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The New Microbiologica May 2023BK virus (BKV) associated with hemorrhagic cystitis (HC) is the most important complication that develops after hematopoietic stem cell transplantation (HSCT) in...
BK virus (BKV) associated with hemorrhagic cystitis (HC) is the most important complication that develops after hematopoietic stem cell transplantation (HSCT) in patients with hematological malignancies. This study aims to investigate BKV infections and HC in pediatric patients after allogeneic hematopoietic stem cell transplantation. Between November 2018 and November 2019, a total of 51 patients between the ages of 11 months and 17 years were included in the study. BKV Bosphore ® v1 quantification kit (Geneworks Anatolia, Turkey) was used for the detection of BKV DNA in urine and blood samples. Among the total of 51 patients, the incidence of BKV infection was found to be 86.3%. Allogeneic HSCT was performed in 40 patients and autologous HSCT in 11 patients. BK viruria and/or viremia were detected in 85% (44) of patients who underwent allogeneic HSCT and in 90% in the autologous group. High-level BK viruria (>107 copies/mL) was found in 41% (9) of 22 patients who were BKV positive before transplantation, while in 27.5% (8) of 29 patients who were BKV negative before transplantation; thus, BKV positivity before transplantation was considered a risk factor for high-level BK viruria. Acute GVHD developed in 6 of 40 patients in the allogeneic group. HC was prevented in 12 (67%) of 18 patients who received preemptive treatment, while HC developed in 6 (33%). HC occurred at a median of 35 days (17-49 days) post-transplant. Despite preemptive treatment, 6 (15%) patients who developed HC associated with BKV were in the allogeneic group but not in the autologous group. Of these patients with HC, 5 received a myeloablative treatment regimen, and 1 patient was given a reduced-intensity treatment regimen. The viral load in urine was found to be 107-9 copies/mL within 2 weeks before the development of HC and has been identified as a prognostic indicator. In conclusion, early diagnosis of viral infections by monitoring BKV viral load in HSCT patients will be effective in preventing the progression of complications such as BKV-associated HC by providing timely initiation of preemptive treatment.
Topics: Humans; Child; Infant; Cystitis; Risk Factors; Hematopoietic Stem Cell Transplantation; Polyomavirus Infections; Transplant Recipients; BK Virus; Hemorrhage
PubMed: 37247234
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Aug 2022: Women with interstitial cystitis (IC) suffer from spontaneous serious bladder pain symptoms without immediate resolution. Women with IC may lack knowledge of how to...
: Women with interstitial cystitis (IC) suffer from spontaneous serious bladder pain symptoms without immediate resolution. Women with IC may lack knowledge of how to help themselves. Therefore, a measurement of IC self-help and medical-resource-seeking for women with IC is needed. : This study recruited 100 women with IC from a teaching hospital in Northern Taiwan. The reliability and validity of the Interstitial Cystitis Self-Help and Medical Resources Scale (ICSR) were assessed using expert validity, confirmatory factor analysis (CFA) to test the construct validity, composite reliability to evaluate the internal consistency, and item analysis to test the discrimination validity of each item. : The results showed that the ICSR had accurate goodness-of-fit indices and the component reliability ranged from 0.42 to 0.83, indicating good reliability and validity. : The ICSR is recommended for screening the self-help and medical-resource-seeking abilities of women with IC to aid in diagnosing IC and providing more precise medical treatments.
Topics: Cystitis, Interstitial; Female; Health Behavior; Humans; Reproducibility of Results; Taiwan
PubMed: 36143860
DOI: 10.3390/medicina58091183 -
The Journal of Pediatrics Jun 2019To determine whether treatment for urinary tract infections in children could be individualized using biomarkers for acute pyelonephritis. (Comparative Study)
Comparative Study
OBJECTIVE
To determine whether treatment for urinary tract infections in children could be individualized using biomarkers for acute pyelonephritis.
STUDY DESIGN
We enrolled 61 children with febrile urinary tract infections, collected blood and urine samples, and performed a renal scan within 2 weeks of diagnosis to identify those with pyelonephritis. Renal scans were interpreted centrally by 2 experts. We measured inflammatory proteins in blood and urine using LUMINEX or an enzyme-linked immunosorbent assay. We evaluated serum RNA expression using RNA sequencing in a subset of children. Finally, for children with Escherichia coli isolated from urine cultures, we performed a polymerase chain reaction for 4 previously identified virulence genes.
RESULTS
Urinary markers that best differentiated pyelonephritis from cystitis included chemokine (C-X-C motif) ligand (CXCL)1, CXCL9, CXCL12, C-C motif chemokine ligand 2, INF γ, and IL-15. Serum procalcitonin was the best serum marker for pyelonephritis. Genes in the interferon-γ pathway were upregulated in serum of children with pyelonephritis. The presence of E coli virulence genes did not correlate with pyelonephritis.
CONCLUSIONS
Immune response to pyelonephritis and cystitis differs quantitatively and qualitatively; this may be useful in differentiating these 2 conditions.
