- Diagnosis, Treatment, and Prevention of Urinary Tract Infection. [Journal Article]
- MSMicrobiol Spectr 2016; 4(6)
- UTI may involve the lower or upper urinary tract and may be uncomplicated or complicated. The emphasis of this chapter is uncomplicated UTI. The diagnosis of uncomplicated cystitis (bladder infection...
UTI may involve the lower or upper urinary tract and may be uncomplicated or complicated. The emphasis of this chapter is uncomplicated UTI. The diagnosis of uncomplicated cystitis (bladder infection) and pyelonephritis (kidney infection) is usually easily made based on the clinical presentation, whereas the diagnosis in patients with complicated UTI is often more complex. Thus uncomplicated cystitis is usually manifested by dysuria, frequency and/or urgency without fever, and pyelonephritis is usually manifested by fever and back pain/costovertebral angle tenderness. However, pyuria is usually present with UTI, regardless of location, and its absence suggests that another condition may be causing the patient's symptoms. Treatment of cystitis is usually straightforward with one of several effective short-course antimicrobial regimens, although antimicrobial resistance continues to increase and can complicate treatment choices in certain areas. Likewise, antimicrobial resistance has complicated our management of uncomplicated pyelonephritis since resistance of uropathogens to the fluoroquinolone class, the mainstay of oral treatment for pyelonephritis, is increasing worldwide, and some of the other agents used for cystitis are not recommended for pyelonephritis due to low tissue levels. The goal of prevention of recurrent cystitis is to minimize the use of antimicrobials and there are several research efforts in progress to develop effective and safe antimicrobial-sparing preventive approaches for this common condition.
- What Is the Real Impact of Urinary Incontinence on Female Sexual Dysfunction? A Case Control Study. [Journal Article]
- SMSex Med 2017 Jan 10
- CONCLUSIONS: Women with UI were more likely to be sexual abstinent than continent women. Furthermore, women with UI showed less sexual desire, sexual comfort, and sexual satisfaction than their counterparts despite having a similar frequency of sexual activity.
- The Association between Exposure to Environmental Bisphenol A and Gonadotropic Hormone Levels among Men. [Journal Article]
- PlosPLoS One 2017; 12(1):e0169217
- Bisphenol A (BPA) is an extensively used chemical with endocrine disrupting properties. Although animal and in vivo studies have suggested possible effects of BPA on levels of gonadotropic hormones, ...
Bisphenol A (BPA) is an extensively used chemical with endocrine disrupting properties. Although animal and in vivo studies have suggested possible effects of BPA on levels of gonadotropic hormones, human studies are limited and inconclusive. The study examined whether environmental BPA exposure was associated with gonadotropic hormones levels in men. A total of 560 men aged 18-55 years were recruited from Sandu County, Guizhou Province, China. We collected urine samples for measurement of BPA, and blood samples for measurement of reproductive hormones. We examined serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (T). Relative risk (RR) was obtained by log-binominal regression to explore the association between urinary BPA level and hormone levels. BPA was detected in 70.4% of urine samples, with a geometric mean of 0.50 μg/gCr. Men with detectable levels of BPA had a 1.52-fold increased risk of having a high LH level (>75th percentile) when compared with men with undetectable levels of BPA, after adjustment for potential confounders (95% confidence interval (CI): 1.04-2.21). The association persisted and slightly intensified among current smokers (adjusted RR (aRR) = 1.76, 95%CI: 1.05-2.95), while it weakened among non-smokers (aRR = 1.17, 95%CI: 0.69-1.96). Urinary BPA level was associated with an increased FSH level among smokers (aRR = 1.64, 95%CI: 1.01-2.67). Urinary BPA level was inversely associated with total T level among males with body max index (BMI) ≥25 kg/m2 although this association was of borderline significance (aRR = 0.52, 95%CI: 0.26-1.05). In conclusion, environmental exposure to BPA was associated with increased serum levels of LH and FSH in male smokers, along with decreased serum levels of total T in men with BMI≥25 kg/m2. These findings suggest that the effects of environmental BPA exposure on hormone levels might be modified by smoking and BMI.
