Method for selecting therapeutic approach to acne in females

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to dermatology, and can be used for selecting a therapeutic approach to acne in females by examining biological fluids and prescribing preparations depending on the clinical findings. The biological fluids are blood and urine; blood serum hormones and steroid urine profile are tested, and the derived values are compared to the standard norms specific for the absence of acne, while the preparations are prescribed according to the comparison results. Specifically, if observing an increase of blood luteinising hormone up to 16 mIU/ml, testosterone up to 4 ng/ml, an increase of urine androsterone up to 20 mcmole/24 hours, etiocholanolone up to 11 mcmole/24 hours, total 17-ketosteroids up to 35 mcmole/24 hours, van de Calseyde's discriminant up to 3, the combined oral contraceptive Jess with the anti-androgenic effect. If also observing an increase of immunoreactive protein up to 12.90 mcUnit/ml and insulin-line growth factor 1 up to 361.04 ng/ml, the combined oral contraceptive Jess and Metformine or Metformine are prescribed. If observing a decrease of blood oestradiol up to 140 pmole/l or an increase of the concentration of luteinising hormone up to 7 mIU/ml, dihydroepiandrosterone sulphate up to 4 mmole/l, 17 - hydroxyprogesterone up to 4 nmole/l and testosterone up to 4 nmole/l in blood and an increase of urine androsterone up to 17 mcmole/24 hours, etiocholanolone up to 17 mcmole/24 hours, 11 - ketoandrosterone up to 2.5 mcmole/24 hours, 11 - ketoetiocholanolone up to 2.5 mcmole/24 hours, 17 - ketosteroids up to 50 mcmole/24 hours and van de Calseyde's discriminant up to 3, the glucocorticoid Metypred is prescribed. The high blood concentration of luteinising hormone up to 15 mIU/ml, dihydroepiandrosterone sulphate up to 6.82 mcmole/l, 17 - hydroxyprogesterone up to 4 nmole/l and an increase of urine androsterone up to 19.5 mcmole/24 hours, etiocholanolone up to 16 mcmole/24 hours, dihydroepiandrosterone up to 7 mcmole/24 hours, 17 - ketosteroids up to 45 mcmole/24 hours and van de Calseyde's discriminant up to 3.5 enables using the combined oral contraceptive Jess and the glucocorticoid Metypred. And the preparation Dostinex is prescribed in observing the above values in a combination with an increase of blood prolactin up to 750 IU/ml and a decrease of blood oestradiol up to 95.48 pcg/ml.

EFFECT: method enables providing higher therapeutic selectivity and clinical effectiveness in acne without the need of thorough examination to be conducted.

4 ex

 

The invention relates to medicine, namely to dermatology.

There is a method of choice in the treatment of acne in history, namely, the relationship of time of acne and the onset of menarche, clinic, establish the type of acne and medication in accordance with the type. However, it is not possible to establish the cause of the disease, such as hyperandrogenism, especially its forms, such as ovarian, adrenal, mixed, which can be complicated by other hormonal abnormalities. In these cases, the treatment is ineffective or need additional examination of the patient, long-lasting and versatile.

The closest to the offer (the prototype) is the method of choice in the treatment of acne (acne), according to which conduct biochemical analysis of saliva, which determine the activity of myeloperoxidase and amylase, and when the activity value of myeloperoxidase 35,23-42,30 MK Mol/mg, and amylase 34,88-42,88 mg/(g·ml) diagnose 1-2 severity of the disease and prescribe vitamins A, B, enzymes, externally - Skinoren"gel, and when the activity of myeloperoxidase more 42,30 MK Mol/mg and the amylase activity more 42,88 mg/(g·ml) diagnose 3-4 severity of acne and prescribe antibiotics (see RF patent № 2323442, CL IPC G01N 33/68, G01N 33/52, publ. 27.04.2008).

However, in the method according to protet the PU the choice of treatment depends on the severity of the disease without regard to its etiology. In hereditary nature or hormonal acne condition that often happens to women, it results in the assignment ineffective treatment, or to severe side effects and complications that affect both the General condition of the patient (increased intracranial pressure, the reaction from the liver and gastrointestinal tract, candidiasis), and the skin - discoloration, allergic reactions, gram-negative folliculitis, difficult to treat.

The objective of the invention is to increase the selectivity and efficiency of the selection method in the treatment of acne without having to spend a long thorough examination.

