EVALUATION OF THE THERAPEUTIC POTENTIAL OF GONADOTROPIN AND KISSPEPTIN IN EXPERIMENTAL ISCHEMIC OVARIAN INJURY
Magradze R.N., Lisovsky A.D.I., Zelener A.O., Amrahov M.V., Lisovsky D.A., Shabanov P.D., Bayramov A.A., Droblenkov A.V.
UDC: 615.225:616.13
Abstract: Objective. To evaluate the pharmacological efficacy of kisspeptin in the correction of experimentally induced ischemic ovarian injury in female Wistar rats. Methods. Ovarian tissue ischemia was reproduced by temporarily applying a ligature to the distal part of the fallopian tube and vascular bundle using open surgery with peritoneal access, which led to occlusion of the ovarian artery for a period of 30 and 60 minutes. Zoletil-xylazine drug anesthesia was used. Pharmacotherapy was performed with preparations of chorionic gonadotropin (hCG) and Kisspeptin (KISS) (respectively, at a dose of 100 IU/kg and 500 mcg/kg) for 5 days. Results. In intact female rats, 30-minute ischemia led to a decrease in the concentration of 17ß-estradiol (E2) and progesterone. With 60-minute ischemia, ovarian production of the main female hormone decreased in a significant range (2.2 times, p0,001). The histological picture of the ischemic ovary was characterized by the death and degenerative changes of a significant part of the viable endocrine cells of the mature tertiary follicle and corpus luteum, most pronounced with one-hour bilateral occlusion of the ovarian vessels. These changes cause a significant decrease in the production of sex steroids, which, in turn, causes hyperproduction of the corresponding pituitary tropins. Administration of hCG and KISS drugs (respectively at doses of 100 IU/kg and 500 mcg/kg) for 5 days to female rats after 30 minutes of ischemia led to a significant increase in the concentration of hormones in the blood of animals determined on the 8th day of the experiment. At 60 minutes of ischemia, the therapeutic effect of hCG and KISS was insignificant compared to the intact group, although it was significant compared to the control (operated) group - an increase in the level of steroid hormones by 61.4% and 37.9%, respectively (p<0.01). Conclusion. HCG and KISS have a pronounced therapeutic effect when exposed to an ischemic ovary: after a single 30-minute ischemic damage to the organ, the hormonal balance in the blood is restored to a level that does not significantly differ from its level in the intact group. At the same time, the pronounced therapeutic potential of CISS is found as a result of both milder and more severe conditions of experimental ovarian ischemia, which makes its clinical application promising in reproductive medicine.
Key words: ишемия яичника, ооциты, эндокриноциты, половые гормоны, фармакотерапия
TREATMENT OF ALCOHOLIC LIVER DAMAGE IN EXPERIMENT
Jafarova R.A., Abasova S.A.
UDC: 615.9:616.36-085; 616.36-003.826-08
Abstract: Objective. To study the effectiveness of various treatment regimens including antioxidants, ursodeoxycholic acid and phytocomplex against the background of the model of alcoholic hepatitis. Method. The experiments were carried out on 70 white laboratory outbred rats divided into 2 groups, where the first group included intact animals (10 rats and the second group included animals in which alcoholic hepatitis was modeled. Animals of the second group were divided into 6 subgroups (p/g) of 10 rats each: the 1st s/g was model, the 2nd s/g - control, where the animals received placebo, the 3rd s/g where animals received Alpha-Tocopherol acetate at a dose of 50 mg/100 g of weight as a treatment, the 4th s/g received ursodeoxycholic acid at a dose of 25 mg/100 g of weight, the 5th s/g - 10% infusion of AZHEPOFİT phytocomplex at a dose of 1 ml/100 g of weight and in the 6th s/g - 10% infusion of AZHEPOFİT phytocomplex at a dose of 1 ml/100 g of animal weight together with ursodeoxycholic acid at a dose of 25 mg/100 g of weight. The animals received the treatment for 2 weeks twice a day. Results. Against the background of the model of alcoholic hepatitis, the use of the phytocomplex together with ursodeoxycholic acid in the blood plasma of animals ALT reduced by 50.6% at p<0.001, AST by 27.2% at p = 0.003. CR increased by 47.7% at p <0.001 and amounted to 1.66±0.09, maximally approaching the intact values equal to 1.88±0.14. γ-GTP decreased by 20.3% at p<0.001. LHD decreased by 12.5% at p=0.002. ALP - by 34.8% at p <0.001. The severity of lipid peroxidation decreased and all the parameters studied were practically normalized. Conclusion. Against the background of alcoholic hepatitis, the use of the AZHEPOFİT phytocomplex in combination with ursodeoxycholic acid has the most favorable effect, all the studied indicators reach almost intact values.
Key words: алкогольный гепатит, оксидативный стресс, маркеры поражения печени, липидный обмен
MORPHOFUNCTIONAL ANALYSIS OF THE LIVER IN THE CASES OF EXTENDED LIVER RESECTION USING BIOIMPEDANCEMETRY IN THE EXPERIMENT
Leonov S.D., Panchenkov D.N., Rodin A.V.
UDC: 616-092.9+616.36-089.87
Abstract: Objective. Assessment of the diagnostic capabilities of bioimpedancemetry in the morphofunctional study of the liver before and after extended experimental liver resection. Methods. The study was carried out on 20 white Wistar rats weighing 180-230 g. Extended liver resection (ELR) was modeled by removing 70% of the organ. Before the surgery, immediately after the ELR, as well as on the 3rd and 14th days after it, invasive bioimpedancemetry of the liver was performed in parallel with the biochemical study of blood serum. Invasive bioimpedancemetry (BIM) of the liver was carried out using an original device for measuring the biological tissues bioimpedance of biological tissues BIM-II (Russian patent No. 2366360). The resected areas of the liver were subjected to histological examination. Results. Biophysical parameters of the liver parenchyma in the cases of ELR were characterized by a statistically significant decrease in impedance at a frequency of 2 kHz compared with the norm immediately after removal of a part of the liver. On the 3rd day there was a statistically significant increase of BIM indices compared with the norm associated with an increase of aspartate aminotransferase in the blood serum and the development of fatty degeneration of the liver. On the 14th day of observation, the electrical impedance of the liver parenchyma did not differ from the values before extended resection. Conclusion. Decrease of impedance indices is registered immediately after extensive liver resection that is associated with intensification of intrahepatic blood flow; with the development of fatty degeneration the impedancemetry indices increase
Key words: обширная резекция печени, функциональный резерв печени, биоимпедансометрия
DISTURBANCES OF MITOCHONDRIAL RESPIRATION OF RAT CEREBRAL NEURONS IN TOTAL AND SUBTOTAL CEREBRAL ISCHEMIA
Bon Elizaveta I., Maksimovich Natalia E., Dremza Iosiph K., Lychkovskaya Maria A.
