bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical management of the proximal injury to the nerves of the upper extremity: strategy at overcoming multiple critical gaps
Authors: Tretyak I.B. , Kovalenko I.V. , Gatskiy A.A. , Tretyakova A.I.
Published: December 2018

Aim of the study — to evaluate the outcomes of reconstruction procedures at complete injuries of brachial plexus in subclavicular region. The retrospective analysis of the reconstruction procedures in 3 men and one woman (mean age 36,4 years) with complete injury of brachial plexus in subclavicular region was conducted. Injury to musculocutaneuos, median, ulnar and radial nerves was accompanied by axillary (2 cases) or brachial (2 cases) artery injury. One patient had no injury to musculocutaneous nerve within the injury’s structure. All patients underwent surgical reconstruction of the neural structures 4,8 months (mean term) post initial vascular surgery. The autografting was the main reconstruction procedure of the long nerves of the upper extremity at their critical gap (mean gap 10,5cm) with donor-nerves of the small (sural nerve) and large (ulnar nerve) cross sectional diameter. Both motor and sensory components of recovery were evaluated with MRC Scale and Seddon Scale respectively. Each patient evaluated the recovered median nerve mediated functions with Brief Michigan Hand Questionnaire. It was revealed that one patients showed poor recovery of the entire complex of the muscles of the upper and lower arm (MRSC 2 points or lower). Two patients showed good recovery of the biceps brachii muscle (MRCS score 5 points) on 14th and 13th month respectively. Mean MRC Scale score among three patients for the muscles of the anterior compartment of the forearm was: 3,3 points for m. flexor pollicis longus, 3,6 points for mm. flexores digitorum and 4 points for m. flexor carpi radialis respectively. Mean MRC Scale score among three patients for the muscles of the posterior compartment of the forearm was: 2,6 points for m. extensor pollicis longus, 3,3 points for m. extensor digitorum sublimis and 4 points for radial wrist extensors respectively. The median nerve mediated sensation recovered to 2,3 points on Seddon scale. Only one patient showed effective recovery of the thumb opposition. Loss of ulnar nerve mediated functions was expectable among all 4 enrolled patients, thereafter we observed no recovery of key pinch and diagonal volar grip. Three patients showed recovery of transversal volar grip only. Mean Brief MHQ score was 55,55 points – unsatisfactory recovery. The reconstruction of the ulnar nerve, thereafter recovery of the “intrinsics”, should be the priority in terms of reanimation of the basic grips and pinches of the upper extremity – one should avoid harvesting of the ulnar nerve at multiple nerve injury cases; the expectable loss of functions at the utililization of the radial nerve as a donor nerve, could be easily recompensed with the tendon transfer procedures in later terms.
Rationale for the use of immunosuppressive therapy in patients with acute myocarditis
Authors: Cherniuk S.V.
Published: December 2018

To date, the expediency of immunosuppressive treatment with corticosteroids in patients with myocarditis is one of the most controversial issues of modern cardiology. The purpose of the study was to establish predictors of corticosteroid therapy efficiency in patients with acute myocarditis. 47 patients with acute myocarditis were examined, who received immunosuppressive therapy for 6 months. All patients underwent for immune state assessment, echocardiography and cardiac magnetic resonance imaging. Statistical processing of the results was performed using Excel XP and Statistica for Windows v. 6.0 programming studying Student's criterion, parametric correlation analysis and distribution of the studied indicators by binary scale. It has been established that the appointment of immunosuppressive therapy in patients with high activity of immunopathological reactions of humoral type in the debut of myocarditis after 6 months of treatment leads to a decrease in the activity of autoimmune damage of the myocardium, recovery of left ventricular systolic function and improvement of heart failure functional class. The predictors of heart failure functional class improvement after 6-months of corticosteroid treatment were determined as: concentrations of immunoglobulin M>2,5 g/l, CD19+ lymphocytes >0,23 × 109/l, tumor necrosis factor α>200 pg/ml, interleukin-1β >150 pg/ml, content of circulating immune complexes >75 un. opt. sq., titre of antibodies to myocardium >20.0 conv. un. before the start of immunosuppressive therapy, as well as the absence of fibrotic changes in the left ventricular myocardium on cardiac MRI. Thus, early prognostic markers of the effectiveness of glucocorticoid therapy in patients with acute myocarditis were established. Further research should focus on the search for criteria of immunosuppressive therapy effectiveness and the introduction of clear recommendations for clinical practice that will contain indications and contraindications for its management in patients with myocarditis.
URGENT CAESAREAN SECTION COUNSELING. PROBLEMATIC QUESTIONS AND WAYS OF OPTIMIZATION
Authors: Misiura A.G.
Published: December 2018