To solve this problem the method of choice in the treatment of acne in women by studies of biological fluids and medication depending on the results of the survey as biological fluids using blood and urine samples, perform laboratory determination of hormones in the blood serum steroid profile of urine and comparing metrics with predefined standard, typical of the lack of acne, and prescription drugs operate by comparing the results: with the increase in blood levels of luteinizing hormone to 16 mIU/ml, testosterone - to 4 ng/ml, the increase in urine levels of Androsterone up to 20 µmol/24 hours, etiocholanolone - to 11 µmol/24 hours, the amount of 17-ketosteroids to 35 µmol/24 hours, discriminants van de Calzada to 3 is a combined oral contraceptive with antiandrogenna effect GES, with an increase of levels of immunoreactive insulin - up 12,90 mked/ml and insulin-like growth factor 1 to 361,04 ng/ml is a combined oral contraceptive with antiandrogenna effect of GES and Metformin or Metformin; when the decrease in the blood level of estradiol to 140 pmol/l and the concentration of luteinizing hormone to 7 mIU/ml, dehydroepiandrosterone sulfate to 4 mmol/l, 17 - hydroxyprogesterone to 4 nmol/l and testosterone - up to 4 nmol/l in the blood and increase in urine levels of Androsterone to 17 µmol/24 hours, etiocholanolone - to 17 µmol/24 hours, 11 - kateandashley - up to 2.5 µmol/24 hours, 11 - ketoaciduria - up to 2.5 µmol/24 hours, 17 - ketosteroids - up to 50 µmol/24 hours and discriminants van de Calzada to 3 - assign glucocorticosteroid - methapred; when the concentration of luteinizing hormone in the blood up to 15 mIU/ml, dehydroepiandrosterone sulfate to 6,82 µmol/l, 17 - hydroxyprogesterone to 4 nmol/l and increase in urine levels of Androsterone to 19.5 μmol/24 hours, etiocholanolone - up to 16 µmol/24 hours, dehydroepiandrosterone to 7 µmol/24 hours, 17 - ketosteroids - up to 45 µmol/24 hours and discriminants van de Calzada to 3.5 - to benyounes oral contraceptive with antiandrogenna effect of GES and glucocorticosteroid - metypred, and with the same indicators plus the increase in blood prolactin to 750 IU/ml and reduced estradiol - up 95,48 PCG/ml in blood - Dostinex.

The study of hormonal patients

Determination of plasma protein: follicle-stimulating hormone, luteinizing hormone; steroid hormones (estradiol, testosterone, progesterone and dehydroepiandrosterone sulfate, cortisol), sexual steroidzawisimaya globulin and prolactin carried out by an enzyme immunoassay based on the detection of specific antibodies specific conformations. The results determined using the calibration curve through 2 points and the reference curve obtained with the aid of a barcode of the reagent. Blood sampling was performed at the polyclinic of the Ministry of economic development of Russia in the first phase of the menstrual cycle (5-8 days), but research in FBSI Central research Institute of Epidemiology.

Research steroid profile urine

Research steroid profile (SP) urine is a unique diagnostic test a number of gynecological diseases, connected with infringement of synthesis and metabolism of steroid hormones, some of which can be diagnosed only when determining the steroid profile of urine. Daily urine, as an object of study, has significant advantages over common in h is currently in clinical medicine immune methods for the determination of hormones in the blood, as it allows to eliminate the influence on the results of circadian rhythms and the instantaneous fluctuations of hormones in the blood, which are often significant. Studies of hormones in the blood can be used for rough estimates only, as the results depend on the laboratory, where such surveys and can range from 200 to 500%. Examination of the urine represent a non-invasive method of diagnosis, so there is no danger for patients of infection transmission infections.

The study of the SP urine is to quantify the individual steroids such as Androsterone, etiocholanolone, dehydroepiandrosterone, 11-ketoendrin, 11-ketoetiocholanoione, 11b-hydroxyandrostenedione, 11b-hydroxyechinenone, cholesterol, total 17-ketosteroids, discriminant van de Calzada.

The study of the SP urine was carried out in clinical diagnostic laboratories on the basis of the clinical hospital №1 Pirogov using high-performance capillary gas chromatography. To do this, use 4 ml of urine taken from daily amounts, mainly in the first phase of the cycle, the vacuum sterile tube. Moreover, the morning portion was poured notice the time. All subsequent urine for days is collected in a clean bowl, the last time the next morning at the same time. The collected urine is stirred measure the total volume. 3 days prior to collection of urine cancel, if possible, the medication. The day before the urine collection prohibit eating foods that are able to paint (such as: beet, carrot, citrus, coffee and the like), alcohol and spicy food, and take hormones.

EXAMPLE 1.

Patient S. 28 years old I went to the doctor the dermatologist complaining of a rash on the skin, which increase during stressful situations.

From the anamnesis. Lesions were first noted at the age of 22 years, about which appealed to the regional dermatovenerologic dispensary, where doctors repeatedly prescribed drugs for topical treatment of acne erythromycin, azelaic acid, benzoyl peroxide). Treatment had a minor and temporary effect. When asking about a family history of acne parents were not observed, however, according to the patient have acne in their native sisters. When collecting gynecological history established: menarche 13 years to 20 years of menstruation regular, then the intervals between periods increased and with 24 years of observed phenomena oligomenorrhea. Pregnancy and childbirth was not.

Dermatological examination. The skin is limited, is located on the skin in the cheeks and chin, presents multiple closed and open comedo the AMI (> 50), papules, deep pustules and isolated nodes. Dermatological index of acne (DIA) - 9 points (average severity of acne).

Laboratory examination.

Study of the level of steroid and peptide hormones in the blood

On the 5th day of the menstrual cycle: luteinizing hormone - 17,32 mIU/ml follicle-stimulating hormone - 4,58 mIU/ml, estradiol - 95,48 PCG/ml, testosterone - 3,15 nmol/l, dehydroepiandrosterone sulfate 6,82 µmol/l, sex steroidzawisimaya globulins - 34,27 PG/ml, prolactin 989,54 IU/ml, 17-hydroxyprogesterone - 4,11 nmol/l, insulin-like growth factor 1 - 332,37 ng/ml, thyroid hormones without deviation. Conclusion: hyperprolactinemia, insulin resistance.

Research steroid urine

Changes in steroid profile urine was characterized by higher levels of Androsterone to 20,34 µmol/24 hours, etiocholanolone to 16,96 µmol/24 hours, dehydroepiandrosterone - 7,33 µmol/24 hours and a pronounced increase in the amount of 17-ketosteroids to 46,58 µmol/24 hours and discriminants van de Calzada to 3,94. Conclusion: mixed form of giperandrogenii.

