{"id":3997,"date":"2015-04-06T14:26:28","date_gmt":"2015-04-06T14:26:28","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=3997"},"modified":"2015-04-06T14:26:28","modified_gmt":"2015-04-06T14:26:28","slug":"gemoterapia-in-patologia-renala-a-copilului","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/gemoterapia-in-patologia-renala-a-copilului\/","title":{"rendered":"GEMOTERAPIA \u00ceN PATOLOGIA RENAL\u0102 A COPILULUI"},"content":{"rendered":"

Infec\u021biile urinare <\/a>recurente reprezint\u0103 o problem\u0103 important\u0103 \u00een patologia pediatric\u0103, pe de o parte datorit\u0103 frecven\u021bei, pe de\u00a0 alt\u0103 parte datorit\u0103 prejudiciilor pe care le pot provoca parenchimului renal (inflama\u021bie cronic\u0103, cicatrici renale).<\/p>\n

Folosirea gemoterapiei \u00een acest domeniu s-a impus datorit\u0103 imposibilit\u0103\u021bii tratamentului conven\u021bional cu antibiotice de a preveni recidivele. \u00cen terapia clasic\u0103 prevenirea recuren\u021belor se face\u00a0 cu chimioterapicele clasice, care trebuie s\u0103 \u00eendeplineasc\u0103 urm\u0103toarele condi\u021bii: s\u0103 nu induc\u0103 rapid rezisten\u021ba, s\u0103 nu produc\u0103 alergizare, s\u0103 se elimine \u00een urin\u0103 \u00een forma activ\u0103 \u0219i s\u0103 asigure concentra\u021bii eficiente \u00een c\u0103ile urinare.<\/p>\n

\u00cen tratatele actuale sunt recomandate pentru profilaxia recidivelor diverse scheme cu monoterapie sau terapiii combinate, cu schimbarea chimioterapicului la 10 zile. Indiferent de tratament, nici unul nu a reu\u0219it s\u0103 rezolve recuren\u021bele infec\u021biilor urinare. Din aceast\u0103 cauz\u0103 a fost imperios necesar\u0103 g\u0103sirea unor\u00a0 noi solu\u021bii, adjuvante tratamentului clasic cu antibiotic, pentru eradicarea infec\u021biilor. \u00cen acest articol doresc s\u0103 prezint experien\u021ba personal\u0103 \u0219i s\u0103 ar\u0103t locul pe care \u00eel poate avea gemoterapia ca tratament adjuvant \u00een infec\u021biile c\u0103ilor urinare, \u00een pediatrie, chiar \u00eentr-un spital de urgen\u021b\u0103.<\/p>\n

\"image<\/a><\/p>\n

Pentru lupta cu bacteriile patogene, \u00een ultimii ani, de mare utilitate a fost introducerea probioticelor, deoarece \u00eens\u0103\u0219i chimioterapicele folosite \u00een tratamentul de profilaxie a recidivelor creeaz\u0103 disbioz\u0103 \u0219i apare un cerc vicios infec\u021bie\u21e8antibiotic\u21e8disbioz\u0103\u21e8infec\u021bie, care \u00een final duce la persisten\u021ba sau recuren\u021ba infectiilor tractului urinar. Cu toate acestea, medicii care au tratat infec\u021bii urinare la copiii cu malforma\u021bii renale, imunodeficien\u021be sau disfunc\u021bii vezicale, s-au confruntat de multe ori cu imposibiliatea steriliz\u0103rii tractului urinar.<\/p>\n

Majoritatea infec\u021biilor urinare apar la v\u00e2rst\u0103 mic\u0103, de obicei sub 3 ani \u0219i \u00een aceast\u0103 etap\u0103 de v\u00e2rst\u0103 nu sunt recomandate antisepticele urinare, folosite\u00a0 \u00een terapie la adult sau la copilul mare. \u00cen afar\u0103 de antibiotic nu avem\u00a0\u00a0 solu\u021bii definitive, de aceea este util s\u0103 apel\u0103m la metode alternative, precum fitoterapia, gemoterapia, homeopatia, kinetoterapia.<\/p>\n

