Efficacy of cephalosporins against enterobacteria isolated from patients with chronic osteomyelitis.

Long-term antibiotic therapy, as well as inappropriate use of drugs in the treatment of osteomyelitis, can lead to the appearance of pan-resistant strains. The existing antibiotic prophylaxis regimens for purulent-septic complications are outdated and need to be adjusted. In this regard, it is necessary to monitor the resistance of microorganisms in order to identify ineffective antibacterial drugs. To analyze the resistance profiles of Enterobacteriaceae isolated from patients with chronic osteomyelitis to cephalosporin drugs over a three-year period. The resistance profiles of 912 clinical strains of Enterobacteriaceae were analyzed: Klebsiella pneumoniae (n=349), Proteus sp. (n=208), Escherichia coli (n=176), Enterobacter cloacae (n=179) for the period from 2018-2020 to cephalosporin drugs. In 2018, 66.2% of Enterobacteriaceace were resistant to the 1st generation cephalosporins, in 2019 - 78.7%, in 2020 - 79.5%. Generation II cephalosporins were most active against Proteus sp. bacteria, but a decrease in clinical effect was observed by 2020. Among the third generation cephalosporins in 2018, cefotaxime was most active, but in 2020 the number of resistant strains doubled and amounted to 86.3%. Ceftazidime was active against 47.1% of Enterobacteriaceae isolates in 2018, in 2019 - 45% of strains, in 2020 - 37.2% of bacterial strains. High activity of ceftriaxone was noted only in 2018 against Proteus sp. Preparations of the IV generation in 2018 showed the highest activity against bacteria of the genus Proteus, the least - against bacteria K. pneumoniae. In the period from 2019-2020, a significant decrease in the effectiveness of cefepime was observed.The monitoring of the resistance profiles to antibiotics of the cephalosporin series revealed their low efficacy against Enterobacteriaceae isolated from wounds and fistulas of patients with chronic osteomyelitis, which shows the inexpediency of their empirical use.

Influence of ß-lactam antibiotics on the activity of K. pneumoniae bacteria biofilm forms isolated from wounds of patients with chronic osteomyelitis.

One of the reasons for the emergence of highly resistant strains is associated with the ability of bacteria to form biofilms on various surfaces. The formation of a biofilm by pathogens leads to a decrease in the activity of the antibiotic, an increase in the time for the production of stress response genes by bacteria, and, as a result, an increase in antimicrobial tolerance. To investigate the effect of imipenem and cefepime on the activity of biofilm forms of K. pneumoniae bacteria isolated from the wounds of patients with chronic osteomyelitis. The object of the study is clinical strains of K. pneumoniae isolated from the wounds of patients with chronic osteomyelitis. In the control series, the level of biofilm formation of K. pneumoniae strains was assessed after 48 hours of cultivation on coverslips and 96-well polystyrene plates. In the second and third series, the biofilm form of K. pneumoniae bacteria was exposed to imipenem and cefepime, and after 24 hours the activity of biofilm formation was assessed according to previously developed criteria. The structure of the emerging biofilm on the surface of the coverslip in all series of the experiment was represented by single adherent cells and microcolonies of various sizes. Cultivation with antibiotics led to a decrease in the number of microcolonies ranging in size from 10 to 10,000 µm2 in the second and third series, however, significant differences from the control series were found only when exposed to cefepime. The intensity of film formation of K. pneumoniae in the control series by the tablet method was 0.350 (0.334; 0.368) units opt.pl. When cultivating biofilms together with antibacterial drugs, the biofilm-forming activity after 24 hours of the experiment was significantly lower than in the control group in all experimental series. K. pneumoniae bacteria isolated from patients with chronic osteomyelitis, when cultivated on polystyrene plates and on the surface of coverslips, actively form a biofilm, exhibiting highly adhesive properties. The studied antibiotics were shown to have a bacteriostatic effect on biofilm forms of K. pneumoniae bacteria. The bactericidal effect of imipenem and cefepime on biofilm forms was not revealed.

Monitoring of the leading causative agents of osteomyelitis and their antibiotic resistance.

