[The identification and sensitivity to antibiotics of clostridia, including Clostridia difficile isolated under infectious complications in oncologic patients.]

The 76 strains of Clostridium related to 14 species including 28 strains of C.difficile, were isolated from 74 samples of biological material taken out of oncologic patients. The species identification of strains was implemented by MALDI-TOF mass spectrometry using technique of direct application without extraction. The 74 strains (97.4%) were identified up to specie with reliability evaluation 2.0-2.5. Among C.non-difficile the most frequently were separated C.perfringens (42%), group of C.clostridioforme (24%). The sensitivity of separated strains to anti-microbial preparations was established with E-tests technique. The different species of Clostridia had different sensitivity to antibiotics. The strains C.perfringens are sensitive to all testing antibiotics whereas species related to group C.clostridioforme are resistant to fluoroquinolones (100%)б penicillin (67%). The resistance to fluoroquinolones was observed in C.scindens, C.ramosum, C.symbiosum. The strains C.scindens, C.tertium are resistant to penicillin. Among C.difficile, 93% of strains were resistant to penicillin, 57% - to imipenem and 100% - to fluoroquinolones.

[Effect of adrenocorticotropic hormone (ACTH4-10) on information network of the cardiovascular systems].

The polyparametric description of adaptation syndromes in students using a uniform set of parameters of cardiovascular system and their relationships is presented. An analog of adrenocorticotropic hormone (ACTH4-10) is shown to exert varying effects on the development of different adaptation syndromes. Adaptation syndromes characterized by moderately active physiological processes (as judged by EGG, rheovasogram, respiration rate) and lowered vascular tonus were associated with marked improvement of the health status.

[Infectious complications in patients with Hodgkin's lymphoma of unfavourable prognosis].

Analysis of the infectious complications in 48 primary patients with Hodgkin's lymphoma of infavourable prognosis recorded within 1998-2006 is presented. Respiratory tract infections, mucositis and Herpes infection were stated in 43, 24 and 22% of the patients respectively. Bacterial infections predominated (61% of the patients), then followed viral and fungal infections (26 and 43% of the patients respectively). Associations of bacterial and fungal infections were most frequent (50% of the patients). Associations of bacterial and viral infections were less frequent (30%) and fungal and viral infection associations were revealed in 20% of the patients. The structure of the bacterial, viral and fungal infections and the dynamics of the pathogen spectra are presented. The results of the analysis showed that the infections were frequent complications in such patients and could be due not only to obligate but also to opportunistic pathogens, that requires design of the diagnostic algorithm for prediction of the complication process and outcome, thus improving the remote results of the treatment.

[Prophylaxis of wound infection in patients with head and neck tumors with an account of the pathogen taxonomic pattern].

The most important problem of onkology, i. e. antibiotic prophylaxis and treatment of postoperative infectious complications is touched upon in the paper. The current publications on the problem are discussed and the autors' experience on the treatment is described. The spectrum of the main pathogens of wound infections in patients with head and neck tumors is considered.

[Production of active oxygen by neutrophils in patients with cancer of the esophagus and stomach before and after surgical interventions].

The state of the oxygen-depended antimicrobial activity of neutrophils on oncologic patients was studied. Production of active oxygen by non-activated and activated neutrophils of peripheral blood from 19 patients (the average age of 56 years, 16 males and 3 females) with esophageal cancer and cancer of the stomach and metastasis to the esophagus was recorded by chemiluminescence before and after surgical interventions (transpleural gastrectomy, Lewis type operation) on the 1st, 3rd and 7th days after the operations. The oxygen-depended antimicrobial activity of the neutrophils was investigated by their ability to produce active oxygen when incubated with opsonized zymosan and N-formyl-methionyl-leucyl-phenylalanine. Luminol chemiluminescence recorded the whole pool of active oxygen and showed the summary activity of myeloperoxidase and NADPH-oxidase, while luceginin chemiluminescence measured formation of superoxide anion radical (*O(-)2) and evaluated the activity of NADPH-oxidase. The results showed that the procedure provided estimation of the functional state of the neutrophil leukocytes and their ability to produce active oxygen. Impairment of the myeloperoxidase- and NADPH-depended production of active oxygen by non-activated and activated neutrophils observed before operations resulted in altered synthesis of active oxygen after the surgery. This is one of the leading factors of the infection development in the end. Detection of the myeloperoxidase- and NADPH-depended production of active oxygen could be of help in revealing the groups of risk among patients at the stage of the preoperative examination and serve as a prognostic factor of the development of severe infectious complications during the postoperative period.

