The experience of using a bacteriophages-based complex antibacterial and analgesic drug in gel formulation in women who underwent various instrumental and diagnostic and treatment interventions

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 42-48
Author(s):  
Alexander O. Vasilyev ◽  
Natalia A. Sazonova ◽  
Vladimir D. Melnikov ◽  
Amir F. Gabdullin ◽  
Andrei V. Zaitsev ◽  
...  

During the spread of bacterial infections with extensive drug resistance, the potential of existing antibacterial drugs is significantly reduced. The medical community is seeking opportunities for the rational use of antibacterial drugs, the development of new drugs, as well as the use of alternative treatments for these infections. Aim. The objective of this study was to evaluate the effectiveness of the use of a complex antibacterial and analgesic drug based on bacteriophages in gel form during various instrumental studies and diagnostic procedures in order to minimize the risk of the urinary system infections complications. Materials and methods. The study included 235 women aged 18 to 75 years who underwent treatment at the Moscow State Clinical Hospital named after Spasokukotsky and in the clinic of urology of Moscow State University of Medicine and Dentistry from September 2019 to January 2020. During the manipulation, all patients of the main group (n=120) used a developed preparation based on bacteriophages, and in the control group (n=115), a topical gel based on chlorhexidine dihydrochloride and lidocaine hydrochloride was used. All patients before the manipulation, as well as 10 days after the manipulation, underwent bacteriological analysis of urine. Efficiency assessment was carried out on the basis of laboratory data obtained, as well as according to the visual analogue scale of the pain syndrome severity. Results. None of the patients in the main group showed intolerance, side effects and allergic reactions of the developed drug based on bacteriophages. Bacteriological analysis of urine received before manipulation in both groups showed the absence of clinically significant titers of pathogenic bacteria, while 1 week after manipulation the number of titers of pathogenic bacteria (104) was significantly higher in the control group (p0.04). In patients of the main group, the incidence of dysuria was lower compared with the control group (p0.05). Conclusion. The study showed good tolerance of the developed drug and its clinical effectiveness in reducing the number of symptomatic bacteriuria; severity of pain after undergoing manipulation was relatively lower in the main group of patients. Conducting multicenter studies with the inclusion of a larger number of patients in the future will reduce the economic costs associated with treating patients by reducing the number of cases of nosocomial infections and reducing postoperative time spent by patients in the hospital.

2020 ◽  
Vol 22 (12) ◽  
pp. 89-92
Author(s):  
Evgenia V. Popova ◽  
◽  
Evgenia V. Popova ◽  
Evgenia V. Popova ◽  
◽  
...  

Background. The high prevalence of nuclear cataracts in older age groups is accompanied by a simultaneous decrease in cognitive abilities as a result of this ophthalmic disease, and other General somatic polymorbid pathology. Aim. To study the cognitive abilities of elderly and senile patients with nuclear cataracts during medical rehabilitation. Materials and methods. In clinical conditions, 68 elderly and senile patients with nuclear cataract underwent femtolaser-assisted cataract phacoemulsification with intraocular lens implantation, and in the postoperative period, medical and non-drug rehabilitation was performed (the main group). The control group con-sisted of 65 patients with nuclear cataract of the same age who also underwent the above-mentioned surgery without rehabilitation measures. The MMSE scale was used to assess cognitive impairment. Results. 9 months after surgical treatment, the cognitive status of patients in the main group improved from 17.4±0.2 to 20.7±0.3 points (p>0.05). Moderate initial cognitive dysfunction in patients of the main group changed to mild after 9 months, while in the control group it remained the same. At the same time, the proportion of patients with moderate cognitive impairment decreased significantly in the main group from 61.71±5.9% before rehabilitation to 13.2±4.1% after it was completed, and the number of patients with no cognitive deficit increased (p<0.001). In the control group, the number of patients with moderate cognitive impairment decreased from 60.0±6.0 to 46.2±6.2% (p>0.05). Conclusion. The implementation of rehabilitation measures in the postoperative period helps to improve the cognitive status of older patients with nuclear ca-taracts.


