Method for treating urogenital chlamydial infection

FIELD: medicine, gynecology, urology.

SUBSTANCE: on isolating Chlamydia out of infection foci and setting a preliminary diagnosis it is necessary to determine their sensitivity to different etiotropic preparations. Then it is important to sample a patient's blood followed by centrifuging and dividing it into plasma, erythrocytic mass and leukocytic suspension. Removed blood plasma should be substituted with physiological solution, and autoerythrocytes should be returned for a patient in physiological solution intravenously by drops. Autoleukocytic suspension should be activated with laser radiation of He-Ne laser at λ=0.63 mcm. Then it should be supplemented with etiotropic preparation moxyfloxacin to be intravenously injected for a patient. The procedure should be repeated daily for about 10-12 d. The innovation suggested enables to shorten the terms of interrupting the main clinical manifestations of the disease due to a purposeful transport of etiotropic preparation being of higher bacteriological efficiency in leukocytes activated with laser radiation, into primary (urogenital tract) and secondary (extraurogenital) foci of inflammation and, also, decrease side action of chemopreparations due to decreasing their course dosage.

EFFECT: higher efficiency of therapy.

2 ex

 

A method for the treatment of urogenital chlamydial infection relates to the field of medicine.

According to official data in recent years in Russia every year there are more than 350,000 patients with urogenital chlamydial infection. But in fact these patients much more. This is largely due to widespread self-medication, lack of registration of patients in commercial diagnostic and treatment centers, and private medical practitioners. Of particular importance are common (generalized) form of this infection, which is caused by hematogenous introduction of the pathogen from the primary foci of infection in the urogenital tract to other organs and tissues, which ultimately leads to the formation of a secondary (extravagantly) foci of infection. The most typical forms of this infection are: disease Reiter, vasculitis, serous meningitis and other Treatment of such patients is not well developed, since it is difficult to find effective treatments for one or another causal drug and rational way of its introduction. The complex factors that result in low efficiency of etiotropic therapy, include: the use of etiotropic drugs without taking into account sensitivity to them chlamydia, insufficient dose and duration of treatment, failure to comply with the control of the cure. So WESM what is important to search for and create new ways technologies that provide adequate and effective therapy for patients with common forms of urogenital chlamydial infection.

Known methods of treatment of urogenital chlamydial infection, such as disease Reiter. Used to treat with traditional combination therapy: massage of the prostate gland No. 10 in a day, ultrasound therapy in the crotch in the area of projection of the prostate gland No. 10, bacteriotherapy (batteryoperated - sporobacterin 1/2 bottle 2 times a day), Essentiale Forte 2 capsules 3 times a day during meals, trental 100 mg daily. Antibacterial therapy of such patients shall be held within 18 days, see "journal of 3abolevaniya, sexually transmitted diseases, No. 1, 1998, s-24.

The disadvantages of this treatment are: lack of effective treatment, long term treatment, resulting in no observed final rehabilitation of the affected tissues from chlamydia, not completely stymied clinical syndromes as immediately after treatment and in long-term follow-up period (2-3 months) after end of treatment.

The closest solution to the proposed method of treatment of urinary Gediminas infection is a method of treating urogenital hladimioz indicated in the journal "Herald of the Russian Academy of medical is their Sciences, No. 10, 2003, p.29-34, article J.V. Lobina, NR. The Volzhanin, A.L. the Paznyak New in the diagnosis and treatment of common forms of urinary hladimioz", and providing a diagnosis to the patient, etiotropic therapy taking into account the sensitivity of the selected chlamydia to etiotropic drugs. In patients with mixed infection, the choice of antibiotic is based on sensitivity to it all microbes is associated with. In the treatment of advanced were used chemotherapy drugs (metronidazole, delagil, makmiror), which strengthened antichlamydial and antimycoplasmal activity such modern etiotropic drugs as jozamitsin and ofloxacin. Patients were treated with a 20-day course of therapy was continuous.

The disadvantages of the above method of treatment are: the use of monoethylether was not sufficiently effective, the biological effectiveness 3 months after treatment was only 66.7%of clinical effectiveness is also insufficient, because there was a great period of treatment and lack of effective treatment secondary extravagantly foci of infection.

The technical result of the treatment of urogenital chlamydial infection are: to improve the effectiveness of treatment by reducing the terms of the relief of the main clinical manifestations of the disease, the bacteria is of bacteriological methods of efficiency thanks to a complete renovation of primary and secondary foci of infection after the end of treatment (12-13 days) and in the more distant the observation period (2-3 months), reducing the dose rate of the use of causal drug 1/3, reducing the possibility of adverse effects of therapy.

