POOL OF FREE AMINO ACIDS IN BRAIN CORTEX AFTER PARTIAL ISCHEMIA
Razvodovsky Y.E., Troyan E.I., Doroshenko E.M., Smirnov V.Y., Pereverzev V.A., Maksimovich N.Ye.
UDC: 616.441.577.112
Abstract: Objective. The aim of this study was to estimate the amino acids (AA) pool in brain hemispheres cortex of rats at different duration of unilateral (left-side filament occlusion of arteria carotis) cerebral ischemia (UCI). Methods. The changes of AAs pool and their derivatives in the frontal cortex of the cerebral hemispheres at different duration of UCI (1 hour, 3 hours, 1 day) were studied in 21 rats. The analyses of the levels of AAs and their derivatives were carried out in the supernatant of protein-free tissue homogenates by reversed-phase liquid chromatography using chromatograph Agilent 1100. Results. The results show that the concentration of several AA was altered 3 hours following ischemia. In particular, we detected a reduction in the levels of valine, leucine and lysine. Ischemia during 3 hours also resulted in decreased levels of asparagine and tyrosine. The ratio of essential/nonessential AA and the ratio of glycogenous/ketogenous AA were also reduced. In contrast, the ratio of the total branched-chain AA (BCAA) levels to aromatic amino acids (AAA) levels was increased. All these changes were normalized 24 hours following ischemia. Conclusion. The results of present study suggest that the changes in the AA pool in brain hemispheres cortex of rats depend on duration of ischemia. In the early period (3 hours) UCI was accompanied by increase in the level of BCAA (valine and leucine) and reduction in the levels of AAA (tyrosine an tryptophan) with the normalization all this changes 24 hours following ischemia.
Key words: аминокислоты, головной мозг, частичная ишемия, amino acids, brain hemispheres, partial ischemia
CHANGES IN CYTOPLASM CHROMATOPHILIA OF LARGE PYRAMID NEURONS OF RATS NEOCORTEX IN POSTNATAL ONTOGENY
Bon L.I., Zimatkin S.M.
UDC: 612.823
Abstract: Objective. Analysis of changes in the chromatophilia of the cytoplasm of large pyramidal neurons in the rat cerebral cortex in postnatal ontogenesis. Methods. The experiments were performed on 156 outbred white rats, born from 75 female rats. The rats were taken for the subsequent histological and electron microscopic examination on the 2nd, 5th, 10th, 20th, 45th, and 90th days after birth. Results. At the light-optical level, the peculiarities of the ratio in the population of various chromatophilia neurons were studied. At the ultramicroscopic level, the features of each of them were revealed. Conclusion. The obtained data on the change in chromatophilia of the cytoplasm of the large pyramidal neurons of the neocortex in postnatal ontogenesis give rise to further study of the age-related changes in this section of the central nervous system both in normal conditions and in the experiment, creating a fundamental basis for the treatment and prevention of cerebral pathology of various genesis.
Key words: крысы, нейроны, неокортекс, хроматофилия, rats, neurons, neocortex, chromatophilia
COMPARATIVE ANALYSIS OF THE STRUCTURE OF THE RATS TESTES ON THE 40TH DAYS AFTER EXPOSURE TO BACTERIAL LIPOPOLYSACCHARIDES
Poplavskaja E.A., Poplavskij D.Ju.
UDC: 611.631.018:[577.114/.115:579.84]-092.9
Abstract: Objective. To study and perform a comparative analysis of structural changes in the testes of rats on the 40th day after administration of bacterial lipopolysaccharides Escherichia coli and Serratia marcescens . Methods. Male rats were once injected with LPS Escherichia coli and Serratia marcescens at a dose of 50 мg / kg intraperitoneally. Paraffin sections were prepared, stained with hematoxylin and eosin. Studies of histological specimens, their microphotography, and morphometry were performed at different magnifications of the Axioskop 2 plus microscope (Zeiss, Germany), Leica DFC 320 digital video camera (Leica Microsystems, Germany) and computer analysis programs ImageWarp (Bit Flow, USA). The assessment of the reliability of changes in the numerical values was performed using non-parametric statistics with the Statistica 6.0 computer program for Windows.Results. As a result of the study, it was established that on the 40th day after LPS exposure, various structural changes develop in the testes of male rats: regardless of the type of LPS, the number of destructive seminiferous tubules on the cut increases by 3 times (p<0.05); the number of cellular associations in the tubules decreases (on administration of LPS E. coli - by 5.57% (p<0.05), on the administration of LPS S. marcescens - by 5.27% (p<0.05); the number of interstitial endocrinocytes (on the administration of LPS E. coli - by 36.43% (p<0.05), on the introduction of LPS S. marcescens decreases by 19.51% (p<0.05) and the area their nuclei (on the introduction of LPS E. coli - by 15.22% (p<0.05), on the introduction of LPS S. marcescens decreases by 18.39% (p<0.05); in convoluted tubules the number of sustentocytes decreases (on the introduction of LPS E. coli - by 34.70% (p<0.05), on the introduction of LPS S. marcescens - by 40.10% (p<0.05) and the area of their nuclei decreases ; as well as the number of spermatogenic epithelium cells - spermatogonia and spermatocytes (on the administration of LPS E. coli , by 21.91% (p<0.05), and on the introduction of LPS S. marcescens , by 19.64% (p<0.05). Conclusion. It was concluded that a single intraperitoneal injection of LPS of gram-negative bacteria E. coli and S. marcescens at a dose of 50 µg / kg of weight to male rats, regardless of the type of LPS, causes the development of structural changes in the testes of animals from the experimental groups: an increase in the number of destructive seminiferous tubules on the cut; a decrease in the number of cellular associations in a tubule;a decrease in the number of interstitial endocrinocytes and in the area of their nuclei; in convoluted tubules the number of sustentocytes and the area of their nuclei, and the number of cells of the spermatogenic epithelium - spermatogonia and spermatocytes decrease. All of these changes may indicate dysfunction of cells, and, ultimately, lead to disruption of the formation of male germ cells.
Key words: липополисахариды, cеменник, сперматогенез, крысы, lipopolysaccharide, testis, spermatogenesis, rats
LEVEL OF GLYCEMIA AND ITS DYNAMICS IN YOUNG PEOPLE WITH DIFFERENT ATTITUDE TO ALCOHOL CONSUMPTION IN THE COURSE OF MENTAL WORK AND ORAL GLUCOSE TOLERANCE TEST
Pereverzev V.A., Sikorsky A.V., Blazhko A.S., Welcome M.O., Evseev A.V., Razvodovsky Y.E., Nikitina O.S., Melnichuk V.I., Pereverzeva E.V.