The annual monitoring of the species composition of the causative agents of osteomyelitis, the identification of antibiotic-resistant strains, the study of the species composition of associations of microorganisms, their adhesive activity will prevent the spread of infection. Analyze the spectrum of the leading causative agents of osteomyelitis, their antibiotic sensitivity, and also the adhesive activity of the identified bacterial associations. A microbiological analysis of 2197 smears of adult patients with various etiological forms of osteomyelitis who were treated in the departments of the purulent center of the FSBI «NMRCTO¼ of the RF Ministry of Health in 2019. The spectrum of pathogenic microflora, sensitivity to standard antibacterial drugs used in the clinic was studied. The biofilm-forming ability of associations of microorganisms was investigated. According to the conducted microbiological monitoring for 2019, the microflora spectrum for osteomyelitis is diverse, the main pathogens are S. aureus, S. epidermidis, P. aeruginosa, K. pneumoniae, Enterococcus sp. A high percentage of isolation of microbial associations was noted, most often mix cultures of gram-positive and gram-negative bacteria. Bacterial associations: S. aureus + P. aeruginosa, S. aureus + S. marcescens, S. aureus + A. baumannii, S. epidermidis + E. cloacae - actively formed a biofilm on the surface of polystyrene plates, and the adhesive potential depended on interstrain relations in the composition of the formed biofilm. Among Gram-negative microflora, multiresistant strains prevail, among Gram-positive microflora - a high percentage of methicillin-resistant Staphylococci. When analyzing the antibiotic sensitivity of the isolated microorganisms, a high percentage of resistant strains is noted. So, with respect to enterobacteria, ß-lactam antibiotics, drugs from the group of aminoglycosides, turned out to be ineffective. Among non-fermenting gram-negative bacteria, A. baumannii strains had multiple antimicrobial resistance. Among gram-positive microorganisms, a high percentage of isolation of methicillin-resistant staphylococci was noted. The specificity of the course of the disease and measures aimed at eliminating the pathogen depend on the species composition in the focus of infection. The study of the etiological structure of osteomyelitis, the monitoring of the antibiotic resistance of pathogens and their persistent potential, makes it possible to adopt sound tactics of conservative and surgical treatment.

[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.

[Polymorphism A1166C of AGTR1 Gene and the State of Intrarenal Blood Flow in Patients with Essential Arterial Hypertension 1-2 Degrees].

AIM: to study relationship between genetic disorders and features of intrarenal blood flow in patients with essential arterial hypertension (AH) of 1-2 degree. MATERIALS AND METHODS: We examined 100 patients (60 women, 40 men) aged 35 to 58 years with 1-2­degree essential arterial hypertension (AH) and chronic kidney disease (CKD) stages I-III. Examination included triplex scanning of renal arteries on the ultrasound scanner Vivid-7 Dimension, genotyping of single-nucleotide polymorphism А1166С of the AGTR1 gene by real time polymerase chain reaction (PCR), estimation of glomerular filtration rate (GFR) using CKD-EPI formula. Patients were divided into 2 groups: group 1 included persons with I and II stage CKD (n=65, 25 men and 40 women), group 2 included patients with stages IIIA and IIIB CKD (n=35, 15 men and 20 women). RESULTS: Among patients of group 1 prevailed genotype AA, while among group 2 patients prevailed genotype AC. Speed of blood flow in interlobar renal arteries was higher in the group 1 compared with group 2, while in the group 2 time of acceleration of blood flow was higher than in the group 1. DISCUSSION: The data obtained are indicative of the decrease of systolic, diastolic, and averaged maximal blood flow velocity and the lengthening of acceleration time in patients with higher CKD stage. CONCLUSIONS: The presence in the genotype of patients with 1-2­degree AH of AGTR1 1166С allele may be considered a risk factor of early development of CKD. Lowering of speed characteristics of blood flow and lengthening of the acceleration time in patients with AH can be a criterion of hypertensive nephropathy development.

[Lipid status and oxidative stress in menopausal women with obstructive apnea syndrome].

