TREATMENT OF PYOINFLAMMATORY COMPLICATIONS WITH INDIVIDUALLY SELECTED OZONE DOSE IN PATIENTS WITH DIABETES.

The severity of purulent-inflammatory process in patients with diabetes mellitus is determined by lymphocytotoxic test. The test shows that application of intravenous ozone therapy with individually selected ozone dose significantly decreases the spread of necrotic suppurative focus already on the third day of treatment. Granulation tissue and marginal epithelization in the wound develops on the 6-8th day of hospitalization; normalization of glycemic levels shorten of the period of the hospital stay up to 3-5 days, compared to the control group.

EVALUATION OF THE USE OF OZONE THERAPY IN TREATMENT OF INFLAMMATORY PROCESSES IN DIABETES MELLITUS IN AN EXPERIMENT.

Studying the effect of ozone therapy on the course of pyoinflammatory processes with diabetes mellitus in the experiment, conducted on 30 white 24-30 month rats, weight 300-450 gr with purulent-inflammatory processes, it was found out that diabetes, which was simulated by subcutaneous injection of alloxan, causes mosaic disturbances of hemostasis system in the presence of pyoinflammatory processes. Complicated changes in blood condition were also detected against the background of diabetes mellitus: chronometric hypocoagulation on the intrinsic pathway of blood coagulation in association with chronometric hypercoagulation by the external thrombinogenesis mechanism and fibrinogenesis depression against the background of hypofibrinogenaemia. Thus, the use of ozone therapy in the presence of soft tissues abscesses in old rats with diabetes does not demonstrate significant protective properties with reduced azoalbumin lysis, total non-enzymatic fibrinolytic activity and proteinase activity by Kunitz in blood plasma. Such changes in old rats can be considered as an exacerbation of purulent inflammation, increase in toxicity, reduced protective properties, increase in manifestations of hypercoagulation against the background of chronic course of diabetes, caused by age-related changes.

[Serum and bile cytokines dynamics in patients with non-tumoral obstructive jaundice and suppurative cholangitis]. / Dinamika tsitokinov v syvorotke krovi i zhelchi u patsientov s mekhanicheskoi zheltukhoi i gnoinym kholangitom neopukholevogo geneza.

AIM: To study serum and bile cytokines dynamics in patients with non-tumoral obstructive jaundice and suppurative cholangitis. MATERIAL AND METHODS: Comparative study of serum and bile cytokines in 49 operated patients with biliary pathology was performed. Patients were divided into 3 groups. The first group included 24 patients with acute calculous cholecystitis (ACCh), the second group consisted of 12 patients with chronic calculous cholecystitis (CCCh) and the third group included 13 patients with choledocholithiasis complicated by obstructive jaundice and suppurative cholangitis. RESULTS AND DISCUSSION: All patients had increased level of TNF-α, IL-4 и IL-6. There was augmentation of biliary cytokines in patients with obstructive jaundice compared with those with acute and chronic calculous cholecystitis. In patients with obstructive jaundice and suppurative cholangitis the highest levels of cytokines were observed. Patients with obstructive jaundice (OJ), suppurative cholangitis (SCh) and chronic calculous cholecystitis had higher levels of cytokines in both blood and bile than in those with OJ, SCh and acute calculous cholecystitis that is explained by development of purulent inflammation on background of previous cytokines imbalance and chronic inflammation. In general, patients with acute calculous cholecystitis had higher levels of TNF-α and IL-6 in blood serum and IL-4 in bile. Patients with chronic calculous cholecystitis had higher concentration of TNF-α and IL-4 in bile and IL-6 - in blood serum. CONCLUSION: Both forms of cholecystitis and their complications are associated with increased cytokines in serum and bile. The level of augmentation depends on the type of inflammation and complications. Comparative study of cytokines can be the most informative criterion to monitor the postoperative period.

[The influence of local and combined acute suppurative Highmore maxillary sinusitis on the serum lactoferrin and interleukin-8 levels in the children].