UDC: 616.831.31-005.4.-092.913:618.33
Abstract: Objective. To study the parameters of respiration of mitochondria of rat brain homogenates with its total and subtotal ischemia. Methods. The studies used models of total and subtotal cerebral ischemia. Cerebral ischemia was modeled under conditions of intravenous thiopental anesthesia (40-50 mg/kg). Total cerebral ischemia was modeled by decapitation of animals. Subtotal cerebral ischemia was modeled by simultaneous ligation of both common carotid arteries. The sampling of material for the study of tissue respiration of mitochondria was carried out 1 hour and 24 hours after decapitation or ligation.To study mitochondrial respiration, the brain was removed in the cold (0-4°C), dried with filter paper, weighed and homogenized in an isolation medium containing 0.32 M sucrose, 10 mM Tris-HCl, 1 mM EDTA, pH 7.4 (in the ratio 1:10) using a Potter-Evelheim homogenizer with a Teflon pestle according to the modified method. Results. An increase in V1 and V2 and a decrease in the phosphorylation coefficient (ADP/O) indicates proton transfer bypassing the ATP synthase complex. Enzymes of the mitochondrial matrix and cytochrome in this model of cerebral ischemia do not yet have pronounced damage, as evidenced by the high rates of V1 and V2. More pronounced disturbances with the use of succinate than with the use of malate/glutamate indicate a greater damage to the succinate dehydrogenase complex of the electron transport chain, as in the case of total cerebral ischemia. Conclusions. The most pronounced decrease in the respiration indices of the mitochondrial fraction of brain homogenates occurs in total cerebral ischemia due to the complete cessation of the blood supply to the brain neurons. With this method of modeling cerebral ischemia, the appearance of hyperchromic shriveled neurons with pericellular edema is characteristic.
Key words: митохондриальное дыхание, нейроны, ишемия головного мозга
ANALYSIS OF THE STRUCTURE AND CAUSES OF VIOLENT DEATH IN THE SMOLENSK REGION ACCORDING TO THE MATERIALS OF THE BUREAU OF FORENSIC MEDICAL EXPERTISE
Andreikin A.B., Anufriev A.G.
UDC: 616-036.886:313.13
Abstract: Objective. Research and operational analysis of the causes of death and mortality rates in the Smolensk region according to the «Smolensk regional bureau of forensic medical expertise» in the period from 2006 to 2021 to expand the activities of the regional health development program. Methods. We use statistical and investigative-analytical research methods of annual report forms N42 «Report of a forensic expert, bureau of forensic medical expertise», investigative work by Order of the Ministry of Health of the Russian Federation dated 22.10.2001 N385 «General statistical data on industry statistical reporting», for the period 2006-2021. The study of the presented documents was carried out by studying them, comparing and system analysis. Results. Showed the dynamics and structure violent and non-violent deaths in the Smolensk region for the period 2006-2021. The main causes of violent death that make up the class of external causes of death in the ICD-10 nomenclature, changes in their contribution and ratios for 2021 are considered. Conclusions. Identified the main parameters for predicting and correcting the rate of violent deaths in the state task and priority national projects context and the topics for further scientific research in the field of organization of the forensic medical expertise in the region are proposed. The revealed trends taking into account regional differences can be extrapolated and applied for comparison with neighboring regions that are similar in demographic and sociocultural terms.
Key words: смертность, виды смерти, причины смерти, судебная медицина, Смоленская область
SOURCES OF MORPHOGENESIS OF INSULIN-PRODUCING CELLS IN THE PANCREAS OF AN ADULT ORGANISM
Mozheyko L.A.
UDC: 612.345:[611.37.018.1:577.175.722]-053.8
Abstract: Objective. The aim is to analyze the results of scientific research on the formation of insulin-producing cells from endogenous pancreatic cells of an adult organism. Method. The review was carried out in the PubMed, Scopus, eLibrary databases by searching for literary sources on this topic. Of the selected publications, the most significant publications of recent years were used for analysis. Results. It has been shown that the sources of morphogenesis of pancreatic islet B cells in the adult body are limited. Possible ways of their formation from endogenous organ cells are considered. The features of the genesis of insulin-producing cells from endocrine and non-endocrine pancreatic cells are detailed. Conclusion. Under certain conditions, an increase in the number of insulin-producing cells in a definitive organ is possible by proliferation of functioning B cells, direct differentiation of pancreatic progenitor cells, or by reprogramming mature pancreatic cells.
Key words: поджелудочная железа, регенерация, В-клетки, протоковые клетки, дифференцировка
THE USE OF GENETICALLY ENGINEERED BIOLOGICAL DRUGS FOR THERAPY WITH SARS-COV-2
Kalmykov R.S., Safonenkov E.M., Zharkova L.P.
UDC: 615.036.8
Abstract: Objective. To study the effectiveness of the use of the main groups of genetically engineered biological drugs (GIBP) for the treatment of severe and moderate cases of coronavirus infection SARS-CoV-2. Methodology. The authors analyzed the available literature on the effectiveness of GIBP in the treatment of severe and moderate forms of coronavirus infection while performing research work SARS-CoV-2. Results. The effectiveness of IL-6, IL-1 and janus kinase inhibitors used in the treatment of coronavirus infection was analyzed SARS-CoV-2. Conclusion. The urgency of the problem is based on the growing number of deaths in cases of the transition of the disease to more severe forms. The presented groups of drugs (IL-6, IL-1 and janus kinase inhibitors) during the analysis of numerous studies showed a different degree of activity in relation to the pathogenetic mechanisms of complications SARS-CoV-2. A comprehensive assessment of these groups of drugs showed the greatest effectiveness of the janus kinase inhibitor.
Key words: новая короновирусная инфекция SARS-CoV-2, генно-инженерные биологические препараты, тоцилизумаб, канакинумаб, барицитиниб
ANTIBIOTIC RESISTANCE AND MODERN APPROACHES TO THE TREATMENT OF NOSOCOMIAL INFECTIONS IN NEWBORNS
Yakovleva E.E., Beletskay Yu.A., Yakovlev A.V., Shabanov P.D.
UDC: 616.94-053.2
Abstract: Objective. Due to the significant spread in the last decade of infections caused by Gr(-) resistant nosocomial flora, to highlight the issues of therapy of septic forms of klebsiella nosocomial infections, including newborns and children with very low and extremely low body weight. Methods. Collection and analysis of the results of modern scientific research on this problem. Results. The resistance of nosocomial strains of enterobacteria to beta-lactam antibacterial drugs is one of the significant problems of our time. Antibacterial therapy of the klebsiella septic process causes difficulties, especially in premature infants, and is often an "off-label" therapy. The evidence of the problem of antibiotic resistance gives reason to pay attention to antibacterial drugs from the groups of polymyxins and phosphonic acid derivatives. Conclusions. The development of new directions and methods of treatment, as well as effective schemes of antibacterial therapy of klebsiella infection in conditions of increasing resistance of Kl. pneumoniae to most modern antibacterial drugs is an urgent task of modern clinical pharmacology.
Key words: Klebsiella pneumoniae, антибактериальная резистентность, нозокомиальные инфекции, новорожденные, антибиотикотерапия
CLINICAL CASE OF KIDNEY TRANSPLANTATION FOR A FEMALE PATIENT WITH CHRONIC KIDNEY DISEASE WITH CONGENITAL THROMBOPHILIA
Chudaeva O.V., Baburina A.V., Komissarov A.S., Tiguntseva M.A.
