How I Healed my Urinary Tract Infection

UTI-Be-Gone By Sherry Han

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Uti be gone Natural Urinary Tract Infection Cure Summary

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Contribution of voltagegated sodium channels to the sensitization of visceral afferent neurones

Inflammation of visceral tissue may therefore modulate sodium currents in visceral afferent neurones and thereby produce sensitization of primary afferents. Recording intracellularly from the terminal endings is not possible with the methods available. However, experiments in DRGs isolated from animals with inflammation of the innervation target show that the expression of sodium currents in the soma is influenced by peripheral inflammation. Thus ileitis induced by instillation of trinitrobenzene sulfonic acid (TNBS) and cyclophosphamide cystitis produce an increase in excitability of isolated DRG neurones labelled from the inflamed viscus 17, 21 . This was manifested as a decrease in the threshold for action potential firing and an increase in the rate of depolarisation of TTX-resistant action potentials, suggesting an increase in TTX-resistant Na+ currents 17, 21 .

Solvents Not Widely Used for Topical Preparations

Dimethylsulphoxide is a universal solvent but can cause itching erythema and uticaria when applied to skin. However, it has been used medicinally in bladder instillations (at 50 in water) for interstitial cystitis, and is a vehicle for idoxuridine for herpes infections (though is of little value). Together with acetone, DMSO is a class 3 solvent under the FDA guidance, not known as a human health hazard at levels normally expected in pharmaceuticals and which can thus be limited by appropriate GMP practices.

Functional role of voltagegated sodium channels in visceral pain

In contrast, NaV1.8 null mice showed no differences from wild-type mice in the pain or referred hyperalgesia induced by cyclophosphamide cystitis 28 . Cyclophosphamide produces cystitis by gradual accumulation of toxic metabolites in the bladder, and thus is a model of tonic noxious chemical stimulation 30 . What accounts for the differential response of the NaV1.8 null mutants to these different visceral stimuli One possibility is that NaV1.8 is expressed in colon but not bladder afferents. However, the majority of both bladder and colon afferent neurons express TTX-resistant currents 18, 22 . Thus it seems likely that the difference in behaviour is due to the sensitizing nature of the stimulus. The NaV1.8 subunit appears to be essential for the expression of visceral pain behaviour generated by sensitization of visceral nociceptors, but not for either acute visceral pain responses or pain generated by a sustained tonic noxious input 28 .

Guidelines for Followup of Asymptomatic Patients

After nephrectomy, preservation of the residual kidney function is essential. Participation in contact sports, especially football, is not advised. Kidney guards are often recommended, although there is no data regarding their efficacy in injury prevention. More likely, the appliance serves to remind the individual of vulnerability. Although urinary tract infection should be treated aggressively in all patients, this is especially important in those with a single kidney or with renal dysfunction. To rule out obstruction,

Genital Tract Infections

In a university study of women with urethral syndrome who had sterile bladder urine, the etiology was found to be related to the presence or absence of pyuria. Infection with C. trachomatis was demonstrated in 62 of women with pyuria and 6 of women without (Stamm et al., 1980). In this report, pyuria was defined as fewer than eight leukocytes per ml of uncentrifuged midstream urine. N. gonorrhoeae was not found to be associated with the urethral syndrome in this population of university students. However, in indigent female populations attending emergency rooms, gonococcal infection was found to be significantly correlated with dysuria, accounting for 61 of the cases studied. C. trachomatis is probably the leading cause of urethral syndrome in female contacts of men with non-gonococcal urethritis (Paavonen et al., 1986), whereas both N. gonorrhoeae and C. trachomatis may be important among women who are at high risk of gonorrhea. HSV infections, though not commonly found among women...

Energy Metabolism Factors That Influence Energy Output

The amount of energy used to perform daily physical activities is normally about 25 per cent of the total energy expenditure, but it can vary markedly in different individuals, depending on the type and amount of physical activity. For example, walking up stairs requires about 17 times as much energy as lying in bed asleep. In general, over a 24-hour period, a person performing heavy labor can achieve a maximal rate of energy uti Because the level of physical activity is highly variable among different individuals, measurement of the BMR provides a useful means of comparing one person's metabolic rate with that of another. The usual method for determining BMR is to measure the rate of oxygen utilization over a given period of time under the following conditions

Evaluation of Overt Sequelae

The structure and function of the GU tract can be assessed by a variety of techniques. Simple screening methodologies include the history, with particular attention to urinary incontinence, urine volumes and urine character (bloody or foamy), as well as, the urinalysis. Creatinine clearance is a simple, cost-effective screen of kidney function. Structural abnormalities can be investigated by several tests, including ultrasound, IVP, CT scan and MRI. Retrograde studies may be useful for structural and functional evaluation of the bladder and ureters. Cystoscopy may be necessary to evaluate hematuria in the long-term survivor. In patients with late-onset hemorrhagic cystitis, cystoscopy may be useful to assess the degree of mucosal damage and to evaluate the etiology of the hematuria. Patients with late-onset hemor- rhagic cystitis are at risk for transitional cell carcinomas of the bladder that may be accompanied by hematuria. An IVP or retrograde study of the upper tracts may be...

