Method of treating secondary immunodeficiency in children in post-operative period in case of severe craniocerebral injury, combined with injuries of musculo-sckeletal system
SUBSTANCE: for treatment of traumatological and neurosurgical diseases ceruloplasmin is included in treatment scheme. Single daily introduced dose is 6-8 mg/kg, depending on child's age, per 200 ml of 0.9% of sodium chloride solution. Medication is introduced by intravenous drip at rate 20-25 drops a minute for not less than 12 days.
EFFECT: efficient treatment of secondary immunodeficiency with minimal side effects of ceruloplasmin treatment.
The present invention relates to medicine, namely to Pediatrics, and can be used in the practice of the treatment of trauma and neurosurgical diseases in children for the treatment of secondary immunodeficiency.
Severe traumatic brain injury, combined with injuries of the musculoskeletal system, leads to the simultaneous loss of a significant volume of circulating blood in the body is disturbed transport of iron, activates the processes of lipid peroxidation, altered neuropeptide regulation of the immune response and, as a consequence, is formed immunosuppression (1; 2; 3). According to our observations in patients after 48 hours from the moment of injuries occur most expressed human immune protection.
Important in the regulation of the immune status is tissue and serum enzyme ceruloplasmin (CP), which is involved in oxidative reactions with antioxidant and immunomodulatory properties(4; 5; 6; 7; 8; 9).
Despite the fact that at the present time, we have accumulated rich clinical experience in the diagnosis and treatment of secondary immunodeficiency, are not well developed corrective actions for this condition. The clinicians have difficulties with supervision of children with severe traumatic brain and concomitant injuries, when encountered in the postoperative p is the period of secondary immune deficiency significantly affects the results of the treatment. Often immunodeficiency States are saved in children even after several months from the time of the injury, which requires additional monitoring of physicians outpatient network and is the cause of re-hospitalization and additional rehabilitation measures.
Currently, the most common method of correction of immunodeficiency, including children, is therapy of drugs on the basis of human immunoglobulins. The transfusion of human immunoglobulin does not always occur without attaching severe side effects. These include: vomiting, headache, chills and fever, changes in neurological status until aseptic meningitis (15).
For the prototype of the present invention, the selected correction method of secondary immunodeficiency in children, including the introduction of drugs, namely Pentaglobin (drug acting which is a human immunoglobulin) (15). The method consists in the fact that this drug was administered to 3-5 ml/kg of body weight intravenously for 10 hours over 3 days, but the high cost of Pentaglobin and technical complexity of its production (not done in Russia) do not allow at present widely to implement it in practical medicine, which led to the search for the new ways of treatment of secondary immunodeficiency in children in particular with severe traumatic brain injury, combined with injuries of the musculoskeletal system.
The task of the invention is given: the development of a method of treatment of secondary immunodeficiency in children with the use of drugs that are highly efficient correction of secondary immunodeficiency at low cost and at the same time characterized by technical simplicity of production.
This object is achieved in that in claim 1 of the claims as drugs used ceruloplasmin, which is administered in a daily dose of 6-8 mg/kg of body weight, depending on age and body weight of the child, in 200 ml of 0.9% solution of sodium chloride intravenous infusion at a rate of 20 drops per minute for 12 days.
Ceruloplasmin is a multifunctional glycoprotein α2-globulin fraction of blood serum, which belongs to the class of metallothionen blue oxidase (10). For the first time in its pure form this enzyme was obtained in 1948 Holmberg. It is established that a small amount of ceruloplasmin is synthesized in the brain tissue (11). In the absence of ceruloplasmin in the Central nervous system decreases the number of dopaminergic neurons, is the accumulation of iron, activating the processes of free radical peroxide Oka the population (12; 13). The authors emphasize that the antioxidant effect of drugs on the basis of ceruloplasmin may be used in the correction of various neurological and neurosurgical pathology.
The main functions of ceruloplasmin in the body is to transport copper, mobilization of serum iron for blood formation, antioxidant activity and inhibition of lipid peroxidation, involved in acute phase reactions, regulation of the level of biogenic amines in the brain. From 1961 initiated clinical application of ceruloplasmin in adults background mutilating surgeries for tumors in the treatment of traumatic and posthemorrhagic shock, radiation sickness, burns, septic pathology (14).
