A new antibiotic from fluoroquinolone series maxaquine (lomefloxacin) made in USA (Searle [correction of Surl]) has been tried in the treatment of urogenital infection (chronic cystitis, prostatitis, pyelonephritis, acute epididymitis, chlamydial urethroprostatitis) as well as to warrant antibacterial preparation before extracorporeal lithotripsy. The duration of the treatment course (3-28 days) was oriented to nosological form. The 24-h dose ranged from 400 to 800 mg. Side effects manifested with dyspepsia in 4 patients, worsening of memory in 2 patients. Photosensitization did not occur. Maxaquine clinical efficacy is similar to aminoglycosides and is superior to cephalosporins of the third generation. As for fluoroquinolone antibiotics, maxaquine can be compared to cyprofloxacine. The drug proved effective against urethroprostatitis and urethrocystitis of chlamydial origin. The responses to maxaquine favour its application in hospitals as second-line drug, whereas outpatiently it can be used for short-term empiric therapy.

Acute Disease↗

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[The concept of the development of a Russian urology].

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Delivery of Health Care↗

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[The differential microbiological diagnosis of bacteremia and sepsis and the results of its practical use].

A rapid method for the detection of classical forms of bacteria and their cell-wall defective (CWD) variants in the blood has been developed and approved. The method is based on the kinetic analysis of bacterial growth with the use of nephelometry. The analysis lasts 3-10 hours. The method permits the differential microbiological diagnosis of bacteremia and sepsis, as well as the rapid control of the effectiveness of antibacterial therapy. The rapid method has revealed that in the presence of antibacterial therapy infective agents persist in the blood as CWD variants and not in the classical bacterial form, which sharply decreases the reliability of the traditional diagnostic method. CWD variants have been detected in the blood of patients treated with the preparations of cephalosporin, chinolon, aminoglycoside, dioxydin, etc.

Bacteremia↗

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[The correction of hyperuricemia in patients with different forms of nephrolithiasis using allopurinol and Allomaron].

Metabolic status was assessed in 48 patients with nephrolithiasis followed-up for 4 years. Allopurinol and allomaron-treated patients were examined biochemically by 17 parameters of the blood and urine. The effects of the drugs were compared. It is concluded that in hyperuricemia up to 0.37 +/- 0.02 mmol/l allomaron is more effective (1--2 pills a day). In higher hyperuricemia allopurinol is preferable (4 pills a day). Allomaron can be also used (1--2 pills a day) under the control of urinalysis.

Adult↗

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[Tobramycin inactivation by cefotaxime in patients with terminal-stage chronic kidney failure].

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Cefotaxime↗

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[Acupuncture in the combined treatment of pyelonephritis].

In the treatment of pyelonephritis which continues to cause problems in practical uronephrology, the main efforts of the clinicians are now directed at enhancement of the patients resistance, improvement of renal blood flow and urodynamics. Acupuncture (AP) is thought capable to meet the above requirements. It was used in combined treatment of 102 pyelonephritis cases (51 with acute and 51 with chronic manifestations) showing intact renal function. According to radionuclide renography, a positive trend in the secretion and urodynamics of the upper urinary tract was demonstrable in 50% of the patients. Dynamic nephroscintigraphy reported a positive response in 60% of cases versus 25% in those treated without AP. AP promotion of earlier recovery or remission, reduction of the scope of chemotherapy, good short- and long-term response permit this modality to be recommended for application in urological and nephrological practice.

Acupuncture Points↗

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[Accelerated elimination of the stone fragments after extracorporeal shockwave lithotripsy].

As shown in experiments on 40 Chinchilla male rabbits, sinusoidal modulated currents (SMC) and ultrasound (US) are able to enhance bioelectrical activity of the ureteral smooth muscles. Activation of the muscular wall biopotential is followed by 0.15-0.2 s contraction. The above effect was used by the authors in rehabilitation of 120 patients after ECIL. SMC and US were included into the physiotherapeutic complex. The above patients whose concrements after the fragmentation diminished to less than 7 cm in size were divided into 2 groups. Sixty patients of group 1 received spasmolytic drugs, sodium chloride or iodine-bromine baths and dynamic amplipulse therapy. Sixty patients of group 2 in addition to the above treatment were exposed to local vibration and US. All the patients were given antibacterial drugs. The percent of patients with complete urolith evacuation in group 1 amounted to 91.7%, with partial evacuation 8.3% (96.7 and 3.3% in group 2, respectively). Dynamic nephroscintigraphy demonstrated that after relevant physiotherapy renal function improved, leukocyte and red cell count in the urine and ferrum, alkaline phosphatase levels in the serum decreased.

