Saratov JOURNAL of Medical and Scientific Research

Babushkina I.V.

Saratov Scientific Research Institute of Traumatology and Orthopedics, Department of Laboratory and Functional Diagnostics, Chief Research Assistant, Candidate of Medical Science

Clinical and laboratory indices of periprosthetic infection in patients with knee endoprosthesis instability

Year: 2019, volume 15 Issue: №2 Pages: 283-286
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shpinyak S.P., Galashina E.A., Babushkina I.V., Girkalo M.V., Kauts O.A., Grazhdanov K.A.
Organization:
Summary:

 Objective: to make assessment of clinical and laboratory indices in patients with deep periprosthetic infection and knee endoprosthesises aseptic instability. Material and Methods. 80 patients with septic and aseptic instability of knee endoprosthesises have been surveyed. All patients were subjected to comprehensive clinical and laboratory examination (intra-articular fuid cytology and microbiology testing, joint tissue histology testing, ELISA was employed for determining the levels of skeletal tissue remodeling markers). Results. The complete combination of several examination criteria specifc for knee periprosthetic infection was

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Bioflm formation by Staphylococcus strains isolated from various biological materials at infectious complications following total knee replacement

Year: 2019, volume 15 Issue: №2 Pages: 261-266
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Mamonova I.A., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

Objective: to study Staphylococcus spp. Strains bioflm forming ability in vitro. These strains are infectious agents for implant-associated infection in patients following total knee replacement depending on the biomaterial under study. Material and Methods. Bioflm forming ability in vitro of 275 Staphylococcus spp. strains has been studied. Bioflm formation was performed using modiefed method of G. D. Christensen. Results. Bioflm forming ability was discovered in 51.2 % of the studied strains, at that it was reliably (p<0.05) higher forcoagulase-positive staphylococci compared to coagulase-negative ones. Staphylococcus strains isolated from sonication fuid obtained after removed prothesiscom- ponents ultrasonication and soft tissue bioptates were chatracterised with high ability for bioflm forming. This ability was reliably (p<0.05) higher than in strains isolated from wounds and aspirate. Interspecies diferences were observed in a group of strains isolated from bioptates: optical density of the S. epidermidis stains extracts was reliably (p<0.05) higher than that of S. aureus strains. Conclusion.Bioflm forming ability of Staphylococcus spp. strains isolated from patients with implant-associated infection depends on the biomaterial under study thus defning the most informative methods of microbiological study.

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The methods of deep periprosthetic infection diagnostics in the area of knee joint

Year: 2018, volume 14 Issue: №3 Pages: 607-610
Heading: Traumatology and Orthopedics Article type: Review
Authors: Shpinyak S.P., Babushkina I.V., Maksyushina T.D., Galashina E.A., Chibrikova Yu.A., Bondarenko A.S., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The data on the methods and promising areas of investigations potent to improve diagnostic tactics in patients with infectious complications after total knee replacement is presented.

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The role of microbial associations in the development of implant-associated infection after primary total knee replacement

Year: 2018, volume 14 Issue: №3 Pages: 492-497
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Mamonova I.A., Shpinyak S.P., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

Aim: to study the role of microbial associations in the etiology of implant-associated infection, the peculiarities of associates antibiotic resistance, to propose informative methods for the microbiological diagnostics of mixed infections. Material and Methods. The biological samples from 488 patients with infectious complications after total knee replacement were studied. Microorganisms were isolated and identified using a BD BBL™ Crystal™ AutoReader analyzer and Crystal™ Enteric/ Nonfermenter ID Kit, Crystal™Gram-Positive ID Kit panels. Results. Polyetiological infectious complications comprise up to 21.4-24.8% out of the total number of implant-associated infection cases; microbial associations have broad microbial spectrum and various component structure. Specific gravity of clinically significant microorganisms — methicillin-resistant Staphylococcus aureus, polyresistant enterobacteria and nonfermentative Gram- negative bacteria is statistically higher (p<0.05) among the associates (38.2, 25.2, 64.3 and 72.8% respectively) than in monocultures (18.2, 11.8, 47.5 and 58.3% respectively). Microbiological methods should be modified in order to verify polyetiological implant-associated infection. Conclusion. The organization of microbiological monitoring of polyetiologi-cal implant-associated infections with detailed study of microbial associations structure, the monitoring of associates antibiotic resistance is necessary to optimize the diagnostics and causal treatment of this pathology.

