[Integrated assessment of hygienic condition of the oral cavity]. / Problemnye voprosy otsenki gigienicheskogo sostoyaniya polosti rta i ikh klinicheskoe reshenie.

THE AIM: To identify the problematic issues of assessing the hygienic state of the oral cavity and the clinical development of possible algorithms for their solution using our modified, highly sensitive (up to 150 CFU/ml versus 5·106-5·108 CFU/ml), objective (2-3% error) method fluorescence spectroscopy. MATERIAL AND METHODS: In a clinical study on 20 patients of working age, it was shown that the authors modified fluorescence spectroscopy method allows each patient to individually perform a comprehensive digital express indication and objective analysis of the oral hygiene state based on express registration and analysis of the entire aggregate of aerobic-anaerobic microflora of various oral biotopes (biotope teeth, lips, gums, cheeks, palate, tongue and saliva) online. RESULTS: Integral indicators of the hygienic state of the oral cavity in individuals with satisfactory oral hygiene before and after brushing have been obtained, which describe the hygienic state of both the oral cavity as a whole and individual biotope in their relationship. CONCLUSION: The results made it possible to substantiate a more objective quantitative methodology for assessing the hygienic state of the oral cavity for the implementation of its individually substantiated clinical use with the identification of the biotope (biotopes) of the mouth, which is the main source of its pollution.

[Clinical and experimental study of the peculiarities of cardiac activity disorders during poisoning by combustion products in persons of different age groups.]

The work is carried out to clarify the mechanisms of cardiac activity disorders and assess the severity of cardiotoxicity in acute poisoning by combustion products in the age aspect. 71 patients with severe carbon monoxide poisoning were examined. The comparison group consisted of 22 patients with acute severe opiate poisoning. The methodological basis of the clinical study was daily monitoring of ECG. The studies were performed in 1 and 3-4 days. Residual cardiac dysfunction was estimated at 12-14 days. The comparison group selected 14 patients with acute myocardial infarction at this stage. Pathomorphological changes were studied on the cadaveric material of 24 experimental animals exposed to carbon monoxide at a dose of 16 g/m3 for 5 minutes on 31 days from toxic injury. It is established that acute poisoning by combustion products leads to the development of severe electrophysiological disorders classifying cardiotoxic effect as severe or extremely severe. Expression of signs of cardiotoxicity is higher in middle-aged and elderly patients. In the outcome of the poisoning, all the victims have formed a toxic cardiomyopathy.

Successful Tigecycline Use in Combined Therapy of Ventilator-Associated Hospital-Acquired Pneumonia: a Clinical Case.

In patients under artificial lung ventilation (ALV) there is often observed development of severe ventilator-associated pneumonia (VAP) due to polyresistant hospital pathogens. It should be noted that in the patient described here with the initial diagnosis of community-acquired pneumonia rapidly subjected to prolonged ALV the previous antibacterial therapy by broad spectrum drugs significantly increased the risk of contamination just by multiresistant nosocomial strains, which hampered the starting therapy of nosocomial pneumonia either when there were not available or sometimes there were available microbial cultures. When the treatment of severe pneumonias caused by multiresistant hospital flora resistant to carbapenems is actual, in the alternative therapy it could be used tigecycline, a tetracycline from the group of glycylcyclines. A case of successful treatment of nosocomial VAP by tigecycline based on the results of the bronchoalveolar lavage (BAL) culture is described. The case is of interest because tigecycline was used as off label.

[USE OF LASER RAMAN-LUMINESCENT TECHNOLOGIES FOR EVALUATION OF QUALITY OF MEAT PRODUCTS AND DETERMINATION OF THE DEGREE OF THEIR BACTERIAL CONTAMINATION].

AIM: Determination of the effect of microorganisms on spoilage of meat products during various temperature regimes of storage by integral indexes of luminescent lines in their spectra and development of an algorithm of microorganism indication by an express method using laser Raman-luminescent spectroscopy. MATERIALS AND METHODS: Minced meat from beef and pork was used. Determination of quantity of mesophilic aerobic and opportunistic-anaerobic microorganisms was carried out by serial 10-fold dilutions with subsequent parallel seeding into Rida count total 24 plates and Petri dishes with 5% blood agar. Sample study was carried out in luminescent software-hardware complex Enspectr L405 (a variant of Enspectr M software-hardware complexes). RESULTS: Meat spoilage was established to be caused to a large degree by Pseudomonas genus (P. fluorescens, P. putida, P. fragi et al.) bacterial growth. Raman-luminescent spectra of bacteria that compose microflora, characterizing and accompanying beef and pork spoilage, were measured and recorded into a database. CONCLUSION: The results obtained will allow to use this technique in the future for both express-indication and differentiation of microorganisms and express-evaluation of quality of meat products at all stages of their manufacturing, storage, transport and realization.

[Identification of microorganisms based on the effect of giant Raman scattering].