UDC: 616.61-089.843:575.191
Abstract: Objective. To examine a case record of the patient with a transplanted kidney in the terminal stage of the chronic kidney disease (CKD) Methods. Consultation, physical examination, medical record review, laboratory and instrumental data research review. Results. In the article a rare clinical case of kidney transplantation by a congenital thrombophilia is described. Chronic pyelonephritis had been firstly diagnosed by a female patient at the age of 4 years old. She was followed up by a kidney doctor. In 2009 CKD was diagnosed, C3a stage. 4 years later the disease reached its terminal stage, peritoneal dialysis was recommended. Several months peritoneal dialysis was changed to program haemodialysis, because the previous method had proven ineffective. Owing to repeated thrombosis, there were lots of attempts to build vessel access. In 2019 the female patient was put in the wait list for cadaver kidney allotransplantation in Botkin Municipal Clinical Hospital (CKAT BMCH). In February 2020 CKAT was made in the right iliac area in Botkin Municipal Clinical Hospital. After allotransplantation the allograft functioned immediately, smooth postoperational period was smooth, the patient got support therapy. In June 2020 the allograft disfunction appeared, the female patient was hospitalized to the nephrology department of the Municipal Clinical Hospital. After treatment remediation, balloon angioplasty and stent implantation of the kidney allograft, the health condition of the female patient improved. Conclusions. Thus, kidney transplantation - is the main treatment method for the patients in the terminal stage of CKD. It became the only and most effective method of kidney dis-function elimination. It combines both improvement of life quality and increase of life expectancy.
Key words: ХБП, трансплантация почки, врожденная тромбофилия, баллонная ангиопластика, гемодиализ
INTEGRATED ASSESSMENT OF CLINICAL DATA AND PHARMACOTHERAPY IN OUTPATIENS WITH COVID-19
Racheeva Y.V., Pleshkov V.V., Avchinnikova D.A.
UDC: 616-08-039.57
Abstract: Objective. The study was conducted to assess the clinical and epidemiologic evidence in outpatients with COVID-19 and influence of received pharmacotherapy on duration, severity of COVID-19, risk of anosmia, risk of hospitalization and grade of lungs lesion. Methods. A retrospective analysis of medical records of 161 patients underwent out-patient treatment of verified COVID-19 on the basis of "Outpatient Department №6", Smolensk since September 2020 to October 2021 was performed. Using the Kendall correlation criterion, the interdependence of COVID-19 duration and intake of certain drugs with a given 95% confidence interval. The reliability of differences in drugs prescriptions in patients with various COVID-19 clinical course with a given confidence interval of 95% was determined using the Fisher angular transformation coefficient (φ). The impact of certain drugs intake on COVID-19 clinical picture, risk of anosmia, risk of hospitalization and grade of lungs lesion was assessed. Results. The intake of "Arbidol", ascorbic acid, vitamin D, antibiotics, polyvitamins, glucocorticoids and nasal spray "Grippferon" use had no impact on COVID-19 duration. Anosmia was found in outpatients with the same rate regardless of vitamin D, zink, "Arbidol" intake and nasal spray "Grippferon" use. Direct oral anticoagulants and "Arbidol" prescription do not decrease the risk of hospitalization. Patients who received "Arbidol" and gargled with antiseptic solutions more often had a light clinical course of COVID-19. The intake of antibiotics, "Arbidol", "Ingavirin", "Kagocel", "Favipiravir" had no impact on the grade of lungs lesion. Conclusions. Derived results of the research may be taken into consideration estimating an efficiency and suitability of mentioned drugs prescription to outpatients with COVID-19, may be used in further improvement of COVID-19 outpatients treatment strategy.
Key words: коронавирусная инфекция, лекарственная терапия, амбулаторное лечение, поражение легких, аносмия, осложнения COVID-19
CARDIOVASCULAR DISEASES AND THEIR COMPLICATIONS IN PATIENTS WITH PSORIATIC ARTHRITIS
Vinogradova E.V., Mayorova A.V., Bazina I.B., Kozyrev O.A., Pavlova M.V., Krechikova D.G.
UDC: 616.12-008;616.72-002.2
Abstract: Objective. To study risk factors, prevalence of cardiovascular diseases as well as ways of their mitigation in patients with PsA. Methods. A total of 70 medical records of patients with PsA treated at Smolensk Regional Rheumatological Center were analyzed. PsA was established based on classification criteria. Lab tests were performed in a central laboratory using standardized methodology. All data collected were entered into Excel followed by statistical analysis with SPSS 20.0 software. Qualitative data was analyzed with Student's test for independent samples (in case of normal distribution). Assessment of correlation between factors was done using correlation analysis (Pearson's chi-squared test or Spearman's test). Results. A total of 70 patients with PsA were analyzed, of them women were 37.1%, men - 62.9% Mean age was 53.8±11.9 years. Duration of disease was 9.3±7.5 years. Average body mass index was 32.6±13.8 kg/m and 78.6% of patients had BMI>25. Arterial hypertension was identified in 81.0% of patients, diabetes - in 22.9%. Stroke was found in records of 7.1% of patients. Stable angina pectoris of II-III functional class was noted in 28.6% of patients, myocardial infarction - 4.3%, persistent atrial fibrillation - 4.3%, occlusive atherosclerosis of lower limb vessels - 2.8%. Average level of total cholesterol was 5.72±1.1 mmol/L, and 74.3% patients had cholesterol >5.0 mmol/L. Average glucose level was 5.6±0.9 mmol/L; glomerular filtration rate - 106.7±30.8 mL/min. C-reactive protein as an indicator of inflammation was significantly increased and was 39.2±2.4 mg/L on average. Women with PsA had higher frequency of cardiovascular diseases comparing to men. Conclusions. Patients with PsA have high frequency of cardiovascular diseases as well as their complications which due to risk factors, autoimmune inflammation and influence of antirheumatic therapy. Major risk factors of cardiovascular diseases are increased blood pressure, obesity, and hyperlipidemia. Cardiovascular risks are higher in women than in men due to higher incidence of arterial hypertension, diabetes, and stroke. An assessment of cardiovascular risks is required during treatment, as well as their mitigation with baseline therapy, prescription of antihypertensives and cholesterol-lowering drugs.
Key words: псориатический артрит, сердечно-сосудистые заболевания, кардиоваскулярный риск
EPIDEMIOLOGICAL AND ENVIRONMENTAL HEALTH ASSESSMENT OF RISK FACTORS FOR CONTRACTING COVID-19 AND MEASURES FOR PROTECTING EMPLOYEES OF HEALTHCARE ORGANIZATIONS
Meshkov N.A., Valtseva E.A., Fesyun A.D., Yakovlev M.Yu., Rachin A.P.
UDC: 613.6.02
Abstract: Objective. To study and analyze publications on health risk factors and protective measures for healthcare workers dealing with COVID-19 patients. Methods. We have analyzed and summarized a set of publications dealing with risk factors for contracting the coronavirus infection among healthcare workers and their workplace safety, as well as organized initial data, visualized results and performed statistical analysis. Results. Analysis of different departments of hospitals providing medical care to COVID-19 patients showed that the risk of contracting the disease for healthcare workers is 4.38 (p<0.001) and 15.40 (p<0.001) higher in general care units than in emergency and intensive care units, respectively. Also, a correlation was found between the age and the risk of contracting SARS-CoV-2 (r=0.998; p=0.039). The probability of developing COVID-19 among HWs aged 40-49 is higher than among those aged 30-39 (OR=1.24; p=0.317) and 20-29 (OR=1.48; p=0.090). When ranked by probability of developing the disease, the risk factors are as follows: no regular training or total lack of special training (OR=3.94; p<0.001); aerosol-generating procedures (OR=1.75; p<0.001); and biological materials obtained from patients (OR=1.52; p<0.001). Airborne transmission is the main way of transmission when HWs come into contact with patients or perform aerosol-generating procedures. Conclusions. Protecting HWs is crucial for the proper functioning of the healthcare system. Risk factors for contracting COVID-19 include violation of safety regulations, insufficient supply of personal protective equipment, its inappropriateness to working conditions, and its misuse, as well as shift length, physical, emotional and psychological stress, and fatigue. Workplace safety can be ensured by providing HWs with occupational health and safety supervision and carrying out prompt assessment of risks for contracting SARS-CoV-2 at workplace.
