[Chronic urinary tract infections and their treatment with the rifampicin-trimethoprim combination (author's transl)].
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Biomedical subjects
Publications and source records attributed to M Hatala.
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Bacteriologic examinations of urine were performed daily in 85 patients admitted for chronic recurrent urinary tract infections and treated with antibacterial drugs. The results have shown that the effect of therapy can be evaluated fairly accurately on the basis of bacteriological findings in urine within the first four days of treatment. When sterility was achieved as early as after one or two days of therapy, the urine remained sterile in more than 90% of the patients throughout the first post-treatment week; in more than 80% therapy had a long-term effect. A slowly subsiding urinary tract infection or reduced urinary bacterial count indicates that therapy will be ineffective.
The effect of active and passive antibacterial immunization on transplantation immunity was investigated in rabbits. Immunization with dead bacterial vaccines prepared from E. coli, Proteus mirabilis and Pseudmonas aeruginosa had no effect on skin allograft survival, whereas immunization with vaccines prepared from streptococcal and staphylococcal strains shortened allograft survival. Similar results were obtained with specific antisera against individual microbial species. Skin allografts survived in rabbits treated with antisera against E. coli, Proteus mirabilis and Pseudomonas aeruginosa in the same manner as in untreated controls, whereas allograft survival was shortened with antisera against streptococci or staphylococci. The possible mechanism of the stimulatory effect of Gram-positive cocci on transplantation immunity is discussed and the possibilities of using active and passive antibacterial immunication in clinical transplantation are considered.
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Twenty-three patients with various types of recurrent urinary tract infection were treated with a single daily dose of 160 mg gentamicin for eight to nine days. The treatment eliminated bacteriuria in 19 patients. Evaluation of the therapeutical results according to the site of infection showed elimination of bacteriuria in all patients with lower urinary tract infection. Thus a single daily dose of gentamicin can be recommended in recurrent lower urinary tract infection, and also in upper urinary tract infection not associated with a major impairment of renal function.
The paper deals with the incidence of infectious complications and rejection crises in patients with renal transplants. It was revealed by statistical methods that there exists a certain correlation between infections and rejections, which depends on the type of the infectious agent. In patients where infectious complications were caused only by gram-negative flora an indirect relationship was revealed, while in patients with infectious complications where gram-positive flora, viruses or fungi participated, a marked direct correlation was found. Statistical methods proved also a higher incidence of rejection crises in patients with active cytomegalic infection.
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The relationship between the elimination constant of gentamicin and the percentage of functioning nephrons in rats cannot be characterized by a simple linear relation. The results support the assumption that gentamicin elimination per residual nephron increased.
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