This result is achieved by the fact that in the treatment of urogenital chlamydial infections, including diagnosis, selection of chlamydia from different foci of infection of the patient, determination of their sensitivity to different causal preparations and creation in the urogenital tract and in extravagantly foci of concentration of the selected drug, after the blood of the patient sequentially separated by centrifugation taken the blood of the patient on plasma, erythrocyte mass and leukocyte suspension, then the remote plasma substitute saline, autoerythrocyte physiological solution is returned to the patient intravenously, and autolackiererei suspension activate the laser radiation, then it add prescribed to treat causal drug antichlamydial activity and is administered intravenously to the patient, repeating the treatment every day for 10-12 days, and the activation of the leukocyte suspension is conducted by radiation from a He-Ne laser with λ=0.63 µm and 10 MW, and antichlamydial causal drug take from fluoroquinolone series, e.g. the R moxifloxacin.

The essence of the invention is expressed in a set of key characteristics, sufficient to achieve provided by the invention a technical result.

The essential features of the method of treatment, coinciding with the known characteristics of the prototype are: A diagnosis; B - allocation of chlamydia from different foci of infection of the patient and determining their sensitivity to different etiotropic drugs; creating in the urogenital tract and in extravagantly foci of concentration of the selected drug.

Salient features of the proposed method of treatment are: G - after collection of blood in a patient sequentially separated by centrifugation taken the blood of the patient on plasma, erythrocyte mass and leukocyte suspension; D - remote blood plasma substitute saline; E - autoerythrocyte physiological solution is returned to the patient intravenously; W - autolackiererei suspension activate the laser radiation; And in the activated suspension type assigned to etiotropic treatment drug with antichlamydial activity and is administered intravenously to the patient; It is a medical procedure is repeated daily for 10-12 days.

Private distinctive signs: L - activation of the leukocyte suspension is conducted by radiation from a He-N laser λ =0.63 µm and 10 MW; M - antichlamydial causal drug take from fluoroquinolone series, such as moxifloxacin.

A method for the treatment of urogenital chlamydial infection include: diagnosis, selection of chlamydia from different foci of infection of the patient. The primary focus - the genitourinary tract is a urethritis, a prostatitis. Secondary foci - extravagantly - this can be a joints - arthritis, synovitis, eye - conjunctivitis, himaruya sinus. Then determine the sensitivity of chlamydia to various etiotropic drugs, and ultimately create in the urogenital tract and in extravagantly foci of high concentrations of selected causal drug. The sensitivity of chlamydia to etiotropic drugs define the culture method in advance before the treatment. For the diagnosis of urogenital chlamydial infection, and to determine the antibiotic resistance in selected chlamydia apply their cultivation on transplantable cell culture. For this purpose use a variety of cell types, with high sensitivity for chlamydia: McCoy, Hela-229, L-229, KSS-221. Preference is thus given to the mixed cell lines from a number of recommended and sent to the demands of medical institutions. When this method is used mixed transplantable cultures the cells LLC+MK2+L929+BNK-21c with pre-reduced resistance. When treating patients with urogenital chlamydial infection after collection (exfuze) venous blood of the patient consistently by centrifugation at refrigerated centrifuge RS-6 for 10 minutes at different speeds share the collected plasma, erythrocyte mass and leukocyte suspension. Remote toxic blood plasma substitute in adequate quantities saline solution of 0.85% sodium chloride (plazmozameschayuschie solution). Autoerythrocyte physiological solution is returned to the patient intravenously. Autolackiererei suspension activate the laser radiation from a He-Ne laser with λ=0.63 µm and 10 MW for 10-15 minutes, then it (the suspension) add prescribed to treat atitray drug with antichlamydial activity (sorbirovaniya) and injected intravenously to the patient. As causal of the drug in this disease the most effective fluoroquinolone, for example, moxifloxacin 400 mg daily. Procedures for the above-stated method for the treatment of urogenital chlamydial infection (also called therapeutic plasma leukocytapheresis with antibiotic therapy) spend every day at the same time of day for 10-12 days.

