DYNAMICS OF MORPHOLOGICAL CHANGES OF THE PYRAMID NEURONS OF PHYLOGENETICALLY DIFFERENT DEPARTMENTS OF THE RAT'S BRAIN CORTEX AT TOTAL CEREBRAL ISCHEMIA
Bon E.I., Maksimovich N.Ye., Zimatkin S.M., Valko N.A., Kot V.N., Mosin O.V., Sulzhitsky A.G.
UDC: 616.831.31-005.4.-092.913:618.33
Abstract: Objective. Analysis of changes in the morphological characteristics of neurons of phylogenetically different parts of the cerebral cortex of rats in different periods after total cerebral ischemia. Methods. The experiments were performed on 42 male outbred white rats with an initial weight of 240±20 g. Total cerebral ischemia in white outbred rats was modeled by decapitation. The material was taken at 1, 5, 15, 30, and 60th minute, as well as 5 and 24 hours following decapitation. Results. With total cerebral ischemia, a significant decrease in the size of neurons and deformation of the perikaryon were observed. Neurochromic neurons at the 60th minute completely disappeared. The number of hyperchromic neurons increased, and then progressively decreased. Shrinkage neurons made up the majority of cells in the studied cortical sections at 30-60 minutes, and then, after 5 and 24 hours, cells with pericellular edema prevailed in the neuron population. Conclusion. The obtained data on histological changes of neurons of phylogenetically different parts of the cerebral cortex in the dynamics of total cerebral ischemia provide the basis for further detailed study of post-mortem changes of the brain, determining the time of death, creating a fundamental basis for studying the properties of neurons, including their transition from one functional state to another.
Key words: крысы, церебральная ишемия, кора головного мозга, rats, cerebral ischemia, cerebral cortex
DIFFERENCE IN HORMONAL RESPONSE OF MALE AND FEMALE MICE UPON L-THYROXIN AND PROPYLTHIOURACL TREATMENT
Proshin Sergei N., Manatov Magomed G., Kuzavleva Anna A., Amirkhanyan Karina K., Kuldeeva Arina N., Osmanov Zagidi M., Samardakov Yurii A., Radjabov Rasul M., Glushakov Ruslan I.
UDC: 16-01/09
Abstract: Objective. To elucidate the relationship of the activity of hypothalamic-pituitary thyroid hormone axis upon experimental modulation of hyper- or hypothyroid status on female and male organism. Methods. The study was performed on virgin 30 mature male mice and 33 mature female mice of the inbred line C3H-A. On male and female mice a model of experimental hyperthyroid and hypothyroid status was reproduced by the administration to L-thyroxin and propylthyouracil, accordingly. The blood samples from animals were assayed for TSH, T (total) and prolactin. Results. In the hyperthyroid male mice, the level of T (total) was significantly higher as compared to the hypothyroid and control groups. No difference in the level of TSH and prolactin was found between the hyperthyroid and the hypothyroid groups. In the hypothyroid female mice, the level of TSH and T (total) was significantly lower and the level of prolactin was significantly higher as compared to the hyperthyroid and the control groups. Conclusion. The male and female mice responded in different ways upon the administration to L-thyroxin and propylthyouracil on the level of TSH, T (total) and prolactin.
Key words: hyperthyroid and hypothyroid status, hormones, L-thyroxin, propylthyouracil, C3H-A mice, гипер- и гипотиреоидный статус, гормоны, L-тироксин, пропилтиоурацил, мыши линии C3H-A
EFFECT OF THE MODIFICATION OF T-CELL IMMUNITY OF WHITE RATS IN THE FIRST HALF OF PREGNANCY ON THE DEVELOPMENT OF FETUSES
Lis R.E., Molko T.L.
UDC: 616-092.12:612.6
Abstract: Objective. To determine the possible teratogenic and embryotoxic effect of concanavalin A and cyclophosphamide and the combined action of concanavalin A and cyclophosphamide when administered to female white rats during pregnancy. Methods. Determination of indicators of pre- and post-implantation death of embryos, measurement of craniocaudal sizes and ossification of the fetuses of rats, processed according to the Dawson-Dyban method and stained with alizarin red. Results. The combined effect of concanavalin A and cyclophosphamide in the first half of pregnancy leads to a significant increase in the post-implantation death of embryos and a decrease in the length of ossification of the mandibular, brachial, ulnar, iliac, and sciatic bones in the fetuses of rats. The separate action of concanavalin A and cyclophosphamide does not cause such an effect in selected doses. Conclusion. Since the combined effect of concanavalin A and cyclophosphamide simulates T-cell immunodeficiency, the dysfunction of the mother's T-cell immunity is teratogenic to the fetus.
Key words: конканавалин А, циклофосфамид, крысы, антенатальное развитие, Concanavalin A, cyclophosphamide, rats, antenatal development
QUANTITATIVE ASSESSMENT OF THE COMBINED EFFECTS OF LOW MOLECULAR WEIGHT PECTIN AND CYCLOPHOSPHAMIDE ON TRANSPLANTABLE SARCOMA C-45
Kylchykbaev A.K., Kudaibergenova I.O., Saiakov U.K., Chakeev I.Sh., Faizova A.A.
UDC: 616.006+616.006.01-616.006.021-616.006.037 В.-74
Abstract: Objective. To study the quantitative patterns of the combined action of the anticancer chemotherapy of cyclophosphamide and citrus pectin, on the C-45 transplantable sarcoma model. Methods. In the experiment 80 mongrel rats weighing 180-200g were used. Reinforcement, maintenance of the strains and evaluation of the results were carried out according to the method adopted by the Russian Oncology Scientific Center of the Russian Academy of Medical Sciences. Treatment of animals with C-45 vaccinated sarcoma started 72 hours after tumor inoculation. Citrus pectin (pectasol) was administered with a probe intragastrically for 7 days, and cyclophosphamide was administered intraperitoneally, once on the 5 day after inoculation of sarcoma C-45. Results. The authors studied the combined use of pectasol and cyclophosphamide on a model of a continuous sarcoma of C-45 rats. Regularities were found in the combined use of pectasol and cyclophosphamide at doses: 1300/50 mg / kg; 650 / 25mg / kg, 320mg / kg. The antitumor effect of these combinations was greater than the sum of the effects of each drug separately, which indicated a variant of synergy - potentiation. Using the program "Compysan" the combinatorial index was calculated. Conclusion. With the combined use of pectasol and cyclophosphamide, a pronounced synergism of both drugs was observed, depending on their dose. The combinatorial index (CI) 0.21 for ED90 (effective dose), calculated using the Compysan program, corresponded to a strong degree of synergy.
Key words: саркома С-45, пектасол, синергия, потенцирование, комбинаторный индекс, sarcoma C-45, pectasol, synergy, potentiation, combinatorial index
NETOSIS LEVEL DEPENDING ON THE NEUTROPHILS ISOLATION METHOD
Gusakova N.V., Gomolyako A.V., Zhelezko V.V.
