Probiotics in the Prevention of the Calcium Oxalate Urolithiasis

Nephrolithiasis ranks third among urological diseases in terms of prevalence, making up about 15% of cases. The continued increase in the incidence of nephrolithiasis is most probably due to changes in eating habits (high protein, sodium, and sugar diets) and lifestyle (reduced physical activity) in all developed countries. Some 80% of all kidney stones cases are oxalate urolithiasis, which is also characterized by the highest risk of recurrence. Frequent relapses of nephrolithiasis contribute to severe complications and high treatment costs. Unfortunately, there is no known effective way to prevent urolithiasis at present. In cases of diet-related urolithiasis, dietary changes may prevent recurrence. However, in some patients, the condition is unrelated to diet; in such cases, there is evidence to support the use of stone-related medications. Interestingly, a growing body of evidence indicates the potential of the microbiome to reduce the risk of developing renal colic. Previous studies have primarily focused on the use of Oxalobacterformigenes in patients with urolithiasis. Unfortunately, this bacterium is not an ideal probiotic due to its antibiotic sensitivity and low pH. Therefore, subsequent studies sought to find bacteria which are capable of oxalate degradation, focusing on well-known probiotics including Lactobacillus and Bifidobacterium strains, Eubacterium lentum, Enterococcus faecalis, and Escherichia coli.

Ibrutinib in Refractory or Relapsing Primary Central Nervous System Lymphoma: A Systematic Review

Primary Central Nervous System Lymphoma (PCNSL) is a rare variant of Non-Hodgkin Lymphoma (NHL) representing 1–2% of all NHL cases. PCNSL is defined as a lymphoma that occurs in the brain, spinal cord, leptomeninges, or eyes. Efforts to treat PCNSL by traditional chemotherapy and radiotherapy have generally been unsuccessful as a significant proportion of patients have frequent relapses or are refractory to treatment. The prognosis of patients with Refractory or Relapsed (R/R) PCNSL is abysmal. The optimal treatment for R/R PCNSL is poorly defined as there are only a limited number of studies in this setting. Several studies have recently shown that ibrutinib, a Bruton tyrosine kinase (BTK) inhibitor, has promising results in the treatment of R/R PCNSL. However, these are preliminary studies with a limited sample size. In this systematic review, we explored and critically appraised the evidence about the efficacy of the novel agent ibrutinib in treating R/R PCNSL.

A nodular type of mantle cell lymphoma in the nasopharynx

Mantle cell lymphoma (MCL) is a subtype of B-cell lymphoma derived from CD5-positive antigen-naïve pre-germinal center B-cells within the mantle zone that surrounds normal germinal center follicles. MCL comprises approximately 5 to 10% of all lymphomas. Tonsil is the most common location of MCL in the head and neck region, followed by the nasopharynx. Primary MCL involving the nasopharynx is extremely rare. Its clinical course is very aggressive with frequent relapses after conventional chemotherapy. It always presents as a protruding mass on the mucosal lining of the pharyngeal cavity. Here, we report a new nodular type of MCL in the nasopharynx. Endoscopically, this case showed multiple nodular lesions of primary MCL on the nasopharyngeal mucosa. This unique finding has not been reported yet in the English literature. These lesions should be differentiated from simple pharyngeal infections or benign lymphoid hyperplasia in the nasopharynx.

TO STUDY THE CPITN INDEX IN THE TREATMENT OF CHRONIC CATARRHAL GINGIVITIS AND CHRONIC GENERALIZED PERIODONTITIS OF MILD SEVERITY USING AN ADAPTOGEN-MODIFIED GEL

