All articles - Urology and Nephrology
Number of articles: 435
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The article is devoted to the problem of restoring bladder functions in disorders of its central and peripheral innervation, issues of the so-called neurogenic bladder in spinal cord injuries. Despite numerous modem studies, bladder function, bladder innervation and the mechanisms of its coordinated activity, as well as their correction in spinal disorders, remain important issues of modem medical science and require their solution in the context of neurorehabilitation. -
Eulminant gangrene of genital organs (Fournier's disease, necrotizing fasciitis, fulminant gangrene of the scrotum, etc.) - acute necrotizing infection affecting the subcutaneous fatty tissue of the external genital organs and the perianal region of men; much less affects the genitals of women. The authors note the importance of an integrated approach to the treatment of Fournier's gangrene, which includes antibacterial, detoxication therapy, correction of disorders of homeostasis and metabolism, disturbances in functioning of organs and systems. Surgical treatment should be carried out without delay, in compliance with the principles of "aggressive surgery", i.e. should be as radical as possible with excision of subcutaneous fat. drainage of fascial spaces. -
Effect of tripsin on immune characteristics and proteolytic activity of sperm in men with fertility disorderIn men with unpaired tenuity, proteolytic and anti-proteolytic activity was studied in the ejaculate, as well as the rates of pro- and anti-inflammatory interleukins after their treatment with trypsin. In men with impaired fertility, there is a decrease in total proteolytic activity and an increase in the antiproteolytic activity of sperm. The increase in antiproteolytic activity is more associated with the local and systemic reaction to the inflammatory process, but to a lesser extent with the inhibition of sperm proteases. After treatment with trypsin in men with impaired fertility, there was a decrease in antiproteolytic and an increase in the proteolytic activity of sperm. The use of trypsin as an immunocorrective factor of male sperm helps to improve its immune characteristics.
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Clinical and laboratory significance of lipid peroxidation and sistem of antioxidant defense of the organism of children with glomerulonefritis69 children with acute (OGN) and 59 with chronic glomerulonephritis (CGN) hospitalized in the nephro-logic department were examined. Blood and urine for analysis in patients are taken during the period of activi-ty of OGN and exacerbation of CGN, for the first time the days of admission to the hospital. Patients with OGN and CGN showed distinct seasonal fluctuations in LPO activity (p <0.001), a significant increase in the phos- pholipase activity of urine and blood compared to the control indices (p <0.001), a significant increase in the cytotoxic lipid lipophosphatidylcholine fraction (LFX) (p <0.001), a decrease in the level of phosphatidylcho-line (PX) (p <0.001), a reduction in mechanical resistance (p <0.001) and erythrocyte deformability (p <0.001). In the examined patients, the level of α-tocopherol (p <0.001) and the activity of superoxide dismutase (SOD) (p <0.001), catalase and peroxidase in the blood (p <0.001) was decreased, while the activity of antiox-idant and antiperoxide enzymes in urine increased (p < 0.001). It has been established that in patients with acute respiratory depression and CGN in aggravation, the activity of lipid peroxidation is increased, the eryth-rocyte FLase activity of erythrocytes and A2 FLase decreases, the level of SOD of erythrocytes decreases, cata-lase and peroxidase activity of the blood, as well as the percentage of LFH in erythrocyte membranes, the me-chanical resistance and deformability decrease red blood cells
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Renal functional state in patients with chronic pyelonephritis under influence of the galvanizationThe indices of radioisotope renography with I 131 -hippuran were studied in 30 patients with chronic kid-ney disease I: pyelonephritis under influence of galvanic current. A prolongation of the period of maximal ac-cumulation of hippuran by the kidneys (p<0,001), the period of half-life washout of a tracer (p<0,01) and elim-ination of the preparation (p<0,001) have been revealed. Accumulation of hippuran in kidneys under the influ-ence of direct current was proved and possibility of galvanization usage to increase the efficacy of inflammato- ry kidney diseases treatment was demonstrated
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The aim of the study was a comparative assessment of the effectiveness of immunotherapy and targeted therapy after nephrectomy. With this aim, the study was conducted in 126 cancer patients with metastases of different localization. Of these, 62 (49.2%) patients had metachronous metastases on average 11 months after radical nephrectomy, and 64 (50.8%) had synchronous metastases to prevent possible complications was per-formed palliative nephrectomy Depending on the methods of treatment, patients were divided into 2 groups. 1 group n=82 nephrectomy + immunotherapy. 2 group n = 44 nephrectomy + targeted therapy. Comparative evaluation of the drug toler- ance, severity of side effects and the immediate effectiveness of the compared methods of treatment significant differences between the groups were not found (p< 0.05). The three-year survival rate was 18.4±2.3% and 24.3±2.2% respectively (p > 0.05)/ five-year survival rate was 0%. The results of the study showed that target-ed therapy has a significantly better three-year survival than immunotherapy -