Animals↗

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[The prevention of infectious-inflammatory complications in the postoperative period in percutaneous surgical interventions in patients with urolithiasis].

The paper describes a number of modifications in the operative procedures, pre-, intra- and postoperative antibacterial treatment introduced to decrease the number and severity of infectious-inflammatory complications of endourological surgery for urolithiasis; presents the results of anti-bacterial prophylaxis of urinary infection aggravation in 29 patients suffering from urolithiasis combined with renal anomalies. Antibacterial treatment was performed with ftorquinolone drug ciprinol (ciprofloxacin hydrochloride) made in Slovenia. 18 patients received ciprinol twice a day at a dose 500 mg 3-5 days before the operation and within 5-7 postoperative days. The other 11 patients received the drug intravenously (100 mg in drops) in parallel with initial anesthesia and during 1-2 postoperative days. It was continued orally within the next 5-6 postoperative days. The analysis of ciprinol pharmacokinetic profile showed its concentrations in the blood and urine to surpass minimal inhibitory concentration for the majority of the isolated microorganisms. Out of 18 patients treated with oral ciprinol, postoperative aggravation of pyelonephritis occurred in 3 (16.7%) versus 8 (40%) cases out of 20 controls. 11 patients on intravenous ciprinol developed no complications. The conclusion is made on high efficacy of preoperative antibacterial preparation and of intraoperative antibacterial therapy continued for some time after the surgery in cases of percutaneous endoscopic surgical interventions for urolithiasis attended by chronic urinary infection. The antibacterial treatment brings about a 2-3-fold decrease in the occurrence of postoperative inflammatory complications.

Anti-Bacterial Agents↗

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[Clinical effectiveness of pefloxacin (abaktal)in the treatment of inflammatory diseases of the kidneys, urinary tracts and genital organs].

Pefloxacin (Abaktal) was used in treatment of 83 patients: 14 patients with acute pyelonephritis, 5 patients with carbuncle of the kidney, 17 patients with postoperative acute pyelonephritis, 3 patients with urosepsis, 7 patients with acute prostatitis, 18 patients with chronic pyelonephritis in the phase of active inflammation, 9 patients with exacerbation of chronic prostatitis, 3 patients with acute cystitis, 2 patients with acute urethritis and 5 patients with epididymo-orchitis. Two dosage forms of pefloxacin were used i.e. tablets of 400 mg and ampoules of 5 ml containing 400 mg of the active substance. The treatment course amounted to 7-14 days. In the patients with inflammatory infectious diseases of the lower urinary tracts (cystitis and urethritis) the treatment course amounted up to 5 days. The results of the treatment with the ampoule solutions were good and satisfactory. With the use of the tablets the results were unsatisfactory in 3 patients (8.1 per cent). Satisfactory bacteriological efficacy of the treatment was stated in 89.5 per cent of the cases. The adverse reactions such as nausea, vomiting, diarrhea and skin eruption were recorded in 5 patients (6 per cent).

Bacterial Infections↗

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[The clinical efficacy of the new drug agent ligentén in urology patients].

A clinical trial was made of a new gel ligenten intended for local urethral anesthesia and treatment of infection and inflammation in the lower urinary tracts. Ligenten was given to 52 patients to manage bladder, prostate, urethral infection and inflammation, for local prophylaxis before cystoscopy, urethral bouginage and transurethral surgery. Apparent advantages of intraurethral introduction of the analgetic compared to instrument lubrication are demonstrated. Ligenten was also effective against chronic cystitis, cystalgia and urethral syndrome in females, especially in ulcerative cystitis. The gel exhibited adequate antiinflammatory and analgetic effect. As a prophylactic means, it prevents inflammation in cystoscopy, urethral catheterization and transurethral operations. No severe side effects have been reported.

Adult↗