Key words: коронавирусная инфекция COVID-19, факторы риска инфицирования, медицинские работники, безопасность труда
CLINICAL MANIFESTATIONS AND DIAGNOSIS OF PERICARDITIS AS A CONSEQUENCE OF A NEW CORONAVIRUS INFECTION WITH COVID-19, SARS-COV-2 (CLINICAL CASE, OWN RESULTS)
Legonkova T.I., Shtykova O.N., Sarmanova L.V., Shpakovskaya K.S., Tolstikova E.A., Dubrovina Yu.A., Vodneva L.M., Dudareva A.L., Fomenkova M.A., Galperin A.A.
UDC: 616.11-002-053.71:[616.98:576.858]
Abstract: Objective. To study the features of the course and clinical manifestations of newly diagnosed pericarditis in a 17-year-old teenager after a coronavirus infection caused by the delta strain COVID-19. Methods. Patient S., 17 years old, was under observation. Clinical and laboratory, instrumental examination and treatment were carried out in accordance with the standards of medical care according to the profile of the disease. Results. Patient S., 17 years old, was diagnosed with effusive pericarditis, post-covid, acute course, NC0. During the 20 days spent on inpatient treatment, positive dynamics in the child's disease was noted. The child's complaints of chest pain, discomfort, feeling of pressure and tightness in the chest, palpitations and dizziness, weakness, fatigue disappeared. At the time of discharge, the condition was satisfactory with a noticeable decrease in signs of inflammatory effusion according to the results of additional diagnostic methods. Conclusions. This study demonstrated the peculiarities of complications from the cardiovascular system in the form of pericarditis in the conditions of the pandemic of the new coronavirus infection COVID-19. The negative impact of coronavirus infection on the patient's quality of life dictates the need to develop a strategy for post-ovarian rehabilitation.
Key words: перикардит, новая коронавирусная инфекция, SARS-CoV-2
FEATURES OF THE COURSE OF THE EARLY POSTOPERATIVE TIME IN CHILDREN WHO UNDERWENT EMERGENCY AND PLANNED SURGICAL INTERVENTIONS AGAINST THE BACKGROUND OF A NEW CORONAVIRUS INFECTION (COVID-19)
Avdeeva T.G., Ostreikov I.F., Usachev R. K., Oleynik D.O., Pudovkina M.M.
UDC: 616.11-002-053.71:[616.98:576.858]
Abstract: Objective. To study the features of the course of the early postoperative time in children who underwent planned and emergency surgery under general anesthesia against the background of coronavirus infection (COVID-19). Methods. A comparative analysis of clinical and laboratory parameters and statistical data on the nature of the course of the early postoperative period in children who received emergency and planned surgical interventions under general anesthesia, depending on age, gender, and the presence of somatic diseases, was carried out. For the first time, the influence of coronavirus infection in this cohort of patients on the course of the postoperative period was analyzed. The studies were carried out on the basis of the Department of Pediatric Surgery, Department of Anesthesiology and Resuscitation of the Smolensk regional clinical hospital in the period from 01.09.2020 to 28.02.2021. The case histories (form 003/y) of 164 children who underwent surgical intervention were analyzed using a continuous sample method. At the same time, the authors studied the catamnesis, their existing concomitant diseases in the form of 112/y (history of child development), presented from children's polyclinics at the place of residence. If a coronavirus infection was suspected according to the epidemiological history and the development of the ARVI clinic in children in the first 7 days after surgery, laboratory diagnostics by PCR for the presence of the pathogen SARS-CoV-2 (COVID-19) was performed. 12 children(PCR+). A comparative analysis of instrumental, laboratory methods of examination in children with confirmed coronavirus infection (COVID-19) was carried out. All results are processed statistically. To test the hypothesis about the normality of the distribution of the studied features, we used the Pearson χ agreement criterion with an equally frequent grouping of data at a significance level of 0.05. Automation of the criterion was provided by statistical functions of the Excel table processor [5]. The reliability of the difference between the studied features was evaluated using the angular Fisher transform. Statistical significance was recognized with a probability of >95% (p<0.05). Results. The assessment of the course of the early postoperative period was carried out in all children operated on for emergency and planned indications under general anesthesia, taking into account laboratory-confirmed new coronavirus infection and children without the presence of infectious and viral diseases. The duration of hospitalization in children with coronavirus infection increased from 2 to 2.5 times. It was found that children who had verified SARS-CoV-2 (COVID-19), in contrast to children without an aggravated epidemiological history, were more likely to have complications in the postoperative period, and also required transfer to the intensive care unit immediately after surgery or in the early postoperative period (83.3%). Patients with confirmed SARS-CoV-2 (COVID-19) had indications for longer-term medication (etiotropic antiviral, hormonal, antibacterial, anticoagulant therapy), long-term respiratory support in the intensive care unit. The most frequent complications in the postoperative period in the group of children with laboratory-confirmed new coronavirus infection were: bilateral polysegmental pneumonia (75%), the development of gastrointestinal symptoms (33.3%), deep vein thrombosis (16.7% of cases). At the same time, analyzing the laboratory parameters in this group of children, it was reliably established that in children, against the background of SARS-CoV-2 (COVID-19), lympho - and leukopenia b (91.6%) was observed in the general blood test, the level of C-reactive protein increased 15-20 times (100%), LDH 2-2.5 times (91.6%). There were changes in the coagulogram in the form of an increase in D-dimer, fibrinogen > 2 norms, a decrease in APTT and prothrombin time, as a result of which it is possible to establish a higher risk of hypercoagulation (DIC) in the postoperative period in children of this group. It is important to note that children with coronavirus infection after discharge from the hospital of the surgical profile of the OGBUZ SOKB in 41.6% of cases (5 children) required continued treatment in the infectious department of the OGBUZ GKB No. 1, taking into account the continuing clinic of infectious-viral disease and laboratory-confirmed PCR (+) SARS-CoV-2 (COVID-19). A comparative characterization of concomitant diseases revealed that the most severe course of SARS-CoV-2 (COVID-19) was observed in children with a burdened somatic background, while in children without somatic diseases SARS-CoV-2 (COVID-19) was mild to moderate.
Key words: дети, COVID-19, SARS-COV-2, диагностика, клинические проявления, соматические заболевания, оперативные вмешательства, послеоперационный период
MENSTRUAL DISORDERS IN FEMALE MEDICAL UNIVERSITY STUDENTS
Kravtsiva A.V., Pokusaeva V.N., Lyamets L. L., Proshina D.A.
UDC: 618.17-008.8-053.81
Abstract: Objective. To study the structure and frequency of menstrual disorders in female students, to determine their relationship with body weight. Methods. A study was conducted aimed at analyzing the menstrual cycle in female students of the 1st-6th year of Smolensk State Medical University. The questionnaire was compiled using the FIGO classification of menstrual disorders. 468 girls took part in the survey, 464 who met the inclusion criteria were included in the analysis. The average age of the subjects was 21.4±0.2 years. The body weight was estimated using the Quetelet index. Results. During the study, polymenorrhea was found in 1.0% of the respondents, opsomenorrhea in 6.7%, oligomenorrhea in 2.4% of the girls. A quarter of respondents (25.2%) had hypermenorrhea. Hypomenorrhea was observed in 4.2%. Half of the subjects had painful menstruation (49.4%). Irregular menstrual cycle was observed in 7,7% of female students. The analyse of the relationship between body mass index and menstrual disorders demonstrated polymenorrhea and hypomenorrhea was associated with a weight deficiency, whereas hypermenstrual syndrome with an excessive weigth. Conclusions. According to the study, the main types of menstrual disorders in female students were dysmenorrhea (49.4%) and hypermenorrhea (25.2%). The relationship between body weight and menstrual cycle disorders has been proven.
