Method of medical rehabilitation of adolescent girls with acute complicated salpingoophorite

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly gynecology and medical rehabilitation of adolescent girls with acute complicated salpingoophorite. It involves 3 plasmapheresis sessions with small plasma exfusion volume in addition to antibacterial therapy over a day interval in post-operation period. Immediately after each plasmapheresis session 2.2 ml of Mucosa compositum, 2.2 ml of Coenzyme compositum and 2.2 ml of Tonsilla compositum is administered intravenously. Injections are repeated after medical plasmapheresis course, the total of 10 injections over one day interval. In addition, Nux vomika-Homaccord, Gynacoheel, Traumel C are administered internally by 10 drops three times per day for one month starting from the first day of therapy.

EFFECT: complex detoxicative, anti-inflammatory, immune modulation effect allowing prevention of secondary mutations of central and peripheral hemodynamics, psychoemotional state, involuntary regulation and menstrual cycle disorders.

3 ex

 

The invention relates to medicine, in particular to pediatric gynecology, and may find application in regenerative therapy of girls with acute complicated oophoritis.

The urgency of the problem is that the frequency of acute gynecological diseases in adolescents currently has no tendency to decrease. Inflammatory diseases of the pelvic organs (PID) range from 1 to 5% of all acute surgical diseases of abdominal cavity organs in children, occupying the frequency of the third place after acute appendicitis and intestinal obstruction. According to the literature, inflammatory diseases of the uterus, mostly purulent character, most often (49,2%) cause of acute abdomen (Korotkevich A.G., Potekhin p. g, 2004). According to the Department of gynecology at children and adolescents Izmailovo children's city clinical hospital, Moscow 51% of all transactions in the internal sex organs in girls performed on an emergency basis, with more than half on the uterus. According to II surgical Department of the same hospital for 2003-2004 5.3% of girls aged 7-16 years, in addition to appendectomy produced by manipulation of the uterine appendages. According to the literature, acute catarrhal or purulent salpingitis acute pelvic pain is detected at laparoscopy in 77.8% of girls. The question is about contingent (girls pre - and pubertal ages) very difficult differential diagnosis of acute surgical pathology and diseases of the reproductive system, especially when they are combined. Puberty has attracted attention of researchers, because the sensitivity to pathological stress is high at all levels of the reproductive system. Appendicitis, moved in puberty, in 25-33% of cases can leave a long trail in the form of chronic salpingitis, tubal infertility, miscarriage, dysmenorrhea and other disorders of the menstrual cycle. Zharova O.Y (1997) noted that even a favorable course and outcome of acute appendicitis and appendectomy have a negative impact on the reproductive system in females, in the pubertal period. According to Yaroslavl VK and Gurkina Y.A. (1997) in children with tumors of the ovary appendectomy in history was carried out in 62 times more likely than healthy girls.

During emergency operations conditions for a child less favorable than for scheduled surgical intervention, due to more severe stress reactions, metabolic and functional disorders, extremely limited period of time to assess the patient and adequate preparation for surgery. The totality of these circumstances creates objective prerequisites for a complicated course of the postoperative period, therefore, adequate rehabilitation in the postoperative period is important for clinical is achey.

In acute complicated PID pathological changes in the reproductive system are Multisystem nature and are accompanied by a second developing violations of adaptive regulatory mechanisms (detox system, hemostasis, immune system), as well as changes in the Central and peripheral hemodynamics, impaired emotional state and autonomic regulation. Girls who have undergone surgical intervention for acute PID, further often have chronic pelvic pain, delayed development, and various forms of disorders of the menstrual cycle, which are dominated by dysmenorrhea and uterine bleeding puberty (Ginova I.G., Glukhova K.M., 2006, Uvarov E.V., Veselova NM, Nemchenko I., 2005).

For the treatment of acute complications of PID use antibacterial drugs, as well as physical, efferent and other drug-free methods.

After surgical interventions for acute complications of PID in the postoperative period spend antibacterial therapy. The use of antimicrobial therapy causes different degrees of severity of immunodeficiency. Therefore, the actual quest activation of protective forces of an organism, nonspecific resistance, restore the physiological state of the systems, Bob is cennych in the pathological process.

Recently in obstetrics and gynecology increasingly used extracorporeal therapies, in particular plasmapheresis for the treatment of complications after gynecologic operations, purulent tuboovarian formations, after cesarean section, early climacteric disorder, gestosis, as well as inflammatory diseases of the uterus and its appendages. The results showed high efficacy in the rehabilitation of patients [Serov V.N., Snimtshikova I.A., Reekin I.A. Application of therapy in combination with local immunotherapy in the treatment of acute inflammatory diseases of genitals // Mat. VI Russian forum "Mother and child". - 2004. - S-481; Fedorov T.A., Reekin I.A., Palchevsky S.V. Application of gemafereza and blood photomodification uses in the treatment of patients with urgent diseases in gynecology // Materials of conference "Critical care in obstetrics, gynecology and neonatology". - M - 2003. - P.76-77; Nemchenko I., Fedorov T.A., Uvarov E.V., ALEXANDER Bryantsev Possible use of therapeutic plasma exchange in the complex rehabilitation therapy girls operated on for acute inflammatory diseases of the pelvic organs // Abstracts of the International Congress "Practical gynecology: new opportunities for a new strategy." M - 2006. - S].

It is known that in policlinic diseases, including pelvic, decreases the activity of membrane receptors. The activity of membrane receptors is increased to normal values after plasmapheresis. With the increase in the activity of membrane receptors after plasmapheresis they become available for their respective substrates, increasing their impact on receptors (Nemchenko I., 1999). Including, in the treatment of antihomotoxic drugs therapeutic effect is more pronounced and is achieved in a shorter time.

Oophoritis is characterized by decreased T - and b-cell component of the immune system, a significant increase in the concentration of serum interferon, CEC, immunoglobulin E, total endotoxin of gram-negative bacteria and bacterial antigens, reduced lysozyme activity of membrane receptors. Plasmapheresis contributes to the correction of the immune system, restores balance immunoregulatory subpopulations of T - and b-lymphocytes, elimination of endotoxin of gram-negative bacteria, antigens of Staphylococcus aureus, Enterococcus and Klebsiella, CEC, serum interferon enhancement of lysozyme and activity of membrane receptors [Nemchenko I. Immunoregulatory effect of plasmapheresis on the contents of leucocytes in peripheral blood at the early stage of rehabilitation treatment in de is next with acute oophoritis after endoscopic rehabilitation. The collection of materials of the XIII Russian National Congress (abstracts), "Man and medicine". M - 2006, - S; Nemchenko I., Uvarov E.V., Fyodorov T.A., Bryantsev A.V. Effect of plasmapheresis on the content of subpopulations of leukocytes in the blood serum of girls with acute oophoritis. Cardio-vascular diseases. Bulletin NC MHS them. After Bakulev RAMS. App. Abstracts of papers of the Ninth annual session of the Scientific center of cardiovascular surgery named. After Bakulev RAMS with the all-Russian conference of young scientists. Moscow, 2005. - S; Nemchenko I., Uvarov E.V., Fyodorov T.A., L. Roshal, ALEXANDER Bryantsev, Kapustin V.A. Dynamics of the content of subpopulations of leukocytes in the blood serum and immunoregulatory index in girls with acute oophoritis after endoscopic rehabilitation and early recovery treatment with plasmapheresis // Modern technologies in the diagnosis and treatment of gynecological diseases. Ed. by V.I. Kulakov, L.V. Adamyan - M., 2006, S-267].

