ANALYSIS OF PROGNOSTIC VALUE OF LEUKOCYTE AND HEMATOLOGICAL INDEXES OF INTOXICATION IN THE DIAGNOSIS OF SURGICAL SEPSIS

The mortality from surgical sepsis remains high and ranges from 17 to 83.7 %. The cause of high lethality is endogenous intoxication and multiple organ failure. The most common laboratory markers for determining the syndrome of endogenous intoxication in surgical sepsis are leukocyte and hematological intoxication indices, such as LII, HII, NII. Aim of the work: to study the predictive value of laboratory and hematological indicators of intoxication in the diagnosis of surgical sepsis. Materials and methods. A retrospective analysis of disease history and prospective follow-up of 41 patients treated for surgical sepsis in the Ivano-Frankivsk (Ukraine) Surgical Department of the CCCH in period between August 2015 and August 2018 was conducted. In the first day after the operation, all the patients been calculated the leukocyte index of intoxication, the hematological index of intoxication and the nuclear index of intoxication to assess their predictive and diagnostic significance. Methods of nonparametric statistics were used in the study: ROC-analysis, Mann-Whitney U-test, Spierman's criterion (Rs). Results. The results of the diagnostic and prognostic significance of LII, HII, NII for 1 day postoperative period, with regard to the prediction of lethality by means of ROC analysis, Mann-Whitney U-test, Spirman criteria (Rs) showed low sensitivity and specificity in patients with surgical sepsis. Common laboratory leukocyte and hematological non-specific indicators of endogenous intoxication determination have low prognostic and diagnostic significance in assessing the degree of endotoxicosis in surgical sepsis and can not serve as prognostic criteria for lethality. Conclusions. The problem of diagnosing endotoxicosis in surgical sepsis requires the further study and introduction into clinical practice of new specific and integrated clinical and laboratory methods for the quantitative determination of endotoxicosis, which could serve as a reliable diagnostic criterion in assessing the severity of the condition and the prediction of hospital mortality

The state of the body's immune system of beef cows with signs of endotoxicosis

During the development of endotoxicosis of various etiologies, secondary immunodeficiency occurs in animals, which progresses due to exposure to toxic metabolites. The work aimed to study the influence of endotoxicosis on the dynamics of indicators of the immune system of beef cows. The research was conducted on the Ukrainian black and spotted dairy breed beef cows. In cows with signs of endotoxicosis, clinical signs such as swelling of the external genital organs and mammary gland, anemia of the mucous membranes, depressed state, impaired appetite, and functional disorders of the antrum and intestines were characteristic. The main immunological tests characterizing the state of the immune system of beef cows are indicators of humoral immunity (bactericidal and lysozyme activity of blood serum), cellular immunity (T- and B-lymphocytes), indicators of non-specific resistance of the organism (phagocytic activity and phagocytic index). In beef cows with clinical manifestations of endotoxicosis, inhibition of cellular, humoral, and non-specific links of the immune system was established, which led to the development of the so-called secondary immunodeficiency. This is evidenced by a decrease in the bactericidal and lysozyme activity of blood serum, a decrease in the number of T- and B-lymphocytes, and a decrease in the phagocytic index and phagocytic activity of the blood of sick cows. In particular, it was established that the lowest indicator of bactericidal and lysozyme activity was observed in the 9th month of pregnancy in the experimental group of cows, where it decreased by 15.9 and 4.91 %, respectively, compared to the control. In the above study periods, a decrease in the phagocytic activity of neutrophils by 5.04 % and the phagocytic index by 33.3 % was established compared to the indicators of the control group. During the analysis of cellular immunity, similar changes were found in determining the number of T- and B-lymphocytes; they were lower by 12.5 % and 4.19 %, respectively. Changes in the indicators of the immune system are significant and objective markers of the state of the cow's body during the development of endotoxicosis, regardless of its causes

