Treatment of Recurrent Urinary Tract Infection Symptoms with Urinary Antiseptics Containing Methenamine and Methylene Blue: Analysis of Etiology and Treatment Outcomes.

PURPOSE: Urinary antiseptics including methenamine and methylene blue are used in the symptomatic treatment of urinary tract infections (UTIs). PATIENTS AND METHODS: This was a prospective, double-blind, randomized, double-dummy safety and efficacy study of 2 urinary antiseptic combinations in the symptomatic treatment of recurrent cystitis: methenamine 120mg + methylene blue 20mg (Group A) versus acriflavine 15mg + methenamine 250mg + methylene blue 20mg + Atropa belladonna L. 15mg (Group B). All subjects underwent pretreatment urine culture and antibiotic sensitivity tests prior to 3-day oral treatment with study drug, followed by 3 days of antibiotic therapy (based on urine culture) + study drug treatment. Efficacy was evaluated using the Urinary Tract Infection Symptoms Assessment Questionnaire (UTISA). The primary endpoint was the percentage of patients presenting improvement in cystitis manifestations on the UTISA domain "Urination Regularity" at Visit 2. The primary safety variable was the incidence of treatment-related adverse events. RESULTS: A total of 144 subjects were randomized per group and 272 completed the study. Primary endpoint analysis demonstrates homogeneity between treatment groups, with 69.4% and 72.2% subjects, respectively, showing improvement in the score of the urinary regularity UTISA domain after 3 days of treatment (p= 0.87). At Visit 2, incidence of treatment-related adverse events was higher in Group B (Group A: n= 11, Group B: n= 31, p= 0.0057). CONCLUSION: Both treatments were effective in reducing UTI symptoms assessed by UTISA questionnaire after 3 days of treatment. The two regimens were comparable in incidence of adverse events, but the combination of methenamine + methylene blue resulted in fewer treatment-related adverse effects.

Therapeutic low-intensity red laser for herpes labialis on plasmid survival and bacterial transformation.

A low-intensity laser is used in treating herpes labialis based on the biostimulative effect, albeit the photobiological basis is not well understood. In this work experimental models based on Escherichia coli cultures and plasmids were used to evaluate effects of low-intensity red laser on DNA at fluences for treatment of herpes labialis. To this end, survival and transformation efficiency of plasmids in E. coli AB1157 (wild type), BH20 (fpg/mutM(-)) and BW9091 (xthA(-)), content of the supercoiled form of plasmid DNA, as well as nucleic acids and protein content from bacterial cultures exposed to the laser, were evaluated. The data indicate low-intensity red laser: (i) alters the survival of plasmids in wild type, fpg/mutM(-) and xthA(-)E. coli cultures depending of growth phase, (ii) alters the content of the supercoiled form of plasmids in the wild type and fpg/mutM(-)E. coli cells, (iii) alters the content of nucleic acids and proteins in wild type E. coli cells, (iv) alters the transformation efficiency of plasmids in wild type and fpg/mutM(-)E. coli competent cells. These data could be used to understand positive effects of low-intensity lasers on herpes labialis treatment.

Laser for treatment of aphthous ulcers on bacteria cultures and DNA.

Low-intensity red lasers are proposed for treatment of oral aphthous ulcers based on biostimulative effects. However, effects of low-intensity lasers at fluences used in clinical protocols on DNA are controversial. The aim of this work was to evaluate the effects of low-intensity red laser on survival and induction of filamentation of Escherichia coli cells, and induction of DNA lesions in bacterial plasmids. Escherichia coli cultures were exposed to laser (660 nm, 100 mW, 25 and 45 J cm(-2)) to study bacterial survival and filamentation. Also, bacterial plasmids were exposed to laser to study DNA lesions by electrophoretic profile and action of DNA repair enzymes. Data indicate that low-intensity red laser: (i) had no effect on survival of E. coli wild type, exonuclease III and formamidopyrimidine DNA glycosylase/MutM protein but decreased the survival of endonuclease III deficient cultures; (ii) induced bacterial filamentation, (iii) there was no alteration in the electrophoretic profile of plasmids in agarose gels, (iv) there was no alteration in the electrophoretic profile of plasmids incubated with formamidopyrimidine DNA glycosylase/MutM protein and endonuclease III enzymes, but it altered the electrophoretic profile of plasmids incubated with exonuclease III. Low-intensity red laser at therapeutic fluences has an effect on the survival of E. coli endonuclease III deficient cells, induces bacterial filamentation in E. coli cultures and DNA lesions targeted by exonuclease III.

