RESUMEN
Currently, the significance of the chronic prostatitis (CP) is undoubted. Oxidative stress is considered as one of the standard mechanisms of cellular damage that is associated with inflammatory diseases such as CP. When choosing the combination therapy for this group of patients, a correction of oxidative stress is pathogenetically justified. Literature data about the pathogenetic feasibility and prospects of using a biologically active complex containing flavonoids and carotenoids quercetin, lycopene and naringin as part of the combination treatment of patients with CP are presented in the article. Considering the various effects of the biologically active complex Querceprost, containing quercetin, lycopene and naringin, among which antioxidant, anti-inflammatory, antimicrobial and immunomodulatory are of greatest importance, as well as taking into account the synergistic effect of flavonoids and carotenoids, we suggest that Querceprost is promising component of combination treatment of patients with CP.
Asunto(s)
Antioxidantes , Prostatitis , Masculino , Humanos , Prostatitis/tratamiento farmacológico , Antioxidantes/administración & dosificación , Antioxidantes/uso terapéutico , Enfermedad Crónica , Quimioterapia Combinada , Quercetina/administración & dosificación , Quercetina/farmacología , Quercetina/uso terapéutico , Estrés Oxidativo/efectos de los fármacos , Carotenoides/administración & dosificación , Carotenoides/uso terapéutico , Licopeno/administración & dosificación , Licopeno/farmacología , Licopeno/uso terapéutico , Flavanonas/administración & dosificación , Flavanonas/farmacología , Flavanonas/uso terapéuticoRESUMEN
INTRODUCTION: Benign prostatic hyperplasia (BPH) can lead to the detrusor hypertrophy and deterioration of the bladder function with a decrease in its contractile activity. A number of publications are presented in the literature, the results of which indicate the possibility of reducing bladder hypertrophy with alpha-blockers. AIM: To carry out the retrospective analysis to study the effect of Alfuprost MR on urodynamic parameters, as well as the influence of the therapy on detrusor thickness and bladder mass in patients with detrusor hypertrophy and bladder outlet obstruction caused by BPH. MATERIALS AND METHODS: Outpatient records of 30 patients with lower urinary tract symptoms (LUTS) caused by BPH who received Alfuprost MR as monotherapy for 24 weeks were reviewed. Based on the diaries, the following parameters were assessed: total IPSS score, IPSS voiding (questions No. 1, 3, 5 and 6) and storage subscale scores (questions No. 2, 4 and 7), maximum flow rate (Qmax) according to uroflowmetry, the volume of the prostate and the postvoid residual (assessed by ultrasound), satisfaction with treatment on the quality-of-life score (QoL), as well as the changes in detrusor thickness and bladder mass index. RESULTS: An improvement in LUTS severity, starting from the 4th week of treatment, followed by a positive trend that persists until the 24th week of therapy with Alfuprost MR, was found. The overall average IPSS score improved by 39.0% by the 24th week of therapy. At the same time, voiding symptoms improved by 46.8%, and storage symptoms improved by 30.9% by 24 weeks of therapy. The average Qmax increased significantly (p<0.05) by 22.1% after 24 weeks of therapy. The average detrusor thickness decreased by 40,2%. Bladder mass index decreased significantly by an average of 34,3% (p<0.05). QoL score improved significantly (p<0.05) by 2.2 points after 24 weeks of therapy. CONCLUSION: During the 24-week treatment of patients with BPH, Alfuprost MR demonstrated clinical efficacy not only in reducing voiding symptoms and in improving the QoL, but also a positive effect on detrusor hypertrophy, as evidenced by changes in detrusor thickness and bladder mass index. The absence of any adverse events, including decrease in blood pressure and heart rate, allows us to recommend Alfuprost MR as an effective treatment for LUTS associated with BPH, which reduces detrusor hypertrophy and has a high safety profile and minimal vasodilating effects.
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Síntomas del Sistema Urinario Inferior , Hiperplasia Prostática , Masculino , Humanos , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/diagnóstico por imagen , Hiperplasia Prostática/tratamiento farmacológico , Vejiga Urinaria/diagnóstico por imagen , Estudios Retrospectivos , Calidad de Vida , Síntomas del Sistema Urinario Inferior/tratamiento farmacológico , Síntomas del Sistema Urinario Inferior/etiología , Síntomas del Sistema Urinario Inferior/diagnóstico , Hipertrofia/complicacionesRESUMEN
OBJECTIVE: identification of clinical and metabolic characteristics of osteogenesis and factors affecting bone mineral density (BMD) in children living in radioactively contaminated territories (RCT) after the ChNPP accident for the use of therapeutic and preventive measures aiming to reduce the incidence of disorders. MATERIALS AND METHODS: Children aged 4 to 18 years old (n = 539) were involved in the study within 4 age groups, namely under 7 years old, 7-10 years old, 10-14 years old, older than 14 years old. Studied parameters in children with a reduced BMD (85-65 relative units and under 65 relative units) were estimated vs. the normative BMD (100-85 relative units) cases. Diagnosis of osteopenia and osteoporosis in children was established according to the BMD T-index. Family history of the relatives of children was studied. Body weight at birth, fractures of the long bones, complaints of osalgia, jaw anomalies, dental caries, presence of obesity, and hypermobility syndrome (HMS) were assessed. Peripheral blood biochemical tests were performed featuring the serum total protein, alkaline phosphatase (APh), calcium, vitamin D, creatinine, serum iron (SI), ferritin, cortisol, pituitary thyroid-stimulating hormone (TSH), and free thyroxine (FT4) assay. BMD was measured and radiation doses in children were reconstructed. RESULTS: BMD depended on the age of children. A direct correlation was established between the cholelithiasis and urolithiasis incidence (Ñ < 0.01), cancer and endocrine diseases (Ñ < 0.05) in the relatives of children that had BMD under 65 relative units. Dental caries developed more often (Ñ < 0.05), while obesity was less frequent (Ñ < 0.05) in the subjects with BMD < 65 relative units. A direct correlation was established between the level of serum creatinine and BMD (Ñ < 0.01), and there was an inverse correlation between the serum APh level and BMD (Ñ < 0.001).Every third child had a vitamin D deficiency. Fractures of long bones and increased content of SI and TSH were characteristic for the children having got osteopenia (BMD within 85-65 relative units), while besides a predisposition to bone fractures the higher levels of SI, APh, cortisol both with calcium deficiency were found in children with osteoporosis (BMD < 65 relative units) compared to the general group with a similar BMD. An increased incidence of HMS was characteristic too. Radiation doses in children with osteopenia were higher than in those with osteoporosis: (1.17 ± 0.09) mSv and (0.92 ± 0.06) mSv respectively (Ñ < 0.05). No correlation was found between the radiation doses and clinical signs, blood biochemistry or BMD. CONCLUSIONS: Study of the functional mechanisms of bone structures in children, depending on their metabolism, had made it possible to reveal the factors that affect bone formation in children living in RCT after the ChNPP accident, and to form the population groups for the timely application of therapeutic and preventive measures aiming to reduce the incidence of disorders of musculoskeletal system.
