Urinary Tract Infections

Urinary Tract Infections (UTIs)
What are urinary tract infections (UTIs)?
Urinary tract infections are a serious, but common, health problem that affects millions of people each year. With the reason remaining unclear, women are especially prone to urinary tract infections.
What causes urinary tract infections?Normal urine is sterile and contains fluids, salts, and waste products. It is free of bacteria, viruses, and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra, the hollow tube that carries urine from the bladder to the outside of the body, and begin to multiply.
Most infections arise from Escherichia coli (E. coli) bacteria, which normally live in the colon.
What are the different types of urinary tract infections?
A urinary tract infection may involve different sections of the urinary tract including the following:
urethritis - an infection of the urethra, the hollow tube that drains urine from the bladder to the outside of the body.
cystitis - a bacterial infection in the bladder that often has moved up from the urethra.
pyelonephritis - an infection of the kidneys that is usually a result of an infection that has spread up the tract, or from an obstruction in the urinary tract. An obstruction in the urinary tract causes urine to back flow into the ureters and kidneys.
What are the symptoms of a urinary tract infection?
The following are the most common symptoms of a urinary tract infection. However, each individual may experience symptoms differently. Symptoms may include:
frequent urination
a painful, burning feeling during urination
fever
urine appears cloudy or reddish in color (blood may be present in the urine)
feeling pain even when not urinating
fatigue
pain in the back or side, below the ribs
nausea and/or vomiting
despite an intense urge to urinate, only a small amount of urine is passed
women may feel an uncomfortable pressure above the pubic bone
The symptoms of a urinary tract infection may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How are UTIs diagnosed?
In addition to a complete medical history and physical examination, diagnostic tests and procedures may include the following:
urinalysis - laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
intravenous pyelogram (IVP) - a series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein - to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
cystoscopy (Also called cystourethroscopy.) - an examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.
renal ultrasound - a non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.
Treatment for UTIs:Specific treatment for UTIs will be determined by your physician based on:
your age, overall health, and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference
Treatment may include:
antibacterial medications
other medications and/or a heating pad to relieve pain
behavior modifications, including the following:
Drink plenty of water to help cleanse the urinary tract of bacteria.
Avoid coffee, alcohol, and spicy foods.
Quit smoking.
Preventing future urinary tract infections:
To reduce the likelihood of developing another UTI, a patient may consider the following:
Drink plenty of water every day.
Drink cranberry juice. Large amounts of vitamin C inhibits the growth of some bacteria by acidifying the urine. Vitamin C supplements have the same effect.
Urinate when you feel the need and do not resist the urge to urinate.
Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
Take showers instead of tub baths.
Cleanse the genital area before/after sexual intercourse.
Avoid using feminine hygiene sprays and scented douches.

Kidney Stones

Kidney Stones

What is a kidney stone?
A kidney stone is a solid piece of material that forms from crystallization of excreted substances in the urine. The stone may remain in the kidney or break loose and travel down the urinary tract. A small stone may pass all of the way out of the body, but a larger stone can get stuck in a ureter, the bladder, or the urethra. This may block the flow of urine and cause great pain.

A kidney stone may be as small as a grain of sand or as large as a pearl, and some are as big as golf balls. Approximately 80 percent of kidney stones are less than 2 centimeters in width.

They may be smooth or jagged, and are usually yellow or brown in color.

Who is affected by kidney stones?
Kidney stones are one of the most painful disorders, and one of the most common disorders of the urinary tract. It is estimated that 10 percent of all people in the United States will have a kidney stone at some point in time.

Consider the following statistics:

• Caucasians are more prone to kidney stones than are African-Americans.
• Although stones occur more frequently in men, the number of women who develop kidney stones has been increasing.
• Kidney stones strike most people between the ages of 20 and 40.
• Once a person develops more than one stone, he/she is more likely to develop additional stones.