AIM: to assess lipid profile, lipid peroxidation and antioxidant system parameters in peri - and postmenopausal women with obstructive sleep apnea syndrome (OSAS). MATERIALS AND METHODS: 37 perimenopausal women and 43 postmenopausal ones were examined. OSAS diagnosis was made on the basis of the clinical picture and the polysomnography results. In perimenopause, the main group consisted of 18 women, in postmenopausal women - 17. All comparison groups are comparable by age and body mass index. Lipid profile, lipid peroxidation and antioxidant system parameters by spectrophotometric methods were determined. Non - parametric criteria were used to analyze the group differences for the independent samples. RESULTS AND DISCUSSION: The increase of total cholesterol (TC) and low - density lipoprotein cholesterol (LDL-C) levels were observed in perimenopausal women with OSAS as compared to control. The increase of TC, triacylglycerol (TG), LDL-C, very - low - density lipoprotein cholesterol (VLDL-C) levels and decrease of high - density lipoprotein cholesterol (HDL-D) level were found in postmenopausal women with OSAS as compared to control. Accumulation of ketodienes and conjugated trienes in perimenopausal women with OSAS and thiobarbituric acid reactants with a decrease of total antioxidant activity of blood serum in postmenopausal women with OSAS as compared to control was observed. Moreover, postmenopausal women with OSAS have a higher lipid peroxidation substrates and diene conjugates levels with a lower α-tocopherol level and total antioxidant activity compared with perimenopausal patients.The integral indicator of oxidative stress assessment indicates an imbalance in the lipid peroxidation and antioxidant system in menopausal women with OSAS. CONCLUSION: The results obtained indicate a violation of lipid metabolism and the development of oxidative stress in patients with OSAS. This is most pronounced in the postmenopause due to the aggravation of the pathological condition.

[Microflora of surgical wounds and fistulas in patients with chronic osteomyelitis of the tibia before reconstructive treatment, in case of recurrence of infection.]

Relevance of microbiological monitoring in chronic osteomyelitis of the tibia developed during treatment of fractures with a plate is associated with a noticeable increase of various kinds of the microflora. A microbiological study was conducted of pathological material taken from wounds, fistulas and from the focus of inflammation in 49 patients with chronic tibial osteomyelitis, developed during treatment of fractures with a plate. The patients underwent sequestrectomy of the tibia and subsequent application of bilocal consecutive compression-distraction osteosynthesis or monolocal compression osteosynthesis. Microbiological study of smears taken before the reconstructive treatment from fistulas and wounds of patients showed that in monoculture there were 30 strains, the remaining 30 - as a part of 14 two - and three-component associations. The frequency of S. aureus strains was 55.3%, followed by coagulase-negative staphylococcus - 13.6% and representatives of the family Enterobacteriacae - 10.2%. There were methicillin-resistant strains of S. aureus in 11.8%, strains of coagulase-negative staphylococcus (MRCoNS) - 6.8%. Recurrence of the disease was observed in 7 patients. The microflora of the discharge from the fistula was represented by monocultures of S. aureus and associations of bacteria in which one of the components was methicillin-resistant strains of S. aureus. We observed differences in the contents of the microflora before reconstructive treatment of patients and in recurrence of infection. In case of recurrence of infection, the qualitative contents of the microflora changed: in 2 patients in the association of microorganisms and in 3 - in monocultures, S. aureus strains acquired resistance to ß-lactam antibiotics, new associations appeared, which were not present in primary cultures before reconstructive treatment. The study showed that the spectrum of micro-organisms in chronic osteomyelitis of the tibia, developed after osteosynthesis with a plate, varied and is subject to change and that dictates the need for microbiological monitoring to detect the etiological structure of pathogens, monitoring of antibiotic resistance of the isolated strains and rational approach to treatment of patients.

[The evaluation of the lipid peroxidation system and antioxidant defense in adolescent boys with exogenously constitutive obesity with using the coefficient of oxidative stress].