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Enfermedades Óseas Metabólicas , Caries Dental , Fracturas Óseas , Osteoporosis , Niño , Recién Nacido , Humanos , Preescolar , Adolescente , Glándula Tiroides/diagnóstico por imagen , Glándula Tiroides/metabolismo , Calcio , Hidrocortisona , Huesos/diagnóstico por imagen , Osteoporosis/diagnóstico por imagen , Osteoporosis/epidemiología , Osteoporosis/etiología , Enfermedades Óseas Metabólicas/diagnóstico por imagen , Enfermedades Óseas Metabólicas/epidemiología , Enfermedades Óseas Metabólicas/etiología , Tirotropina , ObesidadRESUMEN
INTRODUCTION: Chronic prostatitis (CP) is one of the most important and discussed urological diseases. Treatment of bacterial CP with an established pathogen usually is not associated with any difficulties. Chronic abacterial prostatitis (CAP) remains the most problematic issue. Immune defense mechanisms are important in the development of CP, including a decrease in the functional activity of monocytes/ macrophages, neutrophils, as well as imbalance of pro- and anti-inflammatory cytokines. AIM: To evaluate the efficiency of various schemes of using the immunomodulatory drug Superlymph as part of the combination therapy of men with CAP. MATERIALS AND METHODS: A total of 90 patients with category IIIa CAP (NIH, 1995) were included in the study. In the control group, patients received basic therapy of CAP, namely behavioral therapy, 1-adrenoblocker and fluoroquinolone for 28 days. In the main group I basic therapy in combination with Superlymph 25 ME in one suppository q.d. for 20 days was administered. In the main group II basic therapy in combination with Superlymph 10 ME in one suppository b.i.d. for 20 days was given. Evaluation of treatment efficiency was carried out after 14 +/- 2 days (visit 2) and 28+/- 2 days (visit 3) from the start of treatment. RESULTS: The study groups were homogeneous, and baseline characteristics did not differ significantly (p>0.05). However, significant differences were found between the results in the main groups and the control group at visit 2 for all the indicators (p<0.05). The number of daytime urinations was lower in the main group I and II compared to CG by 16.7% and 28.4%, the number of night urination by 28% and 40%, the average IPSS score by 29.1% and 38.3%, the average QoL score by 32.4% and 45.9%, the average NIH-CPSI score by 26.8% and 37.4%, the number of leukocytes in expressed prostatic secretion by 41.2% and 52.1%, prostate volume by 16.8% and 21.8%, bladder volume by 15.8% and 21.7%, and Qmax by 14.3% and 21.2%, respectively. Similar significant differences between the main groups and control group were also seen at visit 3, while the indicators in main groups I and II reached normal values after 28 days of therapy. In this study, for the first time, a comparative analysis of two different treatment regimens with Superlymph was carried out. In the main group I, patients received suppositories at a dose of 25ME q.d., while in the main group II, the drug was administered 10 ME b.i.d. The results indicate a comparable efficiency of both schemes after 4 weeks. However, in the main group II, after 2 weeks, there was a significantly more pronounced positive dynamics of all indicators in comparison with the main group I (p<0.05). Consequently, the use of Superlymph at a dose of 10ME b.i.d. a day allows to reduce the severity of the inflammatory process in a shorter time. CONCLUSION: The use of Superlymph in patients with CAP allows to reduce the severity of clinical manifestations in a shorter time, and has a positive effect on the dynamics of the inflammatory process, which leads to an improvement in the quality of life. According to our results, the most effective scheme in patients with CAP is basic therapy in combination with Superlymph 10 ME for 1 suppository 2 times a day for 10 days. In our opinion, Superlymph can be effectively used as part of the combination therapy of men with CAP.