Author(s):  
Omarov N.B., Aimagambetov M. Zh. ◽  
◽  
◽  

The number of patients with complicated forms of cholelithiasis of cholelithiasis is progressively growing. One of the complications of gallstone disease is Mirizzi syndrome (SM). The reason for the development of which is the spread of the inflammatory - destructive process from the gallbladder to the bile ducts with the formation of pressure ulcers in the common bile duct, as a result of which the formation of a cholecystobiliary fistula occurs, through which stones from the gallbladder enter the main bile ducts. The analysis of the surgical treatment of patients with cholelithiasis (GSD) treated in the UH NJSC "MUS" was carried out. There were 3842 patients in total, Patients were in the period from January 2012. to July 2018 The analysis revealed that of all these patients with gallstones, Mirizzi SM type III and IV syndrome was diagnosed in 25 (0.7%). In 14 (56%) patients with type III SM and type IV SM, 11 (44%). The main group consisted of 10 (40%) patients and 15 (60%) patients included in the control group. The main group completed: 1) In type III SM (only 4 (40%) patients). One patient underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 3 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1); 2) In type IV SM (a total of 6 (60%) patients). 4 patients underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 2 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1). The developed and tested methods of surgical treatment of Mirizzi syndrome of types III and IV make it possible to improve the immediate and long-term results of surgical treatment of patients with this pathology. These methods of surgical treatment allow preserving the physiology of the bile outflow without postoperative complications typical for traditional hepaticojejunostomy (incompetence of the anastomotic sutures, stricture of hepaticojejunostomy).


2016 ◽  
Vol 97 (2) ◽  
pp. 177-181
Author(s):  
A N Osmolovsky ◽  
L V Babenkova

Aim. To assess the effectiveness of the original puncture transvenous temporary endocardial springy electrode use in patients with myocardial infarction complicated by bradyarrhythmias.Methods. The study included 126 patients with myocardial infarction complicated by acute bradyarrhythmias. The original endocardial electrode was used in 38 patients (main group). Temporary artificial heart rhythm control was performed using endocardial springy temporary puncture electrode in 88 cases of bradyarrhythmias (control group). Written informed consent was taken from all patients who underwent the procedure, and in the absence of contact with the patient decision to perform temporary cardiac pacing was made by a council of physicians.Results.. Spontaneous pacing interruption occurred in 13 patients of the main group and 32 control group patients at various times of the artificial pacing. Thanks to the used original electrode constructional features, fatal cases were prevented in 11 (84.6%) patients of the main group. In 9 of 32 patients of the control group with impaired pacemaker, cardiac pacing was restored by the electrode re-fixation to the heart right ventricular endocardium. In 23 patients of the control group artificial rhythm was restored by the method of endocardial electrode reposition. The number of patients with a spontaneous interruption of temporary artificial heart rhythm control had a strong correlation with the number of patients with the identified new changes in the electrocardiogram (ST segment elevation with acute recurrent myocardial infarction; r=0.84, pConclusion. In case of spontaneous interruption of temporary cardiac pacing caused by the loss of myocardial electrical conduction function in the area of the contact with the electrode, for effective and safe fatal cases prevention endocardial electrodes of the original design use is recommended.


2021 ◽  
Vol 14 (6) ◽  
pp. 659-665
Author(s):  
U. G. Shokirova ◽  
S. P. Pakhomov ◽  
A. S. Ustyuzhina ◽  
A. V. Matrosova