UDC: 612.352.12:612.393.1:616-053.81
Abstract: Objective. To investigate the changes in whole capillary blood glucose in people with different attitudes to ethanol in the course of mental work on fasting and dynamics of oral glucose tolerance test (OGT) as important indicators of the risk of pathological (hypo- and hyper-) glycemic states and diabetes mellitus Type 2 (DM-2) development. Methods. The study was carried out on 27 young men (20-29 years old) and 74 girls (19-29 years old), episodic alcohol users (93 subjects) and non-alcohol users (8 total abstainers) after obtaining written consent twice (7 days before and on the day of the experiment). Psychometric indices and attitude towards alcohol were determined in each subject. During the study, the level of glycemia was determined 4 times in each female volunteer and 7 times in each male volunteer. The first glycemic level was measured in whole capillary blood in the state of functional rest. Three consequent measurements of glycemia were conducted during mental activity 2, 4 and 6 hours following the start of work. The last three times of glycemic measurement were carried out only in males - during the OGT (30, 60 and 120 minutes following ingestion of glucose in the amount of 75 g, diluted in 200 ml of water). Linear and rank correlation coefficients were calculated between indicators of alcohol consumption (single and monthly doses, frequency of alcohol consumption and duration of abstinence) and glucose content in whole capillary blood under various conditions (including the dynamics of glycemia). Results. The prevalence of alcohol consumption among young females was 100%, and among young males - 70.4%, including those with harmful consequences - 10.8% of females and 29.6% of males. In abstainers-volunteers, in functional rest on fasting, the glucose content in whole capillary blood was optimal and averaged 4.24 mm/l. During mental work, they had a constant increase in blood glucose levels (by 0.67; 1.16 and 1.54 mmol/l after 2, 4, and 6 hours, respectively). In the first three weeks of abstinence, both males and females who consume alcoholic beverages had an elevated level of fasting glucose, which exceeded the threshold for stimulation of insulin secretion. During mental work on an empty stomach after 6 hours from its onset in sober males and females, there was a decrease in the level of glycemia, indicating the risk of developing hypoglycemic states. Correlation analysis revealed the presence of statistically significant direct (positive) relationships between baseline glycemia and ethanol consumption indicators (frequency, single and monthly doses), as well as negative relationships between its dynamics of glycemia during mental work and frequency, single and monthly doses of alcohol consumption, indicating the dual nature of the effect of ethanol on blood glucose. During OGT, a more pronounced rise in the level of glycemia (sugar curve) in alcohol users compared with non-alcohol users and its relationship with indicators of ethanol consumption (positive) and the duration of abstinence (negative) was established. In 27.8% (P <0.05) of cases in alcohol users, the glucose content in capillary blood following ingestion of 75 g glucose reached 10.9 and 11.0 mm/l, which can be considered an early sign of impaired tolerance to glucose and predisposition to diabetes. Conclusions. The study showed a high prevalence of alcohol use among young people. Elevated fasting blood glucose was shown in boys and girls who consumed alcoholic beverages during the first three weeks of sober state in a state of functional rest and a similar change in glycemia during mental work was established. Smaller doses of alcohol consumed by the females and the same type of changes in fasting glucose during mental work as compared to males indicate a higher toxicity of ethanol for the females and the need to reduce the AUDIT test score from “8” to “4” for females. The findings suggest the dual nature of the effect of ethanol on glycemia, namely, an increase in the risk of both increased fasting hyperglycemia and the development of diabetes mellitus in people who consume alcoholic beverages (even at occasional consumption and relatively small doses), and the risk of developing hypoglycemic states (neuroglycopenia or hypoglycemic coma) with prolonged mental work.
Key words: глюкоза, алкоголь, этанол, гликемия, сахарный диабет, glucose, alcohol, ethanol, glycemia, diabetes
CONTACT OF CHITOSAN FILMS WITH CELLULAR ELEMENTS OF HUMAN VENOUS BLOOD IN VITRO
Burkova N.V., Kirichuk O.P., Kuznetsov S.I., Yudin V.E., Dresvjanina E.N., Romanchuk E.V.
UDC: 616-03+ 57.014
Abstract: Abstract Objective. To study the possibilities of activation and hemolytic activity of chitosan films in contact with human venous blood cell elements in vitro for possible use in clinical practice. Methods. The donor blood of healthy volunteers obtained at the blood transfusion station was studied. Blood was taken from cubital vein into a test tube with lithium at a volume of 9.0 ml. For the manufacture of blood-contact syringe-columns with a volume of 20.0 ml chitosan film weighing 0.36 g with the width of 1-3 mm, obtained from the chitosan company Fluka Chemie (Japan) by dissolving in 2% aqueous acetic acid solution, washing and drying were used. The columns were placed in a rotary stirrer with a rotation speed of 10 rpm. After 5, 20, 40 and 60 minutes, 1.8-2.0 ml of blood were taken and placed in tubes with EDTA. The samples were calculated on the analyzer SySmexXT 1800i. After hematological analysis, the blood sample was centrifuged for 10 min at 3500 rpm, diluted 30 times with saline and the optical density was determined at wavelengths of 414 and 540 nm on the UNICO 2802 (S) device. The obtained hemograms were used to calculate the cell adhesion rate for leukocytes and platelets, as well as the adhesion rate for leukocyte subpopulations (granulocytes and agranulocytes). Results. The contact of blood with the films of chitosan over 20 min leads to increasing erythrocyte hemolysis. To a greater extent, chitosan activates platelets, which suggests the presence of hemostatic properties of this drug. Conclusion. Chitosan films can be used in clinical practice only under the condition of short-term contact with blood (for example, the method of low-volume hemoperfusion).
Key words: хитозан, контактная активация крови, гемолиз, клеточные популяции крови, спектральные характеристики плазмы крови, chitosan, blood contact activating, hemolysis, cell blood populations, spectral characteristics of blood plasma
MECHANISM OF ANTIHYPOXIC ACTION OF COMPLEX COMPOUND NICOTINIC ACID
Katunina N.P., Novikov V.E., Gneushev I.M.
UDC: 615.03:577.164.15
Abstract: Objective. To study the effect of antihypoxant under laboratory code pQ-1043 on the parameters of oxidative metabolism, glycolytic metabolism, hemogram parameters. Methods. The effect of a new zinc-containing derivative of nicotinic acid - bisectioning(II) was investigated on mice-males of the SHR line. The intensity of oxidative exchange was estimated by the amount of oxygen consumption in a closed-type apparatus of S.V. Miropolsky's design and rectal temperature (electric medical thermometer "TPEM-1"). The content of glucose, pyruvic acid, lactic acid, lactate dehydrogenase activity in the blood and glycogen content in the liver were determined by biochemical analyzer Syncurion 4 CE of Bercman (USA). Morphological indicators of blood and the hemoglobin content were determined on the apparatus Microdiff 18 company Coulter (USA). Acute hypoxia with hypercapnia was modeled in a 250 ml pharmacy glassware. Results. The compound πQ-1043 at a dose of 25 mg/kg in the first 1-3 hours after intraperitoneal administration reduces the level of oxygen consumption (by 28 and 13%) and the body temperature of experimental animals. The studied compound does not affect glycolytic carbohydrate metabolism in intact mice, but significantly corrects changes in these parameters that occur after exposure to acute hypoxia in animals. The PQ-1043 compound does not alter hematological parameters in intact mice (erythrocytes, leukocytes, platelets, and hemoglobin), but supports adaptive erythrocytosis in hypoxia. Conclusion. The antihypoxic effect of the compound πQ-1043 is likely to be realized by reversible inhibition of oxidative metabolism, which leads to a decrease in animal oxygen demand. In hypoxia, the studied compound prevents the development of hypoglycemia.
Key words: гипоксия, антигипоксанты, πQ-1043, окислительный обмен, гликолитический обмен, hypoxia, antihypoxants, πQ-1043, oxidative metabolism, glycolytic metabolism
MORPHOLOGICAL PROFILE AND EATING HABITS OF STUDENTS IN THE EDUCATIONAL PROCESS AT HIGH SCHOOL
Smol'yakova N.I., Bubnenkova O.M., Aloina O.S.