Obstetric problems that arise during urgent operational labour, perinatal consequences, psychological component, reproductive perspectives, cosmetology moments are the incomplete list of questions faced by a physician and a patient in case of an urgent caesarean section. The goal is to analyze clinical, perinatal results, psychological component of urgent operational labour by means of CS from the position of categories of urgency to optimize counseling the patients before an emergency surgery. The analysis of cases of abdominal birth of 1st , 2nd and 3rd categories of urgency during the first half of the year 2017 in the Department of Pregnancy Failure of the Lviv Regional Clinical Hospital has been carried out. 97 case histories of childbirth are presented and analyzed, and the labour has been carried out urgently. The age of women at labour ranged from 18 to 36 years. CS of the incomplete pregnancy was carried out in 59 (60.8%) cases and with 38 patients in the full-term pregnancy. Caesarean section of the first category of urgency was carried out with 44 patients (45.4%), the second one with 31 (31.9%), and the 3rd with 22 (22.7%). A retrospective analysis of childbirth histories in case of an urgent CS confirmed the already existing trends and problems of operative obstetrics, as well as showed some practical possibilities, and mostly, their lack in terms of patients being informed and counseled before the CS surgery. Consultation of a pregnant woman before surgery is carried out by an obstetrician-gynecologist, an anesthetist and a neonatologist. The patient gets acquainted with details and being informed gives a written consent to medical intervention by signing two documents for the obstetrician-gynecologist, one for an anesthetist, and this is the minimum package of medical documentation in terms of legal norms. It is also necessary to take into account the psychological state of a woman: awareness of a threatening condition for herself or the child; labour stress, pain, emotional stress, physical exhaustion. On such a ground the counseling of a pregnant woman should be concise, correct, confident, and rational. Thus, therefore, counseling the patients before the operation of the CS cannot be considered standard. The categories of urgency of medical interventions include a varied approach to a specific obstetric situation, the individual selection of information for the patient and her family, the optimal use of the time interval for preparation for the surgery and delivery of information.
Effectiveness of preconceptional prevention of gestational complications by using folates
Authors: Mishchenko V.P. , Rudenko I.V. , Golubenko M.Yu. , Stamova N.A.
Published: December 2018

Preconceptional prophylaxis is a component of medicine, prevents occurrence of gestational complications, perinatal pathology, including congenital malformations. 30 patients and their husbands were examined who underwent preconception training 3 months prior to fertilization and 30 women without preconception training were examined. Preventing gestational complications, perinatal pathology, including congenital malformations, is advisable to begin at least 3 to 4 months before fertilization. This makes it possible to evaluate the premorbid background of the organisms of future parents, to determine and conduct a pathogenetically substantiated differentiated individualized complex stage full-fledged correction of metabolic disorders, taking into account the possible hereditary disruption of the activity of specific enzymes. The effectiveness of preconception prophylaxis of gestational complications depends both on the timely evaluation of the initial state of the organism of future parents and on the correction of the vitamin content in the body, which contributes to the stabilization of oxidation-reduction processes, folate cycle, balanced exchange of macro- and microelements under the control of the initial and the dynamics of monitoring the levels of these substances. The most modern drug of choice for the correction of the content of vitamins, macro-, microelements, amino acids is the vitamin complex Natalker I-II.
Efficiency of treatment of patients with non-alcoholic steatohepatitis combined with diabetes mellitus type 2 using the s-adenosylmethionin
Authors: Pavlovskyi S.A.
Published: December 2018

Non-alcoholic fatty liver disease is an important cause of chronic liver damage in many countries and is growing rapidly in both adults and children due to obesity and diabetes type 2. Aim — investigate the effectiveness of complex treatment of patients for the course of NASH using S-adenosylmethionin on the background of basic therapy. The study included 25 patients with non-alcoholic steatohepatitis against type 2 diabetes, age on average (58.69±1.25) years. The control group comprised 15 healthy individuals. In order to identify the diagnosis, data from clinical and laboratory, biochemical and instrumental studies were fully integrated into account. Statistical processing of the results was carried out using Statistica 6.1. In the group of patients with NASH before treatment, the stage I of hepatosis was observed in 15% of cases, the second — in 50%, the third in 35%. Lipid blood spectrum revealed high levels of low and very low density lipoprotein and low levels of high density lipoprotein. High levels of triglycerides among men and high thyroid test among women were determined. The results of the complex (with the inclusion of S-adenosylmethionine) treatment for patients with NASH showed a significant improvement in the subjective state of patients: reduced complaints of discomfort in the right hypochondrium, general weakness, nausea and dizziness. In the ultrasound study in the group of NASH, the redistribution of the number of patients in the side with the reduction of heavier stages of hepatosis was observed: the number of patients with stage I hepatosis was determined in 52.9% of cases (an increase of 3.5 times), stage II — in 24.9% (reduction in 2 times), the third stage — in 22,2% (reduction by 1,5 times). Among all patients, the cytolysis, mesenchymal-inflammatory syndrome, cytology, hemograms improved, and lipid and metabolic parameters were stabilized, confirming the positive membranotropic effect of S-adenosylmethionin on the membrane structures of hepatocytes and indicating anti-inflammatory, hepatoprotective and regenerative effects of the drug in the treatment of patients with steatohepatitis combined diabetes mellitus type 2.
Dynamics of hormonal parameters in patients with climacteric syndrome in the context of hypothyroidism under the influence of complex therapy with Climact-Hel and Mulimen
Authors: Pavlovska M.
Published: December 2018