AIM: Development and evaluation of express diagnostics of microorganisms for reduction of time spent on study execution. MATERIALS AND METHODS: Giant Raman scattering effect and proposed substrate with metallic nano-balls of silver were used for identification and indication of microorganisms. Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus saprophyticus, Candida albicans, Escherichia coli, Bacillus subtillis, Pseudomonas aeruginosa were used as objects of study. All the microorganisms were cultivated in dense nutrient media and non-fluorescent microbiological membrane filters. RESULTS: Giant Raman scattering method on the substrates used increases sensitivity of indication and specificity of identification of microbes compared with other existing express methods and allows to see the signal from a single bacterium when exposed to laser light. The methodic proposed was also used to determine sensitivity of bacteria to antimicrobial preparations. CONCLUSION: The proposed hardware and method may be used for express diagnostics of processes of microbial nature.

[Directions of interdepartmental interaction in case of delivery of health care for injured in emergency situations in stationing sites of navy].

In points basing of navy will remain probability of emergence of emergency situations which is connected with existence of the enterprises of the industry and objects of navy. As a result of emergency situations in places of basing of navy discrepancy of prospective sanitary losses to possibilities of forces and means of a health service of fleet that demands interaction with health services of other ministries and departments is probable. Criterion of need of interaction is the ratio of quantity struck and possibilities of a health service of navy. Plans of interaction of a health service of fleet with medical institutions of other departments should provide options of use of available forces and means of medical institutions in garrisons for joint assistance struck in an emergency situation. The questions solved during interaction should become: radiation, chemical, biological survey; allocation of forces and means for rendering of medical care; use of sanitary transport; organization of sanitary processing, etc.

[Expert assessment of commands of naval medical service, incorporated in Service for Disaster Medicine].

Expert assessment of possibilities of naval medical service for delivery of assistance in emergency situations in deployment areas is performed. It is noted that the main menaces are radiation, chemical accidents, and explosiveness of objects. Inconsistency between supposed losses and possibilities of naval medical service is probable in case of emergency. This inconsistency requires improvement of interaction with medical services of other ministries, drill of coordinative actions of naval medical commands with other commands of other ministries in organizational frames of united Service for Disaster Medicine.

[Correction of mnestico-intellectual disturbances in the somatogenic phase of acute poisoning with a mixture of psychotropic drugs].

A total of 60 patients suffering acute poisoning with a mixture of psychotropic drugs were available for observation. The study focused on comparative estimation of reintegration of psychic conditions (recovery of consciousness, conceptualization of mnestico-intellectual functions) in these patients. It was shown that intensive therapy of toxic and hypoxic brain lesions with antihypoxic agent cytoflavin results in rapid and effective reintegration of psychic activity including recovery of consciousness and conceptualization of mnestico-intellectual functions.

[Use of cytoflavin into the complex intensive therapy of acute cerebral insufficiency caused by poisoning].

In the result of treatment of 147 patients with toxic acute brain insufficiency were revealed that the employment of citoflavin (20 ml with 400 ml 5% glucosae twice a day) in 7 days intensive therapy of acute brain insufficiency leaded to decrease of hypoxic brain damages and intensity of brain depression, what was revealed in improvement of brain bioelectric activity. Rehabilitation of central nervous system regulation function and life-support systems leaded to quick rehabilitation of respiratory part of oxygen transport. These changes in acute period leaded to quick reparation of cognitive-mnestic functions and social adaptation. The employment of citoflavin leaded to improvement of clinic of toxicohypoxic encephalopathy and to decrease of secondary lung complications (decrease of coma-period from 45,3 ± 8,2 to 27,7 ± 6,9 hours; decrease of secondary lung complications from 72,7% to 35,9%).

[20-year experience with laserofluorescent diagnostics in clinical microbiology].

Results of rapid laser-assisted identification of microorganisms for diagnostics of microbial processes based on auto-fluorescence effect in bacteria-containing materials are summarized. It is proposed to use the auto-fluorescence technique for express diagnostics of pyoinflammatory diseases, evaluation of microflora conditions (eubiosis, dysbiosis) and sensitivity to antibiotics, monitoring and prognostication, assessment of the quality of antibiotic therapy. Priority in the development of this medical technology for laserofluorescent diagnostics and its practical application is protected by 15 patents.

[Using of reamberin on patients with cerebral deficiency due to severe forms of acute poisonings].

The aim of work was to test the using of reamberin on patients with cerebral deficiency due to severe forms of acute poisonings. The investigation was made on 60 patients (38 men and 22 women), whose average age was 34.7 +/- 2.6 (for men) and 28.4 +/- 3.2 (for women). The main group was divided into two parts, which had compared age, sex and gravity of condition. The first one was given reamberin with standart therapy (I - 32 patients), the second - only standart therapy (II - 28 patients). It was revealed that using of reamberin in complex therapy of acute cerebral deficiency lead to decrease of intensity of cerebral deficiency and to increase of speed of cerebral activity rehabilitation. These changes lead to improvement of clinic tendency of cerebral deficiency, what was illustrated by decrease of comatose period from 55.0+/- 2.2 to 33.0 +/- 2.6 hours, decrease of the time of being in reanimatology department from 69.1+/- 3.6 to 53.4+/- 4.3 hours.