According to the modem concept, pathological processes are realized on cell membranes, causing a violation of the structural and functional organization, up to complete destruction. The use of glucocorticoid and cytotoxic therapy in combination with heparin does not guarantee success and lead to complications, especially in children. Consequently, the search for drugs that remove the toxic effects of immunosuppressive therapy continues to be an urgent medical and social problem. What was the reason to study the features of antioxidant therapy in order to optimize the pathogenetic treatment of chronic glomerulonephritis in children. The advantage of therapy with the inclusion of actovegin antioxidant was that parallel to the normalization of malondialdehyde and lysophosphatidylcholine, the other cell membrane fractions increased, apparently due to the ability of aktovegin to reduce the activity of phospholipases. The conducted research will allow to review the tactics of treatment of nephropathy in accordance with the obtained research results, to include in the complex therapy a step-by-step correction of membrane destabilization with Actovegin. In addition, pathogenetic therapy for glomerulonephritis is fraught with complications, ultimately associated with a violation of cellular stability and requires corrective antioxidant therapy. -
Modern methods of diagnosis of varicocele syndrome. The symptoms of varicocele are usually meager. Often patients do not make significant complaints, and the diagnosis is made during screening examinations, and in adulthood - during examination for infertile marriage. Sometimes patients complain of the presence of dilated veins in the scrotum ("bundle of worms"), detected during self-examination and focusing the patient's attention, especially during puberty. Rarely, varicocele is manifested by pulling pains in the corresponding half of the scrotum. Pain may increase with physical exertion, sexual arousal and in an upright position of the body (due to increased venous pressure). The examination begins with a detailed collection of anamnesis, while paying attention to the prescription of the symptom, the presence of trauma to the lumbar region. Next, the patient is examined standing and lying in a warm room. In an upright position, it is necessary to examine both spermatic cords in order to identify the difference in their sizes. Light traction of the testicle is required to reduce the effect of the cremaster reflex. Any signs of testicular atrophy should be noted. Functional tests are carried out - Ivanissevich and Valsalva ("cough push") [4,13,17,26,41,44]. -
Quality of life and sleep related with chronic non-bacterial prostatitis versus benign prostatic hyperplasiaThe quality of life and sleep was determined in 80 sick on the outpatient setting: 47 men with chronic non-bacterial prostatitis (CNP) versus 33 men with benign prostatic hyperplasia (BPH). Quality of life was evaluated using the EuroQol-5D questionnaire. Quality of sleep was analyzed by Somnology Center question-naire. Pain evaluation in both groups was performed by Visual Analog Scale (VAS). Prostate-specific symp-toms were assessed using I-PSS and NIH-CPSI questionnaires. Patients with chronic pelvic pain and lower urinary tract symptoms showed significant disturbances in the quality of life and sleep. In CNP group those were connected with chronic pain syndrome, whereas in BPH group – predominantly with frequent urination and subsequent need of waking at night
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The aim of this work was an attempt to evaluate the effect of complex treatment on some endogenous intoxication indicators in chronic pyelonephritis developed on the background of dismetabolic nephropathy (DMN) (CHP). Patents and methods. A survey of 177 children CHP, aged 4 to 15 years. Patients were divided into 2 groups depending on treatment method. Results. Comparative assessment of the results of the study of endogenous intoxication conducted after treatment in children with CHP, depending on the method of treatment, demonstrated the effectiveness of regional lymphotropic antibiotic therapy in combination with vitamin A compared to other methods of therapy. Conclusion. The use of complex treatment of regional lymphotropic antibiotic therapy in combination with vitamin A when CHP is the most appropriate method of therapy. This method leads to the restoration of the TCA (total concentration of albumin) and ECA (effective concentration of albumin) in the blood and kidney function. -
Computer tomography in the diagnosis of tumor thrombosis of the renal and vena cava inferiorsThe article presents cases of the renal vein and inferior vena cava involvement by a tumor conglomerate, diagnosed by computed tomography. In all cases, patients were examined for complaints not related to the re-vealed underlying pathology and not presumed prior to the examination. Clinical diagnosis was determined with the help of detectable signs of massive expansion of the diameter of the main vessels. Thrombus was demonstrated in the vascular lumen with additional enhancement of CT after intravenous injection of uro-graphic contrast material.
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Estimation of efficiency of application of minimally invasive technologies in diagnostics and treatment of tuberculosis obstructive forms of the urinary waysPercutaneous nephrostomy and stenting for tuberculosis of the kidneys with supravesical obstruction creates the conditions for normalizing the passage of urine. The accumulated experience allows us to positively assess the role of PKNS as a method of choice for the release and assessment of the reserves of renal function against the background of tuberculous changes in the upper urinary tract, and stenting for tuberculosis of the kidneys with supravesical obstruction creates the conditions for normalizing the passage of urine.