Key words: студентки, нарушения менструальной функции, масса тела
SUBCLINICAL ENDOMETRIOSIS-ASSOCIATED COAGULOPATHY AND ITS RELATIONSHIP WITH INDICATORS OF THE GENERAL ANALYSIS OF BLOOD
Ukrainets R.V., Korneva Yu.S.
UDC: 616.61:615.036
Abstract: Objective. To compare coagulogram parameters in patients with endometrioid ovarian cysts and patients with corpus luteum cysts before and after surgery, as well as to determine whether there are correlations between coagulogram parameters and general blood test in the investigated groups. Methods. The study included patients with ovarian cysts: 45 women with a histologically verified diagnosis of "endometrioid ovarian cyst" and 39 women with a histologically verified diagnosis of "corpus luteum cyst" (comparison group). Retrospectively, the following parameters were recorded in the case histories: coagulogram and general blood analysis before and after radical surgical treatment, followed by statistical analysis of the data. Results. The prothrombin index in the endometriosis group is significantly higher before surgery and significantly decreases after radical removal of endometrioid ovarian heterotopia. Prothrombin time, on the contrary, in the presence of an endometrioid ovarian cyst is significantly less than in the comparison group, and increases after its radical removal. The levels of fibrinogen and fibrin did not significantly differ either between the investigated groups before and after surgery. Despite the fact that in patients of both groups the coagulogram parameters are not beyond the normal values, in patients with a corpus luteum cyst no significant changes in the coagulogram were detected after operation. Based on the statistical analysis of coagulogram parameters and their relationship with other hematological parameters in the groups, the formation of a hypercoagulation state in ovarian endometriosis (which is absent in the comparison group) is clearly seen, associated with the systemic influence of heterotopia, which forms an environment favorable for it. Conclusion. Endometriosis is a pathology that has a multifaceted systemic effect on the body and, in particular, on the blood clotting system. Together with a significant increase in the number of platelets in this pathology and the dependence of this phenomenon on the mononuclear phagocyte system, which supports the homeostasis of endometrioid heterotopia, a tendency to hypercoagulation of subclinical endometriosis-associated coagulopathy is formed, which may be an unfavorable background for the development of other intercurrent pathologies.
Key words: эндометриоз, гиперкоагуляция, коагулограмма, общий анализ крови
CLINICAL CASE OF TENOSYNOVIAL GIANT CELL TUMOR OF THE ELBOW JOINT IN A CHILD
Snetkov A.I., Batrakov S.Y., Akinshina A.D., Gorelov V.A.
UDC: 616-006.03
Abstract: Objective. To demonstrate a clinical case of tenosynovial giant cell tumor of the elbow joint a 10-years-old child. Methods. The authors describes a clinical case of tenosynovial giant cell tumor of the elbow joint a 10-years-old child. After a clinical and radiological examination, a biopsy was performed to verify the diagnosis, and then the tumor was surgically removed. Results. In the Department of pediatric bone pathology and orthopedics of the «N.N. Priorov National Medical Research Center of Traumatology and Orthopedics» of the Ministry of Health of the Russian Federation a comprehensive diagnosis, verification of the diagnosis of a tenosynovial giant cell tumor in a 10-year-old child and successful surgical treatment with the rehabilitation of the function of the elbow joint were performed. Conclusion. Tenosynovial giant cell tumor is a rare locally aggressive soft tissue benign tumor. It can disguise itself as synovitis of joints of various etiologies in both adults and children. Morphological verification of the diagnosis and the correct nomenclature of the tumor are required for successful treatment of patients.
Key words: теносиновиальная гигантоклеточная опухоль, пигментированный ворсинчато-узловой синовит, пигментированный виллезно-нодулярный синовит, клинический случай
CLINICAL CASE OF MASSIVE BLADDER HAEMORRHAGE IN PATIENT WITH SEVERE COVID-19 INFECTION
Telesh A.A., Tagil A.O., Telesh M.A., Sokolovskaya V.V., Morozova T.G., Smolynkin N.N.
UDC: 612.466.69
Abstract: Objective. To provide a clinical case of massive bleeding from the bladder in a patient with a severe course of coronavirus infection. Methods. The authors observed a female patient with severe new coronavirus infection, who had a rare complication - massive bladder haemorrhage. The authors analyzed available literature concerned the coronavirus infection effects on the urinary system. Results. The authors presented a clinical case of massive bladder haemorrhage in a patient with severe Covid-19 infection. The authors analyzed reasons of the hematuria, the effects of the treatment were described. Conclusion. The danger of this infection is due to both damage to the lungs and exposure to other organs and systems of the human body, including the organs of the urinary system. It`s important to use differentiated approach to increasing the dose of heparin for patients with severe covid-19 infection.
Key words: гематурия, новая коронавирусная инфекция, COVID-19, мочевой пузырь, эндоскопическое исследование, ультразвуковая диагностика
PROSPECTS FOR USING THE METHOD OF FECAL MICROBIOTA TRANSPLANTATION FOR THE TREATMENT OF DYSBIOTIC CONDITIONS AND RELATED DISEASES
Volk T.G., Savin M.V., Tomilina P.A.
UDC: 616-035.1+616.345
Abstract: Objective. To generalize and present materials about results of use and efficiency of the method of fecal microbiota transplantation for treatment of diseases with disturbances of normal composition of the microbiota of the large intestine and indirectly related to it disorders. To elucidate questions of selection of donors, methods of carrying out of procedure of transplantation, a mechanism of therapeutic action, some historical aspects as well as to estimate prospects of this technique and its therapeutic potential, in particular, current state and possibilities of development of fecal microbiota transplantation in the Russian Federation. Methods. Analysis of several dozens of works including separate clinical trials, some meta-analyses, conference materials and a number of historical monographs devoted to the question of application, benefits and conditions of fecal microbiota transplantation procedure. Results. Evidence has been demonstrated that FMT is highly effective in the treatment of dysbiotic diseases and conditions, particularly for the treatment of Cl. difficile-associated infection. Fecal transplantation has also shown encouraging results in relieving symptoms in other GI diseases and certain extraintestinal diseases such as Crohn's disease, irritable bowel syndrome, ulcerative colitis, constipation and diarrhea of various etiologies, childhood autism, multiple sclerosis, Parkinson's syndrome, metabolic syndrome. Information is presented about the methodology and development of FMT in medical world, as well as information about tendencies in the study of this method in Russia. Conclusion. Transplantation of fecal microbiota may be recommended for the treatment of dysbiosis and related pathological processes. Potentially, FMT can also be applicable to the treatment of other disorders of the gastroenterological, neurological and immunological specialties, as evidenced by the high interest in the method abroad, but in domestic medicine, only some specialized and general research institutes try to develop this direction of therapy.
