[Microflora metabolites of different habitats in bronchopulmonary diseases].

PURPOSE: To investigate the content and profile of metabolites of bronchopulmonary and intestinal microflora, especially such as short chain fatty acids (SCFA) in various biological substrates in patients with lung malignant tumors on the background of COPD. Estimate their diagnostic and tactical implication. MATERIALS AND METHODS: The study involved 98 patients with diseases of the bronchopulmonary system. According to the basic nosology patients were divided into two main groups: COPD (38 patients), and lung cancer in combination with COPD (hereinafter LC) (60 patients). The diagnosis was verified by modern methods of examination. Group of norm included 30 healthy individuals. Groups matched by gender and age. The microbiological examination of sputum and feces was conducted in the studied groups of patients. SCFA in sputum and feces of patients with COPD and LC were identified by GLC method. In healthy individuals the SCFA investigation was performed in bronchial washings, obtained during bronchoscopy in 20 people, the SCFA investigation in feces was performed in 30 people. RESULTS: Study of the content and profile of short-chain fatty acids (SCFA) in patients with COPD and lung cancer (LC) in various biosubstrates indicate on the obvious changes in microbiocenosis ofbioptate (bronchopulmonary and intes- tinal), characterized by the dominance of residual and facultative anaerobic microorganisms in the spectrum. Except that more pronounced changes are ascertained at LC. Also, changes of the SCFA parameters in the sputum may indicate on the alterations in the metabolism of epithelial cells of the lower respiratory tract (LRT). Unidirectional change the SCFA in sputum and feces can indicate on either translocation of microflora in the LRT out of the intestine, and on the possible systemic changes in themetabolism of epithelial tissue in the oncological process. The identification of SCFA by GLC method in various biological substrates can be used in examination of patients with lung cancer for diagnostic purposes (for objectification of microecological violations), as well as to evaluate the prognosis of the disease and its complications.

[Adequate empiric therapy of nosocomial fungal infections in oncologic patients of intensive care units].

The results of a 3-year experience with voriconasole in oncologic practice are presented. Rational schemes for the use of caspofungin and mycofungin in the treatment of oncologic inpatients and the criteria of their use in the therapy of fungal nosocomial infections were developmed. Good clinical and microbiological efficacy of caspofungin and mycofungin against Candida non-albicans was shown.

[Experience with continuous epidural anesthesia used in the complex of combined anesthesia at gastropancreatoduodenal surgery].

The purpose of this study was to assess the experience with long-term epidural space administration of 1% lidocaine in combination with general anesthesia. Anesthesia based on the long-term epidural lidocaine administration in combination with general anesthesia versus total intravenous anesthesia based in ketamine and ataralgesia was analyzed. The anesthesia based on the long-term epidural lidocaine administration in combination with general anesthesia was shown to provide steady-state hemodynamic parameters and an adequate antinociceptive protection and to contribute to the early activation of patients.