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The 49 patients was examinationed (mean age - 50.6 ± 1.6 years, duration of the disease - 9.4 ±1.7 years), male and gout showed clinical and laboratory signs of kidney damage in 65.3%, chronic renal failure - in 49.0% of patients. Kidney damage and signs of CKD were more commonly detected in patients with older age, with a large number of affected joints, tophi, frequent exacerbations of the articular syndrome and increased severity of gout. Clinical forms of metabolic syndrome (MS): 1 and 11 degrees of obesity were diagnosed in 30.6%, arterial hypertension in 26.5%, and type 2 diabetes in 12.2% of patients. The presence of MS contributes to the deterioration of the kidneys. The degree of increase in total lipids and cholesterol in serum is accompanied by a decrease in GFR (r = -0.50; r = -0.40). -
Assessment of the functional condition of kidneys in patients with excessive body weight and obesityThe aim was to study the functional state of the kidneys with overweight and obesity. It was established that the average parameters of the GFR of the examined changed along with the growth of the BMI for all types of GFR. If, when calculating according to the MDRD and CKD-EPI formulas, significant differences between the groups were obtained, then, when calculating using the Cockcroft Gault formula, no significant differences were observed. Calculations of GFR using MDRD and CKD-EPI formulas revealed 1.5 times more patients requiring special nephrological examination, treatment correction, and dynamic observation. The calculation of GFR using the MDRD and CKD-EPI formulas is preferable to the calculation using the Cockcroft-Gault metod.
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The medicinal therapy for urolithiasis should be long-term. The significant side effects of synthetic drugs often requires discontinuation of treatment. Therefore, of the preference is given to herbal medicines. The diu-retic and saluretic abilities of infusions from 15 medicinal plants of the flora of Uzbekistan were studied during treatment of 449 pts with calcium urolithiasis. Infusions has different diuretic power, as well as effects on urine pH and saluresis. The revealed properties of the preparations made it possible to develop criteria for their ad-ministration taking into account the state of diuresis, urine pH, balance of promoters and calcium stone for-mation inhibitors. The selective treatment contributes provide the high therapeutic efficacy and economic bene-fits. -
Early stage of kidney damage in patients with hypertensive diseaseThe defeat of the kidney as the target organ of hypertensive disease in 40% of patients begins to form early - within 5 years from the debut of the disease. The early stage of hypertensive nephropathy is a dynamic process that has clinical and functional markers at each stage, so microalbuminuria, increased intrarenal vas-cular resistance, and changes in the total filtration function of the kidneys are the earliest
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Elaborating of endoscopic treatment algorithm of patients with staghorn and multiple kidney stonesComplex examination and treatment of 158 patients with staghorn and multiple kidney stones was car-ried out. The use of endoscopic treatment algorithm in patients with staghorn and multiple nephrolithiasis al-lowed to increase the stone free rate up to 90.0%. Inclusion of developed algorithm of endoscopic treatment of patients with staghorn and multiple kidney stones in the complex of therapeutic measures allows to increase the effectiveness of treatment of patients with nephrolithiasis
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Clinical characteristics of patients with urogenital candidosisThe goal was to study the main symptoms of urogenital candidiasis depending on gender, place of resi-dence of patients. Installed that the main causes of urogenital candidiasis were endocrinopathy, long-term an-tibiotics and cytotoxic drugs, hypovitaminosis. Specific clinical symptoms of urogenital candidiasis are most often detected in women than in men, without reference to age and place of residence
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Functional condition of kidneys at the premature the newborns who were born from mothers with preeсlampsia40 premature children arc examined, the assessment of a functional condition of kidneys depending on existence of a prccclampsia of mother is carried out. It is revealed that at all premature newborns, decrease in diuresis, decrease in osmotic concentration of urine which raises by the end of the first week of life is noted, but does not reach indicators of healthy children, thus the most expressed changes are observed in group premature, been bom from mothers with a preeclampsia and are followed by an azotemiya which is connected with catabolic processes in an organism and the lowered kidney ekskretion of nitrogenous products.
