A method for the treatment of bedwetting in children and adolescents

 

The invention relates to medicine, namely to Pediatrics, and is intended for the treatment of bedwetting in children and adolescents. The method includes life skill awakening of the patient when the urge to urinate through the use of the apparatus conditioned reflex therapy in the daytime in the waking state of the patient. When the urge to urinate, the patient brings the machine in working condition and produces urinating on the receiving sensor, reflex after interruption of urination apparatus is disconnected and the patient continues to urinate normally. The method simplifies and optimizes the method of using the apparatus of conditioned reflex therapy and reduces the treatment time. table 1.

The invention relates to medicine, namely to Pediatrics, and is intended for the treatment of bedwetting in children and adolescents.

The prevalence of nocturnal enuresis, or bedwetting, various sources estimate 2.1-28,1%. Despite such a significant variation in the results of the calibration of the frequency of occurrence of different authors, even if we focus on the most optimistic estimates, it can be noted that the weight of suffering uh, ajustou, weakly effective ways and means of treatment urination during sleep, the results of which according to various estimates varies in the range of 10.0-36,5% (Vishnevsky E. L., Kazan, I. C., Bannikov C. M., Gusarova I.e., Rostov centuries , Babanin I. L., Danilov, C. C. Diagnosis and treatment of urinary incontinence at different stages of medical care (clinic, hospital). Ministry of health guidelines and MP of the Russian Federation for physicians. - M., 1995; Laszlo Kovacs, E. L. Panchenko. Primary nocturnal enuresis: a new look at an old problem// Pediatrics 3, 1998). Claimed by some authors the effectiveness of treatment by any method, in 90% and above good and satisfactory results, as a rule, difficult to reproduce (Epidemiology of enuresis and related behavior disorders in children in the USA Robert S. Byrd., Michel Weitzman, Nency T. Lanphear, Peggy Auinger/ PLE PEDIATRICS, Volume 1, 1 March, 1998).

Meanwhile, it should be noted the practical importance of the problem solution urination during sleep. Enuresis is a serious inconvenience for the sick child and to an even greater extent teenager, and for the people around him, can cause a neurotic personality, especially in puberty and postpubertatne age. In addition, quartering the development of microbial and inflammatory process in the urinary tract and kidneys (N. Korovin.A., Gavryushova L. P., Zakharov, I. N. Enuresis in children. (A practical manual for doctors). Moscow, 2000, 36 S.; Kuselman A. I., Small, A. L., Negodov A. A. Nocturnal enuresis in children (etiology, pathogenesis, clinic, treatment). Educational-methodical manual for doctors. Ulyanovsk, Ulyanovsk State University. - 1997. - 52 S.

Thus, a higher prevalence of enuresis, the relative severity of this kind of suffering and the lack of effective treatments necessitated the search for alternative methods of treatment or fundamentally new approaches to the use of existing ones.

There is a method of treatment of enuresis in children and adolescents, including conditioned reflex therapy with use of special devices - "real", AL-2, AL-2, AL-5 and other treatment Principle is the life skill of the awakening of the patient when the urge to urinate (method conditioned reflex therapy of enuresis by B. I. Laskavo). On a night sleeping on the belly and back of the patient strengthen the metal plate, and at the exit of the urethra is a special sensor. During the night the disbursement of the first drops of urine and hit her on the sensor includes a device, i.e., occur an electrical circuit and the transmission of electrical impulses on the metal plate to reinforce the data pulses in the reticular formation of the stem and adjacent structures to awaken.

The disadvantages of existing methods is the appearance of more or less stable reflex Wake up to a full bladder during sleep no earlier than 4-6 weeks from the start of treatment, and in some cases its formation is delayed up to 8-10 weeks. Such a long period of treatment, coupled with a fairly time-consuming ghosts device in working condition, care, discomfort when in bed and falling asleep with the connected device, often leads to conversion relationships for ongoing therapy, and in some cases neurotic manifestations. This is especially true for children and adolescents who have a therapeutic effect, as a rule, it is possible to achieve after a significant number of activations of the device and in patients with rare episodes of enuresis.

The objective of the invention is the improved treatment of enuresis by simplifying and optimizing methods using hardware conditioned reflex therapy and reduce treatment time. This object is achieved by using hardware conditioned reflex therapy in the daytime, in the waking state of the patient. Used vehicles "real", AL-5M. During the independently or with the help of parents, the average day care personnel clinic leads the machine in working condition, strengthens plate electric stimulation on the skin of the abdomen and back and makes urination on the receiving sensor. After actuation device sensor and disconnect plate, and the patient makes urination in normal mode. theoretical basis of development is the idea of the act of waking up with the urge to urinate as activation of specific functional systems that provide rastormozheniem cortex and subcortical structures in response to a sufficient intensity of afferent stimulation. Additional flow is centripetal impulses generated by a certain number of repetitions irritant effect faradic current skin in the waking state at the beginning of the evacuation of urine from the bladder, allows to reach the optimal level authorizing afferention during night sleep. According to the proposed methodology treated with 45 children and adolescents with enuresis in age from 9 to 16 years (see table).

