THE INFLUENCE OF PLACENTAL DRUG LAENNEC ON MOTOR FUNCTION OF THE BILIARY TRACT IN PATIENTS WITH FATTY DEGENERATION OF LIVER.

Non-alcoholic fatty liver disease (NAFLD) is one of the most urgent problems of modern medicine - is the subject of numerous studies, causing interest of different medical specialists This paper presents our own experience of supervision of patients with fatty degeneration of liver on the background of the application of human placenta extract - Laennec. We treated 11 patients with fatty degeneration of the liver and examined the motor-evacuation function of the hepa- tobiliary tract before and after treatment. The control group consisted of 50 healthy subject aged between 19 to 21 years. Laennec was administered intramuscularly to 2 ml a day, a course of 20 injections. Usage of placental drug Laennec has a stimulating influence on the processes of choleresis and bile secretion in patients with fatty degeneration of the liver, and normalizes the motility of the sphincter and contractility of the gall bladder.

[Prevention of malignant neoplasm of digestive organs].

Along with the growth of the overall disease incidence, the cancer incidence is constantly growing as well. Malignancies are diseases that lead to high mortality. This work covers one of the most important provisions of internal diseases--gastroenterology. It is known that the main work of healthcare professionals, therapists, is the diagnosis and treatment, and the second part of their work is prevention (primary, secondary and tertiary) of diseases and on this basis--prevention of malignant diseases. The search of precancerous diseases is always complicated, so it is advisable to create risk groups, which are observed in the dynamics. The Article helps to make the program not only of rational control, but also to designate a circle of the activities continuously replacing oncologic transformation of the observed pathology. The psychological condition of the patient in terms of impact of oncological process is included into the examination, as well as the role of health care professionals--therapist, oncologist and psychologist on the stabilization of the process of recovery and cancer patients.

[The use of tolterodine in patients with recurrent chronic cystitis].

The article presents the results of evaluation of effect of M-cholinoblocer tolterodine on the symptoms of lower urinary tract diseases (LUTD) and quality of life of patients with recurrent chronic cystitis. The study included 47 patients with chronic recurrent cystitis at acute stage with non-obstructive type of urination and LUTS. Group 1 included 23 women aged 45 to 56 years, who received tolterodine on the background of antibacterial therapy, taking into account the sensitivity of the isolated strain. Control group included 24 patients who received standard antibacterial therapy, also taking into account the sensitivity of the pathogen, and spasmolytics. The groups were almost homogeneous and did not differ on the basic characteristics. Analysis of the results of the study showed that tolterodine as a symptomatic therapy can reduce the time of rehabilitation. Therapy with tolterodine has shown clinical efficacy for 85.7% of women, has improved the quality of life by 24.8% compared with the control group, and provided relief of urgent and irritative symptoms in the short time.

[Preoperative correction of antihypertensive treatment in urological inpatients comorbid with arterial hypertension].

We studied preoperative correction of antihypertensive treatment in patients with urogenital diseases. The results of the study showed necessity of arterial pressure normalization in such patients especially before extracorporeal lithotripsy. Choice of hypotensive drugs after nephrectomy is specified.

[Detection of prostate cancer based on monitoring of prostate-specific antigen in outpatient clinic].

The study included 320 men with suspected prostate cancer (PC). The mean age was 59 years. The detection rate of prostate cancer depending on PSA level was evaluated. According to the results of histological examination, prostate cancer was detected in 32.8% (105 patients) of cases. The prostate cancer most frequently was diagnosed in patients with PSA levels above 20 ng/ml. Thus, the probability of detection of prostate cancer is directly dependent on the level of PSA. All groups showed signs of prostatic intraepithelial neoplasia (PIN), both low and high degrees, but the direct relationship of identification of PIN depending on PSA level was not established.

[Therapeutic efficacy of Triazavirin, a novel Russian chemotherapeutic, against influenza virus A (H5N1)].

Therapeutic activity of Triazavirin against experimental influenza A was studied on albino mice intranazally infected with influenza virus A/Chicken/Kurgan/Russia/02/05 (H5N1) vs. reference drugs (Oseltamivir, Remantadin and Arbidol). The study showed that in a therapeutic dose of 1 mg/kg Triazavirin was efficient in protection of the animals from death. Its protective therapeutic efficacy (36.7+/-1.7%) was close to that of Oseltamivir (50.0+/-0.0%), comparable with that of Remantadin (38.3+/-1.7%) and higher than that of Arbidol (11.7+/-1.7%). During the whole observation period (up to the terminal phase) Triazavirin inhibited the influenza virus A accumulation in the lungs of the infected albino mice by more than 3 lg.

[Phytotherapy in combined treatment of chronic infection of the upper urinary tract in patients exposed to extracorporeal shock-wave lithotripsy].

