Antimicrobial activity of antiseptics in the prevention of postoperative infectious complications

Recently, among hospital strains of microorganisms, an increase in the number of antiseptic-resistant strains of opportunistic pathogens has been registered, which significantly affects the effectiveness of these drugs. It is important to study their antimicrobial efficacy to justify rational use. The aim is to conduct a comparative study of the antimicrobial efficacy of antiseptics of decamethoxine, chlorhexidine, polyhexanide. During study we examined the antimicrobial activity against 186 clinical strains of microorganisms (Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus spp., Enterobacter spp.) isolated from patients with infectious complications in the postoperative period. The minimum inhibitory (MIC) and bactericidal concentrations (MBC) of 0.02 % and 0.1 % decamethoxine, 0.05 % chlorhexidine bigluconate, 0.1 % polyhexanide were determined; antimicrobial efficacy of drugs was evaluated by the index of antiseptic activity by conventional methods. The study found high antimicrobial properties of decamethoxine, chlorhexidine, which had a high bactericidal effect on clinical strains of S. aureus, Enterococcus spp., Enterobacter spp. Proved the benefits of antimicrobial activity of the drug based on decamethoxine (p<0.001). The polyhexanide has pronounced antimicrobial properties against A. baumannii, bacteria of the family Enterobactericae, P. aeruginosa. Thus, the leading gram-positive (Staphylococcus aureus, enterococci) and gram-negative pathogens (enterobacteria, acinetobacteria, pseudomonads) are sensitive to polyhexanide, chlorhexidine and the domestic drug decamethoxin, with a probable advantage of the antimicrobial properties of the latter over all gram-positive and most gram-negative microorganisms.

Strategic directions of implementing a system of psychophysiological support of professional activity of military pilots

To date, the state aviation of Ukraine has an urgent problem of improving the existing system of medical support for flights by introducing measures of psychophysiological support for improving the professional health of military pilots, increasing the duration of their professional longevity and ensuring the safety of flights. That is why, the purpose of our research was to offer a list of strategic directions of scientific substantiation and development of a conceptual model of a system of measures for psychophysiological support of professional activities of military pilots based on an analysis of the problems of its implementation in the state aviation of Ukraine. For this, the methods of analysis and synthesis, generalization, induction and deduction, complex and system analysis were used. As a result of the research, it was found that the strategy for introducing a system of measures for psychophysiological support of the professional activities of military pilots should be perceived as a process of improving the existing system of medical support for flights of state aviation in Ukraine on the basis of defining qualitatively new goals and objectives of its functioning, harmonizing internal capabilities with the conditions of the professional environment, development of a set of measures to improve its reliability and efficiency in the long term. From these points of view, the systematic approach to determining the strategic directions of implementation of the said system should be based on the complex of organizational, regulatory, information-analytical, personnel and technological problems. To solve them, it is necessary to conduct research on health assessment of different categories of military pilots, hygienic assessment of conditions and features of their professional activity, selection of a set of informative psychophysiological characteristics and methods of their evaluation, development of mechanisms and criteria for access to flights, regulatory, legal, personnel and organizational bases of functioning of system of measures of psychophysiological support of professional activity of military pilots.

Morphological changes in the tissues of the knee joints of rats in carrageenan-induced experimental arthritis

