• Title/Summary/Keyword: Acute cystitis

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Potentially Unnecessary Gastrointestinal Drug Use in Patients with Acute Cystitis (외래 급성 방광염 환자에서 잠재적으로 불필요한 위장약 사용)

  • Taeyeon Kim;Song Hyeon Jeon;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.8-21
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    • 2023
  • Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were prescribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion: The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

A Case of Intravesical Cidofovir Treatment of BK Virus-Associated Hemorrhagic Cystitis after Allogeneic Peripheral Blood Stem Cell Transplantation (동종말초조혈모세포이식 후 발생한 BK 바이러스 출혈성 방광염의 Cidofovir 방광 내 주입 치험 1례)

  • Kang, Seong-Hun;Lee, Hwa-Jeong;Jang, Ye-Su;Ji, Jun-Ho;Lee, Sun-Ah;Lee, Won-Sik;Lee, Jung-Lim;Lee, Kyung-Hee
    • Journal of Yeungnam Medical Science
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    • v.26 no.2
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    • pp.143-147
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    • 2009
  • Hemorrhagic cystitis (HC) is a common complication after allogeneic transplantation. Early posttransplant HC occurs in association with cyclophosphamide, while later on HC results from viral infections such as polyomavirus BK (BKV) and adenovirus. We report here the case of a 57-year-old woman who received an instillation of cidofovir into the bladder for the treatment of hemorrhagic cystitis after allogeneic peripheral stem cell transplantation for her acute myeloid leukemia. Cyclophosphamide and busulfan were used as conditioning treatments. Cyclosporin was administered daily. On the 71st day after transplantation, the patient developed acute severe hemorrhagic cystitis, and BK virus was demonstrated in the urine samples using polymerase chain reaction. Her urinary symptoms did not improve in spite of palliative treatment, but a response was evident after intravesical cidofovir treatment.

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Clinical Study of 25 Interstitial Cystitis Patients (간질성 방광염 환자 25예에 대한 임상적 고찰)

  • Son, Gi-Jeong;Oh, Hyeon-Jo;Lee, Jung-Gon;Nam, Seung-Kyu;Kim, Chul-Jung;Cho, Chung-Sik
    • The Journal of Internal Korean Medicine
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    • v.33 no.2
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    • pp.222-230
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    • 2012
  • Background : Interstitial cystitis is a disorder of the bladder characterized by urgency and frequency of urination, and pelvic pain. The cause of interstitial cystitis is not clear. Modern medical treatments include behavioral therapy, medication, intravesical infusion therapy, and surgical treatment, but the goal of treatment is based on symptom relief rather than a cure. According to a recent report, in an animal model, oriental medicine treatment, Yukmijihwang-tang improved the symptoms of interstitial cystitis. However, clinical studies and experimental research are lacking. Objectives : In this study, We investigated Chuknyojetong-tang, acupuncture, moxibustion and bee venom effect on interstitial cystitis. Methods : We targeted 25 patients diagnosed with interstitial cystitis at the university hospital and treated them for more than one month. We used acupuncture, Chuknyojetong-tang, and bee venom. The effects were evaluated using ICSI and ICPI at the begin of treatment and at the end of treatment. Results : All of the 25 patients were female, average age was $53.3{\pm}13.5$ years, and the average month of disease-duration was $69.0{\pm}59.8$. The duration of treatment was $8.0{\pm}5.4$ months, and 60% of patients were improved. After treatment, we used correlation coefficient method, multiple regression analysis. ICSI difference increased as treatment period increased. ICPI difference increased as age decreased. Total difference also increased as treatment period increased. These results imply that treatment effect was improved. Conclusions : These findings suggest that oriental medicine therapy using Chuknyojetong-tang, acupuncture, moxibustion, and bee venom would be very effective on interstitial cystitis.

Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study

  • Kumaran, Aswathy;Guruvare, Shyamala;Sharan, Krishna;Rai, Lavanya;Hebbar, Shripad
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4483-4486
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    • 2014
  • Purpose: To assess chemoradiation related acute morbidity in women with carcinoma cervix and to find and correlation between hematologic toxicity and organ system specific damage. Materials and Methods: A prospective study was carried out between August 2012 and July 2013 enrolling 79 women with cancer cervix receiving chemo-radiotherapy. Weekly assessment of acute morbidity was done using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4 and the toxicities were graded. Results: Anemia [77 (97.5%)], vomiting [75 (94.8%)] and diarrhea [72 (91.1%)], leukopenia [11 (13.9%)], cystitis [28 (35.4%], dermatitis [19 (24.1%)] and fatigue [29 (36.71%)] were the acute toxicities noted. The toxicities were most severe in $3^{rd}$ and $5^{th}$ week. All women could complete radiotherapy except two due to causes unrelated to radiation morbidity; seven (8.86%) had to discontinue chemotherapy due to leukopenia and intractable diarrhea. Though there was no correlation between anemia and other toxicities, it was found that all with leukopenia had diarrhea. Conclusions: Chemoradiation for cancer cervix is on the whole well tolerated. Leukopenia and severe diarrhea were the acute toxicities that compelled discontinuation of chemotherapy in two women. Though anemia had no correlation with gastrointestinal toxicity, all of those with leukopenia had diarrhea.

Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies

  • Bae, Sul-Hee;Han, Dong-Kyun;Baek, Hee-Jo;Park, Sun-Ju;Chang, Nam-Kyu;Kook, Hoon;Hwang, Tai-Ju
    • Clinical and Experimental Pediatrics
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    • v.54 no.4
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    • pp.169-175
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    • 2011
  • Purpose: Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. Methods: We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam$^{(R)}$ and/or Tornado$^{(R)}$ coils. Results: The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. Conclusion: SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.

New Insights for Febrile Urinary Tract Infection (Acute Pyelonephritis) in Children

  • Lee, Kyung-Yil
    • Childhood Kidney Diseases
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    • v.20 no.2
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    • pp.37-44
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    • 2016
  • Although asymptomatic bacteriuria, cystitis, and acute pyelonephritis (APN) have been categorized as urinary tract infections (UTIs), the immunopathogenesis of each disease is different. APN shows an age predilection; the majority of children (over 70-80%) with APN are under 1-2 years of age, with a male predominance. After 1-2 years of age, female predominance has been reported. This finding suggests that the immature immune state of infancy may be associated with the pathogenesis of APN. Escherichia coli is the most common etiologic agent; other uropathogens associated with UTIs originate from the host and comprise normal flora that are continuously altered by environmental factors. Therefore, uropathogens may have characteristics different from those of extraneous bacterial pathogens. Although antibiotic-resistant uropathogens, including extended-spectrum beta-lactamase-producing strains, are increasing in Korea and worldwide, treatment failure is rare in immune-competent children. The immunopathogenesis of APN remains unknown. Intact bacteria may not be the causative substances in renal cell injury; rather, smaller substances produced during bacterial replication may be responsible for renal cell injury and scarring. Moreover, substances from host cells such as proinflammatory cytokines may be involved in renal cell injury. A dimercaptosuccinic acid scan is used to detect the site of bacterial replication in the renal parenchyma, and may be influenced by the size of the focus and the stage of APN. Traditional aggressive studies used to identify vesicoureteral reflux after the first episode of APN have been modified because of rare cases of chronic kidney disease in patients with recurrent UTI.

Cytologic Findings of Polyomavirus Infection in the Urine - A Case Report - (Polyomavirus 감염의 요 세포학적 소견 - 1예 보고 -)

  • Kwon, Mi-Seon;Kim, Young-Shin;Lee, Kyo-Young;Choi, Yeong-Jin;Kang, Chang-Suk;Shim, Sang-In
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.192-196
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    • 1996
  • The principal significance of the urothelial changes caused by polyomavirus activation is in an erroneous diagnosis of urothelial cancer; however, the clue to their benign nature is the smooth structureless nuclear configuration and the relative paucity of affected cells. Though virologic studies and electron microscopy are usually needed to firmly establish the diagnosis, cytology is the most readily available and rapid means of establishing a presumptive diagnosis of human polyomavirus infection. A urine specimen of a 24-year-old man with hemorrhagic cystitis beginning two months after bone marrow transplantation for acute myeloblastic leukemia(M2) was submitted for cytologic evaluation. Cytologic findings revealed a few inclusion-bearing epithelial cells intermingled with erythrocytes, neutrophils, lymphocytes, and macrophages. Most of the inclusion-bearing fells had large, round to ovoid nuclei almost completely filled with homogeneous dark, basophilic inclusion. The chromatin was clumped along the periphery and the cytoplasm was mostly degenerated. The other cells exhibited irregular inclusions attached to the nuclear membrane surrounded by an indistinct halo. These findings were consistent with polyomavirus infection.

