RU-2861632-C1 - METHOD FOR TREATING UROSEPSIS IN ELDERLY AND SENILE PATIENTS

Abstract

FIELD: medicine; urology. SUBSTANCE: present invention can be used for the treatment of urosepsis in elderly and senile patients. The method includes the use of antibacterial and anti-inflammatory therapy. In addition, no later than 12 hours after drainage of the urinary tract, performing polymyxin endotoxin sorption using columns with immobilised polymyxin B. Then, every 24 hours, performing second and third sessions of polymyxin sorption. EFFECT: reducing the treatment duration of patients, reducing mortality in elderly and senile urological patients. 1 cl, 2 ex

Inventors

• Levitskij Sergej Aleksandrovich
• Ananev Dmitrij Pavlovich
• ALFEROV SERGEJ MIKHAJLOVICH
• Revkovskaya Natalya Sergeevna

Dates

Publication Date

20260506

Application Date

20250731

Claims (1)

1. A method for treating urosepsis in elderly and senile patients, including antibacterial and anti-inflammatory therapy, characterized in that, in addition, no later than 12 hours after drainage of the urinary tract, polymyxin sorption of endotoxin is performed using columns with immobilized polymyxin B, then every 24 hours a second and third session of polymyxin sorption of endotoxin is carried out.

Description

The invention relates to medicine, namely to urology, and can be used to treat urosepsis, which occurs with various inflammatory urological diseases in elderly and senile patients. Aging of the organism is a genetically programmed process, accompanied by certain age-related changes in the body, a natural and inevitable decrease in strength, limitation of physical capabilities occurs (see Abramova, G.S. Age Psychology. - 4th ed. / G.S. Abramova. - M .: Academic project, 2003. - 670 p.). Features of morbidity in the elderly are expressed in the non-specific manifestation of diseases, the unpredictability of their course, the rapid deterioration of the condition, a high frequency of complications and the need for subsequent rehabilitation (see Arieva, G.T. Gerontostomatology - objective reality / G.T. Arieva, A.L. Ariev // Clinical gerontology. - 2008. - No. 7. - P. 3-8.). In older age groups, not only the incidence rate but also the number of diseases in each patient is significantly higher (see Modestov, E.A. Methodological approaches to a comprehensive assessment of the health status of elderly and senile individuals / E.A. Modestov, O.M. Novikov, V.V. Shevchenko et al. / / Sib. med. review. - 2001. - No. 2. - P. 23-25; see Bohmer, F. Aufgaben der Pravention in der Gerontologie / F. Bohmer // Wien. Med. Wochenschr. - 2001. - Bd. 151, No. 18/20. - P. 468-471; see Van den Akker M. Problems in determining occurrence rates of multimorbidity / M.Van den Akker, F. Buntinx, S. Roos, J.A. Knottnerus // J. Clin. Epidemiol. - 2001. - Vol.54, No.7. -P. 675-679). Changing the approach to providing medical care to elderly patients concerns all sections that make up the treatment process (see Modern geriatrics for primary care physicians: a methodological manual for primary care physicians / Tkacheva O.N., Babenko I.V., Vorobyova N.M. [et al.]. - M .: Prometey, 2021 - 172 p.). Compared to young people, the elderly have twice as many diseases, and the elderly have 6 times more (see Aksamentov, G.B. Clinical and functional characteristics of patients in a geriatric hospital / G.B. Aksamentov // Healthcare. - 2002. - No. 2. - P. 51-540). According to V.G. Gomberg, urological pathology occupies a significant place in the structure of diseases in elderly and senile people. (See V.G. Gomberg Urological care for elderly people with various urination pathologies // Urological News. 2019. Special issue). A separate medical and social problem is infectious complications that cause death in elderly patients, among which the most common, along with community-acquired pneumonia, are urinary tract infections (see Lokshin K. Diagnostics and treatment of urinary tract infections. Lecture. - M .: Publishing house "Russian doctor", Magazine "Doctor", 2006. No. 6, pp. 18 - 23; see Melillo K. Asymptomatic bacteriuria in older adults: when it necessary to screen and treat. Nurs. Pract., 1995, 20, 50 - 60). Geriatric aspects of the epidemiology, immunology and pathophysiology of sepsis development are undeniable. In the aging organism, the normal number of B-lymphocytes is preserved, but a decrease in the absolute number of lymphocytes and T-helpers is noted. A decrease in the activity of cellular and humoral immunity factors is observed (see Rautbart S.A., Tyurin I.N., Shurygin S.N., Kozlov I.A. Age-related features of central hemodynamics in sepsis. Bulletin of Intensive Care named after A.I. Saltanov. 2019; 4:88-97). In the work "Characteristics of purulent-septic complications in elderly and senile patients" the authors conducted a clinical and morphological comparison and concluded that in elderly and senile individuals the most common sources of sepsis are urinary tract infection, community-acquired pneumonia, and deep suppurating bedsores. The course of purulent-septic complications occurs with an erased clinical picture with a low level of systemic inflammatory response (SIRS) indicators and the level of multiple organ failure upon admission according to clinical indicators (SOFA), which do not allow for a full assessment of the severity of the condition and the degree of expression of multiple organ failure (see Characteristics of purulent-septic complications in elderly and senile patients. Ermolaeva M.M., Ilyina V.A., St. Petersburg, I.I. Dzhanelidze Research Institute of Emergency Care, October 12, 2015. https://izron.m/articles/perspektivv-razvitiva-sovremennov-meditsiny/seklsiya-28-patologicheskaya-anatomiya-spetsialnost-14-03-02/osobennosti-gnoyno-septicheskikh-oslozhneniy-u-bolnykh-pozhilogo-i-starcheskogo-vozrasta/). Sepsis is a life-threatening, multiorgan dysfunction caused by a dysregulated response to infection (see Singer M, Deuschman CS, Seymour CW, et al. The Third International Consensus definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810. https://doi.org/10.1001/jama.2016.0287). Sepsis is the 11th leading cause of death in adults, with a trend toward an increase in sepsis rates in developed