DYNAMICS OF HEMATOLOGICAL INDICES IN RATS WITH METABOLIC SYNDROME DURING REPARATIVE OSTEOGENESIS
Makarova M.V., Lyashev Yu.D., Shevela T.L.
UDC: 612.11
Abstract: Objective. The aim of the study was to assess hematological indices dynamics in experimental rats with metabolic syndrome during the low jaw defect repairement. Methods. Experimental rats were given a high-fat, high-carbohydrate diet for 12 weeks for metabolic syndrome simulation. Development of metabolic syndrome was confirmed by measuring body weight, plasma glucose, and triacylglycerol levels before and after the diet. The low jaw defect was simulated using Grigoryan A.S. et al. method. Hematological indices were assessed on the 7th, 14th, 21st, and 28th days postoperatively. Results. Development of metabolic syndrome in the rats was accompanied by significant changes in four indices studied, 3 ones (the Bredeck index, the lymphocyte-eosinophil ratio, and the leukocyte index) were decreased, and the Krebs cycle was increased. Significant differences in the indices were observed on the 7th and 14th days postoperatively in experimental animals with the low jaw defects compared to the naïve group: an increase in the Krebs cycle and neutrophil-to-monocyte ratio, a decrease in the Bredeck index and leukocyte index on the 7th day, and an increase in the Krebs cycle, a decrease in the leukocyte index and in the lymphocyte-to-eosinophil ratio on the 14th day. Significant changes in indices were identified primarily on the 14th and 21st days in experimental rats with metabolic syndrome and the low jaw defects compared to the control group. Conclusion. Development of metabolic syndrome in experimental rats was accompanied by meta-inflammation, evidenced by changes in the Krebs cycle, Bredeck index, and leukocyte index. Changes in the neutrophil-to-macrophage ratio indicate the involvement of the microphage component in the early stages of the low jaw defect repairement, and the macrophage component during the stage of active bone formation. The dynamics of the leukocyte index confirms involvement of immune mechanisms in the process of reparative osteogenesis in lower jaw defects.
Key words: метаболический синдром, репаративный остеогенез, гематологические индексы, лейкоциты
PSYCHOPHARMACOLOGICAL PROFILE OF 2-ETHYLTHIOBENZIMIDAZOLE SUCCINATE IN HEALTHY VOLUNTEERS
Ovanesov K.B., Orlov A.I., Buznik G.V., Shabanov P.D.
UDC: 612.821
Abstract: Objective. The study was aimed at investigation of psychopharmacological properties of the antihypoxant 2-ETBI-YAK in healthy volunteers using computerized light and color perception testing and questionnaires, including the Hospital Anxiety and Depression Scale (HADS), the Spielberger-Khanin Anxiety Test (State-Trait Anxiety Inventory), the Well-Being, Activity and Mood Test (WAM), the A.R. Luria 10-Word Test (Luria memory words test) to assess short-term memory parameters, and the Landoldt rings test. Methods. The study involved 290 men and women aged 20-25 years trained at medical universities in St. Petersburg, without known bad habits, visible physical and mental deviations, without severe acute and chronic diseases. All individuals were asked to complete 2 types of testing to identify anxious and depressive personality traits - the HADS test (Hospital Anxiety and Depression Scale) and the Spielberger-Khanin anxiety test. Based on the obtained results, 89 people had signs of accentuation of anxious, depressive and anxious-depressive states. From these individuals, 4 groups were further formed: 1) "control" - individuals with clinically expressed anxiety and subclinical depression (n=19); 2) "anxiety" - individuals with clinically expressed anxiety, but without depression (n=40); 3) “depression” - individuals without anxiety, or with a subclinical level of anxiety, clinically and subclinically expressed level of depression (n=16) and 4) “anxiety+depression” - individuals with clinically expressed anxiety and depression (n=14). Individuals of the 1st group received placebo, the 2nd, 3rd and 4th groups - 2-ETBI-SUC. Tests were conducted three times: 1) before the study, 2) 1 hour after taking a single 250 mg oral dose, and 3) after 2 weeks of administration of 1 250 mg capsule twice daily, morning and evening, 1 hour after the last dose. Results. Psychopharmacological effects of 2-ETBI-SUC were evident after both taking a single dose and having a course of treatment. They resulted in improved higher brain functions (increased concentration, attention span, and working memory) and optimization of emotional state, including a reduction in anxiety and depression. The effects varied somewhat between the study groups, being most pronounced in the "anxiety" and "depression" groups. Conclusions. 2-ETBI-SUC can be considered and, therefore, positioned as both an antihypoxant and a nootropic-like compound, similar in psychopharmacological effects to classical nootropics.
Key words: антигипоксанты, 2-этилтиобензимидазола сукцинат, психофармакологические свойства, здоровые добровольцы
VIEWS OF DOCTORS OF THE BRYANSK REGION ON ANTIMICROBIAL CHEMOTHERAPY FOR COMPLICATED URINARY TRACT INFECTIONS
Kuleshov A.A., Danilov A.I., Evseev A.V., Konovalov I.V.
UDC: 615.9
Abstract: Objective. The aim of the study was to assess awareness of medical doctors in the Bryansk region of antimicrobial chemotherapy for complicated urinary tract infections. Methods. The study involved an anonymous medical doctors’ survey concerning administration of antimicrobial chemotherapy for complicated urinary tract infections. Results. The study included 114 medical doctors woking both a out-patient and in-patients departments. The majority of respondents were urologists (34.2%), internists (29%) and obstetrician-gynecologists (18.4%). Conclusions. Despite clinical recommendations, the problem of choosing therapy for urinary tract infections is complicated in the context of growing antibiotic resistance. The issue is crucial in patients with complicated urinary tract infections who undergo multiple courses of often irrational antimicrobial therapy, hospital readmissions and invasive urological interventions, resulting in increased risks of resistant strains selection.
Key words: осложненные инфекции мочевыводящих путей, респонденты, информированность врачей, антимикробная терапия
ETIOLOGICAL STRUCTURE OF NOSOCOMIAL BACTERIAL INFECTIONS: CURRENT STATE OF THE ISSUE
Vinogradova A.G., Kuzmenkov A.Yu.
UDC: 616.9-022.36:615.015.8
Abstract: Objective. The aim of the study performed was to summarize current data on the etiological structure of nosocomial infections, identify their major clinical forms, the most significant pathogens, and primary trends in antibiotic resistance. Methods. Russian and international publications devoted to the prevalence, clinical forms, etiological structure, and antibiotic resistance of pathogens causing nosocomial infections have been analyzed in the study. The review included data on multicenter studies, systematic reviews, meta-analyses, and epidemiological surveillance reports reflecting the current state of the problem in different world regions. Results. Major clinical forms of nosocomial infections have been shown to be respiratory tract infections, urinary tract infections, surgical site infections, and bloodstream infections. The greatest burden of these infections affects Intensive Care Units. Gram-negative microorganisms, primarily Escherichia coli , Klebsiella spp., Pseudomonas aeruginosa , and Acinetobacter spp., have been found to predominate in the current etiological structure of nosocomial infections. At the same time, contribution of individual pathogens varies depending on the clinical form of infection, the profile of the department, and the characteristics of the patient population. Thus, the general trend is an increasing role of multidrug-resistant gram-negative pathogens, particularly in infections developing in Intensive Care Unit patients. Conclusion. Current etiological structure of nosocomial infections is characterized by the predominance of gram-negative pathogens and increasing antibiotic resistance. Study of these patterns is of fundamental significance for improvement of epidemiological monitoring, effectiveness of infection control, and optimizing rational administration of antimicrobial drugs.
Key words: нозокомиальные инфекции, этиологическая структура, антибиотикорезистентность, грамотрицательные микроорганизмы
DRUG NECROSIS OF THE JAW AS A COMPLICATION OF ANTIRESORPTIVE THERAPY
Yatskina A.V., Danilov A.I.
UDC: 616.9
Abstract: Objective. To provide information on the potential risk of developing drug-induced jaw necrosis on the background of antiresorptive therapy. Methods. A review of the literature using domestic and foreign databases of scientific literature for the period 2007-2026 was carried out. The selected papers are devoted to the pathophysiology of drug-induced jaw necrosis, the pharmacokinetics of bisphosphonates, their effect on kidney function, calcium-phosphorus homeostasis, markers of bone resorption, and drug interactions. Results. Bisphosphonates are characterized by a terminal elimination half-life of up to 10 years and accumulation in bone tissue. The duration of therapy of more than 36 months directly correlates with the severity of osteonecrosis. Drug interactions with glucocorticosteroids, proton pump inhibitors, and loop diuretics potentiate the risk. Conclusions. The pharmacokinetic profile of bisphosphonates, characterized by accumulation in bone tissue and a terminal elimination half-life of up to ten years, is a fundamental risk factor for drug-induced osteonecrosis of the jaw. Renal failure with a decrease in glomerular filtration rate below 60 ml/min is a critical modifiable risk factor.
