Treatment method for chronic purulent otitis media
FIELD: medicine; otorhinolaryngology.
SUBSTANCE: in early postoperative period, after finishing antibiotic system and local therapy course, into patient's ear his own saliva is instilled. The saliva is taken fasting in the morning, after oral cavity cleaning, by spitting into boil treated glass. 3 drops of saliva 3 times a day during 20 to 45 days is instilled.
EFFECT: disease recurrence reducing due to mastoidal cavity populating with normal microflora.
1 tbl, 2 ex
The invention relates to medicine, namely to otolaryngology, and can be used in the treatment of chronic suppurative otitis media after sanitizing operations on the middle ear.
Hitherto the mainstay of therapy of chronic suppurative otitis media after holding a sanitizing operation is systemic and local antibiotic therapy. As a result of such treatment the cavity of the middle ear, as a rule, exempt from pathogenic organisms, and, unfortunately, at the same time suffers saprophyticus microflora, vegetating on the skin of the ear canal is normal. Sanitized cavity of the middle ear in the absence of competing interactions with saprophytes and reduced local immunity against a background of chronic inflammation again obamanauts aggressive pathogens, leading to relapse of chronic suppurative otitis media and the formation of diseases of the operated ear. Numerous studies have shown that a stable remission of chronic suppurative otitis media involves vegetariana in the cavities of the middle ear saprophyticus microflora (Tarasov DI, Fedorova O.K., V.P. Bykov Diseases of the middle ear. - M.: Medicine 1988. - 288 S.). We investigated the microbial landscape of the middle ear in 17 patients previously underwent radical surgery in the state of stable long-term clinical remission is thew not less than 3 years. In 35.2% of observations microflora is not verified, 53% gave a moderate increase, basically no predominance of individual representatives. Abundant growth in a smear from ear had 2 people (11%), suffering from chronic diseases of the pharynx with carriage of Staphylococcus aureus. In microbial landscape was dominated by saprophytes: S.epidermidis (29,4%), S.saprophiticus (23,5%), H.influensia (11,7%). Significantly less frequent carriage of pathogenic species: S.aureus (11,7%), at all and diphtheroids (5,8%) - p<0.05 using the ratio of the total share of saprophytes and pathogens (Spotin VP, Proskurin A.I. and other Microflora when epitympanic in remote terms after sanitizing operations // Abstracts of XVII Congress of otolaryngologists of the Russian Federation. - Nizhny Novgorod, June 7-9, 2006. - S-152).
Thus, there is a need to find ways of settling postoperative cavities nonpathogenic saprophyticus microflora.
In the last decade, widespread probiotics preparations containing strains of microorganisms that are useful to the organism. Requirements that must be met by probiotics: healthy according to the human microflora, high viability and biological activity, antagonism to conditionally pathogenic and pathogenic flora, resistance to physical and chemical factors (pH, osmotic shock, temperature, the same action is cnyh acids, etc.) (Khoroshilova, NV Immunomodulatory and therapeutic effect of probiotics // Immunology. - 2003. No. 6. - S-356). Probiotics are widely spread in veterinary medicine (Bakulina L. F., Permanova N.G., I. Timofeev, and other Probiotics on the basis of spore-forming microorganisms and their use in veterinary medicine // Biotechnology. - 2001. No. 2. - P.48-56) and gastroenterology (Uchaikin V.F., Gasparyan MO, Novokshonov A.A. and other Probiotics in complex therapy of acute intestinal infections in children // Biological products. - 2001. No. 1. - C.2-4). The use of probiotics in otorhinolaryngology limited due to the absence of microorganisms, vegetating in a healthy ENT organs.
