Leukocyte Index Of Intoxication Research Articles

CONSIDERATION OF MORPHOLOGICAL-FUNCTIONAL CHANGES IN THE COMPONENTS OF CALOT’S TRIANGLE IN ACUTE CHOLECYSTITIS AND THEIR INFLUENCE ON THE SPECIFIC LAPAROSCOPIC CHOLECYSTECTOMY TECHNIQUE IN PATIENTS WITH ACUTE CHOLECYSTITIS

From 2018 to 2023, a study was conducted on 89 (100%) patients operated on for acute cholecystitis in the surgical department of the Storozhynets Multidisciplinary Hospital for Intensive Care.The goal is to study the clinical features of acute cholecystitis based on the results of surgical treatment in the general surgery department of a multidisciplinary district hospital for intensive care.Materials and methods. From 2018 to 2023, 89 patients who underwent surgery for acute cholecystitis were studied in the surgical department of the Storozhynets Multidisciplinary Hospital for Intensive Care. Clinical, laboratory, instrumental examinations, and surgical treatment were performed on 89 patients of various age groups (from 18 to 74 years) with manifestations of acute cholecystitis. The patients were divided into two groups. The diagnosis was confirmed clinically, laboratory, by instrumental methods, intraoperative examination, and histological study of the removed specimens. The state of changes in peripheral blood was assessed: the number of erythrocytes, hemoglobin content, number of leukocytes, leukocyte formula, erythrocyte sedimentation rate, and leukocyte intoxication index according to the Kalf-Kalif formula. Statistical processing of the material was performed using the t-test with the determination of the probability corresponding to the Student's t-criterion. When performing statistical processing, the arithmetic mean (M) and the reliability of differences in study results (p) relative to the indicators of different groups were calculated. The results were considered reliable when the confidence coefficient was less than or equal to 0.05.Results. The results of our laparoscopic cholecystectomies for grade I and II (moderate) severity of acute cholecystitis (according to the International Classification) showed a quantitative advantage in prioritizing the laparoscopic method of surgical intervention. However, in the presence of a purulent-inflammatory process in the hepatobiliary zone, priority is given to performing cholecystectomy by the "open method," involving highly experienced surgeons in the surgical team. This option of cholecystectomy is advisable mainly for severe acute cholecystitis (stage III of the pathological process) with a purulent-necrotic process in the hepatobiliary zone detected at the preoperative stage and in the case of peritonitis. Contraindications for laparoscopic cholecystectomy include chronic duodenal obstruction, gangrenous-perforative cholecystitis, and diffuse peritonitis. Considering the features of surgical tactics for treating acute cholecystitis confirms the need for its differentiated determination based on already developed tactical and therapeutic recommendations, the effectiveness of which is evidenced by the accumulated experience of the international school of surgeons and confirmed by our clinical results.Conclusions. 1. Laparoscopic cholecystectomy is currently performed for both chronic and acute cholecystitis. 2. The most optimal time for performing "laparoscopic cholecystectomy" is the first two days from the onset of the inflammatory process in the gallbladder. 3. Performing laparoscopic cholecystectomy considering anatomical landmarks according to the recommendations for "safe cholecystectomy" by Steven Strasberg (1992, 1995 - SVS) and Gary G. Wind (1999) is an effective component of successful laparoscopic cholecystectomy for chronic cholecystitis and in the early stages of acute inflammatory processes in the gallbladder. 4. For acute destructive cholecystitis, the "elephant trunk" technique is practically preferred.

Clinical and laboratory prognostic factors in patients with mixed infection of erythema form of ixodic tick-borne borreliosis and tick-borne encephalitis

Background. Early diagnosis of the mixed infection of ixodic tick-borne borreliosis and tick-borne encephalitis can be difficult without laboratory confirmation of the diagnosis.The aim. To assess clinical and laboratory predictors in patients for building the models of early differential diagnosis between mixed infection of erythema form of ixodic tick-borne borreliosis and febrile form of tick-borne encephalitis and monoinfection of erythema form of ixodic tick-borne borreliosis.Materials and methods. The clinical study included 26 patients with mixed infection of the erythema form of ixodic tick-borne borreliosis with tick-borne encephalitis (mean age – 46.7 years) and 30 patients with monoinfection of the erythema form of ixodic tick-borne borreliosis (mean age – 48.5 years). 59 clinical, epidemiological and laboratory parameters, including 6 leukocyte blood indices, standard and extended hemogram profiles were studied in these patients the first week of the disease. For statistical analysis, we used Pearson and Mann – Whitney goodness-of-fit tests, ROC analysis with calculation of the area under curve (AUC) and logistic regression. Results. Patients with mixed infection, compared to the patients with monoinfection, had increased odds of having febrile fever, weakness, headache and orbital pain; meningism symptoms occurred only in patients with mixed infection. Early predictors of a preliminary diagnosis of mixed infection were elevated values of fever (AUC = 0.87), intoxication syndrome score (AUC = 0.71), leukocyte count (AUC = 0.64) and neutrophils (AUC = 0.71) in the hemogram, levels of leukocyte intoxication index according to V.K. Ostrovsky (AUC = 0.67) and neutrophil-leukocyte index (AUC = 0.65), as well as a decrease in the number of platelets (AUC = 0.77), eosinophils (AUC = 0.72) and basophils (AUC = 0.79) in peripheral blood. Two prognostic models which included clinical and laboratory parameters demonstrated excellent prediction of mixed infection (AUC = 0.90 and AUC = 0.91).Conclusion. Early clinical and laboratory predictors have been established and models have been developed that make it possible, with excellent prognosis quality, to calculate in patients the probability of a preliminary diagnosis of mixed infection of the erythema form of ixodic tick-borne borreliosis with tick-borne encephalitis in comparison with borreliosis monoinfection.

