NEW NICKEL-BASED METAL COMPLEX COMPOUND AND ITS EFFECT ON THE RESISTANCE OF ORGANISM TO ACUTE HYPOXIA
Evseev A.V., Belen'kij A.J.E., Surmenjov D.V., Pereverzev V.A., Evseeva M.A., Danilov A.I., Alexashkin S.V., Stepanov D.V., Kulagin K.N., Shalaeva O.E.
UDC: 614.275 796.015.576
Abstract: Objective. To compare the antihypoxic effects of the new metal complex compound πQ2116 based on Ni(II) with the effects of substances that have proven themselves as antihypoxic agents - amtizole and πQ1983. Methods. Male Wistar rats (n=86) were used in the experiments. The state of acute hypoxia with hypercapnia (AH+Hc) was carried out by placing the animals in transparent tightly closed containers with a volume of 1,000 ml. Substance πQ2116 and reference substances were injected i.p. at a dose of 50 mg/kg over 60 min. up to AH+Hc. The severity of the antihypoxic effect of the substances was determined by lifespan, by content of hypoxia markers HIF1α, EPO in blood plasma, by LPO indicators - SOD, GPO and MDA. Biochemical parameters were determined by ELISA. We also studied the effect of the substance πQ2116 and the reference substances on the content of these indicators in the blood plasma 1 and 24 hours after their administration at a dose of 50 mg/kg. All results were processed statistically. Results. It has been established that the antihypoxic effect of the metal complex (Ni) substance πQ2116 significantly increases the resistance of rats to AH+Hc surpassing in this respect the reference aminothiol antihypoxant amtizole and the selenium-containing metal complex (Zn) compound πQ1983. According to the dynamics of hypoxia markers HIF1α and EPO, the effect on LPO parameters, the mechanisms of the protective action of the substance πQ2116 and amtizole should be considered as similar. The implementation of the basic mechanisms of the antihypoxic action of the studied substances is due to their ability to have a prohypoxic effect which persists after i.p. administration to rats at a dose of 50 mg/kg for no more than 24 hours. Conclusions. The data obtained make it possible to classify the substance πQ2116 as an antihypoxic agent similar in terms of mechanisms of protective action to the antihypoxant amtizole. At the same time, the substance πQ2116 at a dose of 50 mg/kg is superior to amtizole in terms of its ability to increase the lifespan of rats under AH+Hc conditions, which allows it to be regarded as a more preferable compound in the spectrum of preventive care measures at the risk of the development of hypoxia of an enclosed space.
Key words: никель, металлокомплексные соединения, антигипоксанты, острая гипоксия с гиперкапнией, маркёры гипоксии, перекисное окисление липидов
EFFECT OF TAURINE ON THE SPECTRUM OF FREE AMINO ACIDS IN THE BRAIN CORTEX OF RATS UNDERGOING CEREBRAL ISCHEMIA
Razvodovsky Yu.E., Smirnov V.Yu., Troyan E.I., Doroshenko E.M., Pereverzev V.A., Maksimovich N.E.
UDC: 616.441.577.112
Abstract: Objective. Characteristics of changes in the pool of amino acids in the cortex of the frontal and parietal lobes of cerebral hemispheres of rats after administration of taurine against the background of subtotal cerebral ischemia (SCI). Methods . The experiment was carried out on 18 white outbred female rats. SCI was simulated in 12 rats by ligation of both common carotid arteries for one hour. Taurine (at a dose of 100 mg / kg body weight) was injected intravenously just before ligation of the common carotid arteries. The content of amino acids and their derivatives in perchloric acid homogenates of tissues was determined by reversed-phase high-performance liquid chromatography (HPLC). Results. SCI caused a decrease in the cerebral cortex levels of glutamate, asparagine, tyrosine, tryptophan, ornithine, lysine and 1-methylhistidine. The introduction of taurine in SIGM increased the levels of threonine, serine, glutamine and valine, as well as related compounds - glutathione, phosphoethanolamine, a-aminobutyric acid, decreased the concentrations of citrulline, arginine, alanine, methionine, phenylalanine, histidine, GABA, cystathionine and ethanolamine. Conclusions. Subtotal cerebral ischemia causes depletion of the pool of free amino acids in the cerebral hemispheres. The introduction of taurine partially corrects the amino acid imbalance of the pool of free amino acids in the cerebral hemispheres caused by SIGM.
Key words: аминокислоты, кора больших полушарий, субтотальная ишемия головного мозга, таурин
INFARCTION-LIMITING EFFECT OF L-LACTATE DURING ISCHEMIA-REPERFUSION OF MYOCARDIUM IN YOUNG AND OLD RATS UNDER CONDITIONS OF TRANSIENT HYPERCHOLESTEROLEMIA
Chepelev S.N., Vismont F.I., Goubkin S.V.
UDC: 616.127-005-085-092.9:616.153
Abstract: Objective. To elucidate the infarct-limiting effect of postconditioning (PostC) with L-lactate in ischemia-reperfusion of myocardium in young and old rats under conditions of transient hypercholesterolemia (HCE). Methods. The study was carried out on 96 anesthetized male white rats. Animals were divided into 8 groups: Control and Control - young/old rats that underwent 30 min myocardial ischemia followed by 120 min reperfusion; Lactate and Lactate - young/old rats, which after 25 min from the start of reperfusion, received PostC with L-lactate at a dose of 10 mg/kg; OO+Lactate and OО+Lactate - young/old rats that were intragastrically injected with olive oil (OO) at a dose of 10 ml/kg once a day for 10 days; HCE+Lactate and HCE+Lactate - young/old rats with transient HCE, which were intragastrically injected with a 10% solution of cholesterol per OO at a dose of 10 ml/kg once a day for 10 days. After reperfusion, the heart was removed and the size of the area at risk/necrosis area in the myocardium of the left ventricle was studied using computer planimetry. Results. The size of the zone of necrosis in the myocardium of the left ventricle in animals in the studied groups was as follows: Control was 45±4%, Control - 47±5%, Lactate - 33±3% ( p <0.05), Lactate - 35±4% ( p <0.05), OO+Lactate - 35±3% ( p <0.05), OO+Lactate - 37±5% ( p <0.05), HCE+Lactate - 42±5%, HCE+Lactate - 44±4%. Conclusion. It was revealed that PostC with L-lactate at a dose of 10 mg/kg, carried out 25 minutes after the start of reperfusion, leads to a decrease in infarct size in young and old rats. At the same time, PostC with L-lactate does not affect the ratio of infarction zone/risk zone in young and old rats with transient HCE.
Key words: транзиторная гиперхолестеринемия, кардиопротекция, инфаркт-лимитирующий эффект, зона некроза, зона риска, L-лактат
LIPID OXIDATION OF LIVER MICROSOMES BY ENZYMATIC AND NON-ENZYMATIC MECHANISMS OF LIPID PEROXIDATION IN THE PRESENCE OF H-CHOLINERGIC RECEPTOR AGONISTS AND ANTAGONISTS
Tikhanov V.I., Shabanov P.D.
UDC: 615.275.4:612.35]577.352.335
Abstract: Objective. To evaluate the induction of lipid peroxidation (LPO) by liver microsomes in vitro by enzymatic (NADP•H-dependent) and non-enzymatic (ascorbate-dependent) mechanisms in the presence of nicotine and hexamethonium, modulating the H-cholinergic receptors of the liver tissue. Methods. Enzymatic (NADP•H-dependent) and non-enzymatic (ascorbate-dependent) mechanisms of LPO were induced in vitro by adding to the incubation medium a suspension of liver microsomes, 1 mM NADP•H (in the case of enzymatic LPO) or 0.8 mM ascorbic acid (in the case of non-enzymatic LPO). Lipid oxidation of microsomes was determined by the content of one of the TBA-active products - malondialdehyde. The molar concentration of pharmacological substances in the incubation medium (nicotine, hexamethonium benzosulfonate, Sigma-Aldrich, USA) corresponded to the doses of pharmacological agents exhibiting specific activity in vivo in behavioral experiments. The oxidative activity of cholinotropic pharmacological agents was calculated as a percentage. Statistical processing of the results was carried out by the Kruskal-Wallis analysis of variance using the paired Mann-Whitney test at p<0.05. Results. The presence of nicotine in the incubation medium 10-10 M and the induction of the enzymatic mechanisms of LPO reduced the ability of the lipids of the membranes of the endoplasmic reticulum of hepatocytes (MERH) to oxidize. Hexamethonium in the incubation medium, upon activation of the enzymatic mechanisms of LPO, had the opposite effect - it increased the ability of MERH lipids to oxidize. With a decrease in the molar concentration of both nicotine and hexamethonium in the incubation medium, an increase in the ability of MERH lipids to oxidize was noted. With the induction of non-enzymatic (ascorbate-dependent) mechanisms of LPO, nicotine 10-10 M in the incubation medium increases, and hexamethonium under the same conditions reduces the oxidation of MERH lipids. Conclusion. Agonist (nicotine) and antagonist (hexamethonium) of H-cholinergic receptors in different directions change the lipid peroxidation of the MERH. One of the possible mechanisms of the influence of cholinotropic substances on enzymatic (NADP•H-dependent) and non-enzymatic (ascorbate-dependent) LPO is a change in the proton-active potentials of molecules of substances on the principles of one-electron oxidation and reduction of lipids.
