THE EFFECT OF L-TRYPTOPHAN ON THE SPECTRUM OF FREE AMINO ACIDS IN THE BRAINCORTEX OF RATS UNDERGOING CEREBRAL ISCHEMIA
Razvodovsky Y.E., Smirnov V.Y., Troyan E.I., Doroshenko E.M., Pereverzev V.A., Maksimovich N.Ye., Semenenya I.N.
UDC: 616.441.577.112
Abstract: Objective. Characteristics of changes in the pool of amino acids in the cortex of the frontal and parietal lobes of both cerebral hemispheres of rats after administration of L-tryptophan against the background of subtotal cerebral ischemia (SCI). Methods . The experiment was carried out on 18 white outbred female rats. SCI was simulated in 12 rats by ligation of both common carotid arteries for one hour. L-tryptophan (at a dose of 100 mg/kg body weight) was injected intravenously just before ligation of the common carotid arteries. The content of amino acids and their derivatives in perchloric acid homogenates of tissues was determined by reversed-phase high-performance liquid chromatography (HPLC). Results. SCI caused a decrease in the cerebral cortex levels of glutamate, asparagine, tyrosine, tryptophan, ornithine, lysine and 1-methylhistidine. The administration of tryptophan during SCI increased the levels of threonine, tryptophan, serine, leucine, valine, glutathione, phosphoethanolamine, a-aminoadipic and a-aminobutyric acids, and also decreased the concentrations of citrulline, arginine, alanine, histidine, 1-methylanhistidine. In addition, the administration of tryptophan normalized the total pool of amino acids, as well as the pools of essential, glycogenic, neurotransmitter amino acids. Conclusions. SCI induces an amino acid imbalance in the cerebral cortex, which results in decreased levels of a number of amino acids, including tryptophan. The introduction of L-tryptophan prevents a decrease in the level of certain amino acids, including tryptophan, and also normalizes a number of integral indicators of the amino acid fund of the cerebral hemispheres.
Key words: аминокислоты, кора больших полушарий, субтотальная ишемия головного мозга, L-триптофан
DISTURBANCES IN PROOXIDANT-ANTIOXIDANT BALANCE IN CHRONIC PAIN SYNDROME AND EXPERIMENTAL PERIODONTITIS
Brusentsova A.E., Lyashev Y.D., Tsygan N.V., Liashev A.Y.
UDC: 616.314.17-008.1
Abstract: Objective. To clear up the content of malonic dialdehyde and acelhydroperodes as well as the activity of antioxidant enzymes in rats with chronic pain syndrome and experimental periodontitis. Methods. Experimental periodontitis was simulated according to the method proposed by Volozhin A.I. and Vinigradova S.I. Chronic pain syndrome was simulated by bilateral ligation of sciatic nerves in the middle of third of the thigh. Vistar rats were taken out of the experiment by overdosage of narcosis and the content of malonic dialdehyde and acylhydroperoxides as well as the activity of superoxide dismutase and catalase were determined in blood plasma by traditional methods. Results. The decrease in the activity of superoxide dismutase and catalase in the blood plasma of rats with chronic pain syndrome at 5-7 weeks of the experiment was established. The simulation of the experimental periodontitis was accompanied by an increase in the content of malopnic dialdehyde and acylhydroperoxides as well as the drop in the activity of superoxide dismutase and catalase throughout the observation period (7-21 days). In animals with experimental periodontitis and preliminary formed chronic pain syndrome an increase in the concentration on malonic dialdehyde and a decrease in the activity of both antioxidant enzymes were found on the 7 day of the experiment. Conclusion. The development of experimental periodontitis on the background of chronic pain syndrome is accompanied by more significant disturbances in prooxidant-antioxidant balance in the early period of the disease, which manifests itself by the increase in the concentration of malonic dialdehyde and the decrease in the activity of antioxidant enzymes: superoxide dismutase and catalase, in the blood plasma.
Key words: пародонтит, хронический болевой синдром, перекисное окисление липидов, антиоксидантные ферменты
NEUROPEPTIDE ACTH ACCELERATES THE ADAPTATION OF PATIENTS TO DENTAL PROSTHESES
Pozhilova E.V., Abolmasov N.N., Novikov V.E., Derevtsova S.N.
UDC: 615.275.4
Abstract: Objective. To evaluate the effect of neuropeptide ACTH on the process of adaptation to complete removable prostheses in patients with different types of temperament. Methods. Examination and treatment of patients (60-90 years old) was carried out both sexes with total adentia (a simple, blind, randomized, placebo-controlled study). The types of temperament of the patients were determined by means of a questionnaire using a questionnaire by G.Y. Aizenka. Manipulations with the assessment of oral stereognosia (the ability to determine the shape and geometric dimensions of solid objects using tactile receptors of the oral tissues) and speech function (speech intelligibility) in patients were performed before treatment, on the day of prosthetics and at the stages of adaptation to them (7, 14, 30 days after prosthetics). Results. Among the primary and re-prosthetic patients with complete absence of teeth, there is an almost uniform distribution of patients with sanguine, choleric, melancholic and phlegmatic temperament types. However, the ratio of the number of patients of the same temperament during primary or repeated prosthetics is different. Thus, the largest number of patients who initially applied for treatment had a melancholic type of temperament (30%). The sanguine type of temperament prevailed among the re-prosthetic patients (40%). The speed of adaptation of patients with different types of temperament to complete removable prostheses varies. Patients with choleric and sanguine temperament adapt the fastest, phlegmatic and melancholic people need more time. The results of speech tests and oral stereognosy showed a positive effect of pharmacological correction with ACTH neuropeptide (semax 0.1% nasal drops) on the process of functional and psychological adaptation of primary prosthetic patients to complete removable prostheses, regardless of the type of temperament. Conclusions. Pharmacological correction of the process of adaptation of patients to dental prostheses with neuropeptide ACTG (semax 0.1% nasal drops) can significantly improve the quality of adaptation and shorten its duration. At the same time, there is a positive effect on the process of getting used to complete removable prostheses in patients of all types of temperament, which may be due to the regulatory effect of neuropeptide on the activity of nervous processes in the brain.
