جستجوی مقالات مرتبط با کلیدواژه « دستگاه ادراری » در نشریات گروه « پزشکی »

Urolithiasis, with different types of stones, is known as a considerable concern regarding urinary tract. Indeed, urolithiasis is a multifactorial disease with a wide range of risk factors which predisposes patients to it. Because of the importance of urolithiasis around the world and the considerable costs for patients and public health and treatment centers associated with urolithiasis, we made an attempt to determine the most important risk factors in association with urolithiasis.

To prepare  the present systematic review, the English language papers with no limitation in publication date were searched in search engines like Google Scholar and databases, including PubMed, and websites, like ScienceDirect. In this regard, papers which covered the main aim of the study were selected for final analysis.

The prevalence, type, and composition of urinary system stones have different reasons and risk factors. The urinary tract stones are divided into microbial and non-microbial stones. Although urolithiasis is a multifactorial disease, nutrition, as the dominant risk factor, plays pivotal role in prevention, diagnosis, and treatment of urolithiasis.

Men >60, <40, and 40-60 years old are more predisposed to urinary tract stones (both the microbial and non-microbial stones) compared with other age ranges. In contrast, the occurrence of microbial stones in women is higher than that of men because the rates of urinary tract infections are higher in female population. All in all, age, gender, catheterization, urinary tract disorders, geographic zone, climate, season, race, diet, physical activities, drug-induced stones, water and liquid application, gastrointestinal and urinary tracts’ normal flora, inheritance, occupation, and diseases such as gout and diabetes type II are identified as the most important factors of urolithiasis.

Methicillin resistant Staphylococcus aureus (MRSA) have recently emerged as major causes of urinary tract infection (UTI). The aims of this study were to determine antibiotic susceptibility of S. aureus isolated from UTI and to detect the presence of mecA (causing resistance to methicillin) and SCCmec types.

In this cross sectional study, 44 S. aureus isolates were collected in autumn 2017 from patients with UTI in two hospitals in Sanandaj, west of Iran. Susceptibility rates to nine antibiotics and vancomycin were determined by disk diffusion method and E test, respectively. The mecA and SCCmec types were detected by polymerase chain reaction (PCR). Descriptive statistics were used to evaluate the data.

Vancomycin, linezolid, and trimethoprim-sulfamethoxazole showed the highest susceptibility rates (more than 90%), followed by gentamicin (86.4%), cefoxitin (79.5%), tetracycline (77.3%), clindamycin (75%), ciprofloxacin (70.4%), erythromycin (52.3%), and penicillin (6.8%). The isolates from inpatients were more susceptible to antibiotics compared to those from outpatients. Of the 44 isolates, 9 (20.5%) were MRSA, of which 6 were isolated from outpatients. Five of 9 MRSA isolates carried the mecA gene, and of these, two isolates harbored SCCmec V while three were nontypeable.

Our study suggests that trimethoprim-sulfamethoxazole, vancomycin or linezolid would be suitable agents in treatment of UTI caused by MRSA. Identification of an MRSA isolate in urine is a serious concern and highlights the need for monitoring drug resistance in S. aureus.

Urinary tract infection (UTI) is one of the most common bacterial diseases in children. This infection can lead to serious complications, such as chronic kidney injury, chronic renal failure, and even hypertension. The aim of this study was to investigate changes in serum levels of interleukin-8 in upper and lower urinary tract infections, and to investigate its association with the type of urinary tract involvement. This was a cross-sectional and prospective study. The study population consisted of all children aged 3 months to 12 years' old who referred to Amiralmomenin Hospital in Semnan city. By convenience sampling, 57 children were enrolled and received either oral or injectable treatment. Interleukin-8 serum levels were measured before and 3 days after treatment, by ELISA method and using available kits. DMSA scan was performed one week after admission to assess the severity of kidney parenchymal involvement in order to determine and distinguish between lower and upper urinary tract infections. Totally 57 subjects with mean age 21.2 ± 20.76 months were enrolled. Children aged more than 20 months were more likely to have upper urinary tract infection than the other group (P=0.005). In males, the prevalence of upper urinary tract infection was significantly lower (P = 0.049). Children with upper urinary tract infection had a higher interleukin-8 concentration (P=0.001) than the lower urinary tract infection. IL-8 had higher serum concentrations in upper urinary tract infections compared to lower urinary tract infections. As a result, this test can be used as a suitable substitute for DMSA scan, to predict the type of urinary tract infection.

