[Course of urinary schistosomiasis over 3 consecutive years after treatment with metrifonate in a dry savanna village in Upper Volta]

In a dry savanna village in Upper-Volta, after mass treatment with metrifonate (four doses of 7,5 mg/kg at three weeks intervals) checking of the population was carried out for the three following years. In children and adolescents, results show a progressive decline in the cure rate (69.0% one year after treatment, 38.1% three years after treatment) and in egg-output reduction (69.9% one year after treatment, 75.4% three years after treatment). In adults, these two parameters still remain high three years after treatment (90.0% for cure rate and 87.3% for egg-output reduction). The authors point out that in a dry savanna village with a sedentary population and a transmission limited to a small collection of water, chemotherapy even employed alone is an appreciable control method to relieve populations.

Comparative trial of oltipraz versus praziquantel in the treatment of urinary schistosomiasis in the Gabon

The efficacy of oltipraz as a schistosomicidal drug was investigated in Gabonese children suffering from urinary schistosomiasis in the dosages of 1 X 25 mg/kg body weight, 1 X 35 mg/kg body weight, and 2 X 20 mg/kg body weight and compared to praziquantel, 2 X 30 mg/kg body weight. The study was undertaken in 165 patients, and follow-up investigations were carried out 6 weeks and 12 weeks after treatment. Oltipraz showed less efficacy compared to praziquantel when dosages of 1 X 25 and 1 X 35 mg/kg body weight were given. However, oltipraz 2 X 20 mg/kg body weight was equivalent to praziquantel 2 X 30 mg/kg body weight. Parasitological cure was obtained in 79% of patients treated by oltipraz and 81% of patients treated by praziquantel. Side effects were insignificant in both treatment groups. Thus, the same parasitological cure could be achieved by oltipraz as well as by praziquantel, but with a lower dosage of oltipraz.

The oral treatment of urinary schistosomiasis in Egyptian patients with 'Oltipraz'

Oltipraz was given in a daily dose of 1.5 gm for two days to 40 patients with haematobiasis. Cure rates of 92.5% and 82.5% were obtained after two and six months follow-up examinations. A high proportion of egg-reduction of 97% and 98% was obtained in 'egg-positive' cases. Clinical and biological tolerance of patients to the drug was excellent. The drug is easy in administration, given orally and with minimal side effects.

[Seishin-renshi-in therapy for patients with discomforts on the lower urinary tract]

The clinical effect of Seishin-renshi-in was studied in 18 patients with prolonged discomfort in the lower urinary tract. Seishin-renshi-in was administered orally at doses of 7.5 g, for courses ranging from 2 weeks to more than 10 weeks. Except in 4 cases in which administration was stopped because of slight side effects on the gastrointestinal tract; the overall effective ratio was 81%. Our findings suggest that Seishin-renshi-in may be useful in the control of discomforts in the lower urinary tract.

Urological aspects of Wolfram's syndrome

Two new cases of Wolfram's syndrome associated with progressive urinary tract dilatation are reported. The possibility of anatomic outlet obstruction or neurogenic bladder was eliminated radiologically and urodynamically. Dilatation of the urinary tract was considered to be a consequence of high diuresis associated with diabetes insipidus. A very important improvement in bilateral urinary tract distension was achieved with bladder drainage while dDAVP therapy dramatically decreased the daily urinary output. A review of diabetes insipidus and its urological implications is presented.

The development of mesna for the inhibition of urotoxic side effects of cyclophosphamide, ifosfamide, and other oxazaphosphorine cytostatics

Urotoxic side effects on the kidneys and urinary bladder are a limiting factor in chemotherapy with oxazaphosphorine cytostatics such as cyclophosphamide and ifosfamide. Acrolein was found to be the causative factor which is spontaneously formed in the urine from the primary metabolites eliminated via the kidneys. Sodium 2-mercaptoethanesulfonate (INN: mesna) enables regional detoxification of acrolein in the kidneys and deferent urinary tract. The author reports on the pharmacotherapeutic bases and the mechanism of action of this new combination therapy and its clinical results. The untoward urotoxic side effects can be avoided with mesna without interfering with the chemotherapeutic effect on the tumor.

[Urological problems in patients suffering from multiple sclerosis (author's transl)]

Despite the many urological problems which are to be found in patients suffering from multiple sclerosis, not much attention has been drawn upon this problem. We have done a complete urological evaluation of 25 patients suffering from this disease, and after reviewing the pathophysiology suggested a possible treatment.

Evaluation and treatment of urinary candidiasis

The incidence of genitourinary fungal infections is increasing, and because of their lethal potential, early diagnosis and treatment is mandatory. Candida is the most common urinary fungus and is manifest as renal involvement from systemic candidiasis, primary renal candidiasis, bezoar formation, cystitis, and as asymptomatic candiduria. The clinical status of the patient, serial urine cultures, excretory urogram, and serum candidal titers help to differentiate between the various disease states. Treatment is specific and is based on the clinical manifestation of the disease. Systemic candidiasis is treated with intravenous amphotericin. Fungal bezoars are best treated with oral flucytosine, ureteral and renal irrigation with amphotericin and, occasionally, operation. Cystitis is treated with oral flucytosine or amphoteric bladder irrigations. Asymptomatic candiduria is left untreated. A systematized evaluation and treatment regimen is presented.

Hemorrhagic cystitis and ureteritis, and interstitial nephritis associated with administration of penicillin G

Hemorrhagic cystitis and ureteritis, and interstitial nephritis developed in a patient receiving penicillin G and streptomycin as therapy for bacterial endocarditis. After therapy was changed to vancomycin there was prompt resolution of these abnormalities.

Treatment of malakoplakia with trimethoprim-sulfamethoxazole

A case is described of malakoplakia involving the urinary tract and retroperitoneum with recalcitrant infection due to Escherichia coli which was not responsive to seemingly appropriate antibiotics and surgery for drainage, but which subsequently responded to treatment with trimethoprim-sulfamethoxazole. It is speculated that this drug combination may be helpful because of the ability of trimethoprim to enhance the killing of viable undigested microorganisms inside malakoplakic macrophages.