Update on the role of diet in recurrent nephrolithiasis

The role of nutritional factors in the pathogenesis of recidivating nephrolithiasis is reviewed. The ingestion of liquid calcium and citrates is inversely associated with the risk of developing stones, while the ingestion of proteins, sodium, uric, and oxalates have a direct relationship. One should not restrict the ingestion of calcium in the diet, but rather one should recommended a normal or high ingestion of some 850 mg/day, and rather, one should restrict the ingestion of proteins, oxalate, and sodium, as well as keeping up a diuresis greater than 1500 cc/day.     

New aspects in treatment of systemic mycoses

The incidence of systemic fungal infection has been increasing during the last two decades. Candida and Aspergillus spp. are the classical opportunistic pathogens. Rare fungi, such as Mucor, Rhizopus, Fusarium, Trichosporon, Paecilomyces, Alternaria, Cladosporium and Pseudoallescheria, are emerging as cause of systemic fungal infection in the immunocompromised host. For more than 40 years Amphotericin B has been the gold standard of antifungal treatment because of its broad spectrum comprising yeasts, dimorphic fungi and moulds. Its nephrotoxicity has led to the development of lipid-associated preparations of amphotericin B: liposomal amphotericin B, amphotericin B colloidal dispersion and amphotericin B lipid complex. These preparations are less nephrotoxic, but higher doses than those of conventional amphotericin B are needed to achieve the same effect. The triazole fluconazole is the treatment of choice in infections caused by Candida albicans. New antifungal compounds are voriconazole and the candins, the pradimicin/benanomycin family, nikkomycin Z and a liposomal preparation of nystatin.     

The percutaneous endoscopic treatment of staghorn nephrolithiasis

Hyperferremia is shown to affect antioxidant system of the body, oxidation-reduction reactions in the cells seen as shifts in lymphocyte chemiluminescence. Dynamic changes in lymphocyte chemiluminescence reflect the level of hyperferremia.     

The pathogenetic validation of antioxidant therapy in the combined treatment of chronic cholecystitis

Ninety-eight patients with chronic cholecystitis were studied for intensity of lipid peroxidation (LPO), state of the glutathione system (GS), activity of superoxide dismutase (SOD). Revealed in patients at a mature age presenting with exacerbation of chronic cholecystitis were greater extent of LPO, rise in activity of GS enzymes, decline in SOD activity. The main determinant is degree of acuity of the inflammatory process in the gallbladder rather than presence or absence of biliary calculi. The need for and efficacy of antioxidant therapy is shown.     

The treatment of heart decompensation using angiotensin converting enzyme inhibitors. Pharmaco-economic aspects

OBJECTIVE: To value the effects of megestrol acetate wer the weight and the body composition (fat, lean and body water) in patients with AIDS associated cachexia, by bioelectric impedance analysis. Subjects: 25 patients between 23 and 57 years of age, with confirmed HIV infection and prior weight lost of 7.96 +/- 4.6 kg in relation to their habitual weight in the previous months. All the patients were under antiretroviral therapy. METHOD: Basal determination, before the beginning of the antianorexic treatment and at the end of it, using bioelectric impedance analysis by Maltron BF 905 analyzer, calculating fat, lean and total body water in relation to weight, height, age and sex. Oral administration of 320 mg/day megestrol acetate for three consecutive months. Statistical comparation (RSIGMA and SPSS) by paired t-test of the mean weight, body mass index, fat, lean and total body water. RESULTS: During the three months treatment the mean basal body weight of the patients increased 3.54 Kg (p < 0.001) at the expense of an increase of 2.24 kg in the total body lean (p < 0.01), while the increment of the body fat (1.2 kg) was not statistically significant. The total body water increased 1.48 L (p < 0.001) and the body mass index in 1.22 kg/m2 (p < 0.001). CONCLUSION: Treatment with megestrol acetate results in a substained and very significant increase of the weight and body mass index in patients with AIDS related cachexia. This increment in weight is at the expense of body lean.     

Percutaneous ethanol injection therapy for the treatment of postoperative recurrent primary liver cancer

This article reported 109 cases of postoperative recurrent primary liver cancer, treated with percutaneous ethanol injection therapy (PEIT) under the guidance of conventional ultrasonic transducer, the total number of injection being 637 times. No metastasis through the needle track or other serious complications were encountered. The 1.3 and 5 year survival rates were 92.6%, 47.8%, and 19%, respectively. We noted that the key factor affecting the efficacy of treatment was the accurate localization of puncture, rather than the times of injection or the quantity of ethanol injected. Criteria for the judgement of treatment and precautions to be noted concerning the procedure were suggested. It is concluded that PEIT is the treatment of choice in the management of non-operable, single, and comparativly smalle focus of postoperative recurrent primary liver cancer.     

Acetazolamide-induced nephrolithiasis: implications for treatment of neuromuscular disorders

Carbonic anhydrase inhibitors can cause nephrolithiasis. We studied 20 patients receiving long-term carbonic anhydrase inhibitor treatment for periodic paralysis and myotonia. Three patients on acetazolamide (15%) developed renal calculi. Extracorporeal lithotripsy successfully removed a renal calculus in one patient and surgery removed a staghorn calculus in another, permitting continued treatment. Renal function remained normal in all patients. Nephrolithiasis is a complication of acetazolamide but does not preclude its use.     

The pathogenetic basis for detoxifying and antioxidant therapy in the combined treatment of chronic diffuse liver diseases

As many as 98 patients with chronic diffusive liver diseases were studied for markers of endogenous intoxication syndrome as they were for intensity of lipid peroxidation (LPO) processes, condition of the antiradical defence systems, and detoxicating effectiveness of the drug "Thiotriasoline". Revealed in the patients were intensification of LPO processes, enhancement of the glutathionic system enzymes activity, decrease in superoxide dismutase. Accumulation in blood of malonic dialdehyde and molecular LPO products is believed to be a factor of the endogenous intoxication syndrome progression. A correlation was found between activity of LPO processes, intensification of endotoxicosis and degree of activity of the inflammatory process in the liver. The results obtained attest to the need for the antioxidant and adequate detoxicative therapy. High detoxicating efficacy of the drug "Thiotriasoline" has been shown.