Submetre

It was established that production of sebum increased significantly on the skin of the forehead right before 263,15 Μg/cm2and left - 254,32 Μg/cm2and also on the skin of the chin - up 274,58 Μg/cm2.

On the basis of inspection and obsledovanie is diagnosed Acne is moderate.

Assigned therapy

For etiotropic treatment was applied product containing cabergoline (Dostinex) at a dose of 0.5 mg per week, which was divided into 2 doses (½tablet while eating on Monday and Thursday) for 1 year.

The results of therapy

As a result of ongoing therapy has decreased values dermatological index of acne, to the third month of therapy occurred in 33,33% (9 to 6 points), half - 44,44% (up 5 points), to 9 months of treatment - 66,67% (up 3 points) and by the end of the observation period on 88,89% (up 1 point). The slow dynamics of the index was due to a modest reduction of comedones in the first six months of therapy.

Index of therapeutic effect 88,89% - "significant improvement"

The tolerability of therapy was good. Side effects from taking Dostinex was observed in the first two months of treatment, which has shown a slight dizziness and orthostatic hypotension. Adverse events did not require withdrawal of the drug.

Laboratory examination after treatment

Study of the level of steroid and peptide hormones in the blood

The use of the drug Dostinex help normalize hormonal status that were manifested by the reduction of the following indicators: folliculosebaceous the hormone - to 3.47 mIU/ml; LH - to 6.35 mIU/ml (p<0,05); testosterone - up to a 3.87 nmol/l; dehydroepiandrosterone sulfate up to 3.48 mmol/l; prolactin - to 365,39 IU/ml; 17-hydroxyprogesterone - to 3.14 nmol/l; immunoreactive insulin - up to 7.56 mked/ml and insulin-like growth factor 1 - to 226,35 ng/ml Was found to increase estradiol - up 112,36 PCG/ml and sexual steroidzawisimaya globulin - to 57.06 PG/ml.

Research steroid urine

Treatment contributed to the normalization of the steroid profile of urine. First of all, this was manifested by a decrease Androsterone to 13,69 µmol/24 hours, etiocholanolone - to 10.12 mmol/24, the amount of 17-ketosteroids to 25,36 µmol/24 hours and discriminants van de Calzada up to 1.59. The remaining indicators were not changed.

Submetre

The measurement of the secretion of sebum, the patient as a result of treatment showed reduced production of sebum on the skin of the forehead right before 183,48 µg/cm2on the skin of the forehead from left to 185,47 µg/cm2and on the skin of the chin 166,39 µg/cm2.

Thus, the use of Dostinex contributed to the resolution of acne, normalization of hormonal status and steroid urine, with an elimination of symptoms of hyperprolactinemia and insulin resistance.

EXAMPLE 2.

Patient S. 26 years old I went to the doctor the dermatologist complaining of a rash is the skin, that increase in stress situations and before menstruation.

From the anamnesis. Lesions were first noted at the age of 16 years, about what appealed to dermatologists, who repeatedly prescribed drugs for topical treatment acne retinoids and benzoyl peroxide). Treatment had a minor and temporary effect. When asking about a family history of acne parents were not observed, however, according to the patient have acne in their native sisters. When collecting gynecological history established: menarche age of 14 - irregular, heavy and painful. Pregnancy and childbirth was not.

Dermatological examination. The skin is limited, is located on the skin in the cheeks and chin, presents multiple closed and open comedones (>50), papules, deep pustules and isolated nodes. Dermatological index of acne (DIA) - 8 points (average severity of acne).

Laboratory examination.

Study of the level of steroid and peptide hormones in the blood

On the 5th day of the menstrual cycle: luteinizing hormone - 16,92 mIU/ml follicle-stimulating hormone - 6,38 mIU/ml, estradiol - 182,75 PCG/ml, testosterone - 4,21 nmol/l, insulin-like growth factor 1 - 361,04 ng/ml, other steroids and blood thyroid hormones rejected without the th.

Research steroid urine

Changes in steroid profile urine was characterized by higher levels of Androsterone to 20,46 µmol/24 hours, etiocholanolone up of 11.26 mmol/24 hours and a pronounced increase in the amount of 17-ketosteroids to 35,95 µmol/24 hours and discriminants van de Calzada to 3,72.

Identified deviations from carbohydrate and fat metabolism, which was characterized by a reliable increase of immunoreactive insulin to 12,90 mked/ml and index HOMA-IR before 4,34 (fasting glucose to 5.56 mmol/l), decreased low-density lipoprotein to 0.85 mmol/l and higher triglycerides up to 2.67 mmol/L.

Submetre

It was established that production increased sebum on the skin of the forehead right before 281,37 Μg/cm2and left - 264,3 8M kg/cm2and also on the skin of the chin - up 298,14 Μg/cm2.

On the basis of inspection and examination diagnosed with Acne of moderate severity.

Assigned therapy

Was used for treatment preparation containing Metformin at a dose of 1000 mg / day at night for 1 year.

The results of therapy

As a result of ongoing therapy has decreased values dermatological index of acne to the third month of therapy occurred in 75% (8 to 2 points) half - 87.5% (up 1 points), to 9 months of treatment and at the end of the observation period - 100% (0 points).

Index of therapeutic effect of 100 "cure"

The tolerability of therapy was good. Side effects from taking Metformin was not observed.