Child and adolescent obesity deserves special attention, since, beginning in adolescence, it progresses and leads to the development of complications already in the adult state. One of the leading mechanisms of the pathogenesis of obesity is the activation of oxidative stress reactions, with insufficient activity of antioxidant factors. There is an opinion that integrated indicators are more informative when assessing antioxidant status disorders compared to individual indicators. The state of lipid peroxidation processes was assessed in 42 adolescent boys, comparable in age (13-17 years old), 19 of them were diagnosed with exogenous-constitutional obesity. Spectrophotometric and fluorometric methods were used. In adolescent boys with obesity, there was a decrease in the concentration of primary products of LPO - diene conjugates (1.39 fold, p=0.007), with an increase in the level of secondary ketodienes and conjugated trienes (1.65 fold, p=0.011). In the antioxidant defense system, the differences in this group included reduced levels of α-tocopherol (1.42 fold, p=0.016), retinol (1.51 fold, p=0.003) and superoxide dismutase activity (1.19 fold, p<0.001), in the absence of significant changes in the blood total antioxidant activity and components of glutathione status in adolescent boys with obesity in comparison with control. The use of the total oxidative stress factor in the group of obese patients showed a high intensity of development of oxidative reactions, which confirms the results of the development of antioxidant insufficiency in this group of patients.

[THE BIOFILM FORMATION ABILITY OF STRAINS SERRATIA SPP., SEPARATED FROM WOUNDS OF PATIENTS WITH CHRONIC OSTEOMYELITIS IN MONO-CULTURES AND IN COMPOSITION OF ASSOCIATION OF MICROORGANISMS HARVESTED IN VITRO].

The article presents analysis of characteristics of 7 clinical strains of Serratia marcescens separated from fistulas in pre-operational period and from nidus of inflammation during operations in 2013-2015. in 7 patients with chronic osteomyelitis of long tubular bones. The bacteria S.marcescens are separated in one patient in monoculture and in 6 patients in composition of associations: S.marcescens + S.warneri + P.aeruginosa (n=1); S.marcescens + S.aureus (n=4); S.marcescens + M.morganii (n=1). According phometric analysis, strains of S.marcescens were characterized by average ability for biofilm formation on the surfaces of polystyrene dishes and cover glass that is substantiated by values of optic density and is conformed to data of their adhesion activity. The biofilm formation ability of association of microorganisms (S.marcescens + P.aeruginosa, S.marcescens + M.morgani) already after 24 hours of experiment were correspondingly higher in 1.4 and 1.2 times of levels of biofilm formation in monocultures. The activity of biofilm formation of association (S.marcescens + S.aureus) on the first day of experiment was low. However, after 48 hours a significant growth of biofilm was observed that is substantiated by values of optical density. The results of study demonstrated ability of all clinical strains of S.marcescens separated from osteomyelitis nidus to adhesion on surface of erythrocytes and to biofilm formation on abiotic surfaces (polystyrene and glass) both in monoculture and associations with other microorganisms. In consideration that microbial films play leading role in chronization of infectious diseases it is necessary to be aware of seriousness of etiologic role of S.marcescens in development of osteomyelitis as a pathogen.

[Serum Myokines Levels in Patients with Endogenous Cushing Syndrome and Acromegaly: Cross-Sectional Case−Control Study].

Background: Myokines are produced and released by muscle cells in response to muscular contractions. Endogenous Cushing syndrome (CS) and acromegaly cause significant changes in muscle tissue leading to atrophy or hypertrophy. However, there is no data whether these endocrine abnormalities influence myokine secretion. Aims: To evaluate serum levels of myostatin, interleukin-6 (IL6) and irisin in patients with CS and acromegaly. Materials and Methods: Fasting serum samples were taken and stored in aliquot at ≤-20°C from consecutive subjects with clinically evident and biochemically confirmed active CS, acromegaly and healthy volunteers matched by age, sex and body mass index (BMI). Commercially available kits were used to assay serum myokine levels. Grip strength was measured by a dynamometer. Insulin-like growth factor-1 (IGF1) was measured by immunochemiluminescence assay (Liaison), twenty-four hours urine free cortisol (24hUFC) ­ by immunochemiluminescence assay (Vitros ECi), salivary free cortisol ­ by electrochemiluminescence assay (Cobas). One-way ANOVA was utilized to assess the difference between groups. Results: We enrolled 88 subjects: 30 patients suffered from CS (group 1), 28 ­ acromegaly (2) and 30 matched healthy controls (3) with no difference among the groups in sex, age and BMI (p=0.492, 0.062 and 0.174 respectively). Mean 24hUFC in subjects with CS and mean IGF1 in subjects with acromegaly were significantly higher as compared to other groups (p<0.001). Right-hand grip strength was lower in patients with CS as compared to both patients with acromegaly and healthy subjects (p=0.04). However, among these young adults we did not find statistically significant differences in measured myokines levels: irisin ­ p=0.15; IL6 ­ p=0.34; myostatin ­ p=0.50. There was a significant correlation between myostatin and irisin in the whole group of people and in every separately analyzed subset of patients (p<0.001), but no correlation was found between any measured myokines and 24hUFC or IGF1. Conclusions: Hypercortisolism or supraphysiological IGF1 levels do not significantly influence serum levels of myostatin, IL6 and irisin in young adults.