UDC: 572.087-613.2.03
Abstract: Objective. To identify the dynamics of the studied morphological parameters of students, their diet and lifestyle for two years of study at the University to optimize and improve the efficiency of the training process and improve the quality of life. Methods. The research presents anthropometric and bioimpedance characteristics (body length and weight, body mass index, the severity of fat and muscle components) of students-athletes involved in sports games. The article presents a survey of their lifestyle, eating habits, as well as the indicators of the main metabolism and material security for two years of observation. The paper analyzes the menu layout-the content of the main food ingredients, their proper values, the balance of nutrition in composition and its diversity. Results. It was revealed that during the study at the University most students change their attitude to nutrition, engage into active motor mode; the muscle component prevails over fat, which leads to improved performance in all areas of activity. Conclusion. It was concluded that the male subjects during the experiment improved the severity of muscle mass and reduced fat gain; in the group of female subjects fat mass prevailed over muscle.
Key words: студенты-спортсмены, морфологический профиль, компонентный состав тела, образ жизни, статус питания, student-athletes, morphological profile of the component body composition, lifestyle, nutritional status
METHODS OF TESTING THE HYPOTHESIS OF NORMAL DISTRIBUTION OF A SMALL SAMPLE IN PHARMACOLOGICAL STUDY
Lyamec L.L., Evseev A.V.
UDC: 519.253
Abstract: Objective. Pharmacological research is usually expensive and is conducted with limited resources and financial support. Therefore, the sample sets (samples) formed for the study, as a rule, have a small volume. The sample is conventionally considered small if its volume does not exceed 30 units of observation. A typical task of statistical analysis of the sample in pharmacological studies is to check the statistical hypothesis about the normal distribution of the studied features. Substantiation of the normality of the distribution of features opens up opportunities for the use of parametric methods of statistical analysis. To justify the adequacy of the distribution of the studied features, the criterion of consent (Chi-square) can be used.Popular educational and special literature sources describe the theoretical provisions and the algorithm for the implementation of the criterion of consent, in which equal in width intervals are initially used for the implementation of the experimental data grouping, i.e. equidistant grouping is used. For correct application of the criterion of consent, the numerical values of absolute frequencies in the grouping intervals must count at least five. In case of violation of this condition, there is a need to regroup and combine the intervals in which the absolute frequencies are small. This complicates the algorithm of implementation of the criterion of consent, entails additional computational and time costs. For practical activities, it is desirable to have methods, the implementation of which is based on simpler algorithms. The obvious problem situation determined the purpose of the theoretical study, which is to develop a technique for the implementation of the criterion of agreement for small samples, the calculation of power and errors of the second kind for this criterion. Methods. The theoretical substantiation of the possibility of grouping the sample values using four intervals for which the theoretical frequencies are the same (equal frequency grouping) was carried out. The peculiarities of realization of the consent criterion using equal frequency grouping of experimental data were assessed. The theoretical positions underlying the calculation of the power (sensitivity) of the statistical criterion were analyzed. An algorithm for calculating the power of criterion using available modern information technologies was proposed. Results. A method for testing the hypothesis of the normal law of distribution of features in a small sample based on the equal frequency grouping of sample data, which has obvious advantages over the equal interval grouping, was developed and justified. In the proposed technique, based on the equal-frequency grouping, the amount of calculations is less and the calculations themselves are easier than with the equal-interval grouping. Unification of grouping and reduction of the number of computing operations significantly simplify algorithmization and development of software for automation of calculations. The proposed method describes the procedure for calculating the power of the statistical Chi-square test and shows a practical example of automation of calculations using modern information technology. Conclusion. The developed method makes it possible to significantly simplify the calculations associated with the test of the hypothesis of the normal distribution of the studied features in a small sample, and the quantitative assessment of the power of the criterion. Substantiation of the adequacy of the distribution of the studied features is a necessary condition for further correct application of parametric methods of statistical analysis. The technique can be of practical interest for scientists who carry out research in the field of pharmacology and use statistical methods of analysis of experimental datain their work.
Key words: статистический анализ, выборочный метод, проверка статистических гипотез, группировка экспериментальных данных, мощность статистических критериев, нецентральное распределение хи-квадрат, параметр нецентральности, statistical analysis, sampling method, statistical hypothesis testing, grouping of experimental data, power of statistical criteria, distribution of noncentral Chi-square, noncentrality parameter
ROLE OF EXCITOTOXICITY IN PATHOGENESIS OF BRAIN DAMAGE DURING ISCHEMIA
Bon L.I., Maksimovich N.E.
UDC: 616.831.31-005.4.-092.913:618.33
Abstract: Objective. Analysis and synthesis of literature data on the role of excitotoxicity in the pathogenesis of brain damage during ischemia. Methods. The basis of this study was a review of modern foreign and domestic literature on this topic. Results. In the pathogenesis of neuronal death in patients with ischemic brain damage, the development of excitotoxicity is an important link. In ischemia of neurons, excessive release of excitatory neurotransmitters glutamate and aspartate from synaptic terminations into the intercellular space occurs due to disturbances of the ion transport and depolarization of the presynaptic membranes. High levels of glutamate and aspartate as well as the imbalance of excitatory and inhibitory mediators in blood plasma are a manifestation of the initiation of the pathobiochemical cascade of cerebral ischemia. Conclusion. The information presented provides a basis for further study of the pathogenesis of ischemic brain damage and the search for ways to prevent and correct this pathology.
Key words: эксайтотоксичность, нейроны, ишемия, головной мозг, excitotoxicity, neurons, ischemia, brain
ONTOGENESIS DISTURBANCES OF BRAIN HISTAMINERGIC SYSTEM UNDER VARIOUS EXPERIMENTAL ACTIONS
Zimatkin S.M., Zaerko A.V., Phedina K.M.
UDC: 612.82:577.175.824:612.08
Abstract: Objective. The literature analysis and the results generalization of world-wide studies of the individual brain histaminergic system development disorders under various experimental effects. Methods. Data collection, systematization and analysis of the development features of the brain histaminergic system during various experimental influences were carried out in Russian and foreign scientific literature. Results. The review describes disturbances in the ontogeny of the brain histaminergic system in such pathological conditions as diabetes mellitus and diabetes insipidus, hypo- and hyperthyroidism, autism spectrum disorders, changes in dopaminergic signaling and the amount of dopamine, alcohol intoxication. These disturbances demonstrate the role of glucose, vasopressin, thyroid hormones, valproic acid, dopamine and other factors in the individual development of the histaminergic system. Conclusion. The analysis of the literature data allows to conclude that the developmental brain histaminergic system is highly sensitive to various endogenous and exogenous factors.
Key words: гистаминергическая система, головной мозг, онтогенез, histaminergic system, brain, ontogenesis
NICOTINE ADDICTION IN SMOKING PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ALCOHOL DEPENDENCE SYNDR
Ivanova M.A., Punin A.A., Vaulin S.V.