Occupational conditionality of integral hematological indices in metallurgical production workers

The health of the working population is one of the main guarantors of the sustainable and planned development of the state's economy, while working conditions and factors of the production environment play an important role in its formation. Studies of indicators of endogenous intoxication make it possible to identify the formation of adaptive and compensatory changes in the hemogram depending on the conditions of the production environment and the labor 
 process.
 The study aims to explore the degree of professional conditionality of integral hematological indices for early diagnosis of the harmful effects of production factors on the body of workers employed in metallurgy.
 The authors have analyzed the results of some integral hematological indices and carried out the assessment of occupational risk in accordance with the "Temporary methodological recommendations for the calculation of occupational risk indicators" (2005) and the methodological recommendations "Methodology for the detection of occupational diseases and diseases related to working conditions" based on the calculation of relative risk (RR, units) and etiological proportion (EF, %).
 The calculation of the leukocyte intoxication index showed high values in all occupational groups from 50.00% for electricians and gas welders to 88.16% for potash workers. Scientists diagnosed a significantly increased number of eosinophilic granulocytes (more than 5%) in 26.09% of draggers, in 34.52% of rope-winding machinists, in 38.16% of potters compared with the control group (p<0.001). Scientists determined the most pronounced changes in the indicators of endogenous intoxication in the first five years of contact with harmful factors of production. We found high LII values in 62.16% of draggers, 75.00% of compressor unit drivers, 73.53% of rope winding drivers and 45.00% of electricians. The content of eosinophils in peripheral blood, as well as the calculated allergization index, demonstrate almost complete industrial conditionality in all occupational groups of the examined (RR>5, EF=81–100%). In the group of electricians, these indicators have a very high degree of production conditionality.
 Timely identification of workers with violations of integral hematological indices in the dynamics of professional activity allows them to be identified as a risk group for further monitoring and preventive measures.
 Limitations. The conducted study took into account the influence of only harmful production factors on deviations of integral hematological indices in workers of metallurgical production.
 Ethics. The material of the article was approved by the Bioethical Commission at the Ufa Research Institute of Occupational Medicine and Human Ecology (Protocol No. 01-11 dated 11/22/2023).

About diverticular colon disease

Relevance. Despite many studies devoted to diverticular colon disease, the results of treatment of this pathology cannot be considered satisfactory. This is primarily due to the fact that the pathogenesis of this pathology has not been fully studied, there are conflicting data on the clinical significance of the level of intraluminal pressure in the intestine and the degree of violation of collagen synthesis in patients. To a certain extent, these criteria can be decisive in assessing the prognosis of the course of the disease in order to timely conduct proactive conservative therapy and adequate surgical aid. The purpose of the study. Improving the results of treatment of patients with complicated course of diverticular colon disease. Materials and methods. There were 194 patients with diverticular colon disease under observation. In 86% of cases, diverticula were localized in the left half of the colon, and isolated sigmoid colon diverticulosis was detected in 68.0% of patients, in the right half — in 4.7% of cases, total diverticulosis — in 9.3% of patients. In patients, the leukocyte intoxication index, the body resistance index, the neutrophil reactive response, the determination of connective tissue dysplasia, connective tissue metabolism indicators, and the measurement of intraluminal pressure in the sigmoid colon were calculated. Results. Conservative therapy was effective in 158 patients (81.4%). Surgical treatment was required for 36 patients (18.6%), with perforation of the diverticulum — in 13.4%, with stenosis — in 5.2% of cases. The nature of the operation was determined by the localization of diverticula and the variant of complication. Postoperative mortality was 2.8%. It was found that connective tissue dysplasia is observed in all patients with diverticular disease, mild — in 36.6% of patients, moderate — in 63.4%. When assessing the intraluminal pressure in 46 patients, its increase was found in all variants of the course of diverticular disease. The average intraluminal pressure was 13.5 ± 0.4 mm Hg. The maximum pressure level was detected in patients with uncomplicated course of the disease. With the development of complications, a decrease in intraluminal pressure was noted. A decrease in intraluminal pressure to 12 mm Hg or less was an unfavourable factor and a predisposition to the development of a complicated course of the disease. The following signs had a significant effect on the recurrence of the disease: age (61-68 years), complications, duration of the disease (more than 4 years), the size of the diverticulum mouth (less than 0.6 cm and more than 1.0 cm), leukocyte intoxication index (more than 2.4 conventional units), the maximum number of rows of the muscle plate of the mucosa and muscle membranes (more than 8.3 and 84 respectively). Conclusions. To predict the course of diverticular disease, a comprehensive analysis of the age of patients, the stage of the disease and its duration, the diameter of the diverticular mouth, the sum of alternative signs of trouble, leukocyte intoxication index, the reactive response of neutrophils, the number of rows of myocytes of the muscle plate of the mucosa and muscle membranes is necessary. Their evidentiary value exceeds 70%. The level of intraluminal pressure in the colon can act as a criterion for the complicated course of diverticular disease.

