[Clinical significance of the procalcitonin test in differential diagnosis of systemic inflammatory reaction in pancreatonecrosis]. / Klinicheskaia znachimost' prokal'tsitoninovogo testa v differentsial'noi diagnostike sistemnoi vospalitel'noi reaktsii pri pankreatonekroze.

The significance of procalcitonin test (PCT) in the differential diagnosis of sterile and infectious pancreonecrosis was evaluated. Twenty-four patients with destructive pancreatitis were examined. Plasma procalcitonin concentrations were increased in the patients with infectious pancreonecrosis and correlated with the clinical status of patients evaluated by APACHE II and SOFA scores. The sensitivity and specificity of this test in the diagnosis of infectious pancreonecrosis were 84.4 and 83.3%, respectively, its prognostic significance being as high as 93.1%. Plasma concentrations of procalcitonin in sterile pancreonecrosis were normal or slightly increased. These results indicate that measurement of procalcitonin concentrations is an optimal laboratory test for differential diagnosis of sterile and infectious pancreonecrosis. PCT helps determine the treatment strategy in patients with various forms of destructive pancreatitis.

[Efficacy of pefoxacin (abactal) in the complex treatment of patients with pancreonecrosis]. / Effektivnost' pefloksatsina (abaktala) v kompleksnom lechenii bol'nykh s pankreonekrozom.

The efficacy of pefloxacin in the complex treatment of 28 patients with pancreatonecrosis of various etiology was estimated in a prospective trial. The diagnosis of pancreatonecrosis was verified by the data of the disease clinical progress, laboratory findings and instrumental examination. Pefloxacin (Abactal; LEK) was administered intravenously in a dose of 400 mg every 8 hours (1200 mg) in combination with metronidazole in a dose of 1.5-2.0 g a day intravenously. When indicated 3 days after the start of the pefloxacin therapy, the treatment was switched to the oral use of the drug in the same dosage. The positive clinical effect (cure and improvement) at the end of the treatment with pefloxacin was stated in 78 per cent of the patients in spite of the initial severity state of above 15 APACHE II. It was shown that in the treatment of patients with pancreatonecrosis when the severity state was not above 12 APACHE II the antibacterial therapy with pefloxacin in combination with metronidazole was optimal.

[The oxidative modification of blood plasma proteins in patients in critical states]. / Okislitel'naia modifikatsiia belkov plazmy krovi u bol'nykh v kriticheskikh sostoianiiakh.

Current concepts on the formation and biological activity of activated oxygen forms (AOF) in humans are discussed. The main AOF types are produced as a result of consecutive single-electron recovery of molecular oxygen (O2) and are more reactive than O2. AOF are initially normal components of cellular metabolism with certain biological functions. Their reactive aggressiveness is regulated by a potent antioxidant system which is present in any live organism. In disease this balance is distorted towards uncontrolled AOF generation and formation of oxidative stress, when AOF impair all biological structures, including proteins. Unregulated modification of proteins by AOF results in loss of protein biological activities (enzymatic, receptor, transporting function, etc.). Moreover, oxidative modification of proteins generates new antigens and provokes immune response. The authors present experimental data which confirm significant modification of plasma proteins in critical patients. The role of the detrimental effect of AOF on proteins in the formation of critical states deserves special studies.