Asunto(s)
Infecciones Bacterianas , Prostatitis , Masculino , Humanos , Prostatitis/tratamiento farmacológico , Calidad de Vida , Enfermedad Crónica , Infecciones Bacterianas/tratamiento farmacológico , Citocinas , SupositoriosRESUMEN
INTRODUCTION: Benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) are among the most important urological diseases. The right choice of treatment for patients with BPH and CP continues to be contradictory. Recently, a new group of entomological drugs has been increasingly used, one of which is Adenoprosin. AIM: To study the efficiency of Adenoprosin as part of combination therapy, as well as to evaluate the long-term outcomes in patients with BPH and CP. MATERIALS AND METHODS: A total of 60 patients with BPH and CP were included in the study. They were randomized into two groups of 30 each. In the comparison group, traditional therapy with 1-blockers and fluoroquinolones was administered. In the main group, similar therapy was prescribed in combination with Adenoprosin for 6 months. The follow-up period was 12 months. RESULTS: At baseline, the groups were homogeneous. After three and six months, the results in the control group did not significantly improve, but negative dynamics was revealed at visit 4. The results obtained in the main group at visits 3 and 4 were also significantly better (p<0.05) compared to the control group. During 12 months of follow-up, 7 (23.3%) cases of recurrent CP in the comparison group and 1 (3.3%) case in the main group were seen. CONCLUSION: According to our results, the use of Adenoprosin for 6 months allowed more effectively to reduce the lower urinary tract symptoms. The obtained effect persisted for the next 6 months, as evidenced by the dynamics of the studied indicators and the relapse rate of CP.
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Síntomas del Sistema Urinario Inferior , Hiperplasia Prostática , Prostatitis , Humanos , Masculino , Enfermedad Crónica , Terapia Combinada , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/tratamiento farmacológico , Prostatitis/tratamiento farmacológico , Prostatitis/diagnósticoRESUMEN
INTRODUCTION: Benign prostatic hyperplasia (BPH) is among the most significant urological diseases, and improving the effectiveness of treatment of patients with this disease is one of the main tasks in modern urology. The aim of the study is to evaluate the effectiveness of Longidase in the treatment of men with benign prostatic hyperplasia. MATERIALS AND METHODS: The study included 120 patients with lower urinary tract symptoms caused by BPH, who were randomly assigned to 2 groups of 60 people. In the main group (MG), Longidaza 3000 ME therapy was performed in combination with tamsulosin. In the comparison group (CG), tamsulosin monotherapy was performed. The patients were examined during 5 visits for 162+/-3 days. RESULTS: During the treatment period, compliance was 100%, all patients followed the doctors prescriptions, there were no cases of refusal of therapy. In addition, there were no cases of adverse events associated with taking the drug Longidaza. The examination initially revealed symptoms of the lower urinary tract in both groups against the background of prostatic hyperplasia, erectile dysfunction and a decrease in the quality of life. The therapy performed in both groups was effective, as evidenced by a decrease in the average score on the I-PSS scale, an increase in maximum urine flow rate, a decrease in volume of residual urine, which led to an improvement in the quality of life according to the QoL scale. Nevertheless, in the group of patients receiving Longidaza, after 50 days of therapy, there was a more pronounced positive dynamics of both the average score on the I-PSS and QoL scales, and the average maximum urine flow rate value according to the results of uroflowmetry. The differences between the groups according to these indicators were statistically significant (p<0.05). After 50 days of follow-up in GS, the average prostate volume did not change significantly, whereas in MG it decreased, and the differences between the groups were statistically significant (p=0.001). During subsequent visits, there was a tendency to decrease the size of the prostate in the MG, while in the CG there was a moderate increase in the volume of prostate according to ultrasound. CONCLUSION: Thus, according to the results obtained in the course of this observational study, the drug Longidaza 3000 ME can be effectively used in patients with BPH, prevent the progression of the disease, contribute to the persistent relief of LUTS and improve the quality of life of patients in this category.
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Síntomas del Sistema Urinario Inferior , Hiperplasia Prostática , Humanos , Hialuronoglucosaminidasa , Síntomas del Sistema Urinario Inferior/tratamiento farmacológico , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Polímeros , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/tratamiento farmacológico , Calidad de Vida , Supositorios , Resultado del Tratamiento , Vejiga UrinariaRESUMEN
INTRODUCTION: Currently, there is a large selection of -blockers on the pharmaceutical market, while they have comparable effectiveness, slightly differing only in safety profile. However, even small differences are of fundamental importance for comorbid patients, especially for those patients who are prone to developing cardiovascular diseases in adulthood. The choice of -blockers, which is able to minimize the risks of cardiovascular complications, is important. MATERIALS AND METHODS: Outpatient cards of 120 patients with BPH and concomitant high blood pressure or stage 1-2 hypertension, who had been taking Alfuprost MR for at least 12 weeks, were analyzed. All patients were divided into two groups of the same number. In group 1, 60 patients with LUTS/BPH and concomitant high blood pressure did not take any antihypertensive drugs, while 60 patients with LUTS/BPH and stage 1-2 hypertension in group 2 received antihypertensive drugs (according to the recommendation of an internist or cardiologist). Based on the analyzed data, the efficacy of the drug Alfuprost MR, its safety profile, including the effect on blood pressure and pulse, and the recorded adverse events after 4 and 12 weeks were assessed. RESULTS: An analysis of the results of a retrospective study showed an improvement in LUTS in both groups, starting from 4 weeks of treatment, followed by positive dynamics by 12 weeks of therapy with Alfuprost MR. The data obtained correspond to those presented in the literature. During 3 months of therapy, it was recorded: a decrease in the average score on the IPSS scale by 30%; an increase in the average urine flow rate by 20.6%; a decrease in the average amount of residual urine to normal values; an improvement in the quality of life of patients, according to the results of filling out the QoL questionnaire, by an average of 1.8 points. Patients in both groups had clinically insignificant fluctuations in systolic and diastolic blood pressure, less than 1 mmHg (in both groups) during 12 weeks of therapy; changes in heart rate during 3 months of therapy with Alfuprost MR were also clinically insignificant and averaged no more than 1 beat per minute In the medical records of patients, no adverse reactions were registered during therapy with Alfuprost MR, which confirms the high safety profile of the drug in clinical practice. CONCLUSION: Thus, Alfuprost MR is an effective means for the treatment of LUTI in BPH, with minimal vasodilating effects, which allows the drug to be prescribed to comorbid patients with concomitant high blood pressure or hypertension, including those taking antihypertensive drugs.