In hypothyroidism, the climacteric syndrome has a tendency to an early start and a protracted course and manifests itself in the middle and severe forms with a predominance in the clinical picture of psychoemotional and metabolic-endocrine disorders. The purpose of the work is to compare the effectiveness of complex treatment of climacteric syndrome with concomitant hypothyroidism by analyzing hormonal indices before and after complex therapy using antihomotoxicological therapy. For its achievement, patients are divided into two groups: women who received only baseline therapy in accordance with the National Consensus on the management of patients in the climacteric diet (hereinafter — base therapy, group 1) and patients who, in addition to the baseline therapy, received therapy with antihomotoxic drugs (Group 2). After analyzing the patient's outcomes with the climacteric syndrome and concomitant hypothyroidism after the two treatment courses, there was a tendency for the IRI to decrease in both groups, but none of the groups was able to reach the normal level. Calcitriol increased in two observation groups, while in one group the index did not reach normal values. The decrease in the follicle stimulating hormone was observed in both groups and only the 1st group managed to get closer to normal values after two treatment cycles. The decrease in estradiol was observed in both groups of patients, but its significance was significantly lower in patients in the 1st group. Under the influence of treatment in accordance with the protocols in the first group, TTG significantly decreased, reaching the norm after the second course of treatment. In assessing the overall effectiveness of treatment, it turned out that with the use of baseline therapy, the effectiveness was 63.3%, with the use of complex treatment with the use of antihomotoxic drugs — 55.5%.
The modern state of self-work of students of medical universities at learning of intensive therapy
Authors: Semenenko A.I. , Semenenko N.A. , Dmytriiev D.V. , Lysenko S.A.
Published: December 2018

The organization of active self-work while studying at the highest school can teach the future doctors and effectively to replenish their knowledge, to think actively and creatively, to constantly improve themselves, to demonstrate an innovative approach in solving urgent situations. Objective — to analyze the current state of self-work of students of medical universities in the study of intensive care. Discussion of the problem of self-work in the study of intensive care or other professional discipline, as a specific form of educational activity of medical students, is induced by adequate motivation: own self-improvement, personal growth, deepening of knowledge, etc. In the study of intensive care it is advisable to organize the control of knowledge of students. Interviews were conducted to assess the quality, efficiency and necessity of self-training in the study of intensive care when they were students. According to interns, an important point that reduces the effectiveness of the study of intensive care in the form of self-work was low motivation associated with the lack of imagination about his future professional activities and the relationship with her basic provisions of intensive care. The second problem in self-work of students, according to the interns, was the lack of a phased study of the subject, which in their view was due to the lack of time and the large number of students in the group. The third problem is the difficulty in choosing the necessary information when studying intensive care. Often, students face the problem of lack of understanding of the degree of information need and the possibilities of its application, especially in the application of information technology. According to modern requirements, self-work in the study of intensive care by students of medical universities should be divided into self-work for: gaining new knowledge; for application of knowledge in practice; for repetition and verification of knowledge, skills and abilities. So, managed self-work of students is a purposeful activity of teachers and students for systematic assimilation of personality of professionally important knowledge, skills and abilities. The use of traditional and innovative forms and methods of training that, complementing each other, would be the only system in the study of intensive care methods is the main task of organizing self-work of students. Of great importance in the organization of self-work of students acquires a clear organization of this process from the side of the educational institution and its careful planning by the teacher.
THE INFLUENCE OF SANITARY AND HYGIENIC WORKING CONDITIONS OF MINERS OF "LVIVVUHILLIA" ON THE DEVELOPMENT OF DEFORMING ARTHROSIS
Authors: Basanets A.V. , Bulavko M.M.
Published: December 2018

