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Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...

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ASYMPTOMATIC BACTERIURIA AS A PREDICTOR OF PRE-ECLAMPSIA: A CASECONTROLLED STUDY.

A A Adeyemo1, O O Bello1,2, O C Idowu1

  • 1Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria.

Annals of Ibadan Postgraduate Medicine
|February 1, 2024
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Summary

Asymptomatic bacteriuria in pregnancy is linked to a higher risk of pre-eclampsia. This study found a significant association, suggesting it may be a contributing factor to this serious condition.

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Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Maternal Health

Background:

  • Pre-eclampsia is a major global cause of maternal and perinatal mortality.
  • Subclinical infections, including asymptomatic bacteriuria, are implicated in pre-eclampsia's development.
  • Asymptomatic bacteriuria is a common finding during pregnancy.

Purpose of the Study:

  • To investigate the relationship between asymptomatic bacteriuria and pre-eclampsia.
  • To determine if asymptomatic bacteriuria acts as a risk factor for developing pre-eclampsia.

Main Methods:

  • A hospital-based case-control study involving 28 pre-eclamptic women and 56 healthy pregnant women (controls).
  • Participants were at least 28 weeks of gestation.
  • Asymptomatic bacteriuria was diagnosed via mid-stream urine microscopy and culture; data collected through questionnaires and medical records.

Main Results:

  • A significant association was found between asymptomatic bacteriuria and pre-eclampsia.
  • Women with pre-eclampsia had approximately three times the rate of asymptomatic bacteriuria compared to controls (OR: 2.9).
  • After adjusting for confounders, the adjusted odds ratio remained significant (AOR: 1.23).

Conclusions:

  • The study supports asymptomatic bacteriuria as a risk factor for pre-eclampsia.
  • The causal nature of this association requires further investigation.
  • Additional research is needed to elucidate the relationship between asymptomatic bacteriuria and pre-eclampsia.