6mg/dl), LDL cholesterol (-42.5mg/dl), triglycerides (-31.3 mg / dl), fasting glucose (-9.6mg/dl) and glycated hemoglobin (-0.1%). The EG increased the intake of vegetables, from 2.97 to 5.85; fruits (4,09 to 7.18), beans (1.94 to 3.13) and fish (1.80 to 2.74).Significant changes related to the significant reduction of carbohydrate, lipid content and glycemic load of the diet have been observed. Conclusion: This study showed the feasibility and effectiveness of a dietary approach based no Brazilian pattern in reducing blood pressure and biochemical parameters. Dietary changes as proposed may have a great impact on public health.

Artificial urinary sphincters have been used for decades for treatment of urinary incontinence. A commonly used device, the AMS 800 consists of a urethral cuff, pump and an abdominal reservoir. Notable complications of this system include scrotal or labial hematomas, infection or erosion of the cuff and rarely migration of its components. Although there are few reported cases related to effects from pump migration, those documenting reservoir related complications are even rarer. We present a case of reservoir migration adjacent to the ascending colon causing ischemic changes mimicking colonic neoplasm. Our patient, a 66-year old male with medical history of adenocarcinoma of prostate status post radical prostatectomy, had been having abdominal pain for a month. A CT scan showed cecal and proximal ascending colonic irregular nodular thickening suggestive of colonic mass. It also revealed a low-density structure next to the ascending colon abutting into area of the mass. A follow up colonoscopy showed a fungating, ulcerated mass extending from cecum to ascending colon concerning for a malignancy of which biopsy was also done. The patient then underwent right open hemicolectomy. During surgery, a balloon reservoir was seen in the abdominal cavity with its adherence to the right colon but not eroding into it. The surgeon dissected the balloon, repositioned and re-peritonealized it before closing the abdomen. The colonoscopic and surgical pathology instead demonstrated findings of ischemic colitis with mucosal ulceration in cecum and ascending colon limited to the mucosa but no evidence of cancer. Retrospective chart review revealed history of artificial urinary sphincter implantation for urinary incontinence related to radical prostatectomy for adenocarcinoma eight years prior. With manufacturer suggested implant location of the reservoir in prevesical space, the possibility of migration needs to be accounted for. Although there are not many reports of artificial sphincter reservoir related complications, there are cases documenting inflatable penile prosthesis reservoir erosion into abdominal and pelvic structures. As the CT scan demonstrated reservoir indentation into the ascending colon, it likely led to chronic irritation of the adjacent colonic wall due to mass effect. It is hypothesized that constant pressure on colonic wall likely led to localized ischemia. This resulted in localized inflammation including submucosal edema, which can create a mass-like appearance when severe. This case emphasizes that, while preliminary radiographic imaging and even gross colonoscopy findings may be suggestive of a malignancy, it is imperative to await biopsy results to confirm the diagnosis of a malignant neoplasm. Our case report emphasizes the consideration of diagnoses other than colon cancer when faced with a colonic mass especially in the setting of implanted intra-abdominal foreign body to avoid unnecessary surgery and related complications.

Distribution tissulaire de l'ochratoxine marquee chez le rat et la souris (voie orale). Etude de la nephrotoxicite subchronique de doses faibles chez le rat en suivant dans l'urine et les tubules la variation des activites enzymatiques. Effet sur les enzymes de cellules renales mdck en culture. Etude de la genotoxicite de l'ochratoxine in vivo et in vitro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
This thesis was composed of three scientific papers. The first paper was the more comprehensive. All lesions of the urinary system of dogs necropsied between 1999 and 2010 were analyzed. In this time frame, 3,189 dogs were necropsied at the Laboratório de Patologia Veterinária of the Universidade Federal de Santa Maria (LPV-UFSM) and 1,063 had lesions in the urinary system. In most of the dogs (79.1%), lesions were single and in about 21% they were multiple, totalizing 1,373 lesions. Kidneys were 2.8 times more affected than the lower urinary tract (LUT). One third of the lesions in the urinary system were cause of spontaneous death or reason for euthanasia (SD/EUTH) of the affected dogs. The other lesions were considered incidental findings. The main renal lesions diagnosed were: tubulointerstitial nephritis, infarct, granulomatous nephritis, glomerulonephritis, metastatic/multicentric neoplasms, pyelonephritis/pyelitis, and hydronephrosis. The main LUT lesions were: cystitis, presence of viral inclusions bodies, urolithiasis, urinary bladder dilatation, urinary bladder rupture, and metastatic/multicentric neoplasms. Epidemiological aspects such as gender, breed, and age of affected dogs had significant variations according to the type of lesion diagnosed. Uremia was observed in a significant number of cases of SD/EUTH and was mostly due to renal lesions. The second paper was focused on urolithiasis. From 1990 to 2010, 4,872 