What are some of the different types of kidney stones?
A kidney stone develops from crystals that separate from urine and build up on the inner surfaces of the kidney. Normally, urine contains chemicals that prevent or inhibit the crystals from forming, however, in some people, stones still become formed. Crystals that remain small enough will travel through the urinary tract and pass out of the body in the urine without even being noticed.

Calcium Stones

Calcium stones are the most common type of stones. Calcium is a normal part of a healthy diet and is used by bones and muscles. Calcium not used by the body goes to the kidneys where it is normally flushed out with the rest of the urine. In some people, however, the calcium that stays behind joins with other waste products to form a stone.

Struvite Stones

Struvite stones are a type of stone that contains the mineral magnesium and the waste product ammonia. It may form after an infection in the urinary system.

Uric Acid Stones

Uric acid stones may form when there is too much acid in the urine.

Cystine Stones

Cystine stones consist of cystine, one of the building blocks that make up muscles, nerves, and other parts of the body, can build up in the urine and form a stone. Cystine stones are rare. The disease that causes cystine stones (cystinosis) runs in families.

What are the symptoms of kidney stones?
The following are the most common symptoms of kidney stones. However, each individual may experience symptoms differently. Symptoms may include:

• extreme, sharp pain in the back or side that will not go away
• blood in the urine
• nausea and vomiting
• cloudy or odorous urine
• frequent urination
• a burning feeling when you urinate
• fever and chills

Prompt medical attention for kidney stones is necessary.
The symptoms of kidney stones may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
How are kidney stones diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for kidney stones may include the following:
intravenous pyelogram (IVP) - a series of x-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein - to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
urinalysis - laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.
blood tests - laboratory examination of the blood to detect substances that might promote stone formation.
renal ultrasound - a non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction in the kidney.

Treatment for kidney stones:

Specific treatment for kidney stones will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Some kidney stones pass out of the body without any intervention by a physician. In cases that cause lasting symptoms or other complications, kidney stones may be treated with various techniques, including the following:

• Shock waves or extracorporeal shock wave lithotripsy (ESWL) - use of a machine to send shock waves directly to the kidney stone to break a large stone into smaller stones that will pass through the urinary system. There are two types of shock wave machines: with one machine, the patient sits in a tub of water, with the other, the patient lies on a table.
• Ureteroscope - a long wire with a camera attached to it is inserted it into the patient's urethra and passed up through the bladder to the ureter where the stone is located. A cage is used to obtain the stone and remove it.
• Tunnel surgery (Also called percutaneous nephrolithotomy.) - a small cut is made in the patient's back and a narrow tunnel is made through the skin to the stone inside the kidney. The physician can remove the stone through this tunnel.
  

Preventing Kidney Stones
According to the National Kidney and Urologic Diseases Foundation, the best ways to prevent kidney stones are the following:

• Drink more water. Up to 12 full glasses of water a day can help to flush away the substances that form stones in the kidneys. Ginger ale, lemon-lime sodas, and fruit juices are acceptable.
• Limit coffee, tea, and cola to one or two cups a day. The caffeine may cause a rapid loss of fluid.
• Consult your physician regarding dietary modifications.
• Medications may be prescribed to prevent calcium and uric acid stones from forming.
  

VITAL SIGNS - HUMAN BODY

Vital Signs
What are vital signs?
Vital signs are measurements of the body's most basic functions. The four main vital signs routinely monitored by medical professionals and healthcare providers include:

• Body temperature
• Pulse rate
• Respiration rate (rate of breathing)
• Blood pressure (Blood pressure is not considered a vital sign, but is often measured along with the vital signs.)

Vital signs are useful in detecting or monitoring medical problems.
Vital signs can be measured in a medical setting, at home, at the site of a medical emergency, or elsewhere.