Key words: никотин, гексаметоний, липиды микросом печени, ферментативные (NADP•H-зависимые) механизмы окисления, неферментативные (аскорбат-зависимые) механизмы окисления
VIRUS-ASSOCIATED NECROTIZING DISSEMINATED ACUTE LEUKOENCEPHALOPATHY
Ramazanov G.R., Sharifov R. A., Akhmatkhanova L.K.H.-B., Korigova Kh.V., Magomedov T.A., Kanibolotskiy A.A., Petrikov S.S.
UDC: 616.831-002
Abstract: Objective. To demonstrate a clinical example of virus-associated necrotizing disseminated acute leukoencephalopathy in a patient with a new coronavirus infection. Methods. In May 2021, at the Sklifosovsky Research Institute for Emergency Medicine, one clinical case of virus-associated necrotizing disseminated acute leukoencephalopathy was registered. Results. This article discusses a rare and difficult to diagnose disease, virus-associated necrotizing disseminated acute leukoencephalopathy in a patient with a new coronavirus infection. Conclusion. In patients with acute neurological deficits in the case of abnormal ischemic stroke, it is necessary to be vigilant about an alternative disease. One of the rare neurological complications in patients after the new coronavirus infection is a virus-associated necrotizing disseminated acute leukoencephalopathy. Currently, the VANDAL diagnostics is based on the magnetic resonance imaging data, previous infectious history, and confirmed by histological examination. The article indicates etiology, methods of diagnostics and treatment, as well as the outcomes of the disease.
Key words: вирус-ассоциированная некротизирующая диссеминированная острая лейкоэнцефалопатия, коронавирусная инфекция, ишемический инсульт, магнитно-резонансная томография
CLINICAL CASE: PSEUDOMEMBRANOUS COLITIS
Dekhnich N.N., Skripchenko K.S., Molotkov A.O., Andreeva O.V., Tryapyshko A.A.
UDC: 615.33+616.345
Abstract: Objective. To analyze the clinical case of patient M. born in 1970 with a diagnosis of pseudomembranous colitis. Methods. Interview, physical examination of the patient, retrospective analysis of medical records, data from laboratory and instrumental investigation methods. Results. The article presents a clinical case of pseudomembranous colitis in a patient who has undergone clinical death. The patient was in the cardiology department, where he underwent a reperfusion operation, followed by antibiotic therapy. The patient was discharged from the hospital. On the same day, the patient's condition worsened and he was hospitalized in a pulmolological department with a diagnosis of left-sided lower lobe pneumonia. Antibacterial therapy continued. The patient's condition rapidly deteriorated up to infectious-toxic shock. The patient was transferred to the intensive care unit. The diagnosis of pseudomembranous colitis was verified by colonoscopy and examination of colon biopsies. After correction of the treatment, the patient's condition improved. Conclusion. Pseudomembranous colitis is one of the severe complications of antimicrobial therapy. Early diagnosis and treatment of Clostridium difficile infection can prevent serious complications of antimicrobial therapy.
Key words: псевдомембранозный колит, антибиотикотерапия, ванкомицин, Clostridium difficile
IDENTIFICATION OF HIGH CARDIOVASCULAR RISK IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS BY THE PARAMETERS OF PULMONARY VENTILATION
Punin D.A., Milyagin V.A., Punin A.A.
UDC: 616.24
Abstract: Objective. To identify groups of high cardiovascular risk due to increased arterial stiffness in patients with COPD depending on the parameters of pulmonary ventilation. Methods. Spirometry and body plethysmography were performed in 110 COPD patients to assess pulmonary ventilation parameters and divide the patients into groups by the severity of obstructive disorders, by the presence of static pulmonary hyperinflation and “air trapping”. Volume Sphygmography was done to measure cardio-ankle vascular index (CAVI) and modified cardio-ankle vascular index (CAVI0) both characterizing the morphological component of arterial stiffness. Results. An increase in the severity of bronchial obstruction, development of static hyperinflation and “air trapping” were followed by an increase in arterial stiffness mainly due to the morphological component. Patients with extremely severe bronchial obstruction had notably increased values of CAVI and CAVI0; an increase in CAVI to a critical value of 9 was revealed by one and a half times as often as in patients with milder respiratory disorders. Conclusion . Markedly increased arterial stiffness is observed in COPD patients with extremely severe obstructive disorders, in the presence of static pulmonary hyperinflation and “air trapping” that makes it possible to classify these patients into the group of high cardiovascular risk COPD patients.
Key words: хроническая обструктивная болезнь легких, бодиплетизмография, спирометрия, артериальная ригидность, объемная сфигмография, сердечно-лодыжечный сосудистый индекс, CAVI, CAVI0
ROLE OF THE LONG GLUCOCORTICOIDS INTAKE AND CUMULATIVE DOSE OF GLUCOCORTICOIDS IN THE LOSS OF BONE MINERAL DENSITY IN WOMEN WITH RHEUMATOID ARTHRITIS
Papichev E.V., Sivordova L.E., Akhverdyan Yu.R., Polyakova Yu.V., Hortieva S.S., Zavodovsky B.V.
UDC: 616.72-002.772
Abstract: Objective. To study the association between the duration of glucocorticoids intake and cumulative dose of glucocorticoids and bone mineral density in women with rheumatoid arthritis. Methods and materials. 84 women with a verified diagnosis of rheumatoid arthritis were enrolled in our study. Cumulative dose and duration of glucocorticoids intake were determined by history taking. All patients underwent standard clinical and laboratory examination and dual-energy x-ray absorptiometry. Statistical analysis was performed using the “Statistica 12.0” software package. Results. Median age of the patients was 57 years [48,1-62,8]. Osteoporosis was diagnosed in 49 patients (58,3%). 74 patients were taking glucocorticoids at the time of the study. Median cumulative dose of glucocorticoids was 9,8 g [3,7-13,5], median duration of glucocorticoids intake was 35,5 months [14-71]. Moderate inverse correlation was observed between cumulative dose of glucocorticoids and bone mineral density in 1-4 lumbar vertebrae (ρ=-0,333; p=0,0019), femur neck (ρ=-0,304; p=0,0050) and proximal femur (ρ=-0,346; p=0,0012). Weak inverse correlation was observed between the duration of glucocorticoids intake and bone mineral density in 1-4 lumbar spines (ρ=-0,263; p=0,0157), femur neck (ρ=-0,219; p=0,0448) and proximal femur (ρ=-0,277; p=0,0106). Conclusions. The rate of osteoporosis in women with rheumatoid arthritis and history of glucocorticoids intake is higher than 50% (58,3%). There is an inverse correlation between the cumulative dose and duration of glucocorticoids intake with bone mineral density in 1-4 lumbar vertebrae, femur neck and proximal femur. The cumulative dose of glucocorticoids has a greater effect on the reduction of bone mineral density than the duration of their administration.
Key words: ревматоидный артрит, глюкокортикоиды, минеральная плотность костной ткани, МПКТ, остеопороз
FEATURES OF THE DEVELOPMENT OF RENAL CYSTS IN PATIENTS AGAINST THE BACKGROUND OF COVID-19
Sharipova M.B.