The work carried out the comparative evaluation of sanitary and hygienic working conditions of mining workers of breakage face and machinists of shearer mining machines of the SE "Lvivvuhillia". The technology of underground coal mining caused by the interconnected set of basic and auxiliary production processes of extraction and transportation of coal, as well as conducting appropriate preparatory works. The main mining occupations, without which it is impossible to carry out the coal mining cycle of works, include "mining worker of breakage face" (MWBF) and "machinist of shearer mining machines" (МSMM). The aim of the study was the estimation of the influence of sanitary and hygienic working conditions of MWBF and МSMM on the development of deforming arthrosis. The research evaluated the sanitary and hygienic working conditions of mining workers of breakage face and machinists of shearer mining machines of the SE "Lvivvuhillia" on the basis of the processed and generalized data of 40 sanitary and hygienic characteristics of labor activity (29 MWBF and 11 МSMM) for 2015-2017. The obtained data were compared with the normative values of the State Sanitary Norms and Regulations according to the Order № 248 dated from 08.04.2014 "Hygienic Classification of Labor on the Indicators of Hazard and Danger of the Factors of the Production Environment, the Severity and Stress of the Labor Process". Installed that the levels of the main production factors of the development of deforming arthrosis in the workplaces of miners of the main occupations exceeded the approved hygienic standards: moving cargo over a considerable distance (more than 5 meters) among МSMM - to 2072 kg/m, among MWBF - by 1.62 - to 28424 kg/m; lifting and moving goods among MWBF - by 2.2 heavier loads than norm (33 kg against 15 kg, respectively); the static load of miners was excessive among МSMM by 1.22, among MWBF - by 2.31 (122040 kg/f; 231220 kg/f, respectively, against the norm of 100000 kg/f); prolonged stay in a forced working position among МSMM - by 2.52 longer than norm (63 kg/f against 25 kg/f, respectively), among MWBF - by 3.40 (85 kg/f against 25 kg/f, respectively); MWBF were in the working position on the knees - by 6.5 longer than norm (65 kg/f against 10 kg/f, respectively), МSMM - by 2,6 (26 kg/f against 10 kg/f, respectively). So, the mining and geological characteristic of deposits of the Lviv-Volyn coal basin promotes the creation of dangerous working conditions for miners of the main occupations, causing the risk of development of musculoskeletal system pathology, including deforming arthrosis. The main risk factors of development of deforming arthrosis among the miners of these occupations are defined such factors of the production environment as: the severity and intensity of the labor process.
Modern possibilities ofair pollution estimation by pig industryenterprises
Authors: Turos O.I. , Slautenko Ye.G. , Petrosian A.A. , Morguleva V.V.
Published: December 2018

The main problem of pig farms in Ukraine is the mismatch of their capacity to the actual size of the sanitary protection zones, which leads to the risk of negative influence of odor pollution on the health of the population living in nearby settlements. The purpose of the study was to comprehensively assess the pollution of ambient air by emissions from pig breeding complexes containing dust particles and chemicals with pronounced odor properties. The research was conducted between 2012 and 2015 and covered the activities of 14 modern medium and high capacity pig farms. In the course of the study, natural measurements of ambient air pollution were carried out and materials of sanitary and epidemiological examination of these enterprises were examined. Within the framework of the pilot project, a survey of the local population was carried out and a mathematical model of the concentrations of the investigated chemical substances in the surface layer of the atmosphere was calculated, based on data on the odor threshold for these substances. The discrepancy between the existing dimensions of the protection zones of pig complexes and their production capacities was established, while the concentrations of the investigated substances in the air were not exceeded. Out of 126 respondents, 72% complain of a periodic deterioration in their health, which they associate with the pig complex. At mathematical modeling with averaging in 24 hours the excess of a threshold of a smell of hydrogen sulphide (2,8 times) and methylmercaptan (in 2,6 times) is found out. Conclusions are made about the prospects of the method of mathematical modeling of the distribution of chemical substances in ambient air, taking into account their odor threshold.
New data concerning oocyte maturationand embryo production in vitro
Authors: Sarafinyuk L. A.
Published: December 2018

It is reviewed last science data concerning oocyte maturation and pig embryo production in vitro. The aim of the work is to present new data concerning oocyte maturation and embryo production in vitro. Efficiency of different assistant reproductive methods can be improved by treatment of gametes and embryos with sublethal hydrostatic pressure. COCs denudation is better to perform 44 hours from the initiation of maturation procedure. Last 11 hours of maturation is better to perform in medium with decreased quantity of NaCl. Lipid content in oocyte significantly correlates with number of granulose cells per follicle. Larger size pre- and post pubertal oocytes are characterized by greater ability to development. Supplementation of culture medium with glycine leads to increase number of blastocyst cells. Addition of fibroblast growth factor to COCs culture medium benefits its development and blastocyst formation. COCs maturation normalization decreases polyspermy. Bringing endothelial growth factor in COCs medium culture increases rate of blastocyst formation. Different cells processes require different quantity of calcium ion oscillations. Temperature of liquid of preovulatory follicle can be indicator for oocyte quality. 14-days culture of COCs, recovered from early antral follicles, on polyacrylamide gel, results in achievement of larger size oocytes. It is improved method for optical observation of fertilization. It is worked out morula - blastocyst transportation for long distances. Introduction of Lysophosphatidic acid accelerates development of porcine embryos by activating formation of the blastocoel. Conclusion: last literature data show that row of different means of improvement for oocyte maturation and obtaining embryo in vitro is worked out.
Analysis of some homocysteine contradictions
Authors: Zaichko N.V. , Nekrut D.O. , Lutsyuk M.B. , Artemchuk M.A.
Published: December 2018

