[qSOFA score for prediction of outcome in surgical patients in intensive care units. Post hoc analysis of the Russian multi-center trial Rises]. / Ispol'zovanie shkaly qSOFA v prognoze iskhoda lecheniya u khirurgicheskikh patsientov v orit. Subpopulyatsionnyi analiz materialov issledovaniya RISES.

OBJECTIVE: To define the informative value of qSOFA score in the prediction of outcomes in surgical patients admitted to the Intensive Care Units. STUDY DESIGN: Post hoc analysis of multicenter prospective observational study RISES. The following patient information was analyzed: gender, age, diagnosis, presence of infection, SIRS criteria, qSOFA and SOFA scores, outcomes. RESULTS: The study included data of 331 patients with surgical diseases. Infection was not observed in 174 (52.6%) cases, 157 (47.4%) patients had infection. In the group of patients without infection, area under ROC-curve for SIRS criteria was 0.519 (95% CI 0.429-0.610) and similar to that qSOFA (p=0.535). Area under ROC-curve for SOFA scale was 0.619 (95% CI 0.511-0.726) and did not significantly differ from this value for QSOFA (p=0.241). In the group of surgical patients with infection, area under ROC-curve for SIRS was 0.490 (95% CI 0.419-0.561), that was significantly lower than area under ROC-curve for qSOFA (p=0.016). Area under ROC-curve for SOFA scale was 0.803 (95% CI 0.681-0.924), that significantly exceeded area under ROC-curve for qSOFA (p=0.017). CONCLUSION: qSOFA scale is important in surgical patients with infection admitted to ICUs. Increased qSOFA score is associated with augmentation of mortality rate. qSOFA scale significantly exceeds the SIRS criteria, but is inferior to the SOFA in the prognosis of mortality in these patients.

[Fatty acid-binding protein in the serum and sperm].

INTRODUCTION: a composition of seminal plasma reflects a state of reproductive organs that are involved in sperm production. AIM: to study a concentration of fatty acid-binding protein (FABP) in blood serum and sperm samples with normal and altered characteristics. MATERIALS AND METHODS: a total of 82 men with mean age of 33.1+/-4.7 years old who were examined to clarify the cause of infertility were included in the study. The main group (n=21) consisted of men with oligozoospermia, while control group (n=33) consisted of healthy men with normal sperm analysis. In addition, patients with high viscosity of sperm were included in the comparison group (n=28). There were no changes in complete blood count and biochemical blood panel in all participants. The content of FABP in blood serum and seminal plasma was determined. RESULTS: the average content of FABP in seminal plasma was 1.347+/-0.26 ng/ml and exceeded the serum concentration of this compound (p<0.000001), which was 0.305+/-0.193 ng/ml. The concentration in seminal plasma did not depend on its serum concentration (R=0,068194), as well as the sperm volume and viscosity, but it was correlated with sperm concentration (R=0,66387). The concentration of FABP in seminal plasma was highest in the control group (1.47+/-0.33 ng / ml) and it was higher compared to the main group (1.22+/-0.09 ng/ml; p=0.000057) and the comparison group (1.29+/-0.19 ng/ml; p=0.010822). There was no difference between groups in serum concentration of FABP (p=0.9814). CONCLUSION: the obtained data suggest that a reduced level of FABP in seminal plasma can be considered as unfavorable criterion indicating a reduced fertility.

[Ejaculate and serum procalcitonin levels in healthy men and men with oligoasthenozoospermia].

INTRODUCTION: Seminal plasma composition reflects the activity of reproductive organs involved in the semen production. AIM: To study procalcitonin concentrations in serum and semen samples of healthy men and men with oligoasthenozoospermia. METHOD: s .The study included 88 men, who were scheduled for diagnostic evaluation to establish the cause of infertile marriages. The study group comprised 40 men with oligoasthenozoospermia, the comparison group included 48 men with normal sperm concentration. Laboratory testing of all participants revealed no abnormal findings in blood count, blood chemistry studies and urinalysis. RESULTS: Mean seminal plasma procalcitonin level in the study subjects (n=87) was 0,349+/-0,370 ng/ml being about 10 times higher than its serum level, which was 0.037+/-0.027 ng/ml (p<0.000001). In the study group, seminal plasma PCT concentration was significantly greater than in the control group (p=0.0095), while the serum procalcitonin levels in all participants were almost identical (p=0.605). There were no statistically significant correlations between the procalcitonin levels and spermatozoa concentration, total count and ejaculate volume. CONCLUSIONS: The findings suggest that elevated levels of procalcitonin in seminal plasma can be regarded as an unfavorable prognostic factor, indicating the reduced ejaculate fertility. Further studies seem warranted, specifically considering the role and source of procalcitonin production in sperm.

