[Risk Factors for diarrhea associated with Clostridium difficile in patients at a clinical hospital].

AIM: to identify risk factors for Clostridium difficile infection in patients of a therapeutic clinic in a multidisciplinary hospital. MATERIALS AND METHODS: A retrospective analysis of 110 case histories of patients who were hospitalized in therapeutic departments in the Municipal Autonomous Institution "City Clinical Hospital No. 40" in Yekaterinburg (MAU City Clinical Hospital No. 40) in 2014-2015 was conducted, in which antibiotic therapy has developed diarrhea. According to the results of the study of coprofiltrate on Clostridium difficile (CD), patients were divided into 2 groups: 60 patients with a positive result and 50 patients with a negative result. RESULTS: The proportion of patients with CD infection in the structure of patients of the therapeutic profile of the MAU GKB No.40 for 2014-2015 amounted to 0.42%. Predictors of the risk of developing diarrhea associated with CD infection in patients are: age over 65 years (OS 4.33, 95% CI 1.15-16.20, p=0.028), Charlson comorbidity index more than 2 points (OS 3.05, 95% CI 1.29-7.23, p=0.016), the presence of anemia (OR 2.32, 95% CI 1.07-5.02, p=0.048), chronic dialysis in patients with chronic renal insufficiency (CRF) (OR 8.64, 95% CI 1.05-70.81, p=0.020), patients staying in hospital for more than 5 days (OR 3.50, 95% CI 1.57-7.75, p=0.003) and hospitalization of patients in the intensive care unit (ICU) lasting more than 1 day (OS 9.80, 95% CI 1.20-79.47, p=0.011), the use of proton pump inhibitors (PPIs) (OR 2.82, 95% CI 1.12-7.11, p=0.041), antibiotic therapy more than 10 days (OS 39.62, 95% CI 10.85-144.71, p.

[Characteristics of a cytokine profile of T-lymphocytes of peripheral blood and synovial fluid in rheumatoid arthritis].

AIM: To assess cytokine-producing activity of T-lymphocytes of peripheral blood and synovial fluid in rheumatoid arthritis (RA). MATERIAL AND METHODS: The study group consisted of 58 RA female patients aged 28-53 years (mean age 42.1 +/- 2.9 years) with at least 5-year history of RA (mean 10.7 +/- 4.9 years). The control group consisted of 37 healthy women matched by age. Spontaneous production of IL-2, IL-4, IFNgamma (IFNgamma) and TNFalpha (TNFalpha) by CD3(+) and CD3(-) lymphocytes was estimated after 4 hours of incubation in 37 degrees C with phorbol-12-myristate-13-acetate (PMA, 50 ng/ml, Sigma, France), ionomycin (1 mcg/ml, Sigma, France) and brefeldin A (10 mcg/ml, Sigma, France). RESULTS: In RA there is a decrease in a relative and absolute count of peripheral blood T-lymphocytes which occurs spontaneously and due to nonspecific stimulation of synthetizing IL-4, TNFalpha and IFNgamma. IFNgamma-producing lymphocytes (CD3(+) IFNg(+)/CD3(+) IL-4(+) = 4.45 +/- 1.56) prevail in the synovial fluid in RA, but count of lymphocyte IFNgamma , IL-2 and TNFalpha(+) in the synovial fluid is lower than in peripheral blood. CONCLUSION: One of the causes of low count of TNFalpha, IFNgamma and IL-4 producing T-lymphocytes in peripheral blood is migration of relevant TC-subpopulations to the affected joints. Migration of TC1-lymphocytes into the synovial fluid does not result in their prevailing count in the synovial fluid vs peripheral blood.

[Patient non-compliance in rheumatoid arthritis: the degree, frequency, types and correlations]. / Nesoglasie s rezhimom lecheniia u bol'nykh revmatoidnym artritom: stepen' vyrazhennosti, chastota, tipy i korreliatsionnye sviazi.

AIM: To assess the degree of non-compliance (NC) in patients with rheumatoid arthritis (RA) as well as NC frequency, types, correlations. MATERIAL AND METHODS: 34 patients with RA (the study group) and 21 patients with osteoarthrosis (the control group) have filled in an original questionnaire developed by the authors. The analysis was made of correlations between NC degree and clinico-laboratory, social-demographic and psychopathological factors. RESULTS: The degree of NC (general and type-specific) and its frequency appeared to be significantly higher in the group of RA patients. Significant positive correlations were found between the degree of NC and hormone dependence, functional decline of the joint, presence of organic and adaptation mental disorders. CONCLUSION: A high degree of RA patient NC with medical recommendations dictates the necessity of psychocorrective measures for such patients.