As a natural probiotic can be considered the saliva of a person that is not sterile and contains saprophyticus microorganisms. The oral cavity of a healthy person is rich in flora, characterized by relative stability, supported antibacterial properties of saliva. The concentration of microbial cells in 1 ml of saliva may be in the range of 107-1010and on the mucous membrane in gingival pockets and 1011CFU (colony forming units). These include aerobic and anaerobic gram-positive and grammatically rod-shaped and coccoid saprophytes. (Bondarenko A.V., Bondarenko WLM, Bondarenko V.M. Ways to improve etiopathogenetic therapy dysbacteriosis // Ukr. microbio is., Epidemiol. and immunobiol. - 1998. No. 5. - Pp.96-101). We conducted microbiological testing of saliva in 23 persons with purulent otitis media and 20 healthy people. In 32 of them in the saliva found non-pathogenic saprophyticus microorganisms (epidermal and saprophyticus staphylococci, H.influensia). 5 patients with otitis and 3 healthy people on nutrient media derived the growth of Staphylococcus aureus (4 cases), Klebsiella (2 cases), hemolytic Streptococcus (1 case) and Escherichia coli (1 case). In all cases, pathogenic seeding patients had or chronic disorders of the oropharynx, or multiple caries.
Since ancient times for therapeutic purposes are used excreta and fluids of the human body. For millennia, the use of saliva that was stopped and resumed in different modifications. The saliva of a fasting person has been used to remove warts, abscesses, tumors, and birthmarks. Ringworm and skin ulcers in ancient times was treated with compresses of saliva. To get rid of stubborn calluses them put the baking soda, which previously spit (Babylonian Talmud. Chapter 91). The healing features of saliva were observed by ancient healers and successfully applied them not only for the treatment of external injuries and internal ailments. Medical sources Sumerian, Agip TSCA, Tibetan and Greek authors we find information about this unique matter. "It is the only substance created by the body, which is not deduced from it, and like the tides and low tides cyclically pulsing in him, rising and opda." (Abu Ali Ibn Sina. Canon of medical science // 3 parts / Comp. Wierema, August. - Tashkent. Publishing house "Fan" of the Academy of Sciences of the Republic of Uzbekistan, 1994. 400 S. + 360 C. to + 232 C).
In classical and modern literature we have not found sources that indicate the use of human saliva in the treatment of chronic suppurative otitis media. In this regard, as a prototype of the selected method of treatment of chronic purulent middle otitis using other biological fluids - autoseparate (Korsakov B.C., Abant R.K., Scriabin, AS the Results of reconstructive surgery for chronic suppurative otitis media using autoseparate and collagen sponges // West. torinla. - 1998. No. 1. - p.56-58; Korsakov B.C., Scriabin A.S., Fedorova O.K. Method of treatment of chronic purulent middle otitis // Patent RF №2099064 from 20.12.97).
The disadvantages of the prototype include:
- the need for multiple intravenous fences blood that is required for more invasive procedures;
- autoseparate sterile and does not perform the function of settling the middle ear cavity saprophyte the mi;
- as a good medium for microorganisms, autoseparate may, under certain circumstances even to provoke exacerbation of chronic suppurative otitis media;
- requires the attachment of the patient to a medical institution for a long time restricted work.
The aim of the invention is to optimize postoperative treatment of chronic suppurative otitis media and reducing the frequency of its recurrence.
The proposed method of treatment of chronic suppurative otitis media includes sanitizing operation and landfill biological fluid in the ear after surgery. Put in the invention the objective is achieved by the fact that in the early postoperative period, after the completion of systemic and local antibiotic therapy, ear buried on 3 drops of saliva of the patient, obtained in the morning on an empty stomach after toilet mouth by Slavyane processed by boiling in a beaker, burial spend 3 times daily for 3 weeks to 1.5 months.
In the proposed method, the saliva is used in the postoperative period within 8-12 days. During surgery on the ear, made by "open" option, well-formed foreseeable accessible for visual inspection and injecting fluids mastodynia cavity in which to 8-12 day begin the process of epidermization. the usual by this time, under favorable postoperative period, the course system and antibiotic therapy, removed stitches from the ear wounds and patients are discharged to outpatient aftercare. In a smear from the ear before discharge almost most patients not detected the growth of microflora, which speaks to the effectiveness of a hospital treatment. However, due to impaired immunity, as a result of chronic inflammation and transactions, and the absence of competitive impacts of saprophyticus microflora postoperative cavity newly colonized by pathogens, leading to relapse of epitympanic. To avoid this, after discharge, patients begin to drip in the operated ear saliva. The argument of using saliva as a probiotic is vegetariana it saprophyticus microflora. In diseases of oral cavity, salivary glands and pharynx saliva inoculated pathogens in these cases, the use of saliva contraindicated to rehabilitation foci of inflammation. Recommended patients dosage is 3 drops 3 times a day, were chosen empirically and it paid off: at lower dosages saliva had time to dry, at large, because of the abundance of fluids, slowing the reparative processes. The collection of saliva was carried out by patients themselves, in the morning and on an empty stomach after using the toilet strips and mouth (toothpaste, mouthwash). Patients did not change their usual way of toilet mouth when seed after him, from saliva saprophyticus microflora. Saliva was cplegialas processed by boiling a glass beaker and was used during the day, the next day was going to a new portion. The duration of such treatment varied from 3 weeks to 1.5 months depending on the individual capabilities of reparation and the reactivity of the organism. During this period ends, the full epidermization postoperative cavity, it is cleared from the exudate. The criterion for ending the use of saliva was not only a visual inspection, but also microbiological examination with the sowing of the middle ear saprophyticus microflora.