As an example, the particular application of this method can lead to the treatment of patients with disease Reiter (16 che who ovec). Patients were between 18 and 35 years, men without other comorbidity. Treatment effectiveness was assessed with the terms of the relief of the main clinical syndrome (a syndrome common infectious intoxication, artrologicheskoy syndrome, conjunctivitis, severity and duration of urethritis and prostatitis). Introduction causal drug moxifloxacin 400 mg was administered every day for 12 days. As criteria of cure patients from chlamydial infection were used results from the application of the following laboratory methods: polymerase chain reaction, direct immunofluorescence method - PIF, as well as the culture method. Dynamic clinical and laboratory monitoring of patients and survivors was conducted in terms of 13, 23 and 60 days from the start of treatment. In patients with disease Reiter, whose treatment was carried out with the help of this method, in a shorter time stoped main clinical syndromes or immediately after completion of treatment. Research conducted in the remote observation period (60 days from start of treatment)showed no clinical signs (symptoms) of the disease. This method of treatment of urogenital chlamydial infection contributed to the reduction of time (20 days) relief of the main clinical syndromes in patients with disease Reiter and dormancy the hall a high clinical and bacteriological efficacy compared with patients in the traditional way.

Examples of the treatment of patients under the proposed method are specified in appendices 1 and 2.

The use of the invention "Method of treatment of urogenital chlamydial infection compared with the traditional method of treatment is the prototype allows to increase the effectiveness of the treatment by reducing the terms of the relief of the main clinical manifestations of the disease, to improve bacteriological efficacy due to the complete renovation of primary and secondary foci of infection after the end of treatment, and in the more distant the observation period. A reduction in dose rate used causal agent as well as reducing the possibility of side effects. A method of treating substantially (20 days) reduces edema of the main clinical manifestations of the disease, which indicates a high clinical efficacy compared with conventional intravenous antibiotic therapy. Due to the directed transport of causal drug activated by laser radiation the cells in the primary (urinary tract) and secondary (extravagantly) inflammation this method of treatment has higher bacteriological efficacy and lack of side effects. A complete restoration of both primary and secondary foci of infection on udaetsya immediately after the application of the developed method of treatment for 13 days from the start of treatment. Ultimately, the proposed method of treatment allows to achieve rehabilitation of the affected organs from chlamydia and remote observation period (60 days from start of treatment). A method of treating urogenital chlamydial infection, you can create primary and secondary foci of chlamydial infection effective concentration causal drug moxifloxacin, which allows to reduce his dose rate at 30%, and so to avoid the development of side effects during long use. When this is achieved, the economic effect (reduced course the cost of treatment). The treatment efficiency of this method can be recommended for widespread use in medical practice.

APPENDIX 1

Example 1. Patient I., aged 22, he sought medical care in the clinic of infectious diseases about the "fever of unknown etiology", considers himself ill for 3 years, when there were subterrania temperature, General weakness, malaise, recurrent pain and swelling in the joints, dysuric phenomena, disorders of sexual function. Twice was treated about urogenital chlamydia (used antibacterial therapy, bacteriotherapy, immunotherapy, enzyme therapy). However, to achieve full rehabilitation of the urinary tract from chlamydia failed. In Ogloblin the survey in the clinic using molecular-biological methods (PCR), the method of direct immunofluorescence (DIF) and indirect immunofluorescence reaction (NRIF), the culture method C.trachomatis was discovered in soskoba material from the urethra, the prostate gland secretion, centrifugate urine and ejaculate (primary lesions). In addition, this pathogen (chlamydia) was detected in the mucosa of the nasopharynx, conjunctiva, swabs from the maxillary sinus, in lacokanostra venous blood and synovial fluid of affected joints (secondary lesions). According to NIF titles chlamydial antibodies in the serum was 1:32. Research on other infectious, sexually transmitted diseases and pathogens of respiratory and intestinal (yersiniosis) infections were negative. On the basis of the results of examination the patient was put the final diagnosis of the disease Reiter. In the following, using the culture method was found high sensitivity of chlamydia to the causal drug moxifloxacin. Had a course of treatment using the method of drug plasma leukocytapheresis, which includes the diagnosis, selection of chlamydia from different foci of infection of the patient, determination of their sensitivity to various etiotropic drugs, the sampling of venous blood from the patient, centrifuging the blood in the refrigeration unit, the section is a group of plasma, RBC mass and leukocyte suspension, replacement of plasma saline solution, the return of red blood cells in saline solution to the patient intravenously, activation of the leukocyte suspension He-Ne laser with λ=0.63 and radiation power of 10 MW, adding in a suspension with activated leukocytes moxifloxacin and intravenous drip of her patient. Conducted therapy resulted in mild syndrome common infectious intoxication, arthralgias syndrome, conjunctivitis, intensity and duration of urethritis and prostatitis, which is simultaneously accompanied by bacteriological readjustment of the organism from chlamydia. After the course of treatment is 10 days was achieved stable remission (observation period 1 year).

