[Prevention of the development of catheter-associated urinary system infections in the early postoperative period].

BACKGROUND: Bladder catheterization is a common medical manipulation that is associated with the risk of complications, including catheter-associated urinary tract infection (CAUTI), which accounts for 80% of all nosocomial infections of the urological profile. AIM: To evaluate the combined use of the biologically active additive Uronext and ceftriaxone in the prevention of the development of CAUTI in the early postoperative period in 120 patients aged 20-80 years with a Foley indwelling catheter. MATERIALS AND METHODS: The patients were divided into 2 groups: in group I (n=60), D-mannose with cranberry extract and vitamin D3 as part of Uronext dietary supplement was administered orally in the form of sachets 48 hours before surgery and after surgery until urethral catheter was placed, as well as intravenous ceftriaxone 1000 mg 2 hours before surgery and in the postoperative period within 7 days. In group II (n=60), ceftriaxone monotherapy was prescribed in a similar way. RESULTS: According to the results of bacteriological examination of the removed urinary catheter on 3-7 days in Uronext group, bacterial growth was absent in 40 patients (66.67%, p<0.05), versus 23 cases (38.33%) in the control group. CONCLUSIONS: The data obtained confirm the efficiency of the use of the biologically active additive Uronext in combination with an antibacterial drug, which allows to recommend this scheme in patients with an indwelling urinary catheter for the prevention of the development of CAUTI.

[Evaluation of the efficiency and safety of the dispersed form of sildenafil (50 mg) in males with erectile dysfunction].

INTRODUCTION: The erectile dysfunction is defined as an inability to achieve or maintain an erection sufficient for sexual intercourse lasting more than 3 months. According to literature, about 90 million men worldwide suffer from erectile dysfunction of different severity. AIM: To evaluate the efficacy and safety of the dispersed form of sildenafil ("Ridzhamp" 50 mg), compared with the standard tablets of sildenafil (50 mg). MATERIALS AND METHODS: The study included 60 men aged 27 to 67 years (average age 40.2 years) with moderate erectile dysfunction (11-15 points according to IIEF-5). In group I (n=30), patients took a dispersible form of the drug sildenafil, 50 mg ("Ridzhamp") 60 minutes before sexual intercourse; in group II (n=30), a standard form of the drug sildenafil was prescribed at a dosage of 50 mg, 60 minutes before sexual intercourse. RESULTS: Positive dynamics according to IIEF-5 score was found in all the study groups. In group I, IIEF-5 score increase by 53.85%, while in group II by 50% (p<0.05). The average onset of erection in group I was 45+/-2.2 min, while in group II it was 51+/-1.9 min. In the main group (group I) one patient (3.33%) complained of persistent headache after taking the drug, and therefore refused the therapy. In the comparison group (group II) one patient (3.33%) reported dyspeptic disorders while taking the drug, 1 patient (3.33%) reported dizziness. All patients in the main group noted the convenience of taking the "Ridzhamp". CONCLUSIONS: Our results indicate the comparable efficiency of the dispersed form of sildenafil (group I) and the standard tablet form of the drug (group II). All patients in the main group (group I) noted a faster onset of erections, as well as the convenience of "Ridzhamp" and the ability to take the drug without water intake.

[The epidemiological microbiological characteristics of cultures of Candida albicans circulating in hospital for HIV-infected patients.]

The study was organized relating to 70 cultures of Candida albicans isolates from 19 patients (n=45) and from objects of hospital environment (n=25) in July 2013 and October2014 in specialized department for HIV-infected patients. The genetypical characteristic was given related to candida on the basis of polymerase chain reaction of intronic area of gene 25s pRNA and also their biological characteristics taking into account genotype. The rate of prevalence of Candida genotypes A, B, С and В made up to 58.6%, 10%, 18.6% and 12,8% correspondingly. It was established significant predominance of C.albicans genotype A in various commensal (pharynx) and transitory (skin) loci. In most cases, they were a cause of candidiasis, including invasive candidiasis. Besides, epresentatives of this group more frequently (85%) contaminated objects of hospital environment (p=0.0013). The cultures of C.albicans genotype В (Candida dubliniensis) were small in numbers and were isolated only from ecological biotypes of patients without clinic of candidiasis, were not detected in environment, were least active with exo-enzymes (phospholipase and protease) and were sensitive to tested anti-mycotic. In various biotops of single patients as a rule the only one strain persisted. In a number of cases genotypically different cultures were isolated. The residence of patient in hospital enhanced joining of C.albicans of other genotypes and in two cases were established a total change of cultures. Thus, in hospital environment of specialized hospitals can develop and long-time circulate hospital strains of C.albicans with high enzyme activity. The source are HIV-infected patients themselves that increases risk of of development of candidiasis.