UDC: 616.155.34
Abstract: Objective. A comparative analysis of NETosis in neutrophils, obtained from the unfractionated leukocyte suspension, and neutrophils, isolated from peripheral blood on the ficoll density gradient, on the example of healthy individuals and patients with chronic recurrent furunculosis was carried out. Methods. The objects of the study were peripheral blood neutrophils of 30 healthy volunteers and 36 patients with chronic recurrent furunculosis in the remission period. The unfractionated leukocyte suspension was obtained by settling; cell suspensions were standardized by phosphate buffered saline till 5×10 neutrophils/ml. To isolate pure cell cultures of neutrophils the double ficoll density gradient centrifugation was used, in which the density of the upper gradient layer was 1.077 g/cm, the lower one - 1.119 g/cm. NET formation was measured in leukocyte cultures, incubated for 150 minutes without (unstimulated NETosis level) or in presence of soluble S. аureus products (stimulated NETosis level). The suspension was then applied to a slide, dyed by Giemsa and microscopized using immersion (×1000), and the percentage of NET for 200 neutrophils was counted. Results. Our comparative analysis of the NETosis of cells obtained from leukocyte suspension showed that both healthy individuals and patients with chronic recurrent furunculosis had a significant increase of stimulated NETosis level relatively to the unstimulated condition (р<0.001). Unstimulated NETosis level in neutrophils, obtained by gradient centrifugation, did not differ from the values of NETosis during stimulation, and at the same time was significantly higher than the unstimulated NETosis level of cells, obtained from unfractionated leukocyte suspension (р<0,001). Conclusion. To study NETosis in vitro it is recommended to use an unfractionated leukocyte suspension obtained by sedimentation and standardized by the number of neutrophils (5×10 cells/ml).
Key words: нетоз, лейкоцитарная суспензия, нейтрофил, netosis, leukocyte suspension, neutrophil
AGE DYNAMICS OF TOTAL BODY SIZE OF PERSONS OF THE END OF XX - BEGINNING OF XXI CENTURY OF DIFFERENT SOMATIC TYPES AND VARIANTS OF BIOLOGICAL DEVELOPMENT
Safonenkova E.V.
UDC: 611.08
Abstract: Objective. The aim of the study was to assess the age dynamics of growth processes of total body size and identify the phenomenon of "deceleration" in children, adolescents and young people of the late XX - early XXI century. Methods: somatometry, metric somatotyping, evaluation of a variant of biological development (FBG) (R.N. Dorokhov, 1975). Results. Assessment of somatic variability in the studied ontogenesis segment of the male and female subjects of the late XX - early XXI century. showed high individualization of growth processes. In children of the first period of childhood 2006-2012 the survey shows a tendency to decrease in weight and weight indicators, i.e. the prerequisites for the manifestation of the “deceleration” phenomenon are noted, however, no significant differences were found. In the period of the second childhood, adolescence and youth, those surveyed in the 70s were significantly inferior in terms of length and body weight to people in the late XX - early XXI century. Conclusions. An analysis of the age dynamics of the averaged values of the growth processes of the total body size of the examined persons in Smolensk and Vitebsk regions, as well as their distribution by somatic types and variants of biological development, indicates a continuing epochal and intragroup tendency to accelerate the development of modern children, adolescents and boys.
Key words: длина тела, масса тела, децелерация, акселерация, соматический тип, вариант биологического развития, body length, body mass, deceleration, acceleration, somatic type, biological development variant
METHODOLOGY OF DESCRIPTIVE STATISTICAL ANALYSIS OF THE NOMINAL CHARACTERISTICS IN THE SMALL SAMPLE SIZES OBTAINED A A RESULTS OF PHARMACOLOGICAL STUDIES
Lyamets L.L., Evseev A.V.
UDC: 519 253
Abstract: Objective. The aim of the theoretical study was to develop a method of descriptive statistical analysis of nominal characteristics, i.e. features measured in the nominal scale. The technique was developed to analyze the results of experimental pharmacological studies, which are usually for objective reasons represented by sample sets (samples) of small volume with the number of units of observations not more than 30. The technique is an algorithm of computational actions, which will provide a statistical analysis of the nominal characteristics used to describe the pharmacological effects. Method. A review analysis of publications on pharmacology, in which statistical methods of analysis of experimental data were used to obtain new knowledge and substantiate the results of studies, was carried out. The review identified the main, most common research tasks that require statistical analysis of features measured in the nominal scale. The systematization of computational operations necessary for the statistical analysis of nominal characteristics in typical research problems is carried out. On the basis of the systematized computational operations the technique (algorithm of the statistical analysis) of nominal signs which will allow to provide a quantitative justification of inductive conclusions in scientific researches and the positions taken out on protection in dissertations on pharmacological subjects is developed. Results. The technique for descriptive statistical analysis of nominal characteristics in pharmacological studies is developed and justified. The technique is focused on the analysis of small samples in typical, most common research problems. To implement the methodology, the methods of automation of calculations using the Excel spreadsheet are proposed. Conclusion. As a result of the review analysis of publications on pharmacology, the systematization of computational operations necessary for the descriptive statistical analysis of nominal characteristics in typical research problems is carried out. On the basis of systematic computational operations the technique (algorithm of statistical analysis) of nominal characteristics is developed. The practical example of automation of the calculations entering into a technique with use of modern information technologies is shown. The technique can be of practical interest for scientists who carry out research in the field of pharmacology and use in their work statistical methods of analysis of experimental data.
Key words: выборочный метод, номинальные признаки, описательный статистический анализ, интервальные оценки, проверка статистических гипотез, sampling method, nominal characteristics, descriptive statistical analysis, interval estimates, statistical hypothesis testing
EFFICACY AND TOLERANCE OF 10- AND 7-DAY STANDARD TRIPLE THERAPY IN PATIENTS WITH INFECTION IN THE SMOLENSK REGION: RESULTS OF A RANDOMIZED OPEN COMPARATIVE CLINICAL TRIAL
Dekhnich N.N., Khokhlova Ju.A.
UDC: 616.33-00.44(470.332)
Abstract: Objective. The aim of the study was to compare the efficacy of H. pylori eradication and tolerance of 10-day and 7-day of standard triple therapy of H. pylori infection in adults. Methods. In total, 136 H. pylori -infected subjects participated in the randomized clinical trial. 68 patients of the first group received a 10-day standard triple therapy: esomeprazole (20 mg 2 times a day), clarithromycin (500 mg 2 times a day) and amoxicillin (1000 mg 2 times a day). 68 patients of the second group - 7-day standard triple therapy: esomeprazole (20 mg 2 times a day), clarithromycin (500 mg 2 times a day) and amoxicillin (1000 mg 2 times a day). H. pylori stool antigen was performed to check for eradication. Results. The efficacy of H. pylori eradication, according to ITT-analysis, in patients of the first and second groups was 82.4% and 64.7% ( p =0.020), and according to PP-analysis - 87.5% and 66.7% ( p =0.010). Adverse events were reported in 25% of the first group and 36.8% of patients in the second group. There were no statistically significant differences of adverse events in both groups (p>0.05). Conclusion. 10-day standard triple therapy appears to be more effective than 7-day without increasing frequent adverse events. It is not recommended to use 7-day standard triple therapy in the treatment of H. pylori infection in adults in the Smolensk region due to the suboptimal eradication of H. pylori . The use of a 10-day standard triple therapy has extremely acceptable efficacy and can be recommended as a therapy for the first line of H. pylori infection.
Key words: эффективность эрадикации H. pylori, нежелательные реакции, стандартная тройная терапия, efficacy of H. pylori eradication, adverse events, standard triple therapy
INFORMATION VALUE OF COMPLEX EXAMINATION OF CHILDREN WITH BRONCHOPULMONARY DISEASES
Semernik O.E., Lebedenko A.A., Demyanenko A.V., Semernik I.V., Atabaeva M.V.