Key words: медикаментозный некроз челюсти, антирезорбтивная терапия, фармакокинетический профиль, лекарственные взаимодействия
PROMISING AREAS OF DRUG THERAPY FOR TUBERCULOSIS
Kuleshova Yu.A., Slivkin M.D., Konovalov I.V.
UDC: 616.9
Abstract: Objective. To study the directions of drug therapy for tuberculosis. Methods. As part of the study of modern sources, information is provided on the problem of Mycobacterium tuberculosis resistance, and topical drugs for tuberculosis are presented. Results. One of the serious problems of modern phthisiology is the increase in the incidence of tuberculosis caused by drug-resistant strains of Mycobacterium tuberculosis . Diagnosis of Mycobacterium tuberculosis drug resistance in each tuberculosis patient allows us to select the optimal regimen of anti-tuberculosis drugs that ensure high treatment effectiveness. Conclusions. The determination of Mycobacterium tuberculosi s drug resistance is a crucial factor for choosing the optimal tuberculosis chemotherapy, prognosis and timely treatment correction, and also serves as an important indicator of the epidemiological tension of tuberculosis in individual regions or even nationwide.
Key words: туберкулез, Mycobacterium tuberculosis, противотуберкулезные препараты, лекарственная устойчивость
EVALUATION OF CERTAIN HEMODYNAMIC INDICATORS IN MIDDLE-AGED, ELDERLY, AND SENILE PATIENTS BASED ON THE RESULTS OF A COMPREHENSIVE GERIATRIC EXAMINATION
Golovanova E.D., Gaikova A.V., Safrutina V.N.
UDC: 616-053.9
Abstract: Objective. The aim of the study was to evaluate hemodynamic parameters and their relationship with functional status indicators in middle-aged, elderly, and senile patients based on the results of a comprehensive geriatric assessment and bioimpedancemetry. Methods. The study involved 55 individuals: Group 1 <60 years (n=18); Group 2 61-74 years (n=17); Group 3 >75 years (n=20). The assessment included: anthropometric data (height, weight, BMI); comprehensive geriatric assessment ("Age Is Not a Hindrance" screening scale, polymorbidity, handgrip dynamometry, 4-meter gait speed test, orthostatic test); hemodynamic parameters (stiffness index, reflection index, left ventricular ejection time, systolic, diastolic, pulse, and mean blood pressure, heart rate) measured by bioimpedancemetry. Results. Vascular stiffness index (SI) and the tone of small and medium arteries (RI) have been found to naturally increase with age, reaching maximum values in the group of patients aged >75 years. Patients with high SI and RI indices demonstrated significantly lower gait speed and handgrip strength. The obtained data indicate that increased arterial stiffness is associated with a decline in key indicators of physical functioning - mobility and muscular strength which are components of frailty syndrome. Conclusions. Patients with high SI and RI indices represent a risk group for cardiovascular complications and development of frailty syndrome. This integrated approach contributes to holistic understanding of the patient's health status and opens prospects for the development of personalized preventive and therapeutic interventions.
Key words: гемодинамика, сосудистая жесткость, комплексное гериатрическое обследование
ROLE OF A PRIMARY CARE PHYSICIAN IN EARLY DIAGNOSTICS OF FRAILTY SYNDROME IN ELDERLY OUTPATIENTS
Golovanova E.D., Glushko S.A., Vakher A.I., Kozenkova V.V.
UDC: 616-053.9
Abstract: Objective. The aim of the study was to assess the prevalence of frailty syndrome among outpatients aged 65 years and older and design an algorithm for its early identification by.primary care physicians. Methods. A cross-sectional study was conducted in a city outpatient clinic. 100 patients (65 women, 35 men; mean age 74.3±6.2 years) were enrolled. Frailty was assessed using the FRAIL scale, the “Age is not a barrier” questionnaire, the Timed Up and Go (TUG) test, handgrip dynamometry, and the Short Physical Performance Battery (SPPB). Comorbidities, falls and episodes of hospitalizations were recorded. Statistical analysis was performed with StatTech v.2.8 (χ² test, Mann-Whitney U test, Spearman correlation). Results. Frailty was found in 25% of examined patients, prefrailty in 45%. In the frailty group, handgrip strength was 21.2±4.0 kg in men (p<0.001) and 14.1±2.1 kg in women (p<0.001); TUG time was 16.5±3.4 s (p<0.001); SPPB score was 5.8±1.8 (p<0.001). Mean number of chronic diseases in the frailty group was 5.2±1.1. Falls during the previous year occurred in 60% of frail patients, hospitalizations in 48% (p<0.001). Major risk factors for falls were polypharmacy (79% of fallers) and orthostatic hypotension (64%). Decompensated chronic heart failure accounted for 43% of all hospitalizations. After diagnostics of frailty, all patients were referred to a geriatrician and 48% to a neurologist for consultations; newly diagnosed cognitive impairment was found in 22% and vitamin D deficiency in 24% of those examined. Conclusion. Frailty and prefrailty are highly prevalent in elderly outpatients. Screening using the FRAIL scale and the TUG test is efficient, takes 5-7 minutes, and enables timely referral to a geriatrician for further consultations, diagnostics of concomitant geriatric syndromes, and optimization of treatment.
Key words: старческая астения, предастения, скрининг, участковый терапевт, полиморбидность, падения
ASSESSMENT OF ANTHROPOMETRIC PARAMETERS IN FULL-TERM NEWBORNS DURING THE FIRST YEAR OF LIFE WHO DEVELOPED IN AN OPERATED UTERUS
Il`enko L.I., Derevcov V.V.
UDC: 618.3:618.14-007
Abstract: Objective. The aim of the study was to identify critical periods during the first year of an infant’s life based on the assessment of body weight and length in full-term newborns who developed in an operated (with caesarean section) uterus. Methods. We have observed 181 infants including those who developed in an unoperated pregnant woman for the first time (Group 1, n=33), for the third time (Group 5, n=8), and in a single-time operated pregnant woman for the second time (Group 2, n=5), and were born by caesarean section; infants who developed in an unoperated pregnant woman for the first time (Group 3, n=74) and for the second time (Group 4, n=36), and were born vaginally. The infants of the comparison groups were born to mothers with a history of various complications. The control group consisted of healthy children born to healthy mothers who developed in a non-operated uterus and were delivered vaginally (Group 6, n=25). All full-term babies were examined at 1 (n=159), 3 (n=149), 6 (n=142), and 12 (n=126) months of age. A comprehensive study of the infants’ medical history, data on physical examination, as well as body weight and length was conducted. Nonparametric statistical analysis methods were used. Results. There are certain trends in Group 2: from birth to 1 month, towards excessive weight gain; from 1 to 3 months, towards insufficient weight and length gain; from 3 to 6 months, towards excessive length gain; and from 6 to 12 months, towards insufficient weight gain. In children, there are certain trends in Group 4: from birth to 1 month, with excessive weight and length gains; from 1 to 3 months, with excessive weight gain; and from 3 to 12 months, with insufficient weight and length gains. In children from Group 5, there are the following trends: from birth to 1 month there is insufficient gaining in body weight and length, and from 1 to 3 months excessive gaining in body weight and length, from 3 to 6 months there is insufficient gaining in body weight, and from 6 to 12 months insufficient gaining in body weight and length . Conclusion. Development of an infant in an operated uterus can be considered an increased risk factor for proper and well-balanced physical development in full-term infants during the first year of life. We believe that it is reasonable to allocate such children to groups for dispensary monitoring from their birth and carry out personalized rehabilitation procedures.
Key words: измененная матка, масса тела, дети, длина тела
THE ROLE OF THE GUT MICROBIOME IN THE DEVELOPMENT OF SOMATIC DISEASES
Volk T.G., Gaikova A.V., Safrutina V.N.
UDC: 616.34-008.87
Abstract: Objective. The study aims to analyze current data concerning a causal relationship between intestinal dysbiosis and the development of somatic diseases, as well as to evaluate the underlying mechanisms. Methods. The study involved a systematic review on publications (2015-2025). The search for the publications was conducted in the PubMed, Scopus, and Web of Science databases using combinations of keywords. Results. The review confirmed the existence of stable associations between dysbiosis and the development of specific somatic diseases. Thus, metabolic disorders (obesity, type 2 diabetes) are characterized by a decrease in bacterial diversity, reduction in the proportion of Bacteroidetes and Akkermansia muciniphila against the background of an increase in the Firmicutes/Bacteroidetes ratio and the number of proteobacteria. In the pathogenesis of cardiovascular diseases, an intensive production of atherogenic microbial metabolites, such as trimethylamine N-oxide (TMAO), associated with dysbiosis plays a key part. Inflammatory bowel diseases are typically characterized by a significant decrease in microbial diversity, reduction in the amount of anti-inflammatory Faecalibacterium prausnitzii, and an increase in pro-inflammatory bacteria populations. Conclusion. Thus, the results of our systematic analysis indicate that the intestinal microbiome plays a key etiopathogenetic part in the development of certain somatic diseases. The resulting dysbiosis, acting through metabolic, immune, and barrier mechanisms, serves as a trigger and persistent factor in chronic pathology. These findings define the microbiome as a new significant prognostic marker, and its targeted correction as a promising basis for personalized prevention and treatment of non-infectious diseases.
