Method for treating inflammatory diseases of uterine adnexa
FIELD: medicine, operative gynecology.
SUBSTANCE: at final stage of laparoscopic operation for 5-7 min one should introduce 16 U lidase in 1 ml 2%-lidocaine solution into uterine mesentery from both sides, and then, by not removing a needle - a half of single dose of antimicrobial preparation in 1 ml 2%-lidocaine solution, then in postoperational period - an antimicrobial preparation applied during laparoscopy lymphotropically under mucosa of lateral vaginal arch from both sides for 5-7 d once daily and one antimicrobial preparation - intravenously for 5-7 d, moreover, as antimicrobial preparations one should apply gentamicin, metrogyl and other preparations permitted for intravenous application. The present innovation stimulates lymphatic drainage in area of inflammation and activates interstitial humoral transport of antimicrobial preparations that, in its turn, favors complete sanitation of inflammation foci and prophylaxis of disease relapses.
EFFECT: higher efficiency of therapy.
1 cl, 1 ex
The present invention relates to medicine, namely to the field of therapy of human diseases, and may be used to treat patients with inflammatory diseases of the uterus.
There is a method of treatment of patients with inflammatory diseases of the uterus (purulent salpingitis, and pyosalpinx, power, purulent education tubo-ovarian ago when the disease is not more than 2-3 weeks) by the use of laparoscopy in combination with the introduction intramuscularly or intravenously combination of two or three antimicrobials (Krasnopolsky VI and other pyoinflammatory diseases of the uterine appendages. - M.: Medpress, 1998. - 233 S.). However, this method, in our opinion, has several disadvantages.
It is well known that during the development of inflammatory diseases especially important is the role of the lymphatic system, because it provides drainage and detoxification of tissue fluid and lymph (Borodin SCI, 1998). It is proved that under the traditional intramuscular and intravenous antimicrobial drug in the lymphatic system gets the minimum number of medicinal substances, which limits the clinical effect (Levin, Y.M. basis of the medical lymphology. - M.: Medicine, 1986. - 288 S.).
A known method of lymphotropic therapy, including the introduction lidz in the solution of lidocaine (increases resizemode the main substance of connective tissue and directs the fluid flow to the roots of the lymphatic system) and antimicrobial drug. The method allows to create a sufficient and stable concentration of antimicrobial agent in the lymphatic system and lymphatic nodes. This ensures maximum exposure to the pathogen, as in the hearth and in the lymphatic system, which helps to improve the results of treatment of purulent-inflammatory diseases (Buyanov V.M., Danilov KU, Radzikhovsky A.P. Drug saturation of the lymphatic system. - Kiev, 1991. - 134 C.).
Closest to the claimed object (the prototype) is a method of treatment of nonspecific MetroEthernet and acute inflammatory diseases of uterine appendages, namely, that when laparoscopy between the pieces of the broad uterine ligament install microirrigation and fix one or two wikilove seams. Through microirrigation lymphotropic injected the antibiotic once a day for 3-5 days (Goldyreva E.V. Clinical-morphological basis of the method of lymphotropic therapy of acute nonspecific MetroEthernet: author. dis ... KMN - Novosibirsk, 2000. - 23 S.).
However, this method, in our opinion, has several disadvantages:
in the known method is proposed to dissect the broad ligament of the uterus, to enter into parametrium catheter for 5 days, what with purulent nature of the process may contribute to the spread of pathogenic micro district, the organisms on parametri, followed by suppuration and generalization of infection;
- for fixing microirrigation superimposed andosov that requires a certain experience of the surgeon, the availability of special tools;
- finding microirrigation in the abdominal cavity within 5 days promotes the formation around him adhesions, which is also undesirable;
- administration of drugs in the gap between the round ligament of the uterus and fallopian tube (parametrium) provides it enters the region of lifebar from the uterus, which is important for metroendometrit and less important in inflammatory diseases of the uterus.
The objective of the invention is to improve the results of treatment of inflammatory diseases of the uterus.
This object is achieved in that in the method of treatment of inflammatory diseases of the uterus, including laparoscopy and the introduction of antimicrobial drug lymphotropic, at the final stage of the operation within 5-7 minutes of entering the mesentery of the fallopian tube 16 UNITS lidz in 1 ml of 2%lidocaine solution, and then, without removing the needle, half of a single dose of antimicrobial agent in 1 ml of 2%lidocaine solution. The same drugs injected into the mesentery of the fallopian tube from the opposite side.
In the postoperative period, along with the appointment of od is wow antimicrobial drug intravenously, one antimicrobial agent, which was used during laparoscopy, enter lymphotropic under the mucous membrane of the lateral fornix of the vagina on both sides for 5-7 days 1 time per day.