As seen from the above comparisons, the greatest amount of good results have been achieved using conditionally-reflectionally weight of unsatisfactory results from treatment with the use of conditioned reflex therapy during wakefulness was the lowest (8.8 percent). Treatment of enuresis in the daytime, in the waking state of the patient, in addition, it accelerates the production of the conditioned reflex in 1,3-1,5 times, adapting to the apparatus avoids the adverse psychological consequences of prolonged use.

Example. Oleg M. , age 12. Turned, with his parents in the regional children's consultation clinic CCC OMD 18.04.2001 with complaints urination during sleep from 5 years of age. Repeatedly passed the examination and treatment in the district hospital at the place of residence, received a Spa treatment. In the period 1998-2001 received medical treatment - imipramine, entsefabol, spasmes courses, in a dosage of age, lazerorefleksoterapija, UZ in the region of the bladder twice, comprehensive herbal medicine, hypnotherapy. After a course of imipramine was awarded a short-term effect - the child three times during the month, the night he woke up from the desire to urinate. In December 2000 month received treatment for drug Adiuretin DM according to the regimen 2 drops at night intranasally. During administration of the drug remained dry after its cancellation urination during sleep immediately resumed. If the examination is satisfactory, itself the study - changes it is not revealed. Was completed the treatment conditioned reflex therapy of enuresis using the "real" in the daytime, the first self-awakening in the dream when the urge to urinate marked on the 7th day of treatment, from the 16th day found a stable self-awakening, when the urge to urinate. After 3 weeks treatment discontinued. Observation of the child within 6 months confirms good stable result, absence of urination during sleep.

Thus, the use for the treatment of enuresis proposed technique can significantly reduce the treatment time (from 5-6 to 3-4 weeks), simplifies treatment method, because it allows one to conduct therapy in the daytime, during wakefulness of the patient.

Claims

A method for the treatment of bedwetting in children and adolescents by working skill awakening of the patient when the urge to urinate, including the use of the apparatus conditioned reflex therapy, characterized in that the treatment is carried out in the day time in the waking condition of the patient, when the urge to urinate bring the machine in working condition and produce urinating on the receiving dnom mode.

 

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FIELD: medicine.

SUBSTANCE: method involves applying transscleral diaphanoscopic examination method for adjusting intraocular neoplasm localization and size. Rectangular scleral pocket is built 2/3 times as large as sclera thickness which base is turned from the limb. Several electrodes manufactured from a metal of platinum group are introduced into intraocular neoplasm structure via the built scleral pocket. Next to it, intraocular neoplasm electrochemical destruction is carried out in changing electrodes polarity with current intensity of 100 mA during 1-10 min, and the electrodes are removed. Superficial scleral flap is returned to its place and fixed with interrupted sutures. 0.1-2% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transpupillary laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2. the operation is ended with placing sutures on conjunctiva. Platinum, iridium or rhodium are used as the metals of platinum group. The number of electrodes is equal to 4-8. 0.1-1% khlorin solution, selected from group containing photolon, radachlorine or photoditazine, is additionally repeatedly intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2.

EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: method involves intravitreously introducing two electrodes into intraocular neoplasm after carrying out vitrectomy and retinotomy to expose the intraocular neoplasm. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with current intensity of 100 mA during 1-10 min or 10 mA during 10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2.The transformed retina and tumor destruction products are intravitreally removed. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. Another embodiment of the invention involves adjusting position and size of the intraocular neoplasm in trans-scleral diaphanoscopic way. Rectangular scleral pocket is built above the intraocular neoplasm to 2/3 of sclera thickness with its base turned away from limb. Several electrodes are introduced into intraocular neoplasm structure via the built bed. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with the same current intensity in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. Superficial scleral flat is returned to its place and fixed with interrupted sutures. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg after having carried out vitrectomy and retinotomy. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2. The transformed retina and tumor destruction products are intravitreally removed using vitreotome. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. The number of electrodes is equal to 4-8.

EFFECT: reduced risk of metastasizing.

4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves filling vitreous cavity with perfluororganic compound. Two electrodes manufactured from platinum group metal are intravitreally, transretinally introduced into intraocular neoplasm. Electrochemical destruction is carried out with current intensity of 10-100 mA during 1-10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2 in perfluororganic compound medium. The transformed retina and tumor destruction products are intravitreally removed with perfluororganic compound volume being compensated with its additional introduction. Boundary-making endolasercoagulation of retinotomy area is carried out. The perfluororganic compound is substituted with silicon oil. The operation is ended in placing sutures over sclerotmy areas and over conjunctiva. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity. Platinum, iridium or rhodium are used as the platinum group metals.

