MICROBIOLOGICAL PARAMETERS IN PATIENTS WITH INFLAMMATORY COMPLICATIONS AFTER KNEE AND HIP JOINTS ENDOPROSTHESIS REPLACEMENT AND THEIR DIAGNOSTIC EVALUATION

Introduction. Presently in the inflammatory joint diseases diagnosis and treatment microbiological examination plays a leading role. This is due to the infectious diseases frequency general increase, the hospital infections incidence rise risk, the widespread use of antimicrobial agents in medical practice and the change in the infectious foci microbiocenosises structure. Microbiological and, if necessary, serological studies of articular fluid are fundamental components of diagnosis and inflammatory joint diseases effective treatment selection. Etiological agents of inflammatory processes in joints can be microorganisms of different groups. According to the literature, up to 80% of bacterial arthritis cases cause gram-positive cocci, among which S.aureus predominates. At the same time, the number of methicillin-resistant strains of this pathogen (MRSA) increases annually. Less commonly, from the affected joints β-hemolytic streptococcus group A and other groups streptococcus, gram-negative rods, microscopic fungi and anaerobic bacteria are isolated. In view of the microorganisms biological nature characteristic, microbiological studies do not always make it possible to isolate the causative agent of infection. A major problem in bacteriological diagnostics is the periprosthetic and hematogenic infections low-grade causative microorganism, as well as subacute and chronic processes course presence. These include coagulase-negative staphylococcus (for example, Staphylococcus epidermidis) and anaerobic bacteria. Diagnostic and therapeutic difficulties can also be due to the pathogens ability to form antimicrobial therapy resistant microbial biofilms. It is reported that an antibacterial drugs uncontrolled intake, the biofilms formation, errors in the collection and transportation of biological material, can cause a situation when the joint infection infectious agent can not be detected in approximately (10-20) % of the cases. Materials and methods. The material for the studies, were synovial fluid samples collected from 64 patients of the SE "Sytenko Institute of Spine and Joint Pathology, NAMS Ukraine" clinic. The patients’diagnosis were status after knee and hip joints endoprosthesis replacement with inflammatory complications. The biological material was tested in the 2015-2017 period. The synovial material collection was conducted by the attending physician by the joint puncture method. The articular fluid withdrawn into the syringe was immediately got to a microbiological laboratory. The biological samples inoculation was carried out into a fluid thioglycollate storage medium, then to obtain the aerobic and facultative-anaerobic microorganisms pure cultures the isolate passage were conducted to Columbia blood agar, salt agar and Endo medium. Further isolated microorganisms identification was performed by standard methods in accordance with current guidelines. The microorganisms cultures were observed for 14 days. In the absence of microflora’s growth, a preliminary negative result for all synovial material was given after 5-7 days. If there was a based on the disease anamnesis and clinic suspicion on the slowly growing pathogens presence the timing of the studies was increased.The isolates sensitivity to antimicrobial agents was determined by the disc-diffusion method.In determining the microorganism’s sensitivity 29 antibacterial drugs from 8 chemical groups were used: β-lactams, fluoroquinolones, macrolides, aminoglycosides, tetracyclines, lincosamides, glycopeptides, oxazolidinones, glycylcyclines. Results and discussion. As a result of the microorganisms’ identification, 68 cultures of facultative-anaerobic bacteria and microscopic fungi were isolated from the joint fluid. 82.3% of bacterial isolates were obtained in monoculture (n = 56). Of these, 25.0% of the cultures (n = 14) were staphylococcus species with ability to coagulate the blood plasma (S. aureus (n = 9), S. intermedius (n = 5)), other staphylococcus isolation rate was 60.7% (S. epidermidis ( n = 21), S. haemolyticus (n = 9), S. simulans (n = 4)). Pathogenic streptococcus species was isolated from 5.4% of the samples (S. pyogenes (n = 3)). K. pneumonia cultures were isolated from 8.9% of biological material samples (n = 5). Mixed microcenosises were detected in 6 samples of the biomaterial. The cultures associations consisted of two microorganisms species with the associations S. intermedius - S. pyogenes, C. lusitania and C. neoformans (n = 4) prevailing. Two other microbiocenoses were represented by Candida with S. pyogenes and S. haemolyticus. The bacterial cultures sensitivity to antimicrobial agents analysis showed that all S. aureus isolates were sensitive to linezolid, levofloxacin and the ceftriaxone-sulbactam combination. Generally it was determined that the most effective drugs for gram-positive cocci are linezolid, to which 88.1% of the studied isolates are sensitive, including all S. aureus and S. haemolyticus cultures, and tigecycline, which has activity against 78.0% of gram-positive cocci isolates. The estimated aminoglycosides efficacy is 73.7%. The fluoroquinolones, carbapenems and the third generation cephalosporins with sulbactam combinations antimicrobial activity is manifested for 50% of all isolates obtained. About 30% of cultures were sensitive to lincomycin and the third generation cephalosporins - ceftriaxone, cefixime and cefoperazone. Conclusions. 1. Microflora isolated from synovial fluid in case of the knee and hip joints is inflammatory diseases is represented by gram-positive cocci (86.8%) in most cases, gram-negative rods amount is 7.3% and fungi of Candida and Cryptococcus genera are made 5.9%. 2. The isolated microorganisms species antimicrobials sensitivity is characterized by individual diversity with a tendency to vancomycin resistance increasing in 44.4% of coagulase-positive staphylococcus isolates, of which 28.6% are S. aureus strains; 28.5% o are other staphylococcus species cultures and 16.7% are S. pyogenes isolates. This indicates the exactly appropriate antibiotic therapy conducting necessity. 3. When choosing antibiotic therapy in patients in case of coxarthrosis and gonarthrosis it is recommended to take into account the bacterial isolates antibiotic resistance formation actual trends