Efficacy and safety of negative wound pressure in the treatment of surgical complications after radical cystectomy: a retrospective cohort study

Background: Negative pressure wound treatment (NPWT) is a relatively new, but promising method for management of surgical site infection (SSI). The literature data on the use of NPWT for complications in oncology surgery, and after radical cystectomy (RC) in particular, is scarce.
 Aim: To evaluate the short-term results of NPWT dressings in the management of SSI after RC.
 Materials and methods: We retrospectively analyzed data from 446 patients who had RC with various uroderivation types in the Department of Oncourology of the N. N. Petrov National Medical Research Center of Oncology from January 2012 to December 2021. A total of 62 cases of SSI emerging up to day 30 after RC were identified with complete data. Thirty six (36) cases of SSI were managed according to standard procedures, and 26 patients with SSI were treated with NPWT (VivanoTec® S 042) at constant negative pressure mode. The physical condition of the patients before RC was assessed according to the American Society of Anesthesiology (ASA) classification, and the severity of the patient's condition at SSI diagnosis within APACHE II scale. The following parameters were also analyzed: body mass index, median number of days in the hospital, number of program wound sanitations (surgical debridement) or frequency of changing NPWT dressings, changes over time in C-reactive protein and leukocyte index of intoxication, and events of clinical interest (intestinal fistulas and lateralization of the median wound margins, hernias).
 Results: Most cases of post-RC SSIs were identified in men (57/62, 91.93%). The standard management and NPWT study groups were well balanced for age, body mass index, and ASA physical status. The median time from the first surgical debridement of the wound to its closure was significantly shorter in the standard surgical management group: 4 days (0; 8.75) versus 8.5 days (3.25; 12.0) in the NPWT group (p = 0.026). However, this did not negatively affect the length of hospitalization (28.08 ± 12.80 and 30.03 ± 16.27 days, respectively, p = 0.599). The 30-day mortality rates were not significantly different between the groups (p = 0.137). In our series with NPWT dressings, there were no cases of intestinal fistulas in the early and late postoperative periods.
 Conclusion: Negative pressure wound treatment is a safe and effective method of SSI management. It is not inferior to the generally accepted treatment standard with surgical wound debridement, staged sanitations or dressings. NPWT dressings allow for early primary muscular-fascial closure of the abdominal cavity and does not increase the duration of hospital stay, postoperative death rates and the risk of intestinal fistulas.

Clinical approval of intra-peritoneal instilation of recombinant human granulocyte colony-stimulating factor for the treatment of acute peritonitis

To conduct a preliminary evaluation of the clinical use of recombinant human granulocyte colony-stimulating factor (G-CSF) for the treatment of acute peritonitis (AP).Material and methods. 20 patients. The causes of AP were perforated gastroduodenal ulcers – 7, colon perforation – 7, acute appendicitis – 3, small bowel perforation – 2, one case each of mesenteric thrombosis and uterine perforation. Diffuse AP was detected in 4 (20%) patients, generalized – in 16 (80%). The 1st, control, group and the 2nd, experimental groupб included 10 patients each. Similar basic treatment was used in both groups. Patients of the 2nd group at the end of the operation were injected intraperitoneally with a solution of G-CSF with 0.9% NaCl (5 μg/1 ml) at a dose of 10 μg per 1 kg of body weight. After the operation, the amount of glucose (AG), creatinine (AC) in blood plasma, prothrombin index (PI), nuclear index (NI), stress index (SI), leukocyte intoxication index (LII), neutrophil-lymphocyte index (NLI), neutrophil-mononuclear index (NMI), lymphocyte-monocyte index (LMI), immunological reactivity index (IRI).The results. NI in the 2nd group increased after a day (p<0.01), then prevailed almost all the time. SI after a day in both groups was almost not different. On the 3rd day, the SI in the 1st group significantly increased, and in the 2nd group, it decreased. Later there were opposite changes. After a day, LII decreased in both groups. After 3 days, LII decreased in the 1st group (p<0.05). In the 2nd group, after 3 days, LII increased significantly (p<0.01) and decreased after 7 days. NLI indicators changed similarly. In the 1st group, NMI significantly (p<0.05) decreased after 3 days and remained low. NMI significantly prevailed in the 2nd group, increased (p<0.01) after 5 days. In the 1st group, LMI decreased all the time. In the 2nd group, LMI increased (p<0.01) after 2 days, decreased after 3 days, and increased (p<0.05) after 5 days. IRI in the 1st group, after it increased for 3-5 days, then decreased. In the 2nd group, IRI changed like LMI. AG in the 1st group prevailed all the time. In the 1st group, AC increased for 5 days, in the 2nd group - it constantly decreased. PI in the 1st group decreased for 5 days, in the 2nd group it normalized after 3 days, then increased.Conclusions. 1. According to the complex of integral evaluation criteria, in patients with AP who underwent intraperitoneal instillation of G-CSF solution, signs of adequate functioning of cellular components of immune protection were found after the operation. 2. According to the complex of biochemical criteria, signs of an early reduction in the manifestations of intoxication and recovery of kidney and liver function were found in such patients. 3. The results of clinical approbation indicate the possibility and perspective of using this method of treatment for patients with AP.