dogs were necropsied at LPV-UFSM. Out of these, 1.5% had uroliths along the urinary tract. The epidemiological profile of the affected dogs showed predominance of males; adults; and pure breeds. Clinical signs suggestive of urolithiasis were informed in 30.3% of the dogs and consisted mainly of hematuria, anuria, dysuria and urinary incontinency. The uroliths were found in one or more anatomical sites, and the main affected ones, in descending order, were urinary bladder, kidney, and urethra. Secondary lesions to urolithiasis were observed in about 40% of the cases. The most prevalent were cystitis, urethral obstruction, hydroureter, hydronephrosis, urinary bladder rupture, and pyelonephritis. In 25% of the affected dogs, SD/EUTH occurred due to the secondary lesions of urolithiasis. Extra-renal lesions of uremia were observed in 9 out of the 76 cases. The third article was focused on urinary system neoplasms of dogs. The main purposes of this study were to establish the prevalence and types of primary and metastatic/multicentric neoplasms of the urinary system in dogs submitted to necropsy in about 21 years at the LPV-UFSM. Neoplasms of the urinary system were present in 113 (2.4%) dogs. Twenty seven were primary neoplasms and 86 were metastatic or part of a multicentric tumor. The majority of the primary neoplasms were of epithelial origin. Thirteen dogs had primary renal neoplasms (prevalence of 0.27% over all dogs necropsied). Cystadenocarcinoma/cystadenoma and renal cell carcinoma were the most prevalent primary renal neoplasms and transitional cell carcinoma was the most prevalent urinary bladder neoplasm. Metastatic or multicentric tumors affecting the urinary system were the most prevalent (76.1%); mesenchymal tumors were more common than epithelial tumors; most of them were localized in the kidney. Metastases of mammary tumors and multicentric lymphoma were the most prevalent histologic types.
Esta tese foi constituída de três partes que resultaram em três artigos científicos. O primeiro artigo foi o mais abrangente, onde todas as lesões do sistema urinário em cães necropsiados entre 1999 e 2010 foram analisadas. No período estudado foram necropsiados 3.189 cães no Laboratório de Patologia Veterinária da Universidade Federal de Santa Maria (LPV-UFSM) e destes, um terço (1.063) apresentou lesões no sistema urinário. Na maioria (79,1%) dos cães foram observadas lesões únicas e em aproximadamente 21% havia lesões múltiplas, totalizando 1.373 lesões. Os rins foram 2,8 vezes mais afetados que o trato urinário inferior (TUI). Um terço das lesões no sistema urinário foram causa de morte espontânea/eutanásia (ME/EUT). As demais foram consideradas achados incidentais. As principais lesões renais diagnosticadas foram: nefrite túbulo-intersticial, infarto, nefrite granulomatosa, glomerulonefrite, neoplasmas metastáticos/multicêntricos, pielonefrite/pielite e hidronefrose. As principais lesões do TUI diagnosticadas foram: cistite, presença de inclusões virais, urolitíase, dilatação da bexiga, ruptura de bexiga e neoplasmas metastáticos/multicêntricos. As características epidemiológicas como sexo, raça e idade dos cães afetados tiveram variações significativas de acordo com o tipo de lesão diagnosticada. Uremia foi observada em um número significativo de casos de ME/EUT e foi, principalmente, secundária a lesões renais. O segundo artigo enfocou a urolitíase. No período analisado (1990 2010) foram necropsiados 4.872 cães. Destes, 1,5% apresentaram urólitos ao longo do sistema urinário. O perfil epidemiológico mostrou o predomínio de cães machos; adultos; e com raça definida. Sinais clínicos indicativos de urolitíase foram computados em cerca de um terço dos casos e consistiram principalmente de hematúria, anúria, disúria e incontinência urinária. Os urólitos tiveram localização única ou múltipla e os locais anatômicos mais frequentemente acometimentos, em ordem decrescente de prevalência, foram bexiga, rim e uretra. Lesões secundárias à urolitíase foram observadas em aproximadamente 40% dos cães afetados. As mais prevalentes foram cistite, obstrução uretral, hidroureter, hidronefrose, ruptura vesical e pielonefrite. Em 25% do total de cães afetados ocorreu ME/EUT decorrentes das lesões secundárias à urolitíase. Uremia foi observada em 9 dos 76 casos. O terceiro artigo enfocou os neoplasmas que acometem o sistema urinário de cães. Nesse estudo foram determinados a prevalência e os tipos de neoplasmas primários e metastáticos/multicêntricos que ocorreram no sistema urinário de cães recebidos para necropsia no LPV-UFSM num período de aproximadamente 21 anos (janeiro de 1990 julho de 2010). Em 113 (2,4%) dos cães necropsiados no período estudado, foram diagnosticados 27 neoplasmas primários e 86 metastáticos ou como parte de tumores multicêntricos no sistema urinário. Dos neoplasmas primários, a grande maioria teve origem epitelial. Treze casos eram neoplasmas renais primários (0,27% do total de cães necropsiados). Cistadenocarcinoma/cistadenoma e o carcinoma de células renais foram os neoplasmas primários mais prevalentes no rim e o carcinoma de células de transição foi o mais prevalente na bexiga. Os neoplasmas metastáticos e multicêntricos que afetaram o sistema urinário foram os mais prevalentes (76,1%), com predomínio mesenquimal. Destes, a grande maioria estava localizada no rim e, quanto ao tipo histológico, as metástases de neoplasmas mamários e o linfoma multicêntrico predominaram.