Above the optimal rate of introduction of the solutions selected from those considerations that a more rapid introduction of drugs in the interstitial tissue is formed infiltrate, you lose the effect of the stimulation of interstitial humoral transport and lymphatic drainage. Slower introduction does not significantly affect the pharmacokinetics of drugs, however, increases the duration of the operation.
The method is as follows.
Patients with inflammatory diseases of the uterus (purulent salpingitis, and pyosalpinx, power and purulent education tubo-ovarian ago when the disease is not more than 2-3 weeks) perform a laparoscopy. At the final stage of the operation for 5-7 min in the mesentery of the fallopian tubes enter the 16 UNITS lidz in 1 ml of 2%lidocaine solution, and then, without removing the needle, half of a single dose of antimicrobial drug with a wide spectrum of activity in 1 ml of 2%lidocaine solution. The same number of drugs injected into the mesentery of the fallopian tube from the opposite side.
In the postoperative period, along with the appointment of one antimicro the aqueous drug intravenously, one antimicrobial agent, which was used during laparoscopy, enter lymphotropic under the mucous membrane of the lateral fornix of the vagina on both sides for 5-7 days 1 time per day. For lymphotropic use of antimicrobial drugs permitted for intravenous administration.
Example. Patient A., 23 years old (case history No. 19241) entered in the gynecology Department of the regional clinical hospital, Omsk 08.10.02, with a diagnosis of Exacerbation of chronic bilateral adnexitis with the formation of tubo-ovarian formations on both sides. On admission the patient complained of abdominal pain, fever up to 38°C. bimanual examination and according to the ultrasonic scanning region of the uterus on both sides identified tubo-ovarian formations 5×6 see General blood was marked leukocytosis (16,7×109/l), increased erythrocyte sedimentation rate, up to 22 mm/hour. The patient is made operative laparoscopy (salpingoophoritis, salpingotomy on both sides), lymphotropic therapy (lymphotropic in the mesentery of the fallopian tubes on both sides put 80 mg of gentamicin). In the postoperative period continued introduction of gentamicin at a dose of 80 mg lymphotropic under the mucous membrane of the lateral arches of the vagina on both sides of 1 times a day for 7 days. Also what about the, appointed metrogel 500 mghz times a day intravenously for 10 days.
The positive effect of the treatment: the body temperature returned to normal in the first day of therapy, peripheral blood within 72 hours, the pain has stopped within 48 hours. By ultrasound scanning 21.10.02, the parameters of the normal structure of the uterus. Duration of treatment the patient was 17 bed-days (instead of 21 bed-days in the comparison group). The application of the proposed method of treatment has allowed to perform organ-saving operation.
In this way treated 10 patients with inflammatory diseases of the uterus.
Studies have shown that the proposed method improves the efficiency of treatment of patients with inflammatory diseases of the uterus, shorten the hospital stay, reduce the dose rate of antimicrobial drug, to expand the indications for organ-sparing operations.
1. A method of treating inflammatory diseases of the uterus, including laparoscopy and the introduction of antimicrobial drug lymphotropic, characterized in that at the final stage of the operation within 5-7 minutes of entering the mesentery of the fallopian tube with two sides 16 UNITS lidz in 1 ml of 2%lidocaine solution, and then, without removing the needle, half the time the first dose of antimicrobial agent in 1 ml of 2%lidocaine solution, then in the postoperative period antimicrobial agent, which was used during laparoscopy, enter lymphotropic under the mucous membrane of the lateral fornix of the vagina on both sides for 5-7 days 1 time per day and one antimicrobial drug intravenously within 5-7 days.
2. The method according to claim 1, characterized in that as antimicrobial agents used gentamicin, metrogylum and other approved medications for intravenous administration.
FIELD: medicine, pharmacology, pharmacy.
SUBSTANCE: invention relates to a new growth/differentiation factor of TGF-β-family representing the amino acid sequence SEQ ID NO.2 or, if necessary, its functionally active moieties and to pharmaceutical composition based on thereof that can be used for inducing angiogenesis. Invention provides the enhancement of biological activity of preparation.
EFFECT: valuable biological properties of factor.
4 cl, 3 tbl, 4 dwg, 3 ex
FIELD: medicine, thoracic surgery, anesthesiology.
SUBSTANCE: as non-narcotic medicinal preparation one should apply heparin to be introduced intratracheally at the dosage of 300-500 IU/kg, moreover, heparin should be introduced during the first 30 min after the operation is over. The present innovation enables to create prolonged anesthetizing effect in combination with prophylaxis of postoperational thrombohemorrhagic complications due to heparin capacity to be kept in the body due to its accumulation by mast cells at blockade of their fermentative activity followed by its gradual release into the blood.