The existence of contradictory data in the literature and the lack of convincing evidence of the causes of hyperhomocysteinemia syndrome (HHC) associated with the disease give opposing views to the practical significance of high levels of homocysteine (HC) in plasma in patients. The article is written for the aim of having theoretical analysis of ambiguous, sometimes paradoxical data, on the problem of HHC, on the example of its association with cardiovascular pathology (CVP). The following paradoxes are formulated. The first paradox: in the part of clinical work, there was no link between moderate HHC and the risk of CVP. The second paradox: the prescription of vitamin B6, B9, B12 to patients for the prevention and treatment of CVP is usually accompanied by a significant reduction in the level of HC in plasma, but is not always realized by a decrease in the number of cardiovascular events. The third paradox: the mechanisms of the occurrence of HHC have not yet been identified in people with CVP or other diseases that correlate with the level of HC. Exceptions are only cases of these people having insufficient vitamins B6, B9, B12 taking part in the exchange of HC, or congenital defects of enzymes metabolism HC. The fourth paradox: in contrast to controversial clinical research, the results of experimental work are virtually unequivocal - artificial HHC pathogenetically associated with the development of CVP and other types of associated pathology. Thus, analysis of literary sources suggests the existence of opposing opinions, especially clinicians, about the role of HHC in the formation of cardiovascular pathology and the benefits of hypohomocysteinemic therapy. We believe that a definite value for the explanation of the contradictions will be focused research in the following areas: a) whether an increased level of HC is a cause, marker or consequence of cardiovascular disease; and b) whether HC is only a passive intermediate catabolism product of methionine or a biologically active compound with specific metabolic functions, the violation of which may take place both in the HHC, as well as due to hypohomocysteinemic therapy.
Research to antimicrobial action characteristics of antiseptics under protein loading to microorganisms
Authors: Zhornjak O.I. , Divinski D.N. , Stucan O.K. , Zhornjak P.V.
Published: December 2018

Setting of rational antibacterial therapy for treatment of the used for setting fire diseases of oral cavity and throat is the issue enough of the day, the decision of that depends on the row of factors that cause implicit interest of practical medicine. Infectious diseases and purulent-inflammatory processes of microbial origin play an important role in shaping the main indicators of health in Ukraine. Unfortunately, the use of systemic antimicrobial drugs by doctors, in most cases, is empirical, without taking into account regional tendencies of resistance. It can promote the spread of strains of microorganisms with multiple resistance to them, the emergence of outbreaks of hospital infections and increase the risk of severe complications. The aim of this work is to investigate the antimicrobial activity of antiseptic drugs such as septefril, sebidin, agisept on clinical strains of S.aureus. The experiment made in presence of the unfavorable factors (5% and 10 % protein solution). Domestic antiseptic drug septefril in its composition antiseptic decamethoxin®. The basis of the drug itself is chlorhexidine. The basis of the drug agisept is amylmetacresol. The antimicrobial activity of the agisept at 5% protein loading practically did not change. Reduction of anti-staphylococcal activity by 2.3 times observed in the preparation of septefril. The highest decrease in activity observed 6 times in the drug itself. At 10% protein load, the antistaphylococcal activity decreased by seventh-one times in septefril, 1.3 times in agisept. The greatest decrease in activity, in 10.7 times, was at the same time. Thus, we have established a reduction in the antimicrobial activity of antiseptic drugs in the presence of serum protein, but the level of action remained quite high with respect to clinical strains of microorganisms.
The epidemiology and antibiotic resistance in A. baumannii isolates from military health care facilities
Authors: Kovalchuk V. , Kondratiuk V. , Gann Patrick Mc , Kovalenko I. , Erik Snesrud
Published: December 2018

A.baumannii is one of the main causers of health care associated infections. The epidemiological situation has worsened in the past years, with a higher number of countries reporting interregional spread or endemicity of carbapenem-resistant A.baumannii. For these reasons to investigate epidemiology and susceptibility to antibiotics of A.baumannii in modern war wounds is crucial for correct treatment choice. The patients enrolled in study had combat wounds of upper or lower extremities which were treated in the Military Medical Clinical Center of Central Region (MMCC CR) Ukraine in 2014-2016 years. The recovered A.baumannii after primary identification in Department of Microbiology of National Pirogov Memorial Medical University were forwarded to the Multi-drug resistant repository and surveillance network (MRSN) in Walter Reed Army Institute of Research where they underwent additional antibiotic susceptibility testing (AST) and analysis by whole genome sequencing (WGS). There were analyzed 10 isolates. Testing revealed that all isolates were resistant to ampicillin, cefazolin, ciprofloxacin, and levofloxacin and all were sensitive to tigecycline. Susceptibility to other antibiotics varied considerably, with just two isolates displaying resistance to the carbapenems (imipenem and meropenem). An analysis of the antibiotic resistance genes carried by the isolates was in broad agreement with the AST data. Carbapenem resistance in VNMU001 was correlated with the presence of blaOXA-23, while carbapenem resistance in VNMU133 was correlated with the blaOXA-24 variant, blaOXA-72. Overall, 28 different antibiotic resistance genes were identified among the 10 isolates, with the majority encoding β-lactamases or aminoglycoside modifying enzymes (AMEs). The ten A. baumannii isolates represent four separate clades that include a single isolate from ST-1 and ST-2, members of the globally distributed CCI and CCII groups. Both of these clades are notorious for harboring multi-drug resistant strains, and this is reflected in this study where VNMU133 (CCI) and VNMU001 (CCII) displayed resistance to a wide variety of antibiotics and carried multiple antibiotic resistant genes. The remaining 8 isolates were assigned to ST-19, which is also a member of CCI, and all four isolates were closely related. Similarly, the four isolates from ST-400 clustered together, but only the two isolates from the same culture would be considered related. It is possible that ST-19 and ST-400 isolates are circulating within this population and additional surveillance is warranted. These data indicate that ST-19 and ST-400 isolates are still susceptible to many antibiotics but have the potential to acquire and develop more resistance mechanisms.
Features of resistance formation of gram-negative non-fermenting bacteria to antibiotics
Authors: Kondratuk V.M. , Prokopchuk Z.M. , Burkot V.M. , Vovk I.M.
Published: December 2018