UDC: 616.24-002+616.233
Abstract: Objective. To study the information content of modern methods for the diagnosis of bronchopulmonary diseases in children. Methods. A comprehensive examination of 137 children admitted with clinical symptoms of bronchopulmonary system lesions was conducted. According to the established diagnosis all patients were divided into 4 groups: Group I - patients with community-acquired pneumonia - 27 (19.71%) people, Group II - patients with acute rhinolaryngotracheobronchitis 13 (9.49%), III - children with obstructive bronchitis 86 (62.77%) and IV - with acute simple bronchitis - 11 (8.01%) children. Results. It was established that the burdened premorbid background was registered in the majority of patients. The results of an objective examination of patients showed that the vast majority of children had an increase of body temperature to subfebrile values (83.2%). The nature of the temperature curve did not have significant differences among patients of all groups. Complaints of cough were registered in 134 children (97.8%), difficulty breathing in 67 (48.9%) of the examined patients. A detailed analysis of the results of the laboratory examination revealed that the hemogram and biochemical blood test did not have significant differences among all groups of patients. X-ray examination of the chest organs was carried out in 88.89% of patients, while 18.48% of the examined pathological changes were not registered, while 19.71% patients had infiltrative changes in the pulmonary parenchyma, in 81.52% there was an increase in the pulmonary pattern and deformation in the media base zone. Conclusion. The most informative method of the bronchopulmonary system diseases diagnosis is x-ray examination of the chest.
Key words: диагностика, бронхолегочная система, заболевания, дети, diagnosis, bronchopulmonary system, diseases, children
POLYMORPHISMS OF GENES FOR OXIDATIVE STRESS IN OSTEOARTHRITIS WITH CARDIOVASCULAR COMORBIDITY
Kabalyk M.A., Nevzorova V.A.
UDC: 616.72-018.3-002-07:612.018
Abstract: Objective. The aim of the study was to analyze polymorphic variants of oxidative stress genes (EPAS1, GPX4) and their role in the development of cardiovascular comorbidity and osteoarthritis (OA). Methods. The study included 140 patients with OA aged Me 63.1 (Q25-55.4; Q75-76.8). Among them, there were 112 women (80%). As a control group, 90 patients without OA were included in the study group. Me 59.4 (Q25-51.1; Q75-72.8], among which there were 60 women (70%). Absolute cardiovascular risk was determined using the SCORE scale. Pain intensity was determined using a visual (digital) analog pain scale (VAS). Physical dysfunction was assessed using the WOMAC scale. Genetic material was obtained from peripheral blood leukocytes using DNA extraction. Single nucleotide polymorphism genes EPAS1 (rs1867785), GPX4 (rs713041) were investigated using real-time polymerase chain reaction. Results. The group of patients with OA is not statistically significantly different in the frequency distribution of alleles of the polymorphic G/A locus of the EPAS1 gene from the comparison group. However, the GG genotype was statistically significantly more common in individuals without OA. The group of patients with OA is statistically significantly different in the frequency distribution of the alleles of the polymorphic C718T locus of the GPX4 gene from the comparison group. The presence of the C GPX4 gene allele has been found to be a risk factor for OA. The frequencies of heterozygous C718T genotypes of the GPX4 gene differed significantly in patients with different cardiovascular risk. Thus, in patients with high risk, the SS genotype was statistically significantly more frequent. The TT genotype of the GPX4 gene, by contrast, was significantly more common in patients with a moderate risk of CVD. The presence of the C allele GPX4 gene is a high cardiovascular risk factor in patients with OA. Conclusion. The presence of the C allele and the TT genotype of the GPX4 gene (rs713041) is a risk factor for OA and high cardiovascular risk.
Key words: остеоартрит, остеоартроз, сердечно-сосудистый риск, боль, SCORE, оксидативный стресс, osteoarthritis, osteoarthrosis, cardiovascular risk, pain, SCORE, oxidative stress
CHANGES IN VASOACTIVE PROPERTIES IN PATIENTS AFTER CORONARY BYPASS SURGERY WITH DIFFERENT LEVELS OF INTRAOPERATIVE HEMOLYSIS
Maksimovich E.N., Pronko T.P., Yanushko A.V., Snezytski V.A.
UDC: 616.13+616.155.18]:616.12-005.4-089.844-06
Abstract: Objective. The aim of the strudy was to investigate the changes in vasoactive properties of the vascular endothelium in patients with coronary artery disease (CAD) after coronary artery bypass surgery (CABG) with varying degrees of intraoperative hemolysis (IOH). Methods. Studies were conducted in 206 people: 123 patients with CAD and 44 people in the comparison group (CAD without CABG) and 39 healthy people (control). The assessment of the degree of IOH is made by the level of free hemoglobin (Hb). In accordance with the level of Hb at the end of the operation, patients with CABG surgery were divided into three groups: 1 - without IOH (Hb≤ 0,1 g/l), n=43, 2 - with low IOH (lIOH, Hb>0,1 g/l and <0,5 g/l, n=42), 3 - with high IOH (hIOH, Hb≥ 0,5 g/l, n=38). The study of the vasoactive properties of the endothelium was carried out using a test with reactive hyperemia on the Impekard-M hardware-software complex (Belarus) before and during the postoperative period. Results. The patients of all studied groups in the preoperative period showed the presence of endothelium dysfunction, which was exacerbated in the postoperative period. A pronounced inhibition of vasodilator properties in the postoperative period of CABG was noted in patients of the third group with IOH, the value of maximum speed of pulse blood flow was 10.0 (-17.9; -6.6)%, which is less than in patients of the group without IOH (- 3.7(-5.6;-0.8)%, p<0.001) and group with lIOH (-4.8 (-7.6; -3.8)%, p <0.001). The negative correlation relationship between the level of maximum speed of pulse blood flow and Hb in the postoperative period (rs=-0.79) indicates the negative effect of hemolysis on the endothelium-dependent vasodilation. Conclusion The adverse effect of CABG surgery was established on the vascular endothelium in patients with coronary artery disease, which in the postoperative period depended on the severity of intraoperative hemolysis. The obtained data are important for expanding ideas about the mechanisms of development of complications of coronary artery bypass surgery in patients with coronary artery disease, which is important for their prevention both in the pre- and postoperative period.
Key words: дисфункция эндотелия, коронарное шунтирование, гемолиз, endothelial dysfunction, coronary bypass, hemolysis
PRACTICE OF ASSIGNING STARTING ANTIMICROBIAL THERAPY OF INFECTIVE ENDOCARDITIS IN SMOLENSK
Danilov A.I., Kozlov S.N., Evseev A.V., Starkova A.E., Efimova I.A., Emelyanova E.S., Zaytseva K.N., Kareva A.I.
UDC: 616.126-002 + 615.33
Abstract: Objective. To study the features of assigning starting antimicrobial therapy of infective endocarditis in Smolensk. Methods. A prospective pharmacoepidemiological study of the etiology, antibiotic resistance and antimicrobial therapy of infectious endocarditis (IE) was conducted. The study included patients of both sexes of all age groups with definite and probable IE who were hospitalized from January 2016 to December 2018; the diagnosis of IE was made according to the Duke criteria. Results. 21 cases of IE were analyzed. During the appointment of starting antimicrobial therapy in 76.9% monotherapy was used, in 23.1% - combination therapy. The most frequently prescribed glycopeptides (vancomycin) were 35.9%, cephalosporins of generation III (Ceftriaxone) - 30.8% and aminoglycosides (gentamicin, amikacin) - 25.7%. In the course of this therapy, a positive trend was observed in 50% of cases. Conclusions. The practice of prescribing starting antimicrobial therapy for IE in Smolensk does not meet modern clinical recommendations (combination therapy was used only in 23.1%, the appointment of drugs with bacteriostatic effect - in 7.7% of cases). Schemes of antimicrobial therapy with antistaphylococcal activity should be more actively used.
Key words: инфекционный эндокардит, стартовая антимикробная терапия, положительная динамика лечения, infective endocarditis, starting antimicrobial therapy, positive dynamics of treatment
EPIDEMIC FEATURES OF MEASLES OUTBREAK IN THE REPUBLIC OF TAJIKISTAN
Aliyev S.P., Tishkova F.Kh., Saidov Kh.M., Tursunov R.A.