[Gender Features of Radical Oxidation of Lipids in Menopausal Women and Men in Andropause].

Aims: Our aim was to assess lipid peroxidation ­ antioxidant protection in menopausal women and men in andropause and to compare these processes in different gender and age groups. Materials and Methods: 74 women and 37 men were examined. This study was a prospective, randomized cohort study. Women were divided into perimenopausal group (n=22, mean age 49.03±3.13), postmenopausal group (n=15, mean age 54.43±4.54) and control (n=37, mean age 34±1.2). Men were divided into a group of andropause (n=20, mean age 50.38±2.63) and control (n=17, mean age 35.21±4.75). Body mass index in the main and control groups was comparable. Questionnaires, clinical examination, assessment of the lipid peroxidation-antioxidant defense system, and the calculation of oxidative stress ratio were conducted to all participants of the study. Results: In women from the reproductive phase transition to its extinction increases content of compounds with conjugated double bonds by 22% (p<0.05) in perimenopause and by 27% (p<0.05) in postmenopause, increases content of the ketodienes and coupled trienes by 21% (p<0.05) in perimenopause relative to the control group and reduced by 27% (p<0.05) in postmenopausal women relative to the group of perimenopause. The antioxidant system in women observed the following changes: decrease in the α-tocopherol levels in postmenopausal women by 37% relative to control and by 22% (p<0.05) to compare perimenopause; reduction of retinol level by 29% (p<0.05) in the perimenopause and by 39% (p<0.05) in postmenopause relative to control, increasing of the content of GSSG by 18% (p<0.05) in postmenopause to compare control. When comparing groups of men statistically significant differences were not found. When comparing the groups according to gender, we revealed in men the increased content of compounds with conjugated double bonds by 38% (p<0.05), the GSSG by 13% (p<0.05), reduced content of the ketodienes and coupled trienes by 43% (p<0,05), α-tocopherol by 24% (p<0.05), SOD activity by 9% (p<0.05).Coefficient oxidative stress in perimenopausal women was 2,5, in postmenopausal ­ 3,48, in andropause ­ 0,97. Conclusions: Expressed lipid peroxidation activity is more physiological in andropause than in menopause. Men in andropause have large functional reserves and adaptive capacity than menopausal women.

[INDICATORS OF PITUITARY-THYROID SYSTEM AND LIPID METABOLISM IN REPRESENTATIVES OF BURYAT ETHNOS AND EUROPEOIDS].

Characteristic features of indicators of the thyroid status and lipoprotein content were found in blood serum of girls and women representing Buryat ethnos and europeoids. In representatives of Buryat ethnos, as compared to europeoids, a development of adaptive reactions from the side of pituitary-thyroid part of the neuroendocrine regulation system was noted (increased concentrations of free T3 fraction in girls and decreased TTH levels in women). Changes in lipid metabolism parameters lie in lower concen- trations of atherogenic fractions of cholesterol in Buryat girls and increased level of cholesterol-contai- ning blood components in adolescent europeods. At older age period a reverse tendency is observed, cha- racterized by an increased activity of lipid metabolism in representatives of the indigenous nationality.

[The clinical significance of bacteria Acinetobacter spp., separated from patients with chronic osteomyelitis.]

