Method for correcting hemostasis disorders in case of vast operations upon organs of hepatopancreatoduodenal area

FIELD: medicine, anesthesiology, resuscitation.

SUBSTANCE: one should correct hemostasis disorders intra-operationally due to introducing fraxiparine about 40-80 min against the onset of operation along with intravenous injection of mexidol, by drops at the dosage of about 5-6 mg/kg patient's body weight dissolved in 400 ml 0.9%-NaCl solution at the rate of 60 drops/min. The present innovation enables to create the peak of fraxiparine and mexidol concentrations at traumatic stage of operation that enables to correct hemostasiological disorders during operative interference and at early post-operational period due to combined action of preparations onto different links of hemostasis.

EFFECT: higher efficiency and accuracy of correction.

 

The invention relates to medicine, namely to anesthesiology and reanimation, and can be used with extensive operations on the organs typical for hepatic-pancreaticoduodenal area for correction of disorders of hemostasis.

Operations of this type continue 5-9 hours and are accompanied by complex homeostatic disturbances that occur when receiving from the surgical field thromboplastin, triggering blood clotting. This breaks microcirculation, microthrombi formed in various organs and systems. As a consequence of this pathological process of the likely development of DIC. In addition, postoperative thrombosis begin to develop on the operating table are usually asymptomatic and can further lead to pulmonary embolism (PE).

There is a method of correction of disorders of hemostasis in various operations, including lies in the fact that during operations intravenously over 30-60 minutes of entering the nefrackzionirovannam heparin (NFG). Heparin is a natural anti-clotting drug of animal origin (Medmaravis. Medicinal product. Part 2. - M.: Medicine, 1985. - S-76). The anticoagulant action of heparin occurs when it is injected into a vein, into a muscle or under the skin. The most pronounced is the playing technique is observed when intravenous injection.

Heparin acts quickly, but relatively short (no more than 4-5 hours), in connection with which you want to enter it often and in large quantities with stringent control over blood coagulating properties.

The main disadvantages of this method of correction of disorders of hemostasis are:

high risk of bleeding;

the need for laboratory monitoring;

high cost due to the long process of treatment and a high consumption of heparin;

increased platelet aggregation;

the possibility of thrombocytopenia.

Partly, these drawbacks are eliminated by correction of disorders of hemostasis using fraxiparina (nadroparin calcium) - low molecular weight heparin (NMG).

A known method lies in the fact that prevention of thrombosis Fraxiparine injected subcutaneously for 2-12 hours prior to surgery at a dose of 0.3 ml of body weight up to 80-90 kg and 0.6 ml patients greater mass, and repeated the dose prescribed in 10-12 hours after surgery and then 1 time per day for 7-10 days (encyclopedia of drugs in Russia. Edition of 8. - M., 2001. - S).

The action of fraxiparina caused by the blockade Ha-factor, i.e. the drug effect on coagulation hemostasis. The maximum effect occurs within 4 to 6 hours after subcutaneous injection. Fraxiparine in preventing venous thrombosis and embolism the doses when all coagulation parameters practically do not change, and therefore prevention can be performed without laboratory monitoring. The prevalence of anti-XA activity over antithrombin action causes weaker than ordinary heparin effect fraxiparina more pronounced protivotoksicheskoe action.

NMG, in particular Fraxiparine, has the following advantages:

good bioavailability and fast absorption after subcutaneous administration;

more predictable anticoagulant effect;

no need for regular laboratory monitoring of treatment;

resistance to the inhibitory effect of activated platelets;

the duration of action and the possibility subcutaneous injection 1-2 times per day;

lower frequency of thrombocytopenia and other undesirable phenomena.

The disadvantage of this method is the low efficiency of correction of coagulation disorders of hemostasis, resulting in patients during long-term operations on organs typical for hepatic-pancreaticoduodenal area, as the maximum effect of the drug occurs within 4-6 hours and ends up holding traumatic phase of the operation, after which (in 4 to 7 hours after start of the operation) maximum observed abnormalities in the hemostatic system.

