[Prevention of the development of catheter-associated urinary system infections in the early postoperative period].

BACKGROUND: Bladder catheterization is a common medical manipulation that is associated with the risk of complications, including catheter-associated urinary tract infection (CAUTI), which accounts for 80% of all nosocomial infections of the urological profile. AIM: To evaluate the combined use of the biologically active additive Uronext and ceftriaxone in the prevention of the development of CAUTI in the early postoperative period in 120 patients aged 20-80 years with a Foley indwelling catheter. MATERIALS AND METHODS: The patients were divided into 2 groups: in group I (n=60), D-mannose with cranberry extract and vitamin D3 as part of Uronext dietary supplement was administered orally in the form of sachets 48 hours before surgery and after surgery until urethral catheter was placed, as well as intravenous ceftriaxone 1000 mg 2 hours before surgery and in the postoperative period within 7 days. In group II (n=60), ceftriaxone monotherapy was prescribed in a similar way. RESULTS: According to the results of bacteriological examination of the removed urinary catheter on 3-7 days in Uronext group, bacterial growth was absent in 40 patients (66.67%, p<0.05), versus 23 cases (38.33%) in the control group. CONCLUSIONS: The data obtained confirm the efficiency of the use of the biologically active additive Uronext in combination with an antibacterial drug, which allows to recommend this scheme in patients with an indwelling urinary catheter for the prevention of the development of CAUTI.

[Minimally invasive surgery with therapeutic effect in cancer patients].

During recent years ablative technologies have become very popular in tumor treatment. They are used in treatment for inoperable primary and metastatic tumors of the liver and the lung and also localized renal tumors of small sizes. The most studies on thermoablation in oncology are focused on the evaluation of tissue destruction and optimization of physical mechanisms, while potential mechanisms of immune response in thermoablation are still far from understanding. This study shows that with thermoablation of tumor within one month after the procedure the formation of a protective immune response is observed by increasing the content of activated T-helpers and cytotoxic T-lymphocytes.

[Using dietary supplement containing dietary fiber, fermented wine yeasts, vitamins and minerals, under the influence of dust-gas mixture. The experiments on laboratory animals].

In chronic experiment in rats pro for show, what of food biologically active "Rekitsen-RD", promotes increase of efficiency of mechanisms of detoxication, antioxidant activity and immune protection of an organism.

[Efficacy of ciprofloxacine antibiotic prophylaxis of infectious complications after TUR of the prostate].

We compared efficacy of preoperative prophylactic antibiotic treatment (PPAT) with cyprofloxacine used orally (0.5 g), intravenously (0.4 g) and routine antibiotics in TUR of the prostate. A multicenter open randomized study covered 120 patients. PPAT efficacy was estimated by the rate of urinary infection (UI), frequency and duration of antibiotic treatment in the postoperative period, hospitalization duration. All the patients were divided into three groups: 39 patients of group 1 received oral cyprofloxacine 90-120 min before TUR of the prostate, 38 patients of group 2 received intravenous cyprofloxacine 30-60 min before TUR, 43 patients of group 3 (control) received routine antibiotic prophylaxis. The following results were obtained: 24-48 hours after the operation no cases of UI in group 1, 11.5 and 11.6% in groups 2 and 3, respectively, (p = 0.048); 7 days after TUR--UI in all the groups (2.6, 20, 23.3%, respectively); 14 days after TUR--UI in 5.1, 28.6, 27.9% patients, respectively. Mean duration of hospital stay was 11.7 +/- 7.6 days in group 1, 12.1 +/- 8.1 days in group 2, 12.5 +/- 7.8 days in group C (p > 0.05). Postoperative antibiotics were given to 16.7, 34.1 and 68.9% patients, respectively. Thus, cyprofloxacine in group 1 lowered UI risk and postoperative antibiotics significantly, in group 2 it had no influence on UI rate but reduced postoperative antibiotics significantly.

[Antibacterial therapy of complicated urinary infections in outpatients]. / Antibacterial'naia terapiia oslozhnennykh infektsii mochevyvodiashchikh putei.

The term complicated urinary infections (CUIs) includes infections developing in the presence of anatomic anomalies, metabolic or hormonal disorders, immunodeficiency or infection with atypical microorganisms. Complicating factors diminish efficiency of antibiotic treatment, raise probability of recurrence. CUIs account for 45.2% of all cases of outpatient urinary infections in adults in Russia. Nephroliths, diabetes mellitus and renal cysts are most prevalent complicating factors. CUIs causative agents' spectrum is wider and resistance bacteria isolation is more frequent compared to uncomplicated urinary infections. In addition to antibiotic therapy, CUIs treatment should be focused on detection and elimination of the complicating factor. If complicating factors are unremovable, antibiotic therapy should be directed to management of clinical symptoms of urinary infection, prevention of complications and damage to renal parenchyma. CUIs demand longer courses of antibiotics than uncomplicated urinary infections: 7-14 days in infection of the lower urinary tracts, at least 14 days in infection of the upper urinary tracts and 4-6 weeks in failure of the standard course. Fluoroquinolones are drugs of choice in adults.

[Caudal epidural anesthesia for transurethral resection of benign hyperplasia of prostate]. / Kaudal'naia épidural'naia anesteziia pri transuretral'noi rezektsii dobrokachestvennoi giperplazii predstatel'noi zhelezy.

Caudal epidural anesthesia was used as a basic method of anesthesia in 300 elderly patients for transurethral resection of prostate adenoma. There were no complications during and after operation in spite of frequent concomitant diseases in these patients.