The aim: To study the prevalence of ABR among children with UTI over the past 10 years, with an assessment of the sensitivity of E. Coli to common antibiotics in dynamics. Materials and methods: The study involved 1,044 children with UTI aged from 1 month to 18 years. Examination of patients and interpretation of the results was performed in accordance with the provisions of the Declaration of Helsinki of Human Rights. According to the design, the study included 3 comparison groups: Group 1 — children of the 2009 follow-up year (n = 337), Group 2 — of 2014 (n = 328) and Group 3 — of 2019 (n = 379). Results: Escherichia coli is recognized as the leading uropathogen in all study groups: its percentage in Group 1 was 47 % (158/337), in Group 2 — 64 % (210/328) and in Group 3 — 66.5 % (252/379). The prevalence of antibacterial resistance of E. coli strains and the high dynamics of its growth are shown. So the level of resistance of E. Coli in 2019 was 70 ± 4.06 % (176/252). This was 11 % more compared to 2014 and 18.8 % more compared to 2009. The percentage of multiresistant strains tended to increase and amounted to 28 ± 9.97 % (70/252) among patients with UTI and 40 ± 9.12 % (70/176) in the structure of resistance in 2019. The relative risk of ABR increased by 1.6 times in 2019 compared to 2014 (RR2019 = 2.208 ± 0.207 [1.473;3.310], р < 0.05 vs RR2014 = 1.375 ± 0.209 [0.913;2.063]) and by 3 times compared to 2009 (RR2009 = 0.727 ± 0.209 [0.483;1.095]). Ampicillin and amoxicillin showed an equally low sensitivity level (3.5 ± 32.14 % (9/252)). Only every second child confirmed sensitivity to cefuroxime (53.6 ± 5.76 (135/252)). Ceftazidime and ciprofloxacin showed a relatively high sensitivity level — 77.4 ± 3.34 (195/252) and 83 ± 2.81 (209/252), and at the same time the rapidly growing resistance rates — almost twice as high over the past 5 years. Furazidin K showed a high sensitivity level of 85.7 ± 2.53% (216/252), the lowest level of overall resistance of 14.3 ± 15.15 % (36/252) and a slow rate of its formation. An unfavourable prognosis of an increase in the relative risk of ABR by 2.9-3.7 times in the next 5–10 years was determined among patients with UTI, provided that the existing diagnostic and treatment approaches are maintained. Conclusions: The study results are important for understanding the clinical decision on the benefits of antibacterial therapy and optimizing its empirical choice for a patient with UTI.
Резюме. В експерименті на щурах із моделлю системного васкуліту показано, що екзогенне навантаження на організм таких нефротоксичних мікроелементів, як кадмій, літій та молібден, справляє дію на інтегральні морфологічні показники ураження структур нирок, зокрема, в 6,7 раза частішають випадки потовщення базальної мембрани капсули Шумлянського, на 63 % збільшується тяжкість проліферації ендотелію артеріол і на 21 %-дистрофічних (атрофічних) змін канальців.
BackgroundFor frequent extra-articular (systemic) manifestations of joints inflammatory diseases are various damage of the nervous system,2 and the presence and severity of peripheral neuropathy (PNP) have significance in the clinical course, which incidence among these patients is 5%–10%.1 Nevertheless, many clinical and pathogenic aspects of this peripheral neuropathy (PNP) remain obscure.Objectivesto evaluate the rate and clinical features of PNP in rheumatoid arthritis (RA), chlamydia urogenital reactive arthritis (ReA), psoriatic arthritis (PA) and ankylosing spondylitis (AS), to examine the issues of pathogenetic constructions such changes of the nervous system, define risk factors.MethodsThe study included 416 patients with inflammatory joint diseases, among them 131 RA patients, 101 ReA, 76 PA and 108 AS. The average age of the examined was respectively 45, 32, 42 and 38 years, disease duration – 10, 4, 12 and 11 years, male to female ratio – 1:5, 1:1, 1:2 and 10:1.ResultsThe frequency of the PNP in RA, ReA, PA and AS was 13%, 19%, 24% and 34%, while its severity in patients with PA
Введение: целью и задачами работы стали оценка частоты артериальной гипертензии у больных геморрагическим васкулитом Шенлайна — Геноха, ее взаимосвязи с клиническими признаками течения заболевания, определение патогенетической значимости изменений адсорбционно-реологических свойств крови и эндотелиальной функции сосудов. Материал и методы. Под наблюдением находились 144 больных (56 % мужчин и 44 % женщин) в возрасте от 14 до 65 лет, длительность заболевания составила 9 лет, острое течение имело место в 24 % наблюдений, 2–3-я степени активности патологического процесса констатированы у 68 % больных. Результаты. Развитие артериальной гипертензии наблюдается у каждого четвертого больного, что тесно связано с патологией почек, поджелудочной железы и печени, с поражением пястно-фаланговых, лучезапястных, крестцово-подвздошных и позвоночных суставов, с развитием остеокистоза и артрокальцинатов, с нарушениями возбудимости миокарда, изменениями его клапанного аппарата, размеров камер, диастолической дисфункцией левого желудочка, систолическим давлением в легочной артерии, соотношением легочного и периферического сосудистого сопротивления. Отмечаются нарушения адсорбционно-реологических свойств сыворотки крови и эндотелиальной функции сосудов, которые проявляются повышением параметров объемной вязкости, поверхностного натяжения, сурфактантной межфазной активности, фазового угла тензиореограмм, эндотелина-1, тромбоксана-А2, гомоцистеина и циклического гуанозинмонофосфата на фоне уменьшения значений поверхностной вязкости, модуля вязкоэластичности, времени релаксации, угла наклона тензиограмм, параметров простациклин- и нитритемии. Отличия отдельных показателей у больных с нормальным и повышенным артериальным давлением отсутствуют. Выводы: перечисленные факторы физико-химических поверхностно-активных, вязкоэластичных и релаксационных свойств сыворотки крови, вазоконстрикторных и вазодилатационных показателей эндотелиальной функции сосудов не участвуют непосредственно в патогенетических построениях артериальной гипертензии, что диктует необходимость продолжить исследования по изучению других возможных составляющих развития повышения давления у такой категории больных.