Every fifth inhabitant of the earth has been diagnosed with osteoarthritis of various etiologies. Morphological studies of arthritis provide a theoretical basis for creating optimal treatments for this pathology. Given the polyetiological nature of the disease, the choice of the optimal experimental model, which would be as close as possible to the real conditions of inflammatory process reproduction, is the topical issue. The purpose of the study was to confirm the pathological reaction of the joint tissues of laboratory animals in response to intraperitoneal administration of ƛ-carrageenan. The study was performed on 50 white Wistar rats males aged 12 weeks, weighing 130-150 g. The animals were euthanized by an overdose of anaesthesia according to the terms of the study (1 - 30 days). Fragments of the distal metaepiphyses of the femur and proximal metaepiphyses of the tibia were used for histological examination. Staining of sections obtained on the microtome was performed with haematoxylin, eosin, and Van Gieson`s stain. From the first day of the experimental study, a corresponding reaction of the joint tissues was being observed. Particularly pronounced were the changes in the synovial membrane in the form of oedema of the villi accompanied by an increased filling of blood vessels with foci of thrombosis. Gradually, up to 5 days in the synovial membrane, proliferative changes took place with a clear definition of the multilineage of the integumentary layer, vascular reaction with a tendency to thrombosis, in some places necrosis of synoviocytes was observed, but relative integrity of the morphological structure was still provided by protective barriers of bone and cartilage. On the 7th day pronounced resorption of both bone and cartilage tissue occurred, tissue structure became disorganized and functional layer became thin, accompanied by massive intracellular lysis. The process of synoviocytes necrobiosis with fatty degeneration spread. The histological picture of 10 days is characterized by generalized destruction of bone beams; the destroyed cartilage was replaced by granulation tissue with the presence of cavities. Massive foci of lymphocytic infiltration were observed in the synovial membrane. On the 14th day, a fragmentation of cartilage happened, most of the bone beams (trabeculae) were destroyed. After 3 weeks the morphological picture of cartilage tissue was determined by the appearance in the lacunae of viable cells, the number of which was close to normal. Bone beams were restored, although they remained thin. In a synovial membrane, the hyperplasia of apical departments of villi, leukocytes infiltration, disorganization of connective tissue, and separate vascular disturbances remained. 30 days of the experiment were characterized by a relative recovery of structural relationships to normal. The obtained data confirm the feasibility of using carrageenan in experimental studies of osteoarthritis.

Cognitive disorders in patients after cardiac surgery

The occurrence of cognitive disorders is a common problem after surgery. The degree of worsening of cognitive functions after surgery and anesthesia has a significant impact on the patient's health and is significantly associated with prolonged recovery in the hospital, increased morbidity and delayed functional recovery. The aim of the study was to increase the effectiveness of the diagnosis of moderate cognitive impairment and to determine its gender and age characteristics in patients before and after cardiac surgery in the early postoperative period (3 and 7 days). We examined 56 patients who underwent cardiac surgery for coronary heart disease in 37 (66.1 %) and valvular heart defects in 19 (33.9 %) patients. Assessment of cognitive functions was performed before surgery, on the 3rd and 7th day of the postoperative period. Testing was performed using the Montreal Cognitive Test. Statistical processing of the obtained data was performed on a personal computer using the statistical software package SPSS 12.0 for Windows using parametric and non-parametric methods. It was found that presence of cognitive disorders before surgery was registered in 37 (66.1 %) patients, mostly among the age of group of 60-74 years and had no gender difference. It was found that in the early postoperative period there is a significant worsening of cognitive functions in patients after cardiac surgery on 3rd day – in 45 (80.4 %), on 7th day – in 44 (78.6 %) patients, respectively.

Skinfold thickness in men with mild and severe psoriasis without and taking into account the somatotype

Significant prevalence and decline in quality of life caused by psoriasis in combination with the lack of etiotropic methods of its treatment, put this disease, in terms of relevance for modern medicine on a par with diabetes, hypertension, asthma etc. That is, there is a need to find easily accessible markers that would determine the susceptibility to this disease. The aim of the study was to establish the differences in the skinfold thickness between healthy and/or psoriatic Ukrainian men depending on the severity of the disease without and taking into account the somatotype. For 32 Ukrainian men of the first mature age, patients with mild psoriasis and 68 men with severe psoriasis (according to the PASI index) were determined skinfold thickness according to Bunak and determined the somatotype according to the Heath-Carter scheme. The control group consisted of 82 healthy men of similar age, selected from the database of the research center of National Pirogov Memorial Medical University, Vinnytsya. Statistical data processing was performed in the license package “Statistica 5.5” using non-parametric methods of evaluation of the obtained results. It was found that in patients with mild or severe psoriasis of men without division into somatotypes and in representatives of the mesomorphic somatotype compared to healthy men, the skinfold thickness is significantly higher at the lower angle of the scapula, abdomen and side, and significantly lower on the back and front of the shoulder, chest and thighs. When comparing the skinfold thickness between patients with mild or severe psoriasis of endo-mesomorphic somatotype with healthy men of similar somatotype, we found larger values of the skinfold thickness under the lower angle of the scapula (only with mild course), on the abdomen and side, and also smaller values of the skinfold thickness on the posterior surface of the shoulder and only in representatives with severe psoriasis – on the anterior surface of the shoulder, chest and thigh. Between patients with different degrees of severity of dermatosis both without distribution, and with distribution on various somatotypes of reliable or tendencies of differences of skinfold thickness are not revealed. Thus, there are pronounced differences in most indicators of the skinfold thickness between healthy and patients with mild or severe psoriasis of Ukrainian men of the first mature age, both without distribution and with the division into different somatotypes.