Multicomponent biologically active additive Uroprofit made by Russian company Ecomir is used for phytotherapy of urolithiasis and urogenital infectious and inflammatory processes. Of 60 patients with urolithiasis and chronic pyelonephritis exposed to extracorporeal shock-wave lithotripsy (ECSWL), 30 patients received additional anti-inflammatory therapy with Uroprofit. As shown by reduction of leukocyturia and crystalluria, increased 24-h diuresis in patients with urolithiasis after exposure to ECSWL, a positive effect was achieved on urethral inflammation. Thus, Uroprofit phytotherapy has antiinflammatory, diuretic, lithokinetic effects which makes it appropriate for treatment and prophylaxis of infectious-inflammatory process in the urethra.

[Combined treatment of patients with prostatic adenoma and overactive bladder].

Of late, we observe a trend to a progressive rise of overactive bladder (OB) morbidity with age. M-cholinolytic drugs are most effective in management of OB but old patients with prostatic adenoma (PA) and comorbid pathology have a risk of acute urinary retention and serious side effects. We have the experience in combined treatment of 30 old patients with PA and OB with M-cholinolytic and alpha-adrenoblocker. The results of the treatment show its efficacy and absence of complications in the control of residual urine for 3 months. Combination of M-cholinolytic with alpha-adreboblocker significantly reduced daily diuresis, improved an accumulation function of the bladder and life quality.

[Transurethral holmium enucleation of prostatic adenoma].

Laser (holmium) enucleation of the prostate (LEP) for infravesical obstruction caused by prostatic adenoma up to 60 cm3 in size was made in 42 patients in the Moscow city urological hospital N 47 from January to July 2009. Transurethral resection (TUR) of the prostate was made in 42 matched controls. All the patients from both groups have undergone the same standard clinical and laboratory examination before the treatment, 1, 3 and 6 months after it. Duration of surgery was shorter in the TUR group (42.4 +/- 26.1 min vs. 74.8 +/- 39.7 min). Washing system operated longer in the TUR group (23 +/- 7 vs. 10 +/- 5 h). The LEP group patients stayed in the hospital for much shorter time (3.1 +/- 1.2 days vs 4.6 +/- 1.8 days). No significant differences between the groups by basic postoperative parameters were found 1, 3 and 6 months after the operation. Postoperative complications were rare in both groups. Hemorrhagic complications were absent in the LEP group. This makes it possible to recommend LEP for patients with coagulopathy. Trauma of the bladder occurred in 1 case of LEP because of a complicated technique of LEP and the absence of conventional endoscopic reference points characteristic for TUR. Thus, our initial experience with transurethral LEP in comparison with TUR leads us to the conclusion that LEP is effective and safe in surgical treatment of patients with prostatic adenoma. Further gain of experience with LEP conduction may make this method alternative to open adenomectomy.

[Postoperative lesions of the gastrointestinal tract--actual problem of modern urology].

THE AIM: To study the prevalence of diseases of the upper gastrointestinal tract in urological profile patients. MATERIALS AND METHODS: Retrospective analyses of 1960 esophagogastroduodenoscopy were performed in the Clinical Urological Hospital No 47 for the period 2004-2010. THE RESULTS: Ezogofago gastroduodenoscopy in CUH No 47 is performed at an average 3.8% of patients, the acute erosive and ulcerative lesions of the gastrointestinal tract are detected at an average of 50.7% of patients; most often acute erosive and ulcerative lesions of the upper gastrointestinal tract occur in the prostate adenoma, prostate tumors, kidney, bladder, as well as nephrolithiasis, complicated by active pyelonephritis; 94.4% of total accounts of all identified exacerbations are peptic ulcer and stress ulcer; the greatest risk of ulcer complications accompanied by cystectomy, prostatectomy, nefroektomy performed for oncologic indications (respectively 59.6%, 53.7%, 18.2%). CONCLUSION: The urological oncology organ removing interventions are accompanied by a high probability of postoperative complications of ulcers, and the mere presence of malignancy appears as specific, significant risk factor.

[Duodenal intubation: present view (on the occasion of the 100th anniversary of duodenal intubation)].

The paper presents the proceedings on the Symposium on the Occasion of the 100th Anniversary of Duodenal Intubation" at the 9th Congress of the Scientific Society of Gastroenterologists of Russia. Particular emphasis is laid on the significance of the clinical and experimental studies-based scientific discovery made by V. A. Galkin and A. S. Chechulin--the Galkin-Chechulin effect (the 1957 priority) for the detection and treatment of prestone stages of cholelithiasis. The steps for improving the bile examination techniques at duodenal intubation (V. A. Galkin, L. S. Korzyuk, V. A. Maksimov, A. A. Ilyechenko) are described. Duodenal intubation as the method of choice for bile examination is proposed to be included into the mandatory diagnostic standards.