UDC: 616.24+613.81
Abstract: Objective . The purpose of the investigation was to clear up the aspects of nicotine addiction in smoking patients with chronic obstructive pulmonary disease at different stages of alcohol dependence syndrome. Methods. 128 men with the diagnosis of chronic obstructive pulmonary disease at the age from 40 to 88 years were examined. According to the available guidelines, spirometry with the assessment of standard data and the test for the reversibility of obstruction with the use of 400 mg of salbutamol; assessment of nicotine addiction (Fagerstroem-test), the volume of nicotine abuse - amount of smoking index and pack/years were performed. The distribution of patients by stages of alcohol dependence syndrome was carried out on the basis of the criteria set out in the National recommendations in narcology (2008). Statistical processing was performed using the licensed program SPSS 17. Results. There was an increase in nicotine dependence and the level of actual tobacco load with the progress of alcohol disease revealed. This indicated absence of attempts to stop smoking in this group of patients. The interrelation between alcohol and nicotine dependence is based on both morphological and psychopathological grounds. Among older patients there were no persons with terminal form of alcohol disease. This indicated a reduction of life expectancy in intensely smoking and alcohol abusing patients. Conclusions. Therefore, an increase in the level of actual tobacco load and nicotine addiction in patients exposed to alcoholism was revealed. The Faferstroem-test made it possible to objectify the severity of the patient's condition to determine further treatment plan.
Key words: хроническая обструктивная болезнь легких, синдром алкогольной зависимости, никотиновая зависимость, chronic obstructive pulmonary disease, alcohol dependence syndrome, nicotine addiction
PRACTICE MICROBIOLOGICAL DIAGNOSIS OF INFECTIVE ENDOCARDITIS IN THE RUSSIAN FEDERATION
Danilov A.I., Kozlov R.S., Kozlov S.N., Evseev A.V.
UDC: 616.126-002 + 615.33
Abstract: Objective. To study the features of microbiological diagnosis of infective endocarditis in the Russian Federation. Methods. A multicenter study of the etiology, antibiotic resistance and pharmacoepidemiology of infectious endocarditis, consisting of 2 parts: prospective (September 2011 - December 2016) and retrospective (January 2006 - August 2011) was conducted. The study included patients of both sexes of all age groups with certain and probable IE. The diagnosis of IE was made according to the Duke criteria. The study included 406 (in the prospective part - 166, in retrospective - 240) cases of IE. The patients were hospitalized in 11 medical institutions in 9 cities of the Russian Federation (Arkhangelsk, Kazan, Moscow, Omsk, St. Petersburg, Smolensk, Tyumen, Yakutsk, Yaroslavl). All hospitals that took part in the study have a multidisciplinary profile and their own microbiological laboratory. Results. In the general structure of the study, bacteriological diagnosis of blood was carried out repeatedly in 52.7%, once - in 47.3%. At the same time, the timeliness of this study was noted in 20.9% (in the prospective part of the study - in 19.3%, in the retrospective part of the study - in 22.1%). Conclusions. According to the study, the frequency of etiologically significant pathogens was 35.5%. The low level of determination of the etiological structure in infectious endocarditis in the Russian Federation is largely due to the established practice of bacteriological blood tests (low multiplicity of blood samples, the appointment of antimicrobial therapy prior to bacteriological diagnosis of blood).
Key words: инфекционный эндокардит, бактериологическое исследование крови, антимикробная терапия, infective endocarditis, microbiological diagnosis, antimicrobial therapy
ECHOCARDIOGRAPHIC EXAMINATION OF PATIENTS WITH INFECTIVE ENDOCARDITIS IN THE RUSSIAN FEDERATION
Danilov A.I., Abramenkova N.U., Milyagin V.A., Osipenkova T.A.
UDC: 616.126-002 + 615.33
Abstract: Objective. To study the features of echocardiographic examination of patients with infective endocarditis in the Russian Federation. Methods. A multicenter study of the etiology, antibiotic resistance and pharmacoepidemiology of infectious endocarditis, consisting of 2 parts: prospective (September 2011 - December 2016) and retrospective (January 2006 - August 2011) was carried out. The study included patients of both sexes of all age groups with certain and probable IE. The diagnosis of IE was made according to the Duke criteria. The study included 406 (in the prospective part - 166, in the retrospective - 240) cases of IE. The patients were hospitalized in 11 medical institutions in 9 cities of the Russian Federation (Arkhangelsk, Kazan, Moscow, Omsk, St. Petersburg, Smolensk, Tyumen, Yakutsk, Yaroslavl). All hospitals that took part in the study have a multidisciplinary profile and their own microbiological laboratory. Results. In conducting echocardiography in the overall structure of the study, transthoracic echocardiography was used in 84.2% of cases, transesophageal echocardiography - in 3.7%, both methods of echocardiography - in 12.1%. In the prospective study, the corresponding indicators were- 75.3%, 4,8%, 19.9%, in the retrospective study-90.4%, 2.9% and 6.7%. Conclusions. According to the study, the most frequent localization of lesions in the overall structure of the study was the mitral valve - 43.6%, the aortic valve was affected in 37.9%, the tricuspid valve - in 34.7%, the pulmonary valve - in 0.5%. Combined valve damage in the overall structure of the study was noted in 15.9%.
Key words: инфекционный эндокардит, эхокардиографическое исследование, клапанный аппарат сердца, infective endocarditis, echocardiographic examination, heart valves
VARICOSE VEINS OF THE SMALL PELVIS, POLYCYSTIC OVARIAN DISEASE AND OTHER COMORBIDITIES IN WOMEN WITH TUBAL PREGNANCY
Sharipov G.N., Ismoilov M.M., Shaimonov A.Kh., Saidov M.S., Ismoilov E.Kh.
UDC: 616.146.7-007.63-08; 618.11-006.31-07-08
Abstract: Objective. To study the frequency of concomitant gynecological pathology in women with tubal form of ectopic pregnancy, as well as its effect on the reproductive status of patients. Methods. A study of 188 patients with tubal form of ectopic pregnancy, as well as surgical tactics depending on the operational findings, for the period 2013-2017 are presented. The average age of the patients at the time of admission was 25.7±2.1 years. Patients underwent ultrasound and transabdominal examination. Results. During the ultrasound examination of the pelvic organs and the abdominal cavity from the reproductive system, comorbidities were detected in 135 (71.8%) women. A combination of two or even three pathologies detected intraoperatively was also found. Presence of varicose veins of the pelvis (n=92; 48.9%) and polycystic ovaries (n=87; 46.4%) were most frequently confirmed. At the same time, bilateral lesion of the ovaries (n=56; 64.4%) was more common than unilateral (n=31; 35.6%). The nature of the operation performed indicates the severity of the cyst lesion. In 43 (49.4%) cases it was possible to confine to cautery cysts (cauterization with a coagulator), but in 44 (50.6%) - the process was so extensive that it took wedge-shaped resection of the ovary. Uterine fibroids were observed in 35 (20.2%) women, adhesive pelvic disease - in 69 women, and were of different etiology. Conclusions. Women with tubal form of ectopic pregnancy are a contingent with a high frequency of concomitant damage to the pelvic organs.
Key words: трубная беременность, варикозное расширение вен, поликистоз яичников, миома матки, спаечная болезнь малого таза, микрохирургическое восстановление фаллопиевых труб, tubal pregnancy, varicose veins, polycystic ovary, uterine myoma, adhesive pelvic disease, microsurgical restoration of the fallopian tubes
COMPREHENSIVE ASSESSMENT OF THE CORRECTION OF MORPHOFUNCTIONAL DISORDERS IN ADMA PREECLAMPSIA BY TRIMETAZIDINE
Antsiferova O.E., Yurakova A.V., Lokteva T.I., Severinova O.V., Gureev V.V.
