The importance of eliminating microcirculatory disorders in the complex treatment of common soft tissue phlegmon

Background. The treatment of purulent-inflammatory processes of soft tissues remains today an area of surgery that is not given enough attention by specialists of both inpatient and outpatient levels, with many unresolved problems. Of particular importance in the pathogenesis of purulent-septic processes are the emerging microcirculation disorders due to the formation of micro-clots. An important point that aggravates the course of the disease is the development of thrombohemorrhagic syndrome. As a result, even with a variety of antibacterial drugs and the ыavailability of new treatment methods, it is often not possible to achieve positive results in the treatment of this heavy contingent of patients.Aim: to improve the effectiveness of complex therapy of patients with extensive soft tissue phlegmon by relieving thrombohemorrhagic syndrome.Materials and methods. Cryoplasma-anti-enzyme therapy in the composition of complex treatment was received by 59 (48.8 %) patients of the main group, 62 (51.2 %) patients of the comparison group received only the generally accepted treatment. In each group, there are three variants of the course of the disease – moderate, severe and septic.Results. The analysis of the clinical course of the disease showed that in patients of the first group, wounds were cleared of necrotic masses and purulent discharge with filling them with healthy granulation tissue 5.3 days faster than in the second group (p˂0.001). The number of deaths decreased – 11.9 % in the first group against 27.4 % in the second group (p˂ 0.001). The number of deaths decreased – 11.9 % in the first group against 27.4 % in the second group (p˂ 0.001). The proportion of thrombotic and thromboembolic causes of death in the first group (14.3 %) was lower than in the second (17.7 %) (p˂ 0.05).Conclusion. The use of cryoplasma-anti-enzyme therapy as part of complex treatment contributed to the effective relief of thrombohemorrhagic syndrome, the elimination of microcirculatory disorders, which allowed performing plastic closure of a wound defect 1.6 times faster, prevented the progression of multiple organ failure, and contributed to a reduction in mortality.

Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity

To date, there is no effective treatment for celiac disease (CD, gluten enteropathy), an autoimmune disease caused by gluten-containing food. Celiac patients are supported by a strict gluten-free diet (GFD). However, in some cases GFD does not negate gluten-induced symptoms. Many patients with CD, despite following such a diet, retain symptoms of active disease due to high sensitivity even to traces of gluten. In addition, strict adherence to GFD reduces the quality of life of patients, as often it is difficult to maintain in a professional or social environment. Various pharmacological treatments are being developed to complement GFD. One promising treatment is enzyme therapy, involving the intake of peptidases with food to digest immunogenic gluten peptides that are resistant to hydrolysis due to a high prevalence of proline and glutamine amino acids. This narrative review considers the features of the main proline/glutamine-rich proteins of cereals and the conditions that cause the symptoms of CD. In addition, we evaluate information about peptidases from various sources that can effectively break down these proteins and their immunogenic peptides, and analyze data on their activity and preliminary clinical trials. Thus far, the data suggest that enzyme therapy alone is not sufficient for the treatment of CD but can be used as a pharmacological supplement to GFD.

MANAGEMENT OF POST-SURGICAL INFLAMMATION WITH PROTEOLYTIC ENZYME-BIOFLAVONOID COMBINATION

Surgical care is an integral component of health systems, and so is the appropriate management of the surgical wound. Excessive inammation and edema, in the post-surgical period, can result in delayed wound healing, infective complications and increased length of hospital stay, among other complications. Systemic enzyme therapy (SET) with trypsin and bromelain, in combination with the bioavonoid rutoside, has been extensively investigated as alternatives to conventional therapies for pain and swelling associated with many inammatory conditions. The multi-pronged pharmacodynamic action of these ingredients on different inammatory processes has been highlighted in this review. Additionally, clinical studies demonstrating the benecial effects of SET in multiple surgical settings, including general surgical, dental, orthopaedic, cosmetic surgeries, are also discussed