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Sistema Cardiovascular , Adulto , Humanos , Antihipertensivos/uso terapéutico , Calidad de Vida , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: to assess the thyroid disease in the late observation period in children who had received chemo- andradiotherapy for the acute lymphoblastic leukemia (ALL) taking into account gender, age period and disease sub-type. MATERIALS AND METHODS: The incidence and nature of thyroid disease (hypothyroidism, thyroiditis, and thyroid can-cer) were studied in children-survivors of acute lymphoblastic leukemia (ALL) being in remission from 6 to 25 years.The distribution of patients by leukemia subtypes was as follows: «common¼ - 67.4 %, pre-B - 23.9 %, pro-B andT-cell - 4.3 %. Children had been receiving chemo- and radiotherapy according to the protocol. Regarding the ageof patients at the time of ALL diagnosis the prepubertal, pubertal and postpubertal periods were taken into account.The endocrine diseases in family history, body weight at birth, serum content of free thyroxine, pituitary thyroid-stimulating hormone, cortisol, iron, ferritin and thyroperoxidase antibodies were evaluated and assayed. RESULTS: Thyroid disease in children was emerging in the first 2-3 years after the ALL treatment with an incidenceof 22.8 % (hypothyroidism - 14.1 %, autoimmune thyroiditis - 7.6 %, papillary cancer - 1.1 %). Seven children inthis group had received radiotherapy (12-18 Gy doses) on the central nervous system (CNS). No correlation wasfound between the radiation exposure event itself, radiation dose to the CNS and thyroid disease in the long-termfollow-up period. Thyroid cancer had developed in a child 11 years upon chemo- and radiotherapy. Hypothyroidismwas more often diagnosed in the patients of prepubertal age (rs = 0.49). There were endocrine diseases in thefamily history in about a half of children, being significantly higher than in the general sample (Ñ < 0.05). The bodyweight at birth of a child who had later developed hypothyroidism was less than in children having got thyroiditis(rs = 0.57). CONCLUSIONS: Disorders in endocrine regulation and of thyroid in particular can affect the prognosis of blood can-cer course in the long-term follow-up in children, especially in prepubertal age, which requires systematic supervi-sion by hematologist and endocrinologist.
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Leucemia Inducida por Radiación/fisiopatología , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Exposición a la Radiación , Índice de Severidad de la Enfermedad , Sobrevivientes/estadística & datos numéricos , Enfermedades de la Tiroides/fisiopatología , Adolescente , Adulto , Factores de Edad , Accidente Nuclear de Chernóbil , Niño , Femenino , Humanos , Leucemia Inducida por Radiación/etiología , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiología , Factores Sexuales , Enfermedades de la Tiroides/etiología , Ucrania/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: The literature data indicate that bacterial vaginosis (BV) increases the risk of development of lower urinary tract infections (LUTI). Thus, it is reasonable to assume that the use of probiotics, in particular Lactoginal, can be effective in preventing relapses of LUTI. AIM: To study the efficiency of probiotics, particularly Lactoginal, for the prevention of recurrent LUTI and BV. MATERIALS AND METHODS: A total of 120 women with chronic recurrent bacterial cystitis in the acute stage and concomitant bacterial vaginosis were randomized into two groups of 60 patients. In group 1, standard antibacterial therapy was used according to guidelines of professional societies. In group 2, vaginal probiotic Lactoginal was prescribed after standard treatment. RESULTS: The results obtained in this study correspond to the literature data. The additional use of probiotics in the complex therapy of chronic lower urinary tract inflammation contributed to the normalization of the lactobacilli concentration in 93% of cases, in contrast to standard antibacterial therapy, after which the normal flora was preserved only in 40% of cases. In addition, a reduction in the number of relapses of BV was seen. Moreover, it was found that in the group of patients treated with Lactoginal, there was 18.3% less recurrence of cystitis within 6 months than in the control group (p<0.05). CONCLUSION: The use of probiotics, in particular, Lactoginal vaginal capsules, in women with BV after antibacterial therapy contributes to a faster recovery and longer preservation of the normal vaginal flora, which allows to the prolongate the relapse-free period of both chronic bacterial cystitis and BV.
