RESUMEN
Current international and Russian clinical guidelines recommend treating asymptomatic bacteriuria in pregnancy to prevent acute gestational pyelonephritis. At the same time, the growing resistance of uropathogens and the risks associated with antibiotic therapy in pregnancy dictate the need to limit the use of antibiotics and seek alternative approaches to antibacterial therapy. MATERIALS AND METHODS: A retrospective analysis was performed on 60 pregnant women who received either a standard antibiotic regimen (n=32) or the herbal preparation Canephron N (n=28). The primary outcomes were the incidence of symptomatic infections (cystitis or pyelonephritis), premature birth and low birth weight delivery, and incidence of persistent/recurrent bacteriuria. RESULTS: In the group of antibiotic therapy, one patient developed cystitis and three had pyelonephritis; in the Canephron N group, cystitis occurred in one patient, no pyelonephritis cases were observed. Among the whole study cohort (n=60), the incidence of symptomatic infections and pyelonephritis was 8.3 and 5.0%, respectively. The incidence of symptomatic infections (cystitis, pyelonephritis) did not differ statistically significantly between the study groups (p=0.2157). There were three and one premature births in the group of antibiotic therapy and the Canephron N group, respectively (p=0,373), and two low birth weight deliveries in each group (p=0.891). Recurrent bacteriuria was registered in 17 patients from the group of antibiotic therapy and in three in the Canephron N group (p=0.0006). CONCLUSIONS: The management of asymptomatic bacteriuria in pregnancy using Canephron N is not inferior to standard antibiotic therapy regarding the incidence of symptomatic infection, premature birth, and low birth weight delivery. Persistent/recurrent bacteriuria was more common in women receiving the antibiotic therapy.
Asunto(s)
Antibacterianos/uso terapéutico , Bacteriuria/tratamiento farmacológico , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Adulto , Bacteriuria/epidemiología , Bacteriuria/microbiología , Cistitis/epidemiología , Cistitis/prevención & control , Infecciones por Enterobacteriaceae/epidemiología , Infecciones por Enterobacteriaceae/microbiología , Femenino , Humanos , Incidencia , Recién Nacido de Bajo Peso , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , Nacimiento Prematuro/epidemiología , Pielonefritis/epidemiología , Pielonefritis/prevención & control , Estudios Retrospectivos , Federación de Rusia , Adulto JovenRESUMEN
Liquid 4He becomes superfluid and flows without resistance below temperature 2.17 K. Superfluidity has been a subject of intense studies and notable advances were made in elucidating the phenomenon by experiment and theory. Nevertheless, details of the microscopic state, including dynamic atom-atom correlations in the superfluid state, are not fully understood. Here using a technique of neutron dynamic pair-density function (DPDF) analysis we show that 4He atoms in the Bose-Einstein condensate have environment significantly different from uncondensed atoms, with the interatomic distance larger than the average by about 10%, whereas the average structure changes little through the superfluid transition. DPDF peak not seen in the snap-shot pair-density function is found at 2.3 Å, and is interpreted in terms of atomic tunnelling. The real space picture of dynamic atom-atom correlations presented here reveal characteristics of atomic dynamics not recognized so far, compelling yet another look at the phenomenon.
RESUMEN
Neutron diffraction studies of metallic liquids provide valuable information about inherent topological and chemical ordering on multiple length scales as well as insight into dynamical processes at the level of a few atoms. However, there exist very few facilities in the world that allow such studies to be made of reactive metallic liquids in a containerless environment, and these are designed for use at reactor-based neutron sources. We present an electrostatic levitation facility, NESL (for Neutron ElectroStatic Levitator), which takes advantage of the enhanced capabilities and increased neutron flux available at spallation neutron sources (SNSs). NESL enables high quality elastic and inelastic neutron scattering experiments to be made of reactive metallic and other liquids in the equilibrium and supercooled temperature regime. The apparatus is comprised of a high vacuum chamber, external and internal neutron collimation optics, and a sample exchange mechanism that allows up to 30 samples to be processed between chamber openings. Two heating lasers allow excellent sample temperature homogeneity, even for samples approaching 500 mg, and an automated temperature control system allows isothermal measurements to be conducted for times approaching 2 h in the liquid state, with variations in the average sample temperature of less than 0.5%. To demonstrate the capabilities of the facility for elastic scattering studies of liquids, a high quality total structure factor for Zr64Ni36 measured slightly above the liquidus temperature is presented from experiments conducted on the nanoscale-ordered materials diffractometer (NOMAD) beam line at the SNS after only 30 min of acquisition time for a small sample (â¼100 mg).
