Method of treating reactivated form of urogenital cytomegaloviral infection in females of reproductive age

FIELD: medicine.

SUBSTANCE: with underlying antiviral therapy, blood is exposed intravenously to wave length 365 nm first, emission power 2 mWt, exposure 2 minutes. On the next day - at wave length 530 nm, emission power 2 mWt, exposure 8 minutes. There are 15 sessions of intravenous laser blood irradiation prescribed.

EFFECT: terminated reactivation of urogenital cytomegaloviral infection, reduced length of the following recurrent cases, prolongs an intercurrent period and promotes the clinical course of the viral infectious process transformed into a persistence ensured by stimulation of an inadequate immune response, normalises the interferon status and suppression of the hyperactive processes.

2 ex

 

The invention relates to medicine, namely to the treatment of cytomegalovirus infection of the urogenital tract in the process of reactivation.

The main feature of cytomegalovirus infection of the genital organs and urinary tract - ability at any time, often without apparent reason, go to the stage of reactivation. It is noted symptoms of forming an acute inflammatory process localized to the cervix and pelvic organs, which is accompanied by marked abnormalities in General and local immunity (1, 2).

There is a method of treatment of cytomegalovirus infection, consisting in the use of five intravenous injection of 0.04 mg/ml antiviral solution (3).

The disadvantage of this method is the lack of guaranteed termination reactivation, exclusive of inflammation in the genitals and pelvic organs.

This method is used for the prototype.

Achievable with the implementation of the method the technical result is to guarantee termination reactivation cytomegaloviruses infection originalnogo tract in women of reproductive age, reducing the duration of subsequent relapse and increase magnetizing period and transition flow viral infection in persistence.

The method is implemented as clicks the zoom.

On the background of antiviral therapy is combined technique of intravenous laser irradiation of blood, for example, the apparatus ALT "matrix-vlok, the wavelength of 365 nm, 2 mW (laser UFOC), 2 minutes and 530 nm, 2 mW, 8 minutes. The impact of exercise through the day with a different wavelength is a first wavelength of 365 nm, the next day with a wavelength of 530 nm, etc.

Irradiation is carried out for 15 sessions, 8 sessions - 365 nm and 7 sessions - 530 nm.

It is known that low-intensity laser irradiation (LLLT) with a wavelength of 365 nm is better stimulates the immune system (4)than other spectral ranges. When exposed to such laser light activates its own body reserves and antiviral protective reaction. Also in the process of treatment it is necessary to improve the trophic ensure tissue of the affected organs, to restore damaged cells. Traditionally used for this known method of intravenous laser irradiation of blood NEELY in the red spectral region with a wavelength of 635 nm (4). In the proposed method uses NEELY in the green spectral region with a wavelength of 530 nm to enhance the response to treatment. As NEELY green spectrum is better absorbed by the red blood cells, will be better apparent end result, trophic tissues (the main function of blood). So what Braz, provides more effective utilization of the energy of laser light.

The important thing is not concurrent proceedings, and the next day with a different wavelength, alternating impact on various life support systems for a more complete response to each of them.

The claimed method treated 176 patients.

Brief description of the means used

As the antiviral drug can be used Panavir.

Antiviral drug - high-molecular polysaccharide belonging to the class hexonic glycosides. The purified extract of the shoots of plants of Solanum tuberosum consisting of glucose, ramnose, arabinose, mannose, xylose, galactose, uronic acids. Its uniqueness lies in the combination of direct antiviral and immunomodulatory actions, which were studied in the Institute of Virology DI Ivanovo RAMS. The effect of the drug on cytomegalovirus in the cellular system in vitro, in a dose of 3 mg/ml prevents the development of cytopathic effect in infected 0.001 and 0.0001 PFU/CL cells. In a single application increases the level of leukocyte INF 2.7-3 times, which corresponds to therapeutic doses of drugs INFO. Recommended in complex therapy of herpes infections of different localization, secondary immunodeficiency States on the background of infectio the diseases, illnesses, cytomegalovirus infection in patients with habitual miscarriage, papilloma viral infection, tick-borne encephalitis. In therapeutic doses, the drug is non-toxic (LD50 ~ 3000 therapeutic doses) and is well tolerated. Tests showed no mutagenic, teratogenic, carcinogenic, allergenic and embryotoxic action.