The objective of the present study was to estimate the influence of isolated and combined acute suppurative Highmore maxillary sinusitis on the serum lactoferrin (LF) and interleukin-8 (IL-8) levels in the children. A total of 70 children at the age varying from 4 to 15 years were available for the examination. Twenty of them constituted the control group, 29 presented with acute suppurative Highmore maxillary sinusitis, in 21 cildren this condition was combined with frontitis, ethmoiditis, otitis, and adenoiditis. Serum lactoferrin and interleukin-8 levels were measured by solid phase enzyme-linked immunoassay. It was shown that all the aforementioned forms of rhinosinusitis were associated with a significant increase of the serum LF level, an universal factor inactivating the propagation of bacterial, viral, and fungal pathogens. The level of IL-8 known to activate chemotaxis was increased only in the children presenting with combined forms of suppurative Highmore maxillary sinusitis. It is concluded that this difference can be used for the purpose of dufferential diagnostics of different forms of suppurative maxillary sinusitis.

Involvement of minor salivary glands in the pathogenesis of peritonsillar abscess.

OBJECTIVES: To study the relationship between peritonsillar abscess (PTA) and minor salivary glands surrounding the palatine tonsils. STUDY DESIGN: Prospective population-based study. SETTINGS: Tertiary care university hospital. SUBJECTS AND METHOD: Prospective study including 41 patients with PTA and 6 patients with a neck abscess. Amylase levels of the pus and serum were measured and compared between the 2 groups. Clinical data regarding hospitalization length and recurrence rate were also collected. RESULTS: Of the 41 patients with PTA, 7 suffered from recurrent PTA. Average level of amylase in the pus of the PTA group was 3841 U/L versus 7.7 U/L in the neck abscess group (P < .001; median, 62 vs 9.5). Serum amylase was higher in the PTA group (49.3 U/L vs 37.3 U/L; P = .008). There were no recurrences in PTA patients with amylase greater than 65 U/dL in the pus in 0 of 20 (0%) versus 7 of 21 (33%) for amylase lower than 65 U/L (P = .01). CONCLUSION: High amylase in the pus lends further support for involvement of minor salivary glands. However, high recurrence rates related to low amylase in the pus imply an additional pathogenesis possibly related to tonsillar infection. It is possible that both minor salivary glands as well as tonsillar infection play a role in the pathogenesis of peritonsillar infections.

[Diagnostics of septic complications after long tubular bones fractures].

Interleukine (IL-1alpha, IL-4) blood levels and lipid peroxidation--antioxidant agents were assessed in 98 patients with fractures of long tubular bones. Using the data, an algorithm was worked out, which permits prediction of septic complications with a high level of accuracy.

Systemic Th17-like cytokine pattern in gangrenous appendicitis but not in phlegmonous appendicitis.

BACKGROUND: Increasing circumstantial evidence suggests that not all patients with appendicitis will progress to perforation and that appendicitis that resolves may be a common event. Based on this theory and on indications of aberrant regulation of inflammation in gangrenous appendicitis, we hypothesized that phlegmonous and gangrenous appendicitis are different entities with divergent immunoregulation. METHODS: Blood samples were collected from patients with gangrenous appendicitis (n = 16), phlegmonous appendicitis (n = 21), and nonspecific abdominal pain (n = 42). Using multiplex bead arrays, we analyzed a range of inflammatory markers, such as interleukin (IL)-1ra, IL-1rbeta, IL-2, IL-6, IL-10, IL-12p70, IL-15, and IL-17; interferon-gamma; tumor necrosis factor; CXCL8; CCL2; CCL3; and matrix metalloproteinase (MMP)-1 MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-12, and MMP-13 in blood. RESULTS: Compared with patients with phlegmonous appendicitis and nonspecific abdominal pain, the patients with gangrenous appendicitis had increased levels of the proinflammatory markers IL-6, CCL2, IL-17, MMP-8, and MMP-9 (P < or = .04 each) accompanied by increased levels of the anti-inflammatory cytokines IL-1ra and IL-10 (P < or = .02). Patients with phlegmonous appendicitis had increased levels of IL-10 only. CONCLUSION: The finding of a pattern of inflammatory markers compatible with the highly inflammatory Th17 subset in sera from patients with gangrenous appendicitis, but not in phlegmonous appendicitis, supports the hypothesis that gangrenous and phlegmonous appendicitis are different entities with divergent immune regulation. Additional studies of the differential immunopathogenesis of phlegmonous and gangrenous appendicitis are warranted, as this may have important implications in the diagnosis and management of patients with suspicion of appendicitis.