RESUMEN
Remaining generally unchanged, urinary tract infection (UTI) treatment protocols require continuing monitoring due to growing antibiotic resistance and lowered immune status of the majority of patients. The article presents the results of a prospective observational program carried out the Russian Federation in to assess the effectiveness and safety of Ceforal®, Solutab® and Uro-Vaksom® in patients with recurrent uncomplicated lower urinary tract infections (FLORA). The results of the program suggest that Ceforal® Solutab® and Uro-Vaksom® administered as a part of routine clinical practice contribute to a significant reduction in the number of UTI recurrences and have a good safety profile. These findings support recommendation to use this treatment protocol in patients with recurrent UTI, taking into account individual and epidemiological features.
Asunto(s)
Aciclovir/administración & dosificación , Antibacterianos/administración & dosificación , Antivirales/administración & dosificación , Cefixima/administración & dosificación , Infecciones Urinarias/tratamiento farmacológico , Adulto , Femenino , Humanos , Persona de Mediana EdadRESUMEN
The review presents the results of studies on combination therapy of 5α-reductase inhibitors and α-blockers in patients with benign prostatic hyperplasia (BPH). These data demonstrate a significant advantage of the combination therapy versus monotherapy in terms of quality of life and subjective symptoms as well as the safety, better results in the prevention of BPH progression and acute urinary retention, and reduced need for surgery.
Asunto(s)
Inhibidores de 5-alfa-Reductasa/uso terapéutico , Antagonistas Adrenérgicos alfa/uso terapéutico , Hiperplasia Prostática/tratamiento farmacológico , Neoplasias de la Próstata/tratamiento farmacológico , Ensayos Clínicos como Asunto , Quimioterapia Combinada/métodos , Humanos , Masculino , Hiperplasia Prostática/patología , Neoplasias de la Próstata/patologíaRESUMEN
This report introduces results of an 8-year study estimating the risk of acute urinary retention in patients with stage I prostatic adenoma. Patients were randomly assigned into two groups. The first group consisted of 331 men was regularly taking Omnic (tamsulosin) 0.4 mg 1 time daily for 8 years as a means of medical therapy. The second group consisted of 334 patients treated with herbal preparations (Gentos, Tadenan or Speman). In the case of acute urinary retention patients were taken to the urological department to release urine from the urinary bladder by catheterization or by the surgical procedure. The incidence of acute urinary retention in group 1 ranged from 0.3 to 1.2% per year and, for a total of 8 years of follow-up was 6.45%. In the second group, it ranged from 1.8 to 7.3% per year, making a total of 36.2%. Therefore, the risk of acute urinary retention in patients receiving Omnic (tamsulosin) was reduced by 5.6 times in comparison with the group of patients treated with herbal medications. Thus, the need for surgery decreased from 27.8 to 6.3%. According to the results of an 8-year long tamsulosin was found as a safe and highly effective means to reduce the risk of acute urinary retention.
Asunto(s)
Antagonistas de Receptores Adrenérgicos alfa 1/uso terapéutico , Preparaciones de Plantas/uso terapéutico , Hiperplasia Prostática/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Retención Urinaria/prevención & control , Agentes Urológicos/uso terapéutico , Antagonistas de Receptores Adrenérgicos alfa 1/administración & dosificación , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Preparaciones de Plantas/administración & dosificación , Estudios Prospectivos , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/epidemiología , Sulfonamidas/administración & dosificación , Tamsulosina , Resultado del Tratamiento , Retención Urinaria/epidemiología , Agentes Urológicos/administración & dosificaciónRESUMEN
The first part of the review presents the results of the most interesting and major studies on the problem of the treatment of bacterial prostatitis and published after 2010. The second part represents the key provisions of current clinical recommendations of European Association of Urology on the antibacterial treatment of prostatitis, published in 2011 and based on studies up to 2010 inclusive.