Rectal suppositories. Composition (1 suppository): active substance - exony glycoside (potato sprouts extract) - 200 mg, other ingredients: confectionery fat or fat solids - 1,0198 g, paraffin - 0,0900 g, emulsifier T-2 - 0,0900, the Weight of the suppository - 1,2, Antiviral and immunomodulatory agent.

Pharmacological properties of the purified extract of the shoots of plants of Solanum tuberosum consisting of glucose, ramnose, arabinose, mannose, xylose, galactose, uronic acids.

The drug is an antiviral and immunomodulatory agent. Increases nonspecific resistance to various infections and contributes to the induction of interferons alpha and gamma by peripheral blood leukocytes.

In therapeutic doses, the drug is well tolerated.

Tests showed no mutagenic, teratogenic, carcinogenic, allergenic and embryotoxic action. In preclinical studies in laboratory animals negative is Liana on reproductive function and development of the fetus is not installed.

Has anti-inflammatory properties in experimental pericardial edema.

For the treatment of cytomegalovirus infection was used on 1 suppository for 10 days.

Laser blood irradiation was carried out using the apparatus ALT "Lasik-ILIB" specifications: dual-mode, wavelength 365 nm, 2 mW (laser UFOC), 2 minutes and 530 nm, 2 mW, 8 minutes through the day.

Cytomegalovirus infection has clinical polymorphism and often latent in with the persistence of the virus throughout life. Reactivation of cytomegalovirus infection may be influenced by various factors: co-infections, chronic diseases, causing the decrease of immune reactivity, the imbalance of trace elements, endocrine pathology, and more.

At present there are no drugs that can eliminate cytomegalovirus from the human body. Specific protivotsellyulitnye drugs have some serious side effects such as cardiotoxicity, hepatotoxicity, the effect on the blood. Protivotsellyulitnye immunoglobulins are of high value.

A comparative analysis of immunological data of examination of patients with the current cytomegalovirus infections of the urogenital tract was established, corectional flow is accompanied by marked abnormalities in the immune response. Identified as the reduction of NK-cells and b-lymphocytes, which was due to the high availability of the cells to apoptosis, as evidenced by the increased CD95+ $ (520,82±21,63 (p<0,05)on the background of reducing immunoregulatory index due to deficiency of T-helper cells. In the humoral link showed a significant decrease in the level of IgG and IgM. Installed slight decrease in phagocytic activity that primarily moderate but reliable decrease in the phagocytic index, a decrease in the mean values of the index completed phagocytosis and the reduction in the percentage of induced NBT test. In the comparative analysis of indicators of interferon status was marked imbalance in the interferon system: deviations were mainly observed in terms of serum interferon, which was significantly increased as compared to the comparison group. In addition, it was revealed inhibition of the production of IFN-α and-γ. Thus, when the reactivation of cytomegalovirus infection observed changes in various parts of the immune response that dictates the need for a comprehensive immunotherapy with the use of drugs affecting cell-mediated immunity, humoral immunity, the activity of phagocytosis and interferon status and antiviral agents with high profile safety is snasti.

The use of low-intensity laser irradiation on the blood of patients will eliminate the necessity of using numerous drugs that caused a universal mechanism of immunomodulatory effect of laser radiation, which leads to insufficient stimulation of the immune response and suppression of hyperactive processes. Acute exposure to venous blood of patients is radiation 25% of the blood that is sufficient to achieve the modulating effect of the procedure and leads to a prolonged action with normalization of indicators of immunity and elimination of clinical symptoms of acute and chronic infectious processes.