EFFECT: complete destruction of neoplasm; reduced dissemination risk.

6 cl, 12 dwg

FIELD: medicine; infectious therapy.

SUBSTANCE: device for plasma-dynamic treatment of infected wounds and cavities has high voltage electric pulse oscillator provided with low-sized high voltage pulse electric-charge unit housed inside carrier dielectric case. The case has co-axial electrode system which has ring-shaped and rod electrodes separated by dielectric insulator. Co-axial electrode system is placed inside optical-transparent quartz member made in form of flask which has perforated semispherical working end. Co-axial system is disposed to have space relatively inner surface of carrier case of unit. Part of internal surface of the unit - at the area of semispherical working end of flask - is made of material which is able to reflect radiation of visible and UF range of spectrum. Removable outlet union, provided with branch pipe connected to union, is mounted onto working part of carrier case of unit. Branch pipe is connected with member having perforated semispherical working end at the opposite side. Opposite edge part of carrier case has support sealing bushing with inlet pipe which is connected with ozone generator conjugated with vessel for containing oxygen. Inlet pipe communicates with space to inner surface of carrier case of the unit and outer surface of flask.

EFFECT: improved efficiency of treatment; improved reliability of operation.

10 cl, 2 ex

FIELD: medical engineering.

SUBSTANCE: device has means for stimulating sensory organs (auditory and visual analyzers), thermo- and mechanoreceptors and transcutaneous electrostimulation in various combinations and sequences. Device has technical means providing sensory irritations. A set of light-emitting diodes comprising white, blue, green, red ones or their combinations are applied in particular for stimulating visual analyzer. Some of them are located on internal surfaces of sun-protection glasses and others arranged on periphery as radial divergent lines. To stimulate auditory analyzer, a set of micro speakers is used, one of which is mounted in the center of head phone and the others are concentrically arranged at least in two rows on periphery. To stimulate mechanoreceptors, a set of infrared light-emitting diodes is used, one of which is mounted in the center of thermode and the others are concentrically arranged at least in two rows on periphery. To carry out transcutaneous electrostimulation, electrodes with centrally arranged contact plate and electrically isolated contact plates concentrically arranged at least in two rows on periphery. Sensory irritation generators have independent communication channels having centrally and peripherally arranged stimulators. The generators are electrically connected to control unit connected to PC.

EFFECT: wide range of functional applications; enhanced effectiveness of human organism mental correction.

2 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves creating therapeutic circuit fixed on patient body, at least two working therapeutic electrodes, measuring and analyzing patient-dependent electrophysical parameters, charging capacitive storage and its later discharging to the working therapeutic electrodes controlled with control unit. Transmitting defibrillation impulse of given power in discharging is carried out in dosed manner first with the first portion W1 of given power dose with the second portion W2 being accumulated on inductive defibrillation power accumulator and then with the second portion W2 of given power dose. Ratio of the first portion W1 of given power dose to the second portion W2 of given power dose of defibrillation impulse is selected from the range of 0.01 to 150. Defibrillation impulse current intensity is selected only when emitting the first portion W1 of given power dose. Cardiodefibrillation impulse is built as bipolar Gurvich impulse. The given power quantity usable for charging the capacitive defibrillator storage is selected to be equal to a value from the range of 4-500 J, defibrillation impulse current intensity being selected from the range of 0.005 to 175 A and voltage equal to a value from 3 to 30000 V. Means has power supply source having unit for controlling charge level of the capacitive storage, unit for building defibrillation pulses, switchboards formed by controlled keys, at least two working therapeutic electrodes and diodes bypassing the controlled keys, resistive current transducer, analog-to-digital converter and control unit having required functional communications to the analog-to-digital converter and controlled keys. The resistive current transducer is in current feeding bus having minimum potential relative to measuring unit under operation having analog-to-digital converter in its structure.

EFFECT: enhanced effectiveness of usage; high safety of patient treatment procedure.

7 cl, 9 dwg

FIELD: medical engineering.

SUBSTANCE: device has n channels where n is even number. Each channel has stimulating signal generator and stimulating signal shaper. The stimulating signal generator has delay unit, unit for blanking coincident signals, packet envelope shaper and pulse packet oscillator. The stimulating signal shaper has power amplifier and unit containing the first starting cell and the first digital display. Unit for determining mean step is introduced into each stimulating signal generator. The unit output is connected to information inputs of delay unit and of stimulating signal shaper. The first input is combined with delay unit input and is called stimulating signal generator Start input. The second one is combined with corresponding delay unit input and packet envelope shaper and is called Set Zero input of the stimulating signal generator. Output of the unit for blanking coincident signals is connected to packet envelope shaper input. I-th stimulating signal generator delay unit output (I=1...n) is connected to i-th input of the unit for blanking coincident signals and serves as output of delayed signals. Inputs of the unit for blanking coincident signals (with the exception of the i-th one) form a group of delayed signals inputs of the stimulating signals generator. Information outputs of the delay unit and of the packet envelope shaper are the first and the second information outputs of the stimulating signal generator, respectively. Packet envelope shaper output is connected to packet envelope generator start input which output is signal output of the stimulating signal generator.