Matter-mineral characteristics of technogene placers – potential sources of precious metals (on the example of the Nizhneselemdzhinsky gold-bearing node of Priamurye, Russia)

Over tens of years of mining and processing of ores and placers of gold in the world a huge amount of wastes originated in the form of spoil heaps and tailing dumps, in which the content of valuable components allow them to be considered a real additional resource of precious metals. The aim of the work was to establish the changes that took place in time in the spoil heaps of gold mining and to determine the prospects of the technogene placers as a potential source of the precious metal. The investigations were carried out with the use of the methods of the analytical raster electron microscopy and mineralogical and atomic-absorption analyses. On the example of the Nizhneselemdzhinsky gold-bearing node of Priamurye we have done the compatative analysis of the mineral and granulometric composition of the original and developed placers. It is shown that through the technogenesis the mineral composition of the deposits changes including the process of decomposition of the lead and iron minerals with a partial reduction to a native metal. In addition to the native gold in the technogene placers there have been found the following minerals with a high content of the precious metal: rutile, monazite, magnetite, metallic lead, galena, ilmenite, and zircon. The content of free gold in dumps is 190 mg/m3 in the average. The main amount of it (about 83%) consists of the fine gold (< 0.5 mm). We have studied the chemical composition of the native gold and associated rocks. It has been established that the gold has a multiphase composition. The phases are for the most part the gold amalgams and have two-, three-, and four-component compositions (Au-Hg, Au-Ag-Hg, Au-Hg-Pb, Au-Ag-Hg-Pb). About 30% of gold of the technogene placers have a high standard of fineness (~980‰). Almost all native gold is in close intergrowths with the rock-forming matrix of different composition: hydroalumosilicates, oxides, and hydroxides of Fe, Mn, and Pb, highly carbonaceous and carbon-bearing formations, and so on. Under the action of the physicochemical and biochemical process in the technogene placers different transformations of the native gold take place: purification at the expense of the silver evacuation; decomposition of the minerals-concentrators of gold; precipitation of micro- and nano-gold at the geochemical barriers with the formation of the so-called “new” gold (from nanoformations to micro- and macroforms). Through the operation of the technogene placers one should take into account the fact that the ore minerals in them have high concentrations of heavy metals and radioactive elements, and the gold has a complicated multiphase and multicomponent composition, and ¾ of it is amalgamated. The data obtained give the additional information for the elaboration of technologies for the development of the prospective gold-bearing technogene placers