Morphological and biochemical changes in the blood of piglets suffering from Eimeriosis and Balantidiosis

The purpose of the work was to study changes in the morphological and biochemical parameters of the blood of 50-day-old piglets spontaneously infested with Eimeria and Balantidia. An experimental group of animals spontaneously infested with Eimeria and Balantidia and a control group (n=5) not infested were formed. To examine feces for the presence of Eimeria, the McMaster method in Raynaud's modification, Balantidia - native smear was used. Changes in morphological and biochemical indicators of blood during the mixed course of eimeriosis and balantidiosis were determined. In the blood of piglets infected with Eimeria and Balantidia, a decrease in the hemoglobin content by 10.4% and the number of erythrocytes by 17.0% was established. At the same time, the number of leukocytes increased by 22%. In the leukogram, the percentage of eosinophils increased by 40.0%, rod- and segmented-nuclear neutrophils by 26.3% and 2.1%, respectively. The number of monocytes increased by 35.3%, which indicates the appearance of foci of inflammation in the animal's body. An increase in the leukocyte index of intoxication by 11.1% indicates the severity of the inflammatory process. In infected piglets, a decrease in total protein content by 6.5% due to a significant decrease in albumin content by 28.3% was recorded. An increase in the concentration of CIC by 23.5%, the activity of the enzymes AlAT and AsAT by 75.4% and 35.9%, respectively, confirms the development of the pathological process and the occurrence of accompanying structural and functional changes in the internal organs of piglets. During the mixed course of eimeriosis and balantidiosis in 50-day-old piglets, leukocytosis and eosinophilia, an increase in the number of rod-shaped and segmented neutrophils, lymphopenia and monocytosis are observed. Changes in indicators indicate an exacerbation of the inflammatory process in the body of infected piglets and a toxic effect in the places of parasitism - the small and large intestines. In the biochemical composition of the blood serum of piglets with the development of the disease, there is a decrease in the content of total protein and albumins, which is associated with a violation of the biloxintizing function of the liver, and an increase in β-globulins indicates a suppression of the immune response to invasion. An increase in the activity of AlAT and AsAT enzymes indicates the development of dystrophic processes in the liver, which plays a primary role in the neutralization of toxins produced in the body of animals. An increase in the concentration of CIC indicates the gradual development of the immune response to the course of the disease

Informative value of blood l-lactate and integral leukocyte indices for predicting severe course of mycoplasmosis in calves

The aim was to study the informativity of blood L-lactate and integral leukocyte indices for predicting a severe course of mycoplasmosis in calves during their natural infection with M. bovis. Daily clinical observation of 36 Holstein calves naturally infected with M. bovis (at the age of 10-15 days) was carried out for one month on the farms of the Ural Federal District. In blood samples obtained from the jugular vein of animals at the first signs of the disease, the levels of hemoglobin, erythrocytes, leukocytes, platelets, hematocrit on Abacus Junior Vet analyzer (Diatron, Austria), L-lactate concentration - by reaction with paraoxydiphenyl on UV-1800 spectrophotometer (Shimadzu, Japan) were studied. Differential leukocyte counts in Romanowsky- Giemsa stained blood smears were performed using Olympus BX43 microscope (Olympus, Japan). The following integral leukocyte indices were calculated: Krebs index (KI), leukocyte index of intoxication by Y. J. Calf- Calif (LII), neutrophil reactive response by T. Sh. Khabirov (NRR), adaptation index (AI), Bredeck index (IB), nuclear shift index (NSI), lymphocyte- granulocyte index (ILG), neutrophil to monocyte ratio index (NMR), leukocyte shift index (LSI), lymphocyte to monocyte ratio index (LMR) and lymphocyte to neutrophil ratio (LNR). In 22 (61,1 %) calves a mild to moderately severe course was detected, in 14 (38,9 %) - a severe course of mycoplasmosis. The animals predisposed to a severe course of mycoplasmosis had higher blood L-lactate > 1.68 mmol/l, AI > 1.57 units, ILG > 16.7 units, LNR > 1.41 units, reduced KI < 0.645 units and LSI < 0.600 units at the first clinical signs of disease. The information value of predictors for prognosing severe mycoplasmosis in calves was evaluated as very good; the sensitivity was 71.4-85.7 %, the specificity made 81.8-90.9 %. The accumulation of L-lactate in the blood of animals and changes in leukocyte indices (AI, ILG, LNR, KI, LSI) were shown to be interrelated.

