[Efficacy of clinical-serologic diagnosis of wound infection in burned patients]. / Izuchenie éffektivnosti kliniko-serologicheskoi diagnostiki ranevoi infektsii u obozhzhennykh.

Titer of antibodies to microorganisms obtained from wound and blood of 46 patients with burns of IIIAB--IV degree was studied. The majority of the burned patients have ability to synthesize antibodies. Agglutination of the bacteria by antibodies promoted location of infectious agent in primary focus and impeded bacteria to spread into blood and generalization of process. Not all microorganisms of wound provoke antibodies synthesis, i.e. wound infection. Therefore bacteriologic study must be supplemented by serum diagnosis. Detection of bacteria in the blood without serologic data do not permit to consider these bacteria as etiologic factor of wound infection.

[Immune status in diabetic patients with pyo-necrotic lesions of lower extremities]. / Sostoianie immuniteta u bol'nykh sakharnym diabetom s gnoino-nekroticheskim porazheniem nizhnikh konechnostei.

Long-term and severe pyonecrotic processes in diabetic patients testify to severe disorders of immune system in this disease. High titer of antibodies to tested autostrain demonstrated its etiologic role in infectious process. The study group consisted of 29 patients (with diabetic pyonecrotic foot lesions), control group--17 patients with burns of III a, b--IV stage affecting from 20 to 60% of body surface. In diabetic patients antibodies titer to the most encountered infectious agents Staphilococcus aureus and Pseudomonas aeroginosa was lower than in burn patients with immunity deficiency. Decrease of antibodies titer in diabetic patients testifies to high insufficiency of B-immunity.

[Morphological examinations of infected burn wounds]. / Morfologicheskoe izuchenie infitsirovaniia ozhogovykh ran.

Electron microscopical and electron radioautographic methods have been used for morphological examination. This allowed to raise sensitivity of the tests facilitating detection of living solitary bacterial cells (by intensive mark above them). Radioautography showed functional status of wound bacteria (the intensity of the metabolism and reproduction). It was determined that in living tissues, not damaged by the burn and unchanged morphologically bacteria do not penetrate. Especially massive accumulations of the microorganisms are found in necrotic tissues, under the scab, at the external border of demarcation protuberance, and they represent colonization of the wound. When modern methods of treatment and early necrectomy are used, morphological examination usually does not reveal pathogenic microorganisms. Only inflammatory reaction of the wound tissues could be seen: oedema, hyperemia, hemorrhages, cellular infiltrates. The development of granulation tissue indicated cessation of wound infection. Especially favourable feature, demonstrating healing of the wound, was appearance and reproduction of young cells of fat tissue (indusion of labelled thymidine). The results of the study have confirmed the advantage of new electronic methods for microscopy in infected burn wounds.

[The clinical laboratory assessment of vancomycin (Edicin) efficacy in treating suppurative wounds of the skin and soft tissues, burn wounds and the infectious complications of burns]. / Kliniko-laboratornaia otsenka éffektivnosti vankomitsina (Editsin) pri lechenii gnoinykh ran kozhi i miagkikh tkanei, ozhogovykh ran i infektsionnykh oslozhnenii ozhogovoi bolezni.

Clinical and bacteriological efficacies of vancomycin (Edicin, LEK) in the treatment of 17 patients with wound infection and 13 patients with thermal affections were studied. The clinical efficacy in the group of the patients with purulent wounds of the soft tissues amounted to 94.1 per cent and that in the patients with thermal affections was 92.3 per cent. The bacteriological effect was recorded in 86.6 per cent of the patients with purulent wounds of the soft tissues and in 69.3 per cent of the patients with burn infections. The drug intolerability was observed in two cases.

[Clinical and laboratory efficacy of the novel difluoroquinolone Sparflo (sparfloxacin) in therapy of skin and soft tissue infections]. / Kliniko-laboratornaia éffektivnost' novogo diftorokhinolona Sparflo (sparfloksatsina) pri lechenii infektsii kozhi i miagkikh tkanei.

Results of clinical trial of new difluoroquinolone--Sparflo (sparfloxacin, Dr. Reddy's Laboratories Ltd) are presented. Sparfloxacin was used in the treatment of 24 patients at the Department of Wounds and Wounds infections (11 patients) and at the Department of burn wounds (13 patients) of the A.V. Vishnevsky Institute of Surgery. After the treatment with sparfloxacin pathogen eradication was stated in 18 patients, eradication with superinfection--in 13 patients, persistence--in 3 patients. Thus bacteriological efficacy amounted to 87.5 per cent. Pharmacokinetic data demonstrates long-term sparfloxacin circulation in the organism of patients with burns--elimination half-life amounted to 20 hours. Overall after the sparfloxacin use the favourable clinical effect was stated in 100 per cent patients--18 patients (75%) had clinical cure and 6 (25%)--clinical improvement. The drug tolerance was good. It is concluded that clinical and laboratory investigation demonstrated high efficacy of sparfloxacin (Sparflo, Dr. Reddy's Laboratories Ltd) in the treatment of patients with skin and tissue wounds of different localization and genesis, complicated with infections.

[Efficacy of lomefloxacin and ofloxacin in complex therapy of infections in patients with burns]. / Effektivnost' lomefloksatsina i ofloksatsina v kompleksnom lechenii infektsii u obozhzhennykh.

The experience with lomefloxacin and ofloxacin respectively in the complex therapy of 26 and 40 patients with burns is described. The drugs were shown to be highly active in the treatment of burn wound infections and infectious complications of burn disease. The clinical efficacy of lomefloxacin and ofloxacin amounted to 88 and 77.5 per cent and the bacteriological efficacy amounted to 81 and 80 per cent respectively.