The proposed method is performed as follows: after discharge from hospital (8-12 days of the postoperative period), when finished systemic and local antibiotic therapy and stitches BTE wounds, patients in the outpatient setting are beginning to place in the operated ear saliva. Saliva receive daily in the morning before eating and after toilet mouth by Slavyane. A prerequisite for the use of saliva was complete sanitation of the oral cavity and the absence of microbiological examination of pathogenic microflora. We recommended that the instillation of 3 drops 3 times a day is. Permanent fence saliva was not required, it was enough of a morning portion collected processed by boiling a glass beaker. The duration of this treatment was from 3 weeks to 1.5 months, depending on otoscopes and microbial dynamics. Criteria for discontinuing the use of saliva was either the appearance of purulent exudate that spoke of incomplete rehabilitation postoperative cavity from pathogenic microorganisms and demanded the renewal rate of the local anti-inflammatory therapy and then re-use saliva as a probiotic, or termination of exudation, finished epidermization postoperative cavity and seeding in the control of microbiological research saprophyticus microflora.
The difference of the proposed method from the prototype is:
- the use of saliva is a simple method that does not require material expenditures and invasive methods of sampling;
the patient independently, without participation of health workers in the home can use this method of treatment;
- saliva due to the content factors of nonspecific and specific protection, is anti-inflammatory and protective properties;
- in the saliva cultivate non-pathogenic microorganisms, are the same as on the skin, allowing you to use it as probiotics settlement postoperative mastoianni cavity normal for such localization microflora;
- the formation of balanced microflora by instillation into the ear of saliva allows to achieve stable remission chronic suppurative otitis media and to avoid diseases of the operated ear.
We compared the results of treatment of chronic suppurative otitis media in groups of patients with the use of saliva (n = 23) and without the use of saliva (31 people). Microbiological criteria for comparison were: the lack of growth on nutrient media, seeding saprophyticus and pathogenic organisms in smears from the middle ear, which is determined before discharge, after 3 weeks, 1.5 and 3 months after surgery. Clinical comparison criteria were: disease recurrence in the first year after surgery, epidermization postoperative cavity, the presence of productive elements and pathological scarring. The comparison results are presented in table 1.
|The results of treatment of patients with chronic suppurative otitis media depending on the application of saliva|
|Using saliva (n=23)||Without the use of saliva (n=31)|
|There is OST microflora||Before discharge||22||95,6||29||93,5|
|After 3 weeks||0||0||18||to 58.1|
|1.5 months||0||0||3||the 9.7|
|After 3 months||0||0||1||3,2|
|Saprophyticus microflora||Before discharge||0||0||0||0|
|After 3 weeks||21||for 91.3||7||22,6|
|After 3 months||23||100||19||61,2|
|Pathogenic microflora||Before discharge||1||4,3||2||6,4|
|After 3 weeks||2||8,7||6||19,4|
|After 3 months||0||0||11||35,4|
|Relapse in the first year after surgery||1||4,3||8||25,8|
|State trepanations cavity in the late postoperative period||Epidermization||22||95,6||24||77,4|
As can be seen from table 1, the majority of patients in both groups at discharge from hospital in smears from the cavity of the middle ear is not received by the growth of microorganisms. In the group of patients who have not applied saliva (31 people), the absence of microflora in smears after 3 weeks remained in 18 (58.1 per cent) persons, 1,5 month 3 (9,7%), 3 months - 1 (3,2%) person. Postoperative cavity of patients in this group was gradually colonized by microorganisms, three months after surgery in 19 of them (61,2%) was sown saprophytes, 11 (35.4%) of pathogenic microorganisms. All patients (100%) chronic suppurative otitis media, for which treatment was applied saliva, after 1.5 and 3 months after surgery of the ear was sown only saprophytes.
