[An influence of herbal plant based on the combination of natural terpenes, vitamin and essential oil on the spontaneous stone passage after extracorporeal shock-wave lithotripsy].

INTRODUCTION: There are more than 20 drugs, that are widely used as medical expulsive therapy after extracorporeal shock wave lithotripsy (ESWL). Herbal plants are actively used along with the drug therapy in order to improve the efficiency of the treatment. PURPOSE OF THE STUDY: to evaluate the efficiency of the drug "Renotinex" in patients with kidney stones, as medical expulsive therapy. MATERIALS AND METHODS: A total of 41 patients with kidney stones who undergone ESWL were included in the study. Patients were divided into two groups of 21 patients. In the main group, patients received the dietary supplement "Renotinex" 2 capsules 2 times a day for 1 month, along with standard medical expulsive therapy (NSAIDs [Diclofenac suppositories 50 mg in case of pain] + alpha blockers [Tamsulosin 0.4 mg in the morning for 1 month). The efficiency of treatment was evaluated after 2 and 4 weeks by means of ultrasound and x-ray. A presence and mean size of the stone and dilatation of the collecting system were assessed. In addition, complete blood count (hemoglobin, level of red blood cells and white blood cells), as well as urinalysis (microhematuria and leukocyturia) were performed. For statistical analysis, Student's criterion and the Fishers method were used. RESULTS: After 2 weeks of treatment, a decrease in the hemoglobin level, number of leukocytes and erythrocytes in urine, as well as a significant decrease in pelvis size and the average size of the urinary stone were seen in the main group. In the control group, there was also a slight decrease in the hemoglobin and a significant increase in the grade of leukocyturia and microhematuria. After 4 weeks, significant intergroup differences were documented in the level of microhematuria, pelvis size and the presence of stone in the collecting system, as confirmed by ultrasound and X-ray study. Stone-free rate in the main group was 47.6%, compared to 20% in the control group. CONCLUSION: Medical expulsive therapy in combination with dietary supplements "Renotinex" after ESWL is more efficient than standard medical expulsive therapy (NSAIDs and -blockers) as monotherapy.

[Remote monitoring of urinalysis parametres during treatment of patients with uric acid stones by citrate-containing compounds].

INTRODUCTION: Oral dissolution therapy has been successfully used in urologic practice since 1950s. However, many doctors attempt to improve efficiency of this approach. Use of different medical personalized digital devices which are increasingly used in clinical practice, represent one of the solutions of this problem. AIM: Our aim was to assess efficiency of oral dissolution therapy with drug Blemaren in patients with uric acid stones using of portable urinary analyzer with system of remote monitoring. MATERIALS AND METHODS: A total of 12 patients with uric acid stones were followed. All of them had kidney stone with a density less than 500 HU according to CT-urography. Oral dissolution therapy was performed with the drug Blemaren for 8-9 weeks. All patients were advised to maintain urine pH of 6.5-7.0. With aim of dynamic monitoring of urine parameters, a portable urine analyzer "ETTA AMP-01" was given to all patients for 2 months. RESULTS: Complete dissolution was achieved in 10 (83.3%) patients. In one case (8.3%) oral dissolution therapy was complicated by acute pyelonephritis. A stenting was performed and dissolution therapy was continued with a positive effect. In another case (8.3%) partial dissolution was seen, however, extracorporeal shockwave lithotripsy was decided to perform. Doctor who remotely monitored different parameters of urinalysis (n=11) followed urine pH, density, leukocytes, erythrocytes, level of nitrite, which provided a more comprehensive assessment of patients current state. If necessary, the specialist contacted the patient and adjusted the therapy. CONCLUSION: The possibility of remote monitoring of urinalysis and simple communication with urologist allows to titrate drug dose more convenient compared to conventional approach when outpatient urologist controls pH diaries based on dip-stick test. Moreover, such approach gives an opportunity to quickly identify complications and correct the therapy in a timely manner.

Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium or zinc from food in humans.

OBJECTIVE: Low gastric pH is generally believed to be an important factor in intestinal mineral absorption. Thus, hypochlorhydria could be an important risk factor for mineral malabsorption and the development of marginal mineral status. We studied whether the hypochlorhydria associated with treatment with the anti-ulcer medication omeprazole, a potent gastric proton pump inhibition, would affect intestinal calcium, phosphorus, magnesium, or zinc absorption from food. METHODS: Thirteen normal, healthy adults were assigned to either a control group (n = 5) receiving no drug treatment or an omeprazole treatment group (n = 8) to produce increased gastric pH. Omeprazole treatment of normal volunteers resulted in a significant change in postprandial gastric pH (pH 6.4 +/- 0.3 vs. 3.6 +/- 0.5 in control subjects, p < 0.01) and baseline fasting pH (pH 5.8 +/- 0.5 vs. pH 1.8 +/- 0.3 in controls, p < 0.01) after an overnight fast. Net mineral absorption from a standard test meal was measured using a whole gut lavage technique. Mineral absorption was measured twice in each subject, once with 120 mL of 0.1 mol/liter hydrochloric acid and a second time with 120 mL of distilled water alone. RESULTS: We found that despite marked changes in gastric pH due to drug treatment or administration of exogenous HCl, no change in the intestinal absorption of calcium, phosphorus, magnesium or zinc from a standard test meal was evident. CONCLUSIONS: These findings suggest that changing the gastric pH alone does not modify the net intestinal absorption of several minerals from food. Therefore, it is unlikely that moderate hypochlorhydria resulting from short-term omeprazole treatment substantially increases the risk for developing calcium, phosphorus, magnesium, or zinc deficiencies due to mineral malabsorption.