INDEXES OF CYTOKINE PROFILE OF BLOOD IN PATIENTS WITH COMPLICATED ERYSIPELAS.

The cytokine blood profile in patients with complicated erysipelas was investigated. It was found that in patients with complications of erysipelas (gangrene, phlegmon, abscess, thrombophlebitis of the subcutaneous veins of the shin) levels of pro-inflammatory cytokines IL-1ß, TNF-α, IL-2, IL-6 in serum significantly increase and level of anti-inflammatory cytokine IL-4 increases slightly, as well as was found a significant increase in coefficients reflecting the ratio of pro-inflammatory and anti-inflammatory cytokines, which indicates the prevalence in the blood of examined patients with complications of erysipelas an anti-inflammatory properties. A more significant increase in pro-inflammatory cytokines serum levels is typical for patients with destructive forms of erysipelas - phlegmonous and gangrenous, a slight increase - for patients without purulent-necrotic component of complication (thrombophlebitis of the subcutaneous veins of the shin). In the future we plan to study pharmacological correction of shifts in cytokine blood profile with drugs with immunomodulating properties in patients with complicated erysipelas.

[Effectiveness of Reamberin in correction of oxidative stress syndrome in patients with phlegmonous and gangrenous erysipelas against the background of the 2 type diabetes mellitus].

The influence of modern detoxic preparation Reamberin on indicators of oxidative stress syndrome (OSS)--the content of lipoperoxidation products was investigated. It was established that inclusion of Reamberin in the complex of surgical treatment of destructive forms of erysipelas on the background of type 2 DM accelerates the liquidation of OSS.

[Estimation of efficiency reamberin in the correction of endogenous intoxication syndrome at the patients with the phlegmonous and gangrenous forms of erysipelas on background diabetes mellitus at their surgical treatment].

The influence of modern detoxic preparation reamberin on indicators of the of endogenous intoxication syndrome (EIS)--the level of average molecules, malon dialdehyde, cyrcukatiry immune complexes and its fractional composition in blood serum of the patients with destructive forms of erysipelas--phlegmonous and gangrenous on background diabetes mellitus (DM). It is established that the inclusion of reamberin in the complex surgical treatment of destructive forms of erysipelas on background DM accelerates the elimination of SEI. From this we can recommend the use of reamberin in the complex surgical treatment of complicated forms of erysipelas on background DM.

[Application of octreotide in patients with acute pancreatitis]. / Primenenie oktreotida u bol'nykh s ostrym pankreotidom.

In 1986-2002 yrs period 515 patients were treated in the clinic for an acute pancreatitis. The severity of the disease was assessed according to clinical and laboratory data, basing on Ranson scale. Severe acute pancreatitis was diagnosed in 45 (8.7%) of patients. In 16 patients together with conventional treatment octreotide was applied in 100-300 mkg/day dosage during 5 days. Fast improvement of the patients state and elimination of acute pancreatitis symptoms was noted. All the patients are alive.

[Indications and choice of amputation of lower extremity level for diabetic angiopathy with purulent-necrotic lesion of foot tissues]. / Pokazaniia i vybor urovnia amputatsii nizhnei konechnosti po povodu diabeticheskoi angiopatii s gnoino-nekroticheskim porazheniem tkanei stopy.

The results of treatment of 193 patients with purulent-necrotic lesion of foot due to diabetic angiopathy have been analyzed. Amputation of the extremity was conducted at the level of shank and hip using the approach suggested in 36 (18.5%) patients. In 157 patients we succeeded in avoiding amputation.

[Immune disorders in patients with purulent necrotic complications of erysipelas]. / Immunnye narusheniia u bol'nykh s gnoino-nekroticheskimi oslozhneniiami rozhistogo vospaleniia.

There were examined 106 patients with purulent-necrotic complications (PNC) of erysipelas and 102 patients without PNC. Significant disorders of the immune status were revealed: the reduction of T-lymphocytes quantity, their subpopulational content dysbalance, the rise of level of a middle- and small-molecular immune complexes. In patients with PNC the immunocorrection conduction is expedient.

[Laboratory methods of prognostication in suppurative complications of erysipelas inflammation]. / Laboratornye metody prognozirovaniia gnoinykh oslozhnenii rozhistogo vospaleniia.

The dynamics of the leukocyte index of intoxication (LII) and the blood-cell index (BCI) was studied in 2756 patients with erysipelas. Both indexes, raised at the height of the disease, are lowering under the therapy influence. At the purulent-inflammatory complications beginning the LII and BCI level remains high or raises 2-3 days before occurrence of clinical signs of complication. The application of above-mentioned indexes for prognostication and diagnosis is possible.

[Disorders of the blood microcirculation in patients with suppurative-necrotic complications in diabetes mellitus and the approaches to their correction]. / Narusheniia mikrogemotsirkuliatsii u bol'nykh s gnoino-nekroticheskimi oslozhneniiami sakharnogo diabeta i podkhodi k ikh korrektsii.

The results of surgical treatment of 153 patients with diabetes mellitus, suffering from purulent-necrotic complications, were analyzed. The inclusion of parmidin and trental in the complex of treatment have promoted their convalescence and the improvement of microhemocirculation and immunological indexes.

[Metabolic disorders in erysipelas patients with concomitant diabetes mellitus]. / Metabolicheskie narusheniia u bol'nykh rozhei s soputstvuiushchim sakharnym diabetom.

106 patients with erysipelas against the background of manifest diabetes mellitus without pus-inflammatory complications, 102 patients with erysipelas concurrent with diabetes mellitus having pus-necrotic processes and 123 patients with erysipelas without diabetes mellitus (control group) were studied. It has been proved that kallekriin-kinin and sympatho-adrenaline system indices and prostaglandine level are changing depending on the pathological process degree. The most expressed metabolic disorders were found in case of erysipelas pus-necrotic complications against the background of decompensated diabetes mellitus.

[The lipid peroxidation and chemiluminescence indices of patients with erysipelas and concomitant diabetes mellitus]. / Pokazateli peroksidatsii lipidov i khemiliuminestsentsii u bol'nykh rozhei s soputstvuiushchim sakharnym diabetom.

Parameters characterizing chemiluminescence (spontaneous and hydrogen peroxide-induced) and state of lipid peroxidation were studied in 58 patients with erysipelas without diabetes mellitus (group I) and 46 patients with clinically manifest decompensated DM, predominantly type II one (group II), to get more specific information about their role in the pathogenesis of erysipelas presenting with concurrent DM. Group II patients showed more significant increase in measures of lipid peroxidation and degree of chemiluminescence, that did not reverse by the time a patient was discharged from the hospital, which fact is to be considered in instituting therapeutic and rehabilitative measures in those patients with erysipelas concurrent with DM.

[The pathogenetic characteristics and treatment of erysipelas in diabetics]. / Osobennosti patogeneza i lechenie rozhi u bol'nykh sakharnym diabetom.

Pathogenetic role was studied of lipid peroxidation (LPO) in 65 patients with erysipelas with concurrent diabetes mellitus (DM) versus a group of 86 patients without DM. In the former case, significant increase in blood plasma hydroperoxides, such as malonic dialdegide and dienic conjugates, was recordable, which fact suggested activation of LPO processes. Positive correlation was established between blood content of hydroperoxides and levels of circulating immune complexes. A complex of drugs endowed with known antioxidant, anti-inflammatory and immunocorrective activity were found to have a beneficial effect on clinical, immune and biochemical indices.