In addition, for the treatment of inflammatory diseases of the pelvic organs is applied antihomotoxic therapy, including drugs with detoxification, anti-inflammatory, analgesic effects [Tiraspol IV Antihomotoxic therapy in practice obstetrician-gynecologist. - M.: Arnebia, 2001, 526 Is.; Scarborou DU, Usenko L.G. Opportunities to optimize the treatment of inflammatory diseases of the uterus and appendages with antihomotoxic preparations. Biological medicine, 2001, No. 2. - P.42-48; Wemmer U. Pain syndromes in children. Biological medicine, 2004, No. 2, P.26-29; Lobodin IM, Veselova NM, Uvarov E.V., Nemchenko I. Antihomotoxic therapy as an alternative direction in gynecology children and adolescents. Materials of the 8th all-Russian scientific forum "Mother and child". - M., 2006. - S].

The lack of consistent application of these methods is to increase the timing of the treatment process, which is inefficient for the treatment of acute complicated inflammatory diseases of the pelvic organs in girls. In addition, the process of plasmapheresis just before the introduction of drugs increases their efficiency by increasing the activity of membrane receptors.

The objective of the invention is a more effective way to treat adolescents who underwent operative intervention for acute complicated inflammatory diseases of the uterus.

This object is achieved by the method lies in the fact that after the surgery and antibiotic therapy in the postoperative period, in the second phase (1-3 weeks after hee is oricheskogo intervention) conduct 3 sessions of plasmapheresis with a small amount of plasmacyte, when you do this soon after each plasmapheresis carry out intravenous antihomotoxic preparations (Mucosa compositum, Coenzyme compositum, Tonsilla compositum), the introduction of which continue after the end of therapeutic plasmapheresis, in addition, from the first day of treatment with oral take antihomotoxic preparations (Giacomel, NOx vomica-Homaccord, Traumeel S).

Practically the method is as follows.

The treatment begins with a discontinuous (discrete) plasmapheresis with a small amount of plasmacyte whose sessions are conducted in 1-2 days. Throughout the course of treatment 3 session.

Discontinuous (discrete) plasmapheresis was carried out as follows. For 15-20 minutes until exposee blood into the cubital vein started plasmodesmata crystalloid and colloid solutions in proportion to the amount of exposee of 1.2:1. Exposio blood produced by puncture of the cubital vein in plastic containers "Gamecon 500" with anticoagulant-preservative, gleyzer, the amount of disposable exfuze was 30-40% of the volume of circulating plasma (CGO). After thorough mixing of the blood was placed in a refrigerated centrifuge firm "Juan" (France) and centrifuged with a speed of 2500 rpm at 20°C for 20 minutes. Plasma was separated from the cell mass was removed with plasma is extractor. The remaining blood cells resuspendable in 150 ml of physiological solution and repusively the patient. During one session produced 2-3 blood depending on the condition of the patient, weight of the patient, portability procedures. During one session of plasmapheresis amount of exfuze plasma was 30-40% CGO. Heparin was administered based 100-200 units per kg of body weight. Just spent 3 sessions of plasmapheresis.

Calculations for determining the volume of circulating plasma and blood and the number of removed plasma was produced using a mathematical program of the calculation of the volume of circulating blood plasma and the number of removed plasma, based on the anthropometric data of the patient and some physiological constants [Postnikov A.A. optimization methods and mechanisms of therapeutic efficacy of plasmapheresis // Diss.... Prof. the honey. Sciences. - M - 1993. - 248 S.].

Blood volume (CBV) was determined taking into account body weight, height, body type by the method of Moore [Bunyatyan A.A. Handbook of anesthesiology and critical care medicine. - M - 1994, Postnikov A.A. optimization methods and mechanisms of therapeutic efficacy of plasmapheresis. // The Diss. ... Prof. the honey. Sciences. - M - 1993. - 248 S.]:

BCC=M×QC, where

M is body mass in kg;

QC is the amount of blood in ml per kg of body weight depending on sex and body type (women from 55 to 70 ml/kg).

Next thought of gematik is it which is triple the level of hemoglobin (g %): GT=GN×3,

where GT is the hematocrit in %; RH content of hemoglobin in g %.

Then the calculated BCC and the hematocrit was determined CGO:

CGO=CBV×(100%-GT).

From the calculated index CGO was calculated projected percentage removal of plasma (P)by adding to that amount of 5% on additional input in the supply line solution of anticoagulant, for the most part removed from the plasma, and received the largest projected number of removed plasma (PMC):

PMC=CGO×P×(100%+5%)=CGO×P×1,05.

After the last reinfused blood cells on saline intravenous bolus slowly was administered in the same syringe antihomotoxic drugs: Tonsilla compositum 2.2 ml, Coenzyme compositum of 2.2 ml. Mucosa compositum of 2.2 ml. of Such injections were performed 10 (3 injili immediately after plasmapheresis and then another 7 intravenous injection of the indicated composition through the day).

In addition, every day the girl got inside drugs Giacomel, NOx vomica-Homaccord, With Traumeel drops (10 drops of each drug in 100 ml of water 3 times a day for 1 month).

Ginekol.

Registration certificate №012356/01-2000. Available in drops, 100 ml contain: Apis mellifica D4, Ammonium bromatum D4, Lilium lancifolium D4, Aurum jodatum D12, vespa Crabro D4, Chamaelirium luteum D4, Palladium metallicum D12, Platinum metallicum12, Naja naja D12 10 ml, Melilotus officinalis D3, Viburnum opulus 2 no 5 ml of 35%alcohol solution. Anti-inflammatory, analgesic, sedative, wendonside, anti-edema effect. This drug not only inhibits inflammatory processes, but also helps to regulate the functions of the female reproductive organs. Used in the treatment of inflammatory diseases of female genital organs (adnexitis, salpingitis, obesity). Side effects were noted.

Coenzyme compositum.

Registration certificate №014024/01-2002. 2.2 ml contains: Coenzymum And d, Acidum ascorbicum D6, Thiaminum hydrochloricum D6, Natrium riboflavinum phosphoricum D6, Pyridoxinum hydrochloricum D6, Nicotinamidum D6, Acidum cis-aconiticum d Acidum citricum d, Acidum fumaricum d, Acidum alpha-ketoglutaricum d, Acidum DL-malicum d, Acidum succinicum d, Barium oxalsuccinicum D10, Natrium diethyloxalaceticum D6, Natrium pyruvicum d, Cysteinum D6, Pulsatilla pratensis D6, Hepar sulfuris D10, Sulfur D10, Adenosinum triphosphoricum D10, Nadidum d, Manganum phosphoricum D6, Magnesium oroticum D6, Cerium oxalicum d, Acidum alpha-liponicum D6, Beta vulgaris conditiva D4 under 22,0 μl of water for injection, sodium chloride for establishing isotone. The drug has detoxification, metabolic, antioxidant effect. Activates tissue respiration and redox processes in the body (the Krebs cycle). Used in the treatment of disorders of redox processes in the body when vitamin deficiencies, elevated physical and the mental is built loads, diseases of the genitourinary system. Included in the homeopathic drug (promoting regeneration enzymes, trace elements and intermediate catalysts have a wide, but not overly strong therapeutic effect is blocked or inactive enzyme system.

Mucosa compositum.

Registration certificate №012916/01-2001. 2.2 ml of the preparation contains: Mucosa nasalis suis d, Mucosa oris suis d, Mucosa pulmonis suis d, Mucosa oculi suis d, Mucosa vesicae felleae suis d, Mucosa vesicae urinariae suis d, Mucosa pilori suis d, Mucosa duodeni suis d, Mucosa oesophagi suis d, Mucosa jejuni suis d, Mucosa ilei suis d, Mucosa coli suis d, Mucosa recti suis d, Mucosa of ductus choledochi suis d, Ventriculus suis d, Pankreas suis D10, Argentum nitricum D6, Belladonna D10, Oxalis acetosella D6, Anacardium D6, Phosphorus d, Lachesis D10, Ipecacuanha d, Nux vomica d13, Veratrum D4, Pulsatilla D6, Kreosotum D10, Sulfur d, Natrium oxalaceticum d, Colibacillinum D, Condurango D6, Kalium bichromicum d, Hydrastis D4, Mandragora D10, Momordica balsamina D6, Ceanothus D4 22 μl. The drug has immunostimulant, reparative, anti-inflammatory, Antihemorrhagics action. Shown in inflammatory diseases of the mucous membranes of different localization, including the genitourinary system.