Asunto(s)
Antibacterianos/uso terapéutico , Prostatitis/tratamiento farmacológico , Animales , Antibacterianos/administración & dosificación , Ensayos Clínicos como Asunto , Europa (Continente) , Humanos , Masculino , Guías de Práctica Clínica como Asunto , Prostatitis/microbiologíaRESUMEN
Prostamol Uno (PU) efficacy and safety were studied in a multicenter, open-population, randomized and comparative trial. PU was given in a single daily dose 320 mg for 36 months to 50 patients with initial symptoms of prostatic adenoma (PA) in comparison with 50 matched controls. The trial evaluated PU action on the symptoms progression and quality of life with application of questionnaires IPSS and QoL (BS). It was found that PU treatment relieved PA symptoms by IPSS, while these symptoms progressed in the controls. QoL improved in the study group and deteriorated in the control one. Administration of PU significantly increased urinary flow rate though in the controls urinary flow rate decreased, size of the prostate diminished and increased, respectively. Changes in the PSA were not seen and were insignificant, respectively. The results of the study say that prostamol Uno in a dose 320 mg/day can prevent PA progression without side effects.
Asunto(s)
Extractos Vegetales/uso terapéutico , Hiperplasia Prostática/tratamiento farmacológico , Progresión de la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Extractos Vegetales/administración & dosificación , Extractos Vegetales/efectos adversos , Próstata/diagnóstico por imagen , Próstata/efectos de los fármacos , Antígeno Prostático Específico/sangre , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/fisiopatología , Calidad de Vida , Riesgo , Resultado del Tratamiento , Ultrasonografía , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/fisiopatología , Retención Urinaria/etiología , Retención Urinaria/fisiopatología , Retención Urinaria/prevención & control , Urodinámica/efectos de los fármacosRESUMEN
The article presents 2-year pilot results of a multicenter, randomized, controlled trial of prostamol-UNO effects on symptoms progression, quality of life, tolerance and safety in patients with early prostatic adenoma. The drug was used in a single dose 320 mg/day for 36 months. Prostamol-UNO efficacy in arrest of the symptoms progression and quality of life was assessed with the use of IPSS and QoL (BS) questionnaires. Measurements were also made of changes in Qmax, urine volume, residual urine, size of the prostate.
Asunto(s)
Hiperplasia Prostática/tratamiento farmacológico , Progresión de la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Extractos Vegetales , Hiperplasia Prostática/patología , Hiperplasia Prostática/orina , Calidad de Vida , Factores de Riesgo , Factores de TiempoRESUMEN
Inelastic neutron scattering measurements on single crystals of superconducting BaFe1.84Co0.16As2 reveal a magnetic excitation located at wave vectors (1/2 1/2 L) in tetragonal notation. On cooling below T_{C}, a clear resonance peak is observed at this wave vector with an energy of 8.6(0.5) meV, corresponding to 4.5(0.3) k_{B}T_{C}. This is in good agreement with the canonical value of 5 k_{B}T_{C} observed in the cuprates. The spectrum shows strong dispersion in the tetragonal plane but very weak dispersion along the c axis, indicating that the magnetic fluctuations are two dimensional in nature. This is in sharp contrast to the anisotropic three dimensional spin excitations seen in the undoped parent compounds.
RESUMEN
The aim of the study was to improve the results of transurethral prostatic resection (TUPR) by introduction of intraoperative transrectal ultrasonic investigation (TRUSI) and to determine topographic-anatomic features of the prostate, intraorgan relations of adenomatous nodes and surgical prostatic capsule on-line in TUPR. A total of 64 patients with prostatic adenoma (PA) of the second degree aged 52-79 participated in the study. All of them have undergone TUPR. The patients were divided into two study groups (15 patients with volume of the prostate 36.5-78.6 cm3 and 17 patients with prostate size 80-4-141.2 cm3) in which TRUSI was performed and two control groups (n = 14, size 34.9 to 79.2 cm3 and n = 18, size 81.7-130.8 cm3, respectively) who have not undergone intraoperative TRUSI. PA clinical symptoms were similar in all the groups. Intraoperative TRUSI was conducted in 3 stages (in the beginning, middle and end of surgery) in two planes--transverse and sagittal. Postoperative complications required repeated endoscopic interventions in 2 and 4 patients of groups 2, 3 and 4, respectively. Control TRUSI on day 7 after TUPR registered mean volume of the prostate to be 19.3 +/- 1.4 cm3 in group 1, 39.8 +/- 2.1 cm3 in group 2, 28.1 +/- 1.6 cm3 in group 3, 47.7 +/- 3.2 cm3 in group 4. Maximal flow rate 1 month after TUPR was, on the average, 21.4 +/- 1.4 ml/s, 18.8 +/- 1.1 ml/s, 18.3 +/- 1.6 ml/s and 15.5 +/- 1.2 ml/s in groups 1, 2, 3 and 4, respectively. Thus, intraoperative TRUSI provides information which helps the surgeon to orient in the course of surgery and minimize the threat of perforation of the prostatic capsule; minimizes intraoperative complications and enhances efficacy of radical transurethral electroresection of prostatic hyperplasia improving long-term outcomes of the operation.