UDC: 616.61-003.4
Abstract: Objective. Comparative analysis of the incidence and clinical course of kidney cysts before and after the onset of SARS-CoV-2 in Dushanbe. Methods. The study material included 132 patients who applied to the polyclinic of the State Institution "Medical Center of the Executive Office of the President of the Republic of Tajikistan" in Dushanbe with kidney cysts after the appearance of a new coronavirus. The patients were divided into two groups: group I - 34 patients with kidney cysts who applied in the period from 2016 to 2020, group II - 98 patients who applied with kidney cysts after 2020. Men prevailed in clinical groups, their total number in the first group was 23 (67.6%), and in the second group - 61 (62.2%) patients. The age of the patients ranged from 35 to 69 years, the average age of the patients was 53.8±2.4 years. There was no statistically significant difference between the regions of residence and the incidence of cysts. Results. A surge in the appearance of kidney cysts was noted back in 2019. Basically, the total pool of patients increased due to the appeals since November 2019. These data may indirectly support the view that the coronavirus was circulating in society much earlier than its official detection in December 2019. In the future, from year to year, the frequency of visits for the presence of kidney cysts increased, reaching a maximum in 2022. Mainly persons with the localization of cysts in the cortical part applied (87 (65.9%) patients). In the central part, cysts were less common - 45 (34.1%) patients. The main complaints that made patients seek medical help in the urological office were frequent increase in blood pressure - 87 cases, darkening of the color of urine - 45 patients, lower back pain (with the addition of an inflammatory process) - in 16 patients, headaches (against the background of high pressure) - 72 cases, fever (up to 39C) - 62 cases, pollakiuria - 89 patients, general malaise - 132 cases. Moreover, hypertension responded poorly to treatment with standard therapies. Conclusion: The incidence of idiopathic kidney cysts has tripled in the era of the pandemic. Thanks to the ultrasound examination, as a standard method for diagnosing complaints associated with kidney pathology, it became possible to identify the formations in the early stages of their development. Even in the absence of clinical manifestations, the presence of kidney cysts is detected during a standard examination. Given the high incidence of cysts in patients after COVID-19, it is advisable to perform ultrasound routinely in patients with both pulmonary and extrapulmonary complications of a new coronavirus infection.
Key words: кисты почек, новая коронавирусная инфекция, COVID-19, пандемия
ANALYSIS OF SURVIVAL PREDICTORS AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING HEMODIALYSIS TREATMENT AT A REGIONAL HEMODIALYSIS CENTER
Ramazanov R.A., Agayeva K.F.
UDC: 616.61-008.64-036.12-085.38-036.8:616.1
Abstract: Objective. To analyze the predictors of survival of patients with chronic kidney disease in the Lankaran Regional Hemodialysis Center of the Republic of Azerbaijan. Methods. During 2010-2019, hemodialysis care was provided to 460 patients. To assess the role of socio-demographic and clinical laboratory indicators in the formation of the probability of survival of the patient's body at the beginning of the connection of patients to dialysis, the patients were divided into subgroups according to the gradations of the noted characteristics. For all these subgroups, the survival rate and 95% of its confidence interval were calculated. Results. The overwhelming majority of patients were aged 40-60 years, the proportion of persons under the age of 40 and over 60 years was 22.6% and 30.7%, respectively. The ratio of the number of women and men among the patients was 1:1.77. The etiological cause of CKD in most patients was glomerulonephritis (41.3%), in 29.8% of patients, diabetes mellitus was the cause of renal failure. Five-year, six-year, seven-year, eight-year, nine- and ten-year survival rates (0,4208; 0,3942; 0,3862; 0,3781; 0,3700; 0,3659) indicate a slow decline in the indicator. Conclusion. The contingent of the regional dialysis center consists mainly of patients with chronic renal insufficiency caused by glomerulonephritis (41.3%) and diabetes mellitus (29.8%) mainly aged 40-60 years (46.7%). The five-year survival rate of patients treated with hemodialysis was 0.4208 (95% confidence interval 0.3679-0.4737). The predictors of survival of patients treated with hemodialysis are old age, the cause of chronic kidney disease, high systolic and diastolic blood pressure, low hemoglobin, low albumin and globulin levels, calcium and phosphates, cholesterol in the blood and body mass index.
Key words: гемодиализ, пожилой возраст, хроническая болезнь почек, гломерулонефрит
FEATURES OF SALIVA LYSOZYME ACTIVITY IN ADOLESCENT CHILDREN WITH EROSIVE FORM OF CHRONIC GASTRODUODENITIS
Shestakova V.N., Evseev A.V., Bogormistrova V.A., Sosin D.V., Svoboda P.N., Udovenko A.A., Lyamets L.L.
UDC: 616-003.23
Abstract: Objective. To study the lysozyme activity of saliva in children with an erosive form of chronic gastroduodenitis at different stages of development for a tactical approach for further correction. Methods. The study involved adolescent children (n=60). Of these, 30 children - with erosive form of chronic gastroduodenitis in the acute phase (IV group of health). The comparison group consisted of 30 children with a similar pathology, but in complete clinical remission (health group III). The control group was children without lesions of the gastrointestinal tract, who were observed in group I of health (n=60) and children with functional lesions of the gastrointestinal tract - group II of health (n=60). The activity of saliva lysozyme was determined by the nephelometric method according to V.G. Dorofeychuk (1968). Fibroesophagogastroduodenoscopy was performed with a targeted biopsy of the antrum of the gastric mucosa. Based on the results of morphological examination, the diagnosis was made, the phase of the course of the disease and the severity of changes in the gastric mucosa were noted. For quantitative estimation of the central trends of the analyzed samples, average values were used. The normality of the samples was checked using the chi-square criterion. The Student's t-test was used to compare the sample averages. Statistical hypotheses were tested at a significance level of 0.05. A Microsoft Excel spreadsheet processor was used to automate statistical calculations. Results. It was found that children with group I of health have higher indicators of saliva lysozyme activity and its indicators increase as they grow older. The lowest activity of saliva lysozyme is detected in children with chronic pathology at the stage of subcompensation or decompensation. In patients with erosive form of chronic gastroduodenitis, the saliva lysozyme index was lower than in healthy children and children with functional disorders of the gastrointestinal tract. Saliva lysozyme indicators are significantly higher in children in the spring-summer period, regardless of the child's age and health status. Conclusions. The fact of an increase in the level of saliva lysozyme in adolescents with age has been confirmed. In patients with erosive form of chronic gastroduodenitis, saliva lysozyme levels were statistically significantly lower than in healthy children and children with functional disorders of the gastrointestinal tract. Lower saliva lysozyme rates are typical for children with chronic gastroduodenal pathology in the acute phase. Saliva lysozyme indicators are associated with the age of the child, the state of health and the season of the year.
Key words: хронический гастродуоденит, эрозивная форма, дети подросткового возраста, лизоцимная активность слюны, сезоны года
SQUARED CASUIISTRY: A CLINICAL CASE OF KIDNEY STONE DISEASE COMPLICETED BY A BILATERAL "KIDNEY BLOCK" IN A 6 MONTHS CHILD
Shtykova O.N., Legonkova T.I., Sarmanova L.V., Shpakovskaya K.S., Dubrovina Yu.A., Vodneva L.M., Stolyarova M.V., Tolstikova E.A.