The prevalence of chronic kidney disease (CKD) and hyperuricemia is increasing globally. The steady increase in the number of patients with impaired renal function associated with diabetes mellitus, arterial hypertension, and an increase in life expectancy ultimately leads to significant costs associated with the need to use expensive methods of renal replacement therapy. The main task for physicians is the timely determination and slowing down of the progression of CKD, and renoprotection. Hyperuricemia is considered an independent risk factor for the onset and progression of the disease, in addition to the traditional microalbuminuria and decreased glomerular filtration rate. The urgency of detecting hyperuricemia is due to the possibility of its further correction to improve the prognosis of the disease and delay the end stage of CKD, improve the quality of life and reduce the cost of treatment of patients. A decrease in the total pool of uric acid in the body helps to minimize the risk of arthropathy and nephrolithiasis, exacerbation of gout, progression of renal failure and other complications. However, despite hundreds of published clinical studies on the diagnosis and treatment of patients with CKD, the quality of care remains suboptimal. The article presents versatile technologies of preserving renal function in patients with CKD and hyperuricemia, which require improvement.
BackgroundThe extended 2016 EULAR updated report states that for patients on ULT, SUA level should be monitored and maintained to <6 mg/dL (360 µmol/L). SUA level <3 mg/dL (180 µmol/L) is not recommended in the long term. And among EULAR proposals for future research is mentioned the optimal duration for prophylaxis of acute attacks when starting ULT, long-term impact of very low urate levels on the central nervous system, impact of ULT on kidney function.ObjectivesThis project aims to investigate the impact of two target levels urate-lowering therapy (ULT) caused by hyperuricemia (HU) on kidney function and CKD progression measured by eGFR and albuminuria (A).This trial had been formulated by 2016 updated EULAR evidence-based recommendations for the management of gout as a perspective proposal task for future research.The key points are: 1) an unknown target HU level and 2) the time duration of ULT resulting in preserved kidney function in two subject groups a) with gout and b) without gout but highly elevated uricemia and CKD.MethodsThe trial has POEM design with 36 months duration. IMPULsKF is a Clinical Randomised Prospective Controlled Open Multicenter trial that randomly (by chance) assigns 180 participants in parallel groups. These patients with high SUA level (>8 mg/dL; 480 µmol/L) were divided into 2 arms (90+90) 1) with gout (EULAR’s criteria) and 2) without gout but with presence of CKD 1–4) and 2 target SUA levels in each group as 5 mg/dL (300 µmol/L) and ultralow SUA <3 mg/dL (180 µmol/L) achieved either with allopurinol or febuxostat. The data obtained will be compared with control group (45 with gout without CKD and 45 with CKD).ResultsRetrospective analysis and 6 mothes in trial results has been shown that treatment with febuxostat improves GFR and BP control in patients with asymptomatic HU in non-diabetic CKD 2–3.2 Febuxostat treatment led to the most beneficial decrease in the level of uric acid (−223±16 µmol/l, p≤0,01 with control and p≤0,05 with allopurinol group), increased GFR (+10±2 ml/min, p≤0,01 with control and p≤0,05 with allopurinol group), blood pressure decrease (- 7±2/–3±1 mm hg, p≤0,05 with control and p=0,93 with allopurinol group), albuminuria (−131±19 mg, p≤0,01 with control and p≤0,05 with allopurinol group. Potential benefits of febuxostat were better tolerability compared with allopurinol group with target levels of uricemia less 180 µmol/l in 32% of people.ConclusionsTreatment with febuxostat (better than allopurinol) improves GFR and BP in patients with asymptomatic hyperuricemia in non-diabetic CKD 2–3. Ultralow SUA levels seems to be safe in majority of patients but its effect on CKD function is not yet clear.References[1] Richette P, Doherty M, Pascual E, Barskova V, Becce Fet al,2016updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis2017 Jan;76(1):29–42. doi:10.1136/annrheumdis-2016–209707. Epub 2016 Jul 25. http://dx.doi.org/10.1136/annrheumdis-2016-209707[2] Ivanov D, Ivanova M. SP 326 Febuxostat improves GFR and BP in non-diabetic a...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.