- A Pilot Study Linking Endothelial Injury in Lungs and Kidneys in COPD. [Journal Article]
- AJAm J Respir Crit Care Med 2017 Jan 13
- CONCLUSIONS: COPD patients and/or CS-exposed mice have pulmonary and renal endothelial cell injury linked to increased endothelial cell AGEs and RAGE levels. Albuminuria could identify COPD patients in whom ACEi therapy improves renal and lung function by reducing endothelial injury.
- Crude mortality and loss of life expectancy of patients diagnosed with urothelial carcinoma of the urinary bladder in Norway. [Journal Article]
- SJScand J Urol 2017 Jan 13; :6-11
- CONCLUSIONS: The suggested framework leads to clinically relevant prognostic risk estimates for individual patients diagnosed with UCB and the consequence in terms of loss of lifetime expectation. The published probability tables can be used in clinical praxis for risk communication.
- Uterine Fibroids: Diagnosis and Treatment. [Journal Article]
- AFAm Fam Physician 2017 Jan 15; 95(2):100-107
- Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptoma...
Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptomatic women. Fibroids can cause abnormal uterine bleeding, pelvic pressure, bowel dysfunction, urinary frequency and urgency, urinary retention, low back pain, constipation, and dyspareunia. Ultrasonography is the preferred initial imaging modality. Expectant management is recommended for asymptomatic patients because most fibroids decrease in size during menopause. Management should be tailored to the size and location of fibroids; the patient's age, symptoms, desire to maintain fertility, and access to treatment; and the experience of the physician. Medical therapy to reduce heavy menstrual bleeding includes hormonal contraceptives, tranexamic acid, and nonsteroidal anti-inflammatory drugs. Gonadotropin-releasing hormone agonists or selective progesterone receptor modulators are an option for patients who need symptom relief preoperatively or who are approaching menopause. Surgical treatment includes hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided focused ultrasound surgery.
- Innate Immune Responses to Bladder Infection. [Journal Article]
- MSMicrobiol Spectr 2016; 4(6)
- Urinary tract infections are one of the most frequent bacterial infections of mankind. In spite of this frequency, the study of the immune system in the urinary tract has not attracted much attention...
Urinary tract infections are one of the most frequent bacterial infections of mankind. In spite of this frequency, the study of the immune system in the urinary tract has not attracted much attention. This could, in part, be attributable to the widespread use of antibiotics and similar antimicrobial agents, which for many decades have been both highly effective and relatively inexpensive to administer. In light of the emergence of multidrug-resistant bacteria among urinary tract infection isolates, interest in understanding the immune system in the urinary tract has grown. Several recent studies have revealed the existence of a powerful and highly coordinated innate immune system in the urinary tract designed to rapidly clear infecting pathogens; however, it also evokes harmful side effects.
- Corrigendum to "Assessing hazardous risks of indoor airborne polycyclic aromatic hydrocarbons in the kitchen and its association with lung functions and urinary PAH metabolites in kitchen workers" [Clin. Chim. Acta 452 (2016) 204-213.]. [Published Erratum]
- CCClin Chim Acta 2017 Jan 09
- MicroRNA promoter methylation: a new tool for accurate detection of urothelial carcinoma. [Journal Article]
- BJBr J Cancer 2017 Jan 12
- CONCLUSIONS: This panel of miRNAs promoter methylation accurately detects UC in urine, comparing well with other promising epigenetic-based biomarkers. This may constitute the basis for a non-invasive assay to detect UC.British Journal of Cancer advance online publication, 12 January 2017; doi:10.1038/bjc.2016.454 www.bjcancer.com.
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- Treatment efficacy and superinfection rates in complicated urinarytract infections treated with ertapenem or piperacillin tazobactam. [Journal Article]
- TJTurk J Med Sci 2016 Dec 20; 46(6):1760-1764
- CONCLUSIONS: Both ertapenem and piperacillin-tazobactam were effective in the treatment of cUTIs caused by ESBL-producing microorganisms. A high frequency of superinfection in the ertapenem group was the result of Enterococcus and Pseudomonas spp., against which ertapenem is not active. In the presence of urinary catheterization, diabetes mellitus, and urological intervention, patients should be closely monitored for the development of a superinfection, especially patients receiving ertapenem.