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Peculiarities of remodeling of hyalin cartilage at early stages of development of degenerative-distrophic processes of knee joints

Year: 2018, volume 14 Issue: №1 Pages: 70-75
Heading: pathological anatomy Article type: Original article
Authors: Gladkova E.V., Romakina N.A., Ananyeva O.E., Belova S.V., Babushkina I.V., Persova E.A., Karyakina E.M.
Organization: Saratov State Medical University
Summary:

The aim is to develop methods for detection of hyaline cartilage metabolic imbalance in patients with initial degenerative dystrophic changes in the substantiated pathogenetically knee. Material and Methods. Subject of inquiry: 50 women aged from 35 up to 57 (49.1 ±2.4), among them 36 patients with an early stage of knee osteoarthrosis made up an experimental group, 14 women without any musculoskeletal disease clinical presentations made up a control group. We carried out a complex examination including physical assessment, study of orthopaedic status, interview with the use of KOOS (Knee Injury and Osteoarthritis Outcome Score) scale, roentgenography and MRI of the knee and also a number of laboratory tests: enzyme-linked immunosorbent assay determination of the content of cytokine profile indices (IL-1, TNF-a, IL-6), cartilage oligomeric matrix protein (COMP) and bone (SerumCrossLaps and bone isozyme of alkaline phosphatase (BAP)) tissue metabolism markers in blood serum in all the groups of patients. Results. In all the patients of the experimental group the roentgenologic stage of osteoarthrosis was defined as 0-1 according to J. Lawrence and J. Kellgren, but at the same time knee degenerative changes were objectivized on the series of MR images in the form of MR signal changes of the articular cartilage, erosions and cysts, degenerative meniscus. We observed increased serum cartilage oligomeric matrix protein (COMP) in the same group and that is characteristic of hyaline cartilage destruction activation. We also detect disorders in bone tissue remodeling in the form of bone resorption intensification (Serum CrossLaps), osteogenesis increase (BAP) and activation of proinflammatory cytokine system link (IL-1, TNF-a). Conclusion. The leading pathogenetic links of the early degenerative changes of the knee are hyperproduction of proinflammatory cytokines (IL-1, TNF-a), destruction of the hyaline cartilage and disorder in bone tissue remodeling. Assessment of biochemical predictors of cartilage and bone tissue degradation along with the instrumental methods of diagnosis is of great theoretical and practical importance in the system of early detection of incipient osteoarthrosis.

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The etiological role of opportunistic microflora in the pathogenesis of implant-associated inflammation in patients after primary total knee replacement

Year: 2018, volume 14 Issue: №1 Pages: 30-34
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Bondarenko A.S., Ulyanov V.Yu., Chibrikova Yu.A., Adilov R.G., Kupina E.S.
Organization: Saratov State Medical University
Summary:

The aim: to study etiological role of opportunistic microflora in the pathogenesis of implant-associated inflammation in patients after primary knee joint replacement and antibiotic sensitivity of main agent groups. Material and Methods. The retrospective analysis of microbiological samples of 383 patients with implant-associated inflammation occurred after primary total knee replacement. Results. Gram-positive cocci (63.5%) are the leading agents of implant-associ- ated inflammation, and there is an increase in the etiological role of coagulase-positive Staphylococci. Main agents of Gram-negative group were Enterobacteraceae and non-enzyme bacteria. We revealed high resistance of Staphylo-coccus spp. to antibiotics of various groups. Oxazolidinones and glycylcyclines were the most active among all antibiotic groups. Gram-negative bacteria were highly resistant to cephalosporine and macrolides with carbapenems and fluoroquinolones being most active. Conclusion. Gram-negative Enterobacteraceae, non-enzyme bacteria and Gram-positive cocci are most significant etiological factors in the pathogenesis of implant-associated inflammation in patients after primary total knee replacement.

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Prognostic opportunities for infectious inflammatory complications in primary endoprosthesis of large joints

Year: 2017, volume 13 Issue: №3 Pages: 715-719
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Belova S.V., Mamonova I.A., Puchinyan D.M., Babushkina I.V., Gladkova E.M., Adilov R.G.
Organization: Saratov State Medical University
Summary:

The aim: to study prognostic and diagnostic opportunities for infectious inflammatory complications of primary endoprosthesis of hip and knee joints on the basis of cellular immunity indices. Material and Methods. 174 patients with large joint osteoarthrosis aged 61 ±13 yrs which had undergone total joint replacement were enrolled into the study. The experimental group consisted of 22 patients with infectious inflammatory complications emerging from 6 up to 12 months postsurgically. The comparison group included 152 patients with favorable postsurgical period. We carried out WBC differentiation by subpopulations (lymphocytes, monocytes, granulocytes) and their immunophenotyping. 40 conventionally healthy individuals comprised the control group. The outcomes were estimated using the worked-out score system. Results. In patients with favorable postsurgical period total value of indices equaled not more than 4-6 points. In all the other cases the risk of infectious inflammatory complications is significantly higher and reaches its maximal values in patients with 10-12 points. Conclusion. The assessment of laboratory indices reflecting immune response of the body allows estimating the risk of infectious inflammatory postsurgical complications and diagnosing them in III grade large joint osteoarthorisis patients after total replacement.