Key words: кишечный микробиом, дисбиоз, соматические заболевания, метаболический синдром, сердечно-сосудистые заболевания, синдром раздраженного кишечника, воспалительные заболевания кишечника
COMPREHENSIVE CONSERVATIVE TREATMENT OF OSTEOARTHRITIS OF LARGE JOINTS OF THE LOWER EXTREMITIES
Yarygin N.V., Shomina E.A., Guriev V.V., Pogorelov K.O.
UDC: 616.72-002
Abstract: Objective. The aim of the study was systematization of current evidence regarding effectiveness, core principles, and methods of comprehensive conservative treatment for osteoarthritis of major lower limb joints, focusing on multimodal and regenerative biological strategies to substantiate the rationale for personalized patient management based on clinical, imaging, and molecular parameters. Methods. The study methodology is based on a systematic analysis of relevant scientific publications from PubMed, Scopus, and ELIBRARY databases over the past 15 years, focusing on clinical efficacy of drug, biological, and physical therapy methods for the treatment of osteoarthritis. The authors critically synthesize the data obtained to develop algorithms for complex therapy integrating the use of chondroprotectors, PRP technologies, and medical gases within the framework of a personalized approach in the practice of a traumatologist-orthopedist Results. Combination regimens including nonsteroidal anti-inflammatory drugs at the lowest effective doses, long-term use of chondroprotectors, regular exercise therapy programs, and physiotherapy enable a sustained 20-30% reduction in pain and improvement in functional indices according to the WOMAC and Lequesne scales in patients with knee and hip osteoarthritis. Conclusion. It is concluded that a comprehensive, personalized approach based on precise patient stratification by endotype and stage enables a synergistic effect from the combination of pharmacological, biological, and physiotherapeutic methods. Consistent integration of modern technologies and interdisciplinary collaboration ensure a significant reduction in disability, improved quality of life, and the possibility of postponing radical surgery for several years.
Key words: остеоартрит, крупные суставы нижних конечностей, консервативное лечение, хондропротекторы, лечебная физкультуры, физиотерапия, медицинские газы
EMOTIONAL BURNOUT AS A DIAGNOSIS
Kozmidiadi A.O., Smirnov A.S., Evseev A.V., Chernysheva E.A., Shalaeva O.E., Evseeva M.A., Prokopenkova N.V.
UDC: 159.944
Abstract: Objection. The aim of our study was assess publications devoted to the problem of emotional burnout in order to obtain clear understanding significance of this phenomenon in medical practice. Methods. Analysis and generalization of scientific publications was carried out using the PubMed information search engine, ScholarGoogle, IPR SMART electronic library systems (IPR BOOKS), and international electronic resources published by Springer Nature and Elsevier. Results. Emotional burnout should be considered as a syndrome that occurs because of chronic stress at work, which a person cannot cope with and is characterized by three indicators: 1) feeling of loss of energy and exhaustion, psychological detachment from work, 2) feeling of negativism or cynicism about work, and 3) decreased professional effectiveness. It seems logical that burnout is a special case of chronic stress induced by professional activities and responsibilities. Conclusion. Emotional burnout cannot be a diagnosis of any particular disease. The syndrome can be formed stage by stage, starting from a simple protective physiological reaction, up to a condition requiring qualified medical or psychological support and care. It should be agreed that WHO does not consider emotional burnout as a disease, since the allocation of chronic stress caused by professional activities and responsibilities to a separate nosological niche seems somewhat artificial.
Key words: эмоциональное выгорание, хронический стресс, усталость, профессиональная деформация
DIETARY SUGAR SUBSTITUTES AND SWEETENERS: SOME ASPECTS OF NUTRITION AND DENTISTRY
Verdyan O.O., Gavrilova V.O., Ogneva K.E., Semin S.S., Mikhalik D.S., Syomchenkova M.Yu., Vishnevsky S.E., Pogodina M.V., Maksimenkova V.V., Zhukov G.V., Nikolaenkova L.I., Lozovskaya T.A.
UDC: 664.162.81.82
Abstract: Objection. Compare sweeteners (sweeteners) of various origins with an emphasis on their properties, safety and effectiveness. Methods. The analysis of scientific information based on data from domestic and foreign studies is carried out. Results. The history of discovery, classification (natural and synthetic, high- and low-calorie), metabolic mechanisms, effects on carbohydrate metabolism, body weight, and oral health are considered. Special attention is paid to sugar alcohols (polyols): sorbitol, xylitol, erythritol, maltitol, isomalt, and others; their caloric content, sweetness, and typical nutritional uses are presented. In the dental aspect, the anti-caries properties of xylitol and palm sugar are highlighted; phytochemical analysis showed the presence of glycosides, terpenoids, proteins and a reduced content of reducing sugars in palm sugar, which makes it an advantage over cane sugar and saccharin. Conclusion. It is concluded that it is necessary to strictly adhere to the permissible daily doses, take into account individual clinical tasks and prioritize the use of non-cariogenic sweeteners (stevia, erythritol, xylitol) for the prevention of caries and metabolic disorders.
Key words: сахарозаменители, подсластители, сахарные спирты (полиолы), метаболизм
CHONDRODYSPLASIA IN CHILDHOOD: MODERN CONCEPTS OF MOLECULAR MECHANISMS, DIAGNOSTICS, AND MULTIDISCIPLINARY MANAGEMENT
Kasymova E.B., Avedisyan E.V., Avedisyan A.V.
UDC: 616.71-007.17-053.2-07-08
Abstract: Objective. To perform a comprehensive analysis of current data on the molecular genetic basis, diagnostic approaches, and management principles of the most common forms of chondrodysplasia in children to systematize knowledge about key signaling pathways, clinical and radiological diagnostic criteria, as well as innovative therapeutic methods, including pathogenetic treatment. Methods. An analysis of current domestic and international scientific publications, and clinical guidelines on osteochondrodysplasia was conducted. Methods for systematizing and comparatively analyzing data on the etiology, pathogenesis, diagnosis, and treatment of this group of diseases were used. Results. Chondrodysplasias has been found out to represent a clinically and genetically heterogeneous group of diseases caused by disorders of endochondral ossification. Constitutive activation of the FGFR3 receptor signaling pathway plays a central role in the pathogenesis of many forms (achondroplasia, hypochondroplasia, thanatophoric dysplasia). Diagnosis is based on the integration of clinical data (disproportionate short stature, macrocephaly, skeletal deformities), characteristic radiographic features, and is confirmed by molecular genetic testing methods (NGS panels, whole exome sequencing). Effective patient management requires a multidisciplinary approach aimed at the timely correction of complications: neurosurgical treatment of spinal stenosis and brain compression, orthopedic correction of limb deformities, and ENT rehabilitation. The approved pathogenetic drug vosoritide, which inhibits the FGFR3 pathway, has been shown to statistically significantly increase growth velocity in children with achondroplasia, ushering in a new era of targeted therapy. Conclusion. Advances in molecular genetics have radically changed approaches to the diagnosis of chondroplasia, enabling a transition to etiologically based classification and accurate medical genetic counseling. Comprehensive multidisciplinary management can significantly improve patients' quality of life. The development and introduction of pathogenetic drugs, such as vosoritide, demonstrate the fundamental possibility of modulating disrupted signaling pathways. Future prospects are focused on deciphering the functions of new genes, developing gene therapy methods, and finding effective treatments for rare forms of dysplasia, opening the way to modifying the course of these diseases.
Key words: хондродисплазии, остеохондродисплазии, дети, генетика, FGFR3-ассоциированные заболевания, лечение
CHANGES IN THE HEART-LUNG ORGAN COMPLEX IN PATIENTS WITH SEVERE AND EXTREMELY SEVERE COURSE OF COVID-19 DURING PREGNANCY
Rumyantsev Yu.I., Doroshenko D.A.
UDC: 616.1+616.2
Abstract: Objective. The aim of the study was to identify changes in the heart-lung system in patients who had had severe and extremely severe course of COVID-19 during pregnancy. Methodology. A review was conducted, including a systematic publication search of major Russian and international databases, including the Russian Science Citation Index (RSCI), Medline, PubMed, Web of Science, Scopus, and Google Scholar. The search covered publications issued between December 2019 and August 2025 and included keywords such as cardiovascular diseases, "COVID-19" or "SARS-CoV-2," "post-COVID," "long COVID," and "pregnancy" or "pregnant women." Results. After COVID-19 pandemic, patients may experience heterogeneous delayed cardiovascular complications, which in some cases significantly affect quality of life and can lead to serious health consequences. These complications include myocarditis and pericarditis, as well as rhythm and conduction disturbances. Furthermore, there is a risk of coronary heart disease, which manifests itself in an increased incidence of heart attacks and strokes, particularly in the first six months after infection. It should also be noted that patients without preexisting atherosclerosis may develop non-ischemic heart vascular lesions, particularly coronary artery disease. Respiratory complications such as chronic obstructive bronchitis and progressive pulmonary fibrosis are also important to consider. Conclusions: To assess the long-term effects of COVID-19 in patients who had experienced severe forms of coronavirus infection during pregnancy, further research is required, including assessment of myocardial strength characteristics and kinetic energy expenditure as predictors of heart-lung organ system recovery.