UDC: 618.3-06-08:577.112.385.2
Abstract: Objective. To study the effectiveness of the use of the drug Trimetazidine in the correction of morphofunctional disorders that occur during preeclampsia in the experiment. Methods. The experiment was performed on 150 white female rats of the Wistar line weighing 250-300 g. ADMA-like agent (L-NAME) was introduced intraperitoneally at a dose of 25 mg/kg/day from 14 to 20 days of gestation. Trimetazidine (Preduktal, Servier) at a dosage of 3 mg/kg and 6 mg/kg was introduced intragastrically through a probe 1 time per day from 14 to 20 days of gestation. On the 21st day of gestation, functional tests and laboratory tests were performed. Results. Administration of trimetazidine to animals leads to a pronounced correction of pathological changes in experimental ADMA-like preeclampsia with the greatest effect at a larger dose of the preparation used. There was a significant decrease in systolic and diastolic pressure, respectively, improvement of microcirculation in the placenta, restoration of the NO-synthesizing function of the endothelium, reduction of proteinuria. Conclusion. The results of the study indicate the potential of using trimetazidine for the correction of morphofunctional changes in preeclampsia and justify the feasibility of further research in this direction.
Key words: триметазидин, преэклампсия, эндотелиальная дисфункция, крысы, протеинурия, микроциркуляция, trimetazidine, preeclampsia, endothelial dysfunction, rats, proteinuria, microcirculation
CONDITION OF MAMMAL GLANDS IN WOMEN WITH BENIGN OVARIAN TUMORS
Kholova S.H., Niyazova S.D., Khushvakhtova E.H., Bolieva G.U.
UDC: 618.1:616.07 (584.5)
Abstract: Objective. To study the clinical and anamnestic features of women of reproductive age with benign tumors (MILF) and tumor-like formations of the ovaries (OOJ) and dyshormonal diseases of the mammary glands. Methods. A prospective analysis of clinical and anamnestic data of patients of reproductive age with MU and OV ovarian tumor formations was carried out. Results. In the examined patients, a high frequency of extragenital and gynecological pathology was established. In 47.1% (148) patients, ovarian pathology is combined with various types of menstrual disorders. In women of active childbearing age, various types of menstrual disorders are by 2.2 times higher with benign ovarian tumors compared with tumor-like ovarian formations. At the same time, patients of late reproductive age with ovarian tumor formations are by 1.4 times more disturbed in the menstrual cycle than women with benign ovarian tumors. At the same time, diseases of the mammary glands were represented to a greater extent by diffuse forms of fibrocystic mastopathy. Conclusions. The risk of developing ovarian tumors and dyshormonal diseases of the mammary glands increases in women with chronic inflammatory processes of the organs of the genitals, pathology of menstrual function, previously undergone by surgical interventions of the organs of the genitals, hyperplastic processes of endo- and myometrium.
Key words: доброкачественные новообразования яичников, доброкачественные опухоли яичников, опухолевидные образования яичников, репродуктивный возраст, доброкачественные заболевания молочных желёз, benign tumors of the ovaries, benign ovarian tumor, ovarian tumor formation, reproductive age, benign diseases of the breast
DYNAMICS OF THE SEVERITY OF ANXIETY-DEPRESSIVE DISORDERS IN PATIENTS IN THE EARLY RECOVERY PERIOD OF ISCHEMIC STROKE
Golovina O.S., Eliseeva E.V., Kalinskii D.P., Kalinskii P.P., Perelomova O.V.
UDC: 616.831.-005.1-06:616.89-008.454-085.214.2
Abstract: Objective. To evaluate the effect of the drug containing antibodies to the brain-specific protein S-100 and endothelial NO-synthase on the degree of post-stroke of the level of depression in the early recovery period. Materials and methods. 53 patients (37 men and 16 women) were examined in the early recovery period of ischemic stroke, the average age was 60,8±5,3 g. The neuropsychological examination included the following tests: scale of Hamilton, the degree of disability after a stroke on the Rankin scale. Results. After medication of the drug containing antibodies to the brain-specific protein S-100 and endothelial NO-synthase, the severity of depression in the main group decreased by 31.56%, p<0.05; in the comparison group without positive dynamics, the degree of disability in the main group decreased by 53%, 0.94±0.6, p<0.05; and in the control group - by 18%, 1.78±0.68, p<0.05. Conclusions. The use of the preparation containing antibodies to the brain-specific protein S-100 and endothelial NO-synthase at a daily dosage of 0.036 g in patients in the early recovery period of ischemic stroke significantly reduces the severity of depressive disorders, improves the mood background, regresses somatic sensory symptoms, decreases the severity of neurological deficit. During the drug treatment, no side effects were reported.
Key words: ишемический инсульт, ранний восстановительный период, депрессия, неврологический дефицит, антитела к мозгоспецифическому белку S-100 и эндотелиальной NO-синтазе, ischemic stroke, early recovery period, depressive symptoms, antibodies to the brain-specific protein S-100 and endothelial NO-synthase
THE USE OF DIFFERENT METHODS FOR DETERMINING THE SPECTRAL PARAMETERS OF LASER DOPPLER FLOWMETRY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Vasilev P.V., Erofeev N.P., Shishkin A.N.
UDC: 616-71
Abstract: Objective. To analyze the advantages and disadvantages of using the average and maximum amplitudes of the frequency ranges in the determination of the spectral parameters of laser Doppler flowmetry. Methods. The study included 20 patients with type 2 diabetes mellitus and 20 patients without diabetes mellitus. Each patient underwent 5-minute registration of LDF. Spectral indices were calculated in two ways: using the average and maximum amplitudes of certain frequency ranges. Results. In both groups, significantly lower values of the contribution of slow-wave flaxmotions, respiratory flaxmotions and flaxmotion index were obtained using maximum amplitudes (p <0.05). At the same time, values of pulse flaxmotions contribution and intravascular resistance in both groups were significantly higher when using maximum amplitudes (p <0.05). The decrease in the contribution of slow-vave flaxmotions and flaxmotion index reflects dysfunction of microcirculation. Thus, to increase the sensitivity of LDF diagnostics, it seems more advantageous to use maximum amplitudes. However, the differentiating symptom of microcirculatory dysfunction according to the diabetic type is the predominance of the contribution of respiratory fluxmotions over the pulse flaxmotions. Therefore, for the differential diagnosis of diabetic microangiopathy, it is reasonable to use methods that allow one to obtain higher values of the contribution of respiratory and lower values of pulse flaxmotion, which is obtained by using medium amplitudes. Conclusion. Calculation methods using the maximum amplitudes of the characteristic frequency ranges of the LDF spectrum have the greatest potential for identifying dysfunction of the microcirculatory blood flow. In contrast, average amplitudesusing methods can improve the differential diagnosis of diabetic microangiopathy. Thus, it seems reasonable to consider the possibility of using both maximum and average amplitudes simultaneously to increase the sensitivity and specificity of LDF diagnostics for using LDF in the diagnosis of microcirculation disorders.
Key words: лазерная допплеровская флоуметрия, микроциркуляция, спектральный анализ, средние и максимальные амплитуды, laser Doppler flowmetry, micricirculation, spectral analysis, average and maximum amplitudes
POSSIBILITIES OF DIAGNOSING BY THE HISTOLOGICAL METHOD AND REAL-TIME POLYMERASE CHAIN REACTION IN BIOPSY SPECIMENS OF THE GASTRIC MUCOSA IN PATIENTS WITH ISOLATED BY CULTURE
Dehnich N.N., Jejdel'shtejn I.A., Evdokimov A.N., Kireev D.D., Reshetova S.V.