Offered with the royals correction of hemostasis disorders with extensive operations on the organs typical for hepatic-pancreaticoduodenal area, including subcutaneous administration of fraxiparina dose of 0.3 to 0.6 ml

The difference of the proposed method is that the correction is carried out intraoperatively, and through 40-80 min from the start of the operation subcutaneously injected Fraxiparine and intravenous drip at a rate of 60 drops per minute for 2 hours enter Mexidol in a dose of 5-6 mg/kg 400 ml of 0.9%isotonic NaCl.

Mexidol is an inhibitor of free radical processes, membraneelectrode having antihypoxic, stress-protective, neuroprotective, anticonvulsant and anxiolytic action. The drug is approved by the Pharmacological Committee of Ministry of health of Russia 17.10.2002,

The mechanism of action of Mexidol due to its antioxidant lipoic properties.

In medical practice Mexidol has the following indications for use:

acute disorders of cerebral circulation;

dyscirculatory encephalopathy;

dystonia;

mild cognitive disorders antisclerotic Genesis;

anxiety in neurotic and neurosis-like States;

acute purulent-inflammatory processes in the abdominal cavity (acute necrotizing pancreatitis, peritonitis) in complex therapy and other

In the proposed method, first used the properties of Mexidol to reduce aggregation t is ambiatol, to improve tissue metabolism and improve microcirculation and blood rheology.

Joint intraoperative application of fraxiparina and Mexidol, you can affect different stages of hemostasis, korrigirovat hemostatic disorders and prophylaxis of thromboembolic complications and the development of DIC.

The introduction of drugs through 40-80 min from the start of the operation ensures their maximum concentration in traumatic stage of the operation and adequate correction of disorders of hemostasis during surgery and the early postoperative period.

The following is an example of the method.

The procedure of the method has no significant effect on the accepted scheme of surgical intervention on a specific body typical for hepatic-pancreaticoduodenal area and fits into the scheme of anesthesia.

Mexidol prepared from the calculation of 5-6 mg per 1 kg of patient's weight and dissolve it in 400 ml of 0.9%isotonic NaCl. The introduction of drugs to the patient set taking into account the duration of the operation, so that peak concentrations of drugs were traumatic phase of the operation, during which observed the most pronounced disorders of hemostasis. With this in mind set, for example, the start time of the injection 60 min after the start of operation (possible period of from 40 to 80 min). After a specified time Mexidol is administered by intravenous infusion at a rate of 60 drops per minute for 2 hours. This form of introduction of Mexidol corresponds to the volume of surgical intervention and takes into account the duration of the traumatic phase of the operation. Mexidol contributes to the preservation of structural and functional organization of membranes, reduces viscosity and increases their fluidity, simulates the activity of membrane-bound enzymes. The time to reach maximum concentration is 0,45-0,50 h, the retention time of the drug - 0,7-1,3 PM on the same terms as the Mexidol, the patient is injected subcutaneously Fraxiparine dose of 0.3-0.6 ml, which provides, as in the prototype, the effect on coagulation hemostasis.

Thus, the joint intraoperative use of Mexidol and fraxiparina allows you to create a peak concentration of drugs in traumatic stage of the operation, and by acting on different stages of hemostasis to correct the hemostatic disturbances during the surgery as well as in the early postoperative period.

Method for correction of disorders of hemostasis with extensive operations on the organs typical for hepatic-pancreaticoduodenal area, including subcutaneous administration of fraxiparina dose of 0.3-0.6 ml, characterized in that the correction of disorders of hemostasis performed intraoperatively, and fra is siporin enter through the 40-80 min from the start of operations in conjunction with intravenous drip of Mexidol, which is injected at a dose of 5-6 mg/kg of patient's weight, dissolved in 400 ml of 0.9%NaCl solution at 60 drops per minute.



 

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FIELD: medicine, preparative biochemistry.

SUBSTANCE: invention relates to a method for preparing, isolating, purifying and stabilizing of the human granulocytic colony-stimulating factor (HCSF) that can be used for medicinal aims. Method involves disrupting recombinant bacterial cells, isolation of bodies inclusion, removal of inert bacterial proteins, recovery, renaturation, purifying by chromatography method and stabilization of HCSF. Also, invention relates to the immunobiological agent based on thereof. Invention provides high yield, quality and stability of HCSF.