Комбинированный метод лечения ладонно-подошвенных бородавок

The article presents the results of an open-label comparative randomized clinical study of a population of outpatients of FGU UrNIIDViI (Ural Research Institute for Dermatology, Venereology and Immunopathology). The study involved 60 patients with viral palmar and planar warts. The subjects were divided into two groups. Thirty patients from the main group received an immune-modulating drug for 10 days as a therapy with the simultaneous removal of warts by the cryodestruction method with the use of liquid nitrogen, and thirty patients from the control group received treatment for their warts only by the method of cryodestruction with the use of liquid nitrogen. Introduction of an immune-modulating and antiviral drug in the complex therapy of patients with viral palmar and planar warts in a combination with cryodestruction had a clinical effect in 93.3% of patients.Представлены результаты открытого сравнительного рандомизированного клинического исследования, проведенного на популяции амбулаторных пациентов ФГУ «УрНИИДВиИ». В исследование были включены 60 пациентов с вирусными ладонно-подошвенными бородавками. Больных разделили на две группы: 30 пациентов основной группы в качестве терапии получали иммуномодулирующий препарат в течение 10 дней с одновременным удалением бородавок методом криодеструкции жидким азотом, 30 пациентов контрольной группы получали лечение только методом криодеструкции элементов жидким азотом. Включение в комплексную терапию больных вирусными ладонно-подошвенными бородавками иммуномодулирующего и противовирусного препарата в сочетании с криодеструкцией позволяет получить клинический эффект у 93,3% пациентов

Application of modern energy-saving technologies and improved energy efficiency

The article defines the relevance and problems of modern society on the use of energy resources, which are to solve the problems of preventing the energy crisis by saving resources through the development and implementation of modern energy-saving technologies and energy efficiency. The authors give key ways of saving energy resources in the form of principles: replacing traditional energy carriers with alternative energy sources, the use of secondary energy resources (wind, solar, water and other energy), the introduction of energy-efficient technological processes, rationalization and assessment of the feasibility of using modern energy-saving technologies. The article also analyzes in more detail the principles of increasing energy efficiency and proposes energy-saving measures for energy-intensive industries

Search for a W' boson decaying to a bottom quark and a top quark in pp collisions at sqrt(s) = 7 TeV

Results are presented from a search for a W' boson using a dataset corresponding to 5.0 inverse femtobarns of integrated luminosity collected during 2011 by the CMS experiment at the LHC in pp collisions at sqrt(s)=7 TeV. The W' boson is modeled as a heavy W boson, but different scenarios for the couplings to fermions are considered, involving both left-handed and right-handed chiral projections of the fermions, as well as an arbitrary mixture of the two. The search is performed in the decay channel W' to t b, leading to a final state signature with a single lepton (e, mu), missing transverse energy, and jets, at least one of which is tagged as a b-jet. A W' boson that couples to fermions with the same coupling constant as the W, but to the right-handed rather than left-handed chiral projections, is excluded for masses below 1.85 TeV at the 95% confidence level. For the first time using LHC data, constraints on the W' gauge coupling for a set of left- and right-handed coupling combinations have been placed. These results represent a significant improvement over previously published limits.Comment: Submitted to Physics Letters B. Replaced with version publishe

Search for the standard model Higgs boson decaying into two photons in pp collisions at sqrt(s)=7 TeV