Key words: сердечно-сосудистые заболевания, COVID-19, беременность, SARS-CoV-2, постковидный синдром, миокардит, фиброз
TREATMENT OF ANTERIOR ANKLE IMPINGEMENT
Semenov A.I., Kirpichev I.V.
UDC: 616.728.48-009.7-089.819
Abstract: Objective. The aim of the work is to analyze the available literature describing the clinical results and effectiveness of various treatment methods for patients with anterior ankle impingement. Methods. When analyzing the available literature published over the past ten years in the PubMed, Google Scholar, Scopus, eLibrary databases, articles were selected that met the following inclusion criteria: full-length studies reporting on the results of conservative or surgical treatment of AAI in individuals over 18 years of age. Studies reporting on the results of treatment of posterior impingement were excluded. Results. We selected 13 full-length articles published from 2015 to 2024, devoted to the results of minimally invasive interventions for AAI. Unfortunately, no publications describing the results of conservative treatment were found. The total number of patients in all studies was 452 people, the average age was 35.6 years, the ratio of men and women was 271 and 181, respectively. The average follow-up period was 40.6 months. In the vast majority of cases, good and excellent treatment results were obtained with a relatively small number of complications (2.4%). High heterogeneity of the included studies made it impossible to compare their results depending on the localization of the pathological process. Conclusion. Arthroscopic treatment of AAI is one of the most popular treatment methods, providing good and excellent results in the early and late periods with a low incidence of complications. High heterogeneity in the assessment of results by different authors, as well as the lack of detail in the arthroscopic picture, do not allow us to make a convincing conclusion about the influence of the type of impingement syndrome and/or additional pathology on the clinical outcome.
Key words: голеностопный сустав, передний инпинджмент-синдром, артроскопия, результаты лечения
AUTOIMMUNE HEPATITIS WITH PROGRESSION TO CIRRHOSIS AND ITS ROLE IN CONNECTIVE TISSUE DESTRUCTION
Chudaeva O.V., Ivanova A.V., Panshchena A.P., Cherkashina V.E., Magomedbekova D.S.
UDC: 616.36-004
Abstract: Objective. The aim of the study was to analyze a clinical case of a patient with mitral regurgitation caused by complete chordal rupture in the setting of autoimmune hepatitis complicated by cirrhosis. Methods. The methodology involved a comprehensive clinical and laboratory monitoring of a patient with a verified diagnosis of autoimmune hepatitis progressing to cirrhosis. At both the outpatient and inpatient stages, a detailed interview was conducted to assess patient’s history and complaints, along with his physical examination focused on identifying stigmata of chronic liver disease, as well as a retrospective analysis of primary medical records (outpatient chart, discharge summaries). The assessment of the role of connective tissue destruction was based on the interpretation of laboratory fibrosis markers (FIB-4, APRI), instrumental imaging data (liver elastography, abdominal ultrasound), and, where available, the results of morphological examination of liver biopsy specimens. Results. This article describes a clinical case of a patient born in 1967 with severe mitral regurgitation secondary to complete chordal rupture (flail leaflet, grade 3-4 regurgitation), diagnosed in November 2023 in the setting of low-activity autoimmune hepatitis complicated by Child-Pugh class A cirrhosis. In January 2024, surgical treatment was declined at a federal cardiac surgery center in Saint Petersburg due to elevated hepatic enzyme levels. After a course of hepatoprotective and immunosuppressive therapy administered in the gastroenterology department of Smolensk Clinical Hospital No. 1, laboratory parameters improved. In March 2024, the patient was re-evaluated at the N.I. Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, and was deemed suitable for surgical intervention. On May 22, 2024, mitral valve repair was successfully performed under cardiopulmonary bypass. Conclusion. Surgical correction of mitral regurgitation due to chordal rupture effectively prevents the progression of heart failure. The presented case confirms that liver cirrhosis is not an absolute contraindication to surgery, provided there is multidisciplinary management and compensation of liver function.
Key words: клапанные пороки, митральная недостаточность, отрыв хорд митрального клапана, аутоиммунный гепатит, цирроз печени
FROM COVID-19 TO APPENDIX PERFORATION: A RARE CLINICAL CASE IN A YOUNG CHILD WITH PHARMACOECONOMIC ANALYSIS
Sokolovskaya V.V., Litvinova A.A., Kozlov R.S., Labuzov D.S., Alekseeva V.A., Krikova A.V.
UDC: 616.98:576.858]:616.346.2-053.2
Abstract: Objective. The aim of the study was to describe clinical and diagnostic features of the combination of severe COVID-19 and complicated destructive appendicitis in a young child, and assess the direct costs of drug therapy, taking into account stages of hospital treatment (Infectious Department and Surgical Department). Methods. Clinical observation of a 2-year-old boy is presented in the study. A retrospective analysis of the patient's medical history, clinical presentation, laboratory findings, and additional examination results (ultrasound and CT scans of the chest and abdomen), as well as surgical interventions and postoperative course, was conducted. The pharmacoeconomic analysis was performed by assessment of the direct medical costs associated with the patient's medication prescriptions during their hospitalization (10.08-30.09.2022), rounding to whole bottles/packages. Results. The child was hospitalized on the 4th day of the disease course with a confirmed SARS-CoV-2 infection. On the 6th day of the disease course, there was a negative trend with respiratory failure, and CT scan of the chest demonstrated bilateral interstitial pneumonia up to 40% (CT-2), complicated by right-sided pleuritis. Against the background of regression of respiratory symptoms, a "second wave" of fever and abdominal syndrome occurred. CT scan of the abdominal cavity revealed inflammatory changes in the right iliac region. Laparoscopy with conversion, appendectomy, sanitation, and drainage were performed. Acute gangrenous-perforating appendicitis with appendicular abscess was verified. The postoperative course was complicated by a subdiaphragmatic abscess (puncture/drainage) and hydrothorax on the right (Bülaud drainage), and severe inflammatory changes in the blood persisted. The direct cost of drug therapy is estimated at approximately ≈ 47.5 thousand rubles, the largest contribution was made by long-term courses of antibacterial therapy (primarily meropenem and linezol) Conclusions. The case studied illustrates diagnostic complexity of abdominal syndrome in children with COVID-19 and the need for early surgical examination in the event of a second wave of fever. The severity of the course and duration of hospitalization result in a significant economic burden, primarily because of a course of antibiotic treatment.
Key words: COVID-19, лабораторные показатели, инфекция, дети
ACUTE VASCULAR CATASTROPHES IN THE PRACTICE OF AN ANESTHESIOLOGIST-RESUSCITATOR: ANALYSIS OF A CLINICAL CASE ANALYSIS
Drabinoga K.A., Mishenkova O.I., Gulbin E.A., Petrov V.S.
UDC: 616.1-005-08
Abstract: Objective. The aim of the study was to analyze recent data on etiopathogenesis, clinical manifestations and intensive care procedure in acute vascular catastrophes (AVC) using the example of a clinical case of a patient with pulmonary embolism (PE) in order to optimize management algorithms for this category of patients in Intensive Care Units. Methods. The study involved analysis of scientific publications was using PubMed, ScholarGoogle, and electronic library systems, as well as a retrospective analysis of a medical record of a 41-year -old patient Yu., treated at the ICU with a diagnosis of pulmonary embolism. Medical history and physical examination data, laboratory and instrumental diagnostic procedures (CT angiography of pulmonary arteries, echocardiography, coagulogram, CBC), as well as the dynamics of the condition during the course of therapy were studied. Results. Pulmonary embolism is one of the most common and life-threatening AVC in the practice of an anesthesiologist-resuscitator. In the clinical case studied, a patient with Class III obesity, arterial hypertension and a recent history of destructive pneumonia (including aspergillosis) developed massive PE complicated by acute respiratory failure and acute cor pulmonale. Timely diagnosis (CT angiography), adequate anticoagulant therapy (heparin, enoxaparin, warfarin), respiratory support and treatment of the underlying infectious process made it possible to stabilize the patient's condition and achieve discharge. Conclusion. Acute vascular catastrophes require an anesthesiologist-resuscitator to react promptly with a deep understanding of pathophysiology and interdisciplinary interaction. Key success factors are early diagnosis (low threshold for CT angiography in unexplained dyspnea), aggressive anticoagulation in the absence of contraindications, and prevention of secondary complications. The clinical case studied demonstrates that even in patients with high comorbidity, timely intensive care can result in a satisfactory outcome.
Key words: острые сосудистые катастрофы, тромбоэмболия лёгочной артерии, интенсивная терапия, анестезиология-реаниматология, клинический случай
INTENSIVE THERAPY OF SEPTIC SHOCK IN OBSTETRIC PATIENTS
Mishchenkova O.I., Gulbin E.A., Drabinoga K.A., Petrov V.S.