The problem of the antibiotic resistance development of pathogenic microorganisms to the main groups of antibacterial drugs has evolved from medical to socio-economic. There is a resistance increase of P.aeruginosa, A.baumannii belonging to the group of gram-negative non-fermenting bacteria (GNB), to antibiotics that are used in medicine. The possibility of acquiring GNB resistance to the main groups of antibacterial drugs is related to the ability of bacteria to acquire new genetic information. The production of metal-beta-lactamase by GNB become a widespread problem of resistance to beta-lactam antibiotics. Detection of resistance genes to beta-lactam antibiotics blaVIM, blaOXA 23, blaOXA 40, blaOXA 69 and blaOXA 100 was performed using real time polymerase chain reaction (PCR-RT). Sensitivity of isolated strains of microorganisms to antibiotics was investigated using the standard disco-diffusion method (DDM). Influence of meropenem on formation of microorganism resistance was investigated in vitro by method of microorganisms passage on meat-peptone broth (MPB) with increasing concentrations of antibiotics.

In the process of research, 14 clinical strains of P. aeruginosa and 30 strains of A.baumannii were isolated and identified, almost all strains of these types of bacteria, characterized by resistance to antibiotics-carbapenems and third and fourth generation of cephalosporins. At the same time, the three strain-carries of markers of beta-lactamase products exhibited resistance to carbapenems, and one of the strains (P.aeruginosa No. 68) was capable of producing MBL, according to DDM, was sensitive to carbapenems and MCC was 31.2 μg / ml for it. Among the investigated strains of A.baumannii 18 (60%) out of 30 isolated ones were potential producers of beta-lactamases, capable of inactivating carbapenem antibiotics. In this case, only 6 out of 18 strains showed resistance to carbapenems according to DDM. Sensitivity to carbapenems revealed all strains of the beta-lactamase producers OXA 69 and OXA 100 and three strains – OXA 23. In this work, modern ideas about the mechanisms of development of resistance of GNB were described, isolated from patients of medical institutions (Vinnytsa city), the most common are producers of beta-lactamase types of OXA 23, OXA 69, OXA 100 and VIM.
Study of Alnus incana L. Moench fruit extract biologically active substances influence on resistance development in mls-resistant staphylococci skin isolates
Authors: Kutsyk R.V. , Yurchyshyn O.I.
Published: December 2018

The emergence of microorganisms resistant strains is a natural biological response to the use of antimicrobial drugs that creates selective pressure, contributing to pathogens selection, survival and reproduction. The purpose of the investigation was to study the resistance development of staphylococci skin isolates to erythromycin and influence on it Alnus incana L. fruit extract subinhibitory concentrations. Development of resistance to erythromycin and influence on it Alnus incana L. fruit extract (extraction by 90% ethanol) subinhibitory concentrations were conducted with S epidermidis strains: sensitive and resistant to 14 and 15-membered macrolides. The study was carried out within 30 days by multiple consecutive passages of staphylococci test strains (concentration 1×107 CFU/ml) into test tubes containing broth and erythromycin ranging from 3 doubling dilutions above to doubling dilutions below the minimum inhibitory concentration. Statistical analysis of the results was carried out by one-and two-factor analysis of variance (ANOVA) and Microsoft Office Excel 2011. Rapid increase of resistance from 32 to 1024 μg/ml (F=34.2804; F> Fstand. max = 5.9874; p=0.0011) for S.epidermidis with a low level of resistance to 14 and 15-membered macrolides resistance to the erythromycine was observed. In the presence of Alnus incana L. fruit extract subinhibitory concentrations (¼ MIC), the initial MIC of erythromycin was decreased by 32 times to 1 μg/ml (F = 9.7497; F> Fstand. max = 5.9874; p = 0.0205). The sensitive strain after 30 passages did not develop resistance to erythromycin. Under the influence of erythromycin selective pressure, S.epidermidis strain with low initial level of MLS-resistance rapidly reaches a high-level resistance. Biologically active substances of the Alnus incana L. fruit extract significantly inhibit the resistance development in S. epidermidis to macrolides and eliminate it phenotypic features.
The impact of piler-radiation on the growth rate of opportunistic microorganisms
Authors: Pantyo V. V. , Pantyo V. I. , Danko E. M.
Published: December 2018