Laboratory examination after treatment

Study of the level of steroid and peptide hormones in the blood

The use of the drug Metformin help normalize hormonal status, which was expressed by a significant decrease in the following indicators: follicle-stimulating hormone - to was 4.02 mIU/ml; LH - to 7.59 mIU/ml (p<0,05); testosterone - to 2.13 nmol/L.

Research steroid urine

Treatment contributed to the normalization of the steroid profile of urine. First of all, this was manifested by a decrease Androsterone to 11.47 mmol/24 hours, etiocholanolone - to 9.79 mmol/24 and discriminants van de Calzada to 1.45. The remaining indicators were not changed.

Metformin has also contributed to the elimination of dyslipidemia, which reflected increased HDL up to 1.59 mmol/l and reduction of triglycerides to 1.41 mmol/l and eliminate the disturbance of carbohydrate metabolism: reduction of immunoreactive insulin - to 7.93 mked/ml and insulin-like growth factor 1 - to 258,12 ng/ml, with normalization of the index, HOMA-IR - 1,63.

Submetre

The change in the secretion of sebum, the patient as a result of treatment showed a decrease in production the sebum on the skin of the forehead on the right to 159,24 µg/cm2on the skin of the forehead from left to 148,37 µg/cm2and on the skin of the chin 155,02 µg/cm2.

Thus, the use of Metformin has contributed to the elimination of the phenomena of acne, normalization of hormonal status and steroid urine, with an elimination of the phenomena of insulinresistance and dyslipidemia, normalization of anthropometric indices.

EXAMPLE 3.

Patient S. 32 years I went to the doctor the dermatologist complaining of a rash on the skin, which increase before menstruation.

From the anamnesis. Lesions were first noted at the age of 15 years, about which appealed to the regional dermatovenerologic dispensary, where doctors repeatedly prescribed drugs for topical treatment of acne erythromycin and topical retinoids). Treatment had a minor and temporary effect. When asking about a family history of acne had both parents. When collecting gynecological history established: menarche age of 15, by type of optimizarea. Pregnancy and childbirth was not.

Dermatological examination. The skin located on the face, presents multiple closed and open comedones, papules, isolated pustules. Dermatological index of acne (DIA) - 10 points (the average severity of acne).

Laboratory examination.

On the 5th day of the menstrual cycle: luteinizing hormone - 18,02 mIU/ml, estradiol - 91,25 PCG/ml, testosterone is 5.98 nmol/l, dehydroepiandrosterone sulfate 7.41 mmol/l, sex steroidzawisimaya globulins - 36,47 PG/ml, 17 - hydroxyprogesterone - of 4.25 nmol/l, insulin-like growth factor 1 - 354,42 ng/ml, thyroid hormones without deviation.

Research steroid urine

Changes in steroid profile urine was characterized by higher levels of Androsterone to 19,89 µmol/24 hours, etiocholanolone to 17,46 µmol/24 hours, dehydroepiandrosterone - 8,14 µmol/24 hours and a pronounced increase in the amount of 17-ketosteroids to 47,26 and discriminants van de Calzada to 3.88. Conclusion: mixed form of giperandrogenii.

Submetre

It was established that production of sebum increased significantly on the skin of the forehead right before 257,23 Μg/cm2 and left - 249,12 Μg/cm2, and the skin of the chin - up 285,47 Μg/cm2.

On the basis of inspection and examination diagnosed with Acne of moderate severity.

Assigned therapy

For etiotropic treatment was used combined oral contraceptive GES 1 tab. a day without breaks and glucocorticosteroid metypred 4 mg daily for 1 year.

The results of therapy

As a result of ongoing therapy reduced the values of dermatological index of acne by the third month the CC treatment was 70% (from 10 to 3 points) for 6 months 80% (up 2 points), to 9 months of treatment - 90% (up 1 points) and by the end of the observation period - 100% (0 points).

Index of therapeutic effect, a 100% recovery.

The tolerability of therapy was good. No side effects were.

Laboratory examination after treatment.

Study of the level of steroid and peptide hormones in the blood

The use of such combined treatment help normalize hormonal status, which was expressed by a significant decrease in the following indicators: luteinizing hormone - to 5.21 mIU/ml; testosterone - to 2.35 nmol/l; dehydroepiandrosterone sulfate up to 2.67 mmol/l; 17-hydroxyprogesterone to 3,31 nmol/l; and insulin-like growth factor 1 to 246,ng/ml Was found to increase estradiol - up 122,43 PCG/ml and sexual steroidzawisimaya globulin with up to 65,08 PG/ml.

Research steroid urine

Treatment contributed to the normalization of the steroid profile of urine. First of all, this was manifested by a decrease Androsterone to 12,54 µmol/24 hours, etiocholanolone - to 9.16 mmol/24, the amount of 17-ketosteroids to 24,15 µmol/24 hours and discriminants van de Calzada to 1.45. The remaining indicators were not changed.

Submetre

The measurement of the secretion of sebum, the patient as a result of treatment showed a decrease in skin products what about the fat on the skin of the forehead on the right to 177,26 µg/cm2on the skin of the forehead from left to 169,76 µg/cm2and on the skin of the chin 153,31 µg/cm2.

Thus, the use of combined oral contraceptives GES and glucocorticosteroid metypred contributed to the resolution of acne, normalization of hormonal status and steroid urine.

EXAMPLE 4.

Patient C. for 20 years I went to the doctor the dermatologist complaining of a rash on the skin.

From the anamnesis. Lesions were first noted at the age of 11 years, about which alone were treated with various cosmetic preparations that are bought in the pharmacy. Treatment had a minor and temporary effect. When asking about a family history of acne had both parents. When collecting gynecological history established: menarche age of 12, menstrual cycle regular, on average, 31 days.