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Balance of urinary inhibitors and promouters of urolitiasis during treatment by extract of phytopreparationThe 96 male rats were randomly divided into two groups. The standard nutrition and drinking water with 0.75% EG as an inducer of stone formation were free for all rats. The first group received an extract from DG; the second group (control) received a placebo. The strong diuretic effect of the extract was found - by 69.1%. A significant change in inhibitors and promoters of urolithiasis was observed: an increase in urine pH and citrate excretion, a decrease in calciuria and oxaluria. The decrease in the activity of lithogenesis was confirmed by a decrease in the AP [CaOx] index by 70.86% from the baseline. The results confirm that diuretic plant has demonstrated the ability of herbal preparations, in addition to the diuretic effect, to influence on factors of uri-nary lithogenesis. The high diuretic effect in combination with ability of DG to normalise the balance of pro-moters and inhibitors, allows us to offer it for the management of patients with urolithiasis
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Fournier's illness - seldom found disease characterized by scrotum skin gangrene. In pathogenesis of this disease features of a structure of a scrotum and a crotch generally matter. Ways of distribution it is purulent - necrotic process so far are finally not studied. In tactics of treatment of this disease, in what terms it is necessary to open purulent process and how to carry out a nekrektomiya there are different views. On the basis of the supervision we came to a conclusion that in an ctiopatogcncsis special value has diabetes and in complex treatment it is necessary to apply active surgical tactics. -
Nephropathy of metabolic genesis in young children: Assessment of partial renal function121 children with pneumonia on dismctabolic nephroparthy background were investigated, and 20 children with pneumonia wittout urinary syndrome. It were performed following methods of kidney partial functions investigation of glomerulus filtration, ammonia, acidity, osmotic quality of urine, daily metabolites screening (oxalates, urates, urine acid). In patients with pneumonia on dismetabolic nephroparthy background were revealed significant alterations of kidney partial functions, stnictural and functional condition of erythrocytes membrane, increasing of peroxides lipid oxidation processes. For the purpose of correction children with pneumonia and renal pathology it was prescribed following treatment.
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Improvement of results of furnye gangrene complex treatment with co 2 laser and photodynamic therapy usingThe use of CO 2 laser has allowed for the possibility of early and bloodless nekroektomy, improve wound repair, and reduces microbial contamination of purulent wounds. Method has photo coagulating and sterilizing properties effects on the tissue. Photodynamic therapy is a very effective non-invasive and gentle treatment of purulent wounds and serve as justification for the use of the method of photodynamic therapy in clinical prac-tice for the treatment of acute local inflammatory processes combined with CO 2 laser and traditional treat-ments.
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Results of modified surgical access to regional lymph nodes in the treatment of renal cancerPurpose: To study the long-term results of a new method of surgical access to the main vessels and regional renal cancer lymphocollectors. Materials and methods: In the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, as well as in its Tashkent City Branch from 2010-2015, 96 patients were treated. The distribution of patients by sex and age intervals is shown in the figure. There male predominance 51 (53.1%) versus 45 (46.9%) women, the ratio was 1.1: 1. The age range is from 21 to 75 years, the average age of patients was 56.0 ± 1.3 years. From 96 patients participating in the study, a tumor process was established in 51 (53.1%) men and 45 (46.9%) women. The number of patients with metastatic lesion of regional lymph nodes were followings: N1 - 10 (10.5%), N2-6 (6.2%). In the remaining 80 (83.3%) patients, regional lymph nodes were intact. All patients underwent radical-extended nephrectomy. After laparotomy, the ascending and transversely dividing colon of the large intestine is mobilized, the loops of the intestines are pulled back with a moist towel up and to the left. After this, the back of the peritoneum is opened over the projection of the aorta from the level of the aortic bifurcation, the top with the dissection of the triceal ligament is opened beyond the peritoneal space. Results: The character of the histological form of the kidney tumors established after the operation by morphological examination were followings: the clear cell cancer in 77 (80.2%), papillary cancer in 8 (8.3%), unclassifiablc cancer in 4 (4.2% ), chromophobic cancer - in 7 (7.3%). At stage 1, no metastasis was detected. In stage 2 metastasis was noted in 4.2% of cases. In stage 3, 18.0% metastasis was detected. In 27.3% of patients metastasis took place in the 4th stage. All 13 patients (13.5%) had postoperative progression of the disease revealed. Conclusion: In renal tumors with Ti, we recommend performing selective lymphodisection, that is removing of first-order lymph nodes for precise staging. For T2.4N0.2M0 tumors, it is recommended to perform an extended lymph dissection from the level of the diaphragm legs to the aortic bifurcation. The development of surgical access with a cut of the triceal ligament with extended lymph node dissection of the renal cancer and a small number of postoperative complications make it possible to apply it in all patients with renal cancer.
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Relationship inflammatory activity, and kidney disease in systemic lupus erythematosusTo solve the problems in the surveyed 45 patients: examination, laboratory complex, immune and instrumental methods. All 45 patients with SLE kidney disease manifested itself in the form of lupus nephritis. Syndrome hypertension can in 35.5% of cases, the syndrome of chronic renal failure in 37.7% of cases. Urinary syndrome characterized by moderate proteinuria (75.5%), hematuria (73.3%) and leukocyturia (73.3%). Positive correlation of tumor necrosis factor α, C-reactive protein level of creatinine, urea, ESR and SLE activ- ity, which confirms the participation of the factors described in the immune process lupus inflammation
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