Summary. The article deals with the study of immune status of patients with osteomyelitis and trophic disorders of the shin tissues. Objective: to evaluate the immune status of patients with shin-bone osteomyelitis and distrophic processes, and to study dynamics of immunological indices after surgical interventions (clearing and reconstructive restoring surgeries). Materials and Methods. The immune status of 52 patients with posttraumatic osteomyelitis and trophic disorders of the shin tissues was studied. Clinical, immunological, and statistical research methods were used. Results. The study revealed changes in immune defence and in trophic processes in tissues (bones, skin, and muscles) of the damaged extremity. Thus, the presence of changes in the immune status was established: a decrease in the number of T-lymphocytes, T-helpers, cytotoxic T-lymphocytes, as well as changes in the humoral immune system – a decrease in immunoglobulins M and G levels and an increace in the level of circulating immune complexes. Conclusions. Changes in systemic immunity and local trophic disorders revealed in patients mutually aggravate the course of the pathological process and complicate its elimination.
Summary. Subject of the research: immune status of 26 patients (main group) with septic complications after local application of glycocorticoids and 17 patients (comparative group) with septic arthritis, in which the purulent inflammatory process developed due to hematogenous spread of infection of the joint and was not a complication caused by local use of glycocorticoids. Objective: to evaluate the immune status of patients of the main and comparative groups, to study the dynamics of immunological indicators before and after surgical treatment, and to determine factors which are important to predict the disease course and treatment results. Research methods: an analysis of immunological (content of lymphocytes and their subpopulations – CD3+-, CD4+-, CD8+-cells; А, М and G classes of immunoglobulins; levels of circulating immune complexes) and hematological (levels of erythrocytes, leucocytes, thrombocytes, hemoglobin, as well as erythrocyte sedimentation rate) laboratory data of both groups was conducted. Results. Disorders concerning cellular and humoral factors of immune defense as well as hematological indices were revealed. It is shown that the improvement of immune status after clearing surgical intervention and the reduction of inflammatory response in patients of the main group is slower than in the comparative group. Conclusions. Assumption was made that glycocorticoids may be a factor that deepens and prolongs the immunosuppression that patients had before their local use.
Summary. The work is devoted to the studies of immune status of patients with infectious complications after local glucocorticoid injections. Objective: to assess the state of the immune system of patients with infectious complications after local glucocorticoid injections, to monitor the dynamics of immunological parameters before and after sanitizing surgical treatment, and to reveal factors that are important for predicting the course of the disease and treatment results. Materials and Methods. The immune status of 26 patients with purulent inflammatory processes after local glucocorticoid injections in rheumatoid arthritis, deforming osteoarthritis, and chronic synovitis was studied. Immunological, hematological, and statistical research methods were used. Results. Changes of immunity factors as well as hematological parameters were revealed: a decrease in the content of T-lymphocytes (CD3+), T-helpers (CD4+), T-suppressors / cytotoxic lymphocytes (CD8+), immunoglobulins of classes A, M, and G; an increase in the levels of circulating immune complexes (СIC), the number of thrombocytes, erythrocyte sedimentation rate (ESR), and the reaction of the neutrophil leukocytes. It has been shown that the improvement of the immune status and the decrease in the level of inflammatory reactions after the sanitizing surgical intervention occurs slowly, which requires the inclusion of immunocorrective therapy in the treatment of such patients. Conclusions. Primary examination of patients before surgery for the purpose of sanitizing the infection showed that the local inflammatory process in the bones and joints occurs against the background of altered immunological and hematological parameters. Dynamic follow-up showed that we are dealing not only with a local process, but also with a systemic inflammatory response. A variant of the laboratory criterion for the course of infectious complications and the effectiveness of the treatment can be the determination in the dynamics of the content of T-lymphocytes and their subpopulations, the levels of the CIC, platelets and ESR.
Background. Acute phase proteins – ceruloplasmin, haptoglobin, C-reactive protein (CRP) – are markers that characterize the inflammatory process. C-reactive protein is one of the major components of the acute phase (AF) and is a generally accepted indicator of inflammatory processes. Objective: to determine the level and specificity of acute-phase proteins (CRP, haptoglobin, ceruloplasmin), as well as procalcitonin in the modeling of infectious arthritis. Materials and Methods. Experimental studies were carried out on 31 white male Wistar rats. The model of infectious arthritis was created during three days by daily injection of 0.02 ml of S.aureus 108 No. 209 into the knee joint of a rat. The animals were divided into groups, of which group I was the vivarium control. The following model of drug administration was used for the experimental groups: a single daily injection of 0.02 ml of flosteron into the knee joint for three days (group II); daily single administration for three days of 0.02 ml of S.aureus 108 No. 209 (group III); daily one-time alternating (every other day) administration for three days of 0.02 ml of flosteron and 0.02 ml of S.aureus 108 No. 209 into the knee joint (group IV). The effectiveness of the drugs was observed 3 and 14 days after administration. Results. It was established that the concentration of haptoglobin probably increased in the blood serum of rats after 3 days only under the conditions of alternating three-time administration of flosterone and S.aureus 108 No. 209. After 14 days, when the inflammatory progress progressed, this indicator increased in all studied groups of animals, and most of all (by analogy with observations after three days) with the combined effect of flosterone and S.aureus 108 No. 209. The concentration of ceruloplasmin in blood serum increased in all experimental rats both after 3 days and after 14 days in the group after administration of flosterone. The content of C-reactive protein in blood serum increased in all studied groups of rats without exception, which proves its high specificity for detecting inflammatory processes of various severity. The concentration of procalcitonin in the experiment did not reliably change in the blood serum of rats of any experimental group after 3 days. However, significant changes occurred 14 days after the introduction of flosterone and with the combined effect of flosterone and S.aureus 108 No. 209. Conclusions. Determining the content of haptoglobin is not highly effective in early detection of the inflammatory process. At the same time, the synthesis of ceruloplasmin increases precisely during the first three days of the infectious process, which turns it into an effective marker for detecting early infectious complications. The dynamics of changes in the level of C-reactive protein in blood serum demonstrated the highest correlation with the activity of the infectious process, which proves its high specificity for detecting inflammatory processes of various severity. The greatest deviations were observed in rats, which were injected three times alternately (every other day) with flosterone and S. aureus 108 No. 209 into the knee joint. Such changes suggest that the hormonal drug flosteron contributed to the intensification of the inflammatory process.
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