Topics: Acute Disease; Bacterial Infections; Biomarkers; Child, Preschool; Cystitis; Diagnosis, Differential; Female; Humans; Infant; Male; Pilot Projects; Prospective Studies; Pyelonephritis; Urinary Tract Infections
PubMed: 30905425
DOI: 10.1016/j.jpeds.2019.01.012 -
BMC Surgery Mar 2022The urachus is the embryological remnant of the cloaca and allantois. Failure of its regression can cause diseases any time after birth. It is difficult to differentiate... (Review)
Review
BACKGROUND
The urachus is the embryological remnant of the cloaca and allantois. Failure of its regression can cause diseases any time after birth. It is difficult to differentiate an abscess from urachal adenocarcinoma based on the clinical presentation and image findings. Cystitis glandularis reflects chronic irritation of the bladder urothelium, and tumor-like florid cystitis glandularis can be misdiagnosed as malignancy. We report a patient with concurrent urachal abscess and florid cystitis glandularis which increased the resemblance of malignancy.
CASE PRESENTATION
A 57-year-old female was incidentally found to have a heterogeneous pelvic mass abutting the urinary bladder. A cystoscopy examination revealed protruding tumors located in the bladder dome. Her blood test results were all normal, and urinalysis showed microscopic hematuria. Urachal cancer was diagnosed and en bloc excision of the umbilicus, tumor, and the involved bladder dome was performed. Pathology revealed urachal abscess with concurrent cystitis glandularis within the urinary bladder. No malignancy was identified in the resected specimen.
CONCLUSIONS
It is challenging to distinguish urachal abscess from a malignant tumor based on the clinical presentation and imaging studies. As in our case, the coexistence of urachal abscess and tumor-like florid cystitis glandularis increased the resemblance to a malignancy. This is the first reported case of the concurrence of these two disease entities, and emphasizes that the detection of bladder tumors on cystoscopy is not sufficient to make the diagnosis of urachal cancer with bladder involvement.
Topics: Abdominal Abscess; Abscess; Cystitis; Female; Humans; Middle Aged; Peritoneal Diseases; Urinary Bladder Neoplasms
PubMed: 35313861
DOI: 10.1186/s12893-021-01430-w -
Journal of Veterinary Internal Medicine 2023Follicular cystitis is an uncommon inflammatory change in the urinary bladder wall characterized by the formation of tertiary lymphoid structures (TLSs) in the submucosa.
BACKGROUND
Follicular cystitis is an uncommon inflammatory change in the urinary bladder wall characterized by the formation of tertiary lymphoid structures (TLSs) in the submucosa.
OBJECTIVES
To characterize clinical and pathologic features of follicular cystitis in dogs and to explore in situ distribution and possible role of Escherichia coli as an associated cause.
ANIMALS
Eight dogs diagnosed with follicular cystitis and 2 control dogs.
METHODS
Retrospective descriptive study. Dogs diagnosed with follicular cystitis (macroscopic follicular lesions in the urinary bladder mucosa and histopathologic detection of TLSs in bladder wall biopsies) were identified from medical records. Paraffin embedded bladder wall biopsies were subject to in situ hybridization for E. coli 16SrRNA identification.
RESULTS
Follicular cystitis was diagnosed in large breed (median weight 24.9 kg, interquartile range [IQR] 18.8-35.4 kg) female dogs with a history of chronic recurrent urinary tract infections (UTIs; median duration of clinical signs 7 months, IQR 3-17 months; median number of previous UTIs 5, IQR 4-6). Positive E. coli 16SrRNA signal was detected within developing, immature and mature TLSs in 7/8 dogs, through submucosal stroma in 8/8 dogs and within the urothelium in 3/8 dogs.
CONCLUSIONS AND CLINICAL IMPORTANCE
Chronic inflammation associated with an intramural E. coli infection in the urinary bladder wall represents a possible triggering factor for the development of follicular cystitis.
Topics: Dogs; Female; Animals; Escherichia coli; Retrospective Studies; Cystitis; Urinary Bladder; Urinary Tract Infections; Escherichia coli Infections; Dog Diseases
PubMed: 37154220
DOI: 10.1111/jvim.16719 -
QJM : Monthly Journal of the... Jul 2013
Topics: Aged; Anti-Bacterial Agents; Cystitis; Emphysema; Escherichia coli; Escherichia coli Infections; Female; Humans; Urinary Catheterization
PubMed: 22855288
DOI: 10.1093/qjmed/hcs147 -
Australian Family Physician May 2010A woman presenting with symptoms suggestive of bacterial cystitis is a frequent occurrence in the general practice setting. One in three women develop a urinary tract... (Review)
Review
BACKGROUND
A woman presenting with symptoms suggestive of bacterial cystitis is a frequent occurrence in the general practice setting. One in three women develop a urinary tract infection (UTI) during their lifetime (compared to 1 in 20 men).
OBJECTIVE
In this article we provide an outline of the aetiology, pathogenesis and treatment of bacterial cystitis in the primary care setting. We suggest measures that may assist before urological referral and work through a common clinical scenario.