Актуальность постоянных научных исследований в области пародонтологии обусловлена большой частотой воспалительно-деструктивных заболеваний пародонта среди всех возрастных групп населения во всем мире. Лечение и профилактика данной патологии является одной из наиболее сложных и трудоемких в терапевтической стоматологии. На сегодняшний день существует множество лекарственных препаратов отечественного и зарубежного производства, предназначенных для лечения воспалительных заболеваний пародонта. Чаще всего в их состав входят антисептики, противовоспалительные компоненты, ферментные и витаминные препараты. Нехватка в составе данных лекарственных средств иммунокорригирующих препаратов и адаптогенов, в дальнейшем приводят к развитию частых рецидивов. Отсутствие комплексного подхода к лечению данных заболеваний не только приводит к длительному его течению, но и не редко приводит к хронизации процесса, что явилось предпосылкой для исследования влияния стоматологического геля, модифицированного адаптогеном на ткани пародонта при лечении хронического катарального гингивита и хронического генерализованного пародонтита легкой степени. Изучение научной литературы подтверждает, что применение в медицине адаптогенов, при лечении различных заболеваний, оказывает выраженное противовоспалительное, иммуномодулирующее, вяжущее и седативное действие. Данная статья предусматривает изучение комплексного пародонтального индекса у пациентов при лечении хронического катарального гингивита и хронического генерализованного пародонтита легкой степени тяжести в сравнительном аспекте The relevance of ongoing scientific research in the field of periodontology is due to the high frequency of inflammatory and destructive periodontal diseases among all age groups of the population around the world. Treatment and prevention of this pathology is one of the most difficult and time-consuming in therapeutic dentistry. To date, there are many medicines of domestic and foreign production intended for the treatment of inflammatory periodontal diseases. Most often, they include antiseptics, anti-inflammatory components, enzyme and vitamin preparations. The lack of immunocorrecting drugs and adaptogens in the composition of these drugs, further lead to the development of frequent relapses. The lack of an integrated approach to the treatment of these diseases not only leads to its prolonged course, but also not infrequently leads to the chronization of the process, which was a prerequisite for studying the effect of a dental gel modified with an adaptogen on periodontal tissues in the treatment of chronic catarrhal gingivitis and chronic generalized periodontitis of mild degree. The study of scientific literature confirms that the use of adaptogens in medicine, in the treatment of various diseases, has a pronounced anti-inflammatory, immunomodulatory, astringent and sedative effect. This article provides for the study of the complex periodontal index in patients in the treatment of chronic catarrhal gingivitis and chronic generalized periodontitis of mild severity in a comparative aspect

Treatment of Symptom Clusters in Schizophrenia, Bipolar Disorder and Major Depressive Disorder With the Dopamine D3/D2 Preferring Partial Agonist Cariprazine

Cariprazine is currently approved for the treatment of patients with schizophrenia (USA and EU), and for manic, depressive, and episodes with mixed features in bipolar I disorder (USA): several randomized controlled studies have also explored its efficacy in patients with major depressive disorder. This review summarizes its current therapeutic uses and potential advantages for treating the main symptoms of schizophrenia, bipolar I and major depressive disorder, considering its pharmacodynamic properties, efficacy, and tolerability. Its predominantly D3 receptor preferring affinity, with functional selectivity according to the prevailing neuronal environment, contributes to its efficacy across a wide array of psychopathological symptoms (including reality distortion, disorganized thought, negative symptoms, mood disturbance, anhedonia, and cognitive impairment), and to a favorable side effect profile. Cariprazine may be a “drug of choice” in patients with predominant negative and cognitive symptoms of schizophrenia, as well as those with metabolic syndrome. Further investigation of its relative efficacy when compared to aripiprazole or other active comparators is warranted. Its effectiveness in the treatment of bipolar mania, bipolar I depression and bipolar I episodes with mixed features, with minimal accompanying metabolic changes is well-established. The longer half-life and delayed time to relapse in patients diagnosed with schizophrenia when compared to other second-generation antipsychotics represent other advantages, given the high rates of non-adherence and frequent relapses seen in clinical practice. Its efficacy in overlapping symptom domains in other major psychiatric disorders appears promising.

Analysis of cost of various topical and oral antifungal drugs for superficial fungal infections available in India

Background: In tropical countries like India, superficial fungal infections are quite common and certain infections like tinea is rampantly spreading in epidemic proportions and frequent relapses after treatment have increased the need for long term therapy significantly increasing the cost of treatment, so the treatment of fungal infection can raise economic burden on the patient. The aim of the study was to analyze the cost variation of topical antifungal drugs and oral antifungal drugs of various brands for superficial fungal infection available in India.Methods: Cost in Indian Rupees (INR) of antifungal agents manufactured by different pharmaceutical companies in India was collected from the Current index of medical specialities (CIMS) October to December 2019. Minimum cost, maximum cost, cost ratio, cost variation was calculated.Results: In oral dosage form, fluconazole, Itraconazole show the maximum cost variation. In topical single drug therapy luliconazole, terbinafine show maximum cost variation.Conclusions: There is wide cost variation among antifungal agents available in Indian Market. There is need of strict actions for cost policy regulation and sensitization of doctor for selection of appropriate brand drugs.

