Method for treating mallory-weiss syndrome
SUBSTANCE: at performing curative endoscopy one should apply pneumoapplication of granulated sorbent - diovine at the quantity of 0.2 g, the pressure being 15 atm. at the distance of 1.5 cm against the defect onto the surface of bleeding rupture of gastric mucosa. Diovine's coarse-grained structure enables to keep the integrity of mucous-bicarbonate barrier due to providing normal vapor exchange and moisture medium in the defect. Moreover, diovine's antimicrobial action helps to suppress gram-positive and gram-negative microflora that enables to shorten terms for defects healing and decrease the frequency of repeated hemorrhages.
EFFECT: higher efficiency of therapy.
The invention relates to medicine, in particular to surgery, can be used in the treatment of syndrome Mallory Weiss.
Known method of electrocoagulation used to stop gastroduodenal bleeding. Electrocoagulation is produced by high frequency current, resulting in a defect area is created coagulation scab. This provides a hemostatic effect (Panzeri, Y.M., Gallinger SCI Surgical endoscopy of the gastrointestinal tract. - M.: Medicine, 1984. - P.67-72).
However, during electrocoagulation is not possible to accurately control the depth of coagulation, and therefore often there are cases of iatrogenic trauma lower fabrics. Reliable hemostasis is carried out with parabasal coagulation throughout the vessel, so the square of burns of the esophagus and stomach are significant, which lengthens the duration of treatment. In addition, when electrocoagulation is dense adhesion of biological tissues to the electrode, and often occur with a scab for discharge electrode, which causes re-bleeding. Rejection of coagulation scab within 3-5 days after endoscopic hemostasis in this group of patients may be accompanied by recurrence of hemorrhage.
The known method of laser photocoagulation, which consists in absorbing and t is informatsii light energy of the laser beam into heat, with the consequent increase of the temperature of the tissue around the defect and the coagulation of a bleeding vessel (Lutsevich EV, Astapenko V.G., Belov I. Guide to gastrointestinal endoscopy. - Minsk: Visas. HQ., 1990).
However, the high cost of laser equipment and not completely reliable hemostatic results make this method ineffective.
Known injection method of endoscopic hemostasis, including the introduction of adrenaline, ethanol-mixture of procaine, 70% ethanol and other drugs in the area of the defect (Paunov VA and other Diagnostic and therapeutic endoscopy syndrome Mallory Weiss, - Actual problems of modern surgery: proceedings of the Congress. - Moscow, 2003. - P.7).
However, this method often gives the recurrence of bleeding and is not always technically fulfill syndrome Mallory Weiss.
A method of stopping bleeding are also endoscopic applications and injections of film-forming substances and adhesive substances (Panzeri, Y.M., etc. Is urgent endoscopy in acute gastrointestinal bleeding. - Actual emergency surgery. - M., 1994. - P.56-60).
However, the adhesive composition does not have sorption properties, and are water-repellent effect. The rejection of the polymer film from the defect occurs within the first hours after application, so the time of its therapeutic effects are severely limited. In addition, film-forming polymers are not oblad the Ute local hemostatic properties, and the technique of therapeutic procedures has certain difficulties.
Closest to the claimed method is the treatment of syndrome Mallory Weiss using Glavina (Batkaev A.R. Application of endoscopic sorption therapy in patients with the syndrome Mallory Weiss. - Abstract. Dis ... Kida. the honey. Sciences. - Voronezh, 2002. - 25).
The main disadvantage of this prototype include the following: endoscopic treatment elevina syndrome Mallory Weiss is a way to prevent re-bleeding, and not a method of endoscopic hemostasis; when cracks cardioesophageal region with ongoing bleeding monotherapy elevina is not applied, the hemostatic effect of the sorbent can be manifested only in combination with other methods of endoscopic hemostasis, which requires a large number of therapeutic procedures; treatment elevina deep defects cardioesophageal zone is not possible to avoid the resumption of bleeding.
The technical result of the invention is to improve the reliability of hemostasis, reducing the risk of recurrent bleeding and reducing the number of medical purposes.