UDC: 616-036.22
Key words: корь, вспышка кори, вакцинация, вакциноуправляемые инфекционные заболевания, генотипирование
EFFECT OF PERINATAL RISK FACTORS ON THE BIRTH OF CHILDREN WITH EXTREMELY LOW AND VERY LOW BODY MASS IN THE KALININGRAD REGION
Muts E.Yu., Shestakova V.N.
UDC: 61.618.39
Abstract: Objective. To identify perinatal risk factors affecting the birth of an extremely premature baby. Methods. The study involved 120 women who gave birth to premature babies at various periods of gestation in the Kaliningrad region in 2014-2015. The material was collected by copying data from exchange cards, data of childbirth histories, and developed questionnaires. 2 main observation groups and two comparison groups were formed. Results. During the period of pregnancy, the health status of women deteriorated, especially in the group where children were born very prematurely. Before pregnancy, all women of the observation groups considered themselves to be practically healthy. For the first time, chronic diseases were diagnosed in 15 women, children born deeply premature. It was established that among functional disorders lesions of the vegetative nervous system, cardiovascular systems, sensory organs and digestion were in the lead. In 33.3% of the respondents, pregnancy proceeded against the background of acute diseases, as well as genital pathologies. During pregnancy, the frequency of complications increased in those women who suffered from chronic diseases and combined pathology, characterized by a threat of interruption, fetoplacental insufficiency, gestational anemia and pyelonephritis. Conclusion. Thus, significant factors affecting the state of health, contributing to an unfavorable course of pregnancy, are transferred infectious diseases, reduced adaptation indicators in the first half of pregnancy, transferred stressful situations, unreasonable use of drugs, menstrual disorders, the presence of gynecological diseases during pregnancy, untimely hospitalization, non-compliance with regime points, manifestation of chronic pathology.
Key words: дети, недоношенные, беременные, экстремально-низкая, очень низкая масса тела, children, premature, pregnant, extremely low, very low body weight
FEATURES OF PHYSICAL AND NEURO-PSYCHIC DEVELOPMENT OF EXTREMELY PREMATURE BABIES OF EARLY AGE BORN WITH A VERY LOW AND EXTREMELY LOW BODY MASS IN KALININGRAD REGION
Muts E.Yu., Shestakova V.N.
UDC: 61.616-009
Abstract: Objective. To study the physical and neuropsychic development of premature babies of the first three years of life, born with an extremely and very low body weight in the territory of the Kaliningrad region.DD Methods. Assessment of physical development using centile developmental curves for premature babies from 500 to 1500 grams, taking into account sex and recalculated age, and WHO centile tables by, height and weight for children born over 32 weeks of gestation. The neuropsychic development of children was analyzed with the help of CAT/CLAMS scale in recalculation for corrected age. Results. Children born with extremely and very low body weight often have low rates of growth of physical indicators during the first three years of life. This correlates with delays in neuropsychic development, a tendency to more frequent episodes of acute respiratory viral infections and the formation of a combined somatic pathology: the central nervous system, the organ of vision, the respiratory and cardiovascular systems. Conclusion. Children with a deep degree of prematurity require in-depth observation not only in the first year of life, but also in the future, with the involvement of a paediatrician, cardiologist, endocrinologist, immunologist, pulmonologist, neurologist, exercise therapy specialists, behaviour assessment of physical and neuropsychic development taking into account the adjusted age, using special scales.
Key words: недоношенные, дети, нервно-психическое развитие, физическое развитие, экстремально низкая масса тела, очень низкая масса тела, premature babies, neuropsychic development, physical development, extremely low body weight, very low body weight
ASSESSMENT OF ADAPTATION OF INFANTS BORN WITH MILD INTRAUTERINE GROWTH AND DEVELOPMENT DELAY
Ivanov D.O., Derevtsov V.V.
UDC: 616-053.3:618.3-06
Abstract: Objective. To estimate adaptation of the organism of babies born with light severity of delay of pre-natal growth. Methods. 609 children were examined. Since the birth 141 children were under observation, born as a result of complicated pregnancies and deliveries including babies with fetus development delay of light severity - 72 (group 1) and without it - 69 (group 2) cases from mothers with the burdened somatic and obstetric and gynecologic anamnesis. Full-term, mature children were observed at 1 (131), 3 (118), 6 (109), 12 (110 children) months. Comprehensive case history analysis, physical examination, assessment of cardiointervalography and body adaptation to the environment were performed. Non-parametric methods of statistical analysis were used. Results. In children of group 1 and 2 satisfactory adaptation of the organism to conditions of the environment took place at birth in 27.78 and 18.84%, in 1 month - in 33.33 and 24.62%, in 3 months - in 29.82 and 37.7%, in 6 months - in 49.09 and 46.3%, in 12 months - in 46.15 and 50%. Tension and overstrain of adaptation was recorded in 26.39 and 26.09%, 34.85 and 33.85%, 35.09 and 31.15%, 29.09 and 35.19%, 19.23 and 24.14%. Unsatisfactory adaptation was defined at 36.11 and 40.58%, 21.21 and 26.25%, 22.81 and 19.67%, 14.55 and 9.26%, 25 and 18.97%. Failure of adaptation is revealed at 9.72 and 14.49%, 10.61 and 15.38%, 12.28 and 11.48%, 7.27 and 9.26%, 9.62 and 6.9% of children respectively. Conclusion. Study of characteristics of body adaptation to the environment in the scientific community is a perspective area, and any practical application (starting with perinatal centres) of assessment of body adaptation to the environment with follow-up groups identification and further determination during critical periods of growth and development (outpatient monitoring) justifies patient-specific approach to outpatient follow-up of infants born with mild intrauterine growth and development retardation.
Key words: замедление внутриутробного роста, адаптация, младенцы, intrauterine growth and development retardation, adaptation, infants
GENETIC CHARACTERISTIC OF HELICOBACTER PYLORI IN FAMILIES OF CHILDREN WITH CHRONIC GASTRITIS
Spivak E.M., Manyakina O.M., Novikova V.P., Akkuratova I.S.
UDC: 616.329-036.12-053.5: 575.191
Abstract: Objective. To establish the genetic structure of Helicobacter pylori in family members of children with chronic Hр-associated gastritis. Methods.36 patients with Hр-associated chronic gastritis were examined; including 12 children aged 9-15 years and 24 members of their families: parents, sibs, relatives of the second line. 14 genes of Pathogenicity Island were determined by polymerase chain reaction in gastrobioptates: CagA, CagM, CagT, CagH, CagC, CagF, CagE, VacAs1, IceA, Baba, HpaA, OipA, AlpB and UreB. Results. The high prevalence of Hp-associated gastroduodenal pathology in families of children with chronic gastritis was established. Highly pathogenic Hp strains were detected in 31 patients, including 10 children and 21 adults. A direct correlation of the total number of Hp pathogenicity factors among family members was found. Comparative analysis showed 77.7 % of matches of genes of Pathogenicity Island the in close relatives, in pairs "children - parents" this figure was 75%. Conclusion. Among close relatives of children with chronic gastritis, there is a high prevalence of Hp-associated pathology of the upper digestive tract. The genetic structure of Hp causing chronic gastroduodenal diseases in members of the same family is characterized by a high degree of concordance of genes of the Pathogenicity Island.
Key words: хронический гастрит, Helicobacter pylori, геном, семьи, chronic gastritis, Helicobacter pylori, genome, families
CHOICE OF TACTICS OF CHRONIC ENDOMETRITIS TREATMENT ON THE BASIS OF IMMUNOHISTOCHEMICAL AND MICROBIOLOGICAL STUDIES OF THE ENDOMETRIUM
Lyzikova Yu.A.