Asunto(s)
Complicaciones Intraoperatorias/prevención & control , Hiperplasia Prostática/diagnóstico por imagen , Hiperplasia Prostática/cirugía , Resección Transuretral de la Próstata , Ultrasonografía/métodos , Anciano , Electrocirugia , Humanos , Cuidados Intraoperatorios , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
In this open label prospective study in patients with category III prostatitis we assessed efficacy and safety of Sabal serrulata plant extract (prostamol Uno 320 mg) (group I, n=30) as compared to watchful waiting (group II, n=24). Efficacy was evaluated by means of NIH-CPSI, IPSS-QoL questionnaires, patients' general subjective assessment of treatment outcome, uroflowmetry and transrectal Doppler mapping (colour doppler and spectral doppler) of the prostate. Patients receiving prostamol Uno in comparison with watchful waiting group had significant improvement of mean NIH-CPSI (from 17.8 to 11.4 vs 17.1 to 16.5) and IPSS (from 13.0 to 6.3 vs 13.2 to 11.6) scores, Qmax values (from 12.9 ml/s to 17.8 ml/s vs 13.3 ml/s to 14.4 ml/s) and Doppler parameters of vascular resistance in the prostate. According to the patients' subjective assessment, moderate and significant improvement was reported by 76.7% patients in prostamol Uno group vs 23.3% in the watchful waiting group. There were no severe side effects. In prostamol Uno group one patient (3.3%) had moderate dyspepsia that resolved without termination of the drug administration. Prostamol Uno showed good efficacy and safety profile in patients with category III prostatitis.
Asunto(s)
Extractos Vegetales/uso terapéutico , Prostatitis/tratamiento farmacológico , Adolescente , Adulto , Enfermedad Crónica , Humanos , Masculino , Persona de Mediana Edad , Extractos Vegetales/efectos adversos , Estudios Prospectivos , Próstata/diagnóstico por imagen , Prostatitis/diagnóstico por imagen , Resultado del Tratamiento , UltrasonografíaRESUMEN
The aim of the study was to elucidate influence of alpha1A adrenoblocker tamsulosine (omnique) on ischemic heart disease (IHD) symptoms in patients with benign prostatic hyperplasia (BPH). As shown by Holter monitoring, 15 patients of group 1 having IHD, BPH and impaired miction, demonstrated ECG changes before voiding (ST depression, higher rate of supraventricular and ventricular extrasystoles); 28 patients of group 2 had ECG changes unrelated to miction. Subjective and objective effects were registered in a month in all the patients. ECG parameters improved in 11 and 20 patients of group 1 and 2, respectively. Patients without ECG improvement had severe cardial pathology (three-vessel affection of the coronary arteries, effort angina of a high functional class, cardiac failure). Thus, miction impairment due to BPH aggravate IHD. Early administration of tamsulosine (omnique) for BPH improves the course of concomitant IHD in 72% patients.