NOx vomica-Homaccord.

Registration certificate №014022/01-2002. 100 ml contains: Nux vomica D2, D10, D, D30, D200 and D, Bryonia cretica D2, D6, D10, D, D30, D200 and D 0.2 ml, Lycopodium clavatum D3, D10, D30, D200 and D, Citrullus colocynthis D3, D10, D30, D200 0.3 ml Contains alcohol 35 %by volume. Has spazmaliticheskimi, anti-inflammatory, choleretic effect. This drug has a beneficial effect in diseases of the liver, and disorders of the digestive tract due to complications allopathic therapy or exogenous toxins. NOx vomica-Homaccord appointed in all cases where it is necessary to activate the function of the intestines and liver. Activation of liver detoxification function relevant when endotoxicosis, characteristic of acute inflammatory diseases, and to mitigate the consequences of antibiotic therapy, is shown in the pathology of microbial origin.

Tonsilla compositum.

Registration certificate №011211. 2.2 ml of the drug contains: Acidum ascorbicum D6, Nodus lymphaticus suis d, Tonsilla suis D, Medulla ossis suis D10, Funiculus umbilicalis suis D10, Splen suis D10, Hypothalamus suis D10, Hepar suis D10, Embryo suis d13, Cortex glandulae suprarenalis suis d13, Pyrogenium Nosode D, Cortisonum aceticum d13, Pulsatilla pratensis D6, Acidum sarcolacticum D6, Echinacea angustifolia D4, Calcium phosphoricum D10, Aesculus hippocastanum D6, Kalium stibyltartaricum D6, Solanum dulcamara D4, Levothyrotoxin d13, Coccus cacti D6, Ferrum phosphoricum D10, Gentiana lutea D6, Geranium robertianum D6, Mercurius solubilis Hahnemanni d13, Barium carbonicum D, Conium maculatum D4, Galium aparine D6, Sulfur d, Psorinum Nosode D 22 μl. Has a desensitizing, detoxification, immune-modulating, lymphatic drainage effect. This drug has a complex effect on various organs. When this action is e of the preparation is based not only on the extracts from organs and tissues, but on the nosodes, catalysts and other biologically active substances. This action is aimed at strengthening the immunity system of the body in various diseases and intoxications (including the effects of allopathic therapy).

The Traumeel S.

Registration certificate №011686/03-2000. Dosage form of the drug in the form of droplets contains 100 ml: Arnica D2, Calendula D2, Hamamelis D2, Millefolium D3 5 ml, Atropa belladonna, D4 25 ml, Aconitum D3, Mercurius solubilis Hahnemanni d, Hepar sulphuris d no 10 ml, Chamomilla recutita D3, Symphytum d no 8 ml, Bellis perennis D2, Echinacea angustifolia D2, Echinacea purpurea D2 2 ml, Hypericum D2 1 ml Contains alcohol 35 %by volume. Anti-inflammatory, antiexudative, immune-stimulating, regenerating, analgesic, Antihemorrhagics, wendonside influence. Used when soft tissue swelling after surgery or injury, inflammatory processes of various organs and tissues. The Traumeel S - complex homeopathic preparation with triple action. The mechanism of action is determined by the presence of vegetative and mineral components: support and improvement of cellular respiration and redox processes, increased vascular tone, seal, eliminating venous stagnation, stops arterial and venous bleeding, as well as antiviral and anti-inflammatory effect. Anti-inflammatory activity With Traumeel CPA is Nimes with the efficiency of classical non-steroidal anti-inflammatory drugs, but the homeopathic medication Traumeel s has fewer side effects.

This drug is also indicated for General activation of the sulphide enzymes, such as effects of allopathic therapy. Used in acute and chronic inflammatory processes in various organs and tissues (mastitis, adnexitis), postoperative and post-traumatic edema.

This method of treatment is more effective than known, so how do you manage to combine and mutually reinforce two pathogenetic effects. Thus, therapeutic plasmapheresis at the initial stage has a positive effect on blood counts, rapid detoxification, immunomodulatory effects, increases the activity of membrane receptors. This provision proved earlier in [Fedorova., 1996]. Consistently applied antihomotoxic drugs have a more pronounced detoxification, anti-inflammatory, immunomodulatory effects. Using the two above-mentioned method, has been synergistic, qualityuse and complementary clinical effects.

Were developed criteria under which most shows use of restorative treatment with plasmapheresis in combination with antihomotoxic preparations:

1. Condition after surgery for acute complicated in specialnogo diseases of the pelvic organs.

2. Signs of intoxication (according to clinical and laboratory examination).

3. Conducted antibacterial therapy in the postoperative period.

4. The absence of contraindications to plasma exchange (hypocoagulation, severe anemia (Hb < 80 g/l).

5. The presence of venous access.

The following examples illustrate the method according to the invention.

Example No. 1.

The patient S.O., age 13, born in 1992. Diagnosis: acute bilateral salpingo-oophoritis. After a laparoscopy in occasion of ruptured gangrenous appendicitis, omentitis I, secondary bilateral oophoritis.

For the first time with complaints of acute abdominal pain, nausea, vomiting, loss of appetite turned 27.07.05 at the research Institute of emergency children's surgery and traumatology after 5 hours from the onset of the disease (history No. 4499). When admitted to hospital, the temperature was 37,4°C. the State of admission regarded as medium to heavy. The skin was pale. Catarrhal phenomena not observed. The breath in the lungs was vesicular, wheezing not to listen. Heart rate is 112 beats per 1 minute, satisfactory characteristics. The language was a white furred. Abdomen palpation was symmetrical, soft, painful in the lower, more to the right. Percussion of the abdomen in the lower sections was marked tenderness. Si is ptoma of peritoneal irritation were questionable. From the vagina allocated whitish allocation in a small amount. When finger examination through the rectum was determined soreness on the right, which is enhanced by pinch, tumor formations were not determined. Dysuric phenomena not observed. Blood WBC - 13,0×109The sedimentation rate of 13 mm/h. The purpose of differential diagnosis between acute appendicitis and pelvioperitonit performed diagnostic laparoscopy, in which the pelvis was found purulent effusion in the amount of 100 ml, Parietal pelvic peritoneum hyperemic. Bowel movements normal. The greater omentum swollen and hyperemia, with no signs of infiltration and fibrin plaque. From other departments and organs of the abdominal cavity revealed no pathology. Vermiform process was located at the entrance to the pelvis, was destructive changed. The patient was diagnosed: "Gangrenous appendicitis. Omentitis-1. Bilateral salpingitis". Performed typical appendectomy. These histological examination remote vermiform process confirmed surgical diagnosis. The postoperative period was uneventful. In the postoperative period received antibiotic (Amoxiclav) for 5 days. The patient was discharged on the 7th postoperative day in the satisfaction with orfelina condition.