UDC: 618.14-002.2-018-07-08:579
Abstract: Objective. To develop tactics of treatment of chronic endometritis on the basis of immunohistochemical and microbiological study of the endometrium and to evaluate its effectiveness. Methods. 70 patients of reproductive age were examined, 50 patients with chronic endometritis were included in the study group, 20 healthy patients - in the comparison group. All patients underwent immunohistochemical examination of the endometrium and cultural study of the material obtained from the uterine cavity. Results. Chronic endometritis in 33 (66,00%) patients was associated with infertility (c=24,97; p<0,001). Microorganisms in the uterine cavity were revealed in 31 (62,00%) patients with chronic endometritis and in 3(15,00%) patients of the comparison group(c=12,63; p=0,0004). Massive growth of microorganisms in the uterine cavity was determined in 29 (58,00%) patients of the study group (c=19,80; p<0,001). Gr-cocci dominated in the uterine cavity of patients with chronic endometritis (c=6,39; p=0,02), the most common type of bacteria was Escherichia coli (c=7,50; p=0,006). Anaerobic vaginal dysbiosis is associated with chronic endometritis and a negative result of the culture study of the endometrium (χ=11,30, p=0,008). Treatment based on the results of immunohistochemical and microbiological studies of the endometrium led to pregnancy in 7 (14,00%) patients, 6 (85,71%) of which resulted in childbirth. Conclusion. The results of the study allow us to recommend to base the choice of tactics of treatment of patients with chronic endometritis on the results of immunohistochemical and cultural studies of the endometrium. This will help to avoid the unjustified use of antibacterial therapy and increase the effectiveness of treatment of reproductive disorders associated with chronic endometritis.
Key words: хронический эндометрит, бесплодие, СD56 NK-лимфоциты, chronic endometritis, infertility, CD56 NK-lymphocytes
FLUORESCENT DIAGNOSTIC OF BREAST AND COLONIC TUMORS
Maryakhina V.S., Korneva Yu.S., Dorosevich A.E.
UDC: 616-71
Abstract: Objective. To investigate spectral characteristics of benign and malignant tumors of the breast and colon in histological sections to improve the accuracy of differential diagnosis of tumors. Methods. A comparison of the fluorescence excitation spectra of unstained histological sections of benign and malignant tumors of the mammary gland (86 cases) and colon (73 cases) was carried out. Results. Parallels are described between spectral, biochemical, and morphological changes in tissues, reflecting patterns that occur during the malignant transformation of benign neoplasms or at different stages of progression of malignant tumors. The main changes are associated with a decrease in the amount of collagen in the stroma and an increase in the concentration of NADP; however, there is an additional maximum in the spectra of the tissue of breast neoplasms, which characterizes absorption of fatty acids. Conclusion. The results of the investigation may be helpful to clarify the diagnosis of tumors in cases that are doubtful for the pathologist.
Key words: флуориметрия, колоректальный рак, рак молочной железы, предраковые заболевания, флуоресцентная диагностика, fluorimetry, colorectal cancer, breast cancer, precancerous lesions, fluorescent diagnostic
VEGETATIVE REGULATION CONDITION IN PATIENTS OF ELDERLY AND SENILE AGE WITH VARIOUS FORMS OF CARDIOVASCULAR PATHOLOGY
Khalepo O.V., Molotkov O.V., Korchigina N.V., Papilova E.D., Gaponova V.N., Skobeleva P.I., Vasilevich N.D.
UDC: 616.1-053.9
Abstract: Objective. The purpose of the study was to identify the features of vegetative regulation and their connection with the emotional state in elderly and senile persons with various forms of cardiovascular pathology. Methods. The features of autonomic regulation were studied in patients aged 61 to 89 years with chronic forms of ischemic heart disease, including cases of combination with arterial hypertension, having a history of stroke and in people without signs of severe pathology, with use the method of heart rate variability and emotional sphere state. Results. In most patients, the stress index of regulatory systems turned out to be higher than the standard values with a general decrease in the severity of regulatory influences. Patients with combination of ischemic heart disease and stroke had the state of the mechanisms of autonomic regulation not very different from the state of the vegetative status of practically healthy individuals. In patients with ischemic heart disease, including cases of combination with arterial hypertension, an increase in the general mechanisms level of autonomic regulation with an increase in the parasympathetic influences contribution has been revealed. The relationship between severe disorders of the emotional sphere and changes in the vegetative status in patients with coronary heart disease and stroke were found. Conclusions. It was concluded that the peculiarities of autonomic regulation in elderly and senile persons depend on the existing cardiovascular pathology form and provide the optimal level of regulation of the internal organs function, what can be considered as one of the adaptations mechanisms that affect the life expectancy of such patients.
Key words: autonomic regulation, heart rate variability, emotional sphere, life expectancy, elderly and old age, ischemic heart disease, stroke, arterial hypertension, вегетативная регуляция, вариабельность сердечного ритма, эмоциональная сфера, продолжительность жизни, пожилой и старческий возраст, ИБС, нарушения мозгового кро вообращения, артериальная гипертензия
APPLICATION OF LIOPLAST® NANOSIZED COMPOSITE (CLINICAL CASE)
Ivashchenko A.V., Yablokov A.E., Tselkovich L.S.
UDC: 612.821.6
Abstract: Objective. To evaluate the effectiveness of the drug LIOPLAST in neurosurgical practice. Methods. In the description of the optical density of the studied tissues the evaluation of the treatment results was conducted in Magadana window in the range from 50 to 230 HU. These indices were taken for the cartilage tissue. The solid-tissue component of the vertebrae was studied in the bone window in the range from 250 to 1500 HU. Densitometric parameters of bone tissue L4-L5 vertebrae were compared 10 days after surgery and 10 months of follow-up to identify changes. Analysis of the optical density of the intervertebral disc, located in the area of interest, was carried out in the period from 10 days to 10 months to identify its regeneration. Results. 10 days following surgery in the sagittal plane with a step of 0.2 mm, CT images of L4-L5 vertebrae and intervertebral disc containing the studied drug were obtained. The scale Of Hounsfield vertebrae in contact with the operated intervertebral disc, intervertebral disc containing LIOPLAST and intact tissues of this disc were evaluated. Conclusion. The study confirmed the future prospects of using the drug LIOPLAST in directed tissue regeneration in reconstructive operations on the spinal column.
Key words: симптом Ласега, ЛитАр, шкалу Хаунсфилда, цитоактивные материалы, ЛИОПЛАСТ, symptom Lasaga, Litar, scale of Hounsfield, retoactive materials, LIOPLAST
FOURNIER'S GANGRENE ON THE BACKGROUND OF UROLOGICAL PATHOLOGY IN A PATIENT OF OLD AGE (CLINICAL CASE)
Borisov A.A., Romanov I.N., Shakhov A.V., Leontyev A.E., Pavlenko I.V.
UDC: 617-089.844
Abstract: Objective. To show the new possibilities of complex treatment of a patient with Fournier's gangrene. Methods. The article describes the surgical treatment of a patient with Fournier's gangrene using the method of repeated surgical treatments of purulent foci (STPF) and radical removal of all non-viable tissues in the purulent-necrotic phase of the disease. After the transition of the wound process to the stage of regeneration, methods of dosed ligature dermatsenia in combination with split-skin grafting were used to close the formed soft tissue defects. Results. The fulminant development of a purulent-necrotic process on the background of a urological pathology in this patient required immediate surgical intervention. However, after the first surgical treatment of the suppurative focus, the patient's condition rapidly deteriorated, which required treatment in the intensive care unit and intensive care with repeated repeated STPF. After a comprehensive treatment, successful plastic closure of all wound defects, the patient was discharged with healed wound defects, with preserved urinary function through his own urethra. Conclusion. The predictors of the development of Fournier gangrene are considered to be a violation of the hygienic principles of the treatment of the genital organs and organs of the perineum, local trauma of the skin, contributing to the penetration of microbial agents into the deeper layers, pathological processes in the urinary tract. The fundamental tenets that must be adhered to in the event of such a formidable disease as Fournier's gangrene, according to the literature and our own clinical observations are: early diagnosis of the first symptoms of the disease, immediate and highly aggressive surgical tactics in the source of pathologically altered tissues, adequate infusion therapy with massive antibacterial support.