DISCUSSION
Bacterial cystitis in unlikely if the urine is both nitrite and leuco-esterase negative. Empirical antibiotics are justified if symptoms are present with positive urinary dipstick, but microscopy, culture and sensitivity of urine is warranted to ensure appropriate empirical therapy and identification of the causative organism. Risk factors for UTI in women include sexual intercourse, use of contraceptive diaphragms and, in postmenopausal women, mechanical and/or physiologic factors that affect bladder emptying such as cystocoele or atrophic vaginitis. Discussion regarding risk factors and UTI prevention is important. Women with recurrent UTIs (defined as three or more episodes in 12 months or two or more episodes in 6 months) should be screened for an underlying urinary tract abnormality (ultrasound) and may benefit from prophylactic therapy. Patients with complex or recurrent UTIs, persistent haematuria, persistent asymptomatic bacteriuria, or urinary tract abnormalities on imaging may benefit from referral to a urologist.
Topics: Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Cystitis; Cystoscopy; Escherichia coli; Family Practice; Female; Follow-Up Studies; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Middle Aged; New South Wales; Recurrence; Risk Assessment; Severity of Illness Index; Treatment Outcome; Urinalysis; Young Adult
PubMed: 20485716
DOI: No ID Found -
Frontiers in Immunology 2022Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T lymphocyte-associated protein 4 (anti-CTLA4) and anti-programmed death cell protein 1 (anti-PD-1), are... (Review)
Review
Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T lymphocyte-associated protein 4 (anti-CTLA4) and anti-programmed death cell protein 1 (anti-PD-1), are increasingly prescribed in metastatic carcinoma therapy. ICI-related kidney injury is gradually recognized by clinicians. However, immune-related ureteritis and cystitis easily go undiagnosed. We report three cases of PD-1 monoclonal antibody (mAb)-related ureteritis and cystitis. We further carried out a review of the literature about ICI-related ureteritis and cystitis. The cases in our reports manifest urinary irritation, sterile pyuria, gross hematuria, hydronephrosis, dilation of the ureters, and acute kidney injury. Urinary irritation improved effectively; urinalysis and renal function returned to normal after glucocorticoid therapy. During ICI therapy, urinalysis and renal function and urinary imaging examination are recommended to be monitored regularly. It contributes to identify immune-related ureteritis/cystitis earlier to efficiently alleviate urinary symptoms and immunologic urinary tract injury through glucocorticoid therapy while avoiding the abuse of antibiotics.
Topics: Humans; Immune Checkpoint Inhibitors; Glucocorticoids; Inflammation; Urinary Tract Infections; Cystitis; Gastrointestinal Diseases
PubMed: 36685488
DOI: 10.3389/fimmu.2022.1051577 -
BMJ (Clinical Research Ed.) Jul 1996
Topics: Aged; Anti-Bacterial Agents; Cystitis; Estrogen Replacement Therapy; Female; Humans; Middle Aged; Postmenopause; Recurrence
PubMed: 8688769
DOI: 10.1136/bmj.313.7050.129 -
Hong Kong Medical Journal = Xianggang... Dec 2022This systematic review and meta-analysis focused on the literature regarding ketamine-associated uropathy to summarise its clinical manifestations, the results of... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
This systematic review and meta-analysis focused on the literature regarding ketamine-associated uropathy to summarise its clinical manifestations, the results of urological assessments, and current management.
METHODS
A literature search was conducted using keywords and MeSH terms related to ketamine abuse, urinary tracts, and urological examinations. Databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched up to 26 June 2020.
RESULTS
In total, 1365 articles were retrieved; 45 articles (4921 patients) were included in the analysis of patient demographics, clinical manifestations, examination results, and treatments. Frequency was the most common manifestation (pooled prevalence 77.1%, 95% confidence interval [CI]=56.9%-92.2%), followed by urgency (69.9%, 95% CI=48.8%-87.3%) and suprapubic pain (60.4%, 95% CI=35.3%-82.9%). Upper urinary tract involvement was less common; the pooled prevalence of hydronephrosis was 30.2% (95% CI=22.0%-39.2%). Further workup revealed a pooled functional bladder capacity of 95.23 mL (95% CI=63.57-126.88 mL), pooled voided volume of 113.31 mL (95% CI=59.44- 167.19 mL), and pooled maximum urine flow rate of 8.69 mL/s (95% CI=5.54-11.83 mL/s). Cystoscopic examinations and bladder biopsy revealed frequent urothelial denudation, inflammatory changes, and inflammatory cell infiltration. Treatments included oral medications for symptomatic relief, intravesical therapy, and surgery (eg, hydrodistension and bladder reconstruction), but ketamine abstinence was necessary for improvement.
CONCLUSION
Ketamine-associated uropathy frequently involves frequency, urgency, and suprapubic pain; upper urinary tract involvement is less common. Affected patients showed reductions in bladder capacity and urine flow rate. Endoscopic and histological analyses often revealed cystitis. Despite variations in treatment, ketamine abstinence is important for all patients with ketamine-associated uropathy.
Topics: Humans; Ketamine; Cystitis; Urologic Diseases; Urinary Bladder; Pain
PubMed: 36464318
DOI: 10.12809/hkmj209194