Dermatological examination. The skin located on the face, chest, back and presents multiple closed comedones. Dermatological index of acne (DIA) - 7 points (the average severity of acne).

Laboratory examination.

Study of the level of steroid and peptide hormones in the blood

On the 7th day of the menstrual cycle: luteinizing hormone - 8,05 mIU/ml, estradiol - 114,22 PCG/ml, testosterone - 4,78 nmol/l, dehydroepiandrosteron the Ron sulfate 4,16 µmol/l, 17 - hydroxyprogesterone of 4.83 nmol/L.

Research steroid urine

Changes in steroid profile urine was characterized by higher levels of Androsterone up to 20.28 mmol/24 hours, etiocholanolone to 18,31 MK µmol/24 hours, dehydroepiandrosterone - 4,16 µmol/24 hours, 11-kateandashley to 2.79 mmol/24 hours, 11-ketoaciduria to 2.92 mmol/24 hours, and a pronounced increase in the amount of 17-ketosteroids to 54,62 and discriminants van de Calzada to 3,72. Conclusion: adrenal form of giperandrogenii.

Submetre

It was established that production of sebum increased significantly in all measurement points evenly on the skin of the forehead right before 287,16 Μg/cm, on the skin of the forehead from left to 297,64 Μg/cm2on her right cheek before 310,24 Μg/cm2on the left cheek before 289,26 Μg/cm2and on the skin of the chin to 336,43 Μg/cm2.

On the basis of inspection and examination diagnosed with Acne of moderate severity.

Assigned therapy

For etiotropic treatment was applied glucocorticosteroid metypred 4 mg daily for 1 year.

The results of therapy

As a result of ongoing therapy reduced the values of dermatological index of acne to the third month of therapy occurred in 85,71% (from 7 to 1 point), for 6 to 9 months of treatment and at the end of the observation period - 100% (0 points).

Index terapeuticas the wow effect a 100% recovery.

The tolerability of therapy was good. No side effects were.

Laboratory examination after treatment.

Study of the level of steroid and peptide hormones in the blood

The use of this treatment help normalize hormonal status, which was expressed by a significant decrease in testosterone to 1.22 nmol/l, dehydroepiandrosterone sulfate to 1.79 mmol/l and 17-hydroxyprogesterone to 2.43 nmol/l, and increase sexual steroidzawisimaya globulin to 85,76 PG/ml Should be noted the influence of therapy on the level of estradiol, which after a year of treatment tended to increase.

Research steroid urine

Treatment contributed to the normalization of the steroid profile of urine. First of all, this was manifested by a decrease Androsterone to 15,44 µmol/24 hours, etiocholanolone - to 10.36 mmol/24, dehydroepiandrosterone 0.43 µmol/24 hours, 11-ketoaciduria to 0.39 µmol/24 hours, the amount of 17-ketosteroids to 29,35 µmol/24 hours.

Submetre

As shown by the results of cemetrey in this patient revealed a decrease in the rate of sebum production in all points. But normal production of sebum reached only on the skin on both cheeks in the middle to 301,19 µg/see

Thus, the use of glucocorticosteroid is etired contributed to the resolution of acne, normalization of hormonal status and steroid urine.

Presented examples show that the choice of treatment of the claimed method can improve the selectivity and efficacy in the treatment of acne without having to spend a long thorough examination.

The method of choice in the treatment of acne in women by studies of biological fluids and medication depending on the survey results, characterized in that as biological fluids using blood and urine samples, perform laboratory determination of hormones in the blood serum steroid profile of urine and comparing metrics with predefined standard, typical of the lack of acne, and prescription drugs operate by comparing the results: with the increase in blood levels of luteinizing hormone to 16 mIU/ml, testosterone - to 4 ng/ml, the increase in urine levels of Androsterone up to 20 µmol/24 hours, etiocholanolone - to 11 µmol/24 hours, the amount of 17-ketosteroids to 35 µmol/24 hours, discriminants van de Calzada to 3 is a combined oral contraceptive with antiandrogenna effect GES, with an increase of levels of immunoreactive insulin - up 12,90 mked/ml and insulin-like growth factor 1 to 361,04 ng/ml is a combined oral contraceptive with antiandrogenic GES and Metformin or Metformin; when the decrease in the blood level of estradiol to 140 pmol/l and the concentration of luteinizing hormone to 7 mIU/ml, dehydroepiandrosterone sulfate to 4 mmol/l, 17 - hydroxyprogesterone to 4 nmol/l and testosterone - up to 4 nmol/l in the blood and increase in urine levels of Androsterone to 17 µmol/24 hours, etiocholanolone - to 17 µmol/24 hours, 11 - kateandashley - up to 2.5 µmol/24 hours, 11 - ketoaciduria - up to 2.5 µmol/24 hours, 17 - ketosteroids - up to 50 µmol/24 hours and discriminants van de Calzada to 3 - assign glucocorticosteroid - methapred; when the concentration of luteinizing hormone in the blood up to 15 mIU/ml, dehydroepiandrosterone sulfate to 6,82 µmol/l, 17 - hydroxyprogesterone to 4 nmol/l and increase in urine levels of Androsterone to 19.5 μmol/24 hours, etiocholanolone - up to 16 µmol/24 hours, dehydroepiandrosterone to 7 µmol/24 hours, 17 - ketosteroids - up to 45 µmol/24 hours and discriminants van de Calzada to 3.5 - combined oral contraceptive with antiandrogenna effect of GES and glucocorticosteroid - metered, and with the same indicators plus the increase in blood prolactin to 750 IU/ml and reduced estradiol - up 95,48 PCG/ml in blood - Dostinex.