HCA2 receptors have attracted much interest due to their role as the target of important hypolipidemic agent, niacin. In this study, the presence of HCA2 receptors as well as cell types that express them has been evaluated in different parts of male rat's urinary system including kidney, ureter, urinary bladder and urethra (in penis).
In this experimental study, six adult male Wistar rats were used. Histological slides were made from above mentioned parts and were evaluated by immunohistochemical method.
In kidney, capillary epithelium showed a high reactivity while proximal epithelial cells were stained moderately. The epithelial cells of loop of Henle, distal and collective tubules as well as glomerular cells showed weak staining. In urinary bladder, transitional epithelium and capillary endothelium showed weak staining, while smooth muscle had no reactivity. In penile tissue, urethral epithelium and smooth muscle cells were weakly positive while capillary endothelial cells showed moderate reactivity.
This study shows that HCA2 receptors are present in different parts of male rat's urinary tract. Distribution of these receptors is dependent to cell type and location in the urinary tract. The findings pave the road for future studies on possible role of these receptors in urinary system.

Beta-lactamase enzymes are the most important resistance factors among Gram-negative bacteria to the beta-lactam group of antibiotics. This study was conducted to determine the prevalence of extended-spectrum beta-lactamases (ESBL) in Escherichia coli isolates using PCR method.
This descriptive – analytic study was conducted on 120 Escherichia coli samples isolated in hospitals in Sari in northern Iran during 2013. Antibiogram was conducted using combined disk method to determine the sample resistance. The presence of β- lactamase gene of CTX-M-15 in ESBL was assessed using PCR method.
Out of 120 Escherichia coli, 98 (81.6%), 15 (12.5%) and 7 (5.8%) bacteria isolated from urinary tract, blood and wound, respectively. Multiple drug resistance were seen in 98% of urine samples, 12.7% of blood samples and 3.6% of wound samples (P Beta-lactamase enzymes were detected in high percent of Escherichia coli isolated from urine samples.

Uropathogenic strains of Escherichia coli (UPEC) are the most common cause of urinary tract infections. UPEC strains possess an arsenal of virulence factors including fimH, iucD, iroN and hlyA which increase their ability to cause urinary tract infections. This study was done to determine the relationship between phylogenetic group and distribution of virulence genes of Escherichia coli isolated from patients with urinary tract infection. This descriptive - analytic study was performed on 100 isolates Escherichia coli which collected from patients with UTIs. DNA was extracted from all isolates by the boiling method and subsequently DNA was used to determine the presence of genes encoding virulence factors by Multiplex-PCR. In addition, determination of phylogenetic group, A, B1, B2 and D, was performed by determination of present or absent of of yjaA and chuA genes and DNA fragment TSPE4.C2 using Triple-PCR. The frequency of virulence factors, fimH, iucD, iroN and hlyA were 95%, 69%, 29% and 32%, respectively. In all isolates, the frequency of phylogeny of groups A, B1, B2 and D were 17%, 6%, 55% and 22%, respectively. A significant correlation was found between the presence of virulence encoding genes and the B2 phylogenetic group (P<0.05). Virulence genes were common in phylogenetic group B2 isolates among all phylogenetic groups.

Morbidity and mortality of urinary tract infection is common in spite of preh1ion of effective new antibiotics. Chronic pyelonphritis is one of the important reasons of end stage renal failure. Our study is carried out on 167 children admitted in Fatemi koodacan Hospital due to urinary tract infection. Major goal of this study was determination of epidemiology of urinary tract infection. Methods This study was cross sectional deh1ive and sampling method was census. Various Factors such as age gender causative pathogen used antibiotics and required time for getting negative urine culture test were studied. data were collected by means questionnaire. Results According to the study urinary tract infection was more common in females (74.2% of all cases) while in male neonates it is more common than females. Incidence peak of urinary tract infection is seen in children between 1-6 years old. The most common pathogens responsible to urinary tract infection was E coli and Klebsiella. The most common background disease was vesicoureteral reflux. The most common prescribed antibiotic was ceftriaxone (65%). After 2 days of taking antibiotic the majority of patients (87.7%) had negative urine culture. Conclusion In our study E. coli and Klebsiella are the most common pathogen responsible to urinary tract infection. In our study the frequency of urinary tract infection with Proteus was low (only 1.1%) in comparison with other studies. Other epidemiological indices in this study were comparable to previous studies.

Chronic renal failure is an irreversible disease and is a common cause of mortality and morbidity in the children throughout the world. The etiology is different according to genetic and environmental factors. Determining the cause of CRF can contribute to its appropriate management and prevention of its progress.Methods and Materials: A cross sectional study was performed on 76 patients with CRF in a 9 year period. The patients were either admitted to the nephrology ward or were under observation of the nephrology clinic or dialysis division. The required data were filled in special forms and then were analyzed. The average age of the patients for the initiation of CRF was 9.22± 4.1 years. 4.8% of those admitted to the nephrology ward and 0.23% of total admissions in the hospital suffered CRF. The most common causes of CRF in decreasing of frequency were congenital anatomic disorders of the urinary tract (47.4%), acquired nephritis (15.8%), inherited renal diseases (9.2%), and renal calculi (7.9%). 67% of the parents were no educated, 75% were insured, 56.6% were close relatives and had an average monthly income of 1150000 Rials. Eight of the patients were non-Iranians. Early diagnosis and appropriate management of the most common causes of CRF might prevent the disease or retard the progress to end stage renal failure.