Key words: трансплантация фекальной микробиоты, микрофлора кишечника, дисбиоз кишечника, Clostridium difficile-ассоциированные инфекции
OVERVIEW OF THE PHYSICAL AND MECHANICAL PROPERTIES OF ORTHODONTIC ARCHWIRES
Boikova E.I., Valyukhova A.A.
UDC: 616.314-089.23
Abstract: Objective. To analyze the physical and mechanical properties of orthodontic arches. Methods. Analysis, systematization and generalization of the presented topic. Results. Based on the literature data, the analysis of the physico-mechanical properties of orthodontic arches, their shape and the possibility of application in orthodontic practice according to various authors was carried out. A brief historical background on the development of alloys used in orthodontics is provided, the composition of orthodontic arches is studied. The characteristic of arc alloys used in orthodontic practice is carried out. Based on the data of various publications, an overview of the main properties of orthodontic arches is carried out and recommendations are given on the use of the latter in the practice of an orthodontist. Conclusions. Discussing the properties of orthodontic arches, the definition of the term "hysteresis", its brief description and significance for practical activity are given. In addition, various cross-sectional shapes of orthodontic arches and their corresponding properties, possibilities and options for their application at different stages of orthodontic correction have been studied.
Key words: ортодонтия, ортодонтическая дуга, сплав, гистерезис, брекет-система, идеальная начальная дуга
DETERMINATION OF FOREIGN IMPURITIES BY THE HPLC METHOD IN THE STUDY OF THESTABILITY OF GELS WITH DIPYRIDAMOLE AND CETIRIZINE
Magomedova D.G., Abdurakhmanov A.M., Losenkova S.O., Ogai M.A., Stepanova E.F., Nam N.L., Morozov Yu.A., Makieva M.S., Morozova Or.V., Gagloeva D.I., Barkaev G.S.
UDC: 615.454.1
Abstract: Objective. Development of a method for determining foreign impurities by high-performance liquid chromatography (HPLC) in the course of studying the stability of a gel with dipyridamole and a gel with cetirizine by long-term real-time testing. Methods. A technique has been developed and the purity (permissible content of foreign impurities) of a gel with dipyridamole and a gel with cetirizine has been determined using the method of high-performance liquid chromatography on a liquid microcolon chromatograph of the Milichrome A-02 brand during the study of their stability for 6 months of storage. Results. An analytical method for determining the content of foreign impurities by the HPLC method has been developed and validated. When analyzing the gel with cetirizine by the HPLC method after 6 months of its storage in a cold place (at a temperature of 3-5 ° C in a refrigerator) in glass jars of the MTO grade, hermetically sealed with polyethylene lids, not a single area of the secondary peak on the chromatogram of the tested solution exceeded the area of the main peak on the chromatogram of the standard solution B (that is, the content of each individual impurity was less than 1%), and their amount was less than the peak area on the chromatogram of the standard solution B, that is, the content of the amount of impurities did not exceed 2.0% of the declared content. When analyzing a gel with dipyridamole by HPLC, stored in similar conditions for 6 months, not a single area of secondary peak on the chromatogram of the tested solution exceeded the area of the main peak on the chromatogram of the standard solution B (that is, the content of each individual impurity was less than 1%). Conclusion. An analytical method for determining the content of foreign impurities by the HPLC method has been developed and validated. The obtained results of the study of the content of foreign impurities in gels with dipyridamole and cetirizine, stored for 6 months in glass jars of the MGD brand in a cold place, indicate the compliance of dosage forms (LF) with the requirements of regulatory documentation, as well as the stability of the new dosage forms of dipyridamole and cetirizine developed by the authors according to the standardized indicator "Purity".
Key words: цетиризин, дипиридамол, посторонние примеси, хроматограмма, стабильность
DETERMINATION OF CALCIUM AND MAGNESIUM IN THE JOINT PRESENCE IN PHARMACEUTICAL PRODUCTS AND DIETARY SUPPLEMENTS
Endaltseva O.S., Lust E.N.
UDC: 54.064; 543.421
Abstract: Odjective. Development of a method for the determination of calcium and magnesium in their joint presence in pharmaceutical products and biologically active additives.Methods. Determination of the mass fraction of calcium. An aliquot volume of the solution (5 ml) was placed in a titration flask, 3 ml of hydroxylamine hydrochloric acid solution 100 g / dm3 and 3 ml of sodium citrate solution 100 g / dm3 were added. Next, 5-10 drops of an indicator of acidic chromium dark blue were added, 6 ml of sodium hydroxide solution of 200 g / dm3 were added and titrated with a sodium edetate solution of 0.05 M until the color changed from raspberry-violet to blue, comparing with a titrated control sample. Determination of the mass fraction of magnesium. Another aliquot part of the solution (5 ml), in which the amount of calcium and magnesium was determined, was placed in a titration flask, 1-2 drops of methyl orange 1 g / dm3 were added and neutralized with sodium hydroxide solution of 50 g/dm3. Next, 0.5 ml of sodium sulfide solution 20 g / dm3 was added, diluted with water to 100 ml, 5 ml of buffer solution of ammonium chloride pH 10 was added. 5-10 drops of an indicator of acidic chromium dark blue were added and sodium edetate was titrated with a solution of 0.05 M to a stable blue color, compared with a titrated control samplе. The volume of sodium edetate solution of 0.05 M, which went into the titration of magnesium, is determined by the difference between the volumes of sodium edetate of the 0.05 M solution, which went into the titration of the sum of calcium and magnesium and calcium alone. Titration was carried out in two versions: without mineralization and after dry ashing of samples with and without masking reagents.Results. The results of the determination of calcium and magnesium in the joint presence after carrying out the mineralization of the sample of multicomponent composition turned out to be close to the declared content. After dry ashing and application of masking reagents, the influence of interfering components of the sample is reduced.Conclusion. Determination of the content of calcium and magnesium in the joint presence is possible with different indicators under different conditions (different pH values). Setting the desired pH value allows you to determine calcium and eliminate the influence of magnesium, which interferes with normal conditions. For multicomponent preparations, direct determination of ions is possible only after elimination of interfering sample components (a mineralization stage is required).
Key words: кальций, магний, совместное присутствие, комплексонометрический метод, минерализация, сухое озоление, маскирующие агенты
INVESTIGATION OF ELEMENT COMPLEX OF DANDELION ROOTS OF MEDICINAL
Dyakova N.A.
UDC: 615.322
Abstract: Objective. The purpose of the study is to study the macro- and microelement composition of the roots of dandelion medicine. Methods. The preparation of medicinal plant raw materials was carried out in the fall in the Voronezh State Natural Biosphere Reserve. The microelement composition of the vegetable drug was determined by inductively coupled plasma mass spectroscopy on an ELAN-DRC device. Results. It was revealed that the content of the microelement complex is 1.9% in terms of absolutely dry raw materials, 59 elements were determined. Macroelements make up 84.66% of the total elemental composition of dandelion roots. The macroelements are based on potassium (more than 9 mg/g), as well as calcium and phosphorus (more than 2.4 mg/g). Essential trace elements make up 12.66% of total mineral complex of dandelion roots. Among them, the highest content was noted for silicon (more than 2 mg/g), iron (more than 0.2 mg/g). The content of regulated heavy metals and arsenic in the roots of the dandelion medicine meets the requirements of regulatory documentation. The proportion of toxic and poorly studied elements in the total mineral complex of dandelion roots is 2.67%. The highest content was observed for aluminum (447.7 μg/g), titanium (26.6 μg/g), strontium (17.1 μg/g), barium (9.7 μg/g), rubidium (3.4 μg/g), tin (1.27 μg/g). Conclusion. The results of the study showed a rich macro- and microelement composition of the roots of the dandelion drug, which can be used in the medical and pharmaceutical practice of creating drugs and biologically active additives for correcting physiological norms of the content of elements in the human body.
