Purpose
To test whether
d
-mannose powder is effective for recurrent urinary tract infection (UTI) prevention.
Materials and methods
After initial antibiotic treatment of acute cystitis, 308 women ...with history of recurrent UTI and no other significant comorbidities were randomly allocated to three groups. The first group (
n
= 103) received prophylaxis with 2 g of
d
-mannose powder in 200 ml of water daily for 6 months, the second (
n
= 103) received 50 mg Nitrofurantoin daily, and the third (
n
= 102) did not receive prophylaxis.
Results
Overall 98 patients (31.8 %) had recurrent UTI: 15 (14.6) in the
d
-mannose group, 21 (20.4) in Nitrofurantoin group, and 62 (60.8) in no prophylaxis group, with the rate significantly higher in no prophylaxis group compared to active groups (
P
< 0.001). Patients in
d
-mannose group and Nitrofurantoin group had a significantly lower risk of recurrent UTI episode during prophylactic therapy compared to patients in no prophylaxis group (RR 0.239 and 0.335,
P
< 0.0001). In active groups, 17.9 % of patients reported side effects but they were mild and did not require stopping the prophylaxis. Patients in
d
-mannose group had a significantly lower risk of side effects compared to patients in Nitrofurantoin group (RR 0.276,
P
< 0.0001), but the clinical importance of this finding is low because Nitrofurantoin was well tolerated.
Conclusions
In our study,
d
-mannose powder had significantly reduced the risk of recurrent UTI which was no different than in Nitrofurantoin group. More studies will be needed to validate the results of this study, but initial findings show that
d
-mannose may be useful for UTI prevention.
Cilj istraživanja: Predstaviti naše inicijalno iskustvo s laparoskopskom pijeloplastikom u djece, procijeniti sigurnost i kratkoročni ishod. Ispitanici i metode: Retrospektivno je analizirana ...medicinska dokumentacija sve djece koja su u trogodišnjem periodu od 2019. do 2022. godine laparoskopski operirana zbog opstrukcije pijeloureteričnog vrata u Kliničkom bolničkom centru Zagreb. Rezultati: Ukupno desetoro djece, dobi od 10 mjeseci do 17 godina (medijan 4,3 godine) operirano je laparoskopski. Četiri djevojčice i šest dječaka. U osmero bolesnika se radilo o lijevom bubregu, a kod dvoje o desnom. Prosječni promjer pijelona je iznosio 35 mm i prosječna separatna funkcija zahvaćenog bubrega je bila 40%. Intrizična stenoza kao uzrok opstrukcije našla se kod osmero djece, a kod dvoje se radilo o aberantnim krvnim žilama za donji pol bubrega. Prosječno vrijeme trajanja operacije bilo je 190 minuta (raspon 120 – 240 min) dok je prosječno vrijeme hospitalizacije bilo 3,2 dana (raspon 2 – 6 dana). Kod dvoje djece stavljen je abdominalni dren. Nije bilo konverzije u otvoreni zahvat, kao ni intraoperativnih i ranih postoperativnih komplikacija. Peroralni unos je započet 4 – 10 sati nakon operacije. Praćenje pacijenata je bilo od 2 do 40 mjeseca (prosječno 7,8). Prosječni postoperativni promjer pijelona u djece kod kojih je prošlo više od 6
mjeseci od operacije bio je 9,5 mm. Zaključak: Laparoskopska pijeloplastika je sigurna i učinkovita metoda u liječenju djece s opstrukcijom pijeloureteričnog vrata.
Melanoma of the female urethra Papeš, Dino; Altarac, Silvio
Medical oncology (Northwood, London, England),
03/2013, Volume:
30, Issue:
1
Journal Article
Peer reviewed
Primary melanoma of the female urethra is a very rare malignant tumor with high mortality. Due to its rarity, there are no guidelines and recommendations on the diagnosis and treatment of such ...patients, so we aimed to review the reported cases and case series, their treatment, and outcome. We searched through PubMed for all articles reporting on female urethral melanoma. We found 73 articles (case reports and case series) reporting on 112 patients. There are no clinical trials on the topic due to the rarity of the condition. Median patient age at presentation is 68 years. Due to the late presentation, the prognosis of the disease is poor, and median survival is 16 months, with 5-year survival in around 10 % (12 reported patients). Regarding treatment, most authors use either less radical approach (partial or total urethrectomy) or radical approach (anterior pelvic exenteration). We found no evidence that either of the treatment modalities results with higher survival. In local excision, there are indications that margins less than 2–2.5 cm result in high percentage of local recurrence suggesting that resection width should be at least 2.5 cm. For localized urethral melanoma, local resection with margins of 2.5 cm can be recommended and there is no foundation to support radical surgery in such patients. Chemotherapy and immunotherapy can also recommend. For locally advanced disease, the prognosis is poor, and radical surgery will not improve survival significantly.