Correction of Endogenous Intoxication in Patients With Vascular Tumors of the Nose

Benign vascular neoplasms include capillary and cavernous hemangiomas, which, according to most studies, are more common in women. They grow slowly, periodically bleed, gradually increase and can fill the nasal cavity, in addition, tumor processes lead to endogenous intoxication of the body. The level of endogenous intoxication is one of the criteria for the severity of the condition of patients, and therefore its determination and dynamics are of great importance in the treatment of patients with vascular tumors of the nose

Endotoxicosis Induced by Coxiella burnetii Lipopolysaccharide Stimulates a Ribosomal Protein S6 Kinase: Some Properties of the Partially Purified Enzyme

Guinea pig endotoxicosis induced by lipopolysaccharide from Coxiella burnetii Nine Mile phase I stimulates phosphorylation of liver ribosomal protein S6, with a 50% increase at 12 h postinoculation. The responsible protein kinase (S6PK) has been partially purified from liver; its activity is independent of cyclic AMP and of Ca2+ plus phosphatidyl serine or diacylglycerol. The preparation has an apparent optimum concentration of 20 mM Mg2+, while Ca2+ and Mn2+ are each inhibitory at 2 mM. The apparent Km for ATP is 30 microM with intact ribosomes. Because of the central role of phosphorylation in metabolic regulation and a purported role of phosphorylated S6 in protein synthesis, the lipopolysaccharide-induced stimulation of S6PK suggests a significant regulatory role of such enzymes in the pathobiochemistry of Q fever infection and endotoxicosis

Dynamics of endogenous intoxication indicators in condition of acute blood loss complicated by ischemia-reperfusion of the limb, and their correction by carbacetam

Introduction. In the structure of injuries from gunshot wounds dominate the limb injuries that are often complicated by massive bleeding from the main vessels. The only means of rescue on the battlefield is a timely application of a tourniquet. This ensures complete exsanguination of the limb. The duration of exsanguination should not exceed 2 hours. It is proved that in conditions of acute blood loss complicated by ischemia-reperfusion of the limb, there are prerequisites for the development of dysfunction of internal organs, which in turn exacerbates dysmetabolic and functional disorders, stimulates endotoxicosis and may be complicated by multiple organ failure. However, the patterns of formation of the syndrome of endogenous intoxication in the conditions of ischemia-reperfusion of the limb, acute blood loss and their combinations have not been studied. There are no data on the effect of Carbacetam on these processes. It is known that Carbacetam has proven itself to reduce the manifestations of dysfunction of internal organs in the conditions of ischemic-reperfusion syndrome of the limb.The objective of research: To establish the dynamics of endogenous intoxication in the conditions of ischemia-reperfusion of the limb, acute blood loss and their combination. To evaluate the effectiveness of Carbacetam in the correction of identified abnormalities.Materials and methods. The experimental studies were conducted on 108 white nonlinear male rats weighing 200-220 g, which were housed in standard vivarium conditions. All animals were divided into five groups: control and four experimental. Under thiopental-sodium anesthesia in the first experimental group was simulated ischemia-reperfusion of the limb, in the second – acute blood loss, and in the third – these injuries were combined. In the fourth experimental group, animals with acute blood loss and ischemia-reperfusion of the limb were intraperitoneally administered Carbacetam at a dose of 5 mg per kilogram of animal weight. After 1 and 2 hours, as well as after 1, 7 and 14 days in the blood serum was determined the content of middle-mass molecules (MMM254, MMM280).The results and discussion. It was found that ischemia-reperfusion of the limb in comparison with the control group is accompanied by a significant increase of the MMM254 fraction in the blood serum content. From the first hour of the experiment with a maximum after 1 day and normalization of the index up to 14 days. The content in the blood serum of the MMM280 fraction became significantly higher, from the control only after 1 day with subsequent normalization in the following terms of the experiment. After simulation of acute blood loss, both studied fractions of MMM increased from 1 hour of the experiment, reached a maximum after 1 day and did not return to the control level after 14 days. For the first time it was found that two-hour ischemia-reperfusion of the limb significantly aggravates the course of acute blood loss, which revealed a significantly higher content in the serum of fractions MMM254 and MMM280 compared to other experimental groups in almost all periods of the experiment. Due to the use of Carbacetam, the content of both studied fractions of MMM in the serum compared with animals without correction was significantly reduced after 7 and 14 days of the experiment. Although the studied parameters did not return to the level of the Carbacetam control group, it can be considered a pathogenetically justified means of reducing the level of endotoxicosis in the conditions of ischemia-reperfusion of the limb and acute blood loss.Conclusions. Simulation of limb ischemia-reperfusion is accompanied by accumulation of MMM254-280 fractions with a maximum after 1 day of the experiment and normalization up to 14 days. Acute blood loss causes an increase in the serum content of fractions MMM254-280 from 1 hour of the experiment, which up to 14 days do not reach the level of control. The detected disorders are significantly exacerbated after a combination of acute blood loss and ischemia-reperfusion of the limb. The use of Carbacetam in comparison with animals without correction is accompanied by a significant decrease in the content of MMM254-280 fractions in the serum after 7 and 14 days of the experiment