THE USE OF ANTISEPTIC PREPARATIONS IN THE COMPLEX TREATMENT OF TROPHIC ULCER OF THE VENOUS ETIOLOGY IN LOWER LIMBS

For the last decades despite the rapid development of medicine and its significant achievements there is a tendency towards an increase in the number of patients with trophic ulcers. Globally, the number of people suffering from chronic trophic ulcers ranges from 600 thousands to 2 million. Venous pathology is reported as the most common cause of trophic ulcers of lower extremities. Taking into account considerable prevalence of trophic ulcers, which can impede many aspects of life quality of patients, insufficient efficiency of existent conservative methods of treatment, no tendency to the decline in the prevalence of the disease, its prolonged treatment, which mostly lasts 2 – 3 months, and in some patients trophic ulcers do not heal over years, propensity to the frequent relapses in 60 – 70% of patients, considerable economic losses due to the loss of working capacity or disability of patients that ranger from 10 to 67%, and the large expenses for medication pose the trophic ulcer management as a challenging socioeconomic issue. Therefore, the search of new methods of local treatment of trophic ulcers of venous aetiology is remaining as one of the important problems of modern medicine. The article presents the clinical examination findings and treatment outcomes of 47 patients with the trophic ulcers of venous etiology. The participants took the course of treatment at the surgical department, II Municipal Clinical Hospital of Poltava. The treatment included local application of antiseptics. We investigated the clinical parameters of wound healing and check microbiological contamination of wounds. The results of clinical and laboratory investigations have demonstrated that local application of antiseptics in the management of trophic ulcers of venous aetiology of lower extremities promotes healing of trophic ulcers and can considerably reduce the term of treatment and hospital staying.

Von Willebrand’s disease mimicking postoperative bleeding after tibial nailing for tibial shaft fracture

Von Willebrand’s disease (VWD), or von Willebrand’s syndrome, is a bleeding syndrome characterized by low plasma levels of von Willebrand factor (VWF). VWD is the most common inherited human bleeding disorder. Partial quantitative deficiency of serum VWF is responsible for the majority of VWD cases. The effect of VWF deficiency on orthopedic operations is not well documented in the current literature. VWD may cause persistent blee­ding during the operative and postoperative periods. In the majority of cases, VWD occurs as a single episode, but frequent relapses with chronicity can be seen in a small number of cases. We reported a case of a 22-year-old man with VWD operated with intramedullary nailing due to tibial shaft fracture. The patient had no previous history of surgery, and was unaware of his VWD. The purpose of this study is to report a rare complication of an orthopedic surgical procedure with postsurgical bleeding mimicking tibialis anterior arterial perforation. Orthopedic surgeons must be alert to the possibility of VWD due to postsurgical difficulties and persistent bleeding.

Bacterial meningitis in a known case of steroid-resistant nephrotic syndrome

Nephrotic syndrome (NS) is a kidney disorder in which, excess protein is being excreted through urine. While most cases of idiopathic nephrotic syndrome respond to steroid therapy and experience a limited number of relapses prior to complete remission, some cases suffer from frequent relapses and become steroid-dependent or are primarily steroid-resistant. Treatment options are limited to immunosuppressive drugs with significant side effect profiles. Infections in nephrotic syndrome are common and can be severe. Meningitis is one of the complications associated with nephrotic syndrome. Here, we report a child with steroid-resistant nephrotic syndrome (SRNS) with meningitis. Early detection and appropriate treatment of these complications can be lifesaving.

Reproductive health issues of adolescent girls suffering from recurrent urinary tract infections

Currently, adolescent girls with recurrent urinary tract infection have a high frequency of reproductive disorders. In order to study the state of reproductive health of adolescent girls with urinary tract infections, depending on the frequency of relapses, 70 adolescent girls aged 16–18 years were examined, of which 1 group (n=23) — with rare relapses of UTI (relapses up to 3 times a year); 2 group (n=27) with frequent relapses of UTI (more than 3 times a year). The control group (n=30) consisted of adolescent girls of the same age of 1.2 health groups. We studied the features of sexual development, the concentration of gonadotropin and steroid hormones. In patients of group 2, a high frequency of hypoprogesteronemia, hyperandrogenism, and anovulatory cycles was revealed, which contributes to the development of a number of gynecological diseases. An interdisciplinary approach to the dispensary management of these patients is necessary, which prevents the development of reproductive disorders.