The efficiency of proposed method for the treatment of chronic suppurative otitis media can serve as a stable remission EPI is impunity most-treated saliva of patients, relapse in the first year after surgery occurred in 1 patient (4.3 percent) incomplete epidermization postoperative cavity and growth of granulations. At the same time, the patients of the comparison group relapse in the first year after surgery were recorded 6 times more often (25.8%) and were the result of incomplete epidermization (22,6%), education productive elements (16,1%) and pathological scarring with separation trepanations cavity (6,5%).
Our proposed method is embedded in the work of otorhinolaryngological Department Alexander Mariinsky regional hospital Astrakhan and used in the treatment and rehabilitation of 23 patients with chronic purulent middle otitis. Below are examples of approbation.
Example 1. Patient H., born in 1980 admitted in ENT Department 26.02.06 history No. 3162) with complaints of pain in right ear, abundant gnetaceae from him with a sharp putrid smell, hearing loss in the right ear. Sick since childhood. In 1997, in an emergency performed radical surgery on the right middle ear and the right-sided GamesIndustry about secondary purulent meningitis and sepsis. After discharge from the hospital remission has not occurred, continued purulent discharge from the right ear, about which repeatedly treated in hospital with short-term clinical improved the eating. Instrumental and x-ray examination at the hospital showed that despite otoscopes uncoupling of the right cavities of the middle ear of the patient continued osteomyelitic process of the temporal bone with the presence of cholesteatoma. In a smear from the right ear detected abundant growth of Staphylococcus aureus, moderate growth of Escherichia coli and colonies of Proteus and Enterococcus. In saliva, on the background of a complete reorganization of the oral cavity, received moderate growth saprophyticus and epidermal staphylococci. 07.03.2006 under endotracheal anesthesia BTE method performed sanitizing reoperate on the right middle ear "open" method. Removed a large cholesteatoma, caries-modified bone, granulation detected destructive bone defects with exposure of the Dura mater of the middle cranial fossa and the sigmoid sinus. All pathological removed until healthy bone. To increase front epidermization from the ear region taken flap on the supply leg, placed at the bottom mastoianni cavity with cover bone defects (Application for invention No. 2006102403 (002596) from 26.01.06 year). The postoperative period was uneventful. He received a course of systemic and local antibiotic therapy. In the control, before discharge, smear from ear growth of microorganisms is not received. In the outpatient setting on the 12th day after the Opera the AI for 1.5 months buried in the operated ear saliva 3 drops 3 times a day. At the control examination after 1.5 and 3 months after surgery - full epidermization cavities of the middle ear cavity was cleansed, it takes they are not. Microbiological research in the cavities of the middle ear detected the colony saprophyticus and epidermal staphylococci.