Example 1

Patient N. 28 years is a gynecologist with complaints of vaginal discharge, itching and burning of the vulva within 4 months. In the long history, within 3 months of systemic and local antibacterially therapy without effect. When viewed in the mirror there was a strong hyperemia, swelling of the vaginal portion of the cervix and the vaginal mucosa, copious Muco-purulent character from the cervical canal.

Microscopic examination of smears stained by Gram, was characterized by a high leukocytosis in samples from the cervical canal; in the discharge of the urethra and vagina leukocytes were absent, flora was not determined. Bacteriological ISS is adowanie growth of pathogenic and conditionally pathogenic flora was not. Molecular genetic methods detected the DNA of cytomegalovirus (CMV), the results for other STIs and opportunistic microorganisms polymerasechain reaction (PCR) negative. In the study of blood using ELISA anti-CMV IgG and IgM positive. In the study of blood, urine, saliva, detachable vagina and cervical canal on the culture of lung fibroblasts of human embryos cytomegalovirus was detected in the discharge of the vagina and cervical canal.

The diagnosis of Cytomegalovirus infection of the genital tract, reactivated form.

In the study subpopulation composition of peripheral blood lymphocytes of the patient is established to reduce the overall number of lymphocytes in 1 mm to 914 due to the reduction of T-helper cells to 522 in 1 mm. Also registered a decrease of NK cells to 121 in 1 mm and b-lymphocytes to 113 in 1 mm that was due to the high availability of the cells to apoptosis, as evidenced by the increased CD95+ 520 1 µl.

When analyzing the performance interferon status was marked imbalance in the system of interferon. Deviations were characterized by an increase of serum interferon to 8.1 IU/ml, the inhibition of the production of IFN-α to 26,36 IU/ml and to 8.69 IU/ml

A comprehensive treatment approach. From observation there is a strong put the other dynamics of clinical manifestations of the disease: there are no subjective sensations itching and burning in vagina discharge. When viewed in the mirrors 30 day treatment vaginal mucosa and cervix without pathology, allocation moderate. During the control study detachable urogenital tract within 60 days of observation CMV DNA was not determined. In the study of blood using ELISA after 2 months anticmv IgG positive IgG M negative - persisting during the current cytomegalovirus infections. Indicators subpopulation composition of lymphocytes returned to normal by increasing lymphocyte until 1686 1 ál, increase T-helper cells before 1077 in 1 mm. As a result of treatment registered the increase of NK cells to 269 in 1 mm, and b-lymphocytes to 240 V 1 µl. Marked and normalization of interferon status: reduction of serum interferon to 4,ME/ml, increased production of interferon-α to 43,ME/ml and γ to 15,MU/ml

Example 2

The patient P.30 years, aimed gynecologist connection with the failure of antibiotic therapy. Complaints about weak lower abdominal pain, discomfort in the vagina, itching, discharge from the genital tract, urinary discomfort in the course of 2.5 months. History of spontaneous abortion on term of 4-5 weeks, 3 months ago.

When viewed with the help of vaginal mirrors stated hyperemia, edema of the mucous membrane of the cervix and vagina, profuse mucopurulent discharge from the cervical canal and the rear arch is legalese.

In the reading detachable urogenital tract high leukocytosis in samples from the cervical canal, the vagina and the urethra, the flora is absent. In bacteriological studies to determine the pathogenic and conditionally pathogenic anaerobes, facultative anaerobes, aerobes, mushroom growth of flora was absent. The examination of scrapings from the urogenital tract by using polymerase chain reaction was possible to detect CMV DNA in the discharge of the cervical canal, cervix, urethra, results to other pathogens and opportunistic pathogens negative. In the study of blood, urine, saliva, detachable vagina and cervical canal on the culture of lung fibroblasts of human embryos CMV was detected in the urine, discharge from the vagina and cervical canal. In the study of blood using ELISA anti CMV IgGM and IgG-positive.

The diagnosis of Cytomegalovirus infection of the urogenital tract, reactivated form.