After 2 weeks she appealed to the Federal research center of obstetrics, gynecology and Perinatology and gynecology" complaining of periodic nagging pain in the lower abdomen (outpatient map No. 144/06, case history No. 2057/2005). When inspecting the condition is satisfactory. Body temperature - 36,7°C. the Skin was clean, Zev calm. The vesicular breathing, wheezing not to listen. Heart sounds are clear, rhythmic, pulse 76 beats per 1 minute, satisfactory characteristics. Tongue moist, not lined. When superficial palpation of the abdomen soreness was not determined. Symptom Shchetkina-Blomberg was negative. When finger examination through the rectum was determined pastos, the sensitivity of the uterus on the right side. From the vagina marked a small amount of mucous discharge whitish color. In the study of blood from 18.08.05: RW negative, antibodies to HIV, antibodies to HCV, HBsAg was not detected. Produced PCR diagnostics of discharge from the genital tract in the presence of urogenital infections (14.03.06): HSV, CMV, chlamydia, Mycoplasma, Ureaplasma, HPV (shared, type 6, 11, 16, 18) is not detected. In General, the analysis of blood from 18.08.2005: erythrocytes 4,7×1012/l, hemoglobin level 133 g/l, hematocrit of 0.42, erythrocyte sedimentation rate of 3 mm/h, platelets 385×109l, leukocytes 3,8×109l, eosinophils 2%, stab 2%, segmented 37%, lymphocytes 57%, monocytes 2%. the ri biochemical analysis of blood from 18.08.05: protein 73 g/l (reference indicators 64-83 g/l), bilirubin total of 16.4 µmol/l (reference figures 5-21 µmol/l), direct bilirubin 1.4 µmol/l (reference figures 0-5 μmol/l), creatinine 46.5 mmol/l (reference indicators 53-97 µmol/l), urea 2.3 mmol/l (reference figures of 2.2-7.2 mmol/l), glucose 3.7 mmol/l (reference figures 4.1 and 5.9 mmol/l), potassium of 4.95 mmol/l (reference figures 3.6 to 6.2 mmol/l), sodium 142,9 mmol/l (reference indicators 135-152 mmol/l), chlorine 104,2 mmol/l (reference indicators 96-108 mmol/l), iron 20.0 µmol/l (reference figures 9-30,4 µmol/l). In the study of the immune status from 24.08.05 revealed reduction of immunoregulatory index (1,1 at the rate of 1.5). When electroencephalography from 30.08.05 specific espectively not revealed, paroxysmal activity did not reveal marked cerebral changes with signs of dysfunction diencephalic and brainstem structures of the brain (at different levels) with the involvement of fronto-basal parts of the brain. Functional load (hyperventilation) led to the registration of individual outbreaks paroxysmal character. When two-handed study of the body of the uterus was normal consistency and magnitude is slightly tilted to the right, palpation painless. The left and right appendages sensitive paste. Palpation of the walls of the pelvis sensitive to the right. Ultrasound of the pelvic organs from 25.08.05 pathologysaline was not.

Treatment began 24.08.05 was conducted 3 sessions of plasmapheresis with a small amount of plasmacyte through the day.

For 15-20 minutes until exposee blood into the cubital vein started plasmodesmata 6% solution gidroksietilirovannogo starch (Reportan") in the amount of 250 ml of Exfuze blood produced by puncture of the cubital vein in plastic containers "Gamecon 500" with anticoagulant-preservative, gleyzer. After thorough mixing of the blood was placed in a refrigerated centrifuge firm "Juan" (France) and centrifuged with a speed of 2500 rpm at 20°C for 20 minutes. Plasma was separated from the cell mass was removed with plasmacytoma. The remaining blood cells resuspendable in 150 ml of physiological solution and repusively the patient. During one session produced 3 blood sampling, depending on the patient, weight of the patient, portability procedures. During one session of plasmapheresis amount of exfuze plasma was 510 ml 420 ml, 480 ml for 1-2-3 sessions respectively (30-40% CGO).

After the last reinfused blood cells to the patient's physiological solution intravenous bolus slowly was administered in the same syringe antihomotoxic drugs: Tonsilla compositum 2.2 ml, Coenzyme compositum 2.2 ml, Mucosa compositum of 2.2 ml. of Such injections were performed 10 (3 injili immediately after plasmapheresis and Yes is it still 7 intravenous injection of the indicated composition through the day).

In addition, 24.08.05 daily girl got inside drugs Giacomel, NOx vomica-Homaccord, With Traumeel drops (10 drops of each drug in 100 ml of water 3 times a day for 1 month).

After a full course of therapy the patient's General condition improved. When two-handed study of the body of the uterus was normal consistency and magnitude palpation painless, the volume of trips has increased. Appendages palpation were painless on both sides. Palpation of the walls of the pelvis painless on both sides. On EEG positive dynamics that showed improvement of metabolic processes in the brain cells. An ultrasound of the pelvic organs from 29.09.2005, pathology have been identified. In the study of the immune status from 29.09.05 reducing immunoregulatory index not detected (at the rate of 1.6 from 1.5).

The patient was invited for follow-up examination after 1.5 months (11.2005), 4 months (01.2006), 1 year (09.2006) and after 1 year 3 months (12.2006), 1 year 8 months (05.2007) after therapy. Had no complaints, pathology, two-handed and laboratory research have been identified.

Example No. 2.

Pacinda Z.A., age 13, born in 1992. Diagnosis: Bilateral acute salpingo-oophoritis. Pelvic peritoneal adhesions".

For the first time with complaints about pulling the Oli lower abdomen, decreased appetite (increase in body temperature were observed - 36,9° (C) 22.02.06 applied in scientific research Institute of emergency children's surgery and traumatology (history No. 4499) through 21 hours from the beginning of the disease (the appearance of pain in the lower abdomen).

The state of admission regarded as medium to heavy. The skin was pale. Catarrhal phenomena not observed. The breath in the lungs was vesicular, wheezing not to listen. The pulse was 88 beats per 1 minute, satisfactory characteristics. The language was a white furred. Abdomen palpation was symmetrical, soft, moderately painful in the lower, more to the right. Percussion of the abdomen in the lower sections was marked tenderness. Symptoms of peritoneal irritation were questionable. From the vagina allocated whitish allocation in a small amount. When finger examination through the rectum was determined soreness on the right, which is enhanced by pinch, tumor formations were not determined. Dysuric phenomena not observed. In the analysis of blood leukocyte number to 15.4×109, ESR 8 mm/hour. The purpose of differential diagnosis between acute appendicitis and pelvioperitonit performed diagnostic laparoscopy, in which the pelvis is detected purulent effusion in moderation. Parietal pelvic peritoneum hyperemic. Peristil the tick gut normal. The greater omentum swollen and hyperemia, with no signs of infiltration and fibrin plaque. From other departments and organs of the abdominal cavity revealed no pathology. Vermiform process was located at the entrance to the pelvis, was destructive changed. The patient was diagnosed with "Flegmonoznih appendicitis. Secondary bilateral salpingitis". Performed typical appendectomy. These histological examination remote vermiform process confirmed surgical diagnosis. The postoperative period was uneventful. Sutures were removed on the 5th day, the healing per prima. The patient was discharged on the 7th postoperative day in good condition. In the postoperative period received antibiotic (Amoxiclav) for 6 days.

2 weeks after surgery, the girl asked the Federal research center of obstetrics, gynecology and Perinatology and gynecology" complaining nagging pain in the lower abdomen (outpatient map 11700/06, history 1628). When the inspection condition was satisfactory. Body temperature - 36,4°C. the Skin was clean, Zev calm. The vesicular breathing, wheezing not to listen. Heart sounds were clear, rhythmic, pulse 78 beats per 1 minute, satisfactory characteristics. The tongue was moist, white furred. When superficial palpation of the abdomen soreness was not determined. But the om Shchetkina-Blomberg was negative. When finger examination through the rectum was determined pastos, the sensitivity of the uterus on the right side. From the vagina marked a small amount of mucous discharge whitish color. In the study of blood from 06.06.06: RW negative, antibodies to HIV, antibodies to HCV, HBsAg was not detected. Produced PCR diagnostics of discharge from the genital tract in the presence of urogenital infections (13.06.06): HSV, CMV, chlamydia, Mycoplasma, Ureaplasma, HPV (shared, type 6, 11, 16, 18) is not detected. In General, the analysis of blood from 06.06.06: erythrocytes 4,5×1012/l, hemoglobin level 127 g/l, hematocrit of 0.38, ESR 10 mm/h, platelets 318×109/l, leukocytes 6,6×109/l, eosinophils - 0%, stab - 4%, segmented - 59%, lymphocytes - 26%, monocytes - 8%. In the study of the immune status from 24.03.06 revealed reduction of immunoregulatory index (1,4 at the rate of 1.5). When the biochemical analysis of blood from 09.06.06: iron - 19,0 g/l (reference indicators 9,0-30,4 g/l), protein -73 g/l (reference indicators 64-83 g/l), total bilirubin was 13.8 µmol/l (reference figures 5-21), AST - 9 U/l (reference indicators 0-35), ALT - 7 U/l (reference indicators 0-34), urea - 3.2 mmol/l (reference figures of 2.2-7.2), glucose - 4.9 mmol/l (reference figures 4.1 and 5,9), potassium - 4,17 mmol/l (reference figures of 3.6 to 6.2), sodium 140,9 mmol/l (reference indicators 135-152), chlorine - 103,3 mmol/l (reference indicators 96-108), iron - 12.8 µmol/l (reference figures 9-30,4), calcium is 2.46 mmol/l (reference indicators of 2.15-2.50 each). According to the ultrasound of the pelvic organs from 22.05.06, 20.06.06 pathology was not detected. When smear discharge from vagina from 06.06.06 - leukocyte 0-2 in the fields of view of flora sticks morphotypes of lactobacilli, fungi - not detected, Trichomonas is not detected. When electroencephalography from 16.06.06 revealed cerebral changes with signs of dysfunction of the median brain structures. When two-handed study of the body of the uterus was normal consistency and magnitude palpation painless, tours are limited to adhesive structures in the area of the uterus. The left and right appendages sensitive, agile, pasty. Palpation of the walls of the pelvis painless on both sides.