Evaluation of the effectiveness of early intervention methods in newborns who have suffered hypoxic-ischemic CNS damage

Timely diagnosis of cerebral disorders both in the prenatal period and in the early neonatal period, as well as early rehabilitation treatment is the basis for the prevention of childhood disability. To this end, the so-called Early Intervention System is being introduced in Ukraine. The effectiveness of early intervention techniques directly depends on timely diagnosis and correctly chosen intervention tactics. Given the high neuroplasticity of the developing brain, it is advisable to start the elements of neurodevelopmental therapy from infancy. The aim of the work is to evaluate the effectiveness of methods of early intervention in children of the first 3 months of life who have suffered hypoxic-ischemic CNS damage in the neonatal period, by assessing the main indicators of psycho-motor development. 101 children who were treated in the neonatal pathology department due to hypoxic-ischemic CNS damage and did not have concomitant somatic pathology were examined. The children were in the ward for rehabilitation. To assess the effectiveness of comprehensive rehabilitation in young children, it is advisable to use adapted for Ukraine scale of Munich functional developmental diagnostics, which allows to assess the child's development in all major areas, its harmony and effectiveness of rehabilitation measures during the first 3 years of life. Statistical processing of the obtained results should be performed in the license package "Statistica 6.1 for Windows". Timely diagnosis of cerebral disorders both in the prenatal period and in the early neonatal period, as well as early rehabilitation treatment is the basis for the prevention of childhood disability. Given the high neuroplasticity of the developing brain, it is advisable to start the elements of neurodevelopmental therapy from infancy. The effectiveness of the methods recommended for use depends on timely diagnosis and correctly chosen intervention tactics. Assessment of the effectiveness of care for children at risk of deviant psychomotor development should be based on the application of the criteria and scales recommended by international expert groups, which are adapted in our country. Signs of full-fledged early intervention in the region are: perinatal diagnosis of congenital pathology, timely provision of medical and rehabilitation, social and special pedagogical services to children aged 0 to 3 years and their families. In order to achieve the set goals, in our opinion, the priority measures should be steps to implement the national protocol for care for children with perinatal CNS injuries, approval and implementation in Ukraine of the modern International Classification of Functioning, Life and Health Restrictions, providing medical care, rehabilitation and social services for young children.

Peculiarities of relationships of characteristics of adaptation capabilities of the organism and indicators of motor activity of students