Key words: гангрена Фурнье, некротический фасциит промежности, пластическое закрытие ран, Fournier's gangrene, perineal necrotic fasciitis, plastic wound closure
DENTAL HEALTH OF PATIENTS WITH DIABETES MELLITUS
Kuleshova E.V., Khomyakova E.V., Boguta Yu.A.
UDC: 616.379-008.64:616.314
Abstract: Objective. The aim of the study was to evaluate hard dental tissues and periodontium condition of patients with diabetes; to evaluate the relation of dental health with the parameters of longevity of diabetes, its stage, hygienic habits and care of the oral cavity, food tastes etc. Methods. Analysis of data obtained by examination of 48 patients with type I and types II diabetes was held. Examination included polls and dental examination. Polls were held with simple questions about diabetes duration, glycemia control, food tastes, hygienic care of oral cavity. Dental examination, which included visual inspection, probing, palpation and percussion, for obtaining data about the patients’ oral cavitiy condition. Results. Data analysis of questioning of the patients with diabetes revealed: 1) poor control of the course of diabetes in 69% of the patients, usual level of blood sugar of patients who controlled it themselves was above 6.5 mmol/l; 2) lack of patients’ commitment to hygiene prevention of dental and oral mucosa diseases. 80% of patients brush teeth more seldom than it’s necessary for keeping the health of oral cavity, 96% of patients don’t use additional means for oral cavity and dental care. 3) The existence of relation between the condition of dental hard tissues with diabetes duration, patients regular blood sugar level and their age; 4) the frequency of xerostomia grows with regular glycemia level above 8 mmol/l; 5) The frequency of gingivitis and periodontitis development grows in patients with diabetes. Conclusions. A tendency to develop caries, mucosa and periodontium chronic diseases are determined by dental examination. High attention to dental and oral cavity condition is required among the patients with diabetes. The necessity of providing educative talks about the control of diabetes and oral cavity care for patients of this category should be considered.
Key words: сахарный диабет, уровень глюкозы натощак, кариес, ксеростомия, гингивит, пародонтит, diabetes, fasting glucose level, caries, xerostomia, gingivitis, periodontal disease
USE OF MINI-SCREWS IN THE PRACTICE OF ORTHODONTIST AT THE DEPARTMENT OF PEDIATRIC DENTISTRY WITH A COURSE OF ORTHODONTICS
Vasilevsky S.A., Khrolenko M.Yu.
UDC: 616.314-089.23
Abstract: Objective. To improving the efficiency of orthodontic treatment using mini-screws as an additional support. Method. In this work, bio-RAY screws of various sizes were used, which were fixed in the sublateral crest (izc zone) on the upper jaw, in the area of the outer oblique line (buccal shelf (BS) zone) on the lower jaw and the anterior group of teeth. Results. The study found that in patients with mesial, distal occlusion, with deep incisor dentition disocclusion, the use of orthoimplants significantly increases the level and quality of orthodontic treatment, as it allows to achieve more stable results. Conclusion. Mini-screws as an additional support accelerate the process of moving the teeth, which significantly reduces the period of orthodontic treatment.
Key words: анкораж, мини-винты, мини-имплантаты, ортоимплантаты, ортодонтическая опора, ортодонтическое лечение, торк, anchorage, mini-screws, mini-implants, orthoimplants, orthodontic support, orthodontic treatment, tork
MECHANISMS OF THE EFFECTS OF PANCREATITIS-INDUCING FACTORS ON PANCREATIC ACINAR AND STELLATE CELLS
Mozheiko L.A.
UDC: 611.37.018.1:616.37-002
Abstract: Objecive. To present data on the mechanisms of influence of ethanol and its metabolites, bile acid salts on acinar and stellate cells of the pancreas and their role in the pathogenesis of pancreatitis. Methods. The literature data by Russian and Foreign authors on the studied subject were analyzed. Results. It was established that pancreatitis-inducing factors cause intraacinar changes through the mechanisms of oxidative and endoplasmic stress, lysosomal and mitochondrial dysfunction, autophagy disorder, activation of transcriptional nuclear factors. Developing at the same time structural and functional disorders induced by the generation of excessive signals of Ca, contribute to the premature activation of trypsinogen and death of acinar cells. It is assumed that stellate cells transformed into myofibroblast-like phenotype enhance the effect of toxic agents on acinar cells by means of paracrine mechanisms. In chronic pancreatitis, their synthesis of excessive amounts of fibrillar collagen can lead to organ fibrosis. Conclusion. Ethanol and its metabolites, bile acids cause changes in acinar cells such as a sustained elevation of cytosolic Ca, destabilization of lysosomes and zymogenic granules, vacuolization of the cytoplasm, depolarization of mitochondria, a decrease in ATP synthesis, which initiates the premature activation of trypsinogen, death of acinar cell and pathogen, pathogen, and underlie the pathogenesis of pancreatitis. Activated pancreatic stellate cells contribute to the development of necrotic and inflammatory processes.
Key words: поджелудочная железа, звездчатые клетки, ацинарные клетки, панкреатит, pancreas, stellate cells, acinar cells, pancreatitis
RISK FACTORS FOR THE DEVELOPMENT OF DIABETES MELLITUS AS AN IMPORTANT ASPECT OF CHRONIC NON-INFECTIOUS DISEASES
Tursunov R.A., Sharipov Sh. Z., Bandayev I.S., Aliyev S.P., Makhramov Z.H.
UDC: 616.61-02:616.379-008.64
Abstract: Objective. The aim of the study was to, examine the epidemiology and burden of diabetes based on an analysis of the scientific literature in the context of chronic non-communicable diseases (NCD). Methods. For the literature review the results of modern research on diabetes were used. Results. Convincing evidence was obtained of the growing burden of NCD, one of the most important aspects of which is the growing tendency of diabetes, especially in developing countries. This trend requires well-coordinated interdisciplinary assistance for complications and associated diseases, in addition to adequate educational and psychological support. Conclusions. Urgent action is needed, and the first step should be to promote primary prevention of diabetes by changing lifestyles, raising public awareness and health care workers. Diabetes prevention programs can be justified by both economic and humanitarian considerations. At the primary prevention level, such programs may be associated with other NCD prevention programs that also address lifestyle problems.
Key words: хронические неинфекционные заболевания, сахарный диабет, первичная профилактика, образ жизни, психологическая поддержка, chronic non-communicable diseases, diabetes mellitus, primary prevention, lifestyle, psychological support
MODERN APPROACHES TO REHABILITATION OF PATIENTS AFTER STROKE
Fakhretdinov V.V., Brynza N.S., Kurmangulov A.A.
UDC: 614.2+616.831-005.4
Abstract: Objective. To study modern approaches to the rehabilitation of patients with cerebral stroke. Methods. Literature review was carried out on the basis of e-library, Medline, Scopus, RINC. Results. The article describes the techniques currently used in the rehabilitation of stroke patients, and some promising techniques in the field of rehabilitation. The authors analyzed the regulatory and legal framework for the management of patients after stroke at the hospital and outpatient stages, including digital technologies. The possibilities of using virtual reality systems in post-stroke rehabilitation, transcranial magnetic stimulation, software-hardware complexes "brain-computer interface", devices with biological feedback are indicated. Conclusion. Rehabilitation of patients after stroke requires the organization of a system of assistance with the formation of a multidisciplinary approach to physical, psychological, social and legal issues.
