Method for integrated treatment of pathozoospermia in males suffering adrenal hyperandrogenism

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely urology, andrology and endocrinology, and may be used for the integrated treatment of pathozoospermia in males suffering adrenal hyperandrogenism. For this purpose, dexamethasone 0.5 mg is administered additionally twice a day for 8 weeks with underlying standard regimen. Besides, the blood is UV-radiated 3 times a week for 15 minutes; the therapeutic course is 12 procedures.

EFFECT: method provides normalising spermatogenesis ensured by improved microcirculation, anti-inflammatory, immunopotentiating, antioxidant effects, as well as high repair activity with no side effects and substantial contraindications to the treatment.

2 tbl, 2 ex

 

The invention relates to medicine, in particular to urology and endocrinology, and can be used in the treatment of photosphere in men with adrenal hyperandrogenism.

This problem has not only medical but also social, including demographic value. Infertility neuroendocrine origin, according to the world health organization, 35-40% of all cases of infertility). Infertility in men is the inability to fertilize the egg due to erectile dysfunction, ejaculation or spermatogenesis. Causes of male infertility can be pathological processes in the body, leading to degenerative changes in the seminiferous tubules and interstitial tissue of the testes, impaired secretion of sex hormones and photosphere. Androgen is a male sex hormones, which are produced by the testes in men and ovaries in women. Biological effects of androgens are more pronounced in the male body, these hormones enable the development and formation of the organs of the male reproductive system and its regulation. Androgens affect the development of secondary sexual characteristics and also regulate the growth and development of male sex organs. They affect metabolic processes, causing the so-called anabolic effect - stimulating effect on protein synthesis in the body (Deniso the BP, Sakevich VI "on reproductive health". J. "Sociological studies". M., 2004, No.1, p.75-85. The gromenko DS."pathogenesis of idiopathic photosphere in male infertility". Abstract. of thesis ... Dr. med. Sciences: 14.00.16. SPb., 2009, p.17-19).

Cause of giperandrogenii may be diffuse hyperplasia of the adrenal cortex, increases significantly and the amount of hormones produced. When the amplification function of the adrenal glands (sensual stress, the onset of sexual activity, pregnancy) impaired synthesis of steroids in the direction of giperandrogenii, which in turn inhibits the secretion of gonadotropins and disrupts the testicles (Kulakov V.I. "Barren marriage." M., "GEOTAR-Media", 2005, s-219).

All the above indicates the need to expand treatment capabilities of photosphere in men with adrenal hyperandrogenism.

Glucocorticoid hormone (dexamethasone) is a synthetic glucocorticosteroid (GCS) is a methylated derivative of forpension. Anti-inflammatory,

desensitizing, immunosuppressive, anti-toxic effect, increases the sensitivity of beta-adrenergic receptors to endogenous catecholamines. Interacts with specific cytoplasmic receptors with the formation of the complex, inducing the formation of proteins. The principle of action is via GCS suppress the allocation of ACTH (adrenocorticotropic hormone) is used in acute insufficiency of the adrenal cortex, primary or secondary failure of the adrenal congenital hyperplasia of the adrenal cortex in men with adrenal hyperandrogenism and photosphere, to normalize gormonalnogo background and indicators of spermatogenesis (Kulakov V.I., Serov V.N., L.V. Adamyan "guidelines for reproductive health". M., "GEOTAR-Media", 2001, p.24-27).

UFOC holds a special place in the treatment of male infertility, enhances the production of sperm, increases their mobility, has an antioxidant effect and prevents lipid peroxidation

UFOC has antibacterial, antiviral effect, improves microcirculation hormone producing organs, improves their quality of sperm production, stimulates cellular and humoral immune system, has anti-allergic effect, normalizes the gas composition of the blood, reduces blood viscosity, preventing thrombus formation, potentiates the effect of an administered drug (Artsishevskiy R.A. and other Functional changes on the surface of human erythrocytes in norm and pathology after exposure to UV radiation of different spectral composition". Sat. scient. Tr. edited Yeganian, Casamilano. "Mechanisms of influence irradiated with ultraviolet rays of blood on the body of humans and animals". Leningrad, "Nauka", 1986, s-226).