[Infectious complications after prosthesis implantation in patients with bone tumors].

Data on the retrospective analysis of 245 cases of endoprosthetic replacement of bones and major joints are presented. Intraprosthetic infection-related complications were reported in 11%. They developed within 3 months in 64% and their frequency was significantly higher in cases of repeat surgery, resection of proximal tibia with subsequent endoprosthetic replacement of defective knee joint as well as adjuvant polychemotherapy. Anti-infective treatment alone was effective in 11%; complications were aborted by means of surgery of varying extent in 75%.

[Therapeutic effect of blastolysin in athymic mice with transplanted strains of human tumors]. / Terapevticheskii éffekt blastolizina u bestimusnykh myshei s perevivnymi shtammami opukholei cheloveka.

9 transplanted strains were used for the evaluation of antitumour effect of blastolysin. The short-term inhibition of the tumour growth was observed on the following models: breast cancer, stomach cancer, kidney cancer and chorionepithelioma.

[Role of intracellular Ca-depots in the mechanism of action of caffeine on excitation-contraction coupling in the frog myocardium]. / Rol' vnutrikletochnykh Ca-depo v mekhanizme deistviia kofeina na sopriazhenie vozbuzhdeniia i sokrashcheniia v miokarde liagushki.

Caffeine inotropic effects on frog atrial and ventricular muscle were studied under different patterns of stimulation. It was found that in the course of repetitive stimulation (0.5/s) caffeine produced transient potentiation and following inhibition of contractions which were accompanied by an increase in the rate of tension development, a decrease of the time to peak tension, an increase in relaxation duration and a decrease in the relaxation rate. Caffeine reduced the increment of contraction amplitude in Bowdich staircase under stimulation of the heart muscle with a series of impulses. It was concluded that caffeine caused the depletion of calcium in the intracellular stores. On the basis of literature and our data a scheme was proposed to account for two-phase caffeine action on the frog myocardium. According to this scheme caffeine acts simultaneously on both stages of excitation-contraction coupling: it alters calcium current and prevents Ca accumulation in the intracellular stores.

[Multimeasurement analysis of the autonomic status in the development of stress in man]. / Polimetricheskii analiz vegetativnogo statusa cheloveka pri razvitii stressa.

A parallel investigation, an analysis of the clinical physiological study, and polymetrical description were made while examining 245 workers at an electronic plant. The findings allowed the author to identify four main classes in terms of the stages of stress development, to make clinical and physiological evaluation of the multivector spectra-pattern state during stress, to assess the autonomic status and to make an interactive syndromal analysis of a person's functional condition.

[Conceptual approaches to the diagnosis of stress-induced functional disorders in humans under conditions of industrial activity]. / Kontseptual'nye podkhody k diagnostike stress-indutsirovannykh funktsional'nykh narushenii u cheloveka v usloviiakh proizvodstvennoi deiatel'nosti.

In accordance with the fundamental concept of the systems symmetrical approach, a model of the body's "ideal functional status" and a polyparametric method for diagnosing the human functional status (the method has been patented in Russia) were developed, on the basis of the unified set of amplitude and time parameters of a complex of physiological parameters (ECG, etc.). The systems symmetrical approach is basically new in defining the ratio of harmonic parameters acting as new diagnostic evidence for the health status. The unchanging ratio of parameters of autovariation processes in the cardiac, vascular, and respiratory systems, their changes in the development of the adaptative syndrome and the value were examined in healthy individuals at rest and during exercise an intensive productive activity (point brazing at a plant of electron devices), and in the trainees. It was demonstrated that the mechanism of development of adaptative processes was associated with the synchronization of autovariations in the cardiorespiratory and vascular systems and the involution of adaptative processes, their break, depletion, i.e. stress, were determined by the imbalance of relationships and the desynchronization of autovariations in these systems. To define a set of cardiorespiratory and hemodynamic parameters is necessary, but insufficient to evaluate (diagnose) the health status and health-disease intermediate diseases (stress and adaptative overtension). The ratio harmonicity of these parameters, i.e. well-balanced relations between the subsystems is the main characteristic. The assessment of the human health status in terms of the reference-the model of the ideal status as the ideal health status without using the complex and indefinite concept of the normal and moderate health status-is conceptual for polyparametric status estimation.

