УДК: 612.014.484:012.015.1]-078.73-037-092.9

Aim: To study the spectrum of antibiotic resistance of causative agents of wound infection in wounded men at the stage of specialized medical care.
Materials and Methods: Retrospective analysis of the results of culture of wound secretions on chromogenic media. The research involved 113 samples of biomaterial from 85 wounded. Sensitivity of antibiotics was studied by the Kirby-Bauer method.
Results: Analysis of the microflora of the wound surface made it possible to determine the dominance of gram-negative bacteria, they were isolated in 80% of cases. The microbial spectrum of gram-negative bacteria is represented by Pseudomonas aeruginosa – 31 isolates, Acinetobacter baumannii – 29 isolates, 
Enterobacter aerogenes – 21 isolates, Proteus vulgaris – 13 isolates, Escherichia coli – 7 isolates, Enterobacter cloacae – 5 isolates, Klebsiella pneumoniae – 7 isolates and gram-positive bacteria Staphylococcus aureus – 5 isolates, Enterococcus fecalis – 32 isolates. Among all tested isolates of gram-negative non-fermenting 
bacteria and enterobacteria, the highest sensitivity was observed to colomycin and polymyxin B, from 60 to 80%. When analyzing of antibiotic sensitivity of Klebsiella pneumoniae and Acinetobacter baumannii, it was found that these pathogens retain 80-100% of their actual antibiotic sensitivity to polymyxins.
Conclusions: Gram-negative strains isolated from wound infection are sensitive to antibiotics: 70% to polymyxins (colistin), 30% to aminoglycosides (amikacin), 24-16% to cephalosporins (cefoperazone-sulbactam/cefoperazone-avibactam).
KEY WORDS: combat trauma, microbiome, antibiotic resistance

УДК: 612.014.484:012.015.1]-078.73-037-092.9

Aim: To evaluate the effectiveness of selective serotonin reuptake inhibitors (SSRIs) to the treatment of patients with premature ejaculation who have been affected by combat actions.
Materials and Methods: Results of an examination of 50 men injured as a result of hostilities, with sexual dysfunction and complaints of premature ejaculation. 
Patients were divided into smaller subgroups depending on the selected serotonin reuptake inhibitors, which they received for at least 1.5 months: sertraline (n=14), paroxetine (n=12), citalopram (n=12), venlafaxine (n=12).
Results: After treatment with all serotonin reuptake inhibitors, reactive and personal anxiety symptoms, as assessed by the Spielberger-Hanan scale, were objectively reduced in men. Only treatment with paroxetine and citalopram resulted in a likely reduction in depressive symptoms in men with premature ejaculation, Paroxetine and sertraline appeared to be relatively balanced drugs with moderate efficacy but relatively few side effects. The lack of a «gold 
standard» among serotonin reuptake inhibitor drugs for the treatment of premature ejaculation on the Ukrainian market necessitates the search for new, more effective drugs with the possibility of flexible use.
Conclusions: The study demonstrates that the neurotransmitter serotonin plays a key role in the modulation of ejaculation, as the use of reuptake inhibitors increases the intravaginal latency to ejaculation. Among the selective serotonin reuptake inhibitors, venlafaxine was found to be the most effective

 616.69-008.6(079.5)

Сучасне наукове розуміння еректильної дисфункції вказує на переважну вторинність сексуальних розладів стосовно захворювань, що їх спричиняють. Це значною мірою стосується чоловіків, постраждалих внаслідок бойових дій. Основою роботи стали результати анкетування 298 чоловіків, постраждалих внаслідок бойових дій (осколкові та кульові поранення) з використанням анкет Міжнародного індексу еректильної функції-5 (МІЕФ-5). Дослідна група була розділена на дві: чоловіки віком 20–39 років (група 1) і чоловіки віком 40–53 роки (група 2). До контрольної групи увійшли 48 практично здорових чоловіків без скарг на сексуальну дисфункцію чи кардіологічну, неврологічну або ж ендокринологічну патологію. Серед чоловіків контрольної групи – 30 чоловіків віком 20–39 років (група 3) і 18 чоловіків віком 40–60 років (група 4). Показано, що у 196 чоловіків 1-ї групи віком 20–39 років спостерігається легка форма ЕД – сумарний бал – 19,57 ± 0,44. У 102 чоловіків 2-ї групи віком 40–53 роки теж наявна легка форма ЕД, однак сумарний бал значно нижчий – 17,94 ± 0,41. Показники окремих 5 компонентів статевої функції чоловіків і шкала твердості ерекції також були нижчими в пацієнтів 2-ї групи. Найбільш показово знижується домен ЕД-МІЕФ-5 зі ступенем тяжкості ЕД. Усі домени МІЕФ достовірно знижуються при ЕД порівняно зі здоровою групою респондентів, проте диференціація за тяжкістю ЕД відсутня. Тобто, при ЕД будь-якої вираженості одночасно страждають всі інші сексуальні функції – сексуальне бажання, впевненість в ерекції, твердість та підтримання ерекції, задоволення від статевого акту та статевого життя.

UDC: 612.616.2:612.015.1]-07

Background. One of the most important antioxidant defence mechanism in spermatozoa is the gluthatione system which includes glutathione peroxidase (GPx), glutathione reductase (GR), glutathione S-transferase (GST) and reduced glutathione (GSH). It is promising to use ROC analysis, which allows to assessing the diagnostic sensitivity and specificity of indicators.
Materials and methods. Infertile men were divided into 3 groups: patients with oligozoospermia (n = 30), asthenozoospermia (n = 34), and oligoasthenozoospermia (n = 22). To assess the diagnostic sensitivity and specificity of indicators, the values of the biomarkers were tested using the receiver operating characteristic (ROC) curve, and the area under it (AUC), the standard error (SE) and the 95% confidence interval (CI 95%) were calculated.
Results. The ROC analysis showed that GP activity was characterized by excellent diagnostic significance for diagnosing both oligozoospermia and asthenozoospermia (the sensitivity was 100%, and specificity – 100%). The GR activity has moderate diagnostic significance, since the AUC is 0.654 (95% CI from 0.503 to 0.785, P = 0.0645) for oligozoospermic, the AUC is 0.612 (95% CI from 0.454 to 0.7555, P = 0.1979) for asthenozoospermic men. The analysis of the ROC curve revealed a good diagnostic value of GsT activity in sperm samples for the diagnosis of pathospermia (sensitivity of 75% and specificity of 80%). Simultaneously, it was shown that GSH content could not serve as valuable biomarkers for distinguishing patients with pathospermia from healthy controls, with an AUC of 0.615, corresponding to moderate diagnostic significance for oligozoospermia.
Conclusion. The results of this study show that the cut-off points for the biomar­kers glutathione peroxidase and glutathione-S-transferase can be used to distinguish between patients with pathospermia and normozoospermia, and the parameters themselves can serve as valuable diagnostic biomarkers to distinguish patients with pathospermia from healthy controls, regardless of the causes of pathospermia. The value of these indicators below the cut-off point indicates the probable presence of pathology. Indicators of GR activity and GSH content have a low diagnostic value, which makes them unsuitable for use as laboratory tests for the diagnosis of male infertility.

Abstract