Known SPO is about the treatment of autoimmune infertility in men to reduce titers of antisperm antibodies in the blood of a patient includes a peripheral intravenous ultraviolet blood irradiation of the patient apparatus HVAC-3-(04), apply a continuous membrane plasmapheresis (Patent of Russia, having got No. 21 85 211, A61N 5/7, "a Method for the treatment of autoimmune infertility in men", 20.07.2002,, B. I. No. 21, 2002).

The disadvantage of this method is that this way it is possible to treat men only with autoimmune infertility and an increased titer of anti-sperm antibodies.

Our research proved that the application of dexamethasone, ultraviolet irradiation of blood for the treatment of photosphere in men with adrenal hyperandrogenism is: normalization of hormonal levels, increased sperm production and increase their mobility, improvement of spermatogenesis in the direction of increasing activepageindex sperm and, consequently, increase the chances of pregnancy in women.

When conducting a patent search, the use of dexamethasone, ultraviolet irradiation of blood for the treatment of photosphere in men with adrenal giperandrogenii was not found.

Object of the invention is enhanced treatment photosphere men adrenal hyperandrogenism due to the use of dexamethasone, ultraviolet irradiation of blood.

This task is achieved by the method of complex treatment of photosphere in men with adrenal hyperandrogenism against the standard treatment regimens and different is the present, further, for the normalization of a hormonal background, applies dexamethasone 0.5 mg 2 times a day for 8 weeks, to increase sperm production and improve their mobility, is carried out by ultraviolet irradiation of blood 3 times a week for 15 minutes number 12 procedures.

Efficacy of dexamethasone, ultraviolet irradiation of blood for the treatment of photosphere in men with adrenal hyperandrogenism shown in the following examples.

The patient Was 33 years. Diagnosis: Infertility 1. Adrenal hyperandrogenism. Was on routine examination and treatment in the Department of endocrinology NTS PTSRC WITH the RAMS with 16.01.12 on 27.01.12, outpatient treatment for up to 6 weeks.

Complaints: in the presence of infertility in marriage, for 5 years.

Table 1 shows the test results of the patient,

Epic ed O.S.
Table 1
IndicatorsWhen receivingAfter 8 weeksstandards
OAK (complete blood count)
Er of 4.7*1018a 4.9of 3.9 to 5.0*1018l
Hemoglobin 160155120-160 g/l
CP 1,01,01,0
Lei 5,1*1096,04-9*109l
p/I of neutrons 320-4
C/I of neutrons 717050-70
Limp/d 202323
Mono/C 54Up to 6
Eosinophils 11Up to 3
SOA71-20 mm/h
OAM (urinalysis)The inheritance. weight 101210181007-1020
1-2 O.S.0-3 O.S.
Lei/kg 2-3 O.S.ed O.S.1-3 O.S.
Biochemical analysis of bloodAlt,019,3To 41 u/l
AST 18,714,940
Bilirubin is 9.28,9To 20.5 μm/l
Sugar is 4.95,23,3-6.4 mmol/l
Cholesterol 5,0a 4.9To 5.2 mmol/l
DOG 0,040,050.3 to 4.0 ng/ml
Ultrasound of the prostate t/rectal V=20,0V=19,9To 21.0 ml
The body mass index22,022,025-30 kg/m2
Semen:
Volume (ml)3,03,62-4
Sperm category a32825%
Categories a+b245250%
Antisperm antibodiesA negative.A negative.Neg.
Lyuteiniziruyuschy hormone (LH)4,14,00,8-8,4 mIU/ml
Folliculitis is stimulating hormone (FSH) 9,87,01,0-11,8 mIU/ml
Prolactin115154105-540 mIU/ml
Testosterone38,028,0the 12.1-38,3 nm/l
17 oksiprogesterona (17-SNPS)8,32,22.0 to 6.5 nmol/l
Dehydroepiandrosterone
(DHEA)
13,6a 4.92,6-10,92
µmol/l

