Current Problems of Diagnostics and Treatment of Purulent-Inflammatory Diseases and Sepsis in Medical Practice

Background: Poor treatment of burns can lead to sepsis and even death. Especially promising is the use of the method of fluorescence spectroscopy for its diagnostics. The aim of the research is to create a pathogenetic concept as the basis of a diagnostic and treatment model of purulent-inflammatory diseases and sepsis. Material and methods: The study lasted from 2001 to 2019 and included 4 stages. The experimental base of luminescent research at all stages was the luminescence laboratory of the Department of Experimental Physics of the Ivan Franko National University of Lviv. The study was performed by using optical monochromators MDR-2 and MDR-12. The excitation of the blood serum was performed with light with a wavelength of 280 nm, which corresponds to the glow region of human serum albumin. Results: The main indicators, used for the analysis, were the fluorescence intensity (IF) and the position of the maximum fluorescence band (λmax). The object of the study was samples of the blood serum of patients of the main and control groups. In the case of the presence of endogenous intoxication in the body, albumin binding centers are blocked by the products of bacterial metabolism and therefore such “pathological” albumin is unable to perform its functions, including transport and detoxification. Conclusions: The pathogenetic concept as the basis of the diagnostic and treating model of purulent-inflammatory diseases and sepsis was devised. In particular, the important role of albumin solution infusion in the treatment of the above-mentioned diseases was established.

The New Approach to the Diagnostics and Treatment of Endogenous Intoxication in Patients with Burn Injury

Background: The main causes of mortality in patients with burn injury are the development of systemic inflammatory process, multiple organ failure and septic complications. The aim of the research: Improvement of diagnostic and therapeutic approaches to the detection and elimination of endogenous intoxication in patients with burn injury. Materials and methods: The main study group consisted of 19 patients and the comparison group—of 10 patients with burn injury. 92 blood serum (BS) samples of the patients of the main group were tested, using the method of fluorescence spectroscopy (MFS). The advanced therapeutic tactics were proposed for the patients of both groups. The control group consisted of 40 healthy individuals (donors). BS of these patients was also tested using MFS. Results: Patients with burn injury have endogenous intoxication in their blood. The effective concentration of albumin is reduced in patients with burn injury due to the blockage of albumin binding centers by bacterial metabolism products. Fluorescence spectra (FS) of BS in patients with burn trauma and donors were obtained and investigated. Based on MFS results, an improved treatment regimen using infusion of albumin solution was proposed. Conclusions: An improved technique for the management of patients with burn injury is based on the use of MFS for the diagnostic evaluation of endogenous intoxication in them. The idea of pathological changes in albumin molecules in patients with burn injury is pathogenetically substantiated by the successful use of infusion of albumin solution in these patients on the basis of the MFS.

A Prognostic Model of the Development of Postpartum Purulent-Inflammatory Diseases

Background: Currently, postpartum purulent-inflammatory diseases continue to be a prominent issue in medicine. As a result, numerous scientific publications were devoted to finding the solution to this issue. Primarily these solutions included the idea of optimisation of antibiotic-based disease prevention and therapies. However, the early diagnosis and prognosis of these pathologies were unfortunately overlooked. The Aim of the Study: To build a prognostic model of the development of postpartum purulent-inflammatory diseases. Material and Methods: The main focus of our research was establishment of methods of early diagnosis and prognosis of purulent-inflammatory diseases. The main cohort consisted of 170 women diagnosed with purulent-inflammatory diseases while the control cohort was made of 40 women with an uncomplicated course of pregnancy;patient’s blood serum was analysed using fluorescence spectroscopy. Additionally, we implied a variety of standardised algorithms used during clinical and laboratory examination of the patients with postpartum endometritis. Results: Fluorescence spectra were studied for 40 women of control group and 170 women of the main group. Based on the data obtained using fluorescence spectroscopy and data from clinical and laboratory examinations (extragenital pathology, gynecology-related diseases, risk of miscarriage, surgery, TORCH-infections, colpitis, labour duration > 12 hrs, labour anomalies, maximum blood serum fluorescence spectrum values, fluorescence spectrum ≤ 0.845, age, number of bed days, fetal distress), we have derived a prognostic model of the development of postpartum purulent-inflammatory diseases. Conclusion: As a result, we derived a prognostic model based on the main 13 factors, which contribute to development of postpartum purulent-inflammatory diseases. This model was determined correct with a probability of over 99% (р 2 = 174.74;df = 13).