Research on serum and saliva concentration of some bivalent cations in patient with suppurations of the oro-maxillo-facial area.

UNLABELLED: Bivalent cations, such as calcium, magnesium, zinc, copper and manganese play important roles in some physiological and pathological processes on the human body. AIM: To determine possible modifications in serum and saliva concentration of total-Ca2+, total-Mg2+, Zn2+ and Cu2+ in patients with suppurative infections of the oro-maxillo-facial area and eventually their significance for the mentioned pathology. MATERIAL AND METHOD: Study included 47 patients with suppurative infections of the oro-maxillo-facial area, hospitalised during 2006-2008 in the oro-maxillo-facial clinic of "Sfântul Spiridon" Hospital Iasi and 43 healthy control volunteers. RESULTS: Results revealed decreased serum Zn2+ (0.94 +/- 0.21 vs. 1.39 +/- 0.14 mg/L, p < 0.01), decreased serum Zn2+/Cu2+ ratio and increased serum and saliva total-Mg2+ concentration (27.34 +/- 2.61 mg/mL in patients vs. 23.83 +/- 1.61 mg/L in healthy controls- serum, p < 0.05 and 3.79 +/- 0.41 mg/mL in patients vs. 3.21 +/- 0.40 mg/mL in healthy controls - saliva, p < 0.05) in patients with suppurative infections of the oro-maxillo-facial area vs. healthy controls. There were no statistically significant differences in total-Ca2+ concentrations in saliva and serum. Our data are in agreement with medical literature revealing zinc deficiency as a predisposition factor to infection. CONCLUSION: We consider that a significant increase in total-Mg2+ saliva concentration, as well as a decrease in Zn2+/Cu2+ serum ratio could be considered a marker for predisposition to oro-maxillar suppurations.

[Hemostasis system disturbances and their correction in patients with pyonecrotic forms of diabetic foot].

Severe hypercoagulation syndrome was diagnosed in patients with various forms of diabetic foot. Pathology at coagulogram parameters reflects systemic metabolic and inflammatory disturbances. Anticoagulant therapy should be combined with correction of glycemia, treatment of infection and critical ischemia. Only this complex therapy can normalize coagulation parameters and reduce the risk of thrombotic complications.

[Interaction between bacteria and erythrocytes and their role in the development of infectious anaemia].

The concentration of hemoglobin in blood of patients with pyoinflammatory diseases was shown to depend on the ability of bacteria to interact with erythrocytes. Bacteria with high hemolytic activity (> or = 70% hemolysis) and anti-hemoglobin activity (>3 g/1) were isolated from pyoinflammatory foci of patients suffering from anaemia. Structural changes were investigated in vitro and in vivo erythrocytes in terms of their interaction with microorganisms by electron microscopy. For the first time, the phenomenon of coccal location within erythrocytes was established. Staphylococci with a high level of hemolytic and anti-hemoglobin activity appear to survive and multiply within erythrocytes that results in destroying hemoglobin. Staphylococci with a low level of mentioned activities are subjected to destructive changes within erythrocytes and subsequent killing.

[The parameters of blood and leukocytic intoxication index in the evaluation of the severity of inflammatory, purulent, and pyodestructive diseases].