In the present invention first shown the principal possibility of application of ceruloplasmin in children for the treatment of secondary deficits induced severe damage. Previously ceruloplasmin in the treatment of neurosurgical diseases were not applied. A special study of the authors of this application showed the possibility of using this drug in the practice of the treatment of children of different ages from 7 to 18 liters in the postoperative period with severe traumatic brain injury, combined with injuries of the musculoskeletal system. Developed conditions (the eskers, circuit, method of administration), subject to which the application of ceruloplasmin in children causes no side effects at high clinical results of the correction of secondary immunodeficiency. In particular, the authors of this application for the first time found that, in practice, child with severe concomitant injuries are the most effective: 1) single daily dose of 6-8 mg/kg based on body weight and age of the child (in accordance with our clinical observations a dose of less than 6 mg/kg did not provide the necessary clinical effect, and higher than 8 mg/kg a dangerous allergic reactions in the form of increase of body temperature up to subfebrile figures); 2) intravenously at a rate of 20-25 drops per minute as, according to our clinical observations, the increase in the rate of infusion above 25 drops per minute resulted in 5 patients to cephalgia on the background of a sharp increase intracranial pressure (earlier in practice, treatment of ceruloplasmin in adults was used intravenous speeds 30-36 drops per minute, and in patent No. 2268745 from 27.01.2006 "Method of prevention and / or treatment of anemia in children (options)" we suggest the introduction of ceruloplasmin at 40 drops per minute); 3) the use of isotonic sodium chloride (in adult practice is used as isot the technical solution of sodium chloride, and 5% glucose solution), because the use of infusion of ceruloplasmin in children with the use of 5% glucose caused by our observations, the increase in body temperature to 38° (3 patients). The use of isotonic R-RA sodium chloride justified us patent No. 2268745 from 27.01.2006 "Method of prevention and / or treatment of anemia in children (options)".
Developed and substantiated scheme is the introduction of ceruloplasmin in children for the treatment of secondary immunodeficiency after severe head injury.
Thus it is shown that for the treatment of secondary immunosuppression ceruloplasmin children must be entered for at least 12 days after injury and surgery. This is justified as follows: we studied the different schemes under the control of the results of the analysis of indicators of cellular immunity in blood plasma and obtained the following results: introduction within 5-7 days after injury and (or) operation is not enough (the effect is worse than 12 days prior to surgery); introduction after surgery for more than 12 days did not give further rise effect, i.e. after the operation optimally 12 days of injections). The treatment is not less than 12 injections can provide optimal immune-stimulating effect.
The authors of the application as a result of clinical studies have established that on the 2nd day after injury patients formiruet the Xia pronounced immunosuppression, which later becomes the cause of many complications and significantly worsens the prognosis.
The proposed method is as follows:
1. For the treatment of children of secondary immunodeficiency in the postoperative period with severe traumatic brain injury, combined with injuries of the musculoskeletal system, take a vial liofilizirovannogo ceruloplasmin, containing 100 mg, throw the preparation of 5 ml of 0.9% sodium chloride solution until complete dissolution of the powder and a solution pale blue color. This solution is dissolved in 200 ml of 0.9% sodium chloride solution and injected intravenously at a rate of 20-25 drops per minute. Daily dose is calculated from 6-8 mg/kg depending on age and body weight of the child. The drug is administered for at least 12 days after the injury and surgery.
An example of a specific implementation of the method is given in the form of extracts from the history.
Statement of the case history No. 10386 for 2003
Patient PV, 12 HP, Diagnosis: Severe concomitant traumatic brain injury. Brain contusion 1 degree open comminuted fracture of both bones of the left forearm in the bottom third with displacement of bone fragments, usilenno-laceration of the lower third of the left forearm with the rupture of the tendons of the flexors and extensors of the wrist, usilenno-wanye wounds of both elbow joints, right parieto-occipital region.
The boy came after autotray 22.08.03 in serious condition, state of consciousness - deep stunned, disturbed severe pain due to a significant traumatic injuries, wounds were badly contaminated with gasoline and earth, it was noted bleeding.