[The experience of implementation of REP-u RAPD-polymerase chain reaction in epidemiologic characteristic of nosocomial isolates Pseudomonas aeruginosa].

The article presents comparative evaluation of diagnostic value of technique REP- u RAPD-polymerase chain reaction applied under genetic typing of clinical isolates of Pseudomonas Aeruginosa. The strains are isolated in different hospital departments of medical institutions in adult (8 medical institutions; n = 145) and children (5 medical institutions; n = 151) medical networks. The results of study demonstrated different boundary capacity of three reactions. The Simpson discrimination index made up to 0.993, 0.875 and 0.639 for RAPD-, ERIC- and BOX-polymerase chain reaction correspondingly. The RAPD-polymerase chain reaction makes it possible to detect individual characteristics of strains. Out of two alternatives the REP-polymerase chain reaction demonstrated its advantage, besides only with one primer ERIC2. The BOX-polymerase chain reaction has a least discriminating capacity under typing of isolates P. aeruginosa, detecting only species' characteristics. The clinical strains P. aeruginosa are distributed on 24 genome groups and 52 isolates had individual genotypes. The evaluation of results of genetic typing permitted to point out both similarity of tendencies in propagation of strains of P. aeruginosa among hospitalized adults and adolescents and specificity of detection in neonatal clinics. It is obvious that hospitals of different profiles, including departments of reanimation and intensive therapy represent specific ecological environment significantly different in its level of endogenous and exogenous infection.

[Prevalence of cytotoxicity effectors in nosocomial Pseudomonas Aeruginosa strains].

AIM: Analysis of occurrence of the third type secretory system (TTSS) effectors in clinical P. aeruginosa strains. MATERIALS AND METHODS: Intra-hospital (n = 164) and extra-hospital (n = 30) strains of P. aeruginosa were studied. Detection of exoS and exoU genes was carried out by PCR in DNA Engine Dyad Thermal Cycler ("Bio-Rad", USA). Metallo-beta-lactamase (MBL) producers were detected by the presence of blaVIM-2 gene. RESULTS: Screening of intra- and extra-hospital strains for the presence of genes coding ExoS and ExoU showed, that exoS is detected in genome of clinical isolates in 59.8% and exoU--31.1% of cases. At the same time, strains with exoS-/exoU+ genotype predominated in lCU (Φ = 0.466; p = 0.0000). A significant association between the presence of the respective effectors and material of strain isolation was not detected. exoU gene was more frequently detected in genome of MBL producers (Φ = 0.784; p = 0.0004). CONCLUSION: A significant association between exoU and blaVIM-2 could be explained by clonal prevalence of P. aeruginosa ST235 VIM-2, circulation of those is noted on all the territory of Russia. As a rule, ExoU is produced by highly virulent poly-antibiotic resistant hospital isolates that determine unfavorable outcomes of pseudomonas infection.

[Cytological features and chemiluminescent activity of phagocytic cells in bronchial lavage of elderly patients with bronchial asthma].

The aim of the study was to investigate cytological features and chemo luminescent activity of bronchial lavage phagocytic cells in 58 patients (28 of them are over 60 years old and 25 patients younger than 60 years) with bronchial asthma (BA) before and after achievement of medicinal disease control. Bronchial inflammation process in elderly patients (> 60 years) was characterized by significant higher content of neutrophils and lymphocytes as well as lower proportion of alveolar macrophages. Chemo luminescent responses of bronchial lavage phagocyte cells in patients with BA were unidirectional in two comparative aging groups, albeit with quantitative differences. In conclusion, respiratory tract inflammatory process in elderly patients with BA is characterized by less pronounced involvement of effector cells, lower chemo luminescent activity of phagocytes in comparison with similar parameters in the patients younger than 60 years old.