Pentru ini\u021bierea unei infec\u021bii urinare este necesar\u0103 aderarea germenilor la uroteliu (ex. Escherichia coli posed\u0103 fimbrii prin care se fixeaz\u0103 de uroteliu), cu producerea inflama\u021biei locale \u0219i ulterior propagarea infec\u021biei spre c\u0103ile urinare superioare \u0219i parenchimul renal. Avem la dispozi\u021bie unul dintre cele mai folosite produse \u00een toat\u0103 lumea, extractul de Cranberry (MERI\u0218OR), care are ca principal\u0103 ac\u021biune \u00eempiedicarea ader\u0103rii germenilor la mucoasa c\u0103ilor urinare. \u0218tim c\u0103 una din consecin\u021bele coloniz\u0103rii tractului urinar cu bacterii este perturbarea motilit\u0103\u021bii c\u0103ilor urinare, fie prin spasm, fie prin distensie. Apare un sindrom cistitic acut,\u00a0 exprimat clinic al\u0103turi de disurie (ca urmare a inflama\u021biei locale) prin polakiurie,\u00a0 mic\u021biuni imperioase, enurezis\u00a0 sau reten\u021bie urinar\u0103.<\/p>\n

Extractul gemoterapic din ml\u0103di\u021be de Meri\u0219or<\/a> \u00eel putem folosi \u0219i ca un\u00a0 \u201dMotillium \u201c al c\u0103ilor urinare, dac\u0103 exist\u0103 hipotonie sau reten\u021bie urinar\u0103 prin dismotilitate, sau un \u201cNo-spa\u201d pentru aparatul urogenital, dac\u0103 exist\u0103 spasticitate vezical\u0103 (polakiurie, enurezis). De multe ori infec\u021biile urinare se asociaz\u0103 cu constipa\u021bie cronic\u0103, iar Extractul din ml\u0103di\u021be de Meri\u0219or favorizeaz\u0103 \u0219i cre\u0219terea peristalticii tubului digestiv, ceea ce contribuie la sc\u0103derea riscului de recidiv\u0103 (constipa\u021bia poate fi factor favorizant de infec\u021bie urinar\u0103). Dac\u0103 ad\u0103ug\u0103m \u0219i efectul antiinfec\u021bios \u0219i cicatrizant al Meri\u0219orului, putem ob\u021bine o ameliorare a simptomatologiei \u0219i o sc\u0103dere a duratei de administrare a antibioticelor ( \u00een infec\u021biile recurente). Efectul de corec\u021bie al dismotilit\u0103\u021bii poate fi crescut prin asocierea cu Extract gemoterapic din muguri de Tei argintiu (efect pe sistemul nervos vegetativ, u\u0219or anxiolitic). Personal, cu aceast\u0103 schem\u0103 terapeutic\u0103 tratez copiii cu sindroame de insuficien\u021b\u0103 de eliminare (este afectat\u0103 inerva\u021bia intramural\u0103 a plexurilor mienterice a tubului digestiv \u0219i a c\u0103ilor urinare), care asociaz\u0103 la infec\u021biile urinare, reflux vezico-ureteral, constipa\u021bie cronic\u0103, uneori encoprezis sau reflux gastroesofagian.<\/p>\n

\u00cen pediatrie exist\u0103 frecvent cistite virale, mai ales cele hemoragice, datorate adenovirusurilor. \u00cen acest context, simptomatologia este brutal\u0103, cu hematurie macroscopic\u0103 \u0219i sindrom cistitic intens (polaki-disurie, mic\u021biuni imperioase, agita\u021bie \u0219i nervozitate la copilul mic); asocierea la un antiinflamator (ex. Ibuprofen) a gemoterapicului din ml\u0103di\u021be de Meri\u0219or \u0219i a celui din muguri de Tei argintiu scurteaz\u0103 semnificativ durata bolii \u0219i atenueaz\u0103 disconfortul produs de inflama\u021bia vezicii urinare.<\/p>\n

