RESUMO
Bladder washout (BWO) and antibody-coated bacteria (ACB) tests were performed on 25 patients with radiological and/or clinical evidence of chronic upper urinary tract infection (UTI) and 12 patients with asymptomatic bacteriuria. Using a traditional single-washout procedure, the BWO test gave equivocal results in many cases of chronic pyelonephritis; this seemed mainly due to the lack of complete bladder sterilization. A modified procedure, including double sterilization and irrigation, biochemical typing of isolated bacteria, and evaluation of temporal pattern of bacteriuria recurrence, was then introduced. Although preliminary results of the modified BWO test demonstrated a general improvement in the diagnosis of the infection site, it seemed rather difficult, at least in chronic UTI, to establish localizing criteria based on definite numeric changes in bacterial counts after washout.
Assuntos
Bexiga Urinária/microbiologia , Infecções Urinárias/microbiologia , Adulto , Idoso , Bacteriúria/microbiologia , Criança , Doença Crônica , Feminino , Humanos , Técnicas Imunológicas , Pessoa de Meia-Idade , Pielonefrite/microbiologia , Irrigação TerapêuticaRESUMO
A new experimental model is presented for determining the optimum dose of 3 different doses (13 mg, 25 mg, 37 mg per day) of hydrochlorothiazide employed to enhance hypotensive effect of 200 mg/day of metoprolol in human hypertension. The model takes into account the circadian variability of blood pressure as sinusoidal function and wash-out effect as a linear trend so as to compensate for bias due to normal temporal variability.
Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Determinação da Pressão Arterial/métodos , Diuréticos/administração & dosagem , Hipertensão/tratamento farmacológico , Adulto , Pressão Sanguínea/efeitos dos fármacos , Quimioterapia Combinada , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Hidroclorotiazida/administração & dosagem , Hidroclorotiazida/uso terapêutico , Masculino , Metoprolol/administração & dosagem , Metoprolol/uso terapêutico , Pessoa de Meia-Idade , Modelos BiológicosRESUMO
Serum antibodies specific for the bacteria isolated from the urines of 41 patients with chronic pyelonephritis and 14 with asymptomatic bacteriuria were assayed. Even though it is clear that infections which involve the kidney evoke higher antibody responses than do purely bladder infections, it is difficult to establish a cut-off level for distinguishing the two by this method. There is a greater probability that there will be an upper urinary tract infection without an antibody response than that there will be a good antibody response in cases with lower tract infections. In our case list, 49% of the patients with chronic pyelonephritis had titers equal to or greater than 1:400, and another 44% had titers between 1:50 and 1:100. Therefore it appears that the magnitude of the antibody response depends not only on the location of the infection but also on other factors, such as the intrinsic immunogenicity of the different bacterial strains and the properties of the immunological system of the patient.