Clinical assessment of azithromycin dihydrate in the treatment of pediatric impetigo / Avaliação clínica de azitromicina di-hidratada no tratamento de impetigo pediátrico

The primary objective of this double-blind, randomized, controlled clinical trial was to assess the use of azithromycin dihydrate in oral suspension form in the treatment of impetigo in children. The secondary objectives were to compare the efficacy and safety of two presentations of azithromycin dihydrate in the treatment of impetigo in children, on wound healing and on wound pruritus. After screening and obtaining informed consent of the parents or legal guardians, a total of 100 patients ranging in age from 2-8 years old and presenting impetigo were randomized to one of two groups for a 3-day treatment period using azithromycin dihydrate in oral suspension in single doses of 10mg/kg/day: Group A (manufactured by Merck S.A.), and Group B (manufactured by Pfizer). Patients returned to the study center at the end of the 3-day treatment (Visit 2) and 7 days after the Pretreatment visit (Visit 3) for efficacy assessments and safety monitoring. Pretreatment demographic data and impetigo characteristics (type, location, number of lesions, pruritus) were homogenous between treatment groups. At the end of the study, all patients in both groups presented either ?improvement? or ?cured? lesions, with the majority (72.9%) of the patients presenting ?cured? lesions. We observed a statistically significant decrease in pruritus severity at Visit 2 and Visit 3 in relation to pretreatment, with no significant between-group difference at either study visit. Reported adverse events were transient and mild-to moderate in severity in both treatment groups, with no serious adverse events reported during the study. Based on the data collected during this study, we conclude that the two presentations of azithromycin were safe and effective in the treatment of impetigo in the population evaluated.

Tosse persistente: qualidade de vida e avaliação clínica dos resultados de terapia com anti-sépticos pulmonares / Persistent cough: clinical assessment of quality-of-life and treatment outcome using pulmonary antiseptics

JUSTIFICATIVA E OBJETIVOS: A tosse persistente representa uma condição comum e causa frequente de procura por atendimento médico, podendo alterar a rotina diária do paciente afetado. O objetivo deste estudo foi avaliar a resposta clínica e laboratorial à terapia de tosse persistente, utilizando uma combinação de eucaliptol, gomenol, guaifenesina, cansilato de sódio e cloridrato de lidocaína.MÉTODO: Foram obtidos dados referentes a 60 pacientes atendidos no Serviço de Pneumologia do Hospital das Clínicas de Teresópolis Constantino Otaviano, incluindo informações demográficas, resultados de exames físicos, laboratoriais e de espirometria, avaliações do médico e do paciente, bem como uma avaliação através do Cough-specific Quality of Life Questionnaire (CQLQ) que foram analisadas antes, durante e após sete dias de terapia. RESULTADOS: Não houve alterações clinicamente significativas nos exames físicos. Os exames laboratoriais e testes de espirometria permaneceram dentro das respectivas faixas de normalidade e nenhuma diferença significativa nos valores entre as avaliações foi observada. Vinte e nove eventos adversos foram registrados em 22 pacientes, todos com gravidade leve a moderada. As pontuações das avaliações de condição geral do médico e do paciente melhoraram significativamente na Avaliação 3 em relação à Avaliação 1 (Qui-quadrado = 121,1; GL= 16; p < 0,0001, e Qui-quadrado = 61,86; GL = 16; p < 0,0001, respectivamente). As pontuações no CQLQ da Avaliação 3 melhoraram de forma significativa em relação às da Avaliação 1 (t = 6,746; GL = 58; p < 0,0001), indicando melhora substancial na qualidade de vida.CONCLUSÃO: Com base nos resultados obtidos, concluiu-se que a combinação de eucaliptol, gomenol, guaifenesina, cansilato de sódio e cloridrato de lidocaína foi segura e eficaz em pacientes com processos pulmonares produtivos acompanhados de tosse, com impacto positivo na qualidade de vida dos pacientes tratados.

BACKGROUND AND OBJECTIVES: Persistent cough represents a common ailment for which medical attention is often sought, and may cause significant disruption of the affected patient's routine. The objective of this study was to evaluate clinical and laboratory response to persistent cough therapy using a combination of eucalyptol, gomenol, guaifenesin, sodium camsilate, and lidocaine hydrochloride. METHOD: We collected data from 60 patients attended at the Pneumology Service of the Hospital de Clínicas de Teresópolis Constantino Otaviano, including demographic information, physical exams, laboratory, and spirometry exam results, physician and patient evaluations, and a quality-of-life assessment (CQLQ) which were analyzed before, during, and after seven days of therapy. RESULTS: There were no clinically significant changes regarding physical exams. Laboratory exams and spirometry tests remained within the respective normal ranges, and no statistically significant difference in values among study assessments was observed. Twenty-nine adverse events were recorded among 22 patients, all of which were mild to moderate in severity. The scores of the physician and patient evaluation of overall condition improved significantly in Assessment 3 in relation to Assessment 1 (Chi-square = 61.86; Degree of Freedom = 16; p < 0.0001 and Chi-square = 121.1; DF= 16; p < 0.0001, respectively). CQLQ total scores from Assessment 3 improved significantly in relation to those of Assessment 1 (t = 6.746; DF = 58; p < 0.0001), indicating a substantial improvement in quality-of-life. CONCLUSION: Based on the results of this analysis, we conclude that the combination of eucalyptol, gomenol, guaifenesin, sodium camsilate, and lidocaine hydrochloride, was safe and effective in patients with productive pulmonary processes accompanied by cough, positively impacting quality-of-life of the treated patients.

