Quantitative method for the determination of antibiotic-resistant gut bacterial strains for the early diagnosis of chronic arthritis.

Based on the clinical and microbiological monitoring of two groups of children aged 3 to 17 years with acute (n=78) and chronic (n=46) course of reactive arthritis (ReA), a method for early diagnosis of chronic arthritis was developed by determining the number of antibiotic-resistant coprostrains in patients with ReA, characterized by the absence of the need to isolate a pure culture of the pathogen and its identification; inoculation of faeces at a dilution of 10-5 on solid 1.5% GRM-agar with an antibacterial agents used in the treatment of a particular patient, at a minimum inhibitory concentration in the resistance range, followed by incubation and counting of the colonies of microorganisms grown on the plate. A significant relationship between the number of antibiotic-resistant gut bacterial strains and the course of arthritis (acute, chronic) was revealed, and the borderline value of the number of antibiotic-resistant gut bacterial strains was determined - 5×103 CFU/g, which allows differentiating the acute course from the chronic one: in the acute course< 5×103 CFU/g, with chronic - ≥ 5×103 CFU/g. The method allows, at the stage of completion of anti-inflammatory therapy in the active phase of the disease, to identify a risk group for the development of a chronic course of arthritis among patients with ReA, which can contribute to timely therapeutic measures aimed at preventing recurrence of the disease and making the patient disabled.

Diagnostic cytokine marker of male infertility - interleukin 4.

Analysis of the study is to assess the diagnostic significance of cytokines in the sperm plasma of men of reproductive age (20 - 45 years) of two groups: of patients with chronic bacterial prostatitis, not complicated by infertility and with loss of fertility. The study of sperm plasma - the WHO standard. Determination of the level of cytokines in seminal plasma - by enzyme immunoassay («Cytokine¼, Russia). Two methods of mathematical statistics were used: discriminant analysis and classification trees (decision trees).The similarity of interpretations of discriminant analysis and decision tree was noted, where the main role in both cases belongs to the cytokine IL-4. The level of sperm IL-4 in combination with therapeutic monitoring can be used for the medical management of patients with chronic prostatitis in order to prevent the development of infertility and to develop methods for screening diagnostics of fertility disorders in men.

[GUT MICROSYMBIOCENOSIS IN CHILDREN WITH REACTIVE ARTHRITIS].

AIM: To study the state of gut microsymbiocenosis in children with reactive arthritis (RA), with the assessment of biofilm formation (BFF) of microsymbionts and the ability to change cytokine levels (their anticyokine activity) in vitro. MATERIALS AND METHODS: The investigation of gut microsymbiocenosis by means of bacteriological method was conducted in 34 children with RA and 25 relatively healthy 3 - 16 year- old children. Microorganisms were identified with the help of MALDI-TOF mass-spectrometry, anticytokine activity (ACA) of microsymbionts - according to Bukharin O.V et al. (2011), biofilm formation - according to O'Toole G.A., Kolter R. (1998). RESULTS: On the ground of species composition differences of gut microbiota discrimination model was created which allowed to separate the group of children with RA from healthy individuals. Microsymbiocenosis of patients with RA was characterized by increasing number of opportunistic microorganisms (OM) (enterobacteria, clostridia, bacteroides, and Candida), BFF and ACA level. CONCLUSION: The obtained data greatly contribute.to the deciphering of spondylo- arthritis and disclose the role of microbial factor under given pathology. Hypercolonisation of human gut with OM, having pronounced ability to BFF and regulating cytokine level, promotes strengthening of arthritogenic potential and serves as additional marker of arthritis development risk in children.

[On laboratory diagnostics of early alcoholism and comorbid visceropathy].

The article is dedicated to methodical approaches to revealing organopathological consequences of alcohol abuse in adolescents. The author describes laboratory criteria of pre-nosological disturbances in homeostasis which characterize functional changes in the somatic sphere and adaptation. Algorithms of biochemical diagnostics of internal diseases accompanying alcohol abuse are presented.

[Errors in reconstructive-rehabilitative operations on the hip joint]. / Oshibki pri rekonstruktivno-vosstanovitel'nykh operatsiiakh na tazobedrennom sustave.

Based upon the analysis of 1015 case records of patients, aged 16-70, with different hip joint pathology types, carried out during 1985-1990, there were revealed mistakes and complications after reconstructive-restorative operations. In the group of patients with dysplastic coxarthrosis they noted rather frequent (12% of cases) formation of "tectum" in supratrochanteric region that served as the cause of joint instability and development of arthrosis in future. Cartilaginous limbus, not removed at grave forms of dysplastic coxarthrosis, served as the cause of the pain syndrome in 63% of cases. Carrying out of "osteotomy-medicate" only in patients with aseptic necrosis of femoral head was ineffective in 38% of cases. Total removal of necrotization foci in thigh head with subsequent osseous plasty is necessary. In the process of mobilization operation in case of hyperplastic, coxarthrosis, removal of the lower edge of cotyloid cavity is the obligatory step. Thus, the important condition of favourable terminations of reconstructive-restorative operations is the correct selection of indications, carrying out of complete surgical intervention, rigorous observation of the patient control rules in near and distant postoperative period.

[Addiction treatment services in the Russian Federation]. / Narkologicheskaia sluzhba v Rossiiskoi Federatsi.

The purpose of this paper is to address issues pertaining to the substantiation of trends in improving the narcological service with regard to the present restructuring of antialcohol policy. It is necessary to give up the practice of locating narcological facilities in accommodated premises and to develop the network of dispensaries by constructing new types of buildings. It is advisable to drastically expand the basis for post-graduate training of psychiatrists-narcologists by establishing in each economic region chairs of narcology at faculties of post-graduate training of physicians within medical schools, as well as departments of post-graduate training of personnel at scientific research institutes. There is a need to dramatically strengthen the structural subdivisions of narcological service, providing curative and preventive care to drug addicts. Narcological service for teenagers is also in need of improvement, right up to the introduction of posts of psychiatrists-narcologists for teenagers at all narcological institutions. Another task of high priority is the creation of legal mechanism for organising within narcological service, on the cooperative basis, one's own industrial and rural enterprises capable of improving social and labour rehabilitation of patients and, in the and, to ensure the transfer of narcological service to cost-accountable and self-financing practice.

[Forced method of insulin-coma therapy (methodology, effects)]. / Forsirovannyi sposob insulinokomatoznoi terapii (metodika, osobennosti deistviia).

A study of a new regimen of insulin comatose therapy by intravenous instillation has shown the feasibility of determining the minimal comatose dose of insulin and achieving the comatose state in the first days of insulin therapy. This method makes it possible to utilize the advantages of insulin comatose treatment (a more marked arresting antipsychotic action and the remission persistence). At the same time insulin comatose therapy by intravenous instillation permits the physicians to overcome one of the major drawbacks of this treatment, namely the time lag of the therapeutic response associated with the period of time needed to select the minimal comatose dose which was characteristic of the old method.