[Clinical and laboratory study of cefodizime (Modivid) in prophylaxis and treatment of surgical patients]. / Kliniko-laboratornaia otsenka tsefodizima (modivida) pri profilakticheskom i lechebnom primenenii v khirurgii.

The results of the clinical and laboratory study of the efficacy of the prophylactic and therapeutic use of cefodizime (modivid) in patients with chronic calculous cholecystitis and burns are presented. Expediency of the preoperative prophylactic use of the drug and its significance in the treatment of infectious complications of the burn disease were verified. The immunological investigation gave evidence of an increase of the phagocytosis functional activity when cefodizime (modivid) was used prophylactically in cholecystectomy.

Kinetics of homeostatic behavior of receptor-enzyme systems under the action of physiologically active compounds.

We describe two types of models. In the first one it is assumed that regulation of enzyme activity occurs by the product of the enzyme reaction. In the second it is assumed that concomitant action of ligand occurs on at least two targets with opposite effects (dual-action model). Kinetic analysis of models of the first type shows that homeostatic response with respect to the key metabolite of the receptor-enzyme system is possible only if the enzyme kinetics are described by the equation of zero order. In 'dual-action' models, the homeostatic behavior of the system is defined by the mechanisms of compensation of the ligand primary effect.

Kinetic behavior of a receptor-enzyme system: a model for drug addiction.

A theoretical kinetic model describing the behavior of a receptor-enzyme system during formation of drug addiction is considered in this article. The model assumes concomitant action of narcotic on at least two targets with opposite effects. Theoretical kinetic principles that the system must satisfy for the development of drug addiction are formulated. These kinetic principles are the slow inactivation of receptor-enzyme system and the divergence of characteristic times of dynamic concentration of product and enzyme.

[Laboratory and clinical study of nitazole]. / Laboratorno-klinicheskoe izuchenie nitazola.

Nitazole, a drug from the nitrotiazole group, was shown to be active in vitro against bacteroides, peptococci, peptostreptococci, clostridia, staphylococci, colibacilli and streptococci. By its activity and antibacterial spectrum nitazole had some advantages over metronidazole, a drug from the nitroimidazole group. Experimental study of nitazole aerosole formulation in 4 models of purulent wounds of rabbits infected by Bacteroides fragilis, B. melaninogenicus, Clostridium perfringens 27 and Staphylococcus aureus 209P revealed its high therapeutic efficacy. In the treatment of 37 patients with purulent wounds of the soft tissues including 12 cases isolating anaerobic microbes, the clinical process of the acute suppuration in all the patients at the average reduced to the 5th-7th day. By the data of the bacteriological and cytological examinations the wound surface was ready for putting in stitches or free perforated cutaneous graft by the 10th-12th day. The drug tolerance was good. No adverse reaction were observed under the nitazole dressing in any case during the treatment of the wounds.

[The causative agent of wound infection and sepsis in burn patients]. / Vozbuditel' ranevoi infektsii i sepsisa u obozhzhennykh.

The content of antibodies to the autostrains of bacteria isolated from the wound and blood of burn patients was studied. Antibodies were found not to all species and strains isolated from the wound, but only to 1 or 2 of them. Usually Staphylococcus aureus and Pseudomonas were detected. The appearance or sharp rise of the titer of antibodies even to one of all strains contaminating the wound was observed in all examined burn patients, including those having septic complications, i.e. all these patients retained their capacity of antibody formation. The causative agent of wound infection and sepsis, determined by a high titer of antibodies to it, was seldom detected in the blood. This was due to the fact that bacteria were agglutinated by antibodies or retained in tissues on the level of the histo-hematic barrier. In cases of the development of septic endocarditis the inhibiting role of antibodies was not manifested, and the causative agent of this infection was often detected in the blood.

[Use of pefloxacin in the treatment of infected burn wounds]. / Primenenie pefloksatsina dlia lecheniia infitsirovannykh ozhogovykh ran.

The efficacy of a home-made pefloxacin was estimated in clinico-laboratory trials including 25 patients with wound infection. The fluoroquinolone was used in a dose of 400 mg administered orally twice a day for 4-16 days. Good and satisfactory results were stated in 24 patients (96 per cent). The isolates from the patients were mainly susceptible to the drug (86.2 per cent). The bacteriological efficacy amounted to 92 per cent. No side effects to the use of pefloxacin were observed.

[A trial of using sulperazone (cefoperazone/sulbactam) in the combined treatment of patients with a burn infection]. / Opyt primeneniia sul'perazona (tsefoperazon/sul'baktam) v kompleksnom lechenii bol'nykh s ozhogovoi infektsiei.

The experience with the use of sulperazone (a combination of cefoperazone, a 3rd generation cephalosporin, and sulbactam, a beta-lactamase inhibitor, Pfizer, USA) in the treatment of 25 patients with burns and deep burns (1 to 85 and 1 to 70 per cent of the body surface affection respectively) is described. The drug showed high clinical efficacy in the treatment of the infected burn wounds and infectious complications of the burns. Excellent and good results of the treatment were stated in 84 per cent of the patients. The extended affections and wound dissemination by multicomponent associations of polyresistant microbial strains lowered the microbiological efficacy of the treatment which amounted to 58 per cent. Rapid development of resistance to the drug in staphylococci was noted. The tolerance of sulperazone was good. The side effects were observed only in 1 patient.