Treatment began 09.06.06 was conducted 3 sessions of plasmapheresis with a small amount of plasmacyte through the day.

For 15-20 minutes until exposee blood into the cubital vein started plasmodesmata 6% solution gidroksietilirovannogo starch (Reportan") in the amount of 250 ml of Exfuze blood produced by puncture of the cubital vein in plastic containers "Gamecon 500" with anticoagulant-preservative, gleyzer. After thorough mixing of the blood was placed in a refrigerated centrifuge firm "Juan" (France) and centrifuged with a speed of 2500 revolutions per mi the rie at 20° C for 20 minutes. Plasma was separated from the cell mass was removed with plasmacytoma. The remaining blood cells resuspendable in 150 ml of physiological solution and repusively the patient. During one session produced 2-3 blood depending on the condition of the patient, weight of the patient, portability procedures. During one session of plasmapheresis amount of exfuze plasma was 370 ml, 410 ml 460 ml for 1-2-3 sessions respectively (30-40% CGO).

After the last reinfused blood cells of the patient physiological solution intravenous bolus slowly was administered in the same syringe antihomotoxic drugs: Tonsilla compositum 2.2 ml, Coenzyme compositum 2.2 ml, Mucosa compositum of 2.2 ml. of Such injections were performed 10 (3 injili immediately after plasmapheresis and then another 7 intravenous injection of the indicated composition through the day).

In addition, 09.06.06 daily girl got inside drugs Giacomel, NOx vomica-Homaccord, With Traumeel drops (10 drops of each drug in 100 ml of water 3 times a day for 1 month).

When two-handed study of the body of the uterus is of normal consistency and magnitude palpation painless. Appendages palpation were painless on both sides. Palpation of the walls of the pelvis painless on both sides. On EEG positive dynamics that testified at the Uchenie metabolic processes in the brain cells. An ultrasound of the pelvic organs from 18.06.2006, pathology have been identified.

The patient was examined in a planned manner after 1 month (07.2006), 3 months (09.2006) and 6 months (12.2006), 1 year (06.2007) after treatment. Had no complaints, while two-handed study - indirect signs of salacia adhesions in the pelvis, in a laboratory study of pathology have been identified.

Example No. 3.

The patient ZH.A., age 14, born in 1990. Diagnosis: Acute bilateral salpingo-oophoritis.

For the first time with complaints of abdominal pain, vomiting, nausea, loss of appetite, body temperature rise up to 38,2° (C) asked 21.05.05 at the research Institute of emergency children's surgery and traumatology (history No. 3294/2005) after 24 hours from the onset of the disease (the appearance of pain in the lower abdomen).

The state of admission was regarded as moderately heavy. The skin was pale. Catarrhal phenomena not observed. The breath in the lungs was vesicular, wheezing not to listen. Pulse 96 beats per 1 minute, satisfactory characteristics. The language was a white furred. Abdomen palpation was symmetrical, soft, painful in the lower, more to the right. Percussion of the abdomen in the lower sections was marked tenderness. Symptoms of peritoneal irritation were positive. From the vagina of videla is the n whitish allocation in a small amount. When finger examination through the rectum was determined soreness on the right, which is enhanced by pinch, tumor formations were not determined. Dysuric phenomena not observed. In the analysis of blood leukocyte number and 16.2×109, ESR 28 mm/hour. The purpose of differential diagnosis between acute appendicitis and pelvioperitonit performed diagnostic laparoscopy, in which the pelvis is detected purulent effusion in large quantities. Parietal pelvic peritoneum hyperemic. Bowel movements normal. The greater omentum swollen and hyperemia, with signs of infiltration and fibrin. From other departments and organs of the abdominal cavity revealed no pathology. Vermiform process was located at the entrance to the pelvis, was destructive changed. The patient was diagnosed: "Gangrenous-perforated appendicitis. Diffuse purulent peritonitis. Secondary bilateral salpingitis. Omentitis-2. The syndrome of intestinal failure-1". Performed typical appendectomy. The cavity drained. The patient was in the ICU for 5 days. The drainage was removed on the 3rd day. Sutures were removed on the 6th day, the healing per prima. These histological examination remote vermiform process confirmed surgical diagnosis. The patient was discharged on the 13th-the day after surgery in satisfactory condition. In paleoclimatology period received antibiotic (Amoxiclav) for 10 days.

After 2.5 weeks after surgery, the girl asked the Federal research center of obstetrics, gynecology and Perinatology and gynecology" complaining nagging pain in the lower abdomen (outpatient map 14850/05, history 1622/2005). When the inspection condition was satisfactory. Body temperature - 36.6 to°C. the Skin was clean, Zev calm. The vesicular breathing, wheezing not to listen. Heart sounds were clear, rhythmic, pulse 74 hit in 1 minute, satisfactory characteristics. The tongue was moist, white furred. When superficial palpation of the abdomen soreness was not determined. Symptom Shchetkina-Blomberg was negative. When finger examination through the rectum was determined pastos, the sensitivity of the uterus on the right side. From the vagina marked a small amount of mucous discharge whitish color. In the study of blood from 06.06.05: RW negative, antibodies to HIV, antibodies to HCV, HBsAg was not detected. Produced PCR diagnostics of discharge from the genital tract in the presence of urogenital infections (14.06.05): HSV, CMV, chlamydia, Mycoplasma, Ureaplasma, HPV (shared, type 6, 11, 16, 18) is not detected. In General, the analysis of blood from 10.06.05: erythrocytes 4,4×1012/l, hemoglobin level 142 g/l, hematocrit of 0.42, erythrocyte sedimentation rate of 20 mm/h platelets 379× 109/l, leukocytes 10,2×109/l, eosinophils - 1%, stab - 4%, segmented - 76%, lymphocytes - 18%, monocytes - 2%. In the study of the immune status from 24.03.06 revealed reduction of immunoregulatory index (1,3 at the rate of 1.5). When the biochemical analysis of blood from 09.06.06: iron and 9.1 g/l (reference indicators 9,0-30,4 g/l), protein - 77 g/l (reference indicators 64-83 g/l), bilirubin total - 9.1 µmol/l (reference figures 5-21), AST - 12 U/l (reference indicators 0-35), ALT - 7 U/l (reference indicators 0-34), urea - 4.9 mmol/l (reference figures of 2.2-7.2), glucose - 4.9 mmol/l (reference indicators 4,1-5,9), potassium - to 4.98 mmol/l (reference figures of 3.6 to 6.2), sodium 140,8 mmol/l (reference indicators 135-152), chlorine - 103,3 mmol/l (reference indicators 96-108), iron - 12.8 µmol/l (reference figures 9-30,4), calcium - 2,31 mmol/l (reference indicators of 2.15-2.50 each). According to the ultrasound of the pelvic organs from 14.06.05 revealed no pathology. When smear gram discharge from vagina from 14.06.05 - leukocyte up to 7 fields of view, isolated clusters of up to 20-25 groups of epithelial cells of the surface layers. The flora is represented by lactobacilli in moderation. When electroencephalography from 10.06.05 revealed cerebral changes with signs of dysfunction stem (at different levels) and diencephalic brain structures. When two-handed researched and developed the processes in the body of the uterus was normal consistency and magnitude palpation painless, tours are limited to adhesive structures in the area of the uterus. The left and right appendages sensitive, agile, pasty. Palpation of the walls of the pelvis painless on both sides.

