Urethral response to latex and Silastic catheters.
The reaction of the urethral mucosa to latex and Silastic catheters was compared in two groups of patients undergoing prostatectomy. The bacteriologic response in the two groups differed little; however, Silastic catheters produced less cellular reaction than latex catheters. (+info)
Fatal Serratia marcescens meningitis and myocarditis in a patient with an indwelling urinary catheter.
Serratia marcescens is commonly isolated from the urine of patients with an indwelling urinary catheter and in the absence of symptoms is often regarded as a contaminant. A case of fatal Serratia marcescens septicaemia with meningitis, brain abscesses, and myocarditis discovered at necropsy is described. The patient was an 83 year old man with an indwelling urinary catheter who suffered from several chronic medical conditions and from whose urine Serratia marcescens was isolated at the time of catheterisation. Serratia marcescens can be a virulent pathogen in particular groups of patients and when assessing its significance in catheter urine specimens, consideration should be given to recognised risk factors such as old age, previous antibiotic treatment, and underlying chronic or debilitating disease, even in the absence of clinical symptoms. (+info)
Correlation of periurethral bacterial flora with bacteriuria and urinary tract infection in children with neurogenic bladder receiving intermittent catheterization.
Periurethral bacteria are inoculated daily into the urine of children with neurogenic bladder during clean intermittent catheterization (CIC). We examined how frequently periurethral bacterial species produced bacteriuria in children followed longitudinally. When Escherichia coli was detected on the periurethra, bacteriuria was also present 93% of the time. When Klebsiella, Pseudomonas, or Enterococcus species or nonpathogens were detected on the periurethra, bacteriuria was present 80%, 40%, 40%, and 25% of the time, respectively. Clonal typing of multiple colonies of E. coli from each periurethral and urine culture revealed that children carried only one or two E. coli clones in their urinary tracts over months of surveillance. When E. coli was detected in the urine, the identical clone was on the periurethra. E. coli persisted for weeks in the urine without causing symptoms. Occasionally the same E. coli clone carried for weeks caused a urinary tract infection. Bacteriuria frequently occurs after inoculation of periurethral E. coli into the urine during CIC. (+info)
Unilateral iliac vein occlusion, caused by bladder enlargement, simulating deep venous thrombosis.
A variety of conditions cause unilateral leg swelling and thus mimic deep venous thrombosis (DVT). A heretofore-underappreciated condition that may lead to unilateral iliac vein compression, simulating DVT, is massive enlargement of the bladder caused by urinary retention. A case that demonstrates this condition is described. Although this disorder has been reported only three times before, its occurrence should be recognized by clinicians in light of the overall aging of our society. In addition, this case highlights the need for careful and thorough evaluation of patients who have unilateral lower-extremity edema. (+info)
Microbiological characteristics of yeasts isolated from urinary tracts of intensive care unit patients undergoing urinary catheterization.
We studied 70 intensive care unit patients to determine the incidence of nosocomial candiduria associated with indwelling urinary catheters and to assess microbiological characteristics of the yeasts. The yeasts were isolated, 13 of 17 in urine cultures and 4 of 17 in blood cultures, and colonization had occurred 3 days after the insertion of indwelling urinary catheters. For four strains the MICs of the antifungal drugs were high. (+info)
Voiding function study with ultrasound in male and female neonates.
BACKGROUND: The neonatal period has been characterized as a time when males have a much higher incidence of urinary infection and severe ureteral reflux than females. However, little information about the voiding function in the neonatal period is available. METHODS: The bladder urine volumes, before and after voiding, and urinary flow rates were determined with the use of noninvasive voiding-provocation maneuvers and ultrasound in the apparently normal neonates. RESULTS: There was no significant difference in the prevoid bladder urine volume between the two sexes. After they were stimulated to enhance the tension of their abdominal wall musculature, 65 of 118 females (55.1%) and 64 of 115 males (55.7%) voided. The voiding was observed in 94 (81.0%) of the 116 neonates who had had a prevoid volume above 12 ml. The residual urine expressed as a percentage of the prevoid volume was significantly higher in the males (median, 12.0% in males vs. 3.0% in females, P < 0.01), with the values being above 20% in 26 (41%) of the 64 males compared with 10 (15%) of the 65 females (P < 0.01). Urinary flow rates, determined in 52 neonates, were significantly smaller in males than in females (mean +/- SD, 2.6 +/- 0.9 g/second vs. 3.8 +/- 1.3 g/second, respectively, P < 0.001). CONCLUSION: This voiding function study with ultrasound using noninvasive voiding-provocation maneuvers successfully revealed that male neonates have a larger residual urine volume and smaller urinary flow rates than female neonates. This study should be useful for the diagnosis of voiding dysfunction in children with abnormal urinary symptoms. (+info)
Increasing accuracy and decreasing latency during clean intermittent self-catheterization procedures with young children.
We examined the effects of simulation training on performance of clean intermittent self-catheterization procedures with 2 young girls. Simulation training was conducted, after which independent performance was assessed within a multiple baseline design. The training resulted in increased accuracy and decreased latency for both girls. (+info)
Renal medullary interstitial infusion of norepinephrine in anesthetized rabbits: methodological considerations.
We tested methods for delivery of drugs to the renal medulla of anesthetized rabbits. Outer medullary infusion (OMI) of norepinephrine (300 ng. kg(-1). min(-1)), using acutely or chronically positioned catheters, reduced both cortical (CBF; 15%) and medullary perfusion (MBF; 23-31%). Inner medullary infusion (IMI) did not affect renal hemodynamics, whereas intravenous infusion reduced CBF (15%) without changes in MBF. During OMI of [(3)H]norepinephrine, much of the radiolabel (approximately 40% with chronically positioned catheters) spilled over systemically. Nevertheless, autoradiographic analysis showed the concentration of radiolabel was about fourfold greater in the infused medulla than the cortex. In contrast, during IMI, only approximately 5% of the infused radiolabel spilled over into the systemic circulation and approximately 64% was excreted by the infused kidney. The resultant intrarenal levels of radiolabel were considerably less with IMI compared with OMI. In rabbits, OMI therefore provides a useful method for targeting agents to the renal medulla, but given the considerable systemic spillover with OMI, its utility is probably limited to substances that are rapidly degraded in vivo. (+info)