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J Dimitrakov

Publications and source records attributed to J Dimitrakov.

7 recordsLinked to original sources
PubMed2001

[Prostatitis syndrome. Changes in the ejaculate and effects on fertility].

Inflammation and infections of the male reproductive tract represent an important factor in male infertility that is potentially responsive to successful therapy. A standardized diagnostic procedure is a prerequisite for the exact evaluation of alterations of ejaculate specimens, especially in cases of the different forms of the prostatitis syndrome. Several alterations in ejaculate due to inflammation and infection have been identified that have a negative impact on the quality of sperm. Besides the influence of leuko- and bacteriospermia, the effect of inflammatory mediators, such as cytokines and reactive oxygen species (ROS), are being discussed as relevant pathomechanisms. These parameters just recently were incorporated into the conventional range of diagnostic criteria. Clinical studies that investigate the quality of ejaculate in the different forms of the prostatitis syndrome yielded contradictory results. Only antimicrobial therapy has been sufficiently described as a therapeutic option. In the future, it will be decisive to include novel functional and molecular parameters to define an interaction of urogenital infection and male infertility.

Bacterial Infections↗
PubMed2001

Recent developments in diagnosis and therapy of the prostatitis syndromes.

Chronic pelvic pain syndromes, including prostatitis, remain a difficult clinical entity in terms of diagnosis and treatment to both urologists and patients. This review attempts to highlight the most recent developments and advances in the field of chronic pelvic pain syndromes in terms of prevalence, aetiology, pathogenesis, diagnosis, and current approaches to treatment.

Humans↗
PubMed1999

Frequency and clinical characteristics of mycoplasma urinary tract infections in the early post-transplantation period in renal allograft patients.

Using a highly sensitive and specific polymerase chain reaction (PCR) protocol, we studied 36 renal allograft recipients and 30 healthy controls. Midstream urine samples were analyzed using routine microbiological methods and the Mycoplasma IST (BioMerieux, France). Mycoplasma infections of the upper urinary tract were found in 9 patients. In three of them E.coli and Proteus were also present. We discuss the clinical characteristics of mycoplasma infections in the early post-transplantation period and its possible implications for graft rejection.

Adult↗
PubMed1998

A case of Chlamydia trachomatis infection in a renal allograft patient.

We describe a renal allograft patient with a Chlamydia trachomatis infection. A 43 year-old man was diagnosed with end-stage renal disease in 1985 which necessitated the transplantation of a cadaver kidney in 1986. The kidney was rejected two years later. A second transplantation was performed in 1991. At the beginning of 1998 symptoms and signs of chronic renal failure and dysuria set in. Routine microbiological studies were negative. Cell culture on McCoy cell line was positive for an active infection with C. trachomatis--initially 3+, then 2+, 1+ and negative following treatment. The patient was positive on the AMPLICOR CT/NG test (Roche Diagnostic Systems, Branchburg, USA) twice with OD values OVER--above 2 at 450 nm wavelength measured on an ELISA reader. The patient received treatment with azithromycin and doxycycline for 10 days following which the serum creatinine levels fell and the creatinine clearance values improved. Dynamic microbiological follow-up showed disappearance of C. trachomatis as evidenced by the negative PCR test. We conclude that the deterioration of renal function in our patient is complex but the infection with C. trachomatis is part of the complex of the underlying chronic renal failure and immunosuppressive treatment.

Adult↗
PubMed1998

PCR studies on the presence of Chlamydia trachomatis in the upper urinary tract of patients with obstructive pyelonephritis.

Chlamydia trachomatis infections are among the most common sexually transmitted diseases in the world and it is only logical to hypothesize that it alone or in association with mycoplasmas can participate in the initiation and persistence of upper urinary tract infections. Having in mind the inconclusive evidence regarding the role of C. trachomatis in upper urinary tract infections we decided to study the presence of C. trachomatis in the upper urinary tract of patients with obstructive pyelonephritis using the polymerase chain reaction. We studied 20 patients (12 female and 8 male, aged 20-60 years) with symptoms and signs of acute pyelonephritis in accordance with Kunin's criteria (1997). Samples were taken during surgery of the upper urinary tract by aspirating urine from the renal pelvis or the ureter above the level of the obstruction and analyzed for the presence of bacterial pathogens using routine microbiological techniques and employing the "AMPLICOR CT/NG" test (Roche Diagnostic Systems, Branchburg, NJ, USA) for the presence of C. trachomatis. Chlamydia trachomatis was found in the aspirated urine of 5 patients (25%). In 3 of the patients the microbiological tests of the aspirated urine did not establish any other microbial agent. In the other two Escherichia coli and Proteus mirabilis were cultured. The analysis of the clinical and laboratory findings in the patients with Chlamydia trachomatis infection alone and those with an associated bacterial pathogen failed to reach statistical significance. Following the operation all of the patients received treatment with Ofloxacin 200 mg bid for 7 days with a favorable clinical and laboratory outcome. In our opinion, the AMPLICOR CT/NG test is a sensitive and specific method for diagnosing low-number Chlamydia trachomatis infections of the upper urinary tract in patients with obstructive pyelonephritis. Chlamydia trachomatis should be considered as a possible etiologic agent in acute pyelonephritis and the therapeutic regimen in such patients should be targeted at its possible underlying presence.

Adult↗