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Comparative study of complex powdery preparations for soft tissue regeneration

Year: 2017, volume 13 Issue: №3 Pages: 705-710
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Gladkova Е.М., Mamonova I.A., Belova S.V.
Organization:
Summary:

The aim: comparative study of regenerative activity of powdery preparations for local treatment of soft tissue injuries developed from copper and silver nanoparticles in comparison with traditional powders containing antibiotics within the conditions of an experimental conditionally aseptic wound. Material and Methods. The investigation was carried out on 80 albino rats with an experimental conditionally aseptic wound. Copper and silver nanoparticles obtained by the plasma-chemical method, sterile starch, zinc oxide, Baneocin were used. Planimetric and bacteriological research methods were applied. Results. Treatment with the developed preparations in comparison with the traditional ones containing antibiotics supplied more effective course of reparative processes as evidenced by the data of the planimetric indices. Conclusion. Besides the developed preparations due to the evident antibacterial action supplied reliable prevention of the secondary infection which is a compulsory condition for the course of reparative regeneration processes. The use of metal nanoparticles for this purpose allowed to prevent the adverse reactions which are characteristic of similar preparations containing antibiotics.

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The characteristics of cellular element of immunity before and after endoprosthesis of large joints

Year: 2016, volume 12 Issue: №2 Pages: 182-185
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Mamonova I.A., Gladkova Е.М., Uljanov V.Yu., Babushkina I.V., Belova S.V., Puchinyan D.M., Kuzmin E.S., Bezrokov L.Kh.
Organization:
Summary:

The aim of the research is to study the indices of cellular immunity in patients before and after hip joint endoprosthesis. Materials and methods. The indices of cellular element of immunity (quantitative and qualitative composition of T-lymphocytes (CD3+), T-helpers (CD3+CD4+), cytotoxic T-lymphocytes (CD3+CD8+), B-lymphocytes (CD3-CD19+), natural killers (CD3-CD16+CD56)) in 20 patients with post-traumatic osteoarthrosis of III grade preoperatively and in the dynamic follow-up on the 3rd, 7th and 21st day post-surgically. Results. Patients with osteoarthrosis showed expressed immunological impairments both before and after endoprosthesis mostly affecting T-cellular immunity element and manifesting in immunoregulatory subpopulations imbalance as well as in T-suppressors decrement, T-helpers increment and NK-cells enlargement in patients after endoprosthesis. Conclusion. Patients with osteoarthrosis showed expressed immunological impairments both before and after joint endoprosthesis. Surgical intervention resulted in the aggravation of the pre-surgical disturbances in immunodeficiency.

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Cytologic assessment of dynamics of reparative processes in the experimental conditionally aseptic wound under the action of complex preparation based on chitosan and metal nanoparticles

Year: 2013, volume 9 Issue: №4 Pages: 629-632
Heading: Macro- and Micromorphology Article type: Original article
Authors: Konyuchenko Е.А.. Zhandarova L.F., Babushkina I.V., Gladkova E.V., Mamonova I.A., Belova S.V., Karyakina E.V.
Organization: Saratov State Medical University
Summary:

Objective: assessment of dynamics of reparative processes with the help of cytological examination of the preparations obtained from a conditionally aseptic wound under the action of a complex preparation based on biopolymer chitosan and metal nanoparticles. Material and Methods. A conditionally aseptic wound was simulated in 40 white outbred rats. In comparison and experimental groups cytologic assessment of dynamics of reparative processes was carried out. A number of neutrophilic leukocytes and fibroblastic row perl 00 cells in the preparations is recorded on the 3rd, 5th, 7th, 10th, 14th day from the moment of formation of the wound with the use of the immersion objective. Results. It is established, that in the comparison group the cytologic pattern of impression smear was characterized by decrease in neutrophilic leukocytes and increase in fibroblastic row cells by the 14th day from the moment of formation of the wound. In the experimental group (the use of a complex preparation) more intensive reduction of neutrophilic leukocytes and a significant increase in fibroblastic row cells by the 10th day and a complete healing by the 14th day from the moment of formation of the wound has been determined. Conclusion. When treated by a complex preparation based of biopolymer chitosan and metal nanoparticles earlier occurrence of fibroblastic row cells in preparations and a significant decrease in quantity of neutrophilic leukocytes have been observed.

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