[Systems analysis of polyparametrical syndromes in students under study-induced stress]. / Sistemnyi analiz poliparametricheskikh sindromov u studentov pri razvitii stressa v period ucheby.

In addition to routine physical examinations, the polyparametrical method was used to examine 250 students to assess their health. For this, the methods of pattern discrimination and classification were employed to analyze multiparameter data. Clinical and polymetric findings correlated well. The polymetric method revealed 4 main classes of the students' functional and autonomic status. Autonomic changes can be systemic and local. The visualized data of objective functional parameters controlled by the autonomic system made it possible to give a syndromal assessment of functional states and to reveal the intermediate stage between health and disease.

["Augmentin" in the antibiotic prevention of postoperative infections complications in gynecological cancer patients]. / Augmentin v antibiotikoprofilaktike posleoperatsionnykh infektsionnykh oslozhnenii u onkoginekologicheskikh bol'nykh.

Hysterectomies are arbitrarily pure operations and thus require antibiotic prevention. A great risk for postoperative infections is particularly high after Wertheim's operation. This study evaluated the efficiency of infection prevention in 19 cancer gynecological patients by using the antibiotic augmentin (amoxicillin/clavulanic acid). The first dose was administered 30 minutes before surgery in order to achieve the maximum drug concentration in blood and tissue at surgery. There was no wound suppuration. One patient (5.3%) undergone Werthein's operation was diagnosed to have retroperitoneal hematoma suppuration. One more patient (5.3%) had fever of unknown genesis. Urinary infections that are not considered to be a sign of inefficiency of antibiotic prevention and that were due to long-term catheter placement developed in 4 (21.1%) of the 19 patients. The postoperative period was smooth in 14 (73.7%) of the 19 patients. The perioperative Augumentin administration regimen used by the authors was easy-to-use and beneficial and the drug shows a low toxicity so it may be used for antibiotic prevention in cancer gynecological patients.

[Preclinical ECG changes and their evaluation based on the criterion of symmetrical approach]. / Doklinicheskie izmeneniia EKG i ikh kriterial'naia otsenka na osnove simmetriinogo podkhoda.

To reveal preclinical cardiac performance changes, conventional and unique ECG processing procedures were used in 101 individuals. A classification of heart function was developed, which was based on a comprehensive assessment of ECG. The results of the clinicofunctional classification were well comparable with those of a quantitative ECG analysis made with heuristical methods. The ratios of various ECG parameters are more informative than the absolute values of these parameters. In screening, the quantitative ECG analysis have some advantages over the visual one as it requires no thorough clinicopharmacological study. The symmetrical approach to an ECG analysis with the use of geometrical methods of simulation may be useful for the criterion assessment of preclinical alteration in cardiac performance.

[The role of the oscillation of the tail vessels in unanesthetized rats in regulating the blood flow during heat exposure]. / Rol' ostsilliatsii khvostovykh sosudov nenarkotizirovannykh krys v reguliatsii krovotoka pri teplovom vozdeistvii.

Studies of the changes in the rat tail blood vessels in heating shows a considerable increase in slow oscillation frequency, apart from the rheographic index elevation. The hyperthermic effect became considerably lesser in elimination of these oscillations with ganglio- or adrenoblocking agents. The mechanism of hyperemia in heating associated with modulation of mechanic contractions of vascular smooth muscles, are discussed.

[Biphasic action of caffeine on contractile activity of frog myocardium]. / Dve fazy deistviia kofeina na sokratitel'nuiu aktivnost' miokarda liagushki.

Action of caffeine on the isometric contractions and intracellular potentials of the frog heart muscle involved the positive inotropic effect only at high concentrations (0.1-20 mM). The "dose-action" curve for the twitch responses reached plateau at caffeine concentration higher than 4 mM. Two phases of the caffeine effect on the frog myocardium contractility were identified: transient increase of the contraction amplitude (the 1st phase) was followed by the inhibition of contractions and shortening of the APs (the 3nd phase). The magnitude of the contractile changes and the duration of each phase depended on the caffeine concentration.

[Slow rhythms in the rheovasogram of the tail arteries of the unanesthetized rat]. / Medlennye ritmy v reovazogramme khvostovykh arterii nenarkotizirovannykh krys.