The technical result is achieved by pnevmopochtoy Divina on the bleeding defect in the amount of 0.2 g under a pressure of 15 ATM from a distance of 1.5 cm from the gap during which rosedene therapeutic endoscopy.
The method is as follows: during therapeutic endoscopy the fibergastroscope is set before a bleeding defect. In his instrumental channel is inserted a plastic tube (catheter)that is filled with divinam in the number of 0.2, the Distal end of the catheter is fixed at 1.5 cm from the defect. Subsequent blowing powder Divina on the bleeding surface is air jet insufflator under a pressure of 15 ATM.
Example: Patient K., 67 years old (case history No. 13068) received the order of urgent care in the surgical Department of the MUSES GKB №9 (SMP) , Voronezh 17.05.2004, 22 hours and 30 minutes with a diagnosis of syndrome Mallory Weiss. Unstable stopped bleeding.
From the anamnesis: the patient twice suffered a cerebral vascular accident, 15 years, suffering from hypertension 3 tbsp., ischemic heart disease with persistent forms of atrial fibrillation. This deterioration came 17.05.2004, about 18 hours, when the background of hypertensive crisis in a patient appeared vomiting at first light liquid, and then the blood clots. The patient was referred for an urgent esophagogastroduodenoscopy.
On emergency FGDS No. 768 dated 17.05.2004.: the esophagus pass on mucosa - blood smears. In the area of the esophago-gastric junction on the rear panel, there is a deep and broad defect Muco-submucosal layer in length and 3-4 cm, a width of 1.0 cm depth - to 0.3 cm; the bottom it is filled tightly fixed dark clot. At the time of inspection leaking fresh blood there. The stomach is full of dark blood with clots. A detailed inspection is impossible.
Conclusion: The Syndrome Mallory Weiss. Unstable stopped bleeding.
The clinical analysis of blood from 17.05.2004, HB - 71 g/l, erythrocytes - 2,12•1012/l Triglycerides admission: APTT - 41 sec, fibrinogen and 3.3 g/l, fibrinogen B -1, Ht - 44/56, thrombin time is 15 seconds, prothrombin index is 96%ethanol test - negative.
The patient was hospitalized in the intensive care unit, where he held: infusion-transfusion, haemostatic therapy, antiulcer (Almagell, quamatel) and symptomatic treatment.
Recurrent bleeding occurred in 11 hours from the moment of receipt: 18.05.2004, 9 hours and 30 minutes. The patient's condition deteriorated, appeared melena, single vomiting blood. On emergency FGDS №770 from 18.05.2004, In the posterior wall of the distal part of the esophagus in the esophageal-gastric transition has a defect length of 3.0 cm, width of 1.5 to 2.0, see the Bottom filled with a red clot, which marked the dripping blood.
The defect was pnevmopochtoy dry powder divine in the amount of 0.2 g under a pressure of 15 ATM from a distance of 1.5 cm from the defect. When observed within 10 minutes it was noted the, the bleeding stopped.
Conclusion: Recurrence of bleeding from the defect esophageal-gastric junction. Stop bleeding by Divina.
The next day, 19.05.2004, the patient's condition has improved, nausea and vomiting was not, hemodynamics stable. The patient continues to be common hemostatic and symptomatic therapy.
After 2 days, 21.05.2004, the patient's condition is stable. No complains. Nausea, no vomiting. Pulse - 85 tank/min, satisfactory qualities, arrhythmic; BP - 120/70 mm Hg complete blood count: HB - 98 g/l, erythrocytes - 3.04 from•1012/l, leucocytes - 7,0•109/HP
After another 5 days, 26.05.2004,: the condition of the patient is satisfactory. No complains. Skin and visible mucous regular color. The abdomen is soft, painless. Chair regular color.
FGDS No. 720 from 26.05.2004,: defect mucosal esophageal-gastric junction has a thin linear scar length of about 2 cm Mucous around him without signs of inflammation.
27.05.2004, the patient was discharged in satisfactory condition under the supervision of a physician at the place of residence.
Thus, the proposed method for the treatment of syndrome Mallory Weiss by pneumonopathy Divina on the bleeding defect makes it possible to increase the reliability of hemostasis, to reduce the treatment time and the number of therapeutic procedures,thus increasing the effectiveness of the treatment of syndrome Mallory Weiss.