Key words: корни одуванчика лекарственного, микроэлементы, макроэлементы
QUALITY CONTROL IMPROVEMENT OF PECTORAL SPECIES N1
Kakhramanova S.D., Bokov D.O., Samylina I.A.
UDC: 615.072
Abstract: Objective. Consideration of issues related to the standardization of mixed herbal drug - pectoral species No. 1, that is registered on the Russian Federation territory and is freely sold in pharmaceutical market. Methods. This study is based on the review of available scientific literature on the topic. Results. The pectoral species No 1 consist of marshmallow roots (40%), oregano herb (20%) and coltsfoot leaves (40%). This herbal drug belongs to the expectorants group, and also has anti-inflammatory effects. The review considers data on the study of the crude herbal drugs included in the PS No1 chemical composition, their pharmacological activity, as well as recommendations for possible methods improvement for the PS No1 components biological active compounds analysis. Methods for analyzing the PS No1 itself are also proposed, which make it possible to assess its quality. Conclusion. Despite the pectoral species active use in medicine, insufficient attention has been paid to its study: quality control of this crude herbal drug at a given time is carried out without the use of modern methods of analysis. The scientific literature contains comprehensive data on the chemical composition, pharmacological activity and use in medicine, as well as on the methods of standardization of crude herbal drugs that are part of the herbal drug, data on this herbal drug are fragmentary and not systematic. Accordingly, the study of pectoral species No 1, consideration of issues on improving the methods of its standardization are urgent tasks.
Key words: грудной сбор №1, листья мать-и-мачехи, трава душицы, корни алтея, полисахариды, флавоноиды, биологически активные соединения
STATE POLICY ON MEDICAL AND PHARMACEUTICAL CARE FOR CHILDREN AND ADOLESCENTS DURING THE PANDEMIC OF NEW CORONAVIRUS INFECTION IN THE RUSSIAN FEDERATION
Krikova A.V., Sokolovskaya V.V., Bekezin V.V., Kozlov R.S.
UDC: 615.014:616.12-053.2
Abstract: Objective. To study certain legislative acts in the field of state policy in terms of medical and pharmaceutical care for children and adolescents during the pandemic of a new coronavirus infection in the Russian Federation, to analyze the prevalence, to identify epidemiological and clinical features of COVID-19 in this category of persons in Smolensk region. Methods. Legislative acts regulating the procedure of medical and pharmaceutical care for children and adolescents during the pandemic of a new coronavirus infection in the Russian Federation were studied using the method of content analysis. The method of descriptive statistics is a simple generalization of data obtained in a sample study. Fifty-four case histories of children and adolescents with COVID-19 (Clinical Hospital N1) for the year 2020 were studied by continuous sampling method. Results. The state policy of the Russian Federation in the field of medical and pharmaceutical care for children and adolescents during the pandemic of new coronavirus infection is represented by Decrees and Orders of the President of the Russian Federation, Federal Laws, Resolutions and Orders of the Government of the Russian Federation. According to Rospotrebnadzor, 888 cases of new coronavirus infection among children and adolescents in Smolensk region were detected in 2020, accounting for 5.2% of the total morbidity. Assessing the seasonality of COVID-19 spread, it can be noted that it was registered during the whole epidemiological season, with maximum peaks in April (11.25%) and November (8%). The lowest incidence rates in the pediatric population occurred in August and December and amounted to 2.5% and 1.25%, respectively. Conclusion. Regulatory and legal documents regulating the provision of medical and pharmaceutical care in pediatric practice and reducing the risks of spreading the new coronavirus infection COVID-19 have been enacted in the Russian Federation. The study found that 61% of cases of COVID-19 were registered in the age group from 6 to 14 years old. The gender ratio of boys to girls was 1:1.1. Within the first three days of the disease onset 61% of children and adolescents were hospitalized. Coronavirus infection in 64.8% of children and adolescents during the 2020 season was in the form of ARVI. In 60% of cases it was noted that the disease had a moderate degree of severity. Intoxication syndrome occurred in 58,1% of patients (decrease of emotional tone and appetite, pale skin, sleep disturbance) and 66,6% of children and adolescents had increased body temperature. In 2020 lesions in children and adolescents affected different parts of the respiratory tract and had clinical variants of course, in particular, rhinopharyngotonsillobronchitis was observed in 44.2% of cases. Pneumonia, confirmed by chest X-ray data, was observed in 35.2% of cases: 8% of cases had left-sided pneumonia, 40.1% - right-sided, 51.8% - bilateral pneumonia. The average duration of hospital stay was 14.7 bed-days.
Key words: государственная политика, медицинская и фармацевтическая помощь, новая коронавирусная инфекция, COVID-19, клинико-эпидемиологические аспекты
ROLE AND PLACE OF H2-HISTAMINE RECEPTOR BLOCKERS ON THE PHARMACEUTICAL MARKET IN THE RUSSIAN FEDERATION
Bondarenkova O.A., Krikova A.V., Ivanishkina E.V., Dmitrieva E.V., Zaytseva V.M.
UDC: 616-01/-099
Abstract: Objective . To analyze the normative-legal documentation regulating medical and pharmaceutical aspects of drug circulation in the Russian Federation and to conduct separate marketing studies of the assortment of H2-histamine receptor blockers. Methods . Content analysis of regulatory documents, analysis of drugs registered and approved for circulation in the Russian Federation. Data from the State Register of Medicines 2022 (GRLS) were used as materials for the study. A questionnaire was administered to 30 employees of pharmacies in Smolensk. The questionnaire contained 14 questions about the personal characteristics of pharmacists and pharmacists, their advice on the patient's choice of H2-histamine receptor blocker drugs, as well as factors influencing their implementation. Questionnaire survey of 80 end users of H2-histamine receptor blocker drugs. Descriptive statistics method. Results . In the Russian Federation there is a decrease in the incidence of diseases of the population, in particular, diseases of the digestive organs. The pharmaceutical market of drugs of H2-histamine blocker group is represented by international nonproprietary names - ranitidine and famotidine: drugs of ranitidine (INN) are represented in 64% of cases by foreign manufacturers, range of registered manufacturer price from 11.39 to 160.67 rubles; in 36% of cases - by domestic manufacturers, range of registered manufacturer price from 11.38 to 52.69 rubles. Famotidine (INN) drugs were represented in 85% by domestic manufacturers, the manufacturer's registered price range was from 11.09 to 17733.84 rubles; in 25% - by foreign manufacturers, the manufacturer's registered price range was from 34.41 to 201.98 rubles. In March 2022 it was found that of all the drugs ranitidine (INN) registered in the GRLS in 2022 it is impossible to buy remotely in Internet pharmacies (Smolensk). Smolensk) to buy none of the drugs; the drug by INN famodidine was available - the drug quamatel (Gedeon Richter) is available in online pharmacies in the price range of 139.00 - 155.00 rubles; famotidine (Ozon Ltd) - 27.00 - 43.60 rubles; famotidine (Chemopharm) - 64.10 - 86.70 rubles. Conclusions . The study compiled a portrait of a pharmacy worker - a female pharmacist under the age of 25 years, work experience in this position is less than 5 years, does not have a qualification category. According to pharmacy workers, customers choose drugs as prescribed by the doctor, this group of drugs is sold in pharmacies frequently. In 52% of cases, pharmacy workers recommend H2-histamine receptor blockers to patients; the average score of pharmacy workers' familiarity with this group of drugs is 6.5 points (out of 10 points). The most important quality of the drug, in the pharmacist's opinion, is efficacy (80%), and it was noted that the low price of the drug and the work of medical representatives have a very strong influence on the demand for H2-histamine receptor blockers. The end user is a person over 55 years of age, pensioners, with higher education, average monthly family income (per person) from 13,890 to 27780 rubles, visits a general practitioner once every few months, purchases drugs at full price, has gastrointestinal problems, spends from 1000 to 2000 rubles on drugs, takes a drug based on doctor's recommendations. Respondents noted that the most complete information about the drug can be obtained from the Internet, from the doctor, from the abstract. All 100% of the respondents are satisfied with the design of the package of drugs, in 91% of cases respondents prefer drugs of domestic production. End users choose pharmacy located in the area of residence, also important is the availability of discounts and benefits, as well as the location of the pharmacy on the way from work. The respondents (100%) consider effectiveness to be the most important characteristic of the drug. Among the respondents, almost all 91% (73) noted that they are not familiar with drugs from the group of H2-histamine receptor blockers, but when naming drugs by their INN (famotidine and ranitidine), 100% (80) of the respondents noted that they are familiar with these names.