Aim: conduct a systematic analysis of pregnancy development, investigate clinical and laboratory data affecting development of labor abnormalities in women residing in the Belgorod region. Materials and Methods. From 2014 to 2018, 484 women were examined and divided into 2 groups: main group consisted of those who had childbirth complicated with labor abnormalities (n = 344), whereas control group consisted of women lacking complications during delivery (n = 140). The following methods were used in the study: questionnaires, general clinical methods, biochemical blood tests in pregnant and postpartum women, populational statistics as well as methods of standard and multivariate statistics. Results. In the second half of pregnancy in women with labor abnormalities revealed higher rate of moderate preeclampsia (34.30 ± 2.56 % vs. 10.71 ± 2.61%; p < 0.05), polyhydramnios (11.34 ± 1.71 % vs. 5.71 ± 1.96 %; p < 0.05), chronic intrauterine hypoxia (29.6 ± 2.46 % vs. 12.86 ± 2.83 %; p < 0.05), chronic utero-placental insufficiency (60.47 ± 2.64 % vs. 20.00 ± 3.38 %; p < 0.05), sexually transmitted infections (3.78 ± 1.03 % vs. 0.71 ± 0.71 %; p < 0.05), acute respiratory viral infection (8.72 ± 1.52 % vs. 3.57 ± 1.57 %; p < 0.05) as well as a combination of several types of pathology (8.72 ± 1.52 % vs. 13.57 ± 2.89 %; p < 0.05). Laboratory parameters in women with labor abnormalities compared with control antepartum group were noted to have significantly decreased count of red blood cells (3.89 ± 0.38×1012/L vs. 3.99 ± 0.40×1012/L; p = 0.006), eosinophils (0.95 ± 0.69×109/L vs. 1.20 ± 0.67×109/L; p = 0.026) and platelets (226.29 ± 62.71×109/L vs. 245.44 ± 60.32×109/L; p = 0.0003). Blood biochemical parameters in women with labor abnormalities vs. control group were featured with significantly decreased level of bilirubin (6.76 ± 3.16 μmol/L vs. 9.88 ± 3.60 μmol/L; p < 0.05) and alanine aminotransferase (13.94 ± 10.08 U/L vs. 19.41 ± 14.40 U/L; p = 0.004). Analyzing coagulation parameters in the main group showed significantly reduced fibrinogen level (4.30 ± 1.00 g/L) compared with control group (4.71 ± 1.14 g/L; p < 0.05) as well as elevated international normalized ratio (1.07 ± 0.11 vs. 1.03 ± 0.10; p = 0.001). Conclusion. Our study data found that pregnant women with labor abnormalities had altered clinical and laboratory parameters observed as early as in the second half of gestation, which may be used to calculate an individual risk of such labor complication.


2018 ◽  
Vol 85 (6) ◽  
pp. 18-20
Author(s):  
O. G. Kotenko ◽  
V. A. Kondratiuk ◽  
O. O. Korshak ◽  
D. O. Fedorov ◽  
O. V. Hrynenko ◽  
...  

Objective. To analyze late results of preoperative  embolization of the portal hepatic vein branches (EPHVB) in patients, suffering extended hepatic tumors and extremely border-like small calculated residual hepatic volume(CRHV). Маterials and methods. From 2004 to 2014 yr the extended hepatic resection (HER) was performed in 285 patients, to whom EPHVB was applied (the main group), аnd in 353 patients as well, but without endovascular preparation (control group). In both groups dynamics of laboratory indices, structure of complications and lethality, late survival were studied. Results. In the main group a trustworthily lower rate of an acute hepatic insufficiency and connected with a lower postoperative lethality - accordingly 2.3 and 4.6%, comparing with a control group - 9.3 and 8.8%, were suggested. The laboratory data dynamics have witnessed a lesser intensiveness of postoperative hepatocytolysis and lesser degree of the hepatic synthetic function lowering in the main group, what have confirmed a better functional adaptation of hepatic residual in patients, to whom preoperative EPHVB was applied. Conclusion. Preoperative EPHVB permits to lower the postoperative complications and lethality rate in patients, suffering hepatic tumors, due to better functional adaptation of hepatic residual.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
G Vlasova ◽  
S Perminova