UDC: 616.33-002.44-071
Key words: Helicobacter pylori, гистологический метод, полимеразная цепная реакция в реальном времени, гастробиоптаты, Helicobacter pylori infection, histological method, real-time polymerase chain reaction, gastric biopsies
EFFECTIVENESS OF RAPY OF H. PYLORI IN CHRONIC GASTRITIS IN ADOLESCENTS, DEPENDING ON THE GENETIC STRUCTURE OF HELICOBACTER PYLORI
Manakina O.M., Spivak E.M., Akkuratova I.S.
UDC: 616.33-002.2-085-053.7:579.835.12
Abstract: Objective. To establish the dynamics of pathomorphological changes in the gastric mucosa in adolescents with chronic gastritis associated with high- and low-pathogenic strains of Helicobacter pylori, after a course of antihelicobacter therapy. Methods. Clinical, endoscopic and morphological examination of 40 adolescents aged 15-17 with chronic gastritis before and 6 months after a course of H. pylori kvadrotherapy was performed. In the gastrobiopsy genetic structure Hp by polymerase chain reaction was investigated using test systems of "DNA-Technology". Results. In 27 patients out of 40, highly pathogenic Hp strains were detected in the gastric mucosa. In this group of patients, high dissemination of Hp after treatment remained; high severity and activity of the inflammatory process and morphological signs of atrophy were observed. Conclusion. Colonization of the gastric mucosa by highly pathogenic Hp strains is a factor preventing eradication of infection in chronic HP-associated gastritis in adolescents.
Key words: хронический гастрит, Helicobacter pylori, подростки, chronic gastritis, Helicobacter pylori, adolescents
INHALATION OF AMIKACIN IN PATIENTS WITH NOSOCOMIAL PNEUMONIA IN THE INTENSIVE TREATMENT DEPARTMENT
Chukina M.A., Lukina M.V., Andrushchishina T.B., Tsarev I.L., Morozova T.E.
UDC: 616.035.3
Abstract: Objective. To evaluate the efficacy, safety, pharmacokinetic profile of amikacin in inhalation and microbiological results dynamic changes in patients with ventilator-associated pneumonia. Methods. 19 patients were included in the study. A clinical assessment of pulmonary infection score (CPIS) was used to assess the probability of ventilator-associated pneumonia. The empirical antibiotic therapy included carbapenems or cephalosporins with beta-lactamase inhibitors in combination with amikacin inhalation. Efficacy was assessed by clinical, laboratory and instrumental data according to physiological scores on 2nd and 10th day of therapy. Biological fluids samples were collected for pharmacokinetic studies. Statistical processing was performed using R 3.3.2 language [R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, 2008]. Results. The survival rate was 42.1%, p=0.851. A decrease in the CPIS scale points was found. In patients with inhaled amikacin no adverse side effects were observed. The blood concentration of С amikacin after inhalation was 0.82±0.14 μg / ml. Amikacin concentration in the tracheal aspirate reached 157 μg/ml [147.79; 185.00]. The obsedrved predominant respiratory pathogens were gram-negative multidrug-resistant pathogens: Kl. pneumoniae (ESBL +, CR) (n=7), Ps.aeruginosa CR (n=3), Ps.aeruginosa ESBL + (n=4). In the dynamic microbiological analysis there was a decrease in the number of colony forming units of resistant strains. Conclusion. Inhaled amikacin administrationin combination with standard antibiotic therapy is safe. There was a positive clinical and laboratory dynamics in the patients’ condition. The concentration of inhaled amikacin can reach high levels in tracheal aspirate and helps to reduce the colonization of multi-drug resistant microorganisms.
Key words: нозокомиальная (госпитальная) пневмония, вентилятор-ассоциированная пневмония, антибиотикорезистентность, ингаляционный амикацин, фармакокинетические показатели, nosocomial (hospital) pneumonia, ventilator-associated pneumonia, antibiotic resistance, inhaled amikacin, pharmacokinetic parameters
TORSION AND NECROSIS OF THE STRANDS OF THE GREATER OMENTUM IN CHILDREN
Labuzov D.S., Savchenkov A.L., Abrosimova T.N.
UDC: 616.382-007.59-07-089
Abstract: Objective. To present a description of own rare observations of greater omentum torsion in children. Methods. Clinical information analysis of observed by the authors cases of torsion of the greater omentum in patients-boys 5, 6 and 7 years. Results. All patients had a partial primary torsion of the omentum. When collecting anamnesis, clinical, laboratory and instrumental examination, no specific signs of the gland twist were revealed. Indications for diagnostic laparoscopy or laparotomy were the preservation of the clinic and the inability to eliminate the acute process in the abdominal cavity. In all patients, the exact diagnosis was established only intraoperatively. Conclusions. Torsion of the greater omentum occurs under the guise of acute appendicitis. Diagnosis during the ultrasound examination, is hardly possible. Predisposing factors are excess body weight or abdominal ingury. The diagnosis is established intraoperatively when performing laparoscopy or laparotomy, followed by resection of the changed portion of the omentum.
Key words: заворот сальника у детей, хирургическое лечение, лапароскопия, torsion of the omentum in children, surgical treatment, laparoscopy
GIGANT LEIOMYOMA CAUSING SMALL INTESTINAL OBSTRUCTION IN AN ELDERLY PATIENT
Lomachenko Ju.I., Sokolov A.N., Sukharukov A.S.
UDC: 616.341-006.36
Abstract: Objective.To present a rare clinical observation of a giant leiomyoma, which caused small intestinal obstruction in an elderly patient, who required a diagnostic laparotomy with further resection of the small intestine with a tumor. Methods. According to the materials of the case histories, clinical examination, pre - and postoperative patient's management a clinical case of leiomyoma of the small intestine in an86-year-oldpatient treated in Hospital surgery clinic in the Emergency surgery department of №2 of the Clinical emergency hospital of Smolenskwas studied. Results. The recurrent nature of the small bowel obstruction was the reason for seeking medical attention and the indication for the choice of surgical treatment. A special feature of the clinical case should be considered a positive response to conservative therapeutic measures aimed at relieving acute intestinal obstruction. In this case, the organ belonging of the tumor was not accurately established before the operation. Only taking into account the histological study, the removed tumor was recognized as a tumor of the small intestine; the gastrointestinal stromal tumor was not excluded. According to the results of immunohistochemical studies, the diagnosis of leiomyoma was established. The patient recovered. Conclusion. Senile age is no exception for the possible development of small intestine leiomyoma, while it can reach large sizes and have life-threatening complications. In surgical treatment, any tumors of the small intestine should be treated as malignant, taking into account the ambiguity of their histogenesis during the execution of urgent surgery and the possible potential for malignancy. The prognosis of surgical treatment of complicated tumors of the small intestine, leiomyomas-in particular, in elderly patients can be favorable.
Key words: лейомиома тонкой кишки, гастроинтестинальная стромальная опухоль, осложнения, дифференциальный диагноз, хирургическое лечение, small intestine leiomyoma, gastrointestinal stromal tumor, complications, differential diagnosis, surgical treatment
FEATURES OF ORIGINAL NAVIGATION AND POSITIONING SYSTEM FOR HIP REPLACEMENT
Varfolomeev D.I., Samoday V.G.