UDC: 159.944
Abstract: Objective. The aim of the study perdormed was to analyze features of diagnosis, stratification of the severity of the condition and intensive care of sepsis in the practice of an anesthesiologist- resuscitator in terms of modern clinical recommendations of the Russian Federation and the Sepsis-3 concept, as well as to evaluate the impact of timeliness and completeness of intensive care on the outcome of the disease taking a clinical case of an obstetric patient with septic shock as an example. Methods. Analysis of intensive care procedures taking a clinical case of an obstetric patient with postpartum septic shock as an example was carried out using the PubMed information search engine, as well as current clinical recommendations of the Ministry of Health of the Russian Federation and the international protocols Sepsis-3 and the Surviving Sepsis Campaign. A retrospective clinical and analytical analysis of the course of the disease was performed with an assessment of the time intervals of diagnosis, stratification of the severity of the condition on the SOFA scale and the stages of implementation of bundle therapy for sepsis. Parameters of hemodynamics, respiratory support, laboratory parameters of organ dysfunction, antibacterial therapy, infusion-transfusion support, vasopressor therapy and extracorporeal detoxification methods, including renal replacement therapy have been analyzed. Comparison of clinical data with modern literature sources made it possible to assess compliance of intensive care with current standards and to determine the influence of the time factor on the outcome of septic shock. Results. The analysis of the clinical case studied confirms that the decisive factor in improving the outcome of septic shock is both compliance of therapy with modern recommendations and its temporary effectiveness - early initiation of antibacterial and intensive therapy is associated with a faster regression of multiple organ dysfunction. Administration of renal replacement therapy in a hemodynamically unstable patient made it possible to control the water balance effectively, cope with metabolic disorders and exert additional influence on the mediator cascade of the systemic inflammatory response, which contributed to the stabilization of organ functions. Multicomponent approach to nutritional support and correction of coagulopathy has reduced the severity of catabolic syndrome and prevented secondary complications, which is of particular importance in the postpartum period. Conclusion. Clinical observation of an obstetric patient with postpartum septic shock demonstrates that the diagnosis of sepsis in accordance with Sepsis-3 criteria (SOFA ≥2 against infection) allows for early stratification of the severity of the condition and timely verification of the development of multiple organ dysfunction to the stage of irreversible changes. A key factor in a favorable outcome is the early implementation of the principles of sepsis bundle therapy (early antibacterial therapy, adequate infusion resuscitation, vasopressor support, control of the source of infection), which complies with current clinical recommendations of the Ministry of Health of the Russian Federation and international standards of the Surviving Sepsis Campaign.
Key words: интенсивная терапия септического шока, послеродовой сепсис, септический шок, интенсивная терапия при органной дисфункции
DEVELOPMENT OF THE COMPOSITION AND STUDY OF THE STRUCTURAL AND MECHANICAL PROPERTIES OF TABLETS CONTAINING A SOFT EXTRACT OF GANODERMA APPLANATUM FRUITING BODIES
Harbatsevich H.I., Parkhach M.E.
UDC: 615.453.6:582.28:615.244
Abstract: Objective. The aim of the study was to develop the composition and manufacturing technology of tablets containing a soft extract of Ganoderma applanatum fruiting bodies, providing optimal structural-mechanical characteristics and a reproducible release profile of phenolic compounds. Methods. The soft extract was incorporated into model tablet blends at doses of 50 mg and 100 mg. Lactose monohydrate, Ludipress, Kollidon 30, Aerosil, and magnesium stearate were used as excipients. Tablets were produced via wet granulation and direct compression; flowability, mass uniformity, friability, and disintegration were evaluated. The dissolution kinetics of phenolic compounds were assessed using a paddle apparatus in 0.1 M HCl, followed by photometric quantification in terms of gallic acid. Results. Wet granulation was found to be unsuitable for this extract due to granule agglomeration, poor flowability, and failure to meet tablet mass uniformity requirements. In direct compression, formulations containing lactose and PVP exhibited excessive hardness and prolonged disintegration. Reducing binder content and adding Aerosil partially improved tablet properties but did not achieve pharmacopoeial standards. The most pronounced technological and biopharmaceutical improvement was observed with Ludipress: tablets met disintegration requirements (≤15 min) and demonstrated an optimal phenolic release profile. Conclusion. A Ludipress-based formulation is the most promising option for further development and standardization of a tablet dosage form containing a soft extract of G. applanatum .
Key words: Ganoderma applanatum, таблетки, структурно-механические свойства таблеток
STUDY OF AN AMINO ACID COMPOSITION OF THE AERIAL PART OF THE PENTANEMA BRITANNICUM GROWING ON THE VOLGOGRAD REGION
Arutyunova V.V., Yanitskaya A.V.
UDC: 615.322(470.45)
Abstract: Objective. The aim of the study was to perform qualitative and quantitative analyzes of an amino acid composition of the aerial part of Pentanema Britannicum. Methods. Identification of amino acids was carried out on an amino acid analyzer. Operation of the amino acid analyzer is based on post-column derivatization of amino acids with ninhydrin. Results. The study involved a chromatogram of the analysis performed. Information on the qualitative composition and quantitative content of amino acids are summarized in a table. In the study, 16 amino acids were identified, 7 of which are irreplaceable, 2 are conditionally irreplaceable, and 7 more are nonessential, among which the main dominant ones are glutamic acid (1.13±0,041%), aspartic acid (1.08±0,028%) and proline (1.0±0,032%). Conclusion. The data obtained are of practical use to supplement information on the chemical composition of the aerial part of the Pentanema britannicum (L.).
Key words: пентанема британская, аминокислоты, аминокислотный анализатор, глутаминовая кислота, аспарагиновая кислота, пролин
DEVELOPMENT AND VALIDATION OF A TECHNIQUE FOR QUANTIFYING THE AMOUNT OF ANTHOCYANIN COMPOUNDS IN VIRGIN GRAPE LEAVES (PARTHENOCISSUS QUINQUEFOLIA (L.) PLANCH.)
Evsikov F.D., Gudkova A.A., Karlov P.M., Gudkova V.A., Gorokhova A.A., Grigulevich A.A.
UDC: 615.074
Abstract: Objective. The study was aimed at development and validation of a technique for quantitative assessment of anthocyanins in Parthenocissus Quinquefolia (L.) Planch. leaves. Methods. Quantitative content of anthocyanins after extraction with acidified water was assessed according to the PA.2.5.0064.18 methodology. The quantitative content of anthocyanins after extraction with 95% acidified alcohol was assessed according to the method applicable to the leaves of Aronia mitschurinii , developed at the Faculty of Pharmacy of VSU. Validation of the adapted technique was carried out in accordance with the GPA.1.1.0012 in terms of specificity, accuracy, linearity, repeatability, reproducibility, statistical processing of the results was carried out in accordance with the GPA.1.1.0013. Results. As a result of assessment of the optimal technique for maximizing extraction of anthocyanin compounds an innovative technique was recommended. The technique includes extraction of anthocyanins with acidified alcohol. Due to the study performed it has been found out that the largest amount of anthocyanins is typical for the leaves harvested in the autumn. Optimal conditions have been selected to maximize the amount of anthocyanins extracted from Parthenocissus Quinquefolia (L.) Planch. leaves. Validation of the adopted methodology has been carried out. Conclusion. The adapted method of spectrophotometric assessment of anthocyanins in terms of cyanidin-3-O-glucoside in Parthenocissus Quinquefolia (L.) Planch. leaves can be considered as a valid technique.
Key words: винограда девичьего листья, антоциановые соединения, разработка методики, валидация, Parthenocissus Quinquefolia (L.) Planch
ELEMENTAL PROFILE OF CERTAIN MEDICINAL HERBS OF THE ASTERACEAE FAMILY
Dyakova N.A.
UDC: 615.322
Abstract: Objective. The aim of the study performed was to identify an elemental profile of medicinal herbs of the Asteraceae family taking common yarrow and bitter wormwood as an example. Methods. Pharmacopeial types of medicinal plant raw materials of the Asteraceae family - wormwood ( Artemisia absinthium L.) grass and yarrow ( Achillea millefolium L.) grass were used as objects of our study. Plant raw materials and soil samples were taken in the phenophase of flowering plants in the environmentally friendly zone. Sample preparation was carried out by microwave acid decomposition. Quantitative analysis of 59 elements was performed by inductively coupled plasma mass spectrometry (ICP-MS). The biological absorption coefficient was calculated to assess the ability of plants to accumulate elements from the soil. Results. Wormwood and yarrow grass are active accumulators of phosphorus and potassium which are the basis of the energy and osmotic metabolism of any plant, while they practically do not absorb sodium (CBP 0.01), which is a typical phenomenon for species that are not adapted to saline soils. Both plants have a strong control over the uptake of most toxic and ballast elements, maintaining a biоlogical uptake ratio of 0.01-0.1, indicating highly effective exclusionary mechanisms at the root system level. At the same time, yarrow grass is characterized by active accumulation of strontium, wormwood bitter grass accumulates copper. Conclusion. Assessed features of the mineral nutrition of wormwood and yarrow grass can serve as a basis for the development of standardized drugs and biologically active supplements aimed at improvement of the elemental status of a human body.