[Prophylactic and therapeutic efficacies of Ingavirin, a novel Russian chemotherapeutic, with respect to influenza pathogen A (H5N1)].

The experimental study of the Ingavirin efficacy against the influenza virus A (H5N1) on intranasally-infected albino mice vs. Tamiflue and Arbidol showed that when used for the prophylaxis, urgent prophylaxis and therapy it was effective in the protectiom of the animals from death. The efficient dose for the prophylaxis of the influenza infection was 5 mg/kg (protective efficacy of 46.7%) and for the urgent prophylaxis and therapy it was 15 mg/kg (protective efficacy of 40.0 and 35.0% respectively).

[Interferon inductor cupping of postvaccinal complications after variolation].

Efficacy of arbidol and ridostin in cupping postvaccinal complications due to variolation was studied by the clinico-virological, hematological and biochemical indices and it was shown that arbidol was efficient in cupping development of dermal complications, lowered the severity of the postvaccinal reaction and stimulated the cellular and humoral immune response. Ridostin, a high molecular interferon inductor, was highly efficient in cupping all the forms of the postvaccinal complications, including the neurological and cutaneous ones.

[Triazavirin prophylactic efficacy against influenza virus A (H5N1)].

The experimental study of the prophylactic efficacy of Triazaverin against the experimental form of the influenza virus A (H5N1) on albino mice intranasally infected with the influenza virus A/Chicken/Kurgan/Russia/02/05 vs. the reference drugs Tamiflu, Remantadin and Arbidol showed that in doses of 1 to 100 mg/kg it was efficient in the animal protection from death. The drug was also efficient in the urgent prophylaxis. Triazaverin effectively inhibited the influenza A virus multiplication in the lungs of the albino mice.

[Current status of antibiotic resistance of pyelonephritis causing pathogens].

The article gives the analysis of frequent clinical situations arising in empiric therapy of pyelonephritis alone and accompanied with other severe diseases such as decompensated diabetes mellitus, chronic renal insufficiency, HIV infection. The choice of antibacterial drugs for empiric therapy of pyelonephritis is based on the results of the tests for antibiotic resistance of pyelonephritis causing agents, pharmacokinetic and pharmacodynamic studies. Present-day standards and recommendations of leading centers of pyelonephritis empiric therapy are reviewed.

[Management of urological patients with HIV infection].

The analysis of urological care for HIV infected patients treated in Moscow city clinical hospital N 47 covers 12-year trends in hospitalization of HIV-infected urological patients, their nosological distribution, statistics of surgical outcomes. The highest efficacy of empiric antibacterial therapy of acute pyelonephritis in HIV-infected patients was seen in combined administration of fluorofloxacin of the second generation (ofloxacin) and nitroimidasol (metronidasol). Specific features of pharmacokinetics and interaction of antiretroviral drugs with medicines used in urological practice are analysed.

[First experience with outpatient shock-wave lithotripsy].

Clinical experience with administration of extracorporeal shock wave lithotripsy (ESWL) in an outpatient clinic demonstrates feasibility of urolith fragmentation in some patients using certain lithotriptors. Concrements can be removed from about 97.0% patients without their hospitalization.

[Lantox treatment of neurogenic dysfunction of the bladder].

We studied correction of micturition disorders in 9 patients with neurogenic dysfunction of the bladder resistant to conservative treatment. Four patients had neurogenic detrusor hyperactivity and 5 patients had detrusor-sphincter dyssynergia. Injections of botulinic toxin preparation (lantox) were made in the wall of the bladder under endoscopic control in detrusor neurogenic hyperactivity. Women with detrusor-sphincter dyssynergia received transperineal injections of lantox in the region of external urethral sphincter. Men received botulinic toxin directly into the region of external urethral sphincter in urethroscopy. Positive results were achieved in all the cases confirming high efficacy of the method.

[Tamsulosin administration for prophylaxis and treatment of stent-related symptoms].

The study of efficacy and safety of tamsulosin in therapy of stent-related symptoms has demonstrated that tamsulosin relieves stent-related irritative symptoms and improves quality of life. Further prospective trials are needed to finally assess tamsulosin efficacy.

[Using reverse genetics method for developing recombinant strains of influenza viruses acceptable for use as live attenuated vaccines].

Perspectives of using reverse genetics methods for constructing of recombinant influenza virus strains acceptable for use as live attenuated vaccines are discussed. Using of attenuated NS-vectors of influenza virus opens possibilities for the development of recombinant vaccines with optimal ratio of immunogenicity and safety. Reverse genetics is applicable for development of effective vaccines against new pathogens such as highly pathogenic avian influenza A/H5N1.