UDC: 616-72
Abstract: Objective. To conduct a comparative assessment of the developed original navigation and positioning system and optical navigation system for hip replacement. Methods. The navigation and positioning system includes the original navigation system for hip replacement, a device for fixing the patient during hip replacement, a device for determining the length of the limb and offset. A comparison of two groups of patients who were treated at the Voronezh regional clinical hospital N1 from 01.01.2015 to 31.12.2017 was made. The comparison group included 32 patients who were operated using the developed navigation system, the control group included 43 patients operated using an optical navigation system. Results. The developed navigation and positioning system allows to ensure the performance of all functions implemented by modern navigation systems with comparable accuracy of implant placement. At the same time, its advantages are the reduction of traumatic intervention, and also a possibility of control of effort at installation of components of an endoprosthesis. Conclusions. The use of the proposed navigation and positioning system can improve the quality of total hip replacement surgery and improve the quality of life of patients.
Key words: эндопротезирование тазобедренного сустава, навигационная система, гироскоп, акселерометр, hip arthroplasty, navigation system, gyroscope, accelerometer
PHARMACOKINETIC PECULIARITIES OF CIPROFLOXACIN INTRAVENOUS AND ORAL FORM IN PREOPERATIVE PROPHYLAXIS IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA
Sosin I.V., Shabanov P.D., Pobozhy M.A.
UDC: 615.015+616-001.5
Abstract: Objective. To study pharmacokinetic differences after intravenous and oral administration of ciprofloxacin during perioperative prevention of infectious complications in patients with benign prostatic hyperplasia. Methods. The study involved 66 men aged 50 years and older with diagnosed benign prostatic hyperplasia (gland volume - 30-60 cm). All patients who planned TURP, perioperative antibiotic prophylaxis (PAP) was carried out, which was carried out by prescribing the substance ciprofloxacin hydrochloride containing 99.7% of the active substance. The manufacturer of the drug was the company "Zhejiang Goban pharmaceutical" (China). Results. It was found that the concentration of ciprofloxacin in the urine of patients of the 1st (I/V) group was 2 times lower than in the 2nd (inside) and amounted to 58.91 ± 39.57 mg/l, while the introduction of the drug per os provided a concentration of 105.48 ± 64.32 mg/l. subsequently, during the monitoring of patients after TURP, it was noted that the preventive dose of ciprofloxacin inside for 90-120 min. before surgery, postoperative was accompanied by the development of infectious complications in all 2.5% of cases compared to the results, obtained after I / V administration of the drug for 30-60 min. before surgery, 20% of patients in this group had complications. The clinical results of PAP in the study of the ways of ciprofloxacin administration were fully consistent with the data of the population pharmacokinetic study. Conclusions. The obtained data explain the higher efficiency of ciprofloxacin after it was administered per os with the aim of perioperative antibiotic prophylaxis when performing a transurethral resection of the prostate.
Key words: ципрофлоксацин, доброкачественная гиперплазия предстательной железы, периоперационная профилактика, ciprofloxacin, benign prostatic hyperplasia, preoperative antibiotic prophylaxis
QUANTITATIVE DETERMINATION OF THE SUM OF HYDROXYCINNAMIC ACIDS IN THE DRY EXTRACT OF DANDELION HERB AND LARGE BURDOCK LEAF SPECIE
Chistova Yu.I.
UDC: 615.322:547.972.2].074(571.15)
Abstract: Objective. To determine the quantitative content of hydroxycinnamic acids in the dry extract of dandelion herb and large burdock leaf specie. Methods. The object of study is the dry extract dandelion medicinal herb and burdock large leaf, obtained by the method of rematseration, the extractant - purified water, the ratio “raw material/extractant” is 1/10. Quantitative determination of the amount of hydroxycinnamic acids in the extract were held by spectrophotometry. Results. As a result of the research, it was established that the dry extract of dandelion medicinal herb and burdock large leaf contains 5,43-7,51% hydroxycinnamic acids in conversion to chlorogenic acid. A validation evaluation of the spectrophotometric method for determining the quantitative content of the sum of hydroxycinnamic acids were carrying out by the following indicators: specificity, linearity, analytical rage, precision, accuracy. Conclusions. The content of hydroxycorenic acids in conversion to chlorogenic acid in the dry extract of dandelion medicinal herb and burdock large leaf was 5,43 to 7,51%. The method of quantitative determination of hydroxycinnamic acids in the dry extract were validated. The method is valid and can be used to determine the quantitative content of the sum of hydroxycorenic acids in the dry extract of specie of dandelion medicinal herb and burdock large leaf
Key words: экстракт, одуванчик лекарственный, лопух большой, сбор, хлорогеновая кислота, extract, dandelion, burdock, specie, chlorogenic acid
BIOPHARMACEUTICAL RESEARCHES ON OPTIMIZATION OF MEDICINAL SEKSTAFAG® PLATES STRUCTURE
Kovyazina N.A., Nikolaeva A.M., Funkner E.V.
UDC: 615.453:578.81
Abstract: Objective. Optimization of medicinal Sekstafag plates structure. Methods. As the object of the research liquid commercial medicine Sekstafag® and shape-shifter -biodegrading polymers of natural and synthetic origin were used. The medicinal plates were obtained by a homogenization of Sekstafaga and sterile solution of polymer, with the subsequent sublimation drying. Tests of the medicinal plates on the indications of the description, рН water extraction, and the absorbing ability were carried out according to the requirements of OFS 1.4.1.0024.18 "Medicinal sponges". Disintegration was assessed according to OFS 1.4.1.0035.18 "Films". The lytic activity of the Sekstafag was estimated by the Appelman's method. The cryopatronage coefficient (Kkp) was counted by a ratio of lytic activity of a bacteriophage in a medicinal plate, expressed in percentage to lytic activity of the bacteriophage in the integrated polymeric system of gel before drying, expressed in percentage. The release of bacteriophages from the medicinal plates was determined by diffusion method in gel. Optimization of the medicinal Sekstafag® plates structure was performed by means of the generalized function of the Harrington desirability. Results. According to the empirical system of preferences (desirability) it was revealed that form-building polymers of methyl cellulose, collagen and gelatin have optimum biopharmaceutical properties. From this group of polymers, the optimum technological properties for creation the medicinal plates with the immobilized bacteriophage is methyl cellulose, as it is not destructurised at various modes of sterilization and passes into a gel form at a temperature (8±2) °C. Conclusion. The experimental data show that for designing of highly effective medicinal Sekstafag® plates as a formation agent, methyl cellulose use is rational.
Key words: бактериофаг, биологическая доступность, литическая активность, пластины лекарственные, релиз, bacteriophage, biological availability, lytic activity, medicinal plates, release
CREATION OF THE MODEL OF CONFLICT COMPETENCE OF A PHARMACEUTICAL SPECIALIST
Vorozhtsova E.S.
UDC: 615.15
Abstract: Objective. The aim of the review was to comprehensively consider the interpretation of the concepts of conflict competence of workers to develop a model of conflict competence of a pharmacist. Methods. The selection of literary sources for the review was carried out using elements of the method of content analysis. The following key concepts were identified for conducting the search: conflict competence (two words in Russian language - konflictnaya / konflictologicheskaya). Information base of research is formed on the basis of data from the database of scientific publications elibrary. Results. The article discusses the need to build the competence of pharmacists in the field of conflict management. On the basis of current regulatory legal acts, the author formulates the relevance of developing conflict management skills among pharmacists. An analysis of the interpretation of key definitions of conflict competencies from the point of view of various scholars was carried out, and their own definition of the concept of conflict competence was proposed. The authors studied the results of researches on the building of competence in the field of conflict management in various fields of activity. Conclusion. The author developed and proposed a four-component model of conflict competence of a pharmacist.