 

Same patents:

FIELD: biotechnology.

SUBSTANCE: method is implemented as follows. The erythrocytes from the blood sample are washed with physiological saline, then centrifuged, then extracted with chloroform-methanol mixture in the ratio 1: 2, at that shaken periodically, and the ratio of sample: extractant is 0.1: 2.0. Then the extract of erythrocytes and standards of phosphatidylcholine and phosphatidylethanolamine are applied to the chromatographic plate with the sorbent Sorbfil PTSH-AF-A-UF, which is placed in a chromatography chamber with eluent of composition - chloroform:methanol:glacial acetic acid:water taken in a ratio of 60:50:1:4. After 10-15 minutes the chromatographic plate is removed, dried and then developed in iodine vapour. The phosphatidylcholine and phosphatidylethanolamine in the sample are identified according to the path length of the sample spots compared to the path length of standard spots. In case of exceeding the spot size of phosphatidylethanolamine compared to the spot of phosphatidylcholine the damage of the structure of the erythrocyte membrane is determined.

EFFECT: method enables to determine the damage of the erythrocyte membrane structure, which enables to improve the diagnosis of the disease at the cellular level and to carry out monitoring of the efficiency of treatment.

3 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: laparotomy is performed; exudate is taken from an abdominal cavity, and exudate pH is measured. If the exudate pH value is 6.5 or less, the exudate is stated to contain an anaerobic flora, and that ensures indicating for the programmed sanitation re-laparotomy.

EFFECT: method enables fast, accurate and objective determination of indications for the programmed sanitation re-laparotomy.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gastroenterology, and can be used for providing the higher clinical effectiveness in the patients suffering dyspepsia syndrome combined with overweight. The method involves measuring an anxiety level (HARS) and a depression level (HDRS) according to Hamilton rating scales, assessing nutritional status by bioimpedancemetry, a degree of manifestation of sleep disorders, measuring glucose, testing glucose tolerance, immunoreactive insulin, cholesterol, high-density lipoprotein (HDLP), triglyceride in venous blood. If the patient is observed to suffer dyslipidemia and impaired glucose tolerance or variations of immunoreactive insulin, the preparation Dibikor is administered in a dose of 500 mg a day for three months. The patient suffering dyslipidemia and both of the disorders stated above requires administering Dibikor 1000 mg a day for three months. If the patient suffers an overweight with a body weight index falling within the range of 27 to 29.9 standard units and an active cell mass (ACM) percentage of 45 to 55 per cent as shown by bioimpedancemetry, the preparation Dietressa is administered in a dose of 1 tablet 3-4 times a day for three to six months. If the patient suffers an overweight with a body weight index falling within the range of 27 to 29.9 standard units and an active cell mass (ACM) percentage of 45 to 55 per cent as shown by bioimpedancemetry, the preparation Dietressa is administered in a dose of 2 tablet 3-4 times a day for three to six months. If the patient suffers mild and moderate sleep disorders and shows an emotive type of eating behaviour combined with mild affective disorders, the anti-depressant Valdoxane in a single dose of 25 mg a day for the night for two weeks. The course of the disease is followed by the anxiety and depression levels two weeks after the beginning of the therapy, with the positive progression of the diseases, the 25mg dose of Valdoxane remains unchanged to the end of the therapeutic course for three to six months. If no progression is exhibited, the dose is to be increased to 50 mg a day, and the therapy is continued from four to eight months. If the patient suffers severe sleep disorders and shows an emotive type of eating behaviour combined with moderate affective disorders, the anti-depressant Valdoxane in a single dose of 50 mg a day for the night for two to three months.

EFFECT: in each specific case, the method enables providing faster reduction of the clinical symptoms, including body fat weight reduction and active cell mass and water normalisation, normalising circadian rhythms of the vegetative balance, as well as prolonging the remission.

3 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine and concerns diagnosis of an acute toxic hepatic injury in rats. The method consists in lipid recovery, namely in adding 25 mcg of 10% tezit with agitating the mixture by means of a shaker at 20°C and a vibration frequency of 120 a minute for 30 minutes and measuring total phospholipids and triglycerides in the solution. If their relation is 1.01-1.19; the blood alanine aminotransferase growth is increased to 0.50-0.62 mmole/l and more, the acute toxic hepatic injury in rats in diagnosed.

EFFECT: using the technique enables higher effectiveness and accuracy of diagnosing the acute toxic hepatic injury in rats.

2 tbl

FIELD: medicine.

SUBSTANCE: fasting blood test and blood test following taking amino acid mixture are conducted. First, fasting circulating blood volume, hematocrit and total calculated blood amino acid nitrogen content are determined in the morning. That is followed by oral administration of amino acid solution 100.0 ml transported according to one of absorption options with the known concentration of the solution and the amino acid nitrogen content therein The circulating blood volume, the hematocrit and the total calculated amino acid nitrogen content are determined again 30, 40, 50, 60, and 70 minutes after the administration of the amino acid sequence. The blood samples are measured for an amino acid absorption ratio by formula: K=Nn×CBVn×(100Htn/100)N1×CBV1×(100Ht1/100)N, wherein K is the amino acid absorption ratio, N is the nitrogen content in the amino acid mixture, N1 is a blood amino acid nitrogen value before taking amino acids, Nn is a blood amino acid nitrogen value after taking amino acids, CBV1 is a circulatory blood volume before taking amino acids, CBVn is a circulatory blood volume after taking amino acids, Ht1 is a hematocrit value before taking amino acids, Htn is a hematocrit value after taking amino acids, n is a time following the oral administration of amino acids. Taking into account the ratio K and the time following the oral administration of amino acids, a diagram reflecting the amino acid absorption rate in the digestive tract is plotted.