Parametric description of the rheovasogram (RVG) with minimal and maximal amplitude as well as the data obtained in rats suggest that the RVG slow oscillations reflect regular oscillations of vascular tone connected with the c. n. s.

[The use of clindamycin in the prevention and treatment of infectious complications in the cancer clinic]. / Primenenie klindamitsina pri profilaktike i lechenii infektsionnykh oslozhnenii v onkologicheskoi klinike.

Clindamycin used alone or in combination with other antimicrobial drugs such as aminoglycosides, dioxidin and fluoroquinolones in the prophylaxis and treatment of infectious complications in oncological patients was shown to be highly efficient. When clindamycin was used prophylactically in combination with netilmicin, the postoperative infectious complications developed in 3 out of 27 patients with tumors of the head and neck, in 1 out of 24 patients with tumors of the rectum and colon and in 3 out of 16 patients with tumors of the female genitalia. The clinical effect was observed in 36 (87.8 per cent) out of 41 patients with postoperative wound infections and in 38 (82.5 per cent) out of 40 patients with pneumonia. Therefore, the use of clindamycin alone or in combination with other antimicrobial drugs is essential in the treatment of infectious complications in oncological patients.

[Evaluation of the effectiveness of antibacterial therapy]. / Ob otsenke éffekta antibakterial'noi terapii.

It is recommended to estimate the clinical effect of antibacterial therapy in patients with different purulent inflammatory complications with an account of the data on both the clinical and bacteriological examinations. The full affect consisted in disappearance of the clinical signs and complete bacteriological sanation of the purulent inflammatory foci. The partial effect was shown by a marked decrease in the clinical manifestations without complete bacteriological sanation of the foci. The ill effect was evidenced by clinical picture having no time course and no favourable time course in bacteriological tests. No effect was indicated by deterioration of the clinical picture and no favourable time course in the bacteriological tests.

[A trial of the use of mupirocin in the nasal carriage of Staphylococcus aureus in medical personnel]. / Opyt primeneniia mupirotsina pri nazal'nom nositel'stve zolotistogo stafilokokka u meditsinskogo personala.

Many hospital-acquired purulent diseases and wound infections are due to multiresistant hospital strains of Staphylococcus aureus. The role of S. aureus nasal carriage in development of wound infections due to autoinfection is confirmed. Not only inpatients but also hospital staff can be highly colonized with coagulase positive staphylococci. The S. aureus persistence in hospital personnel results in distribution of the microorganisms in the environment. Therefore, detection of S. aureus carriers without signs of the infection among the hospital personnel and eradication of the pathogen make it possible to control outbreaks of S. aureus infection in hospitals. Clinical efficacy of nasal ointment of mupirocin in the treatment of S. aureus carriers among the intensive care personnel of the N. N. Blokhin Cancer Research Center was evaluated. S. aureus nasal carriage was diagnosed in 17 (26 per cent) out of 65 persons. All the isolates were susceptible to oxacillin. 5-7 days after discontinuation of the mupirocin nasal ointment use eradication of S. aureus was stated in 100 per cent of the cases. The effect was still observed in 94 per cent of the cases in 1 month, in 76 per cent of the cases in 5-6 months and in 60 per cent of the cases in 8-9 months. It is believed that mupirocin nasal ointment (Bactroban) is convenient to use, low toxic and highly active in the treatment of persons with S. aureus nasal carriage.

[Imipenem-cilastatin in the treatment of suppurative inflammatory complications in the cancer clinic]. / Imipenem/tsilastatin pri lechenii gnoino-vospalitel'nykh oslozhnenii v onkologicheskoi klinike.

The results of the treatment with imipenem/cylastatin (Merck, Sharp and Dohme) of 46 oncological patients whose condition was severe or extremely severe because of infectious complications are presented. The drug was administered intravenously drop-like in doses of 1.5 or 2 g a day. The paper also presents the data on the in vitro susceptibility of 492 strains of aerobic organisms causing purulent inflammatory and septic complications. The majority of the strains were susceptible to imipenem/cylastatin (80-100 per cent depending on the genus and species). A complete or partial therapeutic effect was observed in 30 out of 46 patients. The adverse reactions in several cases required the use of some other drug. Still, they were not life-threatening. Therefore, imipenem/cylastatin should be considered to be a highly efficient combination with antibacterial action. It is useful in the treatment of severe purulent inflammatory complications in oncological patients.