Introduction: Antimicrobials are widely used in infectious diseases. Only the timely intervention will contribute to the positive outcome of the disease. Unjustified use of antimicrobial prophylaxis may have adverse effects, i.e., result in bacterial resistance to existing antimicrobials, as well as toxic effects on leukocyte lineage and other parameters of the blood. Goal: The goal of this study was to confirm that the antimicrobial therapy of urinary, gynecological and respiratory infections has a toxic effect on leukocyte lineage. Followed by lowered immunity and the emergence of risk for health complications especially in oncology and other immunodeficient patients for whom to apply pharmacotherapy it is necessary to have adequate immunity, or white blood cell count that is greater than 4.0x109/L. Material and methods: A prospective-retrospective study was conducted on a sample of 30 patients in a Primary Health Care Center in Gracanica during the period from March 01, 2013 until April 01, 2014. Testing of this sample was conducted by survey on health status and treatment, or on taking of antimicrobial therapy and other treatment regimens, with the referral diagnosis and determination of leukocytes count in by hematology counter SYSMEX. Results of leukocytes below and close to the lower reference values were statistically analyzed by Students t-test. Results: Mean WBC count in the group treated with antimicrobial therapy was 3.687±0.83 x109/L, in the group which during repeated infection did not use the antimicrobial therapy 5.09±1.04 x109/L, and in the control group of healthy subjects 7.178±1.038 x109/L. Statistical analysis with Student’s t test indicate highly significant differences between group of patients that used antimicrobial therapy with the group of patient that did not used antimicrobial during repeated infection (t=6.091; p=0.0001), as well as significant differences in mean WBC count of both of these groups and the controls (t=4.984; p=0.0001, and t=8.402, p=0.0001). Conclusion: Use of antimicrobial drugs leads to serious toxic reactions, or leukopenia. Indications for the use of antimicrobial therapy must be strictly followed, because banal, frequent infections are not indication for antimicrobial therapy. It is necessary to know the types of infection causes. Important is the proper and timely selection of antimicrobial therapy. When selecting the drug we should bear in mind its antimicrobial activity, pharmacokinetic and toxic properties, as well as patient health status. Possible is also the application of preventive medicine as well as other manner of solving infection.
INTRODUCTION Antimicrobials are widely used in infectious diseases. Only the timely intervention will contribute to the positive outcome of the disease. Unjustified use of antimicrobial prophylaxis may have adverse effects, i.e., result in bacterial resistance to existing antimicrobials, as well as toxic effects on leukocyte lineage and other parameters of the blood. GOAL The goal of this study was to confirm that the antimicrobial therapy of urinary, gynecological and respiratory infections has a toxic effect on leukocyte lineage. Followed by lowered immunity and the emergence of risk for health complications especially in oncology and other immunodeficient patients for whom to apply pharmacotherapy it is necessary to have adequate immunity, or white blood cell count that is greater than 4.0 x 10(9)/L. MATERIAL AND METHODS A prospective-retrospective study was conducted on a sample of 30 patients in a Primary Health Care Center in Gracanica during the period from March 01, 2013 until April 01, 2014. Testing of this sample was conducted by survey on health status and treatment, or on taking of antimicrobial therapy and other treatment regimens, with the referral diagnosis and determination of leukocytes count in by hematology counter SYSMEX. Results of leukocytes below and close to the lower reference values were statistically analyzed by Students t-test. RESULTS Mean WBC count in the group treated with antimicrobial therapy was 3.687 +/- 0.83 x 10(9)/L, in the group which during repeated infection did not use the antimicrobial therapy 5.09 +/- 1.04 x 10(9)/L, and in the control group of healthy subjects 7.178 +/- 1.038 x 10(9)/L. Statistical analysis with Student's t test indicate highly significant differences between group of patients that used antimicrobial therapy with the group of patient that did not used antimicrobial during repeated infection (t = 6.091; p = 0.0001), as well as significant differences in mean WBC count of both of these groups and the controls (t = 4.984; p = 0.0001, and t = 8.402, p = 0.0001). CONCLUSION Use of antimicrobial drugs leads to serious toxic reactions, or leukopenia. Indications for the use of antimicrobial therapy must be strictly followed, because banal, frequent infections are not indication for antimicrobial therapy. It is necessary to know the types of infection causes. Important is the proper and timely selection of antimicrobial therapy. When selecting the drug we should bear in mind its antimicrobial activity, pharmacokinetic and toxic properties, as well as patient health status. Possible is also the application of preventive medicine as well as other manner of solving infection.
INTRODUCTION Prolactinomas are the most common tumors of the pituitary gland and cause of gonadal dysfunction and infertility. OBJECTIVE To determine the effects of bromcriptin to normalize prolactin, gonadal function more tumor mass and infertility. PATIENTS AND METHODS A prospective clinical study included 30 infertile women with micro-macro prolactinoma. We analyzed clinical parameters, the function of sex hormones, the maximum tumor diameter before and after 24-month therapy with bromocriptine. RESULTS Micro prolactinomas were significantly (66.3% vs. 33.7%, p < 0.001) over-represented in infertile women compared to macro prolactinomas. Galactorrhea / amenorrhea, and infertility are common symptoms of macro-micro prolactinomas. Infertile women with present macro prolactinomas had significantly higher mean values of PRL (1900.3 vs. 7.8, p < 0.001), significantly lower mean FSH (3.4 vs. 4.6, p < 0.001), LH (2.9 vs. 5.2, p < 0.001), luteal progesterone (2.5 vs. 14.8, p < 0.001) and estradiol (E2) (98.2 vs. 180.1, p < 0.001) compared to the control group. Infertile women with micro prolactinomas had significantly higher values of PRL (170.4 vs. 7.8, p < 0.001), significantly lower mean FSH (4.1 vs. 4.6, p < 0.01), LH (3.8 vs. 5.2, p < 0.01) luteal progesterone (2.7 vs. 14.8, p < 0.001) and E2 (120.3 vs. 180.1, p < 0.001) compared to the control group. After 24-month therapy bromocriptine in infertile women with micro-macro prolactinomas followed by a significant decrease in PRL (p < 0.05), a significant reduction of the maximal tumor diameter (p <0.05), a significant increase in FSH, LH, E2 (p < 0.05) compared to baseline values before treatment and a significant reduction in fertility (p < 0.05). CONCLUSION The syndrome amenorrhea/galactorrhea and infertility are the most common symptoms of prolactinomas. Micro prolactinomas are more frequent in women. Bromocriptine is an effective drug in the treatment of hyperprolactinemia with prolactinomas. It effectively normalize prolactin, establishing gonadal function and reduces tumor mass.
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