Uneori ne confrunt\u0103m cu o varietate de sindrom cistitic (exprimat clinic mai ales prin polakiurie), cunoscut \u00een literatura francez\u0103 ca cistalgie (poate fi numit echivalentul renal al \u201ccolonului iritabil\u201d) ce apare pe un anumit teren psiho-emo\u021bional, declan\u0219at de viroze, frig, bazin, diverse tratamente sau manevre urologice. Personal, asociez la Driptane, extractele gemoterapice din ml\u0103di\u021be de Meri\u0219or \u0219i din muguri de Tei argintiu, pentru corec\u021bia tulbur\u0103rii de motilitate a c\u0103ilor urinare.<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Frecvent, \u00een practic\u0103 se asociaz\u0103 la infec\u021bie \u0219i litiaza urinar\u0103. \u00cen spital avem frecvent cazuri de nefrocalcinoze ( +\/- nefrolitiaz\u0103) care beneficiaz\u0103 de tratament, fie medical, fie ini\u021bial chirurgical (calculi coraliformi) \u0219i ulterior medicamentos. Tratamentul, dup\u0103 antibioterapie, poate continua cu Extract din ml\u0103di\u021be de Meri\u0219or si Extract din ml\u0103di\u021be de Iarb\u0103 neagr\u0103. Acesta din urm\u0103, asociaz\u0103 efectului antiinflamator, antibacterian \u0219i efectul antilitiazic, mai ales \u00een litiaza oxalo-calcic\u0103, pentru care, \u00een afar\u0103 de vitamina B6, nu avem multe op\u021biuni la copilul de v\u00e2rst\u0103 mic\u0103. De asemenea, este benefic \u0219i efectul antisclerotic al preparatului, mai ales la copiii cu pielonefrit\u0103 cronic\u0103 sau la cei cu malforma\u021bii severe, operate sau tratate conservator. Pacien\u021bii cu infec\u021bie urinar\u0103 grefat\u0103 pe vezica neurogen\u0103, cei care prezint\u0103 manevre urologice frecvente sau cei cu dispozitive medicale (tip sond\u0103 vezical\u0103 sau sfincter vezical) au tendin\u021be sclerogene \u0219i beneficiaz\u0103 de acest efect . Deosebit de util \u00een practic\u0103 este produsul Polygemma 7- c\u0103i urinare (care asociaz\u0103 \u00een formula gemoterapicele de Meri\u0219or, Iarb\u0103 neagr\u0103 \u0219i Afin\u00a0 – ce con\u021bine un derivat hidrochinonic \u2013 arbutina, cu ac\u021biune antiseptic\u0103, antibacterian\u0103 \u0219i antiinflamatoare asupra c\u0103ilor urinare).\u00a0 Afinul are \u00een plus efect uricozuric, iar\u00a0Meri\u0219orul este \u00een plus \u0219i cicatrizant al c\u0103ilor urinare.<\/p>\n

Dup\u0103 30 de ani de practic\u0103 pediatric\u0103, am ajuns la concluzia c\u0103 microbii \u201cau mare inteligen\u021b\u0103 proprie \u201c, este greu de luptat cu un du\u0219man at\u00e2t de abil \u0219i\u00a0 numai tratamentele cu antibiotice\u00a0 nu rezolv\u0103 recuren\u021ba\u00a0 sau persisten\u021ba infec\u021biilor. Accentul trebuie pus pe urm\u0103toarele\u00a0 elemente: evitarea disbiozelor , controlul dismotilit\u0103\u021bilor \u0219i cre\u0219terea imunit\u0103\u021bii .<\/p>\n

Rezultatele ob\u021binute \u00een practica medical\u0103 curent\u0103 de spital, prin folosirea gemoterapicelor, a dus la certificarea direct\u0103 a datelor din literatura de specialitate din acest domeniu \u0219i acest lucru m-a motivat s\u0103 vi le \u00eemp\u0103rt\u0103\u0219esc.<\/p>\n

\u0218ef de lucr\u0103ri – Dr. Gabriela ION<\/strong>\u00a0– Medic primar pediatrie, doctor \u00een \u015ftiin\u0163e medicale, competen\u0163\u0103 nefrologie – Spitalul\u00a0Clinic de Urgen\u021b\u0103 pentru Copii\u00a0\u201cGrigore Alexandrescu\u201d- Bucure\u0219ti<\/p>\n","protected":false},"excerpt":{"rendered":"

Infec\u021biile urinare recurente reprezint\u0103 o problem\u0103 important\u0103 \u00een patologia pediatric\u0103, pe de o parte datorit\u0103 frecven\u021bei, pe de\u00a0 alt\u0103 parte datorit\u0103 prejudiciilor pe care le pot provoca parenchimului renal (inflama\u021bie […]<\/p>\n","protected":false},"author":5,"featured_media":3999,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[1,154],"tags":[155,159,156,157,158],"class_list":["post-3997","post","type-post","status-publish","format-standard","has-post-thumbnail","category-stiri-noutati","category-urologie","tag-cicatrici-renale","tag-cistite","tag-infectie","tag-inflamatie","tag-urinara"],"yoast_head":"\nGEMOTERAPIA \u00ceN PATOLOGIA RENAL\u0102 A COPILULUI - Jurmed - Medici<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/gemoterapia-in-patologia-renala-a-copilului\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"GEMOTERAPIA \u00ceN PATOLOGIA RENAL\u0102 A COPILULUI - 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