Treatment: dexamethasone, the optimal time of admission 8 and 16 hours a day. The dose is determined under the control of dehydroepiandrosterone, testosterone, 17-Oh-progesterone concentrations in patients receiving dexamethasone should not exceed the upper limit of normal, in this case the patient,,, dexamethasone appointed in a dose of 0.5 mg 2 times day, a course of 8 weeks and ultraviolet irradiation of blood 3 times a week, for 15 minutes, number 12 procedures. Were additionally assigned polivet the ins containing potassium iodide at least 150 μg, protective mode.

On the background of this therapy, the patient reported a significant improvement in overall health, normalization of hormonal levels, a decrease in the concentration of testosterone, reducing the concentration in the serum dehydroepiandrosterone, testosterone, 17 - Oh-progesterone and as a consequence of the above changes the normalization of indicators of spermatogenesis, increased sperm production and an increase in the concentration activepageindex sperm involved in fertilization.

For comparison here is the results of treatment of the patient, without the use of dexamethasone conducted using ultraviolet irradiation of blood and standardised treatment of the underlying disease.

Patient I., 31. Diagnosis: Infertility 1. Adrenal hyperandrogenism. Was on routine examination and treatment in the Department of endocrinology NTS PTSRC WITH the RAMS with 16.01.12 on 27.01.12, outpatient treatment for up to 6 weeks

Complaint: on infertility in marriage 2 years.

Table 2 shows the results of analyses of patient I.

Table 2
IndicatorsAt8standards
receiptweeks
OAK (complete blood count)Er 4,24,43,9-5,0
Hemoglobin 149146120-160 g/l
CP 1,01,01,0
Lei 7,36,84-9
p/I of neutrons 320-4
C/I of neutrons 727250-70
Limp/C 212323
the it/C 2 2Up to 6
Eosinophils 21Up to 3
SOA61-20 mm/h
OAM (urinalysis)The inheritance. weight 102110131007-1020
Epic 1-2 O.S.ed O.S.0-3 O.S.
Lei/kg 2-3 O.S.ed O.S.1-3 O.S.
Biochemical analysis of bloodAlt 25,322,3To E/l
AST 26,326,3Up to 40 u/l
Bilirubin 9,0 12,4To 20.5 μm/l
Sugar 4,55,63,3-6.4 mmol/l
Cholesterol of 5.2a 4.9To 5.2 mmol/l
DOG 0,91,00.3 to 4.0 ng/ml
Ultrasound of the prostate t/rectalV=19,lV=20,0To 21.0 cm3
BMI24,324,025-30 kg/m2
sperm count
Volume (ml)3,13,02-4
Sperm category a59 25%
Categories a+b353750%
Antisperm antibodiesA negative.A negative.Neg.
Lyuteiniziruyuschy hormone (LH)3,12,70,8-8,4 mIU/ml
Follicle-stimulating hormone (FSH)8,9the 9.71,0-11,8 mIU/ml
Prolactin271202105-540 mIU/ml
Testosterone25,027,3the 12.1-38,3 nm/l
17 oksiprogesterona (17-SNPS)8,38,12.0 to 6.5 is mol/l
Dehydroepiandrosterone (DHEA)11,211,02,6-10,92 µmol/l

For treatment were assigned a multivitamin containing potassium iodide at least 150 μg, ultraviolet irradiation of blood 3 times a week, for 15 minutes, number 12 procedures, protective mode.

On the background of this therapy in a patient, visible improvements indicators of spermatogenesis and hormonal did not happen.

A comprehensive treatment of dexamethasone, ultraviolet irradiation of blood was studied in 15 patients with a diagnosis of Infertility 1. Adrenal hyperandrogenism.

