[Effects of plasmapheresis and lasers on the state of urinary microflora in chronic pyelonephritis]. / Vliianie plazmafereza i lazernogo vozdeistviia na sostoianie mikroflory mochi pri khronicheskom pielonefrite.

Bacteria isolated from the urine of 142 patients with chronic pyelonephritis (CPN) were examined for pathogenic properties of the strains (bacteriuria, hemolytic, proteolytic properties, urease, adhesive activity, antibiotic resistance, the ability to inactivate bactericidal activity of the serum) to control the effect of the treatment: antibiotics combined with plasmapheresis or antibiotics combined with laser radiation (intravascular, transcutaneous, or both). Combined application of intravascular and transcutaneous laser irradiation in multimodality treatment reduces the number of highly pathogenic strains as well as antibactericidal activity of the urine strains. It also promotes normalization of bacteriuria level. Plasmapheresis is inferior to laser radiation but ranks the second in efficacy of action on urinary microflora. Thus, use of efferent methods, especially transcutaneous plus intravascular laser radiation, plasmapheresis, in combined treatment of pyelonephritis decreases pathogenicity of urine strains and normalizes bacteriuria.

[The potentials of local and intravascular laser irradiation for eliminating the immunological disorders in patients with chronic pyelonephritis]. / Vozmozhnosti mestnogo i vnutrisosudistogo lazernogo oblucheniia dlia ustraneniia immunologicheskikh narushenii u bol'nykh khronicheskim pielonefritom.

61 patients suffering from chronic pyelonephritis in the stage of active inflammation associated with either urolithiasis (67.4%) or prostatic adenoma (32.6%) were divided into three groups. Group 1 received conventional antibacterial treatment, group 2 conventional treatment + local laser radiation (LLR), group 3 received combined therapy including intravascular laser irradiation of blood (IVLIB). The treatments efficacy was controlled by urine seeding for microflora and its sensitivity to antibiotics, by immunological supervision. The patients were found to have immunological abnormalities in the form of cellular and humoral immunity suppression, neutrophil phagocytic hypoactivity, elevated levels of medium-molecular peptides nonresponsive to standard antibacterial therapy. Adjuvant use of LLR improved humoral immunity and reduced total urine bacterial count. LLR replacement for IVLIB resulted in a complete regression of immunological shifts and more pronounced reduction of urinary bacterial contamination.