Packet envelope shaper output is processes visualization output of the stimulating signals generator. Each stimulating signal shaper additionally has in series connected attenuator and output transformer symmetric output of which is shaper signal output. Inverter has input connected to power amplifier output. Switch is available between outputs from the power amplifier, inverter and attenuator input. Power amplifier input serves as signal input of the shaper. the second digital display, clock pulse oscillator, the first switch are introduced into movement corrector. The first input of the first switch is connected to clock pulse oscillator output, the output being connected to combined Start inputs of stimulating signals generators having visualization input with its signal inputs being connected to stimulating signals generators processes visualization outputs. The second switch has output connected to synchronizing output of visualization unit input. The third switch has the first and the second outputs connected to the second and the third inputs of the first switch, respectively. Three start transducers make start transducers set with the available one with the first, the second, the third and the fourth outputs are connected to the second and the third switch inputs. The fourth and the fifth switch are available between the first and the second information outputs of stimulating signals generators, respectively. Output of the delayed signals of i-th stimulating signals generator (I=1...n) is connected to inputs of delayed signals group from the remaining stimulating signals generators. Set Zero inputs of the stimulating signals generators are joined together forming movement corrector Set Zero input.

EFFECT: wide range of functional applications; enhanced effectiveness in treating patient possessing heavy locomotor apparatus disorders both in rest state and in moving.

4 cl, 5 dwg

FIELD: medicine, ophthalmology.

SUBSTANCE: the present innovation deals with treating different forms of amblyopia. It is necessary to carry out medicinal correction of neurological disorders in a patient that includes vasoactive preparations, venotonics, nootropes and metabolics. One should conduct electrophoresis of spasmolytics onto area of jugular vertebral department at current power being 0.5-1.0 mA/sq. cm per 10 min, daily. Simultaneously,, it is necessary to carry out argon-laser stimulation of retinal central area and projection of papillo-macular bundle, about 150-200 impulses/seance, radiation power being 0.05 W, radiation diameter of 1000 mc, exposure time of 0.01 sec, wave length being 498-514 nm every other day. Therapy course lasts for 10 d. The innovation enables to achieve positive dynamics in treating severe forms of amblyopia, restore visual function and obtain correction of neurological disorders.

EFFECT: higher efficiency of therapy.

4 ex

FIELD: medical equipment, applicable for treatment of various inflammatory diseases.

SUBSTANCE: the device has a noise current generator, catheter, series-connected personal computer, control unit and a filter unit, whose input is connected to the output of the noise current generator, the output is connected to the catheter, and the personal computer is provided with a dialogue software of experiment planning.

EFFECT: provided approximation of the frequency spectrum of the current acting on the man organs and tissues to the therapeutically optimal value by determination of the optimal combination of the tuning frequencies and the quantity of filters by the methods of mathematical planning of experiment with employment of a personal computer.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves introducing photosensitizer in pharmaceutical water-soluble dosage form at a dose of 1.5-2.0 mg/kg * 0.7 during 40-60 min. Blood is concurrently exposed to laser radiation at a dose of 600-900 J/cm3. The wavelength is selected to match photosensitizer absorption maximum in the water-soluble dosage form. Chlorine row photosensitizer is introduced 3-3.5h later in liposome form at a dose of 1.5-2.0 mg/kg*0.3. 15 min later, laser radiation is applied all over the whole tumor perimeter in transpupillary mode with neighboring fields overlap by 5% of area with power density of 80-100 J/cm2. The wavelength is selected to match photosensitizer absorption maximum in the liposome form. Then the whole neoplasm surface is irradiated in transpupillary mode in laser radiation fields in circle moving from periphery to the center with neighboring fields overlap being equal to 5% of area. The wavelength is selected to match photosensitizer absorption maximum in the water-soluble dosage form. Power density of 80-100 J/cm2 in peripheral part is gradually increased when moving towards the center to 100-120 J/cm2. Two weeks later, localization is adjusted in diaphanoscopic transscleral way and electrochemical destruction of intraocular neoplasm is carried out with current intensity of 10-100 mA during 10-1 min.

EFFECT: enhanced effectiveness in achieving complete or partial tumor regress; reduced risk of metastatic complications.

4 cl

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