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Probióticos , Infecciones Urinarias , Vaginosis Bacteriana , Femenino , Humanos , Lactobacillus , Probióticos/uso terapéutico , Infecciones Urinarias/prevención & control , Vagina , Vaginosis Bacteriana/tratamiento farmacológicoRESUMEN
INTRODUCTION: Benign prostatic hyperplasia (BPH), and chronic prostatitis (CP) are considered to be among the most common causes of lower urinary tract symptoms (LUTS) in men. The combination of BPH with CP raises many questions when choosing the right treatment strategy. For a long time, bioregulators isolated from the prostate gland of cattle have been successfully used in the treatment of CP. OBJECTIVE: to evaluate the effectiveness of bioregulatory peptides, in particular vitaprost, in the treatment of men with benign prostatic hyperplasia and chronic prostatitis. MATERIALS AND METHODS: The study included 60 patients with BPH and CP, who were divided into two groups of 30 people. In the comparison group (CG), complex therapy with drugs from the group of alpha-blockers and fluoroquinolones was performed. In the main group (MG), a similar complex therapy was performed in combination with vitaprost tablets. The effectiveness of the treatment was evaluated after two weeks (visit 2) and after 4 weeks (visit 3). RESULTS: In the MG, a more effective reduction in the severity of LUTs and manifestations of the inflammatory process was noted than in the HS. After 2 weeks of therapy in OG, the average score on the IPSS, QOL and NICH-CPSI questionnaires was lower by 2.4 points, 1.2 points and 2.5 points, respectively, the number of white blood cells in the prostate secret was on average 1.5 times less, and Qmax was higher by 1.4 ml/sec. The revealed differences were statistically significant (p<0.05). This trend continued after 4 weeks of therapy. CONCLUSION: Thus, the use of bioregulatory peptides, in particular the drug vitaprost, in patients with BPH and CP helps to reduce the severity of LUTs and pain in a shorter time, has a positive effect on the dynamics of the inflammatory process, which leads to an improvement in the quality of life of patients in this category.
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Síntomas del Sistema Urinario Inferior , Hiperplasia Prostática , Prostatitis , Animales , Bovinos , Humanos , Síntomas del Sistema Urinario Inferior/tratamiento farmacológico , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Péptidos/uso terapéutico , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/tratamiento farmacológico , Prostatitis/tratamiento farmacológico , Calidad de VidaRESUMEN
INTRODUCTION: Currently, -blockers (-AB) and 5-alpha-reductase inhibitors (I-5-AR) are recommended as the drugs of choice for the treatment of patients with benign prostatic hyperplasia (BPH). However, despite the clear advantages of combination therapy, at the initial stages of treatment, I-5-AR is either not prescribed at all, or added to therapy after a few months. The aim of our study is to study the effectiveness of early and various options for delayed combined drug therapy of patients with BPH using -AB and I-5-AR. MATERIALS AND METHODS: The study included 90 patients with BPH, who were divided into three groups of 30 people. In group 1, monotherapy with drugs from the -AB group was performed for 6 months, after which they were transferred to treatment with a combined drug. In group 2, monotherapy was performed for three months, after which they were also transferred to treatment with a combined drug. And in group 3, patients were prescribed combination therapy from day 1. RESULTS: Early combination therapy with dutasteride was more effective than delayed Therapy for 6 months. There were no significant differences in the main parameters studied between patients who simultaneously started combination therapy and switched to it after 3 months, by the end of the 12th month of treatment. However, early therapy is a combined drug made it possible to achieve a more rapid effect in relation to LUTS. CONCLUSION: Thus, the data obtained confirm the clinical recommendations regarding the expediency of early initiation of combined therapy with an -adrenoblocker and a 5-reductase inhibitor in patients with moderate and severe LUTS caused by BPH and the risk of disease progression. Postponing the transition to combination therapy for 6 months or more may lead to a decrease in the effectiveness of treatment of patients in this category.
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Hiperplasia Prostática , Inhibidores de 5-alfa-Reductasa/uso terapéutico , Antagonistas Adrenérgicos alfa/uso terapéutico , Quimioterapia Combinada , Dutasterida/uso terapéutico , Humanos , Masculino , Hiperplasia Prostática/tratamiento farmacológico , Resultado del TratamientoRESUMEN
INTRODUCTION: Benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) are common disorders that are typical for age-related health changes in men. The combination of BPH with CP raises many questions when treatment tactics is chosen. Currently, new drugs have been developed and widely used, namely entomological drugs, which are biologically active substances with anti-inflammatory and antioxidant properties. The aim of our study was to study the efficiency of the entomological drug Adenoprosin in the complex therapy of patients with BPH and CP. MATERIALS AND METHODS: A total of 60 patients with BPH and P were included in the study. Patients were randomized into two groups of 30 people. In the control group, alpha-blockers and fluoroquinolones were prescribed. In the main group, patients received the same therapy with alpha-blockers and fluoroquinolones, but additionally took Adenoprosin once a day for three months. The results were evaluated at baseline (Visit 1), after four weeks (Visit 2) and three months (Visit 3) of therapy. The frequency of urination, the number of night urinations, the average score on the IPSS, QOL, NIH-CPSI scales, the maximum urine flow rate (Qmax), prostate volume and residual urine volume, as well as microscopic study and culture of expressed prostatic secretion were evaluated. RESULTS: At baseline, there were no differences between group in all studied values (p>0.05). By the second visit, despite the absence of significant differences (p>0.05), a more pronounced positive changes in the most parameters were showed in the main group. According to evaluation at visit 3, in the control group all values didnt change significantly compared to those at visit 2. In the main group, there was a significant decrease in the number of day and night urinations, an increase in the Qmax and the average score on the NICH-CPSI, IPSS and QOL scales, and a decrease in the prostate volume and residual urine volume. There was significant difference between results in the main and control group (p<0.05). CONCLUSIONS: Considering anti-inflammatory, antioxidant activity and antiproliferative effect, entomological drug Adenoprosin may become a novel drug for the complex therapy of patients with BPH and CP. However, to validate the results and to study the mode of action of this group of drugs in details, there is a need to carry out large-scale placebo-controlled clinical trials.