A search for a Higgs boson decaying into two photons is described. The analysis is performed using a dataset recorded by the CMS experiment at the LHC from pp collisions at a centre-of-mass energy of 7 TeV, which corresponds to an integrated luminosity of 4.8 inverse femtobarns. Limits are set on the cross section of the standard model Higgs boson decaying to two photons. The expected exclusion limit at 95% confidence level is between 1.4 and 2.4 times the standard model cross section in the mass range between 110 and 150 GeV. The analysis of the data excludes, at 95% confidence level, the standard model Higgs boson decaying into two photons in the mass range 128 to 132 GeV. The largest excess of events above the expected standard model background is observed for a Higgs boson mass hypothesis of 124 GeV with a local significance of 3.1 sigma. The global significance of observing an excess with a local significance greater than 3.1 sigma anywhere in the search range 110-150 GeV is estimated to be 1.8 sigma. More data are required to ascertain the origin of this excess.Comment: Submitted to Physics Letters

Measurement of the Lambda(b) cross section and the anti-Lambda(b) to Lambda(b) ratio with Lambda(b) to J/Psi Lambda decays in pp collisions at sqrt(s) = 7 TeV

The Lambda(b) differential production cross section and the cross section ratio anti-Lambda(b)/Lambda(b) are measured as functions of transverse momentum pt(Lambda(b)) and rapidity abs(y(Lambda(b))) in pp collisions at sqrt(s) = 7 TeV using data collected by the CMS experiment at the LHC. The measurements are based on Lambda(b) decays reconstructed in the exclusive final state J/Psi Lambda, with the subsequent decays J/Psi to an opposite-sign muon pair and Lambda to proton pion, using a data sample corresponding to an integrated luminosity of 1.9 inverse femtobarns. The product of the cross section times the branching ratio for Lambda(b) to J/Psi Lambda versus pt(Lambda(b)) falls faster than that of b mesons. The measured value of the cross section times the branching ratio for pt(Lambda(b)) > 10 GeV and abs(y(Lambda(b))) < 2.0 is 1.06 +/- 0.06 +/- 0.12 nb, and the integrated cross section ratio for anti-Lambda(b)/Lambda(b) is 1.02 +/- 0.07 +/- 0.09, where the uncertainties are statistical and systematic, respectively.Comment: Submitted to Physics Letters

Search for new physics in events with opposite-sign leptons, jets, and missing transverse energy in pp collisions at sqrt(s) = 7 TeV

A search is presented for physics beyond the standard model (BSM) in final states with a pair of opposite-sign isolated leptons accompanied by jets and missing transverse energy. The search uses LHC data recorded at a center-of-mass energy sqrt(s) = 7 TeV with the CMS detector, corresponding to an integrated luminosity of approximately 5 inverse femtobarns. Two complementary search strategies are employed. The first probes models with a specific dilepton production mechanism that leads to a characteristic kinematic edge in the dilepton mass distribution. The second strategy probes models of dilepton production with heavy, colored objects that decay to final states including invisible particles, leading to very large hadronic activity and missing transverse energy. No evidence for an event yield in excess of the standard model expectations is found. Upper limits on the BSM contributions to the signal regions are deduced from the results, which are used to exclude a region of the parameter space of the constrained minimal supersymmetric extension of the standard model. Additional information related to detector efficiencies and response is provided to allow testing specific models of BSM physics not considered in this paper.Comment: Replaced with published version. Added journal reference and DO

Measurement of isolated photon production in pp and PbPb collisions at sqrt(sNN) = 2.76 TeV

Isolated photon production is measured in proton-proton and lead-lead collisions at nucleon-nucleon centre-of-mass energies of 2.76 TeV in the pseudorapidity range |eta|<1.44 and transverse energies ET between 20 and 80 GeV with the CMS detector at the LHC. The measured ET spectra are found to be in good agreement with next-to-leading-order perturbative QCD predictions. The ratio of PbPb to pp isolated photon ET-differential yields, scaled by the number of incoherent nucleon-nucleon collisions, is consistent with unity for all PbPb reaction centralities.Comment: Submitted to Physics Letters