Example 2: the Patient Y., born in 1962, suffering from left-sided chronic suppurative otitis media since childhood. Repeatedly passed a course of conservative anti-inflammatory therapy with temporary clinical improvement. The last hospitalization 9.11.2005, history No. 18207) in connection with the continuing generous with sharp putrid smell otaria and arose three days before hospitalization facial paresis. When otoscopy: AD - without a pathology. AS - in the ear canal abundant purulent discharge with a putrid odor. Eardrum scar-modified, hyperemic, visualized Subtotal regional defect. Hearing SHR: AD=6 m, AS=1.5 m On the x-ray temporal bones on the background of sclerotic-type structure of the left mastoid process is determined by destructive cavity with sequestration. Microbiological examination of the cavities of the middle ear sown Association pyogenic Streptococcus, Escherichia coli, yeast, and Proteus; from saliva - superficiali aureus and H.influensia. Sanitizing operation performed by sasniedzam on "open" method tympanoplasty type II. During surgery removed carious and cholesteatoma mass found naked facial nerve, which is covered by a flap on the supply leg, cut from the skin of the ear region (Application for invention No. 2006102403 (002596) from 26.01.06 year). The postoperative period is smooth. Getting the exchange rate of local and systemic antibiotic therapy the patient on the 9 day was discharged from the hospital with minor symptoms of paresis of the facial nerve. When microbiological examination before discharge in the postoperative cavity detected a slight increase pyogenic Streptococcus and Proteus. Starting from the 8th day after surgery within 3 weeks the patient dripped into the ear of his own saliva on 3 drops 3 times a day. Control examination after a month: the cavity of the middle ear expressed, dry, fully epidermiology, neethimangala membrane in a satisfactory condition, the effects of facial nerve paresis disappeared completely, whispered speech on the operated ear to 4.5 meters in smears from ear detected a moderate increase saprophyticus Staphylococcus. When using our proposed method of treatment achieved:
- optimize postoperative treatment of chronic suppurative otitis media and reduce the frequency of its recurrence;
- full rehabilitation of the mastoid process due to the content in the saliva of specific and nonspecific factors of protection;
simplify treatment and facilities in the application of saliva by eliminating invasive methods of sampling of biological fluids;
- check the cavities of the middle ear normal microflora to reduce the recovery time and to achieve stable remission;
- the lack of saliva aggressive chemical compounds does not lead to local pain when using it;
- reduce economic costs due to lower expenses for the purchase antiseptic ear drops in the early postoperative period and reduce episodes of exacerbation in late.
The method of treatment of chronic suppurative otitis media, including sanitizing operation and landfill biological fluid in the ear after surgery, characterized in that in the early postoperative period after completion of systemic and local antibiotic therapy in the ear buried on 3 drops of saliva of the patient, obtained in the morning on an empty stomach after toilet mouth by Slavyane processed by boiling in a beaker, burial spend 3 times daily for 3 weeks to 1.5 months
FIELD: medicine; otorhinolaryngology.
SUBSTANCE: glucocorticosteroids are transtympanic pumped to cavity of middle ear in combination with endaural phoresis of medicinal agent. Medical product is represented with gel composition Pantonic. Phoresis is performed at supersonic frequency current power 1-2 kV within 5-7 minutes. Therapy course is 10-12 daily procedures.
EFFECT: offered method provides antispasmodic and anaesthetising effect; stimulates blood circulation and internal ear tissue trophism; activates tissular metabolism; offsets microcells and biologically active substances deficiency and prevents commissural process.
SUBSTANCE: device includes core containing at least one pharmaceutically active agent. Core is made from elastomeric composition selected from the group consisting of poly(dimethylsiloxane), siloxane-based elastomer including 3,3,3-trifluoropropyl groups attached to Si atom of siloxane units, siloxane-based elastomer, which includes poly(alkyleneoxide) groups, and their mixtures. The said core is encased by membrane. Membrane is made from the same elastomeric composition as core. Pharmaceutically active agent is selected from the group, which includes anti-allergic agents, anti-infection agents, anti-asthmatic agents, anti-inflammatory agents, anti-virus agents, anti-bacterial agents, anti-histamine means, anti-fungal agents, anesthetics, opioids, vasorelaxants, muscarinic agents, sympathomimetics, corticosteroids and their mixtures. Delivering device, according to invention, for nasal or otological application ensures preliminary set, constant rates of release of one or more pharmaceutically active agents.
EFFECT: device is safe and does not cause discomfort to patients.
8 cl, 6 dwg, 1 tbl, 5 ex
SUBSTANCE: method involves introducing Leu-Enkephalin Dalargin. Then, electropuncture is applied to new biologically active points with rectangular pulsating current of negative polarity, intensity of 8-12 mcA, frequency of 5-8 Hz 3-5 min long per each point. 8-10 symmetrically arranged points are treated during one procedure. Leu-Enkephalin Dalargin is introduced every day into inferior nasal conchas at a dose of 1 ml into each of them. Acupuncture treatment is applied to biologically active points of PN19 (hou-ting-xue), PN20 (hou-ting-hui), PN22 (chi-qian), PN23 (yi-ming-qa), PN24 (tiang-ting). The total treatment course is 10 days long.
EFFECT: enhanced effectiveness of treatment.