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Preparaciones Farmacéuticas , Hiperplasia Prostática , Prostatitis , Adenosina , Humanos , Masculino , Hiperplasia Prostática/tratamiento farmacológico , Prostatitis/tratamiento farmacológico , Calidad de Vida , Resultado del TratamientoRESUMEN
INTRODUCTION: Every year, more than 7 million women go to the doctor for chronic cystitis. An important factor is the psychoemotional component of this disease. OBJECTIVE: comparative analysis of various options for complex treatment of women with chronic recurrent bacterial cystitis using phototherapy, chronotherapy and correction of psychoemotional disorders with the anxiolytic drug Adaptol. MATERIALS AND METHODS: 90 women with chronic recurrent bacterial cystitis in the acute stage were examined and divided into 3 groups of 30 people. In group 1, patients received basic therapy with Furamag (furazidin kalium). In group 2, patients received standard therapy in combination with phototherapy in the acrophase of the chronorhythm. In group 3, basic therapy was performed in combination with phototherapy in the acrophase of the chronorhythm and Adaptol. The severity of dysuria and pain, leukocyturia, bacteriuria, chronobiological and psychoemotional status were evaluated. RESULTS: Initially, all patients showed signs of desynchronosis and psychoemotional disorders. All groups showed signs of exacerbation of chronic cystitis. The results obtained on the 5th day of therapy in groups 2 and 3 were statistically significantly different (p<0.05) from those in group 1. In group 3, the number of nocturnal urination (0.9+/-0.7), the number of imperative urges per day (0.7+/-0.5), and the intensity of pain (0.7+/-0.6) were the closest to normal. By day 10, clinical and laboratory parameters in all three groups reached normal values, which indicates the effectiveness of the therapy in each of the groups. CONCLUSION: Thus, the use of Furamag and Adaptol in combination with phototherapy at the maximum peaks of psychoemotional and physiological activity of the body effectively stops the clinical and laboratory manifestations of the disease, corrects the mental status and improves the quality of life of women in a shorter period of treatment.
Asunto(s)
Bacteriuria , Cistitis , Infecciones Urinarias , Antibacterianos/uso terapéutico , Bacteriuria/tratamiento farmacológico , Cistitis/tratamiento farmacológico , Femenino , Humanos , Calidad de Vida , Infecciones Urinarias/tratamiento farmacológicoRESUMEN
Based on the literature data, this review discusses the prevalence and etiology of male infertility, as well as the current view of the reasons for the lack of effectiveness of treatment of idiopathic infertility in men. The effectiveness of antioxidant therapy in various variants of redox balance disorders is evaluated. Possible prerequisites and mechanisms of complications in the administration of antioxidants are described. In addition, the need to introduce laboratory confirmation of oxidative stress and review approaches to antioxidant therapy is justified. The article also discusses the possibility of treating idiopathic pathospermia with the help of a complex drug Androdoz, which, according to the literature, can improve such indicators of sperm as the volume of ejaculate, the number and viability of spermatozoa and the proportion of their actively mobile forms due to the synergy of its components.
Asunto(s)
Antioxidantes , Infertilidad Masculina , Antioxidantes/metabolismo , Antioxidantes/uso terapéutico , Humanos , Infertilidad Masculina/tratamiento farmacológico , Infertilidad Masculina/metabolismo , Masculino , Estrés Oxidativo , Espermatozoides/metabolismoRESUMEN
Lower urinary tract infections (LUTI) currently retain the status of one of the most urgent problems of urology. According to extensive microbiological studies of UTIAP I and II, "DARMIS" the most common pathogens that are detected in the urine of women with LUTI are gram-negative bacteria of the Enterobacteriales family, in particular E. Coli. Antibacterial therapy demonstrates high effectiveness in the treatment of uncomplicated LUTI. However, the problem of recurrent infection remains unresolved. Taking into account known side effects of continuous antimicrobial prevention, as well as data on the high frequency of relapses after its cancellation, it is necessary to identify alternative LUTI prevention strategies. The use of D-mannose can be one of these strategies. D-mannose use for the prevention of relapses of INMP is indicated in the clinical recommendations of the American (AUA) and European (EUA) urological associations. D-mannose is a monosaccharide that is extracted from a larch rod. It is relatively quickly absorbed and reaches the peripheral organs in about 30 minutes, after which it is excreted in the urine. The structure of d-mannose allows it to bind to mannose-sensitive E. Coli fimbriae and prevent their adhesion to the urinary tract mucosa. Several studies demonstrated high safety profile and effectiveness of long-term D-mannose treatment in preventing LUTI. The data presented in the literature allow us to recommend patients with recurrent LUTI long term D-mannose intake helps to reduce the severity of symptoms in acute episodes and prolong relapse-free period. As a source of D-mannose, we can recommend Ecocystin 1 sachet 1 time a day.