The effectiveness of systemic enzyme therapy in complex treatment chronic pancreatitis in old age

Relevance. The variety of functional changes in internal organs characteristicofgeriatricage necessitates the search for drugs that can exert a multifaceted effect on various links in the pathogenesis of chronic pancreatitis (CP) in comorbidity with the most common diseases of the elderly. Purpose. Investigation of the effectiveness of the inclusion of a systemic enzyme therapy drug in the complex treatment of chronic pancreatitis in elderly patients. Materials and methods. We examined 77 patients with CP over the age of 66 years, the average age (71.3 ± 1.4) g. Group I of patients with CP (23 patients) - took aconventional therapeutic complex (MC) for three months: pantoprazole 40 mg on an empty stomach according to requirement, continuous enzyme replacement therapy with pure pancreatin in an adequate dose with each meal, prokinetics / or antispasmodics if necessary. Group II consisted of 34 patients with CP (MC + W), in addition to LK, the drug of systemic enzyme therapy (SET) Wobenzym, 5 tablets, was taken. three times a day for three months. The control group consisted of 20 patients without signs of pathology of the digestive system. The parameters of lipid metabolism were determined by the enzymatic-colorimetric method. The assessment of the depth of exocrine pancreatic insufficiency (PI) was determined by the level of fecal α-elastase (FαE) by enzyme-linked immunosorbentassay using standard BIOSERVELASTASE 1-ELISA kits. Statistical analysis was performed using Excel and the statistical package Statistica v. 5.0. Results. Additional inclusion of the drug SET (Wobenzym) in the generally accepted MC promoted a significant improvement in lipid profile parameters in elderly patients with CP, as well as a reliable correction of the excretory function of the P by the level of FαE (from the level of moderate to mild insufficiency). Conclusions. 1) The inclusion of Wobenzym in the general treatment complex contributed toa decrease in the levels of TC, βLP, TG and LDLP by 15.4%, 19.8%, 32.0% and 33.9%, respectively (p <0.001), as well as an increase in the level of HDLP by 21.7% and a decrease in AF (by 41.3%) (p <0.001); 2) under the influence of treatment with the use of Wobenzym, a significant increase in the level of FαE (by 42.6%) was found relative to this indicator to treatment (p <0.001), which significantly exceeded the results (by 15.8%) in the MC group, which were not statistically significant (p> 0.05).

Anti-inflammatory therapy of lower urinary tract infection in patients with distal urethral diseases

Introduction. Recurrent infection of the lower urinary tract (UTI) is a very common pathology in women of different age groups. This category of urological patients is most often found in the practice of an outpatient urologist. Aim. To study the possibilities of the effect of hydrolytic enzymes on the effectiveness of complex antiinflammatory therapy of chronic infectious and inflammatory diseases of the lower urinary tract in women with pathology of the distal urethra, paraurethral region and on the results of surgical treatment of patients with female hypospadias, paraurethral cysts. Materials and methods. 96 patients with various forms of chronic lower UTI and its complications as a result of diseases of the urethra and paraurethral zone (female hypospadias, hypermobility of the urethra, paraurethral cyst) we was observed. In the course of our study, all the observed patients, were divided into 2 groups. Group I – 40 people (control) patients who received only anti-inflammatory and antibacterial therapy according to the spectrum of the detected pathogen of UTI in combination with surgical treatment, and the group II – 56 patients who received anti-inflammatory and antibacterial therapy according to the spectrum of the detected pathogen of UTI and surgical treatment in combination with enzyme therapy for a course of 14 days. Results. In the II group all patients after discharge from the hospital were monitored for 6 months. Only 1 patient had a relapse of exacerbation of chronic lower urinary tract infection. Enzyme therapy as a component that optimizes anti-inflammatory therapy provides a real chance for earlier relief of the infectious process in these patients and improvement of the results of surgical treatment of paraurethral pathology. Discussion. Chronic recurrent infection of the lower urinary tract in women is often associated with the presence of pathological conditions of the distal urethra in the form of female hypospadias and hypermobility of the urethra, as well as paraurethral pathology in the form of paraurethral cysts. Patients with this pathology need surgical treatment and mandatory complex anti-inflammatory therapy. Enzyme therapy as a component that optimizes anti-inflammatory therapy provides a real chance for earlier relief of the infectious process in these patients and improvement of the results of surgical treatment of paraurethral pathology. Conclusion. The inclusion of hydrolytic enzymes in patients with UTI and with diseases of the distal urethra and paraurethral region in the anti-inflammatory therapy regimen increases the effectiveness of etiotropic therapy and improves the results of surgical treatment of diseases of the distal urethra and paraurethral region.