EFFECT: method enables measuring the total amino acid absorption rate in the digestive tract taking into account the transport system characteristics.

1 ex

FIELD: medicine.

SUBSTANCE: antibacterial, infusion, syndromic, immunosupportive therapies and surgical management are conducted taking into account infant's severity and a process stage. The presence of an intrauterine infection is additionally detected. The presence and manifestation of purulent-septic values are determined. including procalcitonin, C-reactive protein, Calph-Caliph leucocytic intoxication index and immunoglobulin A. If observing at least one intrauterine infection and an increase of purulent-septic values in more than 1.5 times than a norm, a lymphotropic therapy is prescribed once a day for 7-10 days in the form of a single subcutaneous injection of a broad-spectrum antibacterial preparation into a right inguinal region 1 cm above an inguinal ligament, and two intravenous introductions of the other antibiotic.

EFFECT: invention enables reducing drug load on the patients, reducing risk of developing complications and neonatal and infant death.

1 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: method involves controlling the patient's state, wherein the blood troponin I concentration is measured initially and every 60 minutes after the beginning of thrombolysis up to 4 hours, and if observing the troponin I concentration in 10 times and more as compared to the previous value, the thrombolytic therapy is considered to be effective. The invention can be used in acute cardiology for assessing the efficacy of the thrombolytic therapy in the patients with acute myocardial infarction with ST-segment elevation and enables assessing the efficacy of the thrombolytic therapy over a short period of time and to high precision. Recurrent infarctions in past medical history, intervention cardiac procedures and cardiac surgeries have no effect on the findings.

EFFECT: higher assessment accuracy.

3 dwg, 2 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention represents method for prediction of threshold retinopathy of prematurity in infants having no ophthalmic signs of the disease characterised by the fact that blood serum is analysed for vascular endothelial growth factor (VEGF) up to the 33rd week of gestation; if the VEGF level is 1300 pg/ml or more, developing threshold retinopathy of prematurity is predicted.

EFFECT: enabling correction of therapeutic approach to premature newborns at the stages of nursing.

2 dwg, 1 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: invention represents a diagnostic technique for external genital endometriosis involving blood serum analysis, differing by the fact that the blood serum is analysed for high-density lipoproteins, and if the derived value is 0.77 mmole/l and higher, external genital endometriosis is diagnosed.

EFFECT: invention enables providing higher accuracy and simplifying a diagnostic procedure for external genital endometriosis.

3 ex

FIELD: medicine.

SUBSTANCE: general and biochemical blood values, coagulation profile, body weight, abdominal circumference (AC) by formula for I, II, III trimester of pregnancy; an appropriate biological age is determined by formula for I, II, III trimester of pregnancy. The appropriate biological age is subtracted from the biological age, and if the derived difference is -15.00 to -5.00 years, a delayed ageing is stated; the difference falling within the range of -4.99 to +4.99 years shows a physiological ageing, while an accelerated ageing is shown by the difference of +5.00 to +15.00 years.

EFFECT: using the declared method enables determining the biological age of a pregnant woman accurately.

9 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to field of pharmaceutics, in particular represents composition for topic application, which includes, into physiologically acceptable medium at least one derivative of naphthoic acid, benzoylperoxide and at least one film-forming component.

EFFECT: invention is characterised by the fact that said compound of naphthoic acid and benzoylperoxide are in dispersed in said composition form.

23 cl, 14 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to an herbal formulation of topical nanoemulsion for treating acne-related skin disorders. The above formulation contains an aqueous phase comprising a therapeutic agent, rose water and/or lemon juice, and an oil phase containing an essential oil, a non-ionic surfactant and an accessory surfactant. The aqueous and oil phases are related within the range of 1:1 to 1:2, while a particle size of the herbal formulation is less than 5 nm. The essential oil is presented by tea tree oil, basil oil, rosemary oil, lavender oil, jojoba oil, bergamot oil, clove oil and peppermint oil. The invention also refers to a method for preparing the herbal formulation which involves providing the aqueous and oil phases, mixing the above phases to produce a mixture to be emulsified with the non-ionic surfactant to prepare a macroemulsion. The prepared macroemulsion is mixed with ethanol to produce a nanoemulsion with a particle size less than 5 nm.

EFFECT: invention provides the herbal formulation with good penetration, prolonged effect causing no irritation.

8 cl, 4 dwg, 7 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: claimed invention relates to compounds of the following formula , in which n equals integer number from 1 to 15, m equals 0, 1, 2 or 3, and R represents hydrocarbon chain of polyunsaturated fatty acid, selected from omega-3 and omega-6 polyunsaturated fatty acids, and to method of obtaining them.

EFFECT: development of pharmaceutical or cosmetic composition based on said compounds and to method of acne or seborrheic dermatitis treatment for cosmetic purposes.

