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The aim of the study was to summarize and systematize the literature data, as well as the results of the carried out research in the field of medicinal plants used as diuretics in the Russian Federation and abroad.Materials and methods. During the search for this review article materials, the abstract databases of PubMed, Google Scholar, as well as the ResearchGate and elibrary.ru were used. The search was carried out according to the publications for the period from 2005 to 2023. The keywords were as follows: herbal diuretics, diuretic drugs, kidney diseases, types of medicinal plant raw materials. The data from the authors’ previous scientific research on the analysis of the diuretic properties of certain types of medicinal plant raw materials, as well as individual substances of a phenolic nature isolated from them (simple phenols, flavonoids), were also reviewed.Results. It was determined that the diuretic activity of most of the medicinal plants used, is due to such groups of biologically active compounds as terpenoids (essential oils and saponins), simple phenols, flavonoids and anthracene derivatives related to the secondary metabolites. It has been shown that, despite the fact that many herbal diuretics have concomitant anti-inflammatory, antimicrobial, antiviral, antihistamine and other properties relevant from the point of view of etiology and pathogenesis of the disease, it is reasonable to use them as part of collections of medicinal plants and other combined medicinal herbal preparations, as this is in accordance with the global trend. The types of medicinal plant raw materials that can be a promising source of new diuretic herbal medicines, have been examined in this review.Conclusion. It has been determined that terpenoids and phenolic compounds make the greatest contribution to the manifestation of the diuretic activity of medicinal herbal preparations, among which the greatest structural diversity is noted for flavonoids. It has been established that in the composition of any drug, taking into account the peculiarities of etiology and pathogenesis of the disease, herbal diuretics can be both the main drug and an auxiliary component. The expediency of using medicinal plant raw materials with a diuretic effect as part of collections of medicinal plants and other combined preparations used in the treatment of kidney and urinary tract diseases has been also substantiated.
The aim of the study was to summarize and systematize the literature data, as well as the results of the carried out research in the field of medicinal plants used as diuretics in the Russian Federation and abroad.Materials and methods. During the search for this review article materials, the abstract databases of PubMed, Google Scholar, as well as the ResearchGate and elibrary.ru were used. The search was carried out according to the publications for the period from 2005 to 2023. The keywords were as follows: herbal diuretics, diuretic drugs, kidney diseases, types of medicinal plant raw materials. The data from the authors’ previous scientific research on the analysis of the diuretic properties of certain types of medicinal plant raw materials, as well as individual substances of a phenolic nature isolated from them (simple phenols, flavonoids), were also reviewed.Results. It was determined that the diuretic activity of most of the medicinal plants used, is due to such groups of biologically active compounds as terpenoids (essential oils and saponins), simple phenols, flavonoids and anthracene derivatives related to the secondary metabolites. It has been shown that, despite the fact that many herbal diuretics have concomitant anti-inflammatory, antimicrobial, antiviral, antihistamine and other properties relevant from the point of view of etiology and pathogenesis of the disease, it is reasonable to use them as part of collections of medicinal plants and other combined medicinal herbal preparations, as this is in accordance with the global trend. The types of medicinal plant raw materials that can be a promising source of new diuretic herbal medicines, have been examined in this review.Conclusion. It has been determined that terpenoids and phenolic compounds make the greatest contribution to the manifestation of the diuretic activity of medicinal herbal preparations, among which the greatest structural diversity is noted for flavonoids. It has been established that in the composition of any drug, taking into account the peculiarities of etiology and pathogenesis of the disease, herbal diuretics can be both the main drug and an auxiliary component. The expediency of using medicinal plant raw materials with a diuretic effect as part of collections of medicinal plants and other combined preparations used in the treatment of kidney and urinary tract diseases has been also substantiated.
Urinary tract infections (UTIs) are the most common pathology among pregnant women and are associated with maternal and foetal complications. According to some authors, the incidence of UTIs increased 4 times in the last decades of the 20th century. Escherichia coli is the most predominant pathogen causing up to 80% of UTIs, Klebsiella is ranked second causing up to 8% of UTIs, and pathogenic staphylococcus and mixed microflora are ranked third. To diagnose UTIs, laboratory, physical and radiological diagnostic methods are applied. According to most authors, informative value yielded by lab tests is more than 90%. The prescription of antibacterial chemotherapy should be based on the results of urine culture and sensitivity testing. Before the test results are obtained, broad-spectrum antibacterial drugs (ABs) are usually prescribed. The most commonly used therapy regimens are third-generation cephalosporins with dose adjustments, as may be necessary, after sensitivity is determined. Some authors recommend to continue treatment with urinary tract antiseptics after AB therapy is completed. The impaired urine output should be restored before AB therapy is prescribed. This review presents an analysis of the literature that was found in the databases PubMed (the National Library of Medicine), The Cochrane Library, as well as in the research citation databases (Scopus, Web of Science). The etiological factors and features of the pathogenesis of UTIs in pregnant women, as well as diagnostic standards, are described. The current guidelines for the treatment and prevention of UTIs in pregnant women are considered and antibacterial therapy regimens with current dosage forms are presented. The benefits of using cefixime dispersible forms are described in detail.
Aim. To study clinical manifestations of urinary tract infections in pregnant women with type 1 diabetes mellitus (DM).Materials and methods. Pregnant women with urinary tract infections (UTIs) were examined: 110 with type 1 diabetes mellitus (main group) and 133 without diabetes mellitus (comparison group). The diagnosis of UTI was based on the clinical picture (for manifestation forms) and confirmed by a dual culture method using both the classical approach and DipStreak tests. The determination of the sensitivity of the isolated microorganisms to antibacterial drugs was carried out by the disk diffusion test on Mueller-Hinton agar using paper disks. Instrumental research included ultrasound of the kidneys, urinary tract and fetoplacental complex.Results. In the main group, UTIs were pyelonephritis, asymptomatic bacteriuria (AB) and low AB (102–104 CFU/ml) was detected in 38, 69 and 31 patients, respectively. In the comparison group, pyelonephritis, AB and low AB was detected in 41, 63 and 29 patients, respectively. In the main group, the classic course of pyelonephritis was observed in 44.7%, low-symptomatic — in 26.3%, “according to the type of carbohydrate metabolism decompensation” — in 21%, and the obstetric variant — in 7.9% of patients. In the comparison group, the classic version of pyelonephritis was in 70.7%, low-symptomatic — in 24.4%, asymptomatic — in 4.9%. Bilateral pyelonephritis in pregnant women with type 1 diabetes mellitus prevailed over unilateral: 65.8 vs 34.2%. During AB, in patients with type 1 diabetes mellitus, hyperglycemia was observed in 23.1% (n = 16), the threat of pregnancy termination in 53.6% (n = 37), and moderate preeclampsia in 17.4% (n = 12). In patients with low AB, glycemia above the target values was recorded in 16.1% (n = 5), the threat of pregnancy termination in 38.7% (n = 12), and moderate preeclampsia in 12.9% (n = 4).Conclusion. Based on the specifics of the clinical manifestations of UTIs in pregnant women with type 1 diabetes mellitus, the following types of pyelonephritis can be distinguished: classic, low-symptom, “decompensation of carbohydrate metabolism” and obstetric. The classical course of pyelonephritis in pregnant women with type 1 diabetes mellitus is statistically significantly less common (p <0.05) as compared with pregnant women without diabetes mellitus. The features of AB in pregnant women with type 1 diabetes mellitus are the development of hyperglycemia and obstetric complications.
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