The spread of resistant to antimicrobial agents strains of opportunistic microorganisms causes the search for new ways of struggle with them. Among these ways, special attention is drawn to the use of physical factors, in particular, different types of radiation, with potential antimicrobial activity. Purpose: to investigate the direct effect of the PILER wave length line on the growth rate of S.aureus ATCC 25923 and P.aeruginosa ATCC 27853 on solid nutrient media. The influence of PILER (Polarized Polychromatic Incoherent Low Energy Radiation) on various wavelengths on the growth intensity of the collection test- strains of S.aureus ATCC 25923 and P.aeruginosa ATCC 27853 on solid nonselective nutrient media (NA) was investigated. The results were determined by counting the number of bacterial colonies on the dishes and compared with control – similar unirradiated cultures. The effect of PILER of different wavelengths and exposures (5, 10, 15 and 20 min) was investigated by separate series. PILER light source – Med All Bioptron light therapy system by Zepter Group. The obtained results testify to the significant influence of PILER radiation on the intensity of the growth of research objects. The degree of influence depended on the duration of irradiation and showed insignificant stimulation of the growth of bacteria in 5–10-minute exposures and expressed bactericidal and bacteriostatic effect at exposure for 20 minutes. The 20-minute exposure PILER on the S.aureus 25923 strain resulted in a decrease of the number of bacterial colonies by 37–65% compared to control, P.aeruginosa 27853 – by 58–81% compared to control. PILER has a significant modulator effect on the growth of the examined conditionally pathogenic microorganisms on solid nutrient media. The degree of this effect depends on the radiation parameters, in particular on the dose density and the wavelength of light, and at exposures of 20 minutes is manifested in marked bactericidal and bacteriostatic effects on microorganisms.
Restoration of laboratory animal’s normal microflora with induced dysbiosis
Authors: Stepanskiy D.A. , Krushinska T.Yu. , Kremenchutsckyy G.N. , Turlyun S.Ya. , Koshevaya I.P. , Val'chuk S.I. , Stetsenko I.Yu. , Ichenko O.V.
Published: December 2018

The possibility of using autosymbiotic aerococci and their complex as a bacterial basis for probiotic preparations has been studied. Aerococci — A.viridans were selected as probiotic microorganisms being related to a normal microflora. Aerococci have unique properties that distinguish them from a number of common probiotic microorganisms. The aim of the study was to study the effect of autosymbionts A.viridans and their complex on the quantitative and qualitative composition of the intestinal microbiocenosis in experimental dysbiosis induced by long-term administration of ampixus in comparison with A.viridans 167 museums. An experimental model of ampiox-dependent dysbiosis in mice was used to evaluate their effectiveness. have shown Studies changes in the composition of the mice’s microflora after the exposure of ampiox. There was a decrease in the total number of colibacteria, aerococci, bifidobacteria, lactobacilli and an increase of OPM: fungi Candida, Proteus spp., Staphylococcus epidermidis, Enterococcus faecium and Clostridium spp. A comparative study of the dysbiosis correction effectiveness with freshly isolated mice’s autosymbionts (individual strains and a complex preparation containing all clones of the studied autosymbionts) and the heterologous strain A.viridans 167 was carried out. Aerococci were ascertained to restore the microflora of mice with ampiox-dependent dysbiosis to the initial state after 14-day application. Homologous autosymbiotic aerococci, including their complex, and the heterologous strain A.viridans 167 were revealed to effect differently on the ratio of certain components of the microbiocenosis inducing reliable increase of bifidobacteria and lactobacilli content and a decrease of OPM’s one. Autosymbiotic mice’s aerococci, separately and in the complex, showed greater affinity for the mice’s epitheliocytes then heterologous strain №167.
The apple pectin influence on biochemical and hematological parameters in animals with chronic alcohol intoxication
Authors: Sheremeta L.M. , Haynuk M.B.
Published: December 2018