EFFECT: higher efficiency.
1 cl, 1 ex, 3 tbl
FIELD: veterinary science.
SUBSTANCE: one should introduce mineral additives into the diet of animals in postoperational period for 15-17 d at 4.0-5.0 g, zinc sulfate 0.75-1.5 g, cobalt chloride 30-35 mg, manganese sulfate 40-45 mg, potassium iodide 10-15 mg, monopotassium phosphate 80-100 per 100 kg body weight, moreover, elemental sulfur and monocalcium phosphate should be introduced in combination with concentrates, and zinc sulfate, cobalt chloride, manganese sulfate and potassium iodide should be introduced in dissolved form in the mixture with feedstuffs. The present method enables to decrease the terms for wounds healing.
EFFECT: higher efficiency.
FIELD: medicine, obstetrics, gynecology.
SUBSTANCE: rehabilitation should be carried out in the third trimester of pregnancy based upon dispensary situated in ecologically safe region, as an enterosorbent one should apply "Carbopect" preparation per 0.5-0.6 g once daily for 3 wk; as an iodine preparation it is necessary to prescribe "Potassium iodide" 200 mcg once daily till the end of pregnancy period and during the whole period of lactation; as adaptogens one should additionally prescribe "Revit" per 2 lozenges thrice daily for 2 wk; vitamin-containing tea; one should, also, apply aerotherapy named "mountain air" per 15-40 min, 15 procedures, totally. The present innovation enables to improve anthropometric parameters in neonatals, decrease the percentage of complications in babies in early neonatal period, among them those that require antibioticotherapy.
EFFECT: higher efficiency of rehabilitation.
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention describes compound of the formula (I):
as a free form or salt wherein Ar means group of the formula (II):
wherein R1 means hydrogen atom or hydroxy-group; R2 and R3 each means independently of one another hydrogen atom or (C1-C4)-alkyl; R4, R5, R6 and R7 each means independently of one another hydrogen atom, (C1-C4)-alkoxy-group, (C1-C4)-alkyl or (C1-C4)-alkyl substituted with (C1-C4)-alkoxy-group; or R5 and R6 in common with carbon atoms to which they are joined mean 6-membered cycloaliphatic ring or 6-membered heterocyclic ring comprising two oxygen atoms; R8 means -NHR13 wherein R13 means hydrogen atom, (C1-C4)-alkyl or -COR14 wherein R14 means hydrogen atom; or R13 means -SO2R17 wherein R17 means (C1-C4)-alkyl; R9 means hydrogen atom; or R8 means -NHR18 wherein -NHR18 and R9 in common with carbon atoms to which they are joined mean 6-membered heterocycle; R10 means -OH; X means (C1-C4)-alkyl; Y means carbon atom; n = 1 or 2; p = 1; q = 1; r = 0 or 1. Also, invention describes pharmaceutical composition based on compound of the formula (I), a method for preparing compound of the formula (I) and intermediate compound that is used in the method for preparing. Compounds elicit the positive stimulating effect of β2-adrenoceptor.
EFFECT: improved preparing method, valuable medicinal properties of compounds.
13 cl, 3 tbl, 35 ex
where R1represents hydrogen, hydroxy, protected hydroxy, or aryl, optionally substituted with a suitable(and) substituent(s) selected from the group consisting of halogen(lower)alkyl, halogen, hydroxy, protected carboxy, carbamoyl, lower alkylenedioxy, lower alkoxy, optionally substituted aryl, and lower alkyl, optionally substituted by hydroxy or protected carboxy; R2represents hydrogen or lower alkyl; R3is hydroxy or protected hydroxy; R4represents cyano, (hydroxy)minamino(lower)alkyl, carboxy, protected carboxy, N-containing heterocyclic group, optionally substituted amino, or carbarnoyl, optionally substituted with a suitable(s) of the substituent(s) selected from the group consisting of amino, hydroxy, lower alkyl, lower alkylsulfonyl, amidoamine(lower)alkyl, optionally substituted by hydroxy; and-And - is-Q -, or-O-Q-, where Q is a single bond or lower alkylene, or its salt, provided when R2is the lowest Ala the substituent(s), the above, and also provided that the compound of formula I is not 1-(hydroxyethyl)-4-(etoxycarbonyl)imidazole or anilide 1-(2-hydroxyethyl)imidazole-4-carboxylic acid
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to compounds of the formula (I):