Key words: инсульт, реабилитация, телемедицина, восстановительное лечение, качество жизни, stroke, rehabilitation, telemedicine, rehabilitation treatment, quality of life
EFFECT OF ANTIBIOTIC THERAPY ON THE DEVELOPMENT OF OBESITY
Danilov A.I., Kozlov S.N., Vdovichenko V.P.
UDC: 615.33:616 + 056.52
Abstract: Objective. To present the results of studies proving the effect of antibiotics on the development of obesity. Methods. The work was carried out in the framework of studying the long-term effects of antibiotics on the human body. During the preparation, the published data in the scientific literature were used. Results. Metabolic changes can be caused by primary microbiota disturbance, which is associated with modern changes in human physiology, which are initiated by external factors. Epidemiological studies have shown that antibiotic treatment during the first six months of life can increase the risk of overweight accumulation at a later age. This factor does not have a direct effect on calorie intake or on the metabolism of the host, but has a great influence on the microbiome. Conclusions. Mutually beneficial interactions between humans and their own microorganisms can be altered by many aspects of modern lifestyles, including urbanization, international travel, dietary changes, and antibiotic use. The consistency of even one course of antibiotics on specific microbial populations in the wild can be maintained for several years. Prudent use of antibiotics is essential not only to reduce the spread of antibiotic-resistant organisms, but also to minimize the potentially harmful long-term metabolic effects of early exposure to antibiotics.
Key words: ожирение, антибактериальная терапия, кишечная микробиота, obesity, antibacterial therapy, intestinal microbiota
STUDY OF PHARMACO-TECHNOLOGICAL AND PHYSICAL AND CHEMICAL PROPERTIES OF THE SUBSTANCE OF VITAMIN D
Gutnova T.S., Kompantsev D.V., Kulgav E.A., Krymova A.A.
UDC: 615.453.62; 615.356
Abstract: Objective. To study the physico-chemical and pharmaco-technological properties of the substance of vitamin D3 and the prospects for obtaining on its basis specialized tablet dosage forms. Methods. Studies were carried out to analyze the physicochemical and pharmaco-technological properties of the substance according to the methods described in GF XIII and GF XIV; GOST 8074-82 "Instrument microscopes. Types, basic parameters and dimensions. Technical requirements"; according to the national standard GB/T 16913.3-1997 "Methods for determining the characteristics of dust. Part 3. Determination of bulk density. Method of natural bulk mass". Results. In the course of the study, the physicochemical and pharmaco-technological properties of the substance of vitamin D were assessed, rules for the manufacture of dosage forms with vitamin D were formulated, and some auxiliary substances were proposed for the preparation of solid dosage forms based on vitamin D. Conclusion. According to the research, the substance of vitamin D meets the requirements of GF IIIX and XIV. Future research will be focused on the study of the interactions of this substance with other active and auxiliary substances, on the development of formulations and technology of specialized tablet preparations based on vitamin D.
Key words: витамин D, прессуемость, сыпучесть, угол естественного откоса, насыпная масса, гранулометрический состав, vitamin D, compressibility, flowability, angle of repose, bulk density, particle size distribution
ANALYSIS OF CAUSES OF CONFLICTS IN PHARMACIES
Vorozhtsova E.S., Soloninina A.V.
UDC: 615.15
Abstract: Objective. The aim of this study was to investigate and systematize the causes of conflicts in pharmacies that arise between patients and pharmacists. Methods. The study was conducted in two stages. At the first stage, the questionnaire method was used. The questionnaires were developed by the authors to determine the opinions of pharmacists and patients about possible conflicts and their consequences in pharmacies. 385 pharmacists and 385 patients of pharmacies in Perm completed questionnaires. At the second stage, the authors used the method of documentary analysis for a more complete research of the causes of conflicts in pharmacies (from the patients' point of view). The authors studied 619 records of 153 books of “Reviews and Suggestions” from Perm pharmacies. Results. As a result, it was established that if a conflict in a pharmacy occurs, more than half of the patients will leave the pharmacy without a purchase, and more than a third of the patients will not return to this pharmacy again. The analysis made it possible to identify and systematize the main causes of conflicts in pharmacies. One of the most common causes of the conflict in pharmacy - the return (exchange) of previously purchased products was identified. Conclusion. The authors have established and systematized the main causes of conflicts in pharmacies. The authors identified risks for the pharmacy in conflicts with the patients. The most common cause of conflict in a pharmacy - the return (exchange) of previously purchased products was determined.
Key words: конфликт в аптечной организации, причины конфликтов, возврат (обмен) ранее приобретенного товара, конфликтологическая компетентность, управление конфликтами, фармацевтический специалист, conflict in a pharmacy, causes of conflict, return (exchange) of previously purchased products, conflict competence, conflict-management, pharmacist
DEVELOPMENT OF THE PHARMACEUTICAL AND MEDICAL INDUSTRY IN THE RUSSIAN FEDERATION AFTER EU AND USA SANCTIONS
Novikova E.V., Evseev A.V., Popov Y.S., Dovletli K.O.
UDC: 611.61
Abstract: Objective. To assess the total volume of the pharmaceutical market and the volume of its own pharmaceutical and medical-technological production in the Russian Federation after the imposition of sanctions. Methods. The analysis of data reflecting the dynamics of the pharmaceutical market and medical technology industry of the Russian Federation for the period from 2013 to 2018. Results. As of 2013, the Russian pharmaceutical industry accounted for about 0.2 % of GDP ($3.9 billion).). In 2013, the share of domestic medicines in value terms amounted to 24.4%, in natural - 57.1%. Domestic medical and technological production equaled 43.3 billion rubles. In 2017, the share of domestic medicines in the money was 30% and 62% in packages. Domestic medtech production has reached 53,6 billion roubles In the first half of 2018, the volume of production of medical instruments and equipment increased by 1.14 times compared to 2017. Conclusion. Import substitution in the pharmaceutical industry has been more effective than in the production of medical devices. Most of the targets of the pharmaceutical and medical industry development programme until 2020 have not been met. It is necessary to continue the vector of import substitution in the medical sphere. Federal programs aimed at supporting domestic manufacturers of medicines and medical devices contributed to the development of these sectors of the economy. However, the domestic medical industry is not able to solve the most important tasks to ensure the rapidly growing demand and access to world markets. The development of import substitution of medicines and medical equipment is one of the promising science-intensive and high-tech areas in the Russian economy.
Key words: медицинская промышленность, санкции, импортозамещение, лекарственные средства, medical industry, sanctions, import substitution, drugs
RESEARCH OF ORGANIZATIONAL PROFILE OF MEDICAL ORGANIZATIONS OF THE TYUMEN REGION
Brynza N.S., Gorbunova O.P., Reshetnikova Yu.S., Knyazheva N.N.
UDC: 614.2.07
Abstract: Objective. The aimof the study was to search for elements of organizational culture that require improvement in medical organizations of the Tyumen region to form a strategy for improving work efficiency. Methods. The study involved 400 employees of 8 state and municipal medical organizations of the Tyumen region in 2017. The survey was based on the principles of voluntariness and anonymity. The technology of the survey included a remote format for entering the results through an automatic data processing program using the Internet. The assessment methodology included the main elements of the organizational culture. The survey is based on a situational scoring, which consisted in determining the ranking position, reflecting the effectiveness of the selected elements of the organizational culture in accordance with the scale. Results. According to the results of the evaluation of organizational culture in all 14 indicators, only 10.7% of the interviewed employees of all medical organizations rated the organization's policy as fully complying with 5 points, 40.2% - 4 points (the policy of the organization is generally consistent). 34.0% of respondents rated the existing organizational cultures in medical organizations of the Tyumen region with 3 points. A negative assessment in the amount of 2 points and 1 point was given by 9.4% and 5.7% of the respondents, respectively. Conclusion. The formed organizational profile, both, as a whole, for all medical organizations, and for each medical organization separately, makes it possible to determine the main elements of the organizational culture that require improvement. According to the results of the study, the most problematic areas in the organization of management systems that require special attention of the heads of medical organizations were identified.