When admission alone made the CBC-Hb 80 g/l, er 2,9 center of 0.82, a hematocrit of 21%. Among biochemical parameters - about. protein 74,2 g/l, albumin was 59.9%, α1-globulins of 4.4%, α2-globulins of 11.4% (above the norm), β-globulins 8,3, γ-globulins of 16.0%. 24.08.03 performed studies of cellular and humoral immunity: CD3 (total T cells) 32% (average 72±7), CD4 (T-helper) 27% (average 39±5), CD8 (T-suppressor) 15% (average 23±4), CD20 (b-lymphocytes) 13% (norm 11-16), HLA-DR (activated T cells) 11% (average 14±7), CD16 (natural killer cells) 10% (average 12±6), immunoregulatory index of 1.8 (rate of 1.05 and 2.1), IgG 23,5 g/l (normal 12,1±2,61), IgA 2,13 g/l (normal range of 1.46±0,38), IgM 1.5 g/l (normal 1,04±0,46). Thus, the patient noted a pronounced secondary cell immunodeficiency and increased levels of IgG, which is an adverse prognostic sign in terms of the formation of purulent-septic complications.
After surgical interventions on the reposition of bone fragments, and the rehabilitation of infected wounds, antibiotic therapy and in Usinas programs boy received infusions of ceruloplasmin liofilizirovannogo for injection at a dose of 8 mg/kg in 200 ml of 0.9% solution of sodium chloride daily for 12 days at a rate of 20 drops per minute.
By the 12th day of treatment the patient's condition improved significantly, disappeared headaches, muscle pain, appetite, purulent discharge from the wound was not observed secondary healing. In General, the analysis of blood HB 112 g/l, er 3,5, CTC 0,96. Cellular immunity total T cells (CD3) 74%, T-help./inductors (CD4) 44%, T-cytotox. cells (CD8) 31%, b-cells (CD20) 6%, (HLA-DR) Asset. CL 15%, (CD16) natures. killers 12%, immunore. index of 1.4 (all indicators of cellular immune defense within limits), IgG of 12.6 g/l, IgA 1.88 g/l, IgM 1.5 g/L.
Thus, the inclusion in the complex therapy of the drug, "Ceruloplasmin liofilizirovanny for injection" has greatly improved the treatment outcome of the patient.
In the clinic of pediatric surgery GOU VPO "Nigga" on the basis of the neurosurgical Department of the state institution "the CLINIC" the treatment of immunodeficiency in 15 patients with severe traumatic injuries in age from 7 to 18 years old (all boys). Among these, 2 were closed craniocerebral injury with brain injury 2nd degree and epidural hematoma, 2 - brain injury 2nd degree with a depressed fracture and compression of brain structures, 9 - brain contusion 1-3-th degree in combination with fractures of long tubular bones. 2 patients were treated over a compression-comminuted fractures of the spine dysfunction of pelvic organs. Patients received the intravenous infusion of the drug within 12 days from the time of admission to hospital and surgical scheme 1 proposed method.
Analysis of cellular immunity in children after 48 hours from the time of injury revealed signs of immunosuppression: the percentage of total T-lymphocytes (CD3) was reduced in 2 times, T-helper cells (CD4) - by 35.3%, b-lymphocytes (CD20) by 19%. Over the next 12 days in hospital patients received infusions of ceruloplasmin in the above mentioned doses. The laboratory analysis of blood for 10-12 days of treatment revealed significant differences in children treated with the introduction of ceruloplasmin and the control group (15 patients). When using ceruloplasmin percentage concentration of total T-lymphocytes (CD3) increased 1.7 times, and T-helper cells (CD4) - 28%. At the same time, the analysis immunograms children in the control group showed a further deepening of secondary immunodeficiency: a decrease in the total T-lymphocytes (CD3) 2.3 times, T-helper cells (CD4) 1.6 times, T-killer cells (CD8) in 1,4 times, b-lymphocytes (CD20) to 1.27 times. Clinically the patients of the main group were less pronounced manifestations of cerebral symptoms (nausea and vomiting), there was no purulent complications, quickly restored the function of the pelvic organs. On the contrary, in 3 children in the control group appeared purulent-septic complications (furunculosis, destructive pneumonia, abscess of the abdominal wall).