The article deals with the results of analysis of 17 clinical strains of Acinetobacter spp., isolated from wounds of patients with chronic osteomyelitis of long bones. In 8 patients strains of Acinetobacter spp. were isolated in mono-culture, in 8 - in composition of association with staphylococci (Staphylococcus aureus - 4, S.epidermidis - 2, S.hatmolyticus - 1, S.capitis -1) and in one patient - with strains of Enteroccocus faecalis. highly adhesive characteristics were established in 29% of isolates of Acinetobacter spp, average adhesive - in 43% and low adhesive - in 28%. The average index of adhesiveness of analyzed strains made up to 2.86±0.02 units. The strains with high adhesive potential were isolated from associations with Staphylococcus spp. The strains of Acinebacter spp. are characterized as far as of incubating by increasing activity of formation of biofilm on the surface of 96 alveolar tray. The calculated integral coefficient (K>0.5 units) testifies high percentage of strains resistant to selected antibiotics. It is established that the most effective in relation to Acinebacter spp. were aminoglycosides (gentamycin and tobramycin) and carbapenems (meropenem, imipenem).The percentage of resistant strains did not exceed 38%. The implemented study demonstrated that inter-microbial relationships ameliorate capacity of association-forming strains Acinebacter spp. to form bio-films. The derived values of bio-film-forming capacity and coefficient of resistance of clinical isolates Acinebacter spp.isolated from patients with chronic osteomyelitis testify their high pathogenicity. The treatment of infection associated with Acinebacter spp. is to consider both results of antibioticgram and data concerning virulent characteristics of isolated agent.

Lipid Status and Predisposing Genes in Patients with Diabetes Mellitus Type 1 from Various Ethnic Groups.

The peculiarities of HLA class II profile and lipid metabolism were examined in Buryat and Russian ethnic groups of patients with diabetes mellitus type 1. The incidence of type 1 haplotypes in HLA class II gene family was lower in Buryats than that in Russians. In comparison with Russians, the course of diabetes mellitus type 1 in Buryat patients was characterized with a lower content of total lipids, triacylglycerols, total cholesterol, and LDL, which probably explains a more favorable course of the disease in Buryat population.

[Analysis of antioxidant status and actual diet of students].

The study of the features of the antioxidant status and dietary intake of students is highly relevant, since this population cohort is the future labor potential of society. 40 female students (mean age--22.4 +/- 0.6 years) living in hostel dormitories (n=20) and rented apartments (n=20) were surveyed. To assess the nutrition the method of questioning within 5 days, including weekends has been used. Personal energy consumption per diem has been calculated by table-keeping method. It was found that, retinol blood serum content (measured spectrofluorimetrically) in students living in dormitories was 1.45 fold lower than that in students living in rented apartments (1.28 +/- 0.66 vs. 1.86 +/- 0.17 mmol/l, p<0.001). When analyzing the changes of the integral parameter of antioxidant defense system (the total antioxidant activity assessed using as a model system a suspension of egg yolks lipoprotein) a decrease of this parameter with respect to standards for the majority of the surveyed women (65% of students living in dorms and 80% of students living in rented apartments) has been noted. The energy value of the daily ration for girls in both groups (1375 +/- 626 kcal--in a dormitory and 1731 +/- 547 kcal--in a rented apartment) was lower than energy expenditure (1789 +/- 202 and 1808 +/- 234 kcal/day, respectively), with higher energy value in students living in rented apartments (p<0.001). Carbohydrates prevailed in the diet of students living in dormitories (417 +/- 207 g/day vs. 289 +/- 131 g/day in female students living in rented apartments, p<0.0001) while in the diet of the students living in rented apartments fats (110.5 +/- 55.7 g/day, compared with that of the students living in the hostel--66.1 +/- 50.8 g/day, p<0.0001) and proteins (99.1 +/- 47.9 vs. 81.6 +/- 42.7 g/day, p<0.001) prevailed. Thus, the high-risk group with regard to adaptive capacity and unbalanced diet are students living in dormitories, with a crucial role played by low material support.

[Evaluation of the adhesive characteristics of uropathogenic escherichia coli strains in patients with spinal cord injuries].