In this patient was evaluated local immune status. The change was characterized by a change in the subpopulation composition of lymphocytes in cervical-vaginal flushing: a decrease in CD4+ 18,51 PG/ml, increased CD8+ 64,27 PG/ml Also increased CD19+ to 23.59 PG/ml and CD25+23,75 PG/ml and elevation of INF-γ to 0.10 PG/ml

Spent featured Leche is the

Positive dynamics was noted at the end of 3 days of therapy. Vanished abdominal pain, discomfort in the urethra, decreased the number of allocations that have changed their character. When viewed in the mirrors 30 days cervix clean, vaginal mucosa and cervix are not changed. Allocation moderate, slimy character. Treatment the patient was well tolerated, no adverse reactions requiring drug withdrawal was not observed.

During the control study detachable urogenital tract 60 days after therapy CMV DNA was not determined. In the study of blood using ELISA after 2 months anticmv IgG positive IgM negative - persisting during the current cytomegalovirus infections. In this patient was evaluated local immune status. Indicators of local immunity completely normalized by increasing CD4+to 25,53 PG/ml, increased CD8+ to 44,74 PG/ml reduction of CD19+ to 18,43 PG/ml and CD25+ 5,35 PG/ml) and INF-γ to 0.03 PG/ml

Sources of literature

1. Kosovo EJ, Prasolov M.A. "Cytomegalovirus infection" JSC "Vector-best"., 2010:1-3.

2. Mardinly YEAR, Kirpichnikova GI, Neverov, VA "Cytomegalovirus Infection Etiology, epidemiology, pathogenesis, clinical features, laboratory diagnosis, treatment, prevention".-Elektrogorsk: CJSC "Ecolab", 2011: 3.

3. Karalis LU, Kucherov, VA, Stovbun SV, is Aronov DO "Evaluating the effectiveness of using Panamera in various forms in patients of reproductive age with cytomegalovirus infection. // The Russian Bulletin of the obstetrician-gynecologist, No. 4, 2011, C90-93.

4. Geinitz AV, Moskvin ST., Achilov A.A. Intravenous laser irradiation of blood. - M - Tver: LLC "Publishing house "Triad", 2012. - 336 S.

A method for the treatment of cytomegalovirus infection of the urogenital tract in women of reproductive age in the stage of reactivation by antiviral therapy, characterized in that on the background of antiviral therapy is the intravenous laser irradiation of blood (ILIB) first with a wavelength of 365 nm, the radiation power of 2 mW, exposure time 2 minutes, the next day with a wavelength of 530 nm, with a capacity of 2 mW, exposure time 8 minutes, thus, alternating wavelengths, conduct vlok for 15 sessions.



 

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3 ex

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EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

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EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: the present innovation deals with treating vascular cutaneous neoplasms, such as nevus flammeus and gemangiomas. Light-thermal impact at energy ranged 39-47 J/sq. cm should be performed in two stages, and between them, 2-3 wk after the onset of vascular resistance at the first stage one should perform beta-therapy daily for 2-3 d at single dosage being 20 g. Then, 3 wk later it is necessary to conduct the second stage of light-thermal impact by starting at energy value being 42 J/sq. cm, not less. The method enables to shorten therapy terms due to applying combined method to affect vascular cutaneous neoplasms.

EFFECT: higher therapeutic and cosmetic effect.

1 ex

FIELD: medicine.

SUBSTANCE: method involves intravitreously introducing two electrodes into intraocular neoplasm after carrying out vitrectomy and retinotomy to expose the intraocular neoplasm. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with current intensity of 100 mA during 1-10 min or 10 mA during 10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2.The transformed retina and tumor destruction products are intravitreally removed. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. Another embodiment of the invention involves adjusting position and size of the intraocular neoplasm in trans-scleral diaphanoscopic way. Rectangular scleral pocket is built above the intraocular neoplasm to 2/3 of sclera thickness with its base turned away from limb. Several electrodes are introduced into intraocular neoplasm structure via the built bed. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with the same current intensity in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. Superficial scleral flat is returned to its place and fixed with interrupted sutures. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg after having carried out vitrectomy and retinotomy. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2. The transformed retina and tumor destruction products are intravitreally removed using vitreotome. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. The number of electrodes is equal to 4-8.