UDC: 616.62-003.7-053.2
Abstract: Objective. To study the course and clinical manifestations of urolithiasis in a 6-month-old child, to identify factors contributing to the development of urolithiasis. Methods. Patient N., 6 months old, with urolithiasis was under observation. Clinical-laboratory, instrumental examinations and treatment in accordance with the standards of medical care for the profile of the disease were conducted. Results. А clinical case of patient N. is presented. The patient was hospitalized at the Regional Clinical Hospital of Smolensk with a clinical diagnosis of urolithiasis, stones of both kidneys complicated by a block of kidneys. Chronic secondary pyelonephritis, exacerbation stage was diagnosed. Concomitant diseases are rickets II peak period, subacute course; mild IDA; undifferentiated connective tissue dysplasia. Based on the totality of the results of the studies, the patient underwent cystoscopy, retrograde catheterization of the ureters, pyelourethral segment, elimination of the block of the kidneys under general anesthesia. According to laboratory, instrumental methods of examination, on the 20th day from the moment of the disease, the clinic of kidney block again increased on both sides. Repeated cystoscopy and removal of the block of the kidneys wereчса performed. On the 22nd day of the disease, the child was transferred for further treatment to the urological department of the Russian Children's Clinical Hospital of the Pirogov Russian National Research Medical University, Moscow, Russia Conclusion. The treatment of KSD requires interaction between pediatricians, urologists, nephrologists, surgeons, gastroenterologists, endocrinologists, geneticists and nutritionists. After all, the surgical removal of urinary stones, even with the use of high-tech methods, is important for subsequent conservative, including medication, treatment, taking into account the type of stone formation and the presence of metabolic disorders in the child, which will significantly improve the quality of life and prognosis.
Key words: мочекаменная болезнь, конкременты в почках, дети
ANALYSIS OF THE MAIN ELECTROCARDIOGRAPHIC PATTERNS IN CHILDREN WITH COVID-19 IN THE ACUTE PERIOD OF THE DISEASE ACCORDING TO DATA FOR 2021-2022
Litvinova A.A., Sokolovskaya V.V., Litvinova I.A., Krikova A.V., Kozlov R.S.
UDC: 616.98:576.858-053.2
Abstract: Objective. To analyze the main ECG indicators in pediatric patients undergoing inpatient treatment for a new coronavirus infection for the period 2021-2022. Methods. A retrospective analysis of data from archival medical histories of patients aged 0 to 18 years with a diagnosis of "new coronavirus infection" was carried out. The study was conducted on the basis of the Clinical Hospital N1 in Smolensk. After applying the inclusion and exclusion criteria, 135 case histories were included in the analysis. The main ECG indicators were studied. Changes in normal ECG patterns and leading pathological ECG syndromes were revealed. Results. ECG syndromes of "right ventricular stress" were revealed: atrial prong P - 5.9% of cases, high R, small S in V1 - 20%, deep S in V5, V6 - 11.8%, depression ST - 6.7%, violation of intraventricular conduction along the lower wall - 7.4%, signs of pancreatic myocardial tension - 10.4%, signs of metabolic disorders of the pancreatic myocardium - 2.2%, violation of intraventricular conduction by right bundle-branch - 5.2%, diffuse decrease in recovery in the pancreatic myocardium - 2.9%. Rhythm disturbances were diagnosed: sinus arrhythmia (n=65), sinus bradycardia (15.3%), extrasystoles by the type of atrial bigeminia (1.5%), single atrial extrasystoles (0.7%). 1 patient had a grade I AV block. A polyphocus atrial rhythm was registered in 17 patients. Conclusions. The results obtained allow us to note the high incidence of cardiovascular system damage in children with COVID-19. Holter ECG monitoring is recommended for patients with changes in normal ECG patterns during the acute period of the disease.
Key words: новая коронавирусная инфекция, COVID-19, ЭКГ, сердечно-сосудистые осложнения
ARTIFICIAL TERMINATION OF LATE PREGNANCY: OWN EXPERIENCE IN THE CONTEXT OF THE EVOLUTION OF THE METHOD
Pokusaeva V.N., Fofonova I.Yu.I., Lvova P.O., Fridman T.Yu.I.
UDC: 618.33:618.39-085.2/.3
Abstract: Objective. To assess the efficacy and safety of medical abortion in the 2nd trimester. A detailed analysis of the medical, social and legal aspects of late pregnancy termination, the effectiveness of various methods of artificial abortion in maintaining the reproductive potencity of women planning to childbearing was carried out. Methods. The study part includes 76 patients at 12 + 0 - 21 + 6 weeks of pregnancy: 70 - with termination of pregnancy due to fetal pathology, 6 - due to the risk to life and health of the mother. Pregnancy was terminated by drug-induced (61 - 80.2%) and surgical (15-19.8%) methods: hysterotomy (3 - 3.9%), dilation and evacuation (5 - 6.6%), curettage after taking antiprogestins (7 - 9.2%). Results. Medical interruption was successful in 57 of 61 (93.4%) patients. In 10 patients with a scar on the uterus, a medical abort was successful: 8 (80.0%) had a complete abortion, 2 (20.0%) had an ineffective attempt to end with dilation and evacuation. The lack of effect of medication was noted in 4 (6.6%) women: 2 were nulliparous and 2 had a scar on the uterus after a planned caesarean section. All cases of surgical termination of pregnancy led to the simultaneous termination of pregnancy. A serious complication (bleeding that required uterine extirpation) was reported in a female patient with a surgical abortion that followed an ineffective attempt of medical interruption. The average hospitalization term was 7,6±1,2 for surgical and 6,7±0,4 for medical abortions (p<0.05). Conclusion. Medical termination of pregnancy is an effective and fairly safe method of artificial abortion in the 2nd trimester, including scared uterus. The clinical failure rate did not exceed 7%. The length of stay in the hospital was a day shorter than with surgical abortion.
Key words: медицинские показания, прерывание беременности, деторождение
RESULTS OF SURGICAL TREATMENT OF CATARACT AND APHAKIA WITH INTRAOCULAR CORRECTION IN CHILDREN AND ADOLESCENTS
Mogilevtsev V.V., Belkova A.G., Sharshkova M.A., Lyamets L.L.
UDC: 617.741-004.1-089-053.2
Abstract: Objective. To research the effectiveness of surgical treatment of paediatric patients (children and adolescents) from cataract and aphakia of various etiologies with intraocular correction based on the materials of the Children's Ophthalmology department of the OGBUZ SOKB and the Department of Eye Diseases of the SSMU. Methods. Forty-six paediatric patients (children and teenagers) (52 eyes) aged from 1.5 to 16 were observed (the average age is 5.6 years). Congenital cataract was diagnosed in 31 (59.6%) cases, post-traumatic cataract - in 16 (30.8%) cases, monocular aphakia - in 5 (9.6%) cases. The average age of children with congenital cataract and aphakia was 3.8 years, in case of post-traumatic cataract - 9.4 years. Gender distribution: 27 (58%) boys and 19 (42%) girls. Surgical treatment of cataract (phacoaspiration, excision of membranous cataract) and aphakia with implantation of intraocular lens (IOL) was carried out for all children. During the operations, we implanted 26 rigid IOLs (MNTK Eye Microsurgery manufactured, Russia) and 26 elastic IOLs made of hydrophilic acrylic (Rayner, UK and Bausch&Lomb, USA). Before the operation, we used the pattern for calculation of IOLs in children, which was developed in the MNTK «Eye Microsurgery». The refraction of the target was emmetropia in the postoperative period. Results. In all cases phacoaspiration of cataract was carried out using a Simcoe cannula through a corneal paracentesis of 1 mm. During the implantation of rigid IOLs, we put uninterrupted suture to the corneal incision by 10/0 Pirsu method, which was due to the size of the optical part of the IOL (6.0 mm). In case of implantation of elastic IOLs, the operations were performed without suturing. In the presence of the opacity of the posterior lens capsule in the optical zone, we performed posterior capsulorhexis intraoperatively (13 cases out of 52 (25%)). During the follow-up period for 1 year, the development of secondary cataract was detected in three cases (5.8%). There were no cases of IOL dislocation. The level of postoperative inflammatory reaction was no more than 0-I grade, according to the classification of N.V. Perova. In one case, the hyphema was noted. The period of hospitalization proceeded 5 days. By the time of discharge, the maximum corrected visual acuity (MCVA) ranged from 0.02 to 1.0. In case of post-traumatic cataract MCVA was 0,4; in patients with congenital cataract - 0,26. In most cases, rather low visual acuity was connected with the presence of amblyopia. It was the base for the recommendation of pleoptic treatment. During the control examination after 1 year, 29 patients out of 36 (81%) with congenital cataract and aphakia, as a result of surgical and conservative treatment, restored the normal development of visual acuity according to the age of the children. Binocular vision was repaired in 36 out of 46 (78%) children during the observation period. Conclusion. The results prove a high efficiency of intraocular correction in children and adolescents with cataract and aphakia of various etiologies. The calculation of IOL should be carried out based on emmetropia at the time of surgery in order to form optimal conditions for the treatment of amblyopia and the restoration of monocular and binocular visual functions. The opacity of the posterior capsule of the lens in the optical zone is an indication for intraoperative posterior capsulorexis.