Leucocytal indexes in apparently healthy cats

Leukocyte indices are ratios that are used to assess the state of the patient's blood and immune system. The use of leukocyte indices in the diagnosis of feline diseases is currently limited, which is mainly due to the lack of norms in wide publication, as well as studies of patterns characteristic of specific groups of diseases, as well as the nature of the course of pathological processes. The purpose of the presented study was to assess the indicators of leukocyte indices in clinically healthy cats. The analysis of morphological parameters of the blood of 11 mongrel clinically healthy cats with the obligatory absence of a stress leukogram was carried out. The number of leukocytes and leukogram in the blood were determined according to generally accepted methods, followed by the calculation of leukocyte indices: Krebs index (KI), leukocyte intoxication index (LII), G.D. Dashtayants nuclear index (NI), leukocyte shift index (LSI), leukocyte index (LI), neutrophilmonocyte ratio index (NMRI), the index of the ratio of lymphocytes to monocytes (IRLM). The obtained data are expected to further expand the diagnostic and prognostic capabilities of cat diseases. In the future, the study is planned to be expanded with the capture and analysis of individual nosological units and breed characteristics, as well as the features of the diet, the ratio to the severity of the condition, the analysis of life expectancy and survival. It should be noted that in order to more accurately determine the diagnostic significance and the possibility of determining forecasts, it is necessary to increase the number of animal samples with an assessment of indicators in dynamics.

Clinical and biostatistical approach to assessing the severity of physical status of patients with combined midface trauma. Part 2

Objective. To develop a method for predicting mortality among patients with combined midface trauma (CMFT).
 Materials and methods. This study is based on the examination results of 95 patients with CMFT. Depending on the outcome of CMFT, 2 groups of patients were formed: the first group – patients with a favorable outcome (n=50); the second group – patients with an unfavorable outcome (n=45). A group of physiological parameters was measured on the 1st, 3rd, 7th and 14th days of patients’ hospital stays. The creation of the CMFT outcomes predicting method was carried out using factor analysis (principal component method) and discriminant analysis.
 Results. The CMFT outcomes predicting method has been developed in two variants. The first variant (with parameters of the blood gas test) includes the following parameters: leukocyte index of intoxication according to Ya.Ya. Kalf-Kalifu (LII), blood glucose level, concentration of potassium ions in the blood (K+), international normalized ratio, partial pressure of carbon dioxide in arterial blood, partial pressure of oxygen in arterial blood, measured on the 3rd day after injury, and also the age of the patient, evidence of cardiovascular diseases in patient’s medical history and the occurrence of cerebral edema after the injury. The second variant (without the parameters of the blood gas test) includes the following parameters: absolute number of leukocytes (on the 1st day after injury), LII, K+, blood urea level, absolute number of lymphocytes, measured on the 3rd day after injury, as well as patient’s age, evidence of cardiovascular diseases in patient’s medical history and the occurrence of cerebral edema after injury. The classification accuracy when using the first variant was 100%, the second variant – 98.4%.
 Conclusions. Taking into account the set of variables included in our study, and based on the results of this study published in the first and in this part of this article, we can conclude that the optimal time point for predicting the CMFT outcomes is the 3rd day after injury. The method for predicting the CMFT short-term outcomes developed in our study can be used in determining the timing for reconstructive surgery as part of the damage control surgery treatment of patients with this pathology.

Leukocyte index of intoxication according to V. K. Ostrovskii as a criterion for assessing bacterial infection

The OBJECTIVE was choose an informative, convenient and accessible in clinical practice index for assessing the level of endogenous intoxication associated with a bacterial infection.METHODS AND MATERIALS. In the groups of patients with surgical inflammatory bacterial diseases (104 people), with intracellular non-bacterial infection (254 people), and in healthy people (94 people), the degree of LII correlation according to Kalf-Kalif (as a "standard" of indices) was compared with more simple and easy-to-calculate indices: LII according to Ostrovsky, simplified LII according to Ostrovsky ¬ without taking into account plasma cells (sLII according to Ostrovsky), the blood leukocyte shift index according to Yabluchansky, the Harkavy index and the Krebs index.RESULTS. Within all groups of observations, the closest correlation with LII according to Kalf-Kalif was established for LII according to Ostrovsky, slightly less for LII according to Ostrovsky. The latter was chosen for further study due to the possibility of calculation based on the data of the 5diff automatic blood cell analyzer. Compared with the group of healthy people (1.34 (0.93; 1.59)) sLII according to Ostrovsky did not increase in the group of patients with intracellular non-bacterial infections (1.21 (0.82; 1.49)), moderately increased in subgroup of urological and gynecological patients with chronic local inflammatory processes (2.35 (1.49; 2.99)) and was many times higher in subgroups with acute inflammatory and destructive diseases of the abdominal organs (7.64 (2.05; 11.77 )), sepsis (8.58 (2.96; 13.29)) and septic shock (7.34 (4.07; 9.48)).CONCLUSION. The calculation of LII according to Ostrovsky or its simplified version without taking into account plasma cells (neutrophils + immature granulocytes)/(lymphocytes + monocytes + eosinophils + basophils) is appropriate and easily applicable in wide clinical practice for assessing a bacterial infection and the development vector of an infectious process.

