[Efficacy and safety of collagen biomaterial local application in complex treatment of the diabetic foot syndrome (final results of the multicenter randomised study)]. / Éffektivnost' i bezopasnost' mestnogo primeneniia kollagenovogo biomateriala v kompleksnom lechenii sindroma diabeticheskoi stopy (itogi mnogotsentrovogo randomizirovannogo klinicheskogo issledovaniia).

AIM: To evaluate the efficacy and safety of collagen biomaterial application during the 4-week follow-up of patients with diabetic foot syndrome. MATERIAL AND METHODS: 75 patients with diabetic foot (Wagner II (69.3%) and III (30.7%)) aged 30-80 years were included in the multicenter study, among them were 50.7% with the wound unhealed for 1.5-6 months and 49.3% over 6-48 months. Patients were randomized into 2 groups: 1) standard therapy (n=37), 2) the additional use of the collagen material Collost (n=38). Observation period was at least 4 weeks for each patient. The size of ulcers, results of general and biochemical blood tests, oximetry, microbiological testing, ultrasound of lower extremities vessels as well as a detailed medical history, social and functional status, level of cardiovascular comorbidity and ongoing therapy were estimated. RESULTS: Additional use of a collagen biomaterial has led to a significant reduction ulcers of all sizes from 13.5 to 2.1 cm2 (in the comparison group - from 12.5 to 7 cm2). The best dynamics have been registered in Wagner II (4.4-fold average wound area regress in Collost group, from 8.8 to 2.0 cm2; average wound area regress by 1.8 times, from 10 to 5.6 cm2 in the comparison group) than in Wagner III group (in the main group from 55 to 21.3 cm2; in the control group from 36 to 32.4 cm2) and in ulcers existing less than 6 months. Treatment with biological material Collost within standard therapy after 4 weeks led to increase of complete epithelialization by 2.6% (21.1% as compared to 14.7%), while decreasing the frequency of ineffective treatment by 4.1 (7.9% in primary and 32.4% in the comparison group). CONCLUSION: We have proved the efficacy and safety of collagen biomaterial topical application in a diabetic foot syndrome treatment.

[Oxidative stress in patients with mechanical jaundice of different origin and severity].

This randomized clinical study included 118 patients with mechanical jaundice (MJ) of different origin and severity. It highlighted the role of free radical-generation processes (FRP) in the development of the disease within 1 day after its onset. Disbalance of FRP affects oxygen and lipid components of oxidative stress and is especially well pronounced in severe cases and in patients with tumours. It becomes increasingly apparent with time from the onset of jaundice and endotoxicosis. FRP disbalance precedes clinical manifestation of jaundice and persists for a long time even after alleviation of its clinical symptoms. Certain signs have a prognostic values. Therapy with reamberin at a daily dose of 400 ml is shown to effectively correct oxidative stress associated with MJ of tumorous and non-tumorous origin regardless of the severity of the disease. Positive effect of antioxidative therapy is accompanied by the improvement of laboratory characteristics, clinical picture, and outcome of the disease.

[Free radical processes in patients with the acute calculous cholecystitis].

The role of the free radical processes (FRP) is shown and objectified in the development of the acute calculous cholecystitis (ACC). It is revealed on the first day of hospitalization already. In catarrhal and phlegmonic ACC free radical processes changes apply mostly to the oxygen part of the oxidation process. The greatest imbalance of the FRP is registered in the gangrenous ACC. It appeared like decrease of the oxygen and activation of the lipid FRP disregulation. On the first day FRP changes refer to the oxygen part of the oxidation process only. Starts with a second day from the disease début changes in the lipid component of the oxidative stress join the disregulation process. It is proved by the decrease of the antiperoxidant activity of plasma and increase of malondialdehyde. Malondialdehyde level and its rate of rise serve as prognostic criteria of the course and outcome of disease. FRP changes correlate with the clinical presentations of disease. They last till the patient's discharge. The high efficiency of the energetic corrector reamberin in a dose of 400-800 ml was shown in patients with ACC.