Key words: фармацевтический рынок, ранитидин, фамотидин
INFORMATION TECHNOLOGIES FOR PROMOTING RATIONAL USE OF MEDICINES
Trapeznikova N.A., Rostova N.B.
UDC: 615.035.1
Abstract: Objective. To propose the methodology of development of the automated information system "AntiVIСH-1". It aims to support decision-making in selecting and prescribing the most appropriate combination of antiretroviral medicines for a specific HIV-infected patient, taking into account effectiveness and safety criteria. Methods. The functioning of the system is based on the production rules obtained as a result of the cluster analysis of the real prescriptions of antiretroviral therapy to HIV-infected patients, the formulated criteria of effectiveness and safety, contraindications for the use of antiretroviral medicines, the actual presence in the medical organization. Results. By changing the conditions for selecting the combination, users have the opportunity to manage the choice of antiretroviral medicines and their combinations depending on the task at hand. Conclusions. The use of the proposed automated information system in the clinical practice of HIV-infection treatment will allow to rationalize the choice and prescription of antiretroviral medicines, increase the efficiency and safety of therapy, personalize the approach to each patient, prevent possible adverse reactions.
Key words: информационные технологии, автоматизированная информационная система, ВИЧ-инфекция, антиретровирусные препараты, рациональное использование лекарственных средств
KRUG DOBRA" IN THE FRAMEWORK OF DRUG PROVISION FOR PATIENTS WITH ORPHAN DISEASES
Samoshchenkova I.F., Garankina R.Y., Snimschikova I.A., Lebedev A.V., Kucheryavenko E.N., Omelchenko A.A.
UDC: 616-053.2-022.251:614.2
Abstract: Objective. The research of the work of Federal State-funded Institution "Federal Center for Planning and Organization of Medicine Provision of Citizens" of Ministry of Health of the Russian Federation on interaction with the Krug Dobra Foundation in the framework of medicine provision for patients with orphan diseases in 2021. Methods. In the course of the study, a complex of scientific methods of systemic, logical, structural types of analysis was used. Regulatory legal acts, the International Classification of Diseases (ICD-10), the State Register of Medicines (SRM), the lists of vital necessary and important medicines (VNIM), analytical data from the official website of the Federal State-funded Institution "Federal Center for Planning and Organization of Medicine Provision of Citizens" were selected as objects of study. Results. During the analysis of the nosological affiliation of patients with orphan diseases receiving drugs as part of activities of the Krug Dobra Foundation, it was found that patients with class VI nosologies estimated as 82.2%, class IV - 16.6%, class XIII - 0.6% and class XVII - 0.2%. The largest number of patients was provided with medicines for SMA treatment (70.7%). The largest amount of funds was spent for the purchase of Nusinersen (49.34% of the total costs). The leader among suppliers in terms of the number of contracts concluded is Pharmimex JSC (33% of contracts in total). The top 3 in terms of costs of suppliers for the purchase of medicines is headed by Pharmstandard JSC, whose purchases amounted to 46.08% of the total amount of public purchases made by the Federal State-funded Institution "Federal Center for Planning and Organization of Medicine Provision of Citizens" in 2021. Conclusion. A comprehensive review of activities of the Federal State-funded Institution "Federal Center for Planning and Organization of Medicine Provision of Citizens" made it possible to analyze the results of its work for 2021 from different positions. This approach made it possible to study and evaluate the role of this organization in the medicine provision of patients with orphan diseases in the most detailed and structured way in the framework of interaction with the Krug Dobra Foundation.
Key words: орфанные заболевания, нозология, лекарственный препарат, лекарственное обеспечение, государственные закупки, Федеральное казенное учреждение «Федеральный центр планирования и организации лекарственного обеспечения граждан» Министерства здравоохранения Российской Федерации, Фонд «Круг Добра»
ANALYSIS OF THE OPINION OF STUDENTS OF THE FACULTY OF PHARMACY ON PREVENTIVE ACTIVITIES IN A PHARMACY ORGANIZATION
Skvortsova M.V., Zheltkevich O.V.
UDC: 614.27.007
Abstract: Objective. Studying the opinion of students of the Faculty of Pharmacy on the implementation of preventive activities in a pharmacy organization. Methods. A survey of students of the Faculty of Pharmacy was carried out. A statistical method of analysis was used to process the results. Results. The data obtained indicate that the majority of students are familiar with the concept of preventive activity. The pharmaceutical worker should be involved in preventive work, and this requires additional knowledge. The student community believes that in order to increase the effectiveness of preventive measures, modern information technologies should be used: provide information on the website of a pharmacy organization and receive feedback from consumers on maintaining health. The most effective preventive measures were identified, such as interviewing buyers about their risk factors for the development of non-communicable diseases and teaching patients to correctly measure blood pressure. Conclusion. The results of the study can be used to substantiate the development of the preventive direction of the pharmacy organization. The need for further study of this issue and the development of technologies for effective preventive work is shown. This will contribute to the preservation and strengthening of the health of the population.
Key words: фармацевтические работники, профилактическая деятельность, критерии доступности профилактической помощи, формы профилактической работы
MESHKOV NIKOLAY ALEKSEEVICH - PROFESSOR EMERITUS OF SMOLENSK STATE MEDICAL UNIVERSITY (TO THE ANNIVERSARY)
UDC: 929.61
Key words: МЕШКОВ НИКОЛАЙ АЛЕКСЕЕВИЧ
PROFESSOR ELENA IVANOVNA ZAYTSEVA (TO THE 100 ANNIVERSARY OF FOUNDATION OF DEPARTMENT OF PROPEDEUTICS OF INTERNAL DISEASES OF SSMU)
Udovikova O.I., Ivanishkina E.V.
UDC: 929.61
Key words: ЕЛЕНА ИВАНОВНА ЗАЙЦЕВА
PROFESSOR LEONID SEMENOVICH HIBIN (TO THE 85 ANNIVERSARY OF BIRTHDAY)
Udovikova O.I., Ivanishkina E.V.
UDC: 929.61
Key words: ЛЕОНИД СЕМЁНОВИЧ ХИБИН