Treatment began 09.06.05 was conducted 3 sessions of plasmapheresis with a small amount of plasmacyte through the day.

For 15-20 minutes until exposee blood into the cubital vein started plasmodesmata 6% solution gidroksietilirovannogo starch (Reportan") in the amount of 250 ml of Exfuze blood produced by puncture of the cubital vein in plastic containers "Gamecon 500" with anticoagulant-preservative, gleyzer. After thorough mixing of the blood was placed in a refrigerated centrifuge firm "Juan" (France) and centrifuged with a speed of 2500 rpm at 20°C for 20 minutes. Plasma was separated from the cell mass was removed with plasmacytoma. The remaining blood cells resuspendable in 150 ml of physiological solution and repusively the patient. During one session produced 3 blood sampling, depending on the patient, weight of the patient, portability procedures. During one session of plasmapheresis amount of exfuze plasma was 350 ml, 400 ml, 450 ml for 1-2-3 sessions respectively (30-40% CGO).

After the last reinfused blood cells of the patient physiological solution intravenously is trueno was slowly introduced in the same syringe antihomotoxic drugs: Tonsilla compositum 2.2 ml, Coenzyme compositum 2.2 ml, Mucosa compositum of 2.2 ml. of Such injections were performed 10 (3 injili immediately after plasmapheresis and then another 7 intravenous injection of the indicated composition through the day).

In addition, 24.08.05 daily girl got inside drugs Giacomel, NOx vomica-Homaccord, With Traumeel drops (10 drops of each drug in 100 ml of water 3 times a day for 1 month).

When two-handed study of the body of the uterus is of normal consistency and magnitude palpation painless. Appendages palpation were painless on both sides. Palpation of the walls of the pelvis painless on both sides. On EEG positive dynamics that showed improvement of metabolic processes in the brain cells. An ultrasound of the pelvic organs from 01.07.2005, pathology have been identified.

The patient was examined in a planned manner after 1 month (07.2005), 5 months (11.2005) and 9 months (03.2006), 1 year (06.2006), 1.5 years (12.2006), 2 years (06.2007) after treatment. Had no complaints, while two-handed study in the pelvis revealed no pathology and laboratory study of the pathology was not found.

This method of treatment was used for restorative treatment in 18 girls 10-18 years old, operated on for acute complicated FOTS is extreme diseases of the pelvic organs, which in the postoperative period was conducted antibacterial therapy. None of the observations was reported side effects and the formation of a chronic inflammatory process.

Thus, the proposed method of treatment gives a higher positive and lasting effect in comparison with the known method is quick and simple to implement.

The way restorative treatment of adolescents with acute secondary oophoritis who have undergone surgical interventions on the organs of abdominal cavity, located at the entrance to the pelvis, including postoperative antibiotic therapy and therapeutic plasmapheresis, characterized in that sequentially through the day, spend 3 sessions of plasmapheresis with a small amount of plasmacyte, after each plasmapheresis immediately intravenous Mucosa compositum 2.2 ml, Coenzyme compositum 2.2 ml, Tonsilla compositum 2.2 ml and then continue to enter through the day after the end of therapeutic plasmapheresis - a total of 10 injections of the indicated composition, optionally with the first day of therapy for 1 month is the inside of 10 drops 3 times a day Nux vomica-Homaccord, Giacomel, Traumeel S.



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention claims treatment system for diseases affecting mucosa condition, and including immune response modifier (IRM) selected out of imidazoquinolinamines, imidazopyridinamines, cycloalcylimidazopyridinamines condensed in 6 and 7 positions, imidazonaphthyridinamines, oxazoloquinolinamines, thiazoloquinolinamines, imidazoquinolinamines with bridge link between 1 and 2 positions, pharmaceutically acceptable salts of indicated substances, and applicator for IRM effect compound application on mucosa surface. The claimed system including IRM effect compound and applicator can be applied in treatment of diseases affecting mucosa condition, such as cervical dysplasia and cervical intraepithelial neoplasia.

EFFECT: IRM delivery to mucosa.

20 cl, 8 ex, 4 tbl, 19 dwg

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention concerns pharmaceutics, particularly method of obtaining solid formulations containing vardenafil hydrochloride trihydrate. Method involves processing of formulation containing vardenafil hydrochloride or its hydrate (modification) by humid gas with relative humidity from 35 to 100% until vardenafil hydrochloride trihydrate is formed. In addition, invention concerns solid formulation of vardenafil hydrochloride trihydrate obtained by the claimed method.

EFFECT: improved stability of formulations obtained, obtaining solid formulations in unified replicable form.

4 cl, 8 dwg, 8 tbl, 12 ex

FIELD: medicine; venereology.

SUBSTANCE: treatment of urogenital Chlamidia infection in women is ensured by subcutaneous introduction of betaendolysin dosed 7-8 ng/kg/day within 5 days, 5-6 days before menstruation, combined with antibacterial therapy prescribed 3-4 days before menstruation.

EFFECT: klendusity activation before physiological immunodeficiency and optimum for causative agent elimination.

2 ex

FIELD: medicine; obstetrics.

SUBSTANCE: treatment of chronic placental insufficiency is ensured by intravenous drop-by-drop introduction of Cytoflavine dosed 10 ml in 5% glucose solution 200 ml, 1-2 times a day throughout 5-10 days. Herewith twice every 3-5 days, Perftorane infusions are combined with inhalation of humidified 40% oxygen-air mixture through nasal catheter. Perftorane is dosed 0.75 ml/kg of body weight, infusion velocity is 15 drops/min.

EFFECT: normalised amount of amniotic fluid, lipid peroxidation in fetoplacental system, prolonged pregnancy to optimal delivery term.

15 tbl, 2 ex

FIELD: medicine; gynaecology.

SUBSTANCE: hemostatics and uterotonic agents are parenterally introduced. Previously folded intrauterine rubber balloon catheter with delivery and support in the form of tubular element rounded at distal end with length that is comparable to but not less than total length of uterine cavity and vagina is introduced into cavity of birth canal. Irrigation and drain tubes from elastic shape-holding material are located on external surface of balloon. Length of tubes exceeds length of tubular element for delivery and support of balloon catheter with possibility of exit beyond the limits of birth canal - from vagina. Distal ends of tubes are rounded with openings on the surface for contents outlet and collection. One of tubes is arranged with the possibility of connection with syringe for introduction of hemostatic into uterine cavity, other tubes are connected with reservoir for collection of drained liquid. Tubular element for delivery and support of balloon catheter is connected with reservoir for filling of balloon catheter with sterile liquid, the second tube installed in reservoir above liquid level is connected to manometer, and pump for pressure charging is located at its end. This device is located from entry to vagina to uterus bottom, fixing proximal end of balloon catheter with tubes in entry to vagina. Then sterile physiological solution is pumped into catheter by means of pump until visually controlled bleeding is arrested. After bleeding has been stopped, pressure value is fixed, then pressure changes are registered in filled balloon catheter, at that pressure rise is treated as restoration of uterus contractive activity, afterwards pulled pressure is reduced in successive steps down to fixed value. If pressure value in catheter drops, it is increased up to fixed value. In both cases fixed pressure of bleeding arrest is maintained for at least 30 minutes, reduction is carried out in successive steps by 10 mm of mercury column every 5-10 minutes. Hemostatics are introduced into uterine cavity by irrigation tube in appropriate doses, then all tubes are isolated for the time sufficient for creation of blood clot. If no bleeding takes place through drain tubes in process of stepwise pressure reduction, pressure is dropped, liquid is removed from balloon catheter, and it is withdrawn outside.