The health of student youth is largely determined by the level of functional capabilities of the organism, which depends on the level of motor activity, that is the total number of movements that a person performs in a given period of time. The purpose of the work is to establish the features of the relationship between the characteristics of adaptive capacity, functional status and level of development of psychophysiological functions and criteria for motor activity of students. The research was conducted on the basis of National Pirogov Memorial Medical University, where 385 students (200 young girls and 185 young boys) were supervised, who, taking into account the peculiarities of the distribution of different levels of motor activity, were divided into 3 comparison groups – with potentially low, medium and potentially high levels of motor activity. The values of daily energy consumption, number of locomotions and duration of the dynamic component in the daily budget were used as the leading criteria of hygienic assessment of students’ motor activity. Functional features and adaptive capabilities of the organism were determined using conventional methods. The analysis of the obtained results involved the use of a standard application package of multidimensional statistical analysis “Statistica 6.1 for Windows”. The results of studies conducted on the basis of correlation analysis procedures indicate the fact that the largest number of correlations between the characteristics of psychophysiological functions and the leading characteristics of health and indicators of academic performance in professionally oriented disciplines studied are recorded in girls, and boys who belonged to the group with an average level of physical activity (daily energy expenditure of 9000-11000 kJ in young girls and 11000-13500 kJ in young boys). The use of cluster analysis procedures during the prognostic assessment of indicators of health and academic performance in professionally-oriented disciplines, made it possible to identify 3 clusters of the studied characteristics of the functional state of students, which have the most pronounced effect on their values: visual-motor speed cluster (indicators of the latent period of simple and differentiated visual-motor response), visual-sensory cluster (indicators of critical fusion of light flickers and efficiency of work performed) and integrative-coordination cluster (a number of indicators that reflect the properties of major nervous processes, characteristics coordination of movements, indicators of attention functions, etc.). Using factor analysis procedures, it determined that both young girls and young boys have the most positive impact on academic performance in vocational disciplines such factors as “functional state of the visual sensory system”, “functional state of coordination” and “functional state of higher nervous activity”.

The prospects of finding new treatments for acne

An important role in the development of acne is played by the activity of the skin microflora (namely the bacteria Propionibacterum acnes) and members of the genus Staphylococcus. In the schemes of complex treatment of patients with this disease, antibiotics from among macrolides or lincosamides are mainly used. It is of interest to study the current state of susceptibility of staphylococci and propionic bacteria to these drugs, as well as to other antimicrobial agents in order to determine the prospects for expanding the arsenal of methods for treating acne. The aim of the study was to study the susceptibility of microorganisms involved in the development of acne to antimicrobials and antagonistic effects of probiotic strains of lactobacilli. We conducted a bacteriological study of the content of rash elements in 60 patients with acne. The biological characteristics of 40 strains of Staphylococcus spp. and 15 strains of Propionibacterum acnes isolated and researched. The sensitivity of microorganisms to antibiotics and antiseptics was determined by the disco-diffusion method and the method of serial double dilutions of drugs in a liquid nutrient medium. Determination of the sensitivity of acne pathogens to the antagonistic effect of lactobacilli was performed by the method of two-layer agar by reducing the number of microorganisms. The results of the study made it possible to establish that the isolated strains of bacteria show a low level of sensitivity to antimicrobials, which in medical practice are most often used for topical therapy of acne. Only 17.5 % of isolated staphylococcal strains were sensitive to erythromycin, only 45.0 % of strains of this species were sensitive to clindamycin. Strains of Propionibacterum acnes showed a higher level of sensitivity to antibiotics than staphylococci. However, the established indicators do not allow to consider highly effective means for treatment of acne on their basis. At the same time, a high level of sensitivity of acne pathogens to antiseptic drugs decamethoxine and Aeroplysinin 1 and antagonistic effect of Lactobacillus acidophilus was established. Thus, the strains of Propionibacterum acnes and Staphylococcus spp., involved in the development of acne, are characterized by high levels of resistance to erythromycin, clindamycin, chloramphenicol, benzoyl peroxide, which are now the basis of the arsenal of topical therapy for patients with this disease. There is a need to find new effective drugs for the etiotropic therapy of acne.

Evaluation of the effectiveness of a proposed approach to treat infertility against the background of uterine leiomyoma, which includes treatment with a releasing hormone agonist, hysteroresectoscopy or conservative myomectomy, and pre-pregnancy treatment