A method of treating syndrome Mallory Weiss, including the use of pelletized sorbent in therapeutic endoscopy, characterized in that on the surface of bleeding defect produce pneumopericardium divine in the amount of 0.2 g under a pressure of 15 ATM from a distance of 1.5 cm from the defect.
FIELD: medicine, pharmacy.
SUBSTANCE: invention relates to curative ointments with anti-inflammatory effect and with biostimulating properties for treatment of burns, suppurative and infected wounds of different etiology and to a method for treatment above said diseases using the ointment said. The proposed ointment comprising bee wax and greasy basis comprises colophony additionally. As greasy basis the ointment comprises butter and vegetable oil in the following ratio of components, wt.-%: bee wax, 20-30; butter, 30-40; vegetable oil, 15-25; colophony, 15-25. Method involves applying ointment by thin layer 0.5-3 mm on dense cotton fabric, its applying to damaged site, keeping and removing ointment with change of bandage 1-3 times per 24 h for 3-14 days. Method provides enhancing the therapeutic effectiveness of ointment due to significant acceleration the healing process of suppurative wounds and insidious furuncles being the ointment doesn't cause irritating effect.
EFFECT: improved and valuable medicinal properties of ointment.
2 cl, 4 ex
FIELD: medicine, gynecology.
SUBSTANCE: invention relates to treatment of endometriosis and state associated with it. Method involves administration of LHRH antagonist by courses for 4-12 weeks. Also, method involves additional simultaneous and successive administration of nonsteroid anti-inflammatory agents, analgesic agents, contraceptive preparations and androgens. Invention provides prophylaxis of relapses of endometriosis symptoms in the absence of symptoms of estrogenic insufficiency.
EFFECT: improved and valuable method for treatment.
17 cl, 2 dwg
FIELD: medicine, urology.
SUBSTANCE: at the background of curative starvation a patient should be prescribed for peroral intake of 100 ml tincture or 1 teaspoon tincture out of bees twice daily in the morning and in the evening, and, also, 200 ml hempseed decoction based upon milk twice daily in the morning and in the evening at the course of 5 d. On the 3d, 5th, 7th d of starvation one should perform hepatic and biliary ductal purification at 7 p.m. at the intake of 250 ml natural apple juice at 4 p.m., since the 1st to the 7th d of starvation one should daily apply enemas: in the morning - purifying enema with juice of 1 lemon, in the daytime - curative enema with Artemisia decoction. One should daily perform rectal prostatic massage followed by applying microenemas with 30 ml composition containing the tincture of Sophora, oil of wheat germs, decoction of medicinal plant of antiphlogistic action taken at weight ratio of 1:0.5:2, correspondingly, at the course of 10 d long. Duration of curative starvation lasts for 7 d, not less. The method provides shortened terms of therapy due to simultaneous normalization of body metabolic processes, purification of organs against bacteria and parasites.
EFFECT: decreased body allergization.
6 cl, 2 ex
FIELD: veterinary science, pharmacotherapy.
SUBSTANCE: the present innovation deals with performing enterosorption by applying polysorb VP as a sorbent twice daily at the dosage of 100-300 mg/kg calf's body weight supplemented with potassium permanganate at concentration of 0.05-0.01% at the quantity of 500-600 ml. The innovation suggested enables to shorten duration of therapy.
EFFECT: higher efficiency of therapy.
3 ex, 4 tbl
FIELD: medicine, gastroenterology.
SUBSTANCE: invention relates to a method for prophylaxis of relapses of stomach and duodenum ulcer disease. Method involves using 3-(2,2,2-trimethylhydrazinium)-propionate dihydrate and novocain that are given by oral route simultaneously. The medicine 3-(2,2,2-trimethylhydrazinium)-propionate dihydrate is administrated in the dose 200-240 mg, twice per a day and novocain is given in the dose 10-12 mg, twice per a day for 12-15 days in spring-autumn periods. Method normalizes secretory and bioelectric activity of stomach and provides effectiveness for prophylaxis of disease.