2 dwg, 3 tbl
SUBSTANCE: device has gelatin ear tubes containing antibiotics, antiseptics, antifungal preparations, homeopathic preparations, substances of vegetable, animal, mineral, synthetic origin and others contributing to prophylaxis and external ear treatment. Gelatin and glycerol are used as auxiliary substances. Gelatin-based drug immobilization provides for prolonged preparation action.
EFFECT: enhanced effectiveness in delivering drugs to lesion focus; avoided pain and mental disorder manifestations; retained hearing function.
FIELD: medicine, pharmacy.
SUBSTANCE: invention relates to a solid medicinal formulation of agent used in prophylaxis and elimination vertigo and a method for its preparing. Agent comprises betahistine as active pharmaceutical component and special additives in the following ratio of components, wt.-%: betahistine hydrochloride, 4-16; microcrystalline cellulose, 25-70; acid stabilizing agent, 1-3; aerosil, 1-10; disintegrating substance, 1.2-5, and lactose, the balance. Invention provides good decomposition capacity and strength of tablet, simplifying preparing the medicinal formulation.
EFFECT: valuable pharmaceutical properties of formulation, improved preparing method.
8 cl, 2 tbl, 1 dwg, 8 ex
FIELD: medicine, otorhinolaryngology, pharmaceutical industry.
SUBSTANCE: invention proposes an antibacterial agent containing copper acetate, silver nitrate, polyethylene glycol and water taken in the definite amounts. Agent possesses the enhanced antibacterial effect and effective in prophylaxis and treatment of otitis.
EFFECT: proposed agent is used as an antibacterial agent for prophylaxis and treatment of otitis.
SUBSTANCE: method involves applying aqueous suspension compositions containing Ciproflaxin and Dexamethason. The compositions are introduced into patient ear in the amount of 3-4 drops twice a day. Tragus pressure is additionally applied after having introduced the preparation.
EFFECT: enhanced effectiveness and safety of treatment course in cases having opened tympanic membrane.
7 cl, 2 dwg, 14 tbl
SUBSTANCE: method involves sound-treating antiseptic and antibacterial solution in turn in middle ear cavity with low frequency ultrasound. Low frequency ultrasound phonophoresis of Lydase into soft tissues is applied to retroaural zone in mastoid process projection region before carrying out intra-aural insonation. Middle ear cavity insonation is carried out twice for 25-30 s with 20-30 s long pause daily during 5-7 days.
EFFECT: enhanced effectiveness of chronic inflammation treatment; reduced risk of toxic complications.
SUBSTANCE: method involves making incision in the tympanic membrane and otomicroscopic examination for detecting signs of acute otitis media. Their availability being revealed, bypass is set for introducing Dexamethason into the tympanic cavity at a dose of 0.25 ml once a day, keeping patient head in a way that the solution is let cover round labyrinth window recess for 20 min. The total treatment course is 10-12 days long.
EFFECT: enhanced effectiveness of treatment.
SUBSTANCE: method involves cleaning lesion focus from mycotic masses and then treating it with aqueous Tatar motherwort extraction given in concentration of 0.96-3.84 mcg/ml enclosed into 150-30 nm large egg lecithin liposomes.
EFFECT: enhanced effectiveness of treatment; reduced risk of adverse side effects.
FIELD: cosmetic industry.
SUBSTANCE: it is necessary to carry out immobilization of native casein of goat milk at 50°C obtained as a result of flocculation onto methyl cellulose followed by introducing fucoidane hydrolyzate, silver nitrate and glycoproteins of mucus of animal origin at the ratio of components that provide the following ratios of cream's components, weight%: glycoproteins of mucus of animal origin 13.0-15.0; native casein of goat milk 30.0-35.0; methyl cellulose 30.0-35.0; silver nitrate 2.0-2.5; fucoidane hydrolyzate 15.0-22.5.
EFFECT: higher efficiency.
7 cl, 2 ex, 1 tbl
FIELD: medicine, oncology.