Studies of the leukocytic intoxication index (LII), leukocytes, and lymphocytes in patients with inflammatory, purulent, and pyodestructive diseases of the abdomen, lung, and soft tissues at the height of disease have ascertained that LII progressively increased and the relative count of lymphocytes decreased with the worse health status in all groups of patients, particularly in ineffectively treated patients who subsequently died. However, in these patients, the absolute count of lymphocytes did not always tend to decrease. The persistent high LII concurrent with lymphocytopenia indicated a poor prognosis. Leukocytes had less pronounced changes in this respect.

An automated spectrophotometric method for measuring canine ceruloplasmin in serum.

An automated method for the determination of ceruloplasmin activity was developed and validated in canine serum. The method is based on the in vitro oxidase activity that this protein shows with substances such as p-phenylenediamine. In order to determine optimum assay conditions, the effects of the substrate concentration, buffer pH, reaction time and EDTA on the reaction were evaluated. The precision of the assay was good with within-run and between-run coefficients of variation lower than 10%. The method measured the ceruloplasmin values in a proportional and linear manner (r = 0.99) with a limit of detection of 0.0007 +/- 0.0001 Delta Abs/min. A temperature of -20 degrees C kept the reagent stable for 30 days. The method is cheap and easy to adapt to any automated biochemical analyser, considerably decreasing the processing time required with the manual method. Additionally it allows to differentiate dogs with pyometra and trauma from clinically healthy dogs.

[Morphofunctional characteristics of erythrocytes in chronic kidney failure and purulent intoxication]. / Morfofunktsional'naia kharakteristika éritrotsitov pri khronicheskoi pochechnoi nedostatochnosti i gnoinoi intoksikatsii.

The morphology of blood erythrocytes was examined under a scanning electron microscope and erythrocyte surface charge, lipid peroxidation on erythrocyte membranes, and blood viscosity were studied in 213 urological patients with chronic renal insufficiency (CRI) and purulent intoxication (PI) of different severity. CRI and PI were characterized by morphofunctional changes in erythrocytes, which depended on the type and severity of intoxication. Changes in erythrocyte morphology in CRI and PI were paralleled by a decrease in their negative surface charge and activation of lipid peroxidation. These parameters can serve as diagnostic tests for evaluation of the severity of intoxication.

[Transformed and pathological red cells in endogenous intoxication and extracorporeal detoxication]. / Transformirovannye i patologicheskie éritrotsity pri éndogennoi intoksikatsii i ékstrakorporal'noi detoksikatsii.

Peripheral red blood cells obtained from 227 urological patients with chronic renal failure and purulent intoxication (78 of them were treated by hemodialysis and hemosorption) are examined. Scanning electron microscopy, cell surface charge, lipid peroxidation in erythrocytes, blood viscosity data are summarized. Significant morphofunctional changes dependent on the severity of the intoxication and the detoxication efficiency are manifestation of nonspecific features of the cell injury and adaptation. Their complex and dynamics are suggested as important diagnostic criteria.

[Immunological parallels in the use of ultraviolet irradiation of autoblood in patients with suppurative diseases of soft tissue]. / Immunologicheskie paralleli pri primenenii ul'trafioletovogo oblucheniia autokrovi u bol'nykh s gnoinymi zabolevaniiami miagkikh tkanei.

Ultraviolet irradiation of autoblood in patients with suppurative diseases of soft tissues increased the titer of specific antibacterial antibodies and the number of antibody-producing cells (APC), which was the most expressed in cases when the erythrocytes and leukocytes were exposed separately. Study of the count of APC during UV exposure showed it to increase 6-8 h after the procedure.

[Chemoluminescence of blood and urine in diffuse appendicular peritonitis in children]. / Khemoliuminestsentsiia krovi i mochi pri rasprostranennom appendikuliarnom peritonite u detei.