EFFECT: improved and enhanced method for prophylaxis.
FIELD: organic chemistry, biochemistry.
SUBSTANCE: invention relates to new substituted indoles of the formula (I): and/or stereoisometic form of compound of the formula (I) and/or physiologically acceptable salt of compound of the formula (I) wherein R3 means residue of the formula (II): wherein D means -C(O)-; R7 means hydrogen atom (H) or -(C1-C4)-alkyl; R8 means (a) typical residue of amino acid among the group: phenylalanine or homophenylalanine wherein phenyl residue is unsubstituted or substituted with halogen atom; or (b) -(C1-C4)-alkyl wherein alkyl is a linear or branched and (b) 1) mono- or multi-substituted independently of one another with pyrrole residue wherein this residue is unsubstituted or substituted with halogen atom; (b) 2) mono- or bi-substituted independently with residue -S(O)x-R10 wherein x = 0, 1 or 2, or (b) 3) mono- or bi-substituted independently of one another -N(R10)2 wherein R10 means (a) hydrogen atom (H); (b) means -(C1-C6)-alkyl wherein alkyl is unsubstituted or substituted with halogen atom from 1 to 3 times; (c) phenyl wherein phenyl is substituted or substituted with halogen atom from 1 to 3 times; in the case (R10)2 residues R10 have values independently of one another (a), (b), (c); Z means (a) residue of heterocycles group comprising benzothiadizine, pyrrole, pyridine, pyrimidine, pyrazine, imidazole, pyrazole, oxazole, isoxazole, thiazole, isothiazole, tetrazole, oxadiazolone, triazole being heterocycles are unsubstituted or substituted with -NH2=, =O, alkoxycarbonyl or aminocarbonyl from 1 to 3 times, or (b) means -C(O)-R11 wherein R11 means 1. -O-R10 or 2. -N(R10)2; R9 means (a) hydrogen atom (H); (b) means (C1-C6)-alkyl wherein alkyl is unbranched or branched and substituted with phenyl or =O independently of one another from 1 to 3 times; (c) phenyl wherein phenyl is unsubstituted or substituted with halogen atom; R1, R2 and R4 mean hydrogen atom (H); R5 means hydrogen atom (H); R6 means (a) phenyl wherein phenyl is unsubstituted or substituted with -NH2; (b) pyridine, or (c) pyrimidine being pyridine or pyrimidine is unsubstituted or substituted with groups -NH2, -NH-CH3. Compounds of the formula (I) are specific inhibitors of IkB kinase.
EFFECT: valuable biochemical properties of compounds.
3 cl, 3 tbl, 29 ex
FIELD: medicine, surgery.
SUBSTANCE: one should introduce solution "Rheamberin 1.5%"intravenously with infusomates at the dosage of 5 ml/kg/d during the next 5 d. Then, 1-2 h later, one should infuse intravenously "Dalargin" at 30 mg/kg/d dissolved in 60 ml 0.9% sodium chloride at the rate of 120 ml/h for 5 d. Additionally, 4-5 h after "Dalargin" injection it is necessary to perform daily intravenous He-Ne laser irradiation of blood beginning since the first day at wave length being 0.63 mcm, power 1 mW, exposure 50-60 min, course lasts for 5 d. The method enables to interrupt intestinal paresis in case of vertebral traumas and wounds in earlier terms.
EFFECT: higher efficiency of therapy.
FIELD: medicine, gastroenterology.
SUBSTANCE: a patient should follow a diet along with the intake of cholagogue species, oats decoction and symptomatic therapy. Moreover, at postoperative period a patient should be prescribed with the intake of drinking mineral water named "Ust' Kachkinskaya 1/99" at 38-40 C at total mineralization being 8.2-8.6 g/cu. m 40-60 min before meals 5-6 times daily at total amount of 200-250 ml for 24 d. Diet is fractional, 6 times daily, calorie amount of 2800-3000 kcal and decrease of highly digestible carbohydrates up to 30 g/d. The method enables to avoid application of hepatoprotectors and antioxidants during therapy to prevent polypragmasy.
EFFECT: higher efficiency of rehabilitation.