Key words: факоаспирация, детский возраст, интраокулярная линза, амблиопия
RECONSTRUCTIVE SURGERY FOR BURN CONSEQUENCES OF THE CHIN, NECK AND BREAST IN WOMEN
Shaymonov A.Kh.
UDC: 617.53-001.17
Abstract: Objective. Optimization of combined treatment of female patients with consequences of chin, neck and chest burns. Material and methods. The study included 12 women with the consequences of isolated high temperature lesions of the chin, neck and chest, who were admitted to the departments of reconstructive surgery and plastic microsurgery in the period from 2010 to 2020. The mean age of the patients was 24.3±2.1 years. Results. Five-flap plastic surgery was applied in 4 cases, while the Butterfly technique was used in five cases. There was a significant reduction in the time spent on surgical intervention, due to the absence of the need to isolate the tissues of the free flap, as well as its transplantation at the site of scar excision. Among 9 cases of local plasty, suppuration was noted only in one case, and was eliminated by drainage of the subflap space, followed by the use of antibacterial drugs and hypertonic saline. In two cases, marginal necrosis was observed, which was eliminated by loosening the tension, removing some of the sutures, and applying heparin ointment. Functional outcomes, including the degree of head rotation, limited nodding movements, and other activity in the surgical area, showed good results in all cases. Conclusion. The data obtained indicate a high efficiency of the use of five-flap plasty and reconstruction using the Butterfly technique to eliminate post-burn contractures and neck scars. The use of free flaps often not only does not bring positive results, but also significantly aggravates the general condition of the affected tissues.
Key words: последствия ожогов, восстановительная хирургия, свободный лоскут, местная пластика
FREQUENCY OF ESOPHAGEAL-INTESTINAL STENOSIS DEPENDS ON THE METHOD OF ITS FORMATION DURING GASTRECTOMY
Novikov D.S., Soloviev V.I., Zuj V.S.
UDC: 616-006.6
Abstract: Objective. To analyze the frequency of the development of stenosis of the esophago-intestinal anastomosis depending on the method of fistula formation during gastrectomy. To study the methods of treatment and their effectiveness. Methods. Medical documentation (medical histories, outpatient charts, operating logs, journals of the endoscopic department) has been thoroughly studied. An Excel spreadsheet processor was used to automate statistical calculations. Absolute and relative frequencies (n, %) were calculated for qualitative indicators. N quantitative indicators, the average values and their corresponding standard errors were calculated. Results. The study group included 211 patients who underwent surgical intervention (gastrectomy) for stomach cancer, in OGBUZ “Smolensk Regional Oncological Clinical Dispensary" in 2016-2020 at the age of 39 to 75 years, who were divided into 2 groups: in the first group (n = 114), gastrectomy ended with the imposition of anastomosis according to Gilyarovich-Segal. In the second group (n = 97), surgical intervention was performed with the imposition of a Davydov anastomosis. Analysis of statistical data has shown equal susceptibility to stomach cancer by gender. The average age of patients in the first group was 61.8±9.5 years, in the second group - 64.8±8.4 years. Complications in the form of esophageal-gastric stenosis in the first group of patients amounted to 18.4% (n = 21), while men had this complication in 10.5% of cases (12 people), and women in 7.9% of cases (9 people). In the second group, stenosis was observed in 8.2% (n = 8), while in men the incidence of the pathology was 5.2% (5 people), and in women - 3.1% (3 people). Thus, when applying an anastomosis according to Gilyarovich-Segal, a complication in the form of esophageal-gastric stenosis is observed by 2.2 times more often than when applying an anastomosis according to Davydov. As a conservative treatment, augmentation was performed in 29 patients with esophageal-intestinal anastomosis stenosis. No complications were noted. Conclusion. The optimal choice of the method of anastomosis formation should be considered the leading measure of stenosis prevention. The use of an anastomosis according to Davydov will significantly reduce the likelihood of developing stenosis.
Key words: гастрэктомия, анастомоз, стеноз пищеводно-желудочного соустья
ECONOMIC EFFECT OF THE SURGICAL STAGE OF TREATMENT OF PATIENTS WITH COLORECTAL CANCER IN THE SMOLENSK REGION
Ivanova A.I., Soloviev V.I., Zuy V.S.
UDC: 616-006.04
Abstract: Objective. To study the economic damage from colorectal cancer in the Smolensk region in 2019-2020. Methods. We have thoroughly studied 537 case histories of patients of the surgical department of the Smolensk Regional Oncological Clinical Dispensary. The work used information from the official accounting and reporting medical documentation of the Smolensk region, available in the OGBUZ SOOKD. The patients were divided into groups depending on age, gender, stage of the process and were comparable according to these criteria. Statistical processing of the results was carried out using an Excel spreadsheet processor. Results. In 2019-2020, the economic damage from colorectal cancer (CRC) during a two-stage operation (obstructive resection, colostomy closure) amounted to 14878337 rubles (23810195 rubles - 8931858 rubles), while from a three-stage operation (obstructive resection, colostomy, colostomy closure) - 42248414 rubles - (51180272 rubles - 8931858 rubles). The difference in the amount of costs is explained by the conduct of surgical interventions to a large number of patients with complicated CRC. Conclusion. The necessity of diagnosing malignant neoplasms of the colon and rectum in the early stages has been revealed, which will reduce the economic costs of treatment by 6.4 times. These data determine the need to invest in the prevention, early diagnosis and treatment of oncological diseases. Such investments can provide a significant economic effect in the long term, contributing to economic growth.
Key words: колоректальный рак, экономический ущерб, ранняя диагностика
HEPATOCELLULAR CARCINOMA: REVIEW AND CLINICAL CASE
Yashin S.S., Fedorina T.A., Melikdzhanyan M.V., Serdobolskaya Yu.V., Zakhardyaev Yu.V., Dushkin A.A.
UDC: 616.36
Abstract: Objective. To study the causes and factors of carcinogenesis leading to the development of hepatocellular cancer. To study the mechanisms of its occurrence. To analyze the diagnostic possibilities of this pathology that exist today. To consider the treatment options for hepatocellular carcinoma currently used in practical medicine. Methods. This article used publications from the scientific electronic library "CyberLeninka", educational and methodological manuals printed for 2018-2019 and the results of pathoanatomical and microscopic examination of preparations. Results. As a result of the study, conducted mainly on the basis of data obtained from sources of domestic authors, it can be concluded that hepatocellular carcinoma is of great scientific interest for research, which in the future may open up new, more advanced diagnostic and therapeutic possibilities Conclusions. Hepatocellular carcinoma is one of the leading pathologies of the liver, ranking 4th among the causes of cancer mortality. The study of this pathology is relevant, as the most effective and safe methods of treatment are being developed, one of which is the method of immunotherapy. The combination of immunotherapy with liver resection gives tumor regression in a quarter of cases.
Key words: гепатоцеллюлярный рак, гепатоцеллюлярная карцинома, печеночно-клеточный рак
DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING OF THE LIVER AND SPLEEN IN THE COMPREHENSIVE ASSESSMENT OF DIFFUSE LIVER DISEASES
Kovalev A.V., Morozova T.G., Lozbenev F.S.