What is body temperature?
The normal body temperature of a person varies depending on gender, recent activity, food and fluid consumption, time of day, and, in women, the stage of the menstrual cycle. Normal body temperature, according to the American Medical Association, can range from 97.8° F (or Fahrenheit, equivalent to 36.5° C, or Celsius) to 99° F (37.2° C).
A person’s body temperature can be taken in any of the following ways:
What is fever?
Fever (also called pyrexia) is defined as body temperature that is higher than normal for each individual. It generally indicates that there is an abnormal process going on within the body. The severity of a condition is not necessarily reflected by the degree of fever.

For example, influenza may cause a fever of 104° F, while pneumonia may cause a very low-grade fever or no fever at all. Consult with your physician if you have any questions about whether a fever is significant.
OrallyTemperature can be taken by mouth using either the classic glass mercury-filled thermometer or the more modern digital thermometers that use an electronic probe to measure body temperature.
RectallyTemperatures taken rectally (using a mercury or digital thermometer) tend to be 0.5 to 0.7° (Fahrenheit) higher than when taken by mouth.
AxillaryTemperatures can be taken under the arm using a mercury or digital thermometer. Temperatures taken by this route tend to be 0.3 to 0.4° (Fahrenheit) lower than those temperatures taken by mouth.
By ear a special thermometer can quickly measure the temperature of the ear drum, which reflects the body’s core temperature (the temperature of the internal organs).

Body temperature may be abnormal due to fever (high temperature) or hypothermia (low temperature). A fever is indicated when body temperature rises above 98.6° F orally or 99.8° F rectally, according to the American Medical Association. Hypothermia is defined as a drop in body temperature below 95° F.

What is the pulse rate?
The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Taking a pulse not only measures the heart rate, but also can indicate:

1. Heart rhythm
2. Strength of the pulse

The normal pulse for healthy adults ranges from 60 to 100 beats per minute. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men. Athletes, such as runners, who do a lot of cardiovascular conditioning, may have heart rates in the 40's and experience no problems.
How to check your pulse:

As the heart forces blood through the arteries, you feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body. The pulse can be found on the side of the lower neck, on the inside of the elbow, or at the wrist. When taking your pulse:
Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse.
Begin counting the pulse when the clock’s second hand is on the 12.
Count your pulse for 60 seconds (or for 15 seconds and then multiply by four to calculate beats per minute).
When counting, do not watch the clock continuously, but concentrate on the beats of the pulse.
If unsure about your results, ask another person to count for you.
If your physician has ordered you to check your own pulse and you are having difficulty finding it, consult your physician for additional instruction.

What is the respiration rate?

The respiration rate is the number of breaths a person takes per minute. The rate is usually measured when a person is at rest and simply involves counting the number of breaths for one minute by counting how many times the chest rises. Respiration rates may increase with fever, illness, and with other medical conditions. When checking respiration, it is important to also note whether a person has any difficulty breathing.
Normal respiration rates for an adult person at rest range from 15 to 20 breaths per minute. Respiration rates over 25 breaths per minute or under 12 breaths per minute (when at rest) may be considered abnormal.

What is blood pressure?

Blood pressure, measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider, is the force of the blood pushing against the artery walls. Each time the heart beats, it pumps blood into the arteries, resulting in the highest blood pressure as the heart contracts. One cannot take his own blood pressure unless an electronic blood pressure monitoring device is used. Electronic blood pressure monitors may also measure the heart rate, or pulse.
Two numbers are recorded when measuring blood pressure. The higher number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body. The lower number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood. Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column is raised by the pressure of the blood.
High blood pressure, or hypertension, directly increases the risk of coronary heart disease (heart attack) and stroke (brain attack). With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.

According to the American Heart Association, high blood pressure for adults is defined as:
140 mm Hg or greater systolic pressure
and/or
90 mm Hg or greater diastolic pressure
These numbers should be used as a guide only. A single elevated blood pressure measurement is not necessarily an indication of a problem. Your physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension (high blood pressure) and initiating treatment. A person who normally runs a lower-than-usual blood pressure may be considered hypertensive with lower blood pressure measurements than 140/90.