Comparative analysis of postmortem cerebral ammonia level and Alzheimer type 2 astrocytes with intravital blood laboratory parameters of deceased patients with liver cirrhosis of varying degree

Purpose - correlation analysis of the postmortem ammonia level and numbers of Alzheimer type 2 astrocytes in different parts of the brain with intravital laboratory blood parameters of deceased patients with liver cirrhosis of varying severity.
 Material and methods. Autopsied brains of 90 patients with non-alcoholic liver cirrhosis (LC) of class A, B and C according to Child-Pugh formed 3 groups: «A» (n = 30), «B» (n = 30) and «C» (n = 30). Control group - 30 patients deceased from cardiovascular failure. Cortex, white matter, hippocampus, thalamus, striatum and cerebellum were histochemically (HC) studied with Nessler's reagent for ammonia level. Correlation analysis of ammonia expression, Alzheimer type 2 astrocytes (AA2) numbers and 14 intravital laboratory blood parameters was performed.
 Results. HC method reveals region-dependent ammonia expression in the brain neuropil. The most significant correlations are observed in thalamus, striatum, cerebellum, and cortex between ammonia expression (ACUOD), AA2-astrocytosis, and lifetime values of total bilirubin (for Bil/ACUOD & /AA2 r = 0.31-0.97), AST (for AST/ACUOD & /AA2 r = 0.30-0.81), ALT (for ALT/ACUOD & /AA2 r = 0.30-0.78), leukocyte index of intoxication (for LII/ACUOD & /AA2 r = 0.34-0.76), albumin (for Alb/ACUOD & /AA2 r = -0.34 to -0.78), leukocytes (for Wbc/ACUOD & /AA2 r = 0.31-0.68), prothrombin index (for PI/ACUOD & /AA2 r = -0.31 to -0.45) and potassium (for K+/ACUOD & /AA2 r = -0.32 to -0.45), p <0.05.
 Conclusion. During LC ammonia expression and AA2-astrocytosis in cerebellum, thalamus, striatum and cortex significantly correlate with each other, as well as with indicators of total bilirubin, AST, ALT, albumin, leukocytes, leukocyte index of intoxication, prothrombin index and blood potassium.

4427-2023-29-2-155-158 Оценка лейкоцитарных индексов у больных с ревизионным эндопротезированием тазобедренного сустава

Introduction The widespread application of large joint arthroplasty is accompanied by an increase in the complications associated with periprosthetic infection. Currently, treating patients with infectious complications in the area of large joint arthroplasty remains a relevant issue. Purpose To determine the prognostic value of leukocyte indices in patients with revision hip arthroplasty. Materials and methods The study involved 88 patients with revision hip arthroplasty hospitalized at the Ilizarov National Medical Research Centre for Traumatology and Orthopedics. The patients were divided into two groups: group 1 (n = 77) were patients without periprosthetic infection (mean age 60.1 ± 1.5 years) and group 2 (n = 11) were patients with periprosthetic infection (age 55, 2 ± 4.7 years). An analysis of the preoperative results of determining the number of leukocytes and leukocyte formula was carried out with the calculation of the leukocyte index of intoxication and the resistance index of the organism. The reliability of differences in indicators in groups was determined. According to the odds ratio, the probability of developing an infectious process was estimated. Results The level of leukocytes in the blood serum and the leukocyte index of intoxication of patients of groups 1 and 2 had no significant differences. In patients with an infectious process, their level was higher by 19.7 %, however, not going beyond the normal range. Differences in the index of intoxication in patients of groups 1 and 2 were not noted. In the 2nd group of patients, the resistance index of the organism significantly exceeded that of the 1st group, remaining within the normal range in both groups. When calculating the prognosis for the development of infectious complications, the value of the odds ratio for the resistance index of the organism is exactly an order of magnitude higher than this indicator for leukocytes and the leukocyte index of intoxication. Conclusion The prognosis of the clinical situation in revision hip arthroplasty should consider not only local changes and the general condition of the patient, but also an assessment of laboratory parameters, in particular, the resistance index of the body.

HEMOGRAM INDICATORS ASSESSMENT FOR EARLY PREDICTING THE MIXED INFECTION OF THE ERYTHEMA MIGRANS FORM OF LYME BORRELIOSIS AND TICK-BORNE ENCEPHALITIS

Background. It is difficult to confirm the diagnosis of the mixed infection of the erythema migrans form of Lyme borreliosis and tick-borne encephalitis at the onset of the disease because of delayed seroconversion.
 Purpose. Assessment of hemogram predictors to develop a model for early diagnosis of the mixed infection of the erythema form of Lyme borreliosis and tick-borne encephalitis.
 Materials and methods. The study involved 21 patients with the mixed infection of the erythema form of Lyme borreliosis and tick-borne encephalitis (Group 1) and 25 patients with the erythema form of borreliosis monoinfection (Group 2), who were hospitalized no later than the 7th day of the disease. The hemogram parameters, the leukocyte intoxication index and the body resistance index were analyzed. ROC analysis was used. The logistic regression model was developed using STATISTICA 12.0 modules.
 Results. The Group 1 patients compared with Group 2 demonstrated significant increases in the levels of the leukocyte intoxication index, and neutrophils, but decreases in the levels of the body resistance index, eosinophils, basophils and platelets. The leukocyte intoxication index was a “very good” predictor of the mixed infection, and the body resistance index, the number of eosinophils, basophils, neutrophils and platelets in peripheral blood had a “good” predictive values. The model included the body resistance index, the number of eosinophils and basophils.
 Conclusion. The developed model had a “very good” predictive value for the mixed infection early diagnosis of the erythema migrans form of Lyme borreliosis and tick-borne encephalitis.