Thus, the use of ceruloplasmin in children according to the variant of the proposed method is allowed to obtain a high clinical results. When this reached delivered in the present invention task: ceruloplasmin is a tool that has a low cost (645 rubles), unlike Pentaglobin used in the method prototype (more than 10000 rubles), also unlike Pentaglobin ceruloplasmin is characterized by the technical ease of manufacturing. This result is achieved in that the raw material used alcoholic precipitate IY-1 in blood plasma, after receiving the homogenate conduct heat denaturation of protein impurities, conduct sorption homogenate using DEAE-Sephadex, washed sorbent from unbound proteins elute ceruloplasmin, precipitated impurities with chloroform, and ethanol precipitated the desired product ethyl alcohol, dissolve the target residue, conduct sterilizing filtration, pasteurization, filling and freeze drying of ceruloplasmin.
The introduction stage of pasteurization can improve virological safety of the drug.
1. Andreev, A.A., Kartavenko V.I. Golikov, P.P., Davydov BV, Nikolaev POSTGRADUATE Dynamics components of lipid peroxidation and antioxidant system in patients with severe concomitant injuries. // Questions of medical chemistry. - 1998. - T, No. 5. - C-494.
2. Kolesnikov I.S., Lytkin M.I., Pleshakov V.T. Autotransfused blood and its components in hir is rgii. - L.: Medicine, 1979. - 216 C.
3. Gordon M.S. Managing anemia in the cancer patient: old problems, future solutions. // The Oncologist. - 2002. - V.7. - P.331-341.
4. Katsunuma H. Clinical experience with ceruloplasmin on aplastic anemia. // Jap. J. Clin. Med. - 1961. - V 19. - P.424.
5. Arimori S. Treatment of aplastic anemia, with special reference to ceruloplasmin. // Jap. J. Clin. .. Med. - 1966. - V.43. - P.1897.
6. Here I.V., Black, VA, NICHOLAS Berlin, Sanin O.L., Baraboi, VA, staroselskoe IV, Korobko V.B. have been, Kamyanets L.Y., Yaremenko L.Y. Application of ceruloplasmin in combination with adjuvant chemotherapy in cancer of the stomach. // Medical business. - 1991. No. 3. - P.24-27.
7. Zakirova A.N., Zakirova A.D. the Influence of antioxidants on lipid peroxidation, blood rheology and for angina. // Health Bashkortostan. - 1999. No. 2. - P.67-70.
8. Vasiliev V.B. have been, Kachurin A.M., Rocco R.P., Beltramini M Spectral studies of the active site of ceruloplasmin deleting and restoring him of copper ions. // Biochemistry. - 1996. - T, No. 2. - S-307.
9. Seshadri V., P.L. Fox, C.K. Mukhopadhyay Dual role of insuline in transcriptional regulation of the acute phase reactant ceruloplasmin // J. Biol. Chem. - 2002. - V.277. - P.27903-27911.
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11. B.N. Patel, David S. A novel glycosylphosphatidylinositol-dialog form of ceruloplasmin in expressed by mammalian astrocytes. // J. Biol. Chem. - 1997. - V.272. - P.20185-20190.
12. B.N. Patel, R.J. Dunn, Jeong S.Y., Zhu Q., Julien J.-P., David S. Ceruloplasmin regulates iron levels in the CNS and prevents free radical injury. //J. Neurosci. - 2002. - V.22. - P.6578-6586.
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Treatment of secondary immunodeficiency in children with severe traumatic brain injury, combined with injuries of the musculoskeletal system, which includes the introduction of medications, characterized in that as the medications used ceruloplasmin, which is administered in a daily dose of 6-8 mg/kg of body weight, depending on the age of the child, in 200 ml of 0.9%sodium chloride intravenous infusion at a rate of 20-25 drops per minute for at least 12 days.