Key words: медицинская организация, организационная культура, управление проектами, организационный профиль, medical organization, organizational culture, project management, organizational profile
PROJECT IMPLEMENTED BY “THE INTERREGIONAL VOLUNTEERS’ CENTER FOR PROVISION OF CARE FOR THE RURAL POPULATION” IN SMOLENSK STATE MEDICAL UNIVERSITY
Osypova N.N., Dmitrieva E.V., Korotchenko A.A., Nikolaev S.V., Krikova A.V., Zaitseva V.M.
UDC: 364.466
Abstract: Objective. The primary aim of the project implemented was early identification and efficient prevention of diseases with involvement of cardiology and neurology experts, internists, gynecologists and ophthalmologists. Methods. Medical consultations and diagnostic investigations with minimally-invasive procedures were performed by representatives of the University clinical staff and the Research Laboratory of Smolensk State Medical University. Our medical volunteers implemented their project in the town of Demidov in Smolensk Oblast with population of 6213 residents (75 people were examined), the village of Temkino (Smolensk Oblast) with a population of 2692 residents (80 people were examined) and Dan'kovo village in Smolensk Oblast with a population of 205 resident (50 people were examined). The results were statistically processed with Microsoft Excel 10 using “Data Analysis” application. Sample characteristics were presented as a mean ± and a standard error mean. Statistically significant differences were accepted when the probability coefficient was >95% (p<0.05). Results. Principles of a comprehensive approach in prevention and early diagnostics of socially significant and chronic noncommunicable diseases provided by the highly qualified medical professionals and medical volunteers will create additional positive conditions and support for successful implementation of the National Health Care Programs among the rural population of Central Federal District, including Smolensk Oblast. Conclusion. In implementation of the project highly qualified medical specialists and medical volunteers carried out both diagnostic and curative activities focused on socially significant chronic noncommunicable diseases and activities aimed at education of population in healthy life style. The activities covered population of the rural area to improve community responsibility and awareness of good health saving strategies, training the community in modern health-saving procedures, as well as involvement of young people in socially important national projects.
Key words: добровольчество, волонтерство, медицинская помощь, сельское население, volunteers’ activities, volunteers, medical care, rural population
ABOUT FEVER IN «МEDICAL ADVICE» BY JOHANN FRIEDRICH RIBEL
Romanov N.A., Dorosevich A.E., Dmitriev I.V.
UDC: 616. 91 /. 93
Abstract: Objective. To investigate the initial stage of Russian medical terminology history. Methods. A comparative historical research method was used in the study. The sources of investigation were the works of Russian and foreign medical scientists. Results. The formation of Russian scientific medical terminology began in the XVIII century. The creators of this terminology were the authors and translators of medical writings - the founders of Russian science. Among those who created the system of Russian medical terms, a special place is occupied by the name of Professor of the University of Moscow F.I. Barsuk-Moiseev, who translated a huge amount of medical books into the Russian language in the XVIII century. In 1791, he translated from Latin Ribel’s J.F. «Мedical advice». In this article Russian medical terminology of this translation, relating to fevers, is analyzed. Conclusions. The analysis of the above mentioned translated edition demonstrates creativity for terms creation of the translator and confirms, that F. I. Barsuk-Moiseev is an active participant in the complex and difficult process of terminological system of domestic medicine creation. The article describes the peculiarities of the terminology in the above-mentioned «Мedical advice», reflecting the level and nature of medical data at the end of the 18 century, especially - the dominance of humoral theories in the pathology of that time.
Key words: медицина, история, патология, лихорадки, терминология, Ф.И.Барсук-Моисеев, medicine, history of Pathology, fevers, terminology, F.I.Barsuk-Moiseev
POINTS OF HOMEOSTASIS AND THE METHOD TO FIND THEM. II
Prudnikov I.M.
UDC: 519.6-519.83-519.86
Abstract: Obiective. The aim of the study was to develop methods to find homeostasis and equilibrium points in medicine, biology, economics and game theory, in particular, the modes of operation of complex biological-medical devices for the biofabrication of artificial tissue-like formations (the Skolkovo Foundation project “Universal Platform of Frankenstein” for the biofabrication of artificial tissues and bodies" Application N35719 (2015-2019). The methods of coordinate descent are improved and gradient methods are developed for finding the equilibrium points in the model. The functions of losses of each object of the model are the convex functions in one of their variables. Methods. To find the equilibrium points, the gradients and coordinate descent methods are used. To reduce a more complicated case with nonsmooth functions describing the state of each element of the system as damage, loss, or profit, to a case with smooth functions the Steklov average integrals are used that turn nonsmooth functions into smooth ones, for which previously developed numerical methods can be used for finding the equilibrium points. In the process of optimization, the diameters of the sets D, which on an average take place over, are decreased in coordination with the step. The latter allows to obtain infinitesimal small uniformly in k functions participating in the decomposition of smooth functions. When applying the method of coordinate descent, averaging and changing the variables are used. Results. Improved numerical methods such as coordinate and gradient descent methods for finding the equilibrium points in economics, medicine, biology, and game theory are constructed. The convergence of limit points to the equilibrium points is proved. The rules for coordinated decrease of the steps l during optimization and the diameters d(D) of the set Dare given. Conclusion. A new approach is being developed to search for the equilibrium points, which consists in applying the integral averaging and subsequent optimization of the resulting functions together with a consistent reduction of the step and diameter of the set over which integration is done. When applying the method of coordinate descent, averaging and change of variables are used. A gradient method for finding the equilibrium points is described.
Key words: точки равновесия по Нэшу, метод покоординатного спуска, метод градиентного спуска, интегральное усреднение Стеклова, точка некооперативного равновесия, точки гомеостаза, equilibrium points by Nash, method of coordinate descent, method of gradient descent, Steklov integral, noncooperative equilibrium points, homeostasis points
ORTHODOXY AND PSYCHIATRY: EXPERIENCE AND PROSPECTS FOR INTERACTION
Tupikin R.V., Osipova N.N.
UDC: 281.9:6167.89
Abstract: Objective. Exploring the possibilities of interaction between Orthodoxy and psychiatry in the field of mental health. Methods. The work was performed using historical genetic and problem-chronological research methods. Theological, historical and medical sources of literature were used to substantiate an integrated approach to the study of diagnostics and treatment of spiritual and mental diseases. Results. Historical-theological, historical-medical aspects of the interaction of religious organizations and medical institutions in the field of assistance to the mentally ill, especially monastic psychiatry, showing positive experience of a comprehensive approach to the treatment of psychiatric patients have been identified. Conclusion. At present there are sufficient scientific substantiations and significant positive experience in organizing joint practical work of psychiatrists and clergymen. Effective comprehensive assistance to mentally ill patients should include organizing the training of clergymen in the basics of pastoral psychiatry and pastoral care for people suffering from mental disorders, as well as training psychiatrists and psychotherapists in the field of Christian anthropology.
Key words: психическое здоровье, психические расстройства, пастырская психиатрия, христианская антропология, mental health, mental disorders, pastoral psychiatry, Christian anthropology