Показники імунітету і функціонального стану центральної нервової системи при хронічному набутому токсоплазмозі

For the first time, patterns of changes in the ratio of immunity indicators were revealed in chronic acquired toxoplasmosis — leukocyte intoxication index (LII), CD3, immunoregulatory index (IRI), total immunoglobulins, adaptive and compensatory reactions (tension coefficient) and functional state of the central nervous system (CNS) — changes in electroencephalographic research (EEG) according to the stem-diencephalic type — with the help of available informative methods, which allowed to assess the severity of the course, plan treatment and predict the outcome of the disease, without resorting to complex research methods. It has been established that the host-parasite relationship and clinical manifestations in chronic acquired toxoplasmosis largely depend on the protective and adaptive reactions and compensatory capabilities of the human body.

Risk factors of maternal and failed maternal mortality, prediction of severe obstetric conditions

Objective. To determine the priority risk factors for maternal mortality (MM) and failed maternal mortality (FMM) on the basis of clinical and epidemiological features and to develop scientifically based patient-centered models for predicting severe obstetric conditions.
 Materials and methods. Primary documentation of successful and dysfunctional maternal outcomes that occurred at the levels I, II, III of medical organizations in Perm and the territories of Perm Krai from 2007 to 2018. Using random sampling, two observation groups were formed: women with failed maternal mortality, deceased women and the control group. Analytical epidemiological "case-control" studies were carried out, which included the determination of confidence intervals, etiological accuracy using Epi Info and Excel 2016 MSO programs, a package of applied electronic tables Stat2015 of the author ( V.S. Sheludko, 20012016), the MedCalc 15.8 Portable program.
 Results. Socio-behavioral, general somatic, obstetric-gynecological risk factors, the frequency of occurrence of which among women with failed maternal mortality was 1,44,3; 1,225,5; 1,17,6 times more often, and in the group of deceased mothers 1,99,0; 1,729,5; 2,89,0 times higher than in the group of healthy participants. The "indicators of maternal death" have been identified, which increase the risk of a failed maternal death turning into maternal death. Early clinical and laboratory signs of severe obstetric conditions are the following: high leukocyte intoxication index (LII), elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea and creatinine, decreased levels of fibrinogen, prothrombin index (PTI), prolongation of thrombin time (TT). Infectious-inflammatory, hypertensive complications, comorbidity, a high percentage of premature births and, accordingly, severe perinatal conditions are significantly more common in groups with unfavorable outcomes.
 Conclusions. In the course of the study, reliably significant risk factors were identified, on the basis of which scientifically based models for assessing the probability of developing critical obstetric conditions were worked out.

Prognostic value of some leukocyte indices of intoxication and reactivity in fish under the action of physico-chemical stressors

Purpose: determining the prognostic value of leukocyte indexes of intoxication and reactivity in fish under the action of some physicochemical stressors.Materials and methods. The object of the study was the lady of the roach of ordinary Rutilus Rutilus (L.). Control and experimental groups were formed taking into account the principle of analogues (n = 90). The average mass (PP) is 5.29 ± 1.0 g, length (TL) - 7.22 ± 0.39 cm, fish of the juvenile period of development (the sexual structure was not installed). The individuals were accumulated (10 days) and contained the following indices in aquariums (volume - 200 l.) We examined the core index, a leukocytic index of intoxication, blood leukocyte shear index, and a leukocytal index. As physico-chemical stressors, subcutal concentrations of copper (exposition in copper salt 0.01 mg/l and 0.1 mg/l for 7 and 14 days) were studied; imitation of the main phase and the initial period of the phase of geomagnetic storm; The action of high temperature.Results. The analysis of leukocyte indexes of intoxication and reactivity showed that in fish the Krebs index and a leukocytic index have the greatest prognostic importance. The information content of the blood leukocyte shear index and the leukocyte intoxication index should be considered controversial. The blood leukocyte shift index increased only with the exposure of copper salts for 14 days and with the action of physical stressors. Statistically significant changes in the blood leukocyte shift index during exposure by copper salts for 7 days have not been revealed, which may indicate a low sensitivity of the index. The results obtained during the calculation of the leukocyte index of intoxication are similar to the results when determining the Krebs index. Specific changes in the index under the action of physico-chemical stressors have not been identified.

Hematological parameters of the blood of Cameroonian goats

Today, the products of the goat breeding industry are in demand in the con- sumer market of the country, because. differs in taste and dietary properties. The quality of products depends on the health of the animals, which can be assessed using a study of hematological parameters. The study included 6-month-old Cameroonian goats. Hemato- logical studies were performed using a hematological analyzer, blood smears were stained according to Romanovsky-Giemsa, leukogram was counted manually, blood indices were calculated according to generally accepted methods. As a result of the study, the content of erythrocytes was 18.52 × 1012/L, hemoglobin – 100.67 g/L, hematocrit – 28.87%, MCV – 15.57 fl., MCH – 5.33 pg., MCHC – 349 00 g/L. In the study of white blood, the concen- tration of leukocytes was 11.63×109/L, the leukogram contained stab neutrophils – 1.30%, segmented – 25.64; lymphocytes – 63.64; monocytes – 5.02; eosinophils – 4.03; basophils – 0.32%. The calculation of integral leukocyte indices showed that the leukocyte index of intoxication B.A. Flight – 0.37 arb. units, index of allergization T.V. Kobets – 3.54; adapta- tion index L.Kh. Harkavy – 2.48; lymphocytic index according to Shaganin – 2.36; nuclear shift index – 0.05, immunoreactivity index according to D.O. Ivanov – 13.48 conv. units The concentration of platelets in the blood was 342.33×109/L. According to the data obtained, it follows that goats have normochromic anemia and thrombocytopenia, the content of leu- kocytes, the percentage and leukocyte indices correspond to the type of animals, and reflect their age characteristics.