SUBSTANCE: invention refers to medicine, namely to gastroenterology and can be used for acute destructive pancreatitis treatment. Method is ensured as follows. 1% glutoxime solution 1 ml in incubated with whole autoblood 20 ml within 30 minutes to be injected intravenously. The regimen is 5 daily sessions.
EFFECT: method allows for lowered immodeficiency condition associated with acute destructive pancreatitis and for higher clinical effectiveness ensured by effecting metabolic and energy processes in immunocompetent cells by glutoxime incubated with autoblood.
3 tbl, 1 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention concerns pharmaceutics and development of new medicine based on interferon for treatment of infection and inflammatory diseases of periodontium and musculoskeletal system Substance of invention involves medicine containing human recombinant alpha and/or beta and/or gamma type interferon, substances from chondroprotection group -chondroitin sulfate and glucosamine, stimulating connective, cartilage and bone tissue and collagen synthesis and regeneration, preventin indicated tissue and collagen destruction due to collagenase, elastase and hyaluronidase activity suppression, as well as antibacterial and formation components with auxiliary substances. Complex medicine is made in the form of gel, ointment, cream or film.
EFFECT: enhanced efficiency, expanded action range of medicine.
6 cl, 11 ex
SUBSTANCE: invention refers to medicine, specifically to otorhinolaryngology, and is intended for determination of indications for differential therapy in sickly children (SC) suffering from lymphoepithelial pharynx ring pathology. Method is implemented as follows. Operating or biopsy material of lymphoepithelial pharynx ring is analysed for system and local immunity indices. If system and local immunity indices are below normal, system and local immune-response modulating agents are introduced. If system immunity indices only are below normal, system immune-response modulating agents only are introduced. If local immunity indices only are below normal, local immune-response modulating agents only are introduced. If system and local immunity indices are within normal limits, antiinflammatory therapy is applied.
EFFECT: possibility for estimation of immune system state in SC and selection of pathogenetically valid treatment regimen.
3 tbl, 4 ex
SUBSTANCE: for preventive vaccination, vaccine injection is preceded with Tilorone therapy. Tilorone is introduced once a day according to dosage regimen as follows: 1st day - 250 mg, 2nd day - 125 mg, further triduan - 125 mg. Course doze is at least 1250 mg.
EFFECT: higher efficiency of preventive vaccination ensured by higher longevity of protective antibody titre and lower rate of postvaccinal complications due to presented maximal immunomodulatory properties of Tilorone introduced at the specified regimen.
FIELD: medicine; pharmacology.
SUBSTANCE: application of D-glucoronic acid as agent with ability to stimulate Th1-dependent type of immune response.
EFFECT: wider arsenal of agents with immunopotentiating activity.
2 tbl, 2 ex
FIELD: medicine; pulmonology.
SUBSTANCE: treatment of bronchial asthma, either intermittent or mixed of mild severity level is ensured with introduction of anti-inflammatory preparations being labrocyte stabilisers, combined with introduction of immunomodulators Polyoxidonium and Galavit. Herewith specified immunomodulators are introduced sequentially according to the certain schedule.
EFFECT: higher efficiency of treatment due to normalisation of immune system function and structural restoration of bronchi mucous membrane.
FIELD: chemistry; pharmacology.
SUBSTANCE: present invention relates to mono-sodium salt 5-[[(2,3-difluorophenyl)methyl]thio]-7-[[2-hydroxy-1-(hydroxymethyl)-1-methylethyl]amino]thiazole[4,5-d]pyrimidine-2(3H)-on as a modulator of the activeness of chemokine receptors, method of obtaining it and pharmaceutical composition on its basis, and also its application in production of medicinal agents.
EFFECT: obtaining compounds, which can find application in treatment of diseases mediated by chemokine receptors, such as asthma, allergic rhinitis, COPD (chronic obstructive pulmonary disease), inflammatory bowel disease, osteoarthritis, and rheumatoid arthritis.
10 cl, 2 ex
SUBSTANCE: declared is nonspecific immunotherapy agent containing embryonic antitumor modulator (EATM) as active agent and pharmaceutically acceptable carrier. EATM is made of embryonic substances by cryodestruction, extraction and sedimentation in spirits of increasing concentration and contains hyaluronic acid complex, tumour-associated antigens of normal embryogenesis. Agent can be produced in the form of solution, liniment, cream, tooth paste.