EFFECT: fast and efficient arrest of metrorrhagia by coverage of the whole area of possible bleeding and simultaneous additional effect at local hemostasis by introduction of medicines into uterine cavity.

2 cl, 3 dwg, 2 ex

FIELD: medicine; gynaecology.

SUBSTANCE: hemostatics and uterotonic agents are parenterally introduced. Previously folded intrauterine rubber balloon catheter with delivery and support in the form of tubular element rounded at distal end with length that is comparable to but not less than total length of uterine cavity and vagina is introduced into cavity of birth canal. Irrigation and drain tubes from elastic shape-holding material are located on external surface of balloon. Length of tubes exceeds length of tubular element for delivery and support of balloon catheter with possibility of exit beyond the limits of birth canal - from vagina. Distal ends of tubes are rounded with openings on the surface for contents outlet and collection. One of tubes is arranged with the possibility of connection with syringe for introduction of hemostatic into uterine cavity, other tubes are connected with reservoir for collection of drained liquid. Tubular element for delivery and support of balloon catheter is connected with reservoir for filling of balloon catheter with sterile liquid, the second tube installed in reservoir above liquid level is connected to manometer, and pump for pressure charging is located at its end. This device is located from entry to vagina to uterus bottom, fixing proximal end of balloon catheter with tubes in entry to vagina. Then sterile physiological solution is pumped into catheter by means of pump until visually controlled bleeding is arrested. After bleeding has been stopped, pressure value is fixed, then pressure changes are registered in filled balloon catheter, at that pressure rise is treated as restoration of uterus contractive activity, afterwards pulled pressure is reduced in successive steps down to fixed value. If pressure value in catheter drops, it is increased up to fixed value. In both cases fixed pressure of bleeding arrest is maintained for at least 30 minutes, reduction is carried out in successive steps by 10 mm of mercury column every 5-10 minutes. Hemostatics are introduced into uterine cavity by irrigation tube in appropriate doses, then all tubes are isolated for the time sufficient for creation of blood clot. If no bleeding takes place through drain tubes in process of stepwise pressure reduction, pressure is dropped, liquid is removed from balloon catheter, and it is withdrawn outside.

EFFECT: fast and efficient arrest of metrorrhagia by coverage of the whole area of possible bleeding and simultaneous additional effect at local hemostasis by introduction of medicines into uterine cavity.

2 cl, 3 dwg, 2 ex

FIELD: medicine; pharmacology.

SUBSTANCE: invention is related to the field of medicines, in particular to tetrahydroquinoline derivatives with common formula (I), where Y-X means C(O)-O, C(O)-NH, S(O)2-NH, NHC(O)-NH, NHC(S)-NH, OC(O)-NH; R6 stands for H, (1-6C)alkyl, 1- or 2-adamantyl(1-4C)alkyl, (3-9C)heteroaryl, (3-6C)cycloalkyl, (2-6C)heterocycloalkyl, alkylthio(1-4C)alkyl, phenyl(1-4C)alkyl, (3-6C)cycloalkyl (1-4C)alkyl, (2-6C)heterocycloalkyl (1-4C)alkyl, R8, R9 aminocarbonyl (1-4C) alkyl, R8, R8R9-amino (1-4C)alkyl, R8-oxycarbonyl (1-4C)alkyl, R8-oxy (1-4C)alkyl, R8-carbonyl (1-4C)alkyl or phenyl, not necessarily substituted with hydroxy, amino, halogen, nitro, trifluoromethyl, (3-9C)heteroaryl, (1- 4C)alkylcarbonylamino, (1-4C)alkylcarbonyloxy, (3-9C)heteroarylcarbonyloxy, (3-9C)heteroarylsulfonyloxy, (2-6C)heterocycloalkylcarbamoyl or diphenylamino.

EFFECT: modulating activity in respect to FSH receptor.

17 cl, 74 ex

FIELD: medicine; pharmacology.

SUBSTANCE: invention is related to the field of medicines, in particular to tetrahydroquinoline derivatives with common formula (I), where Y-X means C(O)-O, C(O)-NH, S(O)2-NH, NHC(O)-NH, NHC(S)-NH, OC(O)-NH; R6 stands for H, (1-6C)alkyl, 1- or 2-adamantyl(1-4C)alkyl, (3-9C)heteroaryl, (3-6C)cycloalkyl, (2-6C)heterocycloalkyl, alkylthio(1-4C)alkyl, phenyl(1-4C)alkyl, (3-6C)cycloalkyl (1-4C)alkyl, (2-6C)heterocycloalkyl (1-4C)alkyl, R8, R9 aminocarbonyl (1-4C) alkyl, R8, R8R9-amino (1-4C)alkyl, R8-oxycarbonyl (1-4C)alkyl, R8-oxy (1-4C)alkyl, R8-carbonyl (1-4C)alkyl or phenyl, not necessarily substituted with hydroxy, amino, halogen, nitro, trifluoromethyl, (3-9C)heteroaryl, (1- 4C)alkylcarbonylamino, (1-4C)alkylcarbonyloxy, (3-9C)heteroarylcarbonyloxy, (3-9C)heteroarylsulfonyloxy, (2-6C)heterocycloalkylcarbamoyl or diphenylamino.

EFFECT: modulating activity in respect to FSH receptor.

17 cl, 74 ex

FIELD: medicine; pharmacology.

SUBSTANCE: invention is related to the field of medicines, in particular to tetrahydroquinoline derivatives with common formula (I), where Y-X means C(O)-O, C(O)-NH, S(O)2-NH, NHC(O)-NH, NHC(S)-NH, OC(O)-NH; R6 stands for H, (1-6C)alkyl, 1- or 2-adamantyl(1-4C)alkyl, (3-9C)heteroaryl, (3-6C)cycloalkyl, (2-6C)heterocycloalkyl, alkylthio(1-4C)alkyl, phenyl(1-4C)alkyl, (3-6C)cycloalkyl (1-4C)alkyl, (2-6C)heterocycloalkyl (1-4C)alkyl, R8, R9 aminocarbonyl (1-4C) alkyl, R8, R8R9-amino (1-4C)alkyl, R8-oxycarbonyl (1-4C)alkyl, R8-oxy (1-4C)alkyl, R8-carbonyl (1-4C)alkyl or phenyl, not necessarily substituted with hydroxy, amino, halogen, nitro, trifluoromethyl, (3-9C)heteroaryl, (1- 4C)alkylcarbonylamino, (1-4C)alkylcarbonyloxy, (3-9C)heteroarylcarbonyloxy, (3-9C)heteroarylsulfonyloxy, (2-6C)heterocycloalkylcarbamoyl or diphenylamino.

EFFECT: modulating activity in respect to FSH receptor.

17 cl, 74 ex

FIELD: medicine; gynaecology.

SUBSTANCE: solution of photosensitiser "Photoditazine" is introduced intravenously in dose of 0.5-1.0 mg/kg. As soon as 1.5-2 hours have elapsed after infusion, intrauterine light guide is inserted into uterine cavity, and uterine cavity is radiated with laser in fractions at wave length of 662 nm and density of supplied energy of 200 - 350 J/cm2 for 30-45 minutes. After uterine cavity has been radiated, cervical channel is radiated in fractions by laser with application of cylindrical light guide at wave length of 662 nm and density of supplied energy of 200-250 J/cm2 for 15-30 minutes.

EFFECT: highly selective removal of functional and basal layer of uterus mucous layer.

3 ex

FIELD: medical engineering.