Asunto(s)
Antagonistas Adrenérgicos alfa/uso terapéutico , Isquemia Miocárdica/tratamiento farmacológico , Hiperplasia Prostática/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Antagonistas Adrenérgicos alfa/efectos adversos , Anciano , Anciano de 80 o más Años , Electrocardiografía , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/complicaciones , Próstata/diagnóstico por imagen , Hiperplasia Prostática/complicaciones , Sulfonamidas/efectos adversos , Tamsulosina , Ultrasonografía , Vejiga Urinaria/diagnóstico por imagenRESUMEN
A total of 39 patients with prostatic hyperplasia (PH) admitted to the urological clinic of I. M. Sechenov Moscow Medical Academy from 1999 have been inserted a biodegradable catheter stent (BCS). Such stents degrade spontaneously to microfragments and come away with urine 4-12 months after catheterization. BCS were used in PH patients with marked urination disorders due to urethral compression by hyperplastic prostate in whom adenomectomy was contraindicated. BCS was used for elimination of a suprapubic fistula in the urinary bladder of 19 PH patients with contraindications to adenomectomy. 5-7 days before catheterization the urinary bladder was drained 2 times a day to reduce pyoinflammatory process. The cystostomic fistula closed within 24 h in all the patients. Adequate urination recovered. Urethral inflammation persisted for 4-6 weeks. It was treated with antibiotics with effectiveness 89.5% (in 17 of 19 patients). Pyoinflammation persisted in two patients who developed uroliths destructed later at endoscopic pneumatic cystolithotripsy. Control examination 6 months after the stent insertion found that the stent had destructed with evacuation of the fragments. In two patients two large fragments were locked in the urethra provoking acute ischuria. The fragments were removed by the forceps and urination became normal. None of the patients needed recystostomy. 32 stented patients 6 and 12 months after stenting had adequate urination (mean Qmax--12.3 and 10.8 ml/s, respectively). Mean residual urine--32 and 37 ml. BCS improves treatment outcomes and quality of life of PH patients with contraindications to adenomectomy.
Asunto(s)
Materiales Biocompatibles , Hiperplasia Prostática/cirugía , Stents , Biodegradación Ambiental , Humanos , MasculinoRESUMEN
Specialists of the urologic clinic of the I.M. Sechenov Moscow Medical Academy studied effectiveness of lipidosterol extract Serenoa repens (permixon) in 26 patients with prostatic hyperplasia (total prostate-specific antigen was under 4 ng/ml). The trial has been performed from November 1995 up to now. The drug was taken before meal with a small quantity of water in a total daily dose 320 mg twice a day. Initial IPSS values ranged from 8 to 18 scores (mean 11.65 +/- 0.59). Life quality index was 1 to 4 scores (mean 2.46 +/- 0.15). Initial size of the prostate varied from 26 to 63 cm3 (mean 36.23 +/- 1.57 cm3). Maximal urinary flow rate (Qmax) made up 8.7 to 14.6 ml/s (mean 11.83 +/- 0.31 ml/s). Residual urine was initially 0-60 ml (mean 10.58 +/- 2.91 ml). Permixon significantly reduced the disease symptoms and improved quality of life. 5 years of treatment decreased mean IPSS by 8.8 +/- 0.18 (75.5%). QOL--by 1.31 +/- 0.08 (53.3%), size of the prostate--by 10.81 +/- 0.55 cm3 (29.8%). Neither the symptoms nor quality of life became worse for these five years. The size of the prostate reduced in 16, unchanged in 9 and increased only in 1 patient. Qmax was initially under 15 ml/s and rose after the treatment by 4.13 +/- 0.51 ml/s (35%), on the average. Qmax rose above 15 ml/s in 16 patients. Residual urine increased during the treatment in one patient only. Permixon intolerance was not observed. Thus, continuous 5-year therapy with lipidosterol extract Serenoa repens (permixon) proved highly effective and safe in 26 patients with initial or moderate symptoms of prostatic hyperplasia.
Asunto(s)
Antagonistas de Andrógenos/uso terapéutico , Extractos Vegetales/uso terapéutico , Hiperplasia Prostática/tratamiento farmacológico , Humanos , Masculino , Hiperplasia Prostática/fisiopatología , Calidad de Vida , SerenoaRESUMEN
From 1997 to 1999 transrectal ultrasonic dopplerography was used for examination of 10 healthy controls and 57 patients with prostatic hyperplasia. The findings allow to characterize anatomically and functionally vascular structure of the prostate and adjacent tissues in health, hyperplasia, after open and transurethral operative interventions. The role of dopplerography in decision making on the treatment policy in prostatic hyperplasia was studied. Retrospective analysis of the case records provided dopplerographic prognostic signs of intraoperative and early postoperative bleedings. This served the basis for development of additional dopplerographic criteria for choice of surgical policy in prostatic hyperplasia. Thus, the role of transrectal dopplerography is determined not only in diagnosis but also in the treatment of hyperplastic prostate.