The results of the study of hemiluminescence of native blood, plasma and urine in 56 children with diffuse purulent peritonitis demonstrate that changes of light-sum of the luminescence of the investigated media could reflect aggravation of endogenous intoxication connected with development of organic insufficiency. The usage of blood and urine hemiluminescence for definition of the gravity of endogenous intoxication in diffuse forms of appendicular peritonitis in children is suggested.

[Diagnostic value of interleukin-6 level during the post-operative period]. / Diagnosticheskoe znachenie urovnia interleikina-6 v posleoperatsionnom periode.

IL-6, CRP, erythrocyte sedimentation rate, and leukocytes were evaluated in 82 patients after planned surgery. In 60 patients the postoperative period was uneventful, while 22 developed purulent complications which eventuated in death in 6 cases. The authors show the diagnostic significance of evaluating IL-6 level for predicting the development of purulent complications during the postoperative period and their severity. Measurement of IL-6 is valuable for assessing the results of treatment of patients with bacterial shock.

[Lipid peroxidation and the function of the antioxidant system in sepsis in patients with soft-tissue suppurative and inflammatory lesions]. / Perekisnoe okislenie lipidov i sostoianie antioksidantnoi sistemy pri sepsise u bol'nykh s gnoino-vospalitel'nym porazheniem miagkikh tkanei.

While sepsis present in 73 patients with purulent-inflammatory affection of soft tissues and in 76 patients with local purulent inflammation the dynamics of processes of peroxidal oxidation of lipids (POL) and of antioxidant system (AOS) was studied up. In patients of both groups the trustworthy increase of the POL products in a blood plasma and pre- and postoperative AOS suppression was noted.

Nonbacterial pyospermia: a consequence of clomiphene citrate therapy.

OBJECTIVE: Since the development of nonbacterial pyospermia in previously nonpyospermic men treated with clomiphene citrate (CC) has been observed, and nonbacterial prostatitis has been after antiestrogen treatment in an animal model, we sought characterize the occurrence of nonbacterial pyospermia in men treated with CC. PATIENTS AND METHODS: Forty-two nonpyospermic men with low serum testosterone levels treated with 25 mg CC/day were retrospectively compared to 27 untreated nonpyospermic men referred for infertility evaluation. RESULTS: Spontaneous nonbacterial pyospermia developed in CC-treated men [14.3%] at rate nearly twice that observed in controls [7.4%]. Serum testosterone increased in CC-treated men, both pyospermic and nonpyospermic. However, only CC-treated, nonpyospermic men demonstrated improvement in semen characteristics. CC-treated men who developed pyospermia were older than nonpyospermic men [pyospermic, 41.7 +/- 8.1 years; nonpyospermic, 35.6 +/- 4.9 years-P < .01). Men over 35 years of age were over six times as likely to develop pyospermia as men under 35 years of age (P < .05). Eight nonpyospermic, CC-treated men (8/36, 22.2%) have contributed to pregnancies leading to live births, whereas no pyospermic man has done so. CONCLUSION: These findings support an association between a nonbacterial inflammatory response of the human male reproductive tract and CC treatment. This pyospermia may occur without significant deterioration of semen characteristics and with an appropriate response to treatment in terms of serum testosterone level. Men over the age of 35 are statistically more likely to develop pyospermia with this therapy. Our results suggest that clomiphene citrate-associated pyospermia has a negative effect on male fertility.

[The role of plasmosorption in correcting the microcirculatory disorders in patients with suppurative-inflammatory processes of the maxillofacial area and diabetes mellitus]. / Rol' plazmosorbtsii v korrektsii mikrotsirkuliatornykh narushenii u bol'nykh s gnoino-vospalitel'nymi protsessami cheliustno-litsevoi oblasti i sakharnym diabetom.

A positive clinical effect of plasma sorption added to multiple-modality treatment of patients with pyoinflammatory maxillofacial diseases and diabetes mellitus was revealed. Plasma sorption is conducive to normalization of lipid metabolism, improves blood rheology, activates microcirculation, this promoting sooner healing of postoperative wounds and reducing hospitalization periods.