[The use of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency associated with acute poisoning with neurotropic poisons].

Examination and treatment of 262 patients with severe acute intoxication by neurotropic poisons and unaffected oxygen delivery system showed that inclusion of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency significantly reduced severity of metabolic disorders. Specifically, tissue hypoxy, endotoxicosis, lipid peroxidation activity, and immunosuppression decreased while antioxidative protection and clinical picture were improved. Duration of comatose state and artificial lung ventilation was reduced from 64.5 +/- 15.1 to 28.8 +/- 10.2 hours and that of critical condition from 117.2 +/- 17.2 to 63.7 +/- 9.2 hours. Overall lethality dropped from 16 to 9.9%.

[Method of express evaluation of physiological resources in individuals with intensive and long occupational activities].

The authors specified and tested an index of occupational functional resources in specialists with intensive and long occupational activities.

[Rapid identification of mycobacteria using laser fluorescence].

AIM: To develop rapid method of identification of mycobacteria based on laser fluorescence. MATERIALS AND METHODS: Characteristics of laser-induced fluorescence of 19 bacteria species, including 17 species of mycobacteria, were studied. Identification of microorganisms was performed using measurement of spectral-fluorescent characteristics. RESULTS: Library of spectral-fluorescent characteristics of mycobacteria in different concentrations ratios and associations was created, which formed the basis of database for identification of mycobacteria by laser-fluorescent method. Principles of diagnostic algorithm of indication and differentiation of mycobacteria using this method were developed. Effect of myramistin for increasing the intensity of mycobacteria fluorescence, account of the diffracting characteristics of medium for adjustment of spectral characteristics of mycobacteria and processing of data by factor analysis are needed. Efficacy of the method was 80 - 90%. CONCLUSION: Principles of rapid identification of mycobacteria and their associations developed on the basis of laser-fluorescent method are experimentally founded and tested on unknown cultures of mycobacteria and objectively prove the possibility to apply this method for express identification of mycobacteria belonging to M. tuberculosis complex as well as non-tuberculous mycobacteria.

[Antimicrobial activity determination of the preparations used in comprehensive treatment of patients with parodontitis].

Determination of antimicrobic activity of the preparations of Metrogyl denta, Cholisal and Solcoseryl on the complex culture of microorganisms employing the developed procedure was carried out. Degree of the antimicrobic action manifestation of each preparation was revealed.

[Modelling of photoinducted diffusion of antimicrobial preparations in gingival tissues and face skin].

The study was made of laser radiation influence upon diffusion speed of medicines applied on tissue surface. Photophoresis use allow to increase diffusion speed of medicines applied on parodontal tissues and face skin during photophoresis process.

[Impact of liposomes and ceftriaxone-entrapped liposomes on skin wound healing in rats].

"Empty" liposomes and ceftriaxone (CT)-entrapped liposomes were developed. Lipids of natural origin, i. e. soybean phosphatidyl choline (PhCh) and cholesterol were used for the design. The conditions for production of the CT-entrapped liposomes were optimized to provide the maximum content of the antibiotic in the liposomes. The effect of the "empty" liposomes and the antibiotic-entrapped liposomes on healing of skin wounds was studied on rats. The wound on the skin surface of the rat back was purulent due to contamination with E. coli (10(9) cells/ml). The treatment with the antibiotic solution, "empty" liposomes or CT-entrapped liposomes was started in 48 hours. The use of the PhCh "empty" liposomes promoted more rapid healing of the wound vs. the control or the treatment with CT aqueous solution. The treatmen of the wound with the CT-entrapped PhCh liposomes provided 2 times more rapid healing vs. the control or the use of the CT aqueous solution.

[Specified mechanisms of action of preimmunisation with diphtherial anatoxin on myocardial pathology after critical care].

Chronic experiments for 5 weeks made in 41 mongrel adult dogs have shown that prevaccination with diphtheria antitoxin has a negative effect on myocardial and hemodynamic restoration after resustitation. The dogs have arrhythmia, survival of the animals is worse. However, such prevaccination improved survival of the animals due to reduction of reperfusion trauma in animals after hemorrhagic shock in spite of conduction disorders and myocardial ischemia.

[Use of miramistin for the treatment of patients with odontogenic phlegmons in the maxillofacial area].

In experimental and clinical conditions the use of miramystin (0.1% solution and liniment) was validated for complex treatment of patients with odontogenic maxillofacial phlegmons (110 patients with mild, moderate and severe inflammation). Significant efficacy of a wide spectrum antiseptic (miramystin) and laser fluorescent diagnostic method for achievement of objective assessment of the treatment of patients with phlegmons in maxillofacial area is shown. The disease duration (time from its onset till discharge from the hospital) varied from 8.2 to 24.1 days depending upon the degree of severity of the inflammatory process versus 13.7 to 30.4 days in controls, respectively. The developed treatment-and-diagnostic methodology is recommended for wide clinical practice.