[Learning curve of percutaneous nephrolithotripsy: how to achieve perfection?]

PURPOSE: to determine the characteristics of the surgeon training curve in the development of percutaneous nephrolithotripsy (PN). MATERIALS AND METHODS: The first 125 PNs performed by one team of surgeons were investigated. In chronological order, five groups of 25 operations were formed. The assessment was carried out according to the following parameters: the duration of the operation; the number of perioperative complications; stone free rate (SFR). RESULTS: With the advanced training of the surgical team, the duration of the operation tended to decrease; after 50 PN the time decreased from 164+/-12 to 113+/-11 minutes. The duration of the next 50 PN conducted in the third and fourth groups remained unchanged - 105+/-10 and 103+/-12 minutes. In the fifth group, a decrease in time to 99+/-9 minutes had no significant differences with the third and fourth groups. The frequency of complications tended to decrease up to the 75th operation, followed by a plateau. The structure was dominated by complications related, according to the modified Clavien-Dindo classification, to Grade I and Grade II. With the accumulation of surgeons experience, there was a tendency towards an increase in SFR: in the 1st group - 72%, in 2 - 84%, in 3 and 4 - 88%, in 5 - 92% (p<0,05). CONCLUSIONS: in order to achieve the average indicators of the duration and effectiveness of PN, the surgical team must have experience of at least 50 such operations. Due to the long training process, it is advisable to use PN in organization with an estimated number of such operations of at least 30 per year.

[To the history of the department of urology military academy named after S.M. Kirov in the period of the great patriotic war].

The article reveals the formation and work of the Department of Urology during the Grear Patriotic War (1941-1945) based on the memories of its first head, professor A.I. Vasiliev.

[Quality of life of urological patients].

Achieving a high quality of life for patients is a paradigm of modern medicine. The doctrine of the quality of life, originated in the 60s of the twentieth century, is currently actively developing in all fields of medicine, including urology. This article reviews the history, terminology, and methods of studying the quality of life. Along with the general questionnaires, disease specific quality of life instruments are gradually emerging in the standards of examination and follow-up of urological patients.

Identification and evaluation of a combination of chlamydial antigens to support the diagnosis of severe and invasive Chlamydia trachomatis infections.

Chlamydia trachomatis is the most common sexually transmitted organism in industrialized countries. Nucleic acid amplification testing, using non-invasively collected specimens, is considered to be the method of choice for diagnosis of chlamydial infections of the urethra and the lower genital tract. Serological testing has the potential to circumvent the problem of specimen sampling in invasive C. trachomatis infections of the upper genital tract. However, only a few defined chlamydial antigens have been used in a standardized diagnostic assay format. In this study, we used serological two-dimensional proteomic analysis to broaden the spectrum of diagnostically relevant C. trachomatis proteins. The genes encoding an assortment of already known chlamydial antigens, as well as immunogenic proteins that have not been described before, were cloned, and the recombinant proteins were purified in order to compare their diagnostic usefulness in parallel with a newly developed line immunoassay. With 189 sera collected from patients with and without C. trachomatis infection, recombinant major outer membrane protein (MOMP), chlamydial protease-like activity factor (CPAF), outer membrane protein 2 (OMP2), translocated actin-recruiting protein, and polymorphic membrane protein D (PmpD) showed the highest level of diagnostic sensitivity and specificity. In patients suffering from ascending and invasive C. trachomatis infections, such as pelvic inflammatory disease and lymphogranuloma venereum, the sensitivity reached with these proteins ranged between 71% (PmpD) and 94% (OMP2), and the specificity ranged between 82% (PmpD) and 100% (MOMP and OMP2). Recombinant thio-specific antioxidant peroxidase, ribosomal protein S1 (RpsA) and hypothetical protein 17 showed lower sensitivity but comparably high specificity, ranging from 94% to 100%. The novel line immunoassay based on defined recombinant antigens has promise for improved serodiagnosis in severe and invasive C. trachomatis infections.

Evaluation of WLBU2 peptide and 3-O-octyl-sn-glycerol lipid as active ingredients for a topical microbicide formulation targeting Chlamydia trachomatis.

Topical microbicides for prevention of sexually transmitted diseases (STDs) would be especially useful for women who are not able to persuade their partner(s) to take precautions. Many topical microbicides are in various stages of development, based on a variety of active ingredients. We investigated the in vitro activity of an engineered antimicrobial peptide (WLBU2) and a lipid (3-O-octyl-sn-glycerol [3-OG]) which could potentially be used as active ingredients in such a product. Using commercially available cytotoxicity reagents [Alamar Blue, 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT), and lactate dehydrogenase (LDH)], we first determined the toxicity of WLBU2 and 3-OG to the host cells in our assay procedure and excluded toxic concentrations from further testing. To determine activity against Chlamydia trachomatis, we used an assay previously developed by our laboratory in which chlamydial elementary bodies (EBs) were exposed to microbicides prior to contact with epithelial cells: the minimum (microbi)cidal concentration (MCC) assay. To further simulate conditions of transmission, we carried out the same assay in the presence of a simulated vaginal fluid, a simulated seminal fluid, human serum albumin, and a range of pH values which might be found in the human vagina at the time of exposure. Last, we tested WLBU2 and 3-OG in combination to determine if adding them together resulted in synergistic activity. We found that WLBU2 and 3-OG both have excellent activity in vitro against C. trachomatis and significantly more activity when added together. The simulated fluids reduced activity, but the synergy seen is good evidence that they would be effective when combined in a microbicide formulation.

[The stained plate latex microagglutination reaction for the detection of pertussis antibodies in saliva]. / Reaktsiia plastinchatoi okrashennoi lateks-mikroaggliutinatsii dlia vyiavleniia protivokokliushnykh antitel v sliune.

The authors suggest this test for the detection of salivary antipertussis antibodies. Their findings evidence that the suggested technique is more sensitive than the agglutination test, simpler, more rapid, and its results can be more rapidly read.