EFFECT: reduced risk of metastasizing.

4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves building tunnel to posterior eyeball pole in inferoexterior and superexterior quadrants. The tunnel is used for implanting flexible polymer magnetolaser implant to the place, the subretinal neovascular membrane is localized. The implant has a permanent magnet shaped as a cut ring and is provided with drug delivery system and a short focus scattering lens of laser radiator connected to light guide. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 5-7 mTesla units intensity. It is arranged with its north pole turned towards sclera at the place of the subretinal neovascular membrane projection with extrascleral arrangement of laser radiator lens membrane being provided in the subretinal neovascular membrane projection area. The other implant end is sutured to sclera 5-6 mm far from the limb via holes made in advance. The implant is covered with conjunctiva and retention sutures are placed thereon. Light guide and drug supply system lead is attached to temple with any known method applied. Drugs are supplied via the implant drug supply system in retrobulbary way in any order. Triombrast is given in the amount of 0,4-0,6 ml and dexamethasone or dexone in the amount of 0,4-0,6 ml during 3-4 days every 12 h. 0.1-1% aqueous solution of khlorin is intravenously introduced at the third-fourth day after setting the implant as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, at a bolus dose of 0.8-1.1 mg/kg. Visual control of subretinal neovascular membrane cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the subretinal neovascular membrane with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at general dose of 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the subretinal neovascular membrane via laser light guide and implant lens, repeated laser irradiation of the subretinal neovascular membrane is carried out with radiation dose of 30-60 J/cm2.

EFFECT: accelerated subretinal edema and hemorrhages resorption; regression and obliteration of the subretinal neovascular membrane; prolonged vision function stabilization.

6 cl

FIELD: medicine.

SUBSTANCE: method involves filling vitreous cavity with perfluororganic compound. Two electrodes manufactured from platinum group metal are intravitreally, transretinally introduced into intraocular neoplasm. Electrochemical destruction is carried out with current intensity of 10-100 mA during 1-10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2 in perfluororganic compound medium. The transformed retina and tumor destruction products are intravitreally removed with perfluororganic compound volume being compensated with its additional introduction. Boundary-making endolasercoagulation of retinotomy area is carried out. The perfluororganic compound is substituted with silicon oil. The operation is ended in placing sutures over sclerotmy areas and over conjunctiva. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity. Platinum, iridium or rhodium are used as the platinum group metals.

EFFECT: complete destruction of neoplasm; reduced dissemination risk.

6 cl, 12 dwg

FIELD: medicine, applicable for stopping of pains of various nature.

SUBSTANCE: the device has a quantum-mechanical oscillator located in a casing, magnet, vessel for medicinal agent and a hollow cylinder. The magnet is installed between the oscillator and the vessel. Positioned in the vessel is a hollow cylinder having through holes on its surface.

EFFECT: quick and absolute anestesia.

2 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves administering laser radiation therapy once a day using low intensity pulsating radiation of wavelength equal to 890nmand power density of 0.03 mW/cm2. Injured organ projection to frontal abdominal wall is exposed to radiation at the first laser therapy stage in two fields acting upon each field for 2 min with radiation pulse succession frequency equal to 80 Hz in applying stable contact-type method. Total treatment dose on two fields is equal to 0.008 J/cm2. The second laser therapy stage begins immediately after having finished the first one in applying radiation along the large intestine path using labile contact-type method in a way that radiation pulse succession frequency equal to 80 Hz is applied first during 1 min and then frequencies of 600, 150 and 300 Hz are applied also during 1 min, respectively. Total treatment dose is equal to 0.032 J/cm2 at the second stage. Total treatment dose is equal to 0.04 J/cm2 at both stages.

EFFECT: enhanced effectiveness in inhibiting dysbacteriosis; reduced frequency of postoperative complications.

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