Shortterm Prophylaxis Of Bacterial Infections In Hospitalized Cirrhotic Patients

The efficacy of SID with norfloxacin in preventing bacterial infections in cirrhotic patients with gastrointestinal hemorrhage was evaluated by Soriano et al. (34). In this study, 109 cirrhotic patients admitted to hospital with gastrointestinal hemorrhage and free of bacterial infection were included and randomized into two groups. Sixty patients received norfloxacin 400 mg b.i.d. orally or through a nasogastric tube during the first seven days of hospitalization beginning immediately after emergency gastroscopy, and 59 patients were control subjects. The incidence of bacterial infections (10 vs. 37.2 ), SBP and or bacteremia (3.3 vs. 16.9 ), and urinary infections (0 vs. 18.6 ) during the hospitalization period were significantly lower in patients receiving norfloxacin than in the control group, as a consequence of a decrease in the incidence of infections caused by aerobic gram-negative bacilli. The lower hospital mortality rate observed in norfloxacin-treated patients did not...

What Are The Possible Routes By Which Bacteria May Enter The Peritoneum

Second, bacteremia provides a logical common pathway for the great variety of bacteria encountered in patients with spontaneous peritonitis. Other routes of infection, such as unrecognized perforation of the intestinal or biliary tract, direct extension through the diaphragm or passage through the Fallopian tubes, however, must certainly occur. The majority of cases of spontaneous peritonitis can only be explained satisfactorily by the common denominator of a bacteremia. For example, the occurrence of pneumococcal peritonitis in a patient with pneumococcal pneumonia, of streptococcal peritonitis in a patient with erysipelas, or of E. coli peritonitis in a patient with a urinary tract infection caused by the same organism all have in common the bacteremia which delivers the organism to the ascitic fluid. One might thus expect to see spontaneous

Acute Bacterial Meningitis

Chronic urinary tract infection. y , 4 The most common gram- negative bacilli causing meningitis in the older adult are E. coli, Klebsiella pneumoniae, H. influenzae, Pseudomonas organisms, Enterobacter species, and Serratia species.y y 6 Listeria monocytogenes is an important causative organism of neonatal meningitis and of meningitis in patients that are diabetic, alcoholic, elderly, or immunosuppressed, especially transplant recipients. 2 Infection with L. monocytogenes may be acquired through the consumption of soft cheeses, raw vegetables, seafood, cole slaw, and undercooked chicken and delicatessen meats. The staphylococci are the etiological organisms of meningitis primarily in the neurosurgical patient. S. aureus and coagulase-negative staphylococci are the predominant organisms causing infections in patients with CSF shunts or subcutaneous Ommaya reservoirs.

Chemotherapy for Patients with Advanced STS

Currently, a doxorubicin-based regimen should be considered standard therapy for patients with advanced, unresectable STS. Unfortunately, treatment is limited by cardiomyopathy, which occurs in about 10 of patients, and can result in death. Cardiac toxicity can be diminished by giving the drug as a continuous infusion as opposed to a bolus, without comprising therapeutic efficacy. Ifosfamide is the most promising recent addition to the chemotherapeutic armamentarium for patients with stage IV disease. Ifosfamide is a cyclophosphamide analogue that is activated by hepatic microsomes. When used in combination with doxorubicin, response of 30-35 can be achieved.18 Hemorrhagic cystitis, the major toxicity of ifosfamide, can be prevented by use of the uroprotectant agent, mesna. Myelosuppression occurs with doxorubicin ifosfamide in combination but can be diminished with the use of human granulocyte-macrophage colony stimulating factor.

Potential To Affect Microbes Or Host Responses To Them

In addition, glycoproteins in the milk have N- and O-linked oligosaccha-ride chains that may possess receptor activity towards intestinal microbes. The mannose-containing N-linked oligosaccharide chains of secretory IgA are receptors for type 1-fimbriated E. coli9. The O-linked oligosaccharide chains ofthe IgA1 subclass are receptors forActinomyces naeslundii that are part of dental plaques10, and the very complex oligosaccharide chains of secretory component11 interact with Helicobacter pylori12as well as type 1 fimbriatedE. coli9. Other milk glycoproteins carry oligosaccharide receptors for Haemophilus influenzae8 or S-fimbriated E. coli13,, which are associated with urinary tract infection and neonatal sepsis meningitis14.

Radiation Therapy

Organ injury following RT is generally classified as acute (occurring during or soon after therapy) and late (occurring months to years following therapy). Whereas the acute effects are usually transient, late effects are usually progressive. Acutely, RT frequently causes irritation of the mucosa of the bladder and urethra (causing cystitis and urethritis) or of the vagina and vulva (causing pruritus and discomfort). These symptoms usually occur after approximately 20 Gy of radiation. Because almost all children receiving GU tract irradiation are also receiving chemotherapy, normal acute tissue toxicities are seen earlier than they would be seen without concurrent chemotherapy. Typically, cystitis occurs after three to four weeks of radiation, but it can occur after two weeks with concurrent therapy. Occasionally, some morbidity is seen after doses as low as 8-10 Gy. Acute injury of the kidney, prostate and uterus is generally not clinically apparent. The later effects of RT are...