Recurrent urinary tract infections: evaluation of the prophylactic efficacy of urinary antiseptics methenamine and methylthioninium chloride / Infecções do trato urinário recorrentes: avaliação da eficácia profilática dos anti-sépticos urinários metenamina e cloreto de metiltionínio

Introduction: Urinary tract infection (UTI) is a very common condition in clinical practice, affecting an estimated 50% of all adult women during a lifetime. The most common causative agent is E. coli UTI may also be caused by S. saprophyticus, Enterobacteria (Klebsiella sp and Serratia sp.), Enterococcus sp., and P. aeruginosa. Recurrent UTIs occur at least twice per semester or three times a year. Prophylactic measures to prevent recurrent UTIs include changes in contraception methods, cranberry products, increased fluid intake, urination after intercourse, vaginal estrogen therapy for post-menopausal women, antibiotics, and urinary tract antiseptic agents. Objectives: To evaluate the use of a combination of methenamine and methylthioninium chloride in the prophylaxis of recurrent uncomplicated lower UTIs, with respect to: · Signs and symptoms of UTI· Etiologic agent(s)· Recurrence rates· Need for antibiotic therapy in case of recurrence · Incidence of adverse events associated with the treatment, including any reported alterations of laboratory testsMaterials & methods: A descriptive, analytic, restrospective study was performed at Hospital Universitário Constantino Otaviano - UNIFESO. Medical charts from patients presenting recurrent uncomplicated lower UTI attended from 2001-present were analyzed, including the following information: Demographic data (age, gender, weight, ethnicity, living conditions) medical history/ signs and symptoms of UTI identification of treatment and dosing regimens treatment duration recurrence rates and need for antibiotic therapy in case of recurrence other medications prescribed and records of adverse events. Results: E. coli was identified as etiologic agent in 80% of the patients. Following antibiotic therapy, all patients received prophylactic treatment with the combination of methenamine and methylthioninium chloride. Treatment duration ranged from three to six months. Adverse events were observed in 13/60 patients...

Introdução: A infecção do trato urinário é bastante comum na prática clínica, afetando aproximadamente 50% de todas as mulheres adultas em algum momento da vida. O agente etiológico mais comum é a E. coli. A ITU pode também ser causada por S. saprophyticus, Enterobactérias (Klebsiella sp. e Serratia sp.), Enterococcus sp. e P. aeruginosa. ITUs recorrentes ocorrem ao menos duas vezes por semestre ou três vezes ao ano. Medidas profiláticas para prevenir a recorrência incluem alterações nos métodos contraceptivos, produtos de oxicoco, aumento da ingestão de fluidos, micção após a relação sexual, e terapia vaginal de estrogênio para mulheres em pós-menopausa, bem como antibióticos e anti-sépticos urinários. Objetivos: Avaliar o uso da combinação de de metentamina e cloreto de metiltionínio na profilaxia de ITUs recorrentes não-complicados, com respeito à: · Sinais e sintomas de ITU · Agente etiológico · Número de recorrências · Necessidade de terapia antibiótica em caso de recorrência · Incidência de efeitos adversos do tratamento, inclusive quaisquer alterações de exames laboratoriais. Materiais e métodos: Foi realizado um estudo descritivo, analítico, retrospectivo no Hospital Universitário Constantino Otaviano – UNIFESO. Prontuários médicos disponíveis de pacientes apresentando ITU recorrente não complicada, atendidos de 2001-presente foram analisados, incluindo-se as seguintes informações: dados demográficos (idade, sexo, peso, etnia, condições habitacionais) histórico médico/ sinais e sintomas de ITU identificação do tratamento e regime de tratamento recorrência necessidade de tratamento antibiótico no caso de recorrência outros medicamentos prescritos e registro de efeitos adversos. Resultados: E. coli foi identificado como agente etiológico em 80% dos pacientes. Após terapia antibiótica, todos os pacientes receberam tratamento profilático com a combinação de metenamina e cloreto de metiltionínio. A duração do tratamento variou entre três a seis meses...