SUBSTANCE: method involves carrying out lumbal puncture to a patient in post-operative period, subarachnoid space is catheterized, and 5 ml of liquor is removed followed by incubation of liquor with nimustine taken in the dose 5 mg in vitro at temperature 38°C for 30 min, and liquor is administrated into subarachnoid space through catheter. Procedure is carried out 2 times with interval for 7 days. Since the second day after onset of this procedure distant gamma-therapy on bed of removed tumor is carried out up to the total focus dose 60 Gr. Method provides stable remission, decreasing toxicity of chemopreparation, frequency of adverse by-side effects and significant reducing the cost of chemotherapy. Invention can be used in carrying out the adjuvant chemoradiation therapy of brain malignant glial tumors.
EFFECT: improved method of chemoradiation therapy, enhanced effectiveness of method.
FIELD: medicine, oncology.
SUBSTANCE: the present innovation deals with adjuvant chemoradiation therapy of malignant cerebral meningiomas. In postsurgical period it is necessary to carry out lumbar puncture, catheterize subarachnoid space, sample 5 ml liquor, incubate liquor with cisplatin at the quantity of 0.1 mg in vitro at 38°C for 30 min to introduce it through a catheter into subarachnoid space. The procedure should be carried out twice at a 7-d-long interval, since the 2nd d of the beginning of this procedure it is necessary to conduct distance gamma-therapy at the bottom of removed tumor daily for 20 d up to total focal dosage being 60 Gy. The innovation enables to achieve stable remission, decrease toxicity of chemopreparation and frequency of side effects at considerable decrease of its cost price.
EFFECT: higher efficiency of therapy.
FIELD: medicine, oncology.
SUBSTANCE: one should carry out endoliquor therapy, moreover, after surgical removal of cerebral tumor, in early post-surgical period, it is necessary to fulfill catheterization of subarachnoidal cerebrospinal space at L4-L5 level and apply an endolumbar catheter. Then one should sample 5 ml cerebrospinal fluid and mix it with methothrexate at the dosage of 5 mg and hydrocortisone suspension at the dosage of 50 mg. The mixture should be incubated for 30 min at 37° C to be introduced into subarachnoidal space through endolumbar catheter by flow-type technique. There are 5 such infusions during one therapeutic course at 3-d-long interval. Totally, it is necessary to conduct 3 mentioned courses in combination with 5 cycles of adjuvant systemic polychemotherapy at injecting cytostatics upon autoblood. Application of such complex therapy enables to stabilize generalized tumoral process, increase relapse-free and metastases-free periods and prolong patient's life duration.
EFFECT: higher efficiency of therapy.
SUBSTANCE: method involves making lumbar puncture in postoperative period. Subarachnoid space is catheterized and 5 ml of liquor is taken and incubated with 5 mg of Nimustin for 30 min at 38°C and introduced through the catheter into the subarachnoid space.
EFFECT: enhanced effectiveness of treatment; reduced toxic effect.
SUBSTANCE: invention concerns compounds of formula (I) and their pharmaceutically acceptable salts as β-lactamase inhibitors, method of their production, pharmaceutical composition based on them, and methods of treatment involving the claimed compounds. In the general formula (I) one of A and B is hydrogen, while the other is optionally substituted condensed bicyclic heteroaryl group; if aromatic ring part of bicyclic heteroaryl group is imidazole, non-aromatic ring part does not include S atom adjacent to head carbon atom of bridge group; X is S; R5 is H, C1-C6-alkyl or C5-C6-cycloalkyl; or its pharmaceutically acceptable salt where bicyclic heteroaryl group is (1-A) , where one of Z1, Z2 and Z3 is independently S, while the others are CR2 or S, if one of Z1-Z3 is carbon and is linked to the rest of molecule; W1, W2 and W3 are independently CR4R4, S, O or N-R1, if it does not form S-S, O-O, or S-O link with saturated ring system; t=1-4; R1 is H, C1-C6-alkyl, C5-C7-cycloalkyl, -C=O-aryl, -C=O(C1-C6)-alkyl, -C=O(C5-C6)-cycloalkyl, aryl-C1-C6-alkyl, optionally substituted C1-C6-alkoxy; heteroalkyl- C1-C6-alkyl or C=O(heteroaryl), where heteroaryl is 6-member ring containing 1 nitrogen atom, R2 is hydrogen, C1-C6-alkyl, R4 ir H, C1-C6-alkyl.
EFFECT: efficient application in bacterial infection treatment.
29 cl, 3 tbl, 58 ex