UDC: 616.36-073.756.8
Abstract: Objective. To evaluate the possibilities of diffusion-weighted imaging of the liver and spleen with magnetic resonance imaging in the comprehensive assessment of diffuse liver diseases. Material and methods. From October 2019 to July 2022, a comprehensive clinical and diagnostic examination of patients was conducted in the gastroenterology department of the OGBUZ "Clinical Hospital N1" (October 2019 - March 2020 - inpatient stage, April 2020 - July 2022 - outpatient stage). The study involved 179 patients with a variable etiology of diffuse liver diseases (PD). The study group consisted of 112 (67%) men and 67 (33%) women. Results. When comparing the results of laboratory studies and liver DWI data with MRI, it was found that against the background of therapy in 113 (63.1%) patients, positive dynamics was accompanied by a low signal for liver DWI with MRI, while 66 (36.9%) retained changes in laboratory data and a high signal with liver DWI. The presented group of patients was observed for three years and a high correlation was established between the size of the spleen and its MR signal according to the DWI data on admission: in the case of an increase in the size of the spleen, negative dynamics was noted - the progression of the process (n=73) (r=0.845), with normalization of the size of the spleen according to the MR study, clinical and laboratory parameters improved (n=106) (r=0.856). Conclusions. 1. When included in the MR protocol of the examination of the abdominal organs of the DWI, a qualitative assessment of the liver and spleen should be carried out, regardless of the etiology of the PD. 2. B-factor 800 (s/mm) (AUROC 0.954, CI 0.901-0.972) should be evaluated for liver DWI during MRI in patients with PD (AUROC 0.986, CI 0.963-0.917), for spleen DWI - b-factor 1000 (s/mm) (AUROC 0.986, CI 0.963-0.917). 3. A high correlation was noted in the assessment of the favorable and unfavorable course of DZ according to the DWI of the spleen during MRI (r=0.8).
Key words: диффузионно-взвешенное изображение, магнитно-резонансная томография, печень, селезенка
SUBSTANTIATION OF CHOICE OF VISUAL DIAGNOSTICS METHODS INCLUDING ASL MR PERFUSION IN PATIENTS WITH DIFFUSE LIVER DISEASES AND NEW CORONAVIRUS INFECTION COVID-19 (MIDTERM RESULTS)
Telesh A. A., Morozova T.G.
UDC: 616-079.5
Abstract: Objective. To substantiate the choice of visual diagnostics methods including ASL MR perfusion in patients with diffuse liver diseases and new coronavirus infection COVID-19. Method. There were 54 patients examined from June to December 2021. Clinical and laboratory data, severity of the lung involvement on the computer tomography (CT) were estimated in all patients. We conducted ultrasound examination with compression elastography of the liver (n=54). Magnetic resonance imaging (MRI) with ASL MR of the liver was conducted for 48 (89%) patients after discharging from hospital and during dynamic observation. CT of the abdomen was conducted for 15 (28%) patients for the purpose of detection of another disease. Results. Ultrasound examination shows efficiency of the first step of examination. Inflammatory changes in the liver were the reasons of false positive results of compression elastography in the acute period of the coronavirus disease and in the beginning of the recovery period. There was a decrease of volumetric hepatic blood flow according to ASL MR perfusion (n=48), there was the red type of color map (n=39). There was an increase of volumetric hepatic blood flow after 3-6 mounth. Conclusion. Ultrasound examination with color flow doppler is recommended for patients with diffuse liver diseases and new coronavirus infection COVID-19, when they are admitted to a hospital. Compression elastography is recommended to be used 3 months after the onset of the coronavirus disease. MRI with ASL MR of the liver is recommended for patients with diffuse liver diseases, who have suffered from coronavirus infection, 15 days and 3 and/or 6 month after discharging from hospital. MRI with ASL MR is recommended to use 3 months after discharging from hospital in patients who have the red type of color map on ASL MR 15 days after discharging.
Key words: диффузные заболевания печени, магнитно-резонансная томография, методика артериального спинового маркирования, коронавирусная инфекция
REVIEW OF RUSSIAN RECOMMENDATIONS FOR THE MANAGEMENT OF PATIENTS WITH INFECTIVE ENDOCARDITIS
Danilov A.I., Slivkin M.D., Fomin S.G., Shukil L.V.
UDC: 616.126-002-08
Abstract: Objective. To highlight the issues of diagnosis, antimicrobial therapy and surgical treatment of infectious endocarditis presented in the clinical recommendations of 2021. Methods. Based on the approved recommendations, the most pressing issues of the introduction of patients with infectious endocarditis are presented. Results. In recent decades, an increase in reported cases of infective endocarditis has been observed in many countries. The main reason for this trend is an increase in the number and change in the ratio of the main risk factors, among which the most important in most countries is currently injecting drug addiction and other conditions that contribute to the systematic violation of the integrity of the peripheral vascular bed. Despite the success achieved in the management of patients with infective endocarditis, the mortality rate for this disease remains quite high, amounting to more than 20% according to individual sources. Conclusions. The article highlights the issues of diagnosis, antimicrobial therapy and surgical treatment of infectious endocarditis, presented in the 2021 clinical guidelines for the management of patients with infectious endocarditis.
Key words: инфекционный эндокардит, микробиологическая диагностика, эхокардиография, антимикробная терапия
SORT IT OUT": THE IMPACT OF BREAST MILK HORMONES (LEPTIN, GHRELIN, INSULIN-LIKE GROWTH FACTOR-1, ADIPONECTIN) ON THE PHYSICAL DEVELOPMENT OF CHILDREN
Shpakovskaya K.S., Legonkova T.I., Shtykova O.N., Shilina N.M.
UDC: 616.62-003.7-053.2
Abstract: Objective. To study the peculiarities of the effect of breast milk hormones having a metabolic effect on the indicators of physical development of children in the first years of life as a predictor of the development of obesity. Methods. A review of the literature was carried out in order to provide updated information on the effect of leptin, ghrelin, insulin-like growth factor-1, adiponectin contained in breast milk on the growth and body composition of infants and children. Results. The data of the modern scientific literature on the influence of breast milk hormones with metabolic effect: leptin, ghrelin, insulin-like growth factor-1, adiponectin on the physical development of children in the first years of life as a predictor of obesity development are presented. The origin of milk hormones, mechanisms and ways of their penetration into the newborn's body, the impact on the health and further development of the child are considered. Conclusion. The review presents the data of modern scientific literature on the effect of breast milk hormones with a metabolic effect: leptin, ghrelin, insulin-like growth factor-1, adiponectin on the physical development of children in the first years of life, as a predictor of the development of obesity. The origin of milk hormones, the mechanisms and ways of their penetration into the newborn's body, the impact on the health and further development of the child are considered.
Key words: грудное молоко, гормоны, естественное вскармливание, ожирение
FACTORS AFFECTING THE DEVELOPMENT, COURSE AND PROGNOSIS OF VARIOUS TYPES OF HEADACHE
Klimov D.S., Maslova N.N., Malakhova Ju.A., Rakov A.M.
UDC: 616-009.8
Abstract: Objective. To make a systematic review of the literature for qualitative generalization of data on the role of factors affecting the development, course and prognosis of various types of headache. Methods. The review of the problem was based on a primary literature search over the past few years on the official website of the Medical Library (PubMed). Results. We analyzed 52 articles by mainly foreign authors. As we expected, headache is widespread all over the world. There is evidence to suggest that depression, anxiety, poor sleep, high body mass index, dyslipidemia, comorbidity, professional working conditions are potentially prognostic factors for cephalalgia. Conclusion. In our work we identified several significant factors affecting the possibility of occurrence, the nature of the course and prognosis of the disease. Most of them are modifiable. The information highlights the need for more thorough studies of prognostic factors in various types of headache, especially in the category of able-bodied population working in harmful or difficult conditions.
Key words: головная боль, распространенность, факторы риска, коморбидная патология, профессиональные условия труда
EPIDEMIOLOGICAL VIEW OF COMBAT-RELATED INJURIES INCURRED DURING ARMED CONFLICTS AND MEDICAL REHABILITATION OF COMBATANTS
Meshkov N.A.