Key words: макроэлементы, эссенциальные микроэлементы, Asterаceae, полыни горькой трава, Artemisia absinthium L, тысячелистника обыкновенного трава, Achillea millefolium L
ANALYSIS OF THE ECONOMIC AVAILABILITY OF MEDICINES FOR THE TREATMENT OF OSTEOPOROSIS IN THE PENZA REGION
Pronkina A.A., Surina A.S., Tikhonova K.S., Glembotskaya G.T.
UDC: 614.27
Abstract: Objective. To conduct a comprehensive analysis of the economic accessibility of drugs used to treat osteoporosis, using the Penza region as a representative region of Russia. Methods. The study was based on an analysis of drug prices as of October 2025. The accessibility coefficient (Kd) was used to quantify the accessibility. The analysis will include an assessment of the current prices of drugs, their compliance with the provisions of government support programs, and the actual needs of patients for affordable and effective treatment. Results. The study revealed the high cost of modern medications for the treatment of osteoporosis, especially new drugs and injectable dosage forms. The most cost-effective and efficient drugs have been identified, and their use can reduce patients' expenses. The results emphasize the need to consider the cost of course treatment when choosing therapy and developing government programs to increase adherence to treatment and prevent fractures. Conclusion. The results of a comprehensive analysis of the economic accessibility of medicines used for the treatment of osteoporosis in the Penza region indicate significant imbalances that negatively affect the provision of adequate and continuous medical care to patients. Therefore, optimizing the treatment of osteoporosis based on the principles of economic accessibility is not only a matter of financial rationality, but also a key element in ensuring the constitutional right of citizens to accessible and high-quality medical care.
Key words: профессиональные заболевания, фармацевтическая профилактика, фармакопрофилактические лекарственные препараты, фармакоэкономический анализ
DETERMINATION OF SAPONINS AND FLAVONOIDS IN LIQUID WATER-ALCOHOL DOSAGE FORMS FROM HORSE CHESTNUT FLOWERS BY TLC METHOD
Dunilin A.D., Trineeva O.V., Larina A.O., Makeeva D.A.
UDC: 615.072
Abstract: Objective. The study performed was aimed at obtaining and standardizing experimental laboratory samples of aqueous-alcoholic liquid dosage forms from the flowers of the common horse chestnut in terms of the content of flavonoids and saponins using TLC. Methods. The extracts were prepared from horse chestnut flowers dried by the air-shadow method, harvested in the Petrozavodsk urban district, Leningrad, Moscow, Voronezh, Volgograd regions, and the Stavropol Territory during mass flowering in 2024. Ethyl alcohol 70% was used as an extractant for obtaining alcohol-containing forms. To comply with the principle of end-to-end standardization, the type of TLC profile of flavonoids and saponins was previously determined in the raw materials, as well as in the obtained experimental samples of aqueous-alcohol extracts. Results. In the TLC analysis of the sum of flavonoids and saponins in the flowers of the horse chestnut from various growing regions, the presence of 14 zones of bioactive substances of flavonoid nature was established, among which rutin, quercetin, and apigenin were identified, as well as 8 zones of bioactive substances, among which 4 zones of saponin nature were present, including β-escin. Laboratory samples of aqueous-alcoholic liquid dosage forms based on the flowers of the horse chestnut (infusions, tinctures, and liquid extracts) were obtained. In the laboratory samples of liquid dosage forms, the number of zones varied depending on the dosage form being analyzed. The flavonoid profile included 15-17 zones of bioactive substances. The TLC profile of the saponins in the laboratory samples of liquid dosage forms was represented by 3-11 zones, including a zone corresponding to β-escin. Conclusion. Qualitative composition of flavonoids and saponins in the flowers of the horse chestnut from different growing regions has been found out to be consistent. The composition of flavonoids and saponins in aqueous-alcoholic liquid dosage forms is heterogeneous and depends on the type of extractant and other technological parameters of their production. The liquid extract (1:1) has the richest composition of flavonoids and saponins and can be recommended as the optimal dosage form among the studied ones.
Key words: цветки каштана конского, лекарственные формы, сапонины, флавоноиды, ТСХ
STUDY OF AMINO ACID COMPOSITION IN METABOLOMIC ANALYSIS OF EMPETRUM NIGRUM L. FLORA OF THE MAGADAN REGION
Stoyan V.A., Serebryanaya F.K., Samokish N.V.
UDC: 615.014
Abstract: Objective. The study performed was aimed at assessment of an amino acid composition of the fruits of Empetrum nigrum L ., growing in the Magadan region. Methods. Experiments are conducted with an amino acid analyzer equipped with a post-column detection system. The sample is separated into its components in a cation-exchange resin using a step gradient of pH, ionic strength, and temperature. The eluate is mixed with a ninhydrin reagent and reacted in a flow cell of the reactor at 121°C. Strongly acidic ion-exchange resins were used as the stationary phase (resin) for amino acid analysis. The mobile phase (eluent) consisted of elution buffers and a regenerant. The peak areas of the test and standard solutions were then calculated, and the concentration of each amino acid was calculated as a percentage using a certain formula. Total quantitative content of amino acids was calculated was well. Results. Seventeen amino acids have been identified detected in the fruits studied. The most prevalent of these amino acids were aspartic acid, glutamic acid, glycine, alanine, leucine, and arginine. The quantitative amino acid content of Empetrum nigrum L. fruits was 4,22%. Conclusion. The results of the study performed conferm that black crowberry fruits can be used in medicine as a source of amino acids and it is also possible to use them to identify pharmacological effects of these amino acids.
Key words: аминокислоты, плоды, водяника чёрная, Empetrum nigrum L, нингидриновый реагент, аминокислотный анализатор
VALIDATION OF A TECHNIQUE OF QUANTITATIVE ASSESSMENT OF FLAVONOIDS CONTENT IN THE HERB ASTRAGALUS GLYCYPHYLLUS L
Pozdnyakova T.A.
UDC: 615.322+582.736
Abstract: Objective. The study was aimed at validation of a technique for quantitative assessment of the amount of flavonoids in the herb of Astragalus glycyphyllus. Methods. The object of the study was the herb of Astragalus glycyphyllus , harvested in 2024-2025 in the Kursk region. The method's linearity, range, specificity, precision, and accuracy were assessed during validation. Linearity was determined using five hyperoside standard sample solutions supplemented with 2 ml of 5% aluminum chloride solution. The optical density of the resulting complexes was measured using an SF-2000 assay in 10 mm cuvettes. To determine the range, five accurately of the herb of Astragalus glycyphyllus samples were used. After obtaining alcohol extracts, test solutions were prepared with 2 ml of 5% aluminum chloride solution, and their optical density was measured. The specificity of the method was assessed using the coefficient а , whose value should tend to zero. The precision of the technique was studied at the repeatability and intralaboratory precision levels. The repeatability of the technique was assessed using a single sample of the herb of Astragalus glycyphyllus. To assess the intralaboratory precision of the technique, two researchers conducted the experiment using three samples of the herb of Astragalus glycyphyllus in triplicate. Accuracy was assessed using model mixtures of hyperoside solutions of varying concentrations (0,5%, 0,6%, 0,7%) in triplicate. Results. Within the concentration measurement range (from an optical density of 0.33 to an optical density of 0.62), the hyperoside content dependence on the sample weight of the raw material has been found out to be linear. The experimental results revealed that the developed technique is characterized by high specificity, as the influence of impurities on the quantitative determination of total flavonoids is insignificant. A conclusion on the repeatability of the technique was made based on the standard relative deviation, which amounted to 2.85%. A conclusion on the intralaboratory precision of the technique was made based on the standard relative deviation (RSD), which amounted to 5.19%. The data obtained during the accuracy assessment indicate that the average value of the percent recovery in the designed technique is 99.92%, indicating that the technique is valid. Conclusions. Based on current regulatory requirements, a technique for the quantitative assessment of flavonoid in the herb Astragalus glycyphyllus has been designed and validated. Parameters for linearity, range of analysis, specificity, precision, and accuracy of the technique have been established. This technique for the quantitative assessment of flavonoids in the herb Astragalus glycyphyllus can be used to standardize a flavonoid content of in the herb Astragalus glycyphyllus raw materials. Recommended minimal flavonoid content in the herb Astragalus glycyphyllus should be not less than 1%.
Key words: астрагал солодколистный, флавоноиды, спектрофотометрический метод, валидация методики
STUDY OF DIGITAL LITERACY OF PHARMACY EMPLOYEES AS ONE OF THE CRITERIA FOR DETERMINING THEIR DIGITAL MATURITY
Golovko T.P., Loskutova E.E.