FIELD: restorative medicine, pediatrics.
SUBSTANCE: the method deals with inhalations conducted with Hanks' solution at dispersity of particles being 0.8-2 mcm, expenditure of preparation being 1 ml/3.5 min Inhalation time corresponds to 8-10 min, daily. One should perform about 10-12 procedures per a course at the background of complex therapy including the adequate mode of motor activity, curative physical culture, carbonic acid baths. The method enables to improve sputum withdrawal and, correspondingly, bronchial permeability and the values for the function of external respiration.
EFFECT: more prolonged remission.
1 ex, 2 tbl
FIELD: medicine, pharmacy.
SUBSTANCE: invention relates to the solid medicinal formulation comprising chondroitin sulfate. The proposed medicinal formulation comprises 250 mg of chondroitin sulfate as an active component, filling agent, binding agent, antifriction substances and can comprise a solubilizing agent additionally. Pharmaceutical composition is made as a tablet. Invention provides development of the preparation for oral administration with the less amount of active substance and with indices satisfying requirements of the State Pharmacopoeia.
EFFECT: improved and valuable properties of formulation.
8 cl, 16 tbl, 39 ex
FIELD: medicine, hepatology.
SUBSTANCE: the suggested preparation is being polyprenols obtained out of woody greens of coniferous trees, of general formula
known earlier as a hepatoprotector. The innovation keeps organ stromas without any considerable proliferation of connective tissue, activates metabolic processes at no activation of spontaneous pathology (that is affected synthesis of ribosomal RNA and hepatocytic mitosis being not typical for hepatic tissue).
EFFECT: higher efficiency of stimulation.
FIELD: medicine, hematology.
SUBSTANCE: polyfunctional blood substitute for treatment of blood loss and shock comprises polyethylene glycol with molecular mass 20 000 ± 3 000 Da. As saline base electrolytes the blood substitute comprises sodium chloride, potassium iodide and iodine additionally in the following ratio of components, g/l: polyethylene glycol, 13.5-16.5; sodium chloride, 8.6-9.6; potassium iodide, 0.45-0.55; iodine, 0.05; water for injection, up to 1 l. Invention provides hemodynamic effect and simple medicinal formulation providing good injection usefulness.
EFFECT: valuable medicinal properties of blood substitute.
1 tbl, 3 ex
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to derivatives of adamantane of the general formula:
wherein m = 1 or 2; each R1 represents independently hydrogen atom; A represents C(O)NH or NHC(O); Ar represents the group:
wherein X represents a bond, oxygen atom or group CO, (CH2)1-6, CH=, O(CH2)1-6, O(CH2)2-6O, O(CH2)2-3O(CH2)1-3, CR'(OH), NR5, (CH2)1-6NR5, CONR5, S(O)n, S(O)nCH2, CH2S(O)n wherein n = 0, 1 or 2; R' represents hydrogen atom; one of R2 and R3 represents halogen atom, nitro-group, (C1-C6)-alkyl; and another is taken among R2 and R3 and represents hydrogen or halogen atom; either R4 represents 3-9-membered saturated or unsaturated aliphatic heterocyclic ring system comprising one or two nitrogen atoms and oxygen atom optionally being heterocyclic ring system is substituted optionally with one or more substitutes taken independently among hydroxyl atoms, (C1-C6)-alkyl, (C1-C6)-hydroxyalkyl, -NR6R7, -(CH2)rNR6R7; or R4 represents 3-8-membered saturated carbocyclic ring system substituted with one or more substitutes taken independently among -NR6R7, -(CH2)NR6R7 wherein r = 1; R5 represents hydrogen atom; R6 and R7 each represents independently hydrogen atom or (C1-C6)-alkyl, or (C2-C6)-hydroxyalkyl group eliciting antagonistic effect with respect to R2X7-receptors. Also, invention describes a method for their preparing, pharmaceutical composition comprising thereof, a method for preparing the pharmaceutical composition and their applying in therapy for treatment of rheumatic arthritis and obstructive diseases of respiratory ways.
EFFECT: improved method for preparing and treatment, valuable medicinal properties of compounds.
13 cl, 88 ex