[Systemic Antimicrobials Consumption and Expenditures in Departments of Surgery of Multi-Profile Hospitals in the Russian Federation and the Republic of Belarus: Results of Multicentre Pharmacoepidemiological Study].

The results of the systemic antimicrobials (AM) consumption and expenditures assessment in the departments of surgery of multi-profile hospitals in different regions of the Russian Federation and the Republic of Belarus in 2009-2010 based on retrospective collection and analysis of the data from the hospital expenditure notes using ATC/DDD methodology are presented. The average AM consumption and expenditure rates in the above mentioned departments varied from 24.9 DDD/100 bed-days to 61.7 DDD/100 bed-days depending on the department profile, with beta-lactams (cephalosporins and penicillins) share in the consumption being as high as 70-90%, followed by fluoroquinolones and aminoglycosides. Only 55-70% of the consumed AM belonged to the drugs of choice, whereas the improper AM consumption and expenditure rates amounted up to 10-18%. The study outputs can be used for the budget allocation and AM distribution improvement in the departments of surgery, as well as for the development and efficacy control of the local antimicrobial stewardship programs.

[The concentration of procalcitonin in blood andi enteric exudation in patients at early post-operation period].

The study sampling included 46 patients operated on the occasion of acute surgical pathology of abdominal organs. The concentration of procalcitonin was analyzed at 2-3 days after operation in simultaneously obtained samples of blood serum and exudation of small intestine. The level of procalcitonin was analyzed using enzyme-linked immunosorbent assay with test-systems with sensitivity 0.01 ng/ml. The concentration of procalcitonin in content of small intestine was lower than in blood serum (p<0.001) and in most samples of enteric exudation (n=33) did not exceed 0.01 ng/ml. The analysis of correlation interdependences established that concentration of procalcitonin in intestinal exudation has no dependencies with its level in blood serum. The admixture of blood as a result of traumatization of mucous membrane under application of naso-jejunal probe is one of main causes of occurrence of procalcitonin in content of intestine.

[Laboratory diagnosis of urinary tract injuries].

In 238 patients with various surgical diseases of the abdominal cavity, concentration of creatinine in serum and peritoneal cavity exudate was evaluated. In the most cases, no significant differences in creatinine levels were found in these biological fluids, that allowed to recommend to use creatinine level in the exudate, flowing along drainages, as a parameter for dynamic control of nitrogen-excretion renal function. Significant difference in the serum creatinine level and exudate creatinine level was found in cases of injury of organs of urinary system and the penetration of urine into the peritoneal cavity. In these cases (n = 16), creatinine level in the abdominal exudates exceeded the serum level (p < 0.01), that allowed to provide a new method for diagnosis of lesions of the urinary tract.

[Diagnostic value of studying creatinine in abdominal exudates].

The levels of creatinine in serum and peritoneal exudate were studied in 77 patients with acute surgical abdominal diseases. It has been found that the exudate concentration of this compound is mainly determined by its level in the serum, which allows the exudate creatinine to be studied for the diagnosis of renal failure. The creatinine concentration in the abdominal exudate in relation to that in the serum varies in urinary tract injury and in the early hours after abdominal sanitation in peritonitis. Exudate creatinine concentration increases (by 2.7-fold or more) require that the urinary tract should be revised to reveal its injury. Creatinine levels in the exudate can be determined not earlier than 8 hours after abdominal lavage. The determination of creatinine concentrations in the peritoneal exudate is a non-invasive and informative tool that enhances the quality of laboratory monitoring in emergency abdominal surgery.