SUBSTANCE: device has membrane, blood compartment for making blood/plasma circulate, hemodialysis compartment for making hemodialysis solution circulate. Blood/plasma compartment and hemodialysis compartment are separated. The first electrode is introduced into the cartridge placed directly in the blood/plasma compartment or in its inlet part. The second electrode is of opposite sign and placed directly in the hemodialysis compartment or in cartridge inlet part.

EFFECT: enhanced effectiveness in transferring molecules or substances from blood/plasma to hemodialysis solution composed according to patient requirements.

7 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: invention relates to a method for preparing concentrated acid component used in hydrocarbonate hemodialysis in carrying out the extracorporal blood treatment in treatment of patients with acute and chronic renal insufficiency. Method involves forming dry salts sets according to prescription. Salts are dissolved in purified water at room temperature followed by preparing concentrated acidic component for hydrocarbonate dialysis. Then prepared component is added to the device "Artificial kidney" wherein component is diluted. Prepared acidic component contains the following components, mole/l: sodium chloride (NaCl), 137.3-140.3; calcium chloride (CaCl2 x 6 H2O), 0.5-1.0; potassium chloride (KCl), 0.3-4.0; glucose, g/l, 1.0-5.0; sodium acetate, 0.3; citric acid (C6H8O7), 0.1-0.7; succinic acid (C4H6O4), 0.1-1.1. Invention provides simplifying method in preparing acidic component and composition of acidic component based on change of acetic acid for dry reagent - succinic acid and citric acid that shows positive effect on dynamic process in carrying out hemodialysis, decreases number of complications as acidosis that arise in adding significant amounts of acetate ions in body, reducing risk in transporting salt sets containing solution of concentrated acetic acid.

EFFECT: improved and simplified preparing method.

2 ex

FIELD: medicine.

SUBSTANCE: method involves extracorporally uniting immiscible recipient and patient blood flows in transfusion mode in direct and reverse immiscible flows, concurrently taking blood from recipient and patient veins. The blood flows are separated with semipermeable blood-filtering column membrane. The taken blood is returned later into recipient and patient veins.

EFFECT: enhanced effectiveness in restoring incretory relations in general organs and tissues metabolism balance.

3 cl, 2 tbl

FIELD: medicine, anesthesiology-resuscitation, neuropathology.

SUBSTANCE: it is necessary to carry out oxygenotherapy, intravenous injection of physiological solution and those of hydroxyethyl starch. Also, it is important to inject beta-blocators, heparin, opioids, alpha2-adrenoagonists, antagonists of NMDA-receptors, glucocorticoids, nimotope, actovegin. One should prescribe early enteral nutrition. On stabilizing the parameters of cardio-vascular and respiratory systems it is necessary to inject intravenously the solution of mildronate 10% - 10 ml for 10-14 d once daily and the intake of rheaferon-EC-lipint at the dosage of 10000-15000 U/kg or through a gastric probe for 5 d. The innovation enables to efficiently prevent pneumonia due to adequate immunotherapy of the above-mentioned pathology.

EFFECT: higher efficiency of prophylaxis.

3 ex, 1 tbl

FIELD: clinical hematology.

SUBSTANCE: proposed cartridge is constructed in the form of single device allowing multistep hemofiltration and hemodiafiltration, wherein, disposed in the same cartridge, first hemodiafiltration step has first filter elements and second hemofiltration step has second filter elements. Cartridge can be used in a system with intermediate, preliminary or consecutive dilution.

EFFECT: increased degree of filtration and efficiency in removal of toxins.

26 cl, 3 dwg

FIELD: medical engineering.

SUBSTANCE: device has the first canal having gas-impermeable membrane as wall part. Reservoir communicates with the first canal and is intended for storing oxygen. The first inlet opening serves for introducing anesthesia gas directly into the first canal. The reservoir allows oxygen to flow into the first canal from the reservoir when the first canal pressure is lower than in comparison to the ambient medium pressure.

EFFECT: reduced respiratory gas overhead.

17 cl, 4 dwg

FIELD: medicine, toxicology, resuscitation.

SUBSTANCE: one should introduce preparations due to transmembranous wound dialysis: from the 1st to the 3d d after chemical burn one should introduce dialyzate of the following composition: solution of rheopolyglukin 100 ml, 2%-lidocaine 4 ml, 1%-dioxidine 10 ml, dexamethasone 8 mg, and from the 4th to the 7th d of the disease mentioned it is useful to introduce dialyzate including: solution of rheopolyglukin 100 ml, 1%-dioxidine 10 ml, 5%-ascorbic acid 5 ml; moreover, transmembranous wound dialysis should be carried out once daily. The present innovation enables to conduct local treatment of chemical esophageal burns due to taking into consideration the phases of wound process of burn trauma that, in its turn, favors for alleviating and accelerating clinical flow of the disease in question and preventing the development of complications.

EFFECT: higher efficiency of therapy.

1 cl, 2 ex

FIELD: medicine, obstetrics, perinatology.

SUBSTANCE: therapy course consists of 4 stages: during the first stage one should indicate dalargin per 2 mg intramuscularly daily for 10-d-long course, 1 mo later, at the second stage it is necessary to apply polyvalent immunoglobulin per 25 ml intravenously by drops every other day thrice, 1 mo later at the third stage one should indicate thymalin per 1 ml intramuscularly daily for 10-d-long course and 1 mo later at the fourth stage one should perform discrete plasmapheresis every other day thrice. The innovation provides such immunocorrection that enables to remove herpes virus and excludes fetal abortion.

EFFECT: higher efficiency of therapy.

3 ex, 1 tbl

FIELD: medical engineering.

SUBSTANCE: device has line for taking blood and returning erythrocytic mass with air trap, line for supplying anticoagulant and hemodilution agent and forceps. Dosing member is mounted on anticoagulant line being chamber manufactured from plastic film-like material having an opening on one side for anticoagulant to be supplied and another opening for discharging it. Pump segment is set on line collecting blood as a flexible tube having an opening for supplying blood and another opening for delivering the blood to plasma filter connected to pressure control line having valve filter mounted thereon. Unit for supplying drug and discharging air is mounted on the air trap. It is manufactured as a tube with clamp.

EFFECT: enhanced effectiveness in applying continuous and safe plasmapheresis.

1 dwg

Artificial kidney // 2245724

FIELD: medical engineering.

SUBSTANCE: device has reference voltage source, comparison unit, unit for analyzing signs, unit for selecting module, analog-to-digital converter, NOT-gate, clock pulse oscillator, 3 AND-gates of the first and the second group, sodium concentration gage (in patient blood), syringe, outgoing arteriovenous shunt, the first and the second connection members, blood circuit, hemodialysis unit, blood unit, semipermeable membrane, compartment for collecting dialysis liquid, discharge line, means for collecting wasted dialysis liquid and ultrafiltrate, weighing unit, movable supporting member, incoming arteriovenous shunt, inlet line, unit for measuring discharge rate, dialysis component reservoir, clamp and sterile connection member. The dialysis component reservoir has the first, the second and the third reservoir, dosing units of the first and the second group, controlled valves of the first and the second group and mixer unit.

EFFECT: enhanced effectiveness in selecting individual sodium concentration in dialysis liquid; wide range of functional applications.

2 cl,2 dwg

FIELD: medicine.

SUBSTANCE: during acute period of purulent meningitis (BPM) additionally, Wobenzyme is prescribed in daily dose 1 tablet per 6 kg of body weight 3 times a day within 10 days simultaneously with antibacterial therapy. Treatment of meningococcal and pneumococcal meningitis is ensured with prescribed benzylpenicillin in daily dosage 300 thousand units/kg. Haemophilic meningitis is treated by prescribed Ceftriaxone in daily dose 100 mg/kg.

EFFECT: higher efficiency of BPM specific therapy due to Wobenzyme ability to improve antibiotic penetration through blood-brain barrier and transport to inflammatory tissue and autointoxication reduction.

3 cl, 2 tbl, 4 ex

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