UDC: [613.62+616-08]:355.292
Abstract: Objective. Study and epidemiological analysis of combat-related pathology, morbidity among combatants and peculiarities of their medical rehabilitation. Methods. The following bibliographic databases were used: PubMed, eLIBRARY and CyberLeninka. Statistical data processing was done with the help of Microsoft Office Excel 2016. We calculated odds ratios, relative risks and morbidity growth rates. Results. Statistical analysis of temporary casualties in Afghanistan (1979-1989) and the Chechen Republic (1994-1996 and 1999-2002) showed that limb injuries ranked first and abdominal injuries ranked second. Head injuries ranked third both in Afghanistan and in the Chechen Republic (CR) in 1994-1996, and chest injuries placed third in the CR in 1999-2002. The probability of limb injuries during Iraq operations (2001-2014) as compared with those in Afghanistan was 27.3; as compared with those in the CR, 2.47 for 1994-1996 and 2.17 for 1999-2002. The contribution of circulatory diseases to morbidity in Afghanistan was by 1.88 and 2.61 times higher than in the CR (1994-1996 and 1999-2002); that of respiratory diseases in the CR (1999-2002) was by 1.42 times higher than in Afghanistan. Combatants with brain injuries showed higher prevalence of genitourinary, circulatory and digestive diseases than the male population of the Russian Federation. The odds ratio of their growth was 21.19, 3.56 and 6.42, respectively. Conclusion. Analysis of temporary casualties and morbidity among combatants is an important part of medical rehabilitation planning. Analyzing likely consequences of combat-related injuries is the key to making the right choice between medical rehabilitation methods and developing individual rehabilitation programs.
Key words: участники боевых действий, ранения и травмы, заболеваемость, реабилитация
SPECTROPHOTOMETRIC ANALYSIS OF ATENOLOL IN THE NEW SOFT DOSAGE FORM «ATENOLOZOL»
Popova M.I., Kobeleva T.A., Sichko A.I., Shapovalova E.M.
UDC: 543.42.062:615.07
Abstract: Objective. To develop a spectrophotometric method for the analysis of atenolol in a new soft dosage form "Atenolozol" made on the basis of a titanium-containing gel. Methods. Atenolol pharmaceutical substance, «Tizol» gel, a soft dosage form «Atenolozol» containing 0,5 % of beta-adrenoblocker in a titanium-containing base were used for the analysis. The study was carried out by spectrophotometry in the near-ultraviolet region using the device SF-2000. The developed method was validated according to OFS.1.1.0012.15 according to the following parameters: specificity, linearity, precision, correctness. The results of the experimental work were statistically processed according to the requirements of the State Pharmacopoeia of the Russian Federation by methods of modern mathematical statistics (regression analysis), using Microsoft Excel. Results. When studying the absorption spectra of atenolol, we have found that it is reasonable to analyze the drug substance by spectrophotometry in the wavelength range of 275 nm. The sensitivity of determining atenolol was estimated through the opening minimum, which is 4.545 µg/ml. The content of the drug under study in the soft dosage form was established according to the equation of the graduation diagram. The study results showed that the mass of atenolol in the ointment «Atenolozol» is within the range of 0.0403-0.0436 g, which is permitted by the regulatory documentation for the soft dosage forms. Conclusions. According to the results of the study, optimal conditions for the spectrophotometric analysis were selected, on the basis of which the method of atenolol quantitative determination of «Atenolozol» ointment with the relative error not exceeding±1,70 % was developed and suggested.
Key words: атенолол, тизоль, спектрофотометрия, количественное определение, валидация
DEVELOPMENT OF A METHOD FOR THE DETERMINATION OF PREGABALIN BY PHOTOMETRY
Lust E.N., Endaltseva O.S.
UDC: 615.213:54.062:543.422.3
Abstract: Objective. Development of a method for determining pregabalin by photometry. Methods. The authors developed a method for the photometric determination of a derivative of gamma-aminobutyric acid, pregabalin, and validated the method. Results. The conditions for the formation of an ion associate were chosen: an acid dye (bromothymol blue solution), pH of the medium (7.0), the ratio of the reagent and analyte, and the spectral characteristics of the associate, analytical wavelengths (282, 416 nm) were also obtained. During the validation of the methodology, satisfactory results were obtained. The chromatographic method (thin layer chromatography method) proved the formation of an ion associate of pregabalin with an acid dye. Conclusions. The conditions for the analysis of pregabalin by the photometric method are proposed, the technique is suitable for the identification and quantitative determination of the substance.
Key words: Прегабалин, фотометрия, оптическая плотность, ионный ассоциат, кислотный краситель
INVESTIGATION OF THE GENERAL MINERAL COMPLEX OF MEDICINAL PLANT RAW MATERIALS OF THE SYNANTHROPIC FLORA OF THE ROSTOV REGION
Selivanova Yu.A., Dyakova N.A., Vervikina A.A., Slivkin A.I.
UDC: 615.322
Abstract: Objective. To study the content of the general mineral complex of medicinal plant raw materials of the synanthropic flora of the Rostov region using the example of the Morozovsky district. Methods. As the objects of the study, the grass of the mountain bird ( Polygonum aviculare L.), the grass of wormwood ( Artemisia absinthium L.), the grass of yarrow ( Achillea millefolium L.), the leaves of plantain large ( Plantago major L.) were used. Preparation of medicinal plant raw materials was carried out in urban communities of the Rostov region. Results. The most frequent excess of the norms in terms of the numerical indicator "Total ash" was noted for samples of common yarrow herb and leaves of plantain (in 13 out of 42 samples), which can be explained by the residual content of inorganic substances in the soil that give mineral ash residue during combustion, as well as quite high pharmacopoeic requirements for these types of raw materials. Analysis of average values of total ash content makes it possible to build from analysed types of medicinal vegetal raw materials their sequence in order of reduction of content of total mineral complex: yarrow herb > leaves of plantain > wormwood herb > highlander herb. Conclusion. The content of total ash is determined as an indicator of the content of the total mineral complex and an indicator of contamination of medicinal vegetal raw materials with dust particles in six objects collected in the terms of harvesting in various urbocenoses of the Rostov region regulated by regulatory documentation. Permissible distances for collection of medicinal vegetal raw materials are established.
Key words: общая зола, Ростовская область, Polygonum aviculare L, Artemisia absinthium L, Achillea millefolium L, Plantago major L
STUDY OF THE PLATELET AGGREGATION UNDER THE INFLUENCE OF CARRAGEENANS OF THE RED ALGAE
Begun M.A.
UDC: 615.322
Abstract: Objective. Study of the effect of λ- and κ-carrageenans isolated from the red alga Chondrus armatus and their depolymerized derivatives on adenosine diphosphate (ADP)-induced platelet aggregation in experiments in vitro and in vivo . Methods. For in vitro experiments, platelet-rich plasma (PRP) obtained from the whole blood of healthy volunteers was incubated with analyzed polysaccharide samples (at concentrations of 0.05; 0.5; 1; 2 mg/ml) for 5 minutes at 37 °C. The resulting mixture was placed in a cuvette of a Biola aggregometer (Russia), and an inductor (ADP, final concentration 5 μg/mL) was added 10 seconds after the start of the measurement. The degree of aggregation was estimated from the light absorption curve (in %). When conducting in vivo studies, outbred male mice were orally administered solutions of the analyzed polysaccharides and the reference drug (acetylsalicylic acid) for 7 days. On day 8, blood was taken by heart puncture, PRP was obtained, for which ADP-induced platelet aggregation was measured according to the previously described method. Results. The studied samples of carrageenans at concentrations of more than 0.5 mg/ml reduced the degree of platelet aggregation. The fraction of κ-carrageenan caused a change in the level of aggregation by more than 50% only in the native form at a concentration of 2 mg/ml. While λ-carrageenan and its hydrolyzed derivative reduced the degree of platelet aggregation by more than 60% at a concentration of 0.5 mg/ml. The dose-dependent nature of the effect was noted. In experiments in vivo , there was a significant change in platelet aggregation when using the depolymerized form of λ-carrageenan (p<0.05), but the effect shown did not exceed the effect of the positive control. Conclusion. The ability of carrageenans isolated from the algae C. armatus and their depolymerized derivatives to change the functional activity of platelets is determined by the structural features of the molecule. A more pronounced antiaggregant effect is exhibited by λ-carrageenan and its depolymerized derivative - samples with a higher degree of sulfation, in comparison with the κ-fraction. The functional activity of platelets upon oral administration is reduced only by depolymerized λ-carrageenan.
Key words: сульфатированные полисахариды, каррагинан, биологическая активность, агрегация тромбоцитов
MICROSCOPIC RESEARCH OF THE HERB V. KREСZ
Sokolova Ya.V., Mirovich V.M.
