[The clinical course and treatment of fungal infections in the early period after kidney transplantation].

The article discusses the critical issues of clinical manifestations and treatment of fungal infections in patients after kidney transplantation. In fungal infection, which is usually detected in the composition of microbial associations, lungs are more often affected. In this case, mortality reaches 60%. Affecting the renal transplant by Candida spp. or Aspergillus spp. can lead to the loss of function of transplanted kidneys. At the current stage, lipid formulations of amphotericin B are drugs of choice for antimycotic therapy in posttransplant period. Nephrotoxic effect of amphotericin B is reversible and does not represent a serious threat to the function of the transplantate. Administration of lipid formulations of amphotericin B is the most justified, since it does not affect the concentration ofimmunosuppressive drugs in the blood serum of patients after transplantation.

[Laparoscopic operations in patients with chronic renal failure on peritoneal dialysis].

The aim of our study was analysis of efficacy of laparoscopic operations for treatment of complications arising in patients with terminal chronic renal failure (TCRF) on peritoneal dialysis (PH). A total of 86 TCRF patients participated in the trial. The study group consisted of 36 patients who have undergone laparoscopic surgery for correction of dysfunction of the peritoneal catheter, for treatment of acute and progressive chronic diseases of the abdomen. A control group included 50 patients treated with laparotomy. All the patients were on the dialysis for 1-48 months. After laparoscopic operations 7 patients were switched on hemodialysis. In the control group peritoneal dialysis was discontinued in 30% patients, lethality in this group was twice higher. Thus, laparoscopic operations allow prolongation of peritoneal dialysis in dysfunction of peritoneal catheter and in development of acute and progression of chronic surgical diseases of the abdomen.

Can the routine use of fluoroquinolones for community-acquired pneumonia delay the diagnosis of tuberculosis? A salutary case of diagnostic delay in a pilgrim returning from Mecca.

Guidelines advocate using fluoroquinolones as first-line treatment for community-acquired pneumonia (CAP). However, the use of fluoroquinolones in patients with undiagnosed tuberculosis may cause a delay in the diagnosis of tuberculosis and may also promote the development of resistance to these drugs if used as monotherapy in undiagnosed tuberculosis. We illustrate the former with the following case report of a patient who developed tuberculosis after a pilgrimage to Mecca.

[Peritoneal dialysis in the treatment of chronic renal failure]. / Primenenie peritoneal'nogo dializa v lechenii KHPN.

Fifty-four patients were treated with peritoneal dialysis for terminal chronic renal failure. Clinical-laboratory indices were assessed in patients on chronic peritoneal dialysis. Advantages of continuous ambulatory peritoneal dialysis over hemodialysis are analysed in terms of social rehabilitation of the patients. Complications of chronic peritoneal dialysis as a method and algorithms of their treatment are outlined. The role of peritoneal dialysis as a preparatory stage before transplantation of the kidney is assessed.