Model of Osteomyelitis in Rats.

We developed a rat model of chronic osteomyelitis of the femur caused by Staphylococcus aureus. The clinical, histomorphological, and laboratory signs were compared in rats with osteomyelitis (infected) and control animals receiving saline. On day 21 after infection, clinical, histomorphological, and laboratory signs of chronic osteomyelitis were found in experimental rats.

[Economic aspects in sIngle-event multilevel orthopedic surgery in patients with cerebral palsy].

This article reports an assessment of direct expenses for surgical treatment of patients with cerebral palsy and secondary orthopedic complications, who have undergone single-event multilevel orthopedic surgeries (SEMLS). It has been demonstrated that modern approach based on SEMLS is substantiated from the medical point of view and at present it is also justified from the point of view of economic assistance for that type of treating activity of a Federal Centre specialized in trauma and orthopaedics. Organization of surgical treatment using multilevel orthopaedic interventions requires selection of implants for specific characteristics and, on expenditure side, not exceeding funding of direct expenses intended for this treating process.

[Dependence of biofilm-forming ability on the antibiotic sensitivity of Pseudomonas aeruginosa clinical strains isolated from patients with chronic osteomyelitis.]

Due to the spreading highly resistant strains among clinically significant P. aeruginosa clones, it becomes necessary to prescribe antibiotics not only taking into account the knowledge of sensitivity spectrum of a particular isolate but the data of microorganism biofilm activity as well. To study the dependence of biofilm-forming ability on the sensitivity to antibacterial preparations of P. aeruginosa clinical strains, isolated from patients with chronic osteomyelitis. 36 patients above 18 with chronic osteomyelitis of long tubular bones who were treated in the center of purulent osteology took part in the experiment. Object of the study - material isolated from wounds, fistulas, as well as from inflammatory foci. The sensitivity of isolated microorganisms to 10 antibiotics was analyzed: Piperacillin/Tazobactam, Imipenem, Meropenem, Aztreonam, Amikacin, Ciprofloxacin, Ceftriaxone, Ceftazidime, Cefotaxime, Cefepime. High- and medium-adhesive strains accounted for 86,1 % among P. aeruginosa clinical isolates, obtained from the wounds of patients with chronic osteomyelitis of long tubular bones. Highly adhesive strains are resistant to a wide range of antibacterial preparations used clinically. Penicillins were the most effective preparations when analyzing antibioticograms obtained for highly adhesive strains, for medium adhesive strains - penicillins, aminoglycosides and carbapenems, for low adhesive ones - aminoglycosides, penicillins, carbapenems, monobactams, quinolones. P. aeruginosa multi-resistance is a serious problem in the treatment of patients with chronic osteomyelitis. Spreading antibiotic-resistant strains of P. aeruginosa is associated with the presence of bacteria in the biofilm. Since adhesion is the first step in the biofilm formation, it is important to identify strains having high adhesive ability timely.

[The Optimization of Amount of Laboratory Analyses in the Federal Orthopedic Clinic].

The article presents the analysis of efficiency of medical services support related to laboratory analyses in case of alteration of system of Federal clinic financing. The analysis was implemented using the example of functioning of three departments of endoprosthesis replacement of the Federal State Budget Institution "The Academician G. A. Ilizarov Russian Research Center 'Restorative Traumatology and Orthopedics' " in 2013-2015. It is established that during examined period in the structure of laboratory analyses of the Center decreasing of total number of prescriptions to all types of laboratory analyses occurred. The observed decreasing of laboratory analyses had no impact to quality of treatment of patients of the departments of endoprosthesis replacement. In particular, percentage of post-surgery complications among patients of these departments was decreasing during the examined period. The study demonstrated that to the end of 2015 decreasing of average costs in rubles per patient of departments of endoprosthesis replacement related to laboratory analyses occurred up to 20.28% as compared with 2013. The proposals were made concerning structuring of laboratory analyses for patients with endoprosthesis replacement of large joints.

[METABOLIC STATUS OF PATIENTS OF DIFFERENT AGE GROUPS ON THE STAGES OF OSTEOARTHRITIS].

This study investigated the biochemical parameters of blood and urine in patients with osteoarthritis in the stages of the pathological process in different age groups. The patients of all age groups in the stages of osteoarthritis demonstrated metabolic acidosis, activation of the antioxidant system and increase in acute phase proteins. In addition to the total for all age groups metabolic shifts the characteristic age-related changes were observed: activated reaction of lipid peroxidation in middle-aged patients and negative calcium balance, with increasing energy metabolism disorders in elderly patients.