UDC: 615.322+582.949.2+581.8
Abstract: Objective. Study of anatomical and diagnostic features of the herb Leonurus deminutus V. Kreсz. and their quantitative characteristics. Methods. The stems, leaves and flowers of L. deminutus blooming in the Irkutsk region and the vicinity of Irkutsk in July 2021 were used as the object of the research. Preparation of surface preparations and cross sections was carried out in accordance with the requirements of the OFS.1.5.3.0003.15 of the State Pharmacopoeia of the XIV edition. The study was carried out using a digital microscope «Levenhuk D870T», anatomical and diagnostic features were recorded with a built-in camera, the images were processed in the program «Levenhuk ToupView (Levenhuk Image Editor) 3.7.». Results. The distinctive microscopic features the herb of L. deminutus have been established: epidermal cells with a characteristic low and strongly sinuous walls on leaves and flowers, four-cell glandular trichomes, capitate trichomes with a rounded head in all structures, capitate trichomes oval head on the sepals, multicellular trichomes from the falling cells on the upper lip of the flower, the presence of prism crystals of calcium oxalate in the structures of the corolla and round pollen with a groove in the middle. Conclusion. The conducted research can be used to establish the authenticity of medicinal plant raw materials, as well as to develop regulatory documentation for the introduction of the herb L. deminutus into pharmaceutical practice.
Key words: микроскопия, Leonurus deminutus V. Kreсz, анатомо-диагностические признаки, лекарственное растительное сырье
DEVELOPMENT OF A METHOD FOR THE QUANTITATIVE DETERMINATION OF THE HERB ASTRAGALUS MEMBRANACEUS L
Labkovskaya M.V., Kurkin V.A., Shmygareva A.A., Sankov A.N.
UDC: 615.322: 582.736: 615.07
Abstract: Objective. Development of a technique for quantitative determination of the amount of flavonoids in the herb Astragalus membranaceus L. Methods. The objects of the study were samples of the grass astragalus woolly ( Astragalus membranaceus L.) produced by LLC "Company Horst", Russia, Barnaul, 2021; LLC "Russian Roots", Russia, Rostov region, 2020; LLC "Vita", Russia, Barnaul, 2021. Electronic spectra were measured using a UNICO 2800 UV spectrophotometer, Vilitek VBS ultrasonic bath, LAB-TB-6/Sh water bath, IR-1 LT rotary evaporator. Results. In the present article, a new method for quantifying the amount of flavonoids in terms of hyperoside is proposed for the raw materials of Astragalus membranaceus ( Astragalus membranaceus L). This method is based on the use of extraction of biologically active substances in the vacuum boiling mode. When using this method, the maximum content of the total flavonoids (calculated on hyperoside) was 4.80%. The proposed method is simple in execution and requires minimal time for analysis and provides the maximum possible extraction of active substances. Conclusions. In the process of developing a methodology for the quantitative determination of active substances for the herb of Astragalus membranous , optimal conditions for extracting raw materials were selected, significantly increasing the output of flavonoids from raw materials with minimal time spent on the study.
Key words: астрагал перепончатый, Astragalus membranaceus L, флавоноиды, гиперозид, стандартизация, спектрофотометрия
CHARACTERISTICS OF THE PHARMACY SECTOR AND THE ACTIVITIES OF PHARMACIES IN THE KINGDOM OF MOROCCO
Guryanov P.S.
UDC: 615.12
Abstract: Objective. To study the pharmacy sector and the rules for the operation of pharmacies in Morocco to improve Russian pharmaceutical education for Moroccan citizens. Methods. Studying of policy documents of the national pharmaceutical policy of Morocco, regulatory documents regulating the pharmaceutical industry, scientific papers about pharmaceutical sector in Morocco, expert assessments of local industry experts. Results. The rules for the operation of pharmacies in Morocco have significant differences from Russian ones: chains are prohibited; the pharmacist is the owner of his or her pharmacy; minimum area is 24 sq.m.; distance between pharmacies is at least 300 meters; the assistant pharmacist does not have a pharmaceutical education; in large cities, it is forbidden to work at night, on Sundays and on holidays, except once a month, when the pharmacy is on duty; drug prices and margins are fixed; drugs for the treatment of the digestive system are most in demand (21.8% of the market in packages); the main regulatory document regulating the industry is Dahir (Royal Law) 17-04 "Code of Medicines and Pharmacy" 2006; pharmacies opened before the adoption of the new regulation are governed by the old legislation. The assortment of pharmacies differs from the Russian one: abortion drugs are prohibited; extemporaneous medicines are divided into trunk, official, specialized, hospital; personal hygiene products and cosmetic products contain biologically active substances and are classified as medicines; through pharmacies, the sale of chemical reagents is allowed. Conclusion. For the growing economy of Morocco, it is necessary to train an increasing number of pharmaceutical specialists, which can be carried out by Russian universities. At the same time, it is necessary to familiarize with the peculiarities of the sector regulation, which has significant differences from Russian practice. In addition to the traditional orientation of Moroccan citizens to work in a pharmacy, Russian universities should prepare Moroccans for work in the industrial pharmaceutical sector, since the pharmacy sector shows signs of oversaturation and an economic crisis in large cities of Morocco.
Key words: аптека, Марокко, фармацевт, лекарства, правила, регулирование
ANALYSIS OF ELEMENTS OF SOCIAL RESPONSIBILITY OF PHARMACEUTICAL COMPANIES
Mezentseva E.S., Khabibova M.R.
UDC: 615:658
Abstract: Objective. To study the elements of the concept of social responsibility of business in pharmaceutical companies. Methods. In the frame of the study, the authors conducted a content analysis of open materials posted on the official websites of pharmaceutical companies. The objects of the study were 30 pharmaceutical companies included in the ratings of analytical agencies in 2020-2021. The top 10 Russian pharmaceutical companies, the top 10 manufacturers of medicines by value in the Russian pharmaceutical market and the top 10 pharmaceutical companies by global market revenue were selected for the analysis. The subject of the study was the elements of the concept of social responsibility of pharmaceutical business (according to Bratishko Yu.S.). Results. Information about social responsibility was available on the websites of all studied companies. The most complete information about the social responsibility of business in the top 10 Russian companies was provided only by 20% of companies. The top 10 pharmaceutical companies of global market revenue have a similar indicator reaching 100%. The comparative analysis of the websites of Russian and foreign pharmaceutical companies revealed significant differences in the information content of the components of social responsibility of business. Russian companies are less concerned about posting information about the sustainable development and social responsibility of business, focusing on the quality of goods, charity and internal responsibility. Foreign companies are more focused on the agenda of environmental sustainability and protection of human rights (including inclusion). Conclusion. The analysis made it possible to study the main elements of the concept of social responsibility of pharmaceutical business, to establish differences in the published information of Russian and foreign pharmaceutical companies.
Key words: корпоративная социальная ответственность, устойчивое развитие, производители лекарственных препаратов, анализ сайтов
PROBLEMS OF PRODUCT IDENTIFICATION - MINERAL WATER
Maleeva T.L., Novikova N.V., Goncharova Yu.M.
UDC: 615.15
Abstract: Objective. The purpose of the article is to summarize the requirements of legal documents regulating the term and definition of "mineral waters", their classification, as well as to systematize the requirements for labeling mineral waters. Methods. The objects of study were normative legal acts that reflect the requirements for the circulation of mineral waters in the territory of the Russian Federation, as well as methodological recommendations for their use in the treatment and prevention of diseases. Logical methods were used: analysis, comparison and grouping. Results. The regulatory legal framework that regulates the circulation of mineral waters on the territory of the Russian Federation, including the regulatory documents of national legislation and the Eurasian Economic Union, has been studied. Classifications of mineral waters are given by purpose, by mineralization, by chemical composition, by application, by degree of saturation with carbon dioxide. Information on classifications of mineral waters according to various characteristics and requirements for labeling of mineral waters was systematized and generalized. Conclusion. The study revealed a lack of uniformity of terminology for the designation of the commodity group "mineral waters". It has been established that "mineral waters" used in the Federal Law "On the Circulation of Medicines" should be understood as "natural mineral waters". The obtained materials will allow specialists of pharmacy organizations to correctly identify mineral waters during their purchase, check the compliance of their labeling and quality with mandatory requirements during acceptance control and subsequent sale.
Key words: природная минеральная вода, аптечные организации, классификация, маркировка пищевой продукции