Role of short-term use of L. acidophilus DDS-1 and B. lactis UABLA-12 in acute respiratory infections in children: a randomized controlled trial.

BACKGROUND/OBJECTIVES: Evidence suggests that the long-term consumption of probiotics may help in reducing the incidence of or modifying acute respiratory infection (ARI). We assessed the role of the short-term use of probiotics in ARI in children. SUBJECTS/METHODS: This was a randomized, double-blind, controlled study that enrolled 315 children with 90 dropouts. On the first day of appearance of a sick household member, otherwise healthy children of both sexes aged 3-12 years were allocated to receive Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABLA-12 (Up4-Junior) in a dose of 5 billion colony-forming units daily with 50 mg of fructooligosaccharide (the probiotic group) or rice maltodexrin (the control group). Test supplementation and follow-up lasted for 2 weeks or until the end of the secondary ARI in a child. The primary outcome measure was the incidence of ARI. Time to resolution and the severity of ARI served the secondary outcome measures. RESULTS: In all, 64 of 113 children in the probiotic group (57%) and 73 of 112 children in the control group (65%) developed ARI (P=0.261). Time to resolution of the secondary ARI was shorter in the probiotic group (5.0 (interquartile range (IQR): 4.0-6.0) vs 7.0 (IQR: 6.0-8.0) days, P<0.001). The median severity of ARI was 240 (IQR: 163-350) score-days in the probiotic vs 525 (IQR: 364-736) score-days in the control group (P<0.001). CONCLUSIONS: The short-term use of probiotics does not reduce the incidence, but shortens ARI in preschool and elementary school children.

[Efficiency of mexidol in patients with endocrine polyneuropathy].

OBJECTIVE: To evaluate the efficacy of mexidol and necessity of using it in patients with endocrine polyneuropathies caused by primary hypothyroidism (PPHT). MATERIALS AND METHODS; We have examined 51 patients with confirmed diagnosis of PPHT and assessed their neurological status and indicators of metabolic homeostasis before and after treatment. Electroneuromyography (ENMG) was performed to assess the status of the peripheral nervous system. RESULTS: The results indicate the presence of endocrine disorders of obligate metabolic homeostasis in patients with polyneuropathies. Antioxidants, in particular, mexidol, in a complex with other drugs can be used in the treatment of these disorders. Worsening of ENMG-parameters, demonstrating a trend towards the normalization in response to treatment antioxidants, are characteristics of this pathology. CONCLUSION: The efficacy of mexidol in patients with PPHT has been confirmed.

[The results of proton radiosurgery for pituitary endosellar adenomas].

465 patients with pituitary endosellar adenomas have passed irradiation on the synchrocyclotron PNPI (1000 MeV). Due to the high energy of the proton beam the rotating-convergent shoot-through technique was used. The single dose of 80-100 Gy was given. In patients with prolactin adenomas clinical remission was detected in 80%, and the stabilization of the disease was achieved in 15%. Pregnancies in 21 patients ended in the birth of healthy children, and 4 of them gave the birth twice. Complete clinical remission was observed in 92% of patients with Cushing's disease. Sustained recovery and full normalization of growth hormone level were observed during long-term follow-up in 86% of patients with acromegaly. There was significant reducing of the high hormone level on the fifth year of follow-up in any clinical form of pituitary adenomas while the development of the secondary hypopituitarism was not defected in the most of the patients. Clinical remission in patients with non-secreting adenomas was 95%. Irradiation by the proton beam was not accompanied by serious life-threatening complications. Thus this type of treatment for pituitary endosellar adenomas is highly effective and safe and, sometimes, the only method.

[Stereotactic proton irradiation of cerebral arteriovenous malformations in patients with onset of disease in childhood].

The report discusses the results of proton stereotactic irradiation in 27 children, aged 6-15 (mean--12.5 yrs.), and 21 adults, aged 16-47 (mean--23 yrs.), with arteriovenous malformations (AVM) in the brain. The AVM volume ranged 0.2-37.7 cu cm; absorbed dosage at dose field maximum--40-80 Gy. Complete AVM obliteration was attained in 17 (35%) (mean AVM volume--3.1 cu cm); 50% decrease and more--12 (25%)(mean AVM volume--7 cu cm). When AVM volume was cut down to less than 50% (9) (19%) (mean AVM volume--9.2 cu cm) and 10 (21%) (mean AVM volume--19.6 cu cm), no effect was reported.

[Accelerated postoperative chemoradiotherapy for malignant cerebral glioma].

Procedure of accelerated immunotherapy for cerebral glioma is presented. Large fractions of radiation ranged from 3 Gy, 5 times a week, to a total focal dose of 51 Gy. After accumulation of total doses of 18, 33 and 48 Gy, vincristine was injected intravenously. Urea derivatives were given on reaching 21, 36 and 51 Gy. Treatment with the immunomodulator roncoleukine was carried out on completion of radiotherapy. An evaluation of the immediate end results of accelerated immunotherapy showed improved survival as compared with standard treatment.