UDC: 615.15
Abstract: Objective. The aim of the study was to assess digital literacy of pharmacy employees as one of the key indicators of digital maturity and to identify factors influencing digital literacy of pharmacy employees. Methods. The study was conducted using a survey method and involved an original questionnaire, the general section of which was developed based on recommendations from the National Agency of Financial Investigations (NAFI) analytical center [2]. The study included the following stages: 1) creating a research database for target groups; 2) grouping respondents by specific characteristics; 3) calculating subindices for all components of digital literacy: information, computer, media, communication, and technological innovation; 4) calculating a digital literacy index; 5) comparative evaluation of results by creating tables and graphs in Excel; 6) identifying independent factors influencing respondents' digital literacy using a one-way analysis of variance. A total of 462 questionnaires were analyzed. Results. The digital literacy index for pharmacy employees was 83%, along with subindices for information, computer, media, and communication literacy, and a subindex for technological innovation. Furthermore, the feasibility of using a generational approach to characterize pharmacy employees was demonstrated, and an independent variable directly influencing respondents' digital literacy was identified: age characteristics. Conclusion. An inverse relationship between the digital literacy of pharmacy employees and their age was found. Therefore, generational differences, which influence respondents' behavior and determine their level of digital literacy, should be considered when developing strategies to optimize the digital transformation of pharmacy operations.
Key words: цифровая трансформация, цифровая грамотность, цифровая зрелость, аптечная организация, фармацевтические работники, поколение
DIGITAL TECHNOLOGIES IN ORGANIZATIONAL PROCESSES OF THE MANAGEMENT SYSTEM OF PREFERENTIAL DRUG PROVISION TO THE POPULATION OF THE TYUMEN REGION
Onegina L.V., Knysh O.I.
UDC: 615.1
Abstract: Objective. The aim of the study was to analyze organizational processes in the management system for subsidized drug provision to the population of the Tyumen Region using digital technologies. Methods. The study involved regulatory documents from the Russian Federation and the Tyumen Region Government concerning the use of digital technologies in organizing subsidized drug provision for certain categories of citizens, as well as scientific publications and data from the information systems of medical and pharmaceutical organizations in the region. Content analysis, analytical, structural, systemic, and computered methods were employed. Results. The subsidized drug provision management system in the Tyumen Regiont is a crucial element of the region's healthcare system, ensuring access to medications for certain categories of citizens. Its operation is implemented via the State Healthcare Information System of the Tyumen Region and the implementation of digital technologies that enable information exchange between medical and pharmaceutical organizations and the healthcare authority. This study defines its structure and the regulatory framework of the Tyumen Region legislation on the development of healthcare information subsystems. The hierarchy of organizational processes within the region's subsidized drug provision management system is defined. An algorithm to work with electronic prescriptions within the subsidized drug provision system is described, and the functional roles of medical and pharmaceutical professionals are defined. Conclusion. An analysis of the regulatory and legal acts, as well as organizational processes of the subsidized drug provision management system has allowed us to describe the structure of a unified digital environment in healthcare in the Tyumen Region, identify digital technologies used in the organizational processes of subsidized drug provision for certain categories of citizens, and identify the specifics of their information interaction.
Key words: единая государственная информационная система здравоохранения, информационные технологии, отдельные категории граждан, система льготного лекарственного обеспечения, электронный рецепт
MARKET ANALYSIS OF ANTITHROMBOTIC DRUGS USED FOR GERIATRIC PATIENTS
Polovnikova P.A., Knysh O.I.
UDC: 615.12 + 615.22
Abstract: Objective. The aim of the study was analyze the market of antithrombotic drugs used for geriatric patients in the Russian Federation. Methods. The methods of content analysis, system, logical, structural, and graphical analyses were used to summarize scientific data, structure, and systematize information. The following materials were used in the study: Clinical guidelines: "Aortic Insufficiency" (2025), "Atrial Fibrillation and Flutter" (2025), "Stable Ischemic Heart Disease" (2024), "Deep Vein Thrombosis of the Extremities. Adults" (2025), the State Register of Medicines of the Russian Federation, instructions for the use of drugs from the reference book of drugs "Vidal" and the Register of Medicines of Russia "RLS", and other scientific publications. Results. Based on scientific publications and the Ministry of Health's Clinical Guidelines, it was found that specific antithrombotic therapy is used to treat coronary heart disease, aortic insufficiency, atrial fibrillation, deep vein thrombosis, pulmonary embolism, thrombophlebitis, and other pathologies. Dosage forms, dosages, countries of registration, and the specifics of their use in geriatric patients summarized data on nine international nonproprietary names of antithrombotic agents, represented by 170 trade names. Analysis of the instructions for medical use of these medications and scientific sources revealed that only acetylsalicylic acid, clopidogrel, rivarouxoban, and edoxoban do not require dosage reduction or other adjustments in pharmacotherapy for the elderly. Analysis of the State Register of Medicines of the Russian Federation shows that the majority of antithrombotic drugs are available in tablet form - 73%, and Russia is the leader among countries-holders registration certificates - 69%. Conclusion. It is necessary to develop personalized approaches to pharmacotherapy for the treatment of geriatric patients, taking into account somatic and physiological changes in the body for this category of citizens to reduce risks of thrombosis and bleeding, as well as to study antithrombotic therapy in terms of pharmacoeconomics.
Key words: гериатрические пациенты, тромбоэмболические осложнения, антитромботические средства, антикоагулянты, антиагреганты, рынок ЛП
RESULTS OF EARLY IDENTIFICATION OF STUDENTS AT SMOLENSK STATE MEDICAL UNIVERSITY EXPOSED TO THE IDEOLOGY OF TERRORISM
Kozhurina A.A., Krikova A.V., Dmitrieva E.V., Ulasen T.V., Starodubtsev N.N.
UDC: 378.4:323.28
Abstract: Objective. The aim of the study was to assess potentials of early identification of students at Smolensk State Medical University that can be at risk of adopting terrorist ideology. Methods. The study was carried out in two stages: 1. Regulatory and legal documents governing liability for terrorist activities have been analyzed. 2. A survey of University students using specialized rapid-response questionnaires to study personal needs and inclinations toward deviant behavior was performed.The study involved 424 respondents (2019) and 252 respondents (2025), aged 17-24 years who studied at the Faculty of General Medicine, the Faculty of Pediatrics, the Faculty of Dentistry and the Faculty of Pharmacy). Data collection employed various data measurement scales (dichotomous, ordinal, and Likert-type). For preliminary data processing, frequencies and percentages were calculated. Comparative analysis of data obtained in 2019 and 2025 was performed using the Z-test for two proportions (for dichotomous scales), the Mann-Whitney U test (for ordinal scales). The significance level was set at p<0,05. Results. The study identified a relationship between emotional instability, frustration of basic needs for love and support, and a tendency toward aggression. This creates a “psychological vulnerability profile” in some students, characterized by: frustration of the need for acceptance; dependence on external support; need for group belonging; presence of aggressive tendencies. This profile increases the risk of involvement in destructive groups that offer: an illusion of belonging; simple answers to complex questions; substitute forms of support. Prevention efforts are aimed at proactively addressing these needs in constructive ways, rather than merely combating the consequences. Conclusion. The "vulnerability profile" identified in students (emotional instability, frustration of the needs for love and respect, hidden aggression) forms the basis for the search for identity in destructive groups. The prevention of extremism requires a transition from prohibitive measures to proactive psychocorrection. The university's key strategy is based on creating constructive alternatives at the university (mentoring, communities, projects) that legitimately satisfy the basic needs of students in acceptance, belonging and respect, forming internal resistance to destructive influence.
Key words: терроризм, профилактика, аддитивное поведение
RELATIONSHIP BETWEEN VITAMIN D CONTENT WITH BODY MASS INDEX AND LIPID PROFILE IN ADOLESCENTS AND YOUNG PEOPLE
Bekezin V.V., Rodin A.V., Amalitsky V.Yu.
UDC: 616.211-002/616-092.11
Abstract: Objective. The aim of the study performed was to investigate epidemiology of serum vitamin D levels in adolescents and young adults (medical university students were taken as a sample) and to analyze characteristics of their lipid profile and nutritional status (based on body mass index (BMI)) depending on vitamin D levels. Methods. The study included 164 students: 41 adolescents (17 years old) and 123 young adults (18-23 years old). Depending on their serum vitamin D (25-hydroxycalciferol (25(OH)D)) levels, the examined students were divided into 3 groups: Group 1 (n=81) - students with vitamin D levels of 10 ng/ml or less (vitamin D deficiency); Group 2 (n=57) - students with vitamin D levels in the range of 11-29 ng/ml (vitamin D insufficiency and deficiency). Group 3 (n=26) included students with vitamin D levels of 30 ng/ml or higher (normal vitamin D levels). Results. Only 13.5% of students had normal vitamin D levels (30 ng/ml or higher). Nutritional status deviations (based on BMI) in students in Groups 1 and 2 were characterized by a predominance of overweight and obesity over malnutrition and a high frequency of abdominal fat distribution. Among students in Group 2, overweight and obesity were 5,28 times more common than malnutrition, while among students in Group 1, it was 7,78 times more common. Among students in Group 2, abdominal fat distribution was detected in 33,3 % of overweight and 75 % of obese cases. Among students in Group 1, the abdominal type was diagnosed in 47,4 % of overweight and 75 % of obese cases. A multiple correlation analysis between serum vitamin D levels and lipid profile parameters (including the atherogenic index) revealed a positive correlation between high-density lipoproteins and vitamin D, as well as a negative correlation between low-density lipoproteins and the atherogenic index, on the one hand, and vitamin D, on the other, in students in Groups 2 and 3 (p < 0,05). Conclusion. Assessment of lipid profile characteristics in adolescents and young adults depending on vitamin D levels, as well as the results of a multiple correlation analysis between lipid profile parameters and vitamin D, demonstrated a «dose-dependent effect» of vitamin D (depending on its serum level) on lipid fractions.