Enterosorbents and prebiotics are included in treatment protocols for somatic disorders in chronic alcohol intoxication. Considering on relevant properties of pectin, the purpose of the study was to investigate its effect on biochemical and hematological parameters of experimental animals in chronic alcoholic intoxication. The study was conducted on 30 white outbred rats (males) weighing 180-200 g, which injected 30% ethanol into the stomach (control), animals in experimental groups after 30 minutes, got apple pectin at a dose of 0.2 g/100 g of body weight and reference preparations — activated charcoal and silicon dioxide — by 0.25 g and 0.05 g, respectively for 11 days. The statistical analysis was performed by Microsoft Exel and Statistica 5.5 (Multiple Regression) software using variation statistics methods. Research results. Changes in lipid metabolism were manifested by an increase in serum cholesterol of alcoholic animals without treatment by 29.8% compared with intact (p˂0.05). The use of pectin and reference drugs significantly reduced cholesterol levels. In the group with the use of pectin, this indicator was 36% lower, activated charcoal — by 19%, silicon dioxide — by 26.4% (p˂0,05) compared to untreated animals, at the same time, practically did not differ from intact animals. The level of triacylglycerols increased in all experimental groups and, although, it significantly differed from the intact, at the same time, it was essentially lower in all groups of treated animals than in non-treated ones (p˂0.05). A normalizing effect of pectin and silicon dioxide on the number of erythrocytes and hemoglobin levels comparing to alcoholated and treated activated charcoal animals also were shown (p˂0.05). The apple pectin curative effect on lipid and protein metabolism, as well as on the content of erythrocytes and hemoglobin in the blood of animals with chronic alcohol intoxication, practically equaled to standard enterosorbents, and on some indicators exceeds their effect, which may also be due to partial neutralization of ethanol.
Analysis of the monitoring study of the antibiotic-resistance of the agents of purulent-inflammatory processes of soft tissue
Authors: Prevar A.P. , Kryzshanovskaya A.V. , Radionov V.A. , Mrug V.M.
Published: December 2018

The main factor in the treatment of suppurative and inflammatory processes is the timely optimization of treatment measures taking into account the nature of the microflora and its susceptibility to antimicrobial drugs. The purpose of the study is to monitor the spectrum of microorganisms – pathogens of purulent-inflammatory processes of soft tissues in surgical patients; study of the sensitivity of isolated strains to antibiotics. The material was collected in accordance with aseptic rules. The identification of a pure culture of bacteria was carried out according to morphological, culture, biochemical properties, and the presence of virulence enzymes. Sensitivity of bacteria to antibiotics was determined by the standard disks method (by Kirby-Bauer’s). 255 patients with purulent-inflammatory processes of soft tissues were examined for the period from 2014 to 2017. 229 strains of isolated bacteria were included to Escherichia coli, Citrobacer freundii, Enterobacter cloacae, E.aerogenes, Proteus vulgaris, Staphylococcus aureus, S.epidermidis, Streptococcus pyogenes, S.viridians, S.agalactiae, Pseudomonas aeruginosa. The main cause of purulent-inflammatory processes of soft tissues is Staphylococci (67,2%). Compared to previous studies, the number of P.aeruginosa isolated cultures increased (7.9%). In monoculture and in association with other microorganisms, E. coli (9.6% of cases), E.cloacae et aerogenes (3.9% of cases), P.vulgaris (3.9% of cases), C.freundi (2.5% of cases), S.agalactiae, S.pyogenes, S.viridans (3.5%). The number of associated sows reaches 12%. Clinical strains of microorganisms remain most sensitive to fluoroquinolones, cephalosporins, and also retains high sensitivity to gentamicin, lincomycin, rifampicin, which is important for empirical antibiotic therapy. To increase the effectiveness of antibacterial therapy, strict adherence to the mode of appointment of antibiotics, justification of indications, a combination of antibiotics of different spectrum of action, mandatory correction after determining the sensitivity of the pathogen.
Sensitivity of biofilm and planktonic forms of non-fermenting bacteria to the action of antiseptics
Authors: Trofimenko Y.Y. , Makac E.F. , Stucan O.K. , Burkot V.M.
Published: December 2018

It is known that bacteria colonize endotracheal intubation tubes [EIT], form biofilms. Bacterial cells that are in the film matrix are protected from the effects of external factors and differ in high levels of resistance to the action of antibiotics, antiseptics, and disinfectants. The purpose of our study was to determine the sensitivity of the antiseptics of biofilm and planktont forms of non-fermentable gram-negative bacteria to the action of the antiseptics of decamethoxin, chlorohexidine bigluconate, povidone iodine, hydrogen peroxide. In order to create bacterial biofilms, sterile fragments of the endotracheal tubes were placed in test tubes with meat-peptone broth and the daily culture of the studied strain of microorganisms was blocked. To determine the influence of antiseptics on biofilms of bacteria, the method of two successive dilutions was used. The results of a comparative study of the activity of antiseptic agents (decamethoxin, bichluconate chlorhexidine, povidone iodine, hydrogen peroxide) in relation to planktonic and biofilm forms of pseudomonad and acinetobacter strains testify that in all investigated antiseptics and bacterial films pseudomonads forms are more resistant to drags preparations than in planktonic form. In bichluconate, chlorhexidine and decamethoxin MBcK for a bacterial film are 3,2 times greater than for a planktonic form. The smallest difference MBtsK for planktonic and biofilm forms of pseudomonad was in the drug povidone-iodine. MBcC bichluconate chlorhexidine for the biofilm form of acinetobacter, in comparison with planktonic form, was 3,3 times higher, for decamethoxin in 3.7 times, for povidone-iodine in 3,5 times. Biopharmaceutical forms of gram-negative nonfermenting bacteria have the ability to achieve high levels of resistance to antiseptics.