[Experience of proton stereotactic therapy for cerebral arteriovenous malformations in children].

The authors present the results of proton stereotactic therapy (using continuous double-axis pendulum irradiation) in 27 children with cerebral arteriovenous malformations (AVM). At the moment of therapy, the children's age was 6 to 15 years. The volume of AVM was 0.2 to 31.2 cm3. The absorbed doses in the maximum of a dose field were 40 to 80 Gy. Complete AVM obliteration (the mean volume in the group was 3.03 cm3) was obtained in 11 (41%) patients. A 50% or more reduction in AVM volume (mean volume, 10.6 cm3) was seen in 8 (30%) patients. There was a less than 50% reduction in AVM volumes (mean volume 9.6 cm3) in 2 (7%) patients and no effect could be achieved in 6 (22%) (mean AMV volume 19.7 cm3).

[Effectiveness of treatment of urethral traumatic stricture complicated with prostatitis and vesiculitis]. / Effektivnost lecheniia travmaticheskoi striktury mocheispuskatelnogo kanala, oslozhnennoi prostatitom i vezikulitom.

A system for the assessment of the results of the operative treatment of a traumatic stricture of the urethral canal is suggested. Of the 63 patients operated on, a long-term results was studied in 39 (62%). The radical operation of Karpenko, Kholtsov, Rusakov have proved to be the most effective. Maximum effectiveness of the operative treatment was noted in diseases duration of up to 1 year. A new concept of pathogenesis of the complications which occur in patients with recurrent traumatic stricture of the urethral canal has been developed.

[Rehabilitation of sexual function in patients with traumatic urethral injuries]. / Reabilitatsiia polovoi funktsii u postradavshikh s travmaticheskim povrezhdeniem mocheispuskatelnogo kanala.

The complex urologic and sexologic examination of the urethral canal was performed in 56 sufferers with urethral trauma. By means of cavernosography, the ways of the venous blood chrowing from the cavernous bodies were established. Pathogenesis of impotence is considered. The recommendations on rehabilitation, prophylaxis of the disorder in sexual function in patients with traumatic stricture of the urethral canal are given. It is shown that endofallografting is the most effective and pathogenetically substantiated method for the treatment of impotence in sufferers with traumatic injury to the urethral canal.

[Changes in the urogenital organs in traumatic strictures of the urethra]. / Izmeneniia v mochepolovykh organakh pri travmaticheskikh strikturakh uretry.

The urogenital tract has been examined in 35 patients who required 3 or more years of therapy. A range of studies revealed a short urethral stricture in 11, long urethral stricture in 26, megalocystis in 6, domicile urinary bladder in 2 and bladder diverticulosis in 6 patients. Simple and diuretic excretory urography showed normal bilateral renal function in 5, moderately impaired function in 14 and severe loss of function in 6 patients. Single-kidney functional impairment was seen in 10 patients. Over 504 of patients showed prolonged urographic retention of urine in the pelvis and ureter. Bilateral ureterohydronephrosis was found in 3 and unilateral one in 3 patients. Descending, ascending and micturitional urethrocystography revealed urinary reflux into the prostate (n = 13), seminiferous ducts (n = 3), seminal vesicles (n = 4) and ureters (n = 4). Vasovesiculographic sizes and shapes of the seminal vesicles were normal in 2 patients while the vesicles were uni- or bilaterally dilated or constricted in other patients. The treatment was operative in 34 patients. Histological examination of scars and resected tissues showed fibrous sclerotic lesions in the prostate and suppurative inflammatory and fibrous lesions in seminal vesicular walls. With long treatment of urethral strictures, micturition disorders were superimposed by reflux of infected urine into the prostate, seminal vesicles and ureters, inducing inflammation and functional abnormalities; these caused shrinkage and compression of the posterior urethra, bladder cervix, intramural and prevesical ureteral segments, resulting in chronic renal failure. An early and radical plastic operation on the urethra may prevent the mentioned disorders.

[Diagnosis and treatment of complicated and recurrent traumatic strictures of the urethral canal]. / Diagnostika i lechenie oslozhnennykh i retsidivnykh travmaticheskikh striktur mocheispuskatel'nogo kanala.

In 40 patients, the treatment for traumatic stricture of the urethra lasted 3 and more years. In complex examination, the short urethral stricture was revealed in 10, long one--in 30 patients. Stricture of the membraniform portion of the urethra was diagnosed in 28, prostatic one--in 10, spongiform one--in 2 patients; changes in the prostate and seminal vesicles were revealed in 36. At operation, the scars of the narrowed urethra were excised en-block with the cicatricially changed prostate up to the neck of the urinary bladder, it was anastomosed to the unchanged portion of the urethra. Drainage was accomplished via the urethra by means of the Foley catheter and suprapubic drain. In all the patients, the independent uresis was restored.