EFFECT: it is possible to use as highly effective agent for nonspecific immunotherapy.
SUBSTANCE: declared is application of embryonic antitumour modulator (EATM) as agent of antimetastatic action. EATM is made of embryonic substances by cryodestruction, extraction and precipitation in alcohols of increasing concentration and contains proteoglycan complex of hyaluronic acid, tumour-associated antigens of normal embryogenesis.
EFFECT: provides antimetastatic action.
SUBSTANCE: oral introduction of monoacetyldiacylglycerin derivatives detains development of hamster's induced cancer by activation of lymphocytes, monocytes and dendritic cells, as well as apoptosis induction of cancer cells owing to intensified cytotoxicity of immune cells in relation to cancer cells. Besides, induction of septic shock at mice is accompanied with shown 100% survival rate even in 120 hours, reached by immunity control and suppressing apoptosis effect. Monoacetyldiacylglycerin derivatives according to this invention can be effectively applied as agent for sepsis and cancer treatment and as healthy food preventing cancer or autoimmune diseases.
EFFECT: discovers application of monoacetyldiacylglycerin derivatives extracted from antler as agent suppressing cell abnormality resulted from autoresponse.
11 cl, 16 dwg, 11 ex, 6 tbl
SUBSTANCE: invention refers to medicine, namely to physiotherapy. Treatment mode includes physiotherapy combined with nonsteroid antiinflammatory pharmacotherapy. The patient while lying on back is exposed to pulse magnetotherapy within a projection of anterior knee joint within 10 minutes. Then the action contrast temperatures and low-frequency ultrasound are combined with injection of protein-degrading enzyme Chymopsinum into a projection of superior torsion of knee joint. The course includes 10 procedures.
EFFECT: method improves microcirculation and reduces congestions in knee joint due to higher lymphatic and venous drainage and arterial inflow to the whole knee joint.
9 tbl, 1 ex
SUBSTANCE: invention concerns ophthalmology and is intended for treatment of patients with clottage of central vein of retina. Subtotal vitrectomy is spent. After excision of a vitreous body, the vitreous cavity is filled with air, entering a solution of the recombinant prourokinase on the retina in a projection of an optic disk in the amount of 0.5 ml 1500-2000 ME for 15-20 minutes then the rest of the preparation is washed away. After that the handpiece of the vitreotome is established over an optic disk and, in an aspiration regimen, at value of vacuum of 200-300 mm hg within 1 minute the gradient of pressure in the field of a trellised plate is alternately framed. Then again the vitreal cavity is filled with air and the recombinant prourokinase in the same volume 500-1000 ME is repeatedly entered, and the patient is located in a prone position for 2 hours.
EFFECT: method allows to provide fast penetration of clot-busting drug in a lumen of the central vein of retina and to carry out high-grade lysis of thrombus at level of a trellised plate with simultaneous partial destruction of thrombus and disturbance of its intimate communication with vascular wall.
1 dwg, 1 ex
SUBSTANCE: invention concerns medicine, particularly media of surfacial wound and burn treatment, and can be applied in surgery, traumatology, therapy, ophthalmology, veterinary and adjoining fields. Wound healing medium is superexpanding polymer matrix including collagenase in amount of 1-10 wt % of matrix weight. Superexpanding polymer matrix is a matrix obtained by copolymerisation of at least two monomers of group including maleic, crotonic and acrylic acids and/or their derivatives in the presence of binding agent.
EFFECT: efficient wound healing agent viable for composition standardisation.
5 cl, 3 tbl, 4 ex
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.
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
FIELD: medicine; ophthalmology.
SUBSTANCE: after carrying out of photorefractive keratectomy (PRK), at revealing of complication in the form of a subepithelial crape, carry out lymphotropic therapy by performance of pterygopalatine blockades (PPB) course of 4-6 procedures, with an interval in day, with use of the medicinal admixture containing: 30-50 mg of lidocaine, 16-32 un of lydasums, 2-4 mg of histochrome, 0.5-1.0 mg of dalargin. The pterygopalatine blockades are carried out on the side of the damaged eye that provides fast entering and accumulation of medicinal substances in lymphatic region of an orbit.