EFFECT: improved preparing method.

4 cl, 5 dwg, 6 tbl, 16 ex

FIELD: medicine, pharmacology.

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FIELD: medicine, pharmacology.

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FIELD: medicine, pharmacology, pharmacy.

SUBSTANCE: invention relates to formulations comprising heparin as an active component and a base consisting of lipid and polymeric components for oral using. The lipid component is able preferably to enhance effect of the main component while the polymeric component possesses ability to dissolving or swelling, and at least part of the lipid component is incorporated into the polymeric matrix being in the molecular-dispersed state. Invention provides the sufficient complete absorption of active substance in digestive tract after its oral intake.

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9 cl, 2 dwg, 8 ex

FIELD: medicine.

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EFFECT: enhanced effectiveness of treatment; high objectivity in evaluating patient health state.

1 dwg, 6 tbl

FIELD: organic chemistry, medicine, pharmacy.

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EFFECT: valuable medicinal properties of compounds and compositions.

17 cl, 14 tbl, 12 ex

Haemostatic agent // 2275201

FIELD: pharmaceutical industry, in particular haemostatic agent.

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EFFECT: haemostatic agent of improves quality.

FIELD: organic chemistry, medicine, pharmacy.

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EFFECT: valuable medicinal properties of compounds and compositions.

12 cl, 5 tbl

FIELD: medicine, veterinary science, pharmacy.

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EFFECT: improved and valuable properties of preparation.

3 tbl, 4 ex

FIELD: medicine, transfusion, infusion therapy.

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EFFECT: valuable medicinal properties of agents.

5 cl, 6 tbl, 4 ex

FIELD: organic chemistry, medicine, neurology, pharmacy.

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EFFECT: valuable medicinal properties of compounds and pharmaceutical composition.

32 cl, 10 tbl, 129 ex

FIELD: organic chemistry, medicine, pharmacy.

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and , and to a pharmaceutical composition possessing the PPAR-ligand binding activity and comprising the indicated compound, and a pharmaceutically acceptable vehicle. Also, invention relates to a method for treatment of patient suffering with physiological disorder that can be modulated with the compound possessing the PPAR-ligand binding activity. Method involves administration to the patient the pharmaceutically effective dose of indicated compound or its pharmaceutically acceptable salt.

EFFECT: valuable medicinal properties of compounds and pharmaceutical composition.

10 cl, 1 tbl, 104 ex

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EFFECT: topical composition having no side-effects, with combined component action and increased penetration effect through hypoderm.

2 cl

FIELD: medicine.

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EFFECT: high reliability in determining shape and localization of helminth even in the cases of negative coprological and serological examination results.

FIELD: medicine.

SUBSTANCE: method involves taking into consideration dose-exposure plot, age, hourly diuresis, hemolysis, exotoxic shock, larynx edema, hemoglobinuria availability, measuring body temperature and evaluating each symptom in points. The points are summed. Their sum being less than -17, favorable prognosis is formulated and line emergency team gives medical care. The sum of points being from -17 to +23, outcome prognosis is doubtful. The sum being greater than +23, the prognosis becomes unfavorable. The last two cases Poison dose is additionally determined irrespectively of exposure, vomiting and its nature, gastroesophageal hemorrhage, hemolysis, oliguria, larynx edema exotoxic shock, hemolysis, hemoglobinuria availability, measuring body temperature and evaluating each symptom in points. The points are summed. Their sum being less than -20, line emergency team gives medical care. The sum of points being greater than +20, resuscitation aid and calling for resuscitation group of emergency team on himself with state stabilization and transporting patient with the resuscitation group to the nearest resuscitation department following. Premedication, analgesics, spasmolytics, corticosteroids and hemostatics are administered with probe-mediated gastric lavage and infusion therapy being started.

EFFECT: enhanced effectiveness of treatment; high objectivity in evaluating patient health state.

1 dwg, 6 tbl

FIELD: medicine.

SUBSTANCE: the present innovation deals with the preparation of antimutagenic activity towards chemical mutagens as betulinic acid previously known as an antimutagen towards ultraviolet and as an antioxidant. The decrease of chromosomal aberrations has been shown in animals towards chemical mutagens of dioxidine and cyclophosphamide due to the action of betulinic acid within wide range of dosages.