Bladder

Bladder damage, including hemorrhagic cystitis, fibrosis and occasional bladder shrinkage, can occur following chronic administration of alkylating agents such as cyclophosphamide 33 and ifosfamide 34 . The metabolic byproducts of these drugs include acrolein (of the same chemical class as the aniline dyes), which is excreted in the urine and irritates the bladder mucosa. This leads to exposure of sub-mucosal blood vessels and subsequent bleeding 35 . Fortunately, drug-induced hemorrhagic cystitis and related fibrosis can nearly always be prevented by increased hydration during drug administration and the concomitant administration of intravenous or oral mercaptoethane sulfonate (MESNA). MESNA serves as a chemical sponge that binds the metabolites, thereby inactivating them and preventing their toxic action on the urothelium. Cyclophosphamide has also been associated with the induction of bladder tumors 36 . The interaction between RT and chemotherapy and their effects on hemorrhagic...

Therapy

Hemorrhagic cystitis may require cystoscopy and cauterization of bleeding sites. Persistent or refractory late-onset hemorrhagic cystitis may be treated with formalin instillation into the bladder. However, this procedure is not without risk. A complication rate as high as 14 has been reported using higher concentrations of formalin 62 . Hyperbaric oxygen has become widely used in the adult population and may be considered 63 . Severe bleeding may necessitate partial or total cystectomy, with reconstruction.

Diagnosis

Diagnosis of PE in clinical practice is not difficult and is based on patient self-report, clinical history and examination findings alone. Men with PE should be evaluated with a detailed medical and sexual history, a physical examination, and appropriate investigations, to establish the true presenting complaint and any identifying obvious biologic causes, such as genital or lower urinary tract infection. Treating physicians must interpret patient self-report of PE with some caution as both PE and non-PE men tend to somewhat overestimate their intravaginal ejacula-tory latency time (IELT) compared to stopwatch-recorded IELT. Pryor et al. reported that non-PE men, however, overestimate their IELT to a larger extent than PE men, and that IELT estimations for PE men correlate reasonably well with stopwatch-recorded IELT 24 . Although this observation has yet to be confirmed in other studies and differs from anecdotal observations of treating physicians, it does provide some evidence to...

Septicaemia

6.3 Urinary tract infection Urinary tract infection may occur after colonization of the periurethral area by intestinal bacteria, mainly E. coli, which subsequently spread to the urinary tract. P fimbriae are the major virulence associated trait for urinary tract infection - such adhesins bind to urinary tract epithelial cells which both facilitates colonization and triggers an inflammatory response93. P fimbriae are also a colonization factor in the human large intestine - E. coli expressing P fimbriae have better capacity to persist in the microflora than strains lacking such adhesin94-96 Susceptibility to urinary tract infection correlates with carriage of P-fimbriated strains in the intestinal microflora97. Breast-feeding is moderately protective against urinary tract infection (Table 1) and the effects lasts for some time after breast-feeding has ceased9899. There is therefore reason to believe that a modulation of the in Urinary tract infection

Clinical aspects

Because tetanus toxin does not affect sensory nerves or cortical function, the patient unfortunately remains conscious, in extreme pain and in anxious anticipation of the next tetanic seizure. These seizures are characterized by sudden, severe tonic contractions of the muscles, with fist clenching, flexion and adduction of the arms and hyperextension of the legs. Without treatment, the seizures range from a few seconds to a few minutes with intervening respite periods, but as the illness progresses the spasms become sustained and exhausting. The smallest disturbance by sight, sound or touch may trigger a tetanic spasm. Dysuria and urinary retention result from bladder sphincter spasm forced defecation may occur. Fever, with temperatures occasionally as high as 40 C, is common because of the substantial metabolic energy consumed by spastic muscles. Notable autonomic effects include tachycardia, arrhythmias, labile hypertension, diaphoresis, and cutaneous vasoconstriction. The tetanic...

Table 9 Continued

Males, age> 55 years, cigarette, pipe, and cigar smoking occupational exposures to aromatic amines metabolic polymorphism slow N-acetyltransferase phenotype chronic cystitis or urinary tract infections coffee drinking chlorinated tap water Anti-inflammatories (e.g. sulindac, Piroxicam, aspirin, ibuprofen) antiproliferatives (e.g. DFMO) retinoids (e.g. fenretinide)

Months

Patients are frequently submitted to aggressive diagnostic and therapeutic interventions, it is possible that some bacterial infections are related to the increased risk of infection associated with these invasive procedures. This fact may explain some episodes of urinary tract infection in patients with urinary catheters, of pneumonia in patients with tracheal intubation, and of gram-positive bacteremia in patients with central venous catheters. However, it is un-