Escherichia coli pode causar infecção intestinal e extra-intestinal, de origem comunitária ou hospitalar, prevalecendo como agente de infecção do trato urinário (ITU). O objetivo do presente estudo foi caracterizar a produção de b-lactamases de espectro estendido (ESBL), grupos filogenéticos, e a relação clonal em isolados clínicos de E. coli recuperados de pacientes ambulatoriais e internados atendidos em um Hospital Universitário de São Paulo, no período de 2005 a 2007. Seis por cento (34/562) dos isolados de E. coli estudados foram caracterizados como produtores de ESBL, sendo associados exclusivamente a infecções extra-intestinais, tanto nos pacientes ambulatoriais (10/28, 36%) como nos internados (18/28, 64%), dos quais 56% (19/34) foram recuperados de uroculturas. Os isolados produtores de ESBL exibiram um fenótipo multirresistente apresentando um perfil de resistência a ampicilina (100%), cefalotina (100%), cefotaxima (100%), ceftazidima (79%), sulfametoxazol-trimetoprim (62%), gentamicina (56%), ciprofloxacina (50%) e amicacina (6%) e permanecendo suscetíveis ao imipinem. A produção de ESBL esteve associada com a presença de genes do tipo blaCTX-M-2 (94%, 32/34), blaCTX-M-15 (3%, 01/34) e blaCTX-M-1 (3%, 01/34). Entre os isolados produtores de ESBL, os grupos filogenéticos B1 (53%, 18/34) e A (18%, 6/34), de baixa virulência, foram predominantes sobre os grupos filogenéticos, de alta virulência, B2 (12%, 4/34) e D (18%, 6/34). De fato, os genes de virulência pap, cnf1, sfa, hly, e iuc, associados com adesão, invasão e disseminação, não foram identificados. A tipagem genotípica por PFGE (utilizando a enzima Xbal) com posterior análise em dendrograma, identificou a presença de 31 clusters entre os 34 isolados produtores de ESBL. Em resumo, a alta incidência de isolados clonalmente não relacionados, pertencentes aos grupos filogenéticos A e B1, de baixa virulência, sugere que cepas comensais de E. coli podem adquirir genes de resistência do tipo blaCTX-M por transferência horizontal contribuindo no estabelecimento e no prognóstico de infecções extra-intestinais, principalmente do trato urinário.
Escherichia coli can produce both intestinal and extraintestinal community- or nosocomial-acquired infection, being the main agent of urinary tract infection (UTI). The aim of this study was to characterize the extended-spectrum beta-lactamase (ESBL) production, phylogenetic groups, and clonal relationship among E. coli clinical isolates recovered from inpatients and outpatients admmited at a university hospital in São Paulo. During 2005 to 2007, six percents (34/562) E. coli isolates were characterized as ESBL producers, being associated exclusively to extraintestinal infections in both inpatients (10/28, 36%) and outpatients (18/28, 64%), of which 56% (19/34) were recovered from urine cultures. ESBL-producing E. coli exhibited a multidrug-resistant phenotype with a resistance profile to ampicillin (100%), cephalotin (100%), cefotaxime (100%), ceftazidime (79%), sulphamethoxazole-trimethoprim (62%), gentamicin (56%), ciprofloxacin (50%), and amikacin (6%), and remaining susceptible to imipenem. In this regard, ESBL production was associated with the presence of blaCTX-M-2 (94%, 32/34), blaCTX-M-15 (3%,1/34) and blaCTX-M-1 (94%, 32/34) genes. On the other hand, low-virulence phylogenetic groups B1 (53%, 18/34) and A (18%, 6/34) were predominant over high-virulence phylogenetic groups B2 (12%, 4/34) and D (18%, 6/34), among ESBL-producing E. coli isolates studied. In fact, pap, cnf1, sfa, hly, and iuc virulence genes associated with adhesion, invasion and dissemination were not identified. Finally, genotyping by PFGE (using XbaI restriction) with subsequent cluster analysis (dendrogram) revealed the presence of 31 cluster among 34 ESBL-producing E. coli. In summary, the high prevalence of clonally unrelated ESBL-producing E. coli belonging to low-virulence phylogenetic groups A and B1 suggest that comensal E. coli can acquire blaCTX-M-like resistance genes through horizontal gene tranfer, contributing to the establishment and outcome of extraintestinal infections, mainly in the urinary tract.