In all cases, the normalization of indicators of spermatogenesis was observed significantly faster and remained for a long time, more cycle of spermatogenesis (on average more than 72 days)than without receiving offer comprehensive treatment.

The proposed method of complex treatment of photosphere in men with adrenal hyperandrogenism with the use of dexamethasone to normalize hormonal levels, enhance sperm production and improve sperm motility; ultraviolet blood irradiation is carried out to improve sperm production, stimulates the growth of seminiferous tubules, the fact itself is m providing the sperm maturation process, reduces the time of treatment, is not required for hospital stay (subject to availability HVAC-03 may at polyclinics). This method of complex treatment of photosphere in men with adrenal hyperandrogenism lengthens the duration of viability of sperm and activity of sperm production, increases concentration activepageindex sperm involved in fertilization, has no harmful side effects on the body and has no significant contraindications.

This method of complex treatment of photosphere in men with adrenal hyperandrogenism has a high incentive opportunities spermatogenesis, anti-inflammatory, immunostimulant, antioxidant, and also has a high regenerative activity in men with infertility, adrenal giperandrogenii normalization of spermatogenesis in the direction of increasing activepageindex sperm, and as a consequence increase the chances of pregnancy in women, improves endocrine organs, contributing to their recovery by improving microcirculation, which causes therapeutic effect and allows to expand the range of therapeutic actions. Recommended as the method of complex treatment what s photosphere in men with adrenal hyperandrogenism.

The method of complex treatment of photosphere in men with adrenal hyperandrogenism against the standard regimens, characterized in that it additionally applies dexamethasone 0.5 mg 2 times a day for 8 weeks and is carried out by ultraviolet irradiation of blood 3 times a week for 15 minutes number of 12 treatments.



 

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FIELD: medicine.

SUBSTANCE: invention refers to medicine and aims at treating the patients with depression of consciousness accompanying acute ischemic strokes using a photochomotherapy with a monochrome green light. With underlying intensive therapy, the patients with depression of consciousness undergo the photochomotherapy involving the contact transorbital exposure on closed eyes alternately. The exposure represents the monochrome green light at average wave length 540 nm, maximum intensity 28.8 mWt, maximum power density 2.8 mWt/cm2, radiant intensity 100%. The exposure length is 5 min for each eye. The exposure length increases by 1 min every next procedure. Once the exposure length reaches 10 min, the exposure length no longer increases. The treatment is started not later than 7 days after the moment of depression of consciousness after diagnosing. The therapeutic course consists of 8-10 daily procedures.

EFFECT: method enables extending the range of aids used in treating the patients with acute ischemic stroke accompanied by depression of consciousness which reduces the length of patient's coma and promotes beginning the rehabilitation actions at the earlier stage, increases the clinical effectiveness and reduces the risk of recurrent stroke, transient ischemic attacks and formation of Wernicke-Mann position.

3 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly ophthalmology, and may be used for treating inflammatory and dystrophic eye diseases. If observing an anterior segment of an eyeball, therapeutic agents are administered subcutaneously into a temporal region 1.8-2.2 cm above the middle of a cheek bone into a lymphatic capillary accumulation. If observing a posterior segment of the eyeball, the therapeutic agents are administered subcutaneously 0.8-1.2 cm below the top of a mastoid bone, as well as into the lymphatic capillary accumulation. Heparin in a single dose of 0.3 to 0.6 ml with the therapeutic substance concentration of 96% to 100% is initially administered into the above regions. The basic substance solution in a single dose of 0.6 to 0.8 ml with the therapeutic substance concentration of 45% to 55% is administered thereafter. That is followed by administering Contrykal in a single dose of 0.4 to 0.6 ml with the substance concentration of 45% to 55%. The manipulations are daily for 7-10 days with the therapeutic course repeated every 1-6 months.

EFFECT: method provides better trophism and microcirculation of an optic disk and retina, lower intensity of pathological reactions with obtaining the therapeutic substance concentrations faster, reducing injuries of the manipulation and doses of the administered preparations.

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