Antibiotic prophylaxis during extracorporeal shock wave lithotripsy in the prevention of urinary tract infections in patients with sterile urine before the procedure

Introduction: There are controversies in the literature regarding the need and the duration of antibiotic prophylaxis in patients with extracorporeal shock wave lithotripsy (ESWL), who had a negative urine culture before the operation. This study was performed to evaluate the efficacy of the antibiotic prophylaxis in patients with proven sterile urine before they underwent ESWL. Materials and Methods: In this clinical trial, 150 patients with renal or urethral stones and sterile urine were examined for bacteriuria (positive urine culture) following ESWL. These patients were classified into 3 groups which received either a single dose of oral co-trimoxazole (Tab, 400/80 mg)- group A, a single dose of nitrofurantoin (Tab:100mg) -group B and no treatment- group C. Patients were followed with urine analysis and urine culture after two weeks. Results: The occurrence of post-ESWL urinary infections (positive urine culture) was 14% in group A, 10% in group B and 14% in group C. The complications among the groups were not statistically significant. Conclusion: The incidence of urinary tract infections after ESWL is extremely low, provided that in patients who had sterile urine before ESWL, prophylaxis antibiotics do not seem to be necessary

Effect of Combined Subsurface Structures and Steps on Hyporheic Exchange

The deployment of artificial structures in streambeds has been proposed as a way to enhance hyporheic exchange, and numerical models can be used to quantify their effects. In this study, combinations of different structures—that is, boxes, steps and a new type of subsurface structure (L-shaped structure)—were considered to evaluate their potential applicability on river restoration. Flow-3D and COMSOL were applied to simulate surface and subsurface flow, respectively. The performance of the structures was evaluated on the basis of hyporheic flow and residence time distributions. For the structure sizes here considered, results showed for steps (single step, combination of two steps) and L-shaped structures (single L-shaped structure, combination of two L-shaped structures) most hyporheic flowpaths return to the stream after 5 and 2.5 hr, respectively. Instead, shorter residence times (<0.25 hr) were found for boxes (single box, combination of two boxes). For combinations of steps and permeable boxes, the values of hyporheic flow per unit width are higher (0.35 and 0.3 m2/hr, respectively) than for the combination of L-shaped (0.06 m 2/hr). As a result, the combinations of steps and boxes are more effective in increasing hyporheic flow. However, when subsurface structures are combined with steps the resulting hyporheic exchange is dominated by the steps. Therefore, the combined use of in-stream and subsurface structures separately may increase their benefits for hyporheic exchange, but when steps are the other subsurface structures provide minor advantages

Aspects of urinary tract infections and antimicrobial resistance in hospitalized urology patients in Asia: 10-Year results of the Global Prevalence Study of Infections in Urology (GPIU)

10.1016/j.jiac.2017.11.013Journal of Infection and Chemotherapy244278-283JICH