The adhesion characteristics of 9 clinical E.coli strains, isolated from the urine of 9 patients with spinal cord injuries in late period were evaluated. Patient age was 21 to 54 years. Neurogenic urination disordes observed in patients were the result of a spinal injury in the cervical (5 patients), thoracic (2 patients) and thoracolumbar (2 patients) spine. The duration of disease ranged from 2 to 12 years. Despite primarily a low adhesion activity of tested strains, the formation of biofilm occurs on the surfaces having both hydrophobic (polystyrene) and hydrophilic (cover glass) properties. After 24 h, according to the photometric evaluation, 7 of 9 strains had weak, 1 - medium, and 1 - high ability to form biofilms. After 48 hours, only 4 strains had low ability to form biofilms, of whom 2 had an increase ability compared to the previous period of observation. Other strains possess the medium ability to form biofilm. When quantifying the ability of bacteria to form biofilms on the surface of the cover glass, it was revealed that a large fraction of the area of the field of view was accounted for microcolonies with size 10 microm2 at 24 hours, and microcolony with size from 100 to 1000 microm2 at 48 h. There were number of significant correlations between parameters studied. After 24 h, the correlation coefficient between the optical density (OD630) and the number, OD630 and proportion of microcolonies with size 10 to 10000 microm2 varied from 0.79 to 0.9. After 48 hours, there was a direct correlation between the OD630 and the number (r = 0.73, P = 0.025), OD630 and proportion (r = 0.81, P = 0.009) of microcolonies with size 1,000 to 10,000 mkm2.

[Adaptation-compensatory response in adolescents, indigenous people North of Irkutsk region].

A study of pro- and antioxidant status in healthy boys and girls adolescents' representatives Tofalars and Evenks compared to Caucasians newcomers. Revealed activation of the adaptive-compensatory processes in the body young men and women, indigenous peoples of the North as compared to Caucasians alien population, which was reflected statistically significant increase in non-enzymatic components of antioxidant defense system.

[The evaluation of adhesive activity of bacteria extracted from patients with infected endoprostheses of large joints].

The article presents the results of study of adhesive characteristics of 67 clinical strains of bacteria extracted from patients with infected endoprotheses of large joints. All analyzed strains of microorganisms had adhesive characteristics. The unequal distribution by degree of adhesiveness for analyzed groups is marked. The capability to adhesiveness in Gram-negative microorganisms is higher in comparison with Gram-positive microorganisms. The Gram-negative microorganisms form biofilms more actively.

Effects of composition of biocomposite materials implanted into hole defects of the metaphysis on the reparative regeneration and mineralization of bone tissue.

We carried out a comparative analysis of morphological pattern and element composition of regenerated bone tissue forming in the metaphysis defects after substitution of these defects with calcium phosphate substance containing low-molecular non-collagen bone proteins with various affinities to ion exchangers. We have found that regenerated tissue in the defects grew from the edges to the center and its element composition depended on the maturity of newly formed bone tissue. Implantation material containing non-collagen bone proteins with various affinities to ion exchangers induced no significant changes in the content of analyzed elements of bone tissue around the defect. The content of analyzed elements in the areas distant from the defect area did not change during the experiment.

[The state of the antioxidant status of children of different ages].

The parameters of lipid peroxidation (blood plasma content of primary products of lipid peroxidation and the end of TBA-active products) and indexes of antioxidant protection (total antioxidant activity, the content of fat-soluble vitamins A and E in blood plasma and riboflavin in blood) has been evaluated in 75 healthy children living in Irkutsk. All respondents were divided into three age periods: preschool age (3-6 years old, mean 4.7 +/- 1.0 - 21 children), primary school age (7-8 years, 7.6 +/- 0.4, - 28 children) and middle-school age (9-11 years, 9.9 +/- 0.7, 26 children). We used spectrophotometric and fluorometric methods. Identified the distinctive features of the metabolic reactions in children at different ages. The increase of the content of the primary products of lipid peroxidation in the early school years and of the end of TBA-active products for children of secondary school age in comparison with the preschool children has been determined. At the same time an increase in the level of total antioxidant activity and fat-soluble vitamins and riboflavin content in young and middle-school aged children in comparison with the pre-school children has been observed. The measurement of vitamins status demonstrated the insufficiency of alpha-tocopherol in half of pre-school children, in 36% of primary school children and 38% of children of secondary school age. Retinol and riboflavin deficiency has been detected in a small proportion of children of all ages. In this regard, the additional supply with vitamins of children in pre-school and middle-school period is essential.