16 cl, 4 dwg, 2 tbl, 3 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to a compound of formula (I)

where Y represents a group of formula -(CR9R10)n-; X represents -C(=O)-; Z represents a group of formula -(CR13R14)q-; R1 is selected from a group, consisting of (a) C2-C12alkenyl, substituted with 4-chlorophenyl; or (b) C6-C10aryl, optionally substituted with one or two halogen atoms; R2 and R3 represent H; R4 is selected from a group, consisting of H, C1-C12alkyl, optionally substituted with hydroxyl, methoxy or benzyloxy, C3-C12cycloalkyl, C6aryl, optionally substituted with an amino group or pyperidine, C-bound C1-C18heteroaryl, selected from pyridine and imidazole, C(=O)R15, C(=O)NR16R17 and ONR16C(=NR17)NR18R19; each R5a and R5b represents H, each R6, R7 and R8 is independently selected from a group, consisting of H, C1-C12alkyl and C6-C18aryl, each R9 and R10 represents H; each R13 and R14 represents H; R15 represents H, each R16, R17, R18, R19 and R20 is independently selected from a group, consisting of H, C1-C12alkyl, C3-C12cycloalkyl, C6aryl and pyridyl, or any two of R16, R17, taken together with atoms, to which they are bound, form a cyclic group, containing 5 carbon atoms, or n equals to 1; q represents an integer number, selected from a group, consisting of 1, 2, 3, 4 and 5; r equals to 1; or its pharmaceutically acceptable salt.

EFFECT: invention relates to a pharmaceutical composition for treatment of MC5R-associated conditions, which contains a formula (I) compound and a pharmaceutically acceptable carrier, a diluent or a filling agent.

23 cl, 6 tbl, 53 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to pharmaceutical industry, in particular to a composition, possessing immunomodulating and anti-inflammatory properties. The dermatological composition, possessing immunomodulating and anti-inflammatory properties, as an active ingredient, contains an extract of the aboveground part/parts of oat, collected before ear formation. The cosmetic composition, possessing immunomodulating and anti-inflammatory properties. Application of the extract of the aboveground part/parts of oat, collected before ear formation, possessing immunomodulating and anti-inflammatory properties, as a medication.

EFFECT: composition and extract possess expressed immunomodulating and anti-inflammatory properties.

15 cl, 1 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to cosmetic industry and represents a non-foaming cosmetic composition of an oil-in-water emulsion containing (i) retinol, (ii) at least one polar emollient specified in a group consisting of propylene glycol stearyl ester, propylene glycol isostearate and mixtures thereof (iii) at least one non-polar emollient specified in a group consisting of aromatic or linear esters, Gerbe ester, mineral oils, squalane, isohexadecane, squalene, liquid paraffin and mixtures thereof with the weight ratio of the above polar emollient and the above non-polar emollient is found within the range of approximately 95 to 5 to approximately 40 to 60.

EFFECT: provided considerable reduction of retinoid-caused skin irritation and higher efficacy or retinoid.

11 cl, 3 ex, 7 tbl, 3 dwg

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to pharmaceutical industry, namely a method of treating acne. The method of treating acne by prescribing line seed oil 10 ml 2 times a day, sodium selenite 90 mcg 1 time a day, tocopherol acetate 100 mg 2 times a day for 1 month.

EFFECT: method of treating acne is effective and enables reducing the length of treatment.

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to cosmetology and dermatology, and represents a water-based formulation for local application for treating acne, containing water, a water-miscible organic solvent and benzoyl peroxide, wherein the organic solvent concentration is 1-4 times higher than the benzoyl peroxide concentration in the formulation; the water and organic solvent concentrations are related as at least 7:1, preferentially at least 10:1, more preferentially at least 20:1; the benzoyl peroxide concentration in the formulation makes less than 5.0 wt %, but at least 1.0 wt %.

EFFECT: invention provides the clinical effectiveness with the reduced active agent concentration, as well as reduced irritant action.

27 cl, 4 ex, 3 tbl

FIELD: medicine.

SUBSTANCE: invention refers to cosmetology and represents a cosmetic composition containing: hydrolised yeast proteins as an active substance, and at least one acceptable carrier, differing by the fact that the above hydrolised yeast proteins are prepared by exogenic enzymatic hydrolysis and/or acid hydrolysis and/or alkaline hydrolysis of the yeast membranes.

EFFECT: invention provides improved cosmetic activity, excellent time stability.

17 cl, 6 ex, 3 tbl, 2 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, specifically to dermatology, and may be used for treating the patients suffering acne. That is ensured by local applications of a therapeutically effective amount of a fixed-dose combination containing adapalene and benzoyl peroxide. That is combined with oral administration of a therapeutically effective amount of an antibiotic for a particular period of time.

EFFECT: method provides the effective treatment of these patients, manifested as a significant decrease of all types of acne involvements, prevents the further development of these involvements, including after the withdrawal of oral antibiotics and the development of resistance, due to the synergistic effect of the above local combination and oral antibiotic.

11 cl, 11 tbl, 4 dwg, 2 ex

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine. System of medication delivery includes, at least, one compartment, which contains loaded with medicinal substance heart-shaped layer from thermoplastic polymer, loaded with medicinal substance intermediate layer from thermoplastic polymer and non-containing medicinal substances coating from thermoplastic polymer, which covers intermediate layer. Heart-shaped layer is loaded with crystals of first compound, in particular with pharmaceutically active compound. Intermediate layer is loaded with crystals of second compound, in particular with pharmaceutically active compound. Both active compounds are loaded over their corresponding concentration of saturation. Described is method of contraception, application of delivery system for application in contraception or hormone-substituting therapy, application of system for production of contraception set and method of producing three-layer system of medication delivery.

EFFECT: ensuring independent speed of release of active compounds.

15 cl, 7 ex, 8 tbl, 26 dwg

Up!