Contemporary approaches to assessment of the body's condition of dogs with gastrointestinal pathologies based on the intensity of the inflammato-ry process and the level of endogenous intoxication

Due to the existing methods of diagnosing diseases of domestic animals are ineffective and imperfect, our goal was to develop a technology for assessing the state of the body of dogs to be able to diagnose the occurrence of diseases at an early stage. The article provides data on the development of technology to assess the state of the body, as well as to check its functioning in practice by determining the presence of such typical pathological processes (TPP) as inflammation and endogenous intoxication of the German Shepherd dogs. Clinical, laboratory, and statistical methods were used for the study. As a result of the study, an effective method of assessing the condition of the dog's body was developed and based on two algorithms for determining the intensity of the inflammatory process and endogenous intoxication. This method is effective, sensitive, and fully reproducible in practice, which allows the veterinarian to correctly diagnose and effectively carry out therapy and rehabilitation of sick animals

The Use of Plasmapheresis in Treatment of Patients with Infertility, Peritoneal Endometriosis and Nat2 Gene Polymorphism

It is known that 30–40 % of patients with peritoneal endometriosis suffer from infertility. Half of the patients with endometriosis are identified point mutation in NAT2 – gene, which plays an important role in the acetylation of aromatic and heterocyclic amines, in the accumulation of endotoxins, activation of free radical oxidation, impaired microcirculation. These factors involve the use of methods of gemapheresis which have detoxification, the blood rheology corrective and immune corrective effects. The purpose of this study was to evaluate the efficacy of therapeutic plasma exchange in treatment of patients with peritoneal form of endometriosis, infertility and point mutations in the gene NAT2. The study included 140 patients with infertility, peritoneal form of endometriosis and point mutations in the gene NAT2. All patients are performed laparoscopy, coagulation foci of endometriosis. In the following 93 (66.4 %) patients were treated with a the course of therapeutic plasmapheresis using the apparatus «PCS-2» with the removal of 20–25 % the volume of circulating plasma with replacement plasma of crystalloid and colloid solutions. Before treatment were shown the signs of endotoxemia, activation of oxidative stress. After treatment with the use of plasmapheresis was revealed the significant reduction of endogenous intoxication parameters and oxidative stress. Also is noted the increase in the pregnancy rate, both independently and in IVF programs, especially during the first 3 months after treatment. The findings suggest that the efficiency of the proposed comprehensive treatment techniques (laparoscopy and subsequent course of therapeutic plasmapheresis) of patients with peritoneal endometriosis and infertility and with point mutations in the gene NAT2. The use of plasmapheresis is pathogenetically justified in patients of the studied group