Abstract Study question Do patients with infertility and rheumatoid arthritis (RA) treated with methotrexate (MTX) have ovarian reserve alterations? Summary answer Women with infertility and RA treated with MTX were found to have statistically significant decrease of ovarian reserve. What is known already Rheumatoid arthritis (RA) is one of the most prominent inflammatory diseases affecting women of child-bearing age [Brouwer J. et al, 2014]. RA and its treatment may interfere with the female reproductive physiology. The vast majority of patients with RA are treated with methotrexate (MTX) which is a folate antagonist that inhibits DNA synthesis. MTX, which is the anchor drug in RA, targets actively proliferating cells including the oocytes and granulosa cells which may impair the ovarian reserve [Min Tun Kyaw et al, 2020]. Study design, size, duration A prospective case-control study that enrolled 72 female patients with infertility was conducted in the 2-year time period of September 2018 to October 2020. Participants/materials, setting, methods The main group comprised 32 patients with infertility and RA; the control group consisted of 40 women with infertility only. Patients with RA were stratified into subgroups based on whether or not they received MTX. To investigate ovarian reserve measurement of serum anti-Müllerian hormone (AMH) was used. The level of AMH was evaluated concerning RA duration and activity, as well as the age at initiation of MTX therapy, dosage, and treatment duration. Main results and the role of chance The mean age of the study population was 36±3 years. The duration of RA was 4 [3;11] years. The low disease activity based on DAS28-ESR (disease activity score based on 28 joints using the erythrocyte sedimentation rate) prevailed(56.2%). In the main group 19(59.4%) women received MTX therapy. The MTX dosage was 15 [15;20]mg /wk, the duration of MTX therapy by the day of inclusion in the study was 18.7[1;15]months. The AMH level was significantly lower in the main group (2.1 n /ml vs 2.73ng /ml, p = 0.043). The number of patients with decreased ovarian reserve (AMH level&lt;1.0ng/ml) significantly prevailed in the group of patients with RA (25% vs 5%, p = 0.015). When assessing the AMH level in patients with RA who received MTX (n = 19) and patients in the control group, there was a tendency towards a decrease in the indicator in the first subgroup, but no statistically difference was found (p = 0.074). Correlation analysis of the dependence of AMH level on the patient age showed the most significant decrease in AMH in the patients with RA receiving MTX compared to the patients with RA who did not, and compared to all patients with RA regardless of the therapy received (rs=-0.563)(p &lt; 0.05). Limitations, reasons for caution The lack of statistically significant data in certain cases may be due to the small sample size. Wider implications of the findings RA and MTX administration are associated with a significant decrease in AMH levels. The age of initiation of the therapy is negatively correlated with the AMH level. In this regard, patients with already compromised reproductive function who are planning to receive MTX should be advised to preserve the genetic material. Trial registration number 567890


2018 ◽  
pp. 81-83
Author(s):  
I. Basiuha ◽  

The article focuses on clinical-statistical analyses of microbiocenosis of maternity pathways of women with oligohydramnios, which will enable the usage of etiotropic mediator aimed at reducing of the frequency of fetus and newborn’s infecting. The objective: to learn the biotope of vaginal environment in the process of pregnancy complicated by oligohydramnios. Materials and methods. There were observed 120 pregnant women with oligohydramnios at gestation term of 27–29 weeks (the main group). 30 women with physiological pregnancy process constituted the control group. Oligohydramnios was diagnosed on the basis of complex examination of pregnant women at the term of 27–29 weeks with the help of standard determination of amniotic fluid index. All the women underwent bacterioscopic and bacteriological examination and detection of antigens to: chlamydia, ureaplasma, mycoplasma, virus of genital herpes, cytomegalic virus. Results. In the main group of women there was diagnosed ureaplasmosis, Gardnerella vaginalis, chlamydiosis, trichomoniasis, Candida albicans, more than half of women had increased concentration of pathogenic bacteria (staphylococcus epidermidis, aureus, saprophyticus, enteric bacteria, enterococcus faecalis), genital herpes, cytomegalovirus. Most of the representatives of the main group had bacterial infection of genital tract (69.17%), and complex bacterial-viruses infection (30.83%). Conclusion. Results of the research show that pregnant women with urogenital infections, inflammations of pelvic organs complicated by obstetrical – gynecological anamnesis should be referred to the group of high risk in reference to the development of oligohydramnios. Key words: pregnancy, microbiocenosis of vulva, oligohydramnios, infections.


2020 ◽  
Vol 30 (10) ◽  
pp. 3753-3760
Author(s):  
Hannes Beiglböck ◽  
Alexander Kautzky ◽  
Paul Fellinger ◽  
Tamara Ranzenberger-Haider ◽  
Bianca Itariu ◽  
...  