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Two Cases of Oriental Diagnosis and Treatment at the Patients with Urinary Tract Infection (요로감염에 대한 한의학적 변증치료 2례에 대한 임상보고)

  • Han, Jhee-Wan;Yim, Young-Nam;Ko, Ho-Yun;Park, Jung-Sup;Jung, Seung-Min;Kim, Dong-Woo;Han, Yang-Hee;Jun, Chan-Yong;Park, Jong-Hyung
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.373-382
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    • 2004
  • Cystitis and acute pyelonephritis(APN) are usually caused by ascending infection. Two cases of urinary tract infection(UTI) were encountered. Because antibiotics might cause some adverse reactions such as diarrhea, eruption, anorexia, nausea and vomiting, so Korean Traditional Medicine has been applied to UTI, and several reports can be found in the literature. This study was performed on two patients with UTI who were treated with herbal medicine, acupuncture and moxibustion. Noteworthy results were obtained in hematology and urinalysis. UTI symptoms, signs and laboratory findings are indicative of successful treatment. Results suggests that Korean Traditional Medicine applied to UTI is effective. These findings are reported with a brief review of related literature.

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Intensity-modulated Radiotherapy Combined with Endocrine Therapy for Intermediate and Advanced Prostate Cancer: Long-term Outcome of Chinese Patients

  • Luo, Hua-Chun;Cheng, Hui-Hua;Lin, Gui-Shan;Fu, Zhi-Chao;Li, Dong-Shi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4711-4715
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    • 2013
  • Aim: The aim of this study was to evaluate acute adverse events and efficacy of three-dimensional intensitymodulated radiotherapy (IMRT) combined with endocrine therapy for intermediate and advanced prostate cancer. Methods: Sixty-seven patients were treated with three-dimensional IMRT combined with maximum androgen blockade. The correlation between radiation-induced rectal injury and clinical factors was further analyzed. Results: After treatment, 21 patients had complete remission (CR), 37 had partial remission (PR), and nine had stable disease (SD), with an overall response rate of 86.5%. The follow-up period ranged from 12.5 to 99.6 months. Thirty-nine patients had a follow-up time of ${\geq}$ five years. In this group, three-year and five-year overall survival rates were 89% and 89.5%, respectively; three-year and five-year progression-free survival rates were 72% and 63%. In univariate analyses, gross tumor volume was found to be prognostic for survival ($X^2$ = 5.70, P = 0.037). Rates of leucopenia and anemia were 91.1% and 89.5%, respectively. Two patients developed acute liver injury, and a majority of patients developed acute radiation proctitis and cystitis, mainly grade 1/2. Tumor volume before treatment was the only prognostic factor influencing the severity of acute radiation proctitis (P < 0.05). Conclusions: IMRT combined with endocrine therapy demonstrated promising efficacy and was well tolerated in patients with intermediate and advanced prostate cancer.

Diagnosis and Treatment of Benign Prostate Hyperplasia in a Shih-tzu dog (Shih-tzu견에서 발생한 전립선 비대증 진단 및 치료 1례)

  • 김방실;황순신;박철호;오기석;손창호
    • Journal of Veterinary Clinics
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    • v.21 no.2
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    • pp.200-204
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    • 2004
  • A 3-year-old, male Shih-tzu dog with clinical signs of dysuria and hematuria was brought to the Veterinary Teaching Hospital. Chonnam National University. The patient was suspected urolithiasis by history taking and clinical signs but urinary and urethra calculus was not found in the radiographic examination. Enlarged prostatic gland (29.0$\times$28.0 mm) and severe finding of cystitis was observed from the ultrasonographic examination. The dog was finally diagnosed as the secondary urethral obstruction by benign prostatic hyperplasia. Castration was performed to treatment of acute hyperplasia of prostatic gland and prostatic cysts. After 26 days of operation, the prostate was defined small, hypoechoic, symmetric and decreased size (18.5$\times$18.0mm) by ultrasonography and dysuria cured completely.