RESUMO
A prospective, randomized study was undertaken to compare the efficacy and safety of tobramycin and ceftazidime in the treatment of serious infections in 77 urological patients. Of the 39 tobramycin-treated and 38 ceftazidime-treated patients, 74% and 82%, respectively, were cured clinically. Microbiological cure rates were 72% and 79%, respectively. Three patients treated with tobramycin and two treated with ceftazidime developed a significant superinfection. Both drugs were tolerated well. Because of potential ototoxicity and nephrotoxicity the use of aminoglycosides is less advantageous than ceftazidime for seriously infected urological patients.
Assuntos
Ceftazidima/uso terapêutico , Sepse/tratamento farmacológico , Tobramicina/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Doenças Urológicas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ceftazidima/farmacocinética , Ceftazidima/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Sepse/microbiologia , Tobramicina/efeitos adversos , Infecções Urinárias/microbiologiaRESUMO
We report the first patient in Finland and Scandinavia with a deficiency of adenine phosphoribosyltransferase (APRT). About 30 clinically affected patients have been reported in the literature. APRT deficiency is an enzyme disorder which is inherited autosomally in a recessive manner. The use of adenine in purine metabolism is disturbed and it accumulates in the body, where it is oxidised to poorly insoluble 2,8-dihydroxyadenine by xanthine oxidase. The dihydroxyadenine forms stones which can be mistaken for uric acid stones. Our patient had had frequent episodes of urolithiasis and the diagnosis was finally made after pyelolithotomy and stone analysis. The total APRT deficiency was detected in the haemolysate of erythrocytes. Partial deficiency of APRT in the patient's relatives showed heterozygosity of the enzyme defect. The only clinical manifestation of the defect is the formation of urinary stones. This can be prevented by diet and allopurinol.
Assuntos
Adenina Fosforribosiltransferase/deficiência , Adenina/análogos & derivados , Pentosiltransferases/deficiência , Cálculos Urinários/análise , Adenina/análise , Alopurinol/uso terapêutico , Feminino , Finlândia , Humanos , Pessoa de Meia-Idade , Cálculos Urinários/tratamento farmacológicoAssuntos
Adenina Fosforribosiltransferase/deficiência , Adenina/análogos & derivados , Pentosiltransferases/deficiência , Ácido Úrico/análise , Cálculos Urinários/análise , Adenina/metabolismo , Adenina Fosforribosiltransferase/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Cálculos Urinários/genéticaRESUMO
Traumatic rupture of the penis is a rare accident. One or both corpora cavernosa may be affected. Approximately one third of the cases are associated with rupture of the urethra. In view of previous studies, and the present case reports both of which occurred during the same night, the authors propose primary surgical repair of the corpora cavernosa.