EFFECT: higher efficiency.

3 tbl

FIELD: medicine, therapy.

SUBSTANCE: the present innovation deals with preventing post-injection necrosis of soft tissues as a result of false subcutaneous injection of 10%-calcium chloride solution. One should detect the volume of the introduced 10%-calcium chloride solution; then it is necessary to introduce 5-fold volume of 5%-sodium citrate solution against the volume of calcium chloride injected; then one should apply a sac with ice onto the site of injection for the period of 30 min, not less. The innovation suggested enables to inhibit the processes for tissue damage due to binding calcium cations with anions of sodium citrate along transforming soluble calcium salt into insoluble one to stop calcium transport into the cells and, thus, prevents its damaging action.

EFFECT: higher efficiency.

1 ex

FIELD: medicine.

SUBSTANCE: method involves introducing drug of gas transportation activity in distal position with respect to blood circulation arrest place immediately after blood circulation arrest. Perfluoran is selected as the drug of gas transportation activity at a dose not exceeding 30 ml per 1 kg of injured zone mass.

EFFECT: improved oxygen supply to ischemic tissues; reduced risk of reperfusion complications.

FIELD: organic chemistry, pharmacy.

SUBSTANCE: invention relates to new compounds of the general formula (I) in racemic form, enantiomer form or in any combinations of these forms possessing affinity to somatostatin receptors. In the general formula (I): R1 means phenyl; R2 means hydrogen atom (H) or -(CH2)p-Z3 or one of the following radicals: and Z3 means (C3-C8)-cycloalkyl, possibly substituted carbocyclic or heterocyclic aryl wherein carbocyclic aryl is chosen from phenyl, naphthyl and fluorenyl being it can be substituted, and heterocyclic aryl is chosen from indolyl, thienyl, thiazolyl, carbazolyl, or radicals of the formulae and and it can be substituted with one or some substitutes, or also radical of the formula: R4 means -(CH2)p-Z4 or wherein Z4 means amino-group, (C1-C12)-alkyl, (C3-C8)-cycloalkyl substituted with -CH2-NH-C(O)O-(C1-C6)-alkyl, radical (C1-C6)-alkylamino-, N,N-di-(C1-C12)-alkylamino-, amino-(C3-C6)-cycloalkyl, amino-(C1-C6)-alkyl-(C3-C6)-cycloalkyl-(C1-C6)-alkyl, (C1-C12)-alkoxy-, (C1-C12)-alkenyl, -NH-C(O)O-(C1-C6)-alkyl, possibly substituted carbocyclic or heterocyclic aryl; p = 0 or a whole number from 1 to 6 if it presents; q = a whole number from 1 to 5 if it presents; X means oxygen (O) or sulfur (S) atom n = 0 or 1. Also, invention relates to methods for preparing compounds of the general formula (I), intermediate compounds and a pharmaceutical composition. Proposed compounds can be used in treatment of pathological states or diseases, for example, acromegaly, hypophysis adenomas, Cushing's syndrome and others.

EFFECT: improved preparing method, valuable medicinal properties of compounds and composition.

11 cl, 2 tbl

FIELD: medicine.

SUBSTANCE: remedy comprises mixture of phytoecdysteroids of 20-hydroxyecdysone and 25S-inocosteron extracted from aerial plant top of Serratula genus of Asteraceae family, preferably from leaves gathered in vegetation phase, mass budding phase or at the beginning of flowering.

EFFECT: enhanced effectiveness of treatment; wide range of medical applications.

FIELD: medicine, pharmacology, pharmacy.

SUBSTANCE: invention relates to formulations comprising heparin as an active component and a base consisting of lipid and polymeric components for oral using. The lipid component is able preferably to enhance effect of the main component while the polymeric component possesses ability to dissolving or swelling, and at least part of the lipid component is incorporated into the polymeric matrix being in the molecular-dispersed state. Invention provides the sufficient complete absorption of active substance in digestive tract after its oral intake.

EFFECT: valuable properties of formulation.

9 cl, 2 dwg, 8 ex

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