Abstract Context A substantial number of patients undergoing bariatric surgery are prescribed psychopharmacological medication. However, the impact of concomitant psychopharmacological medication on the frequency of relevant vitamin deficiencies in postoperative follow-up is not known. Methods Five hundred twenty-four patients with obesity who underwent bariatric surgery (January 2004 to September 2018) with follow-up of at least 12 months, were included in retrospective analysis. Postoperative follow-up visits between January 2015 and September 2019 were analyzed. Anthropometric and laboratory data were analyzed at the first documented follow-up visit after on average 39.5 ± 37.3 months and at every following visit during the observation period. Patients with prescribed psychopharmacological drugs (PD) were compared with patients without (control group, CON). Results Psychopharmacological medication was documented in 25% (132) of patients. In 59 patients documented prescription of more than one psychiatric drug was found, whereas psychopharmacological monotherapy was found in 73 patients. Frequencies of vitamin deficiencies were comparable between PD and CON (vitamin A: p = 0.852; vitamin D: p = 0.622; vitamin E: p = 0.901; folic acid: p = 0.941). Prevalence of vitamin B12 deficiency was rare (6% CON, 1% PD) but was significantly higher in CON (p = 0.023). A comparison of CON and POLY also showed no significant differences between the groups concerning prevalence of vitamin deficiencies. Conclusions Intake of psychopharmacological medication is highly prevalent in patients after bariatric surgery. Patients with psychopharmacological medication, who participate in structured follow-up care after bariatric surgery, are not at higher risk for vitamin deficiencies compared with controls.


Author(s):  
A. I. Gorbatenko ◽  
N. O. Kostyanaya

Efficacy of platelet-rich autoplasma (PRA) in treatment of osteoarthrosis was evaluated. Prospective study included 120 patients (83 females, 37 males, mean age 52.8±4.5 years) with clinical and roentgenologic diagnosis of II-IV stage osteoarthrosis by Kellgren-Lawrence classification. The patients from the main group (n=60) were on courses of PRA intraarticular injections (3 injections with 1-2 weeks interval). In the control group the patients received nonsteroidal anti-inflammatory drugs (NSAIDs) and periodically injections of glucocorticoids when indicated. Results were assessed by the verbal efficacy scale, Lequesne index and the pain visual analog scale. Follow up period made up 6 months. Use of PRA enabled to eliminate pain syndrome and improve knee joint function without adverse effects. In 6 months the number of patients who noted the efficacy of treatment was 31% higher in the main group than in the control one. The obtained results allow recommending PRA use for knee osteoarthrosis treatment as an alternative to NSAIDs especially in contraindications to the latter.


2021 ◽  
Vol 8 (1) ◽  
pp. 48-54
Author(s):  
Aigul T. Safi ◽  
Aigerim B. Ospanova ◽  
Svetlana Yu. Kalinchenko ◽  
Mekan R. Orazov

Objective to evaluate and compare clinical, anamnestic and laboratory data of patients with polycystic ovary syndrome (PCOS) and without syndrome, including the level of vitamin 25(OH) D3. Material and methods. In this work, 81 patients were examined, who, at the 1st stage of the study, were divided into two groups depending on the presence or absence of signs of PCOS. The main group included 51 patients with signs of PCOS. The control group included 30 healthy women without signs of PCOS, matched by sex and age with the main group. The main and control groups were compared by clinical and anamnestic data, including birth weight, by the presence of complications of pregnancy and childbirth in their mothers during their gestation, by the level of vitamin D. PCOS was verified on the basis of diagnostic criteria Rotterdam (2003) and International guidelines on PCOS (2018). Vitamin 25(OH)D3 was determined by mass spectrometry (ng/ml). At the 2nd stage of the study, the main group with PCOS was divided into 2 subgroups depending on the waist circumference (WT). Subsequently, the subgroups were compared with each other in the same parameters as at stage 1, as well as in the level of insulin, low-density lipoprotein (LDL), triglycerides (TG), anti-Mllerian hormone (AMH), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To reflect the statistical results, the parametric parameters of the Students t-test were applied for two independent samples with equal or different variance. For nominal data Pearsons Chi-test, when the means are not calculated and a test is carried out for the presence of a relationship between nominal variables. Results. There was no statistically significant difference in vitamin 25(OH)D3 levels in patients with and without PCOS. Statistically significant differences in vitamin 25(OH)D3 levels were found in women with PCOS, depending on the waist circumference (WT). In these subgroups, differences were also found in the level of insulin, LDL, TG. Conclusion. The values of the level of vitamin 25(OH)D3 do not differ in the groups of patients with PCOS and without PCOS, but significantly correlate with the metabolic profile of patients.


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