Key words: конфликтологическая компетентность, фармацевтический специалист, модель, управление конфликтами, фармацевтическое образование, conflict competence, pharmacist, model, conflict management, pharmaceutical education
DYNAMICS OF INDICATORS OF USING THE BONE FUND OF URBAN MULTIDISCIPLINE HOSPITAL
Suslin S.A., Vavilov A.V., Ginnyatulina R.I.
UDC: 614.21-082
Abstract: Objective. The purpose of the work is to analyze the dynamics of the utilization rates of the bed fund of a large city multi-profile hospital named after N.I. Pirogov in the city of Samara to improve the organization of medical care. Methods. In the hospital and in the departments, the indicators for the average annual employment of the bed, the turnover of the bed, average length of stay for the period 2007-2016 were calculated and analyzed in the dynamics for 2007-2016. We used statistical and analytical methods of investigation. Results. In the hospital there was a reduction in the number of beds by 9.5% from 1,056 to 956 beds on 17 predominantly surgical profiles. The indicators of average bed occupancy increased by 7.6% from 304 to 327 days and bed turnover - by 6.8% from 36.7 to 39.2, which indicates an increase in the intensity of the treatment and diagnostic process in the hospital. The average length of stay in the hospital remained stable at 8.2-8.3 days and a quarter lower than the average regional indicator, which is rational given the prevalence of emergency hospitalizations, the surgical orientation of the hospital and the introduction of minimally invasive surgical techniques. In most departments, the average length of stay of patients is reduced, in addition to the departments of neurosurgical and neurological profiles, into which patients in a serious condition and with the presence of concomitant pathology arrive in a considerable volume. Conclusion. The indicators of the use of hospital beds vary considerably in the departments both in the direction of low and high values, which requires additional organizational measures to further optimize the use of bed capacity in structural units and in the hospital as a whole.
Key words: городская многопрофильная больница, коечный фонд, среднегодовая занятость койки, оборот койки, средняя длительность пребывания пациента, city multidisciplinary hospital, bed fund, mid-year bed occupancy, bed turnover, average length of stay of the patient
HEALTH CARE SYSTEM REFORMING IN MODERN RUSSIA
Danilov A.I., Bizenkov A.S.
UDC: 614.25
Abstract: Objective. To study the main stages of Health care system reformation in modern Russia . Methods. The work was carried out as part of the authors ' training in Smolensk and Bryansk branches of the Russian Presidential Academy of national economy and public administration. The Constitution of the Russian Federation and published literary sources were used in the preparation. Results. In the development of health care system of the 1990-ies, two periods can be destinguished: before and after the introduction of the law of the Russian Federation "On health insurance of citizens of the Russian Federation." The fundamental principles of the reform of the first period were decentralization of management, demonopolization of the public health sector, multi-ownership of health organizations, multi-channel financing and the introduction of market mechanisms in the field of medical goods and services. Law of the Russian Federation on health insurance of citizens of the Russian Federation in 1993 year significantly changed the management and financing of the industry, as well as the relationship between patients and health care professionals. Conclusions. In the early 1990s, the health sector took a sharp turn from a centralized system of governance to the decentralized one, with the emergence of Autonomous regional systems. In the context of the formation of a competitive environment in health care, the dominant role of the manufacturer of medical services significantly reduced and the role of the patient increased. Centralized health planning was transformed into the development of public health policy with the focus on public health regulation and quality of care. At the same time, despite some positive changes in the health status of the population and the health system of the Russian Federation, there are many unresolved problems.
Key words: здравоохранение, продолжительность жизни, медицинское страхование, health, life expectancy, health insurance
NAVIGATION SYSTEM AS A CRITERION FOR ASSESSING THE QUALITY OF MEDICAL ORGANIZATION'S SPACE PROVIDING PRIMARY HEALTH CARE
Kurmangulov A.A., Reshetnikova Y.S., Brynza N.S., Knyazheva N.N.
UDC: 614.2+616-71+616-082
Abstract: Objective. To study modern ideas about the navigation system as part of the visualization of the space of a medical organization that provides primary health care. Methods. The article presents the results of a review of references in the databases of e-library, Medline, Scopus, Pub Med, The Cochrane Library and RINSC. Results. Visualization is a classic method of lean manufacturing, actively being introduced into the Russian health care system at the moment. Navigation systems of medical organizations providing primary health care are a type of visualization. One of the criteria for compliance with the new model of medical organization is the criterion of the quality of space, in general, and the navigation system, in particular. Basics of navigation consist of the architectural planning solution, space design and navigation elements. The main function of the navigation system is to create comfortable conditions for patients to stay in a medical organization with a quick orientation in space and the ability to independently choose the best route for their movement through the medical organization. The capabilities of certain types of navigation can allow them to be used in the process of optimizing the health system based on the principles of lean manufacturing. Conclusion. Evidence-based qualimetry of the navigation systems of medical organizations that provide primary health care is not currently represented conclusively. The development of quantitative and qualitative criteria for assessing navigation systems requires an integrated approach with the mandatory consideration of the peculiarities of the current situation in the field of architectural and planning decisions of medical organizations of the Russian Federation.
Key words: новая модель медицинской организации, бережливое производство, бережливые технологии, визуализация, навигация, new model of medical organization, lean manufacturing, lean technologies, visualization, navigation
INDUSTRIAL REVOLUTION AT THE END OF XVIII-XIX CENTURIES AND NEW HEALTH RISKS
Kitsenko O.S., Kitsenko R.N.
UDC: 614.2:613.6(09)
Abstract: Objective. The purpose of the study is to identify health risk factors that emerged in European countries and the Russian Empire in connection with the industrial revolution of the late XVIII-XIX centuries. Methods. The study used historical-genetic and historical-comparative research methods. Sources of research were the works of Russian and foreign scientists, as well as materials of medical legislation. Results. The industrial revolution that embraced the European countries in the 19th century led to significant changes in people's way of life, causing new health risks. Mechanization of labor and a long working day became factors of industrial injuries. The development of the chemical industry caused massive toxic damage at work and at home. The spread of foodborne diseases was associated with the problems of food delivery and storage in cities, as well as with the practice of food falsification. In large industrial centers, conditions for the spread of infectious diseases developed: overcrowding, undernourishment, and lack of sanitation. Cholera became «the plague of the XIX century», outbreaks of which were observed in Europe throughout the century. Tuberculosis and typhoid became widespread. Urbanization and high population density created new risks for children's health: congenital diseases, digestive diseases, and rickets. The appearance of nurseries and orphanages led to the spread of acute childhood infections: diphtheria, scarlet fever, measles, whooping cough. Heavy long hours of routine work, unsatisfactory housing conditions, low wages caused the spread of alcoholism and related diseases in the proletarian milieu. Conclusions. The industrial revolution posed new problems for doctors, the public and the governments of industrialized countries. The spread of infectious diseases determined the development of microbiology, immunology, epidemiology, hygiene. The identification of social factors of morbidity led to a tendency of public and government control over sanitary conditions, labor protection, motherhood and childhood.
Key words: индустриальная революция, урбанизация, риски для здоровья, industrial revolution, urbanization, health risks