Potential role of systemic enzyme therapy with trypsin, bromelain and rutoside combination in burns

Burns is a global public health problem, with a higher prevalence rate in the Southeast Asia region, including India. The therapeutic interventions mainly target the control of complications following burn injury and assisting in physiological recovery. However, the excessive inflammatory changes and loss of immunological integrity, seen in burns patients, interfere with the healing process. An orally applied formulation composed of hydrolytic enzymes (bromelain, trypsin) and the flavonoid rutoside has a long history of use as natural anti-inflammatory agents. This combination has been found to exert anti-inflammatory, anti-thrombotic and antioxidant effects through myriad mechanisms that include favorable modulation of inflammatory mediators, enhancement of plasmin levels, reduced leukocyte migration to injury site and suppression of the formation of reactive oxygen species. These actions have been demonstrated in multiple in vitro and animal models. Further, the beneficial effects of the combination on inflammatory markers have been reported from multiple clinical studies. This review provides a discussion of the current understanding of cellular mechanisms and pathways involved in burn injury and the evidence highlighting the beneficial role of systemic enzyme therapy with trypsin-bromelain-rutoside combination in the management of burn injury patients.

The influence of enzyme therapy with adaptogens when candidiasis on blood parameters, increase the livability and meat productivity of geese

It has been established that in propolis, which is a biologically active product of beekeeping contains several dozen compounds, trace elements and vitamins. It contains most of the compounds of flavonoid and terpenoid nature, phytoncides, unsaturated aromatic acids, trace elements: copper, cobalt, potassium, sodium, manganese, zinc, calcium, barium, titanium, nickel, chromium, vanadium, tin, vitamins (A, B, C, E, PP), glucose, fructose, cinnamon alcohol. This composition provides a favorable complex effect of propolis on the body: bactericidal and virusocidal (kills bacteria and viruses), bacteriostatic (slows their growth), regenerative (restoring tissues, heals wounds) and fungicidal (kills fungi). The main therapeutic effect in this biologically active beekeeping product is provided by ferulic, caffeic and benzoic acids, galantine, chrysin, isalpine, pinocebrin. They are combined with trace elements and vitamins, as well as probiotics and prebiotics, which provide the greatest therapeutic effect. This circumstance is important for fungal diseases of poultry and especially for candidiasis. Geese candidiasis has been causing great economic damage to poultry farming all over the world in recent decades. The search for effective prevention measures and therapies remains an unsolved problem to date. The data on the development of reactions basophils, pseudoeosinophils, eosinophils, lymphocytes, monocytes on the background of candidiasis and their enzyme adaptogens: probiotic and propolis for traditional microbiotheria is not effective and does not contribute to the restoration of cytological reactions and meat production of poultry have been presented in the article. At the same time as shown by our studies in farms affected by candidiasis geese timely application of enzyme therapy on a background of immune propolis and propitiatory not only contributes to the full restoration of all biological indicators, but more intense live weight gain of poultry and improve the livability of their livestock. This underlines the importance of taking measures to prevent candidiasis in goose farms, together with good conditions for feeding and housing poultry.