EFFECT: increase of treatment efficiency.
FIELD: medicine; ophthalmology.
SUBSTANCE: subtotal vitrectomy is carried out. After excision of a hyaloid, retinotomy of hemorrhage is carried out and vitreal cavity is filled with air. On the retina in the hemorrhage dimension recombinant prourokinases "gemaza" solution is injected in the amount of 0.3-0.5 ml 1500-2000 ME for 15-20 minutes and liquid blood fraction is evacuated from under the retina. The rest of the preparation is washed away. In case of incomplete excision of blood from under the retina, the vitreal cavity is filled with air again and recombinant prourokinases is repeatedly injected in the same volume of 500-1000 ME. Air is replaced by aeriform perfluorineorganic bond. After the operation the patient is placed in "on back" position for 2 hours, and then in "face downwards" position for 1-3 days. The method allows to carry out valid and accelerated fibrinous clot lysis which makes a basis of hemorrhage.
EFFECT: termination of mechanical fibrin influence and liquidation of toxic influence of decomposition product of formulated blood elements on retina neuroepithelium and pigmental epithelium with minimisation of retina mechanical trauma during surgical intervention.
2 cl, 2 dwg, 1 ex
FIELD: medicine; oncology.
SUBSTANCE: during a course of chemotherapy administer sodium enoxaparin to the patient daily in a dosage of 40 mg a day subcutaneously and in addition, preparation of system enzymotherapy Vobenzyme in a dose of 3 tablets 3 times a day perorally.
EFFECT: potentiation of anticoagulate effect of low-molecular heparins, preventive maintenance of thrombotic complications for the account of lysis of fresh micro and macrothrombuses, prevention of formation of new thrombuses and reduction of microinnidiation process.
FIELD: medicine; dermatology.
SUBSTANCE: spend mesotherapy of the stretch marks area with an admixture of preparations the tsel-T and kutis-kompozitum at 1:1. Carry out injections immediately in area of dermal defects on 0.1 ml of a solution through every 2-3 mm. Then perform phonophoresis of Lydasums in the stretch mark area within 10-15 minutes. Alternate the specified procedures in day with carrying out of applications of cosmetic clay on the stretch marks area within 30-40 minutes at temperature of 40-50°C.
EFFECT: method excludes possibility of occurrence of allergic reactions and is simple in execution.
2 ex, 4 cl
FIELD: medicine, ophthalmology.
SUBSTANCE: in cases of large-swinging nystagmus, horizontal or rotatory, it is suppressed by implementing preoperational retrobulbar anesthesia with drug composition, containing: lydocaine - 20 to 40 mg, epinephrine - 0.4 to 0.5 mg, and lydase - 4 to 6 units. After the eyes moves are stopped, on average in 1 to 2 minutes, adjusting of the laser is made by macular reflex glow, and ablation is conducted. In cases of small- or middle-swinging horizontal nystagmus, after cornea flap cutting during conduction of laser keratomyleusis in situ or photorefraction keratectomy, vacuum ring is installed, and then in small-swinging nystagmus case adjusting of tracker is made, and in middle-swinging nystagmus case adjusting of laser by macular reflex glow is made. Whereupon, ablation is implemented.
EFFECT: method provides suppressing of any nystagmus kind and promotes lowering of nystagmus degree.
2 cl, 4 ex
SUBSTANCE: invention concerns medicine, namely, to oncology and can be used at treatment of malignant tumours. The essence of the declared method is the following: intravenously inject nanoparticles of phthalocyanines in a dose not below 5 mg/kg of weight and not above as much as possible tolerable dose with the subsequent irradiation of a tumour laser impulses with a wavelength in the field of intensive absorption nanoparticles at energy density in impulse not lower than 0.1 J/cm2 and total density of energy not lower than 10 J/cm2.
EFFECT: increase of treatment efficiency of malignant tumours in comparison with earlier applied nanoparticles of carbon due to higher absorption coefficient of nanoparticles of phthalocyanines.
4 tbl, 4 ex