TREATMENT EXPERIENCE OF CHRONIC LUNG ABSCESSES USING MINI-INVASIVE ELECTROSURGICAL TECHNIQUES

The aim: To increase the efficiency of surgical treatment of patients with chronic lung abscesses by developing mini-invasive methods of surgical treatment using electrosurgical technologies. Materials and methods: Conducted study of the results of surgical treatment of 78 patients with chronic lung abscesses operated from 2011 to 2021. Patients were divided into two groups: the main group (37 patients who were treated using developed technologies) and a comparison group (41 patients, treated using traditional tactics). Results: Transthoracic and endobronchial sanitation of the purulent cavity in the lung at the first stage of treatment contributed to the rapid elimination of inflammation and significantly accelerated the regeneration of lung tissue. Clinical effectiveness in the main group was expressed in reducing the phenomena of intoxication, decrease in Leukocyte intoxication index (LII) (early as on day 5 after surgery), on the 10th day, a significant reduction in patients bacterial excretion was noted (in the main group by 18.9%, in the comparison group – by 14.6%), the average time of reducing the abscess cavity by 1/4 of the volume 6 days less, the healing time of the cavity of the AL which is on average 13 and 16 days, respectively, less. Conclusions: The developed methods of surgical interventions made it possible to significantly positively influence the level of endogenous intoxication indicators, avoid resection surgical interventions, reduce the number of postoperative complications, avoid damage to neighboring organs, reduce the time of patients with achieving a stable positive effect.

FEATURES OF CHANGES IN INTEGRATIVE INDICATORS OF ENDOGENOUS INTOXICATION, REACTIVITY, INFLAMMATION ACTIVITY IN PATIENTS WITH CHRONIC VIRAL HEPATITIS AND CHRONIC RENAL FAILURE

The aim: to study the peculiarities of changes in integrative indicators of endogenous intoxication, reactivity and activity of inflammation in patients with chronic viral hepatitis B and C, and with chronic renal failure undergoing hemodialysis. Materials and methods. 19 patients with chronic viral hepatitis B (HBV) and chronic viral hepatitis C (HCV) with chronic renal failure and patients with chronic kidney disease (KD) were examined. Comparison group included 40 healthy blood donors. Epidemiological, clinical and laboratory examination was performed. Indicators of endogenous intoxication, nonspecific reactivity and inflammatory activity were calculated and analyzed using statistical criteria (M±m, Student's test and Mann–Whitney test). Results: an increase in the integrative indicators of endogenous intoxication in patients with the combined pathology of chronic KD and chronic viral hepatitis (VH) is a consequence of the activation of tissue disintegration, cytolysis of hepatocytes and a significant impairment of liver function. A change in the indices of non-specific inflammation indicate expressed activity of the inflammatory process and immunological disorder of reactivity. These changes also suggest decompensated endotoxicosis, as a possible consequence of a chronic infectious process and decompensated endogenous intoxication. Indicators of leukocyte intoxication index (LII), leukocyte shift index (ISL), hematological intoxication index (HII), intoxication index severity (IIS), immunoreactivity index (IR), neutrophil-monocyte ratio (NMR) are increased in all patients with chronic KD, which may be related to the actual cause of development – glomerulonephritis, chronic pyelonephritis, concomitant pathology. More pronounced deviations were found in men of both groups than in women, which may be related to greater adherence to diet, water load between hemodialysis procedures in the latter. Conclusions. Patients receiving invasive manipulations, including hemodialysis, belong to the risk group and are more susceptible, taking into account immunodeficiency, to infection with hepatitis viruses than the general population. CVH is one of the most common types of lesions in them. The obtained changes, namely, a more pronounced increase in the integrative indicators of endogenous intoxication, in patients with the combined pathology of CKD and CVH indicate the activation of the processes of tissue decay, cytolysis of hepatocytes and significant liver function impairment. At the same time, a change in indices of non-specific inflammation indicates a pronounced activity of the inflammatory process and an immunological disorder of reactivity. A clear systemic reaction to inflammatory processes in the body of patients is determined, the probable development of decompensated endogenous intoxication, which is possible consequence of a chronic infectious process. A simultaneous increase in ISL and a decrease in ILG was established, which is associated with the development of endogenous intoxication and a violation of immunological reactivity due to autointoxication of the body. A decrease in Ilymph indicates an active adaptive reaction of white blood cells and a cell-type immunodeficiency, in particular, a decrease in non-specific anti-infective protection. Indicators of LII, ISL, HII, IIS, IR, NMR are increased in all patients with CKD, which may be related to the actual cause of development – glomerulonephritis, chronic pyelonephritis, etc. The difference of integrative indicators between men and women was established, more pronounced deviations from normal were found in men of both groups than in women, which may be associated with greater adherence to diet, water load between hemodialysis procedures in the latter.