RESUMO
BACKGROUND AND PURPOSE: In the light of increasing resistance to antibiotics used for the treatment of acute urinary tract infections, nitrofurantoin currently experiences a renaissance. Nitrofurantoin shows good efficacy against most bacteria expected in urinary tract infection, and the development of resistance is low. A study on the antimicrobial and clinical efficacy of nitrofurantoin in the treatment of acute lower urinary tract infections was conducted in Mexico City, an area where resistance rates of uropathogens to trimethoprim/sulfamethoxazole (cotrimoxazole) are high. PATIENTS AND METHODS: In this open-label, single-arm study 20 adult patients (18 females, 2 males) with positive urine culture were treated orally with nitrofurantoin sustained release 100 mg twice daily for 7 days. Urinary nitrofurantoin concentrations were determined at baseline and day 4 of the study. Primary endpoint was the antimicrobial efficacy of nitrofurantoin at 12 to 16 days after baseline, assessed by changes in urine culture results. RESULTS: In the patient population treated per protocol, primary endpoint analysis revealed a microbial eradication rate of 92.3%. At 35 to 42 days, the eradication rate was 83.3%. At these times, all patients in the per protocol population were free of symptoms. In patients with complicating factors, e.g. diabetic polyneuropathy, both antimicrobial and clinical efficacy appeared to be reduced. Urinary nitrofurantoin concentrations were mostly above minimum inhibitory concentrations of the isolated uropathogens. The study drug was generally well tolerated. Most frequent drug-related adverse event was mild headache, occurring in 10.8% of patients. Two patients discontinued the study due to rash. CONCLUSION: The results of the present study indicate good antimicrobial and clinical efficacy of nitrofurantoin in the treatment of acute uncomplicated urinary tract infections as well as acceptable tolerability in adults.
Assuntos
Anti-Infecciosos Urinários/uso terapêutico , Bacteriúria/tratamento farmacológico , Nitrofurantoína/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Administração Oral , Adulto , Idoso , Anti-Infecciosos Urinários/efeitos adversos , Anti-Infecciosos Urinários/farmacocinética , Bacteriúria/urina , Preparações de Ação Retardada , Esquema de Medicação , Feminino , Humanos , Masculino , Taxa de Depuração Metabólica/fisiologia , México , Pessoa de Meia-Idade , Nitrofurantoína/efeitos adversos , Nitrofurantoína/farmacocinética , Recidiva , Resultado do Tratamento , Infecções Urinárias/urinaRESUMO
UNLABELLED: The objective of the present study was to determine the efficacy and safety of a fixed dose of vardenafil in the treatment of patients with erectile dysfunction (ED). MATERIAL AND METHODS: This was an open label, prospective and multicentric trial. After a 4-week wash out period, all patients received 20 mg of vardenafil given on demand for 12 weeks. Primary efficacy variables were the erectile function domain of the International Index of Erectile Function (IIEF), answers to questions 2 and 3 of the Sexual Encounter Profile (SEP) and the Global Assessment Question (GAQ). All adverse events were recorded and reported. RESULTS: 229 patients were screened. 177 received at least one dose of vardenafil and were included in the safety analysis. Mean age was 54.4 years old. Etiology of ED was organic or mixed in 77% of the patients. Erectile function domain of the IIEF changed from a basal mean score of 14.8 to 25.5 at the end of the study. 80.5% of the patients reported erections of rigidity and duration enough for satisfactory sexual intercourse and 93.3% improved their erections at the end of the study. Adverse events were mild to moderate and the most common were headache, dyspepsia, rhinitis and facial flushing. The drop out rate due to adverse events was 1.7%. CONCLUSIONS: This multicenter study confirms the high efficacy of this new phosphodiesterase type 5 inhibitor, vardenafil. There was a low rate of discontinuations due to adverse events and a favorable safety profile. The results of this study are similar to the results of other studies conducted in other parts of the world.
Assuntos
Disfunção Erétil/tratamento farmacológico , Imidazóis/uso terapêutico , Inibidores de Fosfodiesterase/uso terapêutico , Piperazinas/uso terapêutico , Sulfonas/uso terapêutico , Triazinas/uso terapêutico , Adulto , Idoso , Humanos , Masculino , México , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Dicloridrato de VardenafilaRESUMO
Con el propósito de difundir mayores conocimientos en torno a la hiperplasia prostática el comité Mexicano para el Estudio de la Próstata se ha dado a la tarea de efectuar una serie de revisiones que en su conjunto logren que el urólogo y el internista puedan diagnosticar y tratar adecuadamente los casos de hiperplasia prostática. En este artículo se hace una completa revisión de la fisiopatogenia de esta afección desde su mecanismo hormonal, teoría de la célula precursora hasta la teoría de la interacción estremo-epitelial.
Assuntos
Humanos , Masculino , Hiperplasia Prostática/fisiopatologia , Neoplasias da Próstata/fisiopatologia , Células-Tronco/metabolismo , Testosterona/efeitos adversos , Substâncias de Crescimento/efeitos adversos , Estradiol/efeitos adversos , Fatores de Crescimento de Fibroblastos/efeitos adversos , Androgênios/efeitos adversos , Estrogênios/efeitos adversos , Mitógenos/efeitos adversos , Próstata/lesõesRESUMO
Para valorar la utilidad de la tomograía axial computaorizada (TAC) en el diagnóstico y manejo del absceso renal se analizaron en forma retrospectiva 15 casos de absceso renal comparándose este método radiológico con el ultrasonido renal, la urografía excretora y la placa simple de abdomen. La urografía excretora fue diagnósica en el 71.4%, el ultrasonido en el 80%, la placa simple de abdomen en el 33.3% y la TAC en el 100 por ciento. De los 15 pacientes, en 12 el tratamiento fue quirúrgico y en tres casos con servador con antibióticos parenterales. La mortalidad global fue del 16.6 por ciento. Los resultados de nuestro trabajo indican que la TAC es un elemento diagnóstico sensible y superior a los métodos radiológicos convencionales para la detección del absceso renal. Por otro lado, determina con mayor precisión su localización y extensión
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Abscesso/diagnóstico , Nefropatias/diagnóstico , Tomografia Computadorizada por Raios X , Abscesso , Abscesso/mortalidade , Estudos Retrospectivos , RimRESUMO
Reportamos el caso de un niño de 8 años con criptorquidia bilateral en quien se practicó autotrasplante d eun testículo intr-abdominal utilizando técnica microvascular, con resultado satisfactorio. Se localizó la gónada preoperatoriamente mediante tomografia axial computada. La evaluación de la perfusión testicular postquirúrgica se efectuó con gamagrafía. Diez meses después de la operación el testículo autotrasplantado es normal a la exploración física. Se discuten las indicaciones de este procedimiento, los métodos de evaluación pre y postperatoria y se revisa la literatura. Consideramos que esta técnica es útil cuando la indicación es precisa y sólo si se cuenta con el instrumental y entrenamiento especiales para microcirugía