ANNEX 2

Example 2. Patient R., aged 35, has applied for medical assistance in the infectious diseases clinic complaining of severe pains in the perineum, smack in the testicles and suprapubic region, pain in the knee and ankle joints, painful rash on the glans penis. Urination was several casino. The elucidation of the history has allowed to establish that the patient had previously been treated for chronic prostatitis. A week before the development of the disease the patient was on holiday in Turkey. Sex denies there. Modern laboratory is priori methods revealed mixed chlamydial Ureaplasma-gardnerelly balanitis urinary infection, which type of prostatitis and vesiculitis with exonerative formations and microabscesses in the center and advanced replacement bubbles, the results of ultrasound scanning. Chlamydia has also been detected in conjunctivitis. The patient had a long, three or four courses of treatment with several drugs (antibacterial, immunomodulators, hepato - and angioprotectors) with physiotherapy and massages the prostate. Had a course of treatment (12 days) using the method of treating drug plasma leukocytapheresis. After treatment, the pain had stopped, the mucous membrane in the area of erosion at the head of the penis returning to a normal color came epithelialization. Bacteriological studies sosabravo materials from the urethra, conjunctiva, secret of the prostate gland, centrifugate urine and semen on sexually transmitted infections after treatment, after 1 month were negative.

A method for the treatment of urogenital chlamydial infection, including the determination of sensitivity of chlamydia isolated from the patient after setting the preliminary diagnosis, to various etiotropic drugs, characterized in that the patient take the blood, sequentially centrifuged and separated into plasma, red blood cell mass and leukocyte suspension, the ATEM remote blood plasma substitute saline solution, autoerythrocyte physiological solution is returned to the patient intravenously, and autolackiererei suspension activate the laser radiation from a He-Ne laser with λ=0.63 µm, then it add causal drug moxifloxacin and injected intravenously to the patient, repeating the treatment every day for 10-12 days.



 

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2 ex

FIELD: medicine, oncology.

SUBSTANCE: the present innovation deals with treating disseminated forms of melanoma along with metastases into regional lymph nodes and intracutaneous metastases, the diameter being up to 2 cm at the depth of location up to 1 cm together with a locus. The method deals with intravenous injection of anti-tumor preparation as a photosensitizer (PS) of chlorine class into cubital vein of one hand at the dosage of about 1.5 - 2.0 mg/kg for 40-60 min and simultaneously, fulfill intravenous laser blood irradiation (IVLBI) into cubital vein of another hand at wave length corresponding to the maximal absorption of light radiation with PS, at the dosage of irradiation being 600-900 J/sq. cm. In about 3-3.5 h it is important to carry out spectral-fluorescent diagnostics (SFD) of metastatic foci and if the ratio of their fluorescence against that of surrounding tissue is not less than 3:1 one should conduct transcutaneous laser irradiation (TLI) of metastatic foci at wave length being correspondent to maximal absorption of light radiation with PS. In 24 h on finishing TLI one should carry out additional laser irradiation. The innovation provides either complete or partial regression of metastases along with considerable decrease of the possibility for dissemination out of metastatic foci.

EFFECT: higher efficiency of therapy.

3 cl, 1 ex

FIELD: medical engineering.

SUBSTANCE: device has optical block connected to processor having two radiators producing visible spectrum laser radiation and near infrared region in optical bandwidth, respectively. They are brought through converter socket to fiber-optical light guide having replaceable diffuser on distal end, a temperature sensor control, the power supply, programming port, data input block and display. The temperature sensor control is carried out by means of coaxially distributed thermodes connected to the processor and fixed on optical fibers end faces, movable in longitudinal direction in hollow needle tip canals inclined towards periphery.

EFFECT: enhanced effectiveness of treatment; exact tumor tissue localization, simultaneous endoscopic control and automatically adjustable irradiation process.

2 cl, 3 dwg

FIELD: medicine, narcology.

SUBSTANCE: method involves sampling venous blood in volume less 10-155% of total circulating blood for the first 24 h of disease and cellular mass of blood is separated from plasma. Mexidol in the dose 3 mg/kg of body mass is added to one portion and sibazon in the dose 0.25 mg/kg of body mass is added to another portion. Each portion is incubated separately and infused in a patient being mexidol-containing portion is infused firstly and then sibazon-containing portion is infused at temperature of a patient body. Method provides accelerating elimination of intoxication syndrome and reducing the treatment period based on the fixed therapy. Invention can be used in treatment of alcoholic delirium.

EFFECT: enhanced effectiveness of treatment.

1 ex

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