Asunto(s)
Cistitis/tratamiento farmacológico , Infecciones Urinarias/tratamiento farmacológico , Antibacterianos/uso terapéutico , Escherichia coli , Femenino , Humanos , ManosaRESUMEN
INTRODUCTION: Lower urinary tract infections (LUTI) are one of the most common diseases among women. The risk of LUTI increases with the onset of peri- and postmenopause. Vulvovaginal atrophy occurs in 30% of women aged 55 years and 75% of women aged 70 years. Currently, local hormone therapy is the main method of its treatment. However, different variants of complex therapy are also used. MATERIALS AND METHODS: The study included 60 women aged with the diagnosis: "Postmenopausal atrophic vaginitis. Chronic recurrent bacterial cystitis in the acute stage". The patients were divided into 2 groups of 30 people. In group 1 was carried out etiotropic antibiotic therapy in combination with local use of single-agent preparation or estriol for 3 months. In group 2, the patients received antibiotics in combination with Triozhinal for 3 months. The effectiveness was monitored on the 1st and 7th day of therapy, as well as 3 months after the start of treatment. RESULTS: At admission in both groups there were signs of vulvovaginal atrophy and exacerbation of chronic cystitis. Complex therapy with Triozhinal, containing lyophilized culture of lactobacilli L. casei rhamnosus Doderleini, contributed to the normalization of PH, restoration of vaginal biocinosis, and, consequently, reduce the severity of complaints of dryness and burning in the vagina, dyspareunia. Thus, despite the reduction of symptoms in the majority of women, the proportion of such patients in group 2 was higher and amounted to 96.7% against 83.3% in group 1. Supportive reception of the drug for 3 months. it allowed to preserve the normocinosis of the vagina until the restoration of its trophic, as well as to reduce the frequency of bacteriuria and leukocyturia by 20% compared with the results of group 1, and to significantly reduce the number of relapses of infection (p<0.05). CONCLUSION: Triozhinal improves the results of treatment of recurrent urinary infection in women with vulvovaginal atrophy in peri- and postmenopausal and can be recommended for use in combination therapy.
Asunto(s)
Cistitis , Probióticos , Infecciones Urinarias , Anciano , Atrofia , Cistitis/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana Edad , Posmenopausia , Probióticos/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , VaginaRESUMEN
Mortality after pancreaticoduodenectomy (PD) decreased from 25% to 1-3% in the last decade. However, the number of early postoperative complications varies from 29.5% to 70%. Therefore, there is a need in new methods of perioperative management of patients after PD to improve the immediate results. To analyze the effectiveness of perioperative treatment regimens, a prospective retrospective study of the results of 78 patients after PD with diseases of the head of the pancreas and the periampular zone for the period from 2003 to 2017 was conducted. For comparative analysis, the patients were divided into 2 groups: group I included 39 patients for the period from January 2015 to December 2017, the perioperative treatment of which was carried out in accordance with the enhanced recovery program, group II -39 patients from January 2003 to December 2014, which were conducted according to the traditional method. We studied the time of the restoration of oral nutrition, postoperative complications, the length of hospital stay (LoS).There were no mortality in groups. The overall incidence of Clavien-Dindo complications in I group was less than in II (10 (25.6%) vs. 18 (46.1%), p = 0.029). In I group, the incidence of delayed gastric emptying (DGE) was lower compared to II (15.4% (6 patients) versus 35.9% (14 patients), p=0.009). Pancreatic fistula (PF) in I and II groups did not differ significantly - 10.2% (4 patients) and 12.8% (5 patients), respectively (p=0.36). The incidence of surgical wound infections in I group was reduced in comparison with II (5.1% (2 patients) versus 17.9% (7 patients), (p=0.031).The LoS in I group was significantly less compared with II (14 days 95% CI: [13, 17] vs. 18 days 95% CI: [16, 18], p=0.012). The results of the ERAS program after PD shows the reducing number of postoperative complications and LoS, demonstrating the feasibility in clinical practice.
Asunto(s)
Cuidados Posteriores , Enfermedades Pancreáticas , Pancreaticoduodenectomía , Atención Perioperativa , Complicaciones Posoperatorias , Humanos , Cuidados Posteriores/métodos , Cuidados Posteriores/organización & administración , Vaciamiento Gástrico , Incidencia , Tiempo de Internación/estadística & datos numéricos , Evaluación de Procesos y Resultados en Atención de Salud , Enfermedades Pancreáticas/epidemiología , Enfermedades Pancreáticas/cirugía , Pancreaticoduodenectomía/efectos adversos , Pancreaticoduodenectomía/rehabilitación , Pancreaticoduodenectomía/estadística & datos numéricos , Atención Perioperativa/métodos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Periodo Posoperatorio , Estudios Prospectivos , Estudios Retrospectivos , Infección de la Herida Quirúrgica/epidemiologíaRESUMEN
INTRODUCTION: Currently, chronic recurrent cystitis is one of the most important problems in urology. Considering the role of immune status disorders in the pathogenesis of inflammatory diseases, the use of immunocorrective drugs as part of the complex therapy is of particular relevance. AIM: to study the efficiency of therapy for chronic recurrent bacterial cystitis in combination with immunomodulators (Galavit). MATERIALS AND METHODS: A total of 60 women with acute stage of chronic recurrent bacterial cystitis were examined. The patients were randomized into 2 groups of 30 patients. In the control group, standard antibiotic therapy was administered. In the treatment group, patients received Galavit in combination with standard therapy. All patients were followed-up on the 1st, 5th and 10th day. Voiding diaries, chronobiological status and pain severity using a 5-point scale were evaluated. In addition, complete blood count, urinalysis, urine culture and enzyme immunoassay for determination of serum level of interleukin (IL) 1, IL-6, tumor necrosis factor (TNF-) were analyzed. A number of recurrences after 3 months of therapy was assessed. RESULTS: Complex therapy in combination with Galavit in women with acute stage of chronic bacterial cystitis allows to decrease in desynchronosis by 20%, reduce pain by 2.5 times, frequency of urination by 1.7 times, the number of urgent voids and night urination by 2.4 and 5 times, respectively, by the 5th day of therapy. In the group of patients receiving immunomodulators a significantly more pronounced decrease in the level of IL-1, IL-6, TNF- and CRP was noted. During 3 months of follow-up, there were 2 recurrences in the control group and no recurrences in treatment group (10%). CONCLUSION: The use of Galavit in the treatment of women with chronic recurrent bacterial cystitis has pathogenetic basis. A clear advantage of the drug is more rapid relief of symptoms, normalization of laboratory parameters, recovery of chronorhythms and the achievement of clinical remission.
Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Cistitis/tratamiento farmacológico , Luminol/análogos & derivados , Infecciones Urinarias/tratamiento farmacológico , Antibacterianos/administración & dosificación , Enfermedad Crónica , Quimioterapia Combinada , Femenino , Humanos , Luminol/administración & dosificación , Luminol/uso terapéutico , RecurrenciaRESUMEN
AIM: For a long time, benign prostatic hyperplasia (BPH) was considered as only cause of lower urinary tract symptoms (LUTS) in elderly men. More than 30% of patients underwent surgery by the age of 80. Unsatisfactory outcome of surgical treatment of BPH are observed in 9-27% of cases. Various irritative symptoms, which are typical for detrusor overactivity, persist especially often. Currently, anticholinergic drug therapy (m-cholinoblockers) is the main treatment for detrusor overactivity. The aim of our study was to assess the effectiveness of m-cholinoblockers for the treatment of persisted LUTS in men with BPH who had undergone transurethral resection of prostate (TURP). MATERIALS AND METHODS: The study included 60 patients with BPH who underwent TURP. All patients were divided into two groups. In Group 1, anti-inflammatory therapy for 10 days with 1-month follow-up was prescribed. In Group 2, anti-inflammatory therapy was combined with the drug Toviaz for 1 month. Evaluation of the treatment effectiveness was carried out 3-5 days, 14-15 days and 1 month after TURP, respectively and included voiding diary, IPSS score, QOL, uroflowmetry, adverse events and acute urinary retention. RESULTS: At baseline, in the Group 1 and 2, average urination frequency was 12.6 and 12.7 times per day, the number of urgency episodes was 9.2 and 9.0 times and number of nocturnal voiding episodes was 5,2 and 5.3 times, respectively. The average IPSS score was 19.8 and 19.7 points and Qmax was 6.5 and 6.7 ml/sec, respectively. By the 14th-15th day of therapy, in both groups positive changes were found. There was a significant decrease (p<0.05) in the urination frequency and nocturnal voiding episodes according to voiding diaries, an increase in Qmax and average IPSS and QOL score. The adverse events rate in group 2 was 16.7%. By the 30th day of therapy in the group 1 there were no significant changes. However, in group 2, urination frequency, number of urgency episodes, average IPSS and QOL score decreased to an average of 5.7 times a day, 0.4 times, 1.2 times, 9.3 points and 1.6 points, respectively. Average Qmax increased to 15.5 ml/sec. No adverse events were detected. CONCLUSION: According to the results of our study, the use of m-cholinoblockers, in particular Fesoterodine (Toviaz), in combination with standard therapy in patients with detrusor overactivity after TURP is reasonable and allows to effectively and safely alleviate irritative symptoms.
Asunto(s)
Compuestos de Bencidrilo , Hiperplasia Prostática , Resección Transuretral de la Próstata , Agentes Urológicos , Anciano , Compuestos de Bencidrilo/uso terapéutico , Humanos , Masculino , Hiperplasia Prostática/cirugía , Resultado del Tratamiento , Agentes Urológicos/uso terapéuticoRESUMEN
INTRODUCTION: Acute cystitis is the most common manifestation of uncomplicated urinary tract infection. One of the drugs whose effectiveness in the treatment of patients with INMP has been proven is fosfomycin, which has been on the pharmaceutical market for a long time and is widely used in urological practice. despite the good results of etiotropic therapy, the problem of recurrent UTI remains unresolved, which occurs in about 30% of women within a year after the first episode of cystitis. alternative prophylactic agents, such as probiotics, cranberry preparations, phytopreparations, etc. are increasingly used in prolongation of the inter-relapse period. One such remedy is D-mannose. OBJECTIVE: to evaluate the effectiveness of D-mannose and the combined drug Ecofomural containing fosfomycin and lactulose in the complex treatment of women with uncomplicated lower urinary tract infection. MATERIALS AND METHODS: 60 women with acute uncomplicated cystitis were examined and treated. By random sampling, all women were divided into 2 groups of 30 people. In group 1, antibiotic therapy with Ecofomural once 1 sachet after urination was prescribed. The product contains 3G of fosfomycin and 1.5 g of prebiotic lactulose. In group 2, a similar antibacterial therapy with the enrichment of the diet with a source of D-mannose (Ecocystin) 1 sachet 1 time per day for 6 months. Evaluation of the effectiveness of antibacterial therapy was carried out on the 3rd and 7th day. It included analysis of dysuric symptoms according to diaries of urination, assessment of pain intensity, laboratory tests. Long-term results of therapy were evaluated within 6 months after taking the antibacterial drug. The examination included a comparative analysis of the frequency of relapses of the disease, filling diaries of urination and laboratory tests. RESULTS: When treated, all women showed signs of acute cystitis. On the 3rd day of therapy in both groups there was a statistically significant (p<0.05) positive dynamics of the studied parameters. By the 7th day in both groups marked relief of dysuric phenomena and pain. The number of white blood cells in the urine of all patients was within normal values. During a further 6-month follow-up, relapses of the disease were detected in 7 (23.3%) patients in group 1 and in 1 (3.3%) in group 2. Bacteriological examination in group 1 revealed the same pathogen in 5 (16.7%) cases as in the first treatment. The other women had different pathogens. CONCLUSION: The results of the study demonstrated the high efficacy and safety of complex therapy with Ecofomural containing fosfomycin and lactulose, in combination with long-term enrichment of the diet with D-mannose (Ecocystin) b in order to prolong the inter-relapse period of uncomplicated lower urinary tract infection.