There is much discussion about the effect of uterine leiomyomas on the outcomes of assisted reproductive technologies (ART). This study aimed to analyze the effectiveness of in vitro fertilization following the use of a therapy scheme we propose to treat infertility with the background of uterine leiomyoma. The therapy scheme includes the use of a releasing hormone agonist, hysteroresectoscopy or conservative myomectomy and pre-pregnancy pre-treatment. The clinical study involved 175 women of reproductive age who had been diagnosed with uterine leiomyoma, and were divided into the groups as follows. The treatment group A included 137 women with uterine leiomyoma, and was further divided into subgroups. Subgroup A1 included 55 women with uterine leiomyoma after conservative myomectomy who underwent the proposed treatment scheme (TS); A2 included 45 women with uterine leiomyoma after hysteroresectoscopy who underwent the TS; A3 included 37 women with uterine leiomyoma who underwent the TS but not the surgical removal of uterine leiomyoma. Control group B included 38 women with uterine leiomyoma after conservative myomectomy. All patients with intramural and submucosal myoma nodules underwent a hormonal preparatory treatment with a gonadotropin-releasing hormone (GnRH) agonist (Diphereline 3.75 mg intramuscularly once every 28 days for 3 months) prior to the myomectomy. After the surgery, patients were prescribed a combination therapy with a vitamin complex FT 500 plus, vitamin D3 and Pelvidol for three months before and during controlled ovarian stimulation (COS) protocol up to the follicle puncture. We determined that the incidence of pregnancy was the lowest (37.8 %) in women with infertility against the background of uterine leiomyoma, who surgically treated for the myomas, but underwent pre-pregnancy pre-treatment. The frequency of pregnancy did not differ between the A1 and A2 treatment groups, and was on average 7.0 % higher than in the control group, and 11.0 % higher than in the A3 group. The relative incidence of clinical pregnancies was the highest in A1 (45.5 %) and A2 (44.4 %) treatment groups. The frequency of live births in the A1 group was significantly higher than in A3 group (by 14.0 %), while the relative number of term live births in the A1 group exceeded that of A3 group by 26.0 %. Thus, both proposed therapy schemes to treat infertility against the background of uterine leiomyoma, which include the use of a releasing hormone agonist, either a conservative myomectomy or hysteroresectoscopy and pre-pregnancy pre-treatment in addition to the ART protocol with a multi-vitamin complex with inositol, vitamin D3, alpha-lipoic acid and magnesium, had the equivalent effects on the incidence of clinical pregnancy, however the frequency of live births was highest after conservative myomectomy (84.0 %).

Forms of infectious complications after use of metal foreign bodies of the auricle and determination of the ability of detected microorganisms to biofilm formation

Ear or nose are quite vulnerable to foreign bodies. Foreign bodies cause various side effects in the body. A special category consists of foreign bodies that are introduced for aesthetic purposes, in particular piercing products. Decoration implanted in the tissues of the ear or nose is a foreign body and is a field of increased contamination and reproduction of pathogenic and opportunistic microorganisms. The aim of the study was to determine the infectious forms of complications that occurred after prolonged use of metal foreign bodies and to study the ability of biofilms by microorganisms isolated from the pathological contents of the foreign body of the auricle. 93 patients who applied to the ENT department of Kharkiv Regional Hospital for complications after implantation of metal foreign bodies and 10 people, control group, which had no foreign bodies, and were randomly selected from healthy individuals, were examined, to determine the qualitative composition of the microbiocenosis of the auricle skin. The material for the study was pathological discharge from a foreign body of the auricle. The microbiological study was performed using MICRO-LA-TEST identification kits. Studies of the formation of biofilms were studied by determining the ability of bacterial strains to adhere to the surface of polystyrene. The obtained cultures were washed with suspension media individual for each family of bacteria. The optical density of bacterial suspensions was measured using a microplate reader "MultiskanEX" (type 355). Statistical analysis of the obtained data was performed using MSExcel, Statisica 10 software. As a result of the conducted researches the dependence between the development of infectious complications of the auricle in the presence of metal foreign bodies and the microbiocenosis of the pathological focus was revealed. The study allowed to establish the structure of the microbial landscape of the skin of the auricle in the area of the metal foreign body, to determine the dominant forms of complications of infectious origin, after prolonged use of metal foreign bodies and to study the ability to form biofilms by microorganisms from different metals. The ability of various types of microorganisms to form biofilms when using products from different types of metals has been studied. It is established that the use of metal foreign bodies made of silver and gold reduces the risk of purulent-inflammatory process. It is proved that the optical density of biofilms of most microorganisms isolated from the pathological contents of the area of foreign bodies made of silver and gold is significantly lower than when using steel and titanium products.