Key words: подростки, лица молодого возраста, витамин Д, липидный спектр, избыточная масса тела, ожирение
EFFECTIVENESS OF PROBLEM-BASED LEARNING IN THE PREVENTION OF PERSISTENT ALLERGIC RHINITIS IN PRIMARY SCHOOL CHILDREN
Bekezin V.V., Koroleva A.E., Meshkova R.Ya.
UDC: 616.211-002
Abstract: Objective. The aim of the study was to evaluate effectiveness of problem-based learning in the prevention of persistent allergic rhinitis in high risk primary school-age children. Methods. At the 1st stage, a screening cross-sectional study of 180 children aged 7-10 years with allergic rhinitis (AR) in remission was performed, including anthropometry (weight (kg), height (m), body mass index (BMI (kg/m2)) and determination of IL-1ß in blood serum by ELISA. In 128 schoolchildren included in the study at stage 2 with intermittent AR on the background of overweight or obesity (BMI equal to or greater than +1SDS BMI, taking into account age and gender), the 75th percentile of IL-1ß in blood serum was 0,029 pg/ml. At stage 3, depending on the level of IL 1ß, 32 primary school-age children with intermittent AR and an IL 1ß value equal to or greater than 0.029 pg/ml (a high-risk group for persistent allergic rhinitis) were included in the study. Later, depending on the course they completed, they were divided into 2 groups: Group 1 (n=15) - children who had completed problem-oriented training; Group 2 (n=17) - children who had not completed such training. Repeated clinical and anamnestic examination of children of the 1st and 2nd groups was carried out after 1 year. Results. It has been revealed that in dynamics (after 1 year), only 1 child (6,7 %) of the 15 examined in Group 1 who had a problem-based learning course (PBL) had a persistent course of AR; the rest retained an intermittent course of AR (93,3 %). In 14 of the 17 children of Group 2 who did not undergo PBL, a persistent course of AR was registered after 1 year (82,4%), and only the remaining 3 children (17,6%) retained an intermittent course of AR. A combined statistical analysis of the two groups, depending on the passage/non-passage of PBL using the chi-square criterion (χ2), confirmed the relationship between factorial (passage/non-passage of POL) and effective (diagnosis of persistent AR (yes/no)) signs (χ2=18,331; significance level p<0,001). Conclusion. Thus, early identification of a high-risk group in primary school-age children with intermittent AR on the background of overweight/ obesity provides an opportunity for early prevention of persistent AR in the form of problem-based learning with the development of personalized preventive programs and help to avoid further development of metabolic risks and the progression of allergic pathology.
Key words: школьники, аллергический ринит, избыточная масса тела, ожирение, ИЛ 1ß, группа риска персистирующего течения АР, проблемно-целевое обучение
SEROTYPE COVERAGE OF STREPTOCOCCUS PNEUMONIAE BY MODERN VACCINES IN CHILDREN CONSIDERING CLINICAL FORMS OF INFECTION
Muravyev A.A.
UDC: 616.211-002
Abstract: Objective. The aim of the study was to assess serotype distribution of Streptococcus pneumoniae and potential coverage of circulating serotypes by modern pneumococcal vaccines in children considering clinical forms of infection. Methods. A prospective multicenter study was performed. A total of 1898 S. pneumoniae isolates were analyzed, including 889 (46.8%) from pediatric patients. Serotype distribution and vaccine coverage (PCV13, PCV20, PPV23) were assessed according to clinical forms of infection. Statistical analysis included absolute and relative frequencies, 95% confidence intervals (Wald method), and odds ratios (OR); significance level was set at p<0.05. Results. Asymptomatic carriage predominated in children (70.1%), whereas invasive forms accounted for 1.1% of cases. Serotype coverage in invasive infections reached approximately 70% for PCV13, over 80% for PCV20, and up to 85% for PPV23. In non-invasive infections and carriage, coverage was lower: 55-60% for PCV13, approximately 70% for PCV20, and up to 75% for PPV23. Cumulative coverage in the total sample was 63.0% for PCV13, 72.6% for PCV20, and 75.8% for PPV23. Conclusion. Coverage of S. pneumoniae serotypes by modern vaccines varies depending on clinical forms of infection and age structure. Increasing vaccine valency improves potential prevention but does not fully eliminate circulating strains. Vaccination should be considered a tool for reducing both infectious burden and antimicrobial use.
Key words: S. pneumoniae, дети, серотипы, пневмококковые вакцины, перекрываемость, вакцинопрофилактика
VITAMIN D AND THE MICROCIRCULATORY-TISSUE SYSTEM IN ADOLESCENTS AND YOUNG PEOPLE
Bekezin V.V., Rodin A.V., Amalitsky V.Yu.
UDC: 616.211-002/616-092.11/616-053.4
Abstract: Objective. The aim of the study was to investigate the state of the microcirculatory-tissue system in relation to vitamin D levels in adolescents and young adults (using medical university students as a sample) using laser Doppler flowmetry and fluorescence spectroscopy. Methods. The study included 164 students: 41 adolescents (17 years old) and 123 young adults (18-23 years old). Depending on the content of vitamin D (25-hydroxycalciferol (25(OH)D)) in the blood serum, the examined students were divided into 3 groups: Group 1 (n=81) - students with a vitamin D level of 10 ng/ml or less (vitamin D deficiency); Group 2 (n=57) - students with a vitamin D level in the range of 11-29 ng/ml (vitamin D insufficiency and deficiency); Group 3 (n=26) - students with a vitamin D level of 30 ng/ml or more (normal vitamin D content). A comprehensive examination of schoolchildren included anthropometry (weight, height, BMI (kg/m2), waist circumference (WC, cm)), as well as laser Doppler flowmetry (LDF) and laser fluorescence spectroscopy (LFS) of the skin in the forearm area using analyzer «Lazma PF» (Russia). Results. Assessment of the structure of the functional state of the microcirculatory tissue system (FS MTS) in students revealed that adolescents and young adults in Group 2 had increased FS MTS activity 1,82 times more often (p<0.05) than students in Group 3; 14,0 % of students in Group 2 experienced decompensation of FS MTS. Students in Group 1, compared to adolescents and young adults in Group 3, had 2,01 times less active microcirculatory dysfunction, indicating the preservation of compensatory and adaptive mechanisms at the microcirculatory level. Decompensation of microcirculatory dysfunction was observed in 29,6% of students in Group 1, which is significantly more frequent than in adolescents and young adults in Groups 2 and 3. Conclusion. Identified staging of changes in the functional state of the microcirculatory tissue system in students depending on serum vitamin D levels (overstrain of compensatory and adaptive mechanisms is followed by a stage of decompensation against the background of a further decrease in vitamin D) indicates the need to correct vitamin D deficiency in adolescents and young adults, taking into account the severity of the deficiency, in order to reduce cardiovascular and metabolic risks.
Key words: подростки, лица молодого возраста, витамин Д, микроциркуляторно-тканевая система, кардиоваскулярный риск
CORRECTION OF SARCOPENIC OBESITY IN ADOLESCENTS: THE ROLE OF PROTEIN-ORIENTED DIET THERAPY
Pogrebnova L.A., Cherednikova K.A., Filina N.Yu.
UDC: 616-008.9/616-053.4
Abstract: Sarcopenic obesity is a pressing issue in modern pediatrics, characterized by a combination of excess body fat and reduced skeletal muscle mass. Unsustainable approaches to weight loss in children and adolescents can contribute to muscle tissue loss, highlighting the need for protein-rich dietary interventions.
Key words: ожирение, дети, подростки, саркопения, диетотерапия
FEATURES OF THE CLINICAL AND LABORATORY STATUS OF PREMATURE NEWBORNS WITH BRONCHOPULMONARY DYSPLASIA
Zhulego E.S., Boydak M.P., Prylutskaya V.A.
UDC: 616-07-053.32:616.24-008.4
Abstract: This article presents an analysis of the clinical and laboratory status of premature infants with bronchopulmonary dysplasia (BPD) in the first day of life. Fifty-nine newborns with gestational ages ranging from 23 to 30 weeks were examined. Two groups were identified: a study group with severe BPD (n=23) and a comparison group with mild to moderate BPD (n=36). A relationship between peripheral blood laboratory parameters and the severity of BPD was identified
Key words: недоношенные новорождённые, бронхолёгочная дисплазия, показатели периферической крови