wherein X means group of the formula (X-1) wherein R15 means halogen atom, (lower)-alkyl and perfluoro-(lower)-alkyl; R16 means hydrogen, halogen atom and (lower)-alkyl; or X means group of the formula (X-2) wherein Het means 5- or 6-membered heteroaromatic ring comprising 1 or 2 heteroatoms as nitrogen (N) atom; R15 and R16 have values indicated above for (X-1); R30 means hydrogen atom or (lower)-alkyl; p means a whole number from 0 to 1; or X means group of the formula (X-3) wherein R18 means aryl; R19 means unsubstituted arylalkyl or heteroarylalkyl representing 6-membered heteroaromatic ring comprising nitrogen (N) atom as a heteroatom; R20 means unsubstituted (lower)-alkanoyl; Y means group of the formula (Y-1) wherein R22 and R23 mean independently from one another hydrogen atom, (lower)-alkyl, halogen atom or perfluoro-(lower)-alkyl and at least one of radicals R22 and R23 doesn't mean hydrogen atom; R24 means hydrogen atom; or Y means group of the (Y-3) wherein R25 means group of the formula: R26-(CH2)e- wherein R26 means (lower)-alkoxy-group, (lower)-alkylthio-group, (lower)-alkylsulfonyl; or R26 means group of the formula: -NR28R29 wherein R28 means hydrogen atom; R29 means (lower)-alkanoyl or (lower)-alkylaminocarbonyl; Q means -(CH2)f- wherein e means a whole number from 0 to 4; f means a whole number from 1 to 3; a bond denoted as a dotted line can be hydrogenated optionally; and to its pharmaceutically acceptable salts and esters. Also, invention proposes a pharmaceutical composition designated for treatment or prophylaxis of rheumatic arthritis, cerebrospinal sclerosis, intestine inflammatory disease and asthma and containing compound of the formula (I) or its pharmaceutically acceptable salt or ester in combination with a compatible pharmaceutical carrier. Invention proposes derivatives of thioamide inhibiting interaction between α4-comprising integrins and VCAM-1.
EFFECT: valuable medicinal properties of compounds and pharmaceutical composition.
20 cl, 1 tbl, 86 ex
where R1and R3designate one or more identical or different substituents selected from the group consisting of halogen, (C1-C3)-alkyl, (C1-C3)-alkoxy; provided that, if R1denotes one Deputy, he is in the ortho-position, and if R1refers to several substituents, at least one substituent R1located in the ortho-position; and R2denotes one substituent in the ortho-position, and this Deputy is selected from the group consisting of halogen, (C1-C3)-alkoxy; and R3can additionally denote hydrogen; R4represents hydrogen; X represents oxygen; Q represents -(CO)- or a bond; Y represents (C5-C15)alkyl, (C2-C15)olefinic group; and any of these groups may be optionally substituted by one or more identical or different substituents selected from the group consisting of substituents of formula R5defined below, except that when Q represents a bond, then Y appears lcil, substituted by one or more substituents selected from the group R5; or a group of formula - (Z-O)n- Z, where Z is a (C1-C3)alkyl, n is an integer >1, and the number of atoms in a continuous linear sequence of atoms in the group Y does not exceed 15; R5denotes halogen, hydroxy, amino, (C1-C6)-alkylamino, (C1-C3)alkoxycarbonyl, -COOH, -CONHR' or-COONR'R' R' means (C1-C3)alkyl; or its pharmaceutically acceptable salt
where R1means independently one or more identical or different substituents selected from the group consisting of halogen, (C1-C3)alkyl, (C1-C3)alkoxy; provided that when R1means one Deputy, he is anthopology, and when R1means more than one Deputy, at least one substituent R1is orthopaedie; R2means one Deputy in anthopology, and specified the Deputy is chosen from the group consisting of halogen and (C1-C3)alkoxy; R3means halogen; R4means hydrogen; X is oxygen; and its salt with a pharmaceutically acceptable acid, or a hydrate or MES
where R denotes H, C1-C7alkyl and halogen; R1denotes H or halogen, provided that in the 4th position R1not denotes bromine or iodine; R2denotes H or CF3; R3denotes N or C1-C7alkyl; R4denotes H, halogen, C1-C7alkyl and others; R5denotes N or C1-C7alkyl; X represents-C(O)N(R5)-, -N(R5)-C(O)- or-C(O)O-; Y represents -(CH2)n-, -O-, -S-, -SO2-, -C(O)- or N(R5’)-; R5’means (ness.)alkyl; Z represents =N-, -CH= or-C(C1)=; n denotes a number from 0 to 4; and their pharmaceutically acceptable salts
SUBSTANCE: method involves cutting the sternum from top to down without xiphoid process being intersected. Thoracic wound dilator with additional hooks is used for stretching upper and lower angle of the wound. Upper angle of the wound is deviated using Farabeuf hook with groove. Sternotome saw is moved behind the jugular incisure through a slot in Farabeuf hook.
EFFECT: enhanced effectiveness of treatment.