[Characteristics of the latent period of sensorimotor reactions in middle-aged and elderly outpatients with asthma during long-term treatment with inhaled glucocorticosteroids].

AIM: To study a relationship of the characteristics of simple and complex visual sensorimotor reactions to asthma controllability in middle-aged and elderly outpatients during disease-modifying antirheumatic drug therapy with beclomethasone, fluticasone, or budesonide in average and high daily doses. SUBJECTS AND METHODS: Eighty middle-aged and elderly patients with asthma were examined. The level of asthma control, the main parameters of external respiratory function, and the characteristics of simple and complex visual sensorimotor reactions were assessed. RESULTS: Uncontrolled asthma was observed in more than 50% of the asthmatic patients in the outpatient setting. Moderate linear relationships were found between the main physiological parameters and the level of the standard asthma control test. CONCLUSION: In the patients with controlled asthma, the latent periods of simple and complex visual sensorimotor reactions were significantly shorter than in those with poorly controlled asthma.

[Clinical significance of cytological characteristics of bronchial inflammation in obstructive pulmonary diseases]. / Klinicheskoe znachenie tsitologicheskoi kharakteristiki vospaleniia bronkhov pri obstruktivnykh bolezniakh legkikh.

AIM: To evaluate a clinical role of cytological characteristics of induced sputum (IS) and bronchial lavage (BL) in patients with different forms of bronchial asthma (BA) or chronic obstructive bronchitis (COB). MATERIAL AND METHODS: The study included 128 BA patients (53 males and 75 females) at the age of 17 to 70 years (mean age 51.3 +/- 8.4 years) and 53 COB patients (32 males and 21 females) at the age 17 to 70 years. The material for the cytological examination was BL obtained by fibrobronchoscopy and IS obtained after 20-min halotherapy. RESULTS: Percentages of eosinophils, neutrophils, lymphocytes and alveolar macrophages in IS and BL have the same trends and a highly significant correlation coefficient by all the studied cells both in BA and COB patients. CONCLUSION: It was found possible to use IS cytology for evaluation of air way inflammation in BA and COB patients.

[Cyto-oxidant markers of inflammation in assessing the efficacy of differentiating therapy of severe obstructive pulmonary diseases]. / Tsitooksidantnye markery vospaleniia v otsenke éffektivnosti differentsirovannoi terapii tiazhelykh form obstruktivnykh zabolevanii legkikh.

The study purpose was the cytooxidant properties of inflammation in patients with severe heterogenic forms of chronic obstructive pulmonary disease (COPD); and the informative value of the changes in the studied indices for assessment of anti-inflammatory efficiency of differential therapy. The cytological test (CT) and chemiluminescent biotesting of bronchial lavage (CB) obtained with fibrobronchoscopy were conducted in 155 patients with severe bronchial asthma and chronic obstructive bronchitis. The patients were divided into groups according to current classification and predominant etiological factor of the exacerbation. The data of CT and CB in exacerbation significantly differ from the findings in the control group. They also differed in bronchial asthma and chronic obstructive bronchitis. The differentiated treatment resulted in improvement but did not reach the parameters of the control group. Thus, changes in CT and CB proved to be of the differentiated nature and this enables to use the tests as additional sensitive examinations in clinical practice.

[Dynamics of the fatty acid composition of guinea pig liver and lung mitochondrial lipids in experimental tuberculosis]. / Dinamika zhirno-kislotnogo sostava lipidov mitokhondrii pecheni i legkikh morskikh svinok pri éksperimental'nom tuberkuleze.

Composition of fatty acids was distinctly different in lipids of guinea pig liver and lung mitochondria; unsaturated polyenic acids containing 18 carbon atoms prevailed in lipids of liver mitochondria, saturated fatty acids dominated in lipids of lung mitochondria and monoenic acids were found among unsaturated fatty acids of the fraction. Experimental tuberculosis was accompanied by dissimilar alterations in fatty acid composition of lipids from mitochondria of these tissues: content of saturated fatty acids was increased in liver mitochondria and the content of unsaturated fatty acids--in lung mitochondria.