Key words: нейропептид АКТГ, семакс, адаптация, стоматологические протезы, типы темперамента
STUDY OF PRESCRIPTION OF NONSTEROIDAL ANTI-INFLAMMATORY IN OUTPATIENT CLINICS OF SMOLENSK
Khaykin A.M., Zharkova L.P., Khaykina E.V., Konchakova F.K., Bykova A.V., Malyutina E.O., Sidorova M.V.
UDC: 615.036.8
Abstract: Objective. To study the therapeutic aspects of prescribing non-steroidal anti-inflammatory drugs (NSAID) by doctors of outpatient clinics in Smolensk Methodology. A one-stage, prospective study was performed, which consisted in in studying outpatient patient records to assess the rational use of drugs of this group by primary outpatient doctors, taking into account a personalized approach to the patient. Results. The analysis of outpatient records of 465 patients who applied for medical care to outpatient clinics N1, N3 and N4 of Smolensk during 2016-2020. Тe main indications for prescribing of NSAIDs were destructive and inflammatory diseases of the joints and spine (47%), radiculopathy and neuralgia (31%), symptomatic treatment of acute respiratory viral infections (30%), prevention of arterial thrombosis (22%). The most prescribed drugs for the treatment of diseases of the musculoskeletal system were nimesulide, ketoprofen, diclofenac and aceclofenac. The average duration of NSAID therapy for joint diseases was 21 days. In 19% of cases, the parenteral route of administration of NSAIDs was used on an outpatient practice. Information about only one episode of a possible adverse drug reaction to NSAIDs has been recorded in the studied outpatient cards. Conclusion. Defects of NSAIDs outpatient clinic doctors prescribing associated with violations in the recommendations for the choice of drugs and the regimen for its administration, analysis of concomitant medical care, drugs interactions and the safety of pharmacotherapy were revealed.
Key words: НПВС, нежелательные лекарственные реакции, рациональное назначение, врачи поликлиник
MORPHOLOGICAL SIGNS OF REGENERATION AND HYPERTROPHY OF BRAIN NEURONS
Bon Elizaveta I., Gritsuk Anastasia A., Kulevich Maria V.
UDC: 616.831.31-005.4.-092.913:618.33
Abstract: Objective. Generalization and systematization of literature data on regeneration and hypertrophy of brain neurons. Methods. The basis of this study was a review of the literature on this topic. Results. There are several ways to regenerate neurons: intracellular regeneration, restoration of the neuropil, the formation of new neurons (in some parts of the nervous system - the hippocampus, the subventricular layer of the lateral ventricles and olfactory bulbs) and the formation of heterokaryons (fusion of a neuron with an oligodendrocyte). Hypertrophy of neurons may indicate both compensation and the development of a pathological process. To clarify the nature of this phenomenon, it is necessary to conduct an ultramicroscopic study of the organelles of the nerve cell. Conclusions. The subsequent study and detailing of the processes of regeneration and hypertrophy of neurons, especially of the central nervous system, will significantly improve the quality of prevention, diagnosis and treatment of neurodegenerative diseases.
Key words: нейроны, головной мозг, регенерация, гипертрофия
AGING OF THE BONE TISSUE OF MATURE AND ELDERLY WOMEN
Bazhenova D.S., Ayrapetyan K.E., Golovanova E.D., Mihalik D.S.
UDC: 611.-018.-055.2:613.98
Abstract: Objective. To examine the age of bone tissue in relation to sarcopenia in mature and elderly women using ultrasound densitometry for early screening of osteopenia. Methods. 60 women were examined at the therapeutic site at the age of 40-55 years (n=30) - group 1, at the age of 56-75 years (n=30) - group 2 with various comorbid pathologies. Anthropometric data were examined (height, weight, body mass index (BMI); assessment of bone mineral density (BMD) was carried out according to ultrasound densitometry of the calcaneus (FURUNO CM200 light Japan), with the determination of propagation speed of ultrasound waves (SOS m/s), bone's age, T- and Z-criteriaes. To diagnose sarcopenia was used algorithm F-A-C-S (EWGSOP 2) with the determination of muscle strength (hand grip force) using dynamometer (TVES-DMER-120). Results. Postmenopausal patients were more likely to have risk factors such as obesity, operative menopause and fractures in their medical history. Sarcopenia as a whole was detected in 13,3% of cases in the examinedsample. The prevalence of osteopenia was 23,3% in group 1 and 54% in group 2. 3 variants of deviation of the bone tissue age (BAT) from the calendar age (CA) were revealed (1-BCA was 5 or more years less than the CA, 2-in the range of ±5 years and 3-if the BCA was 5 or more years higher than CA). Variant 3 of BAT deviation was detected in patients with T-criterion value in the range from -1,5 to -2,5 SD. In patients with BMI >25 kg/m2, values were higher than in those with BMI <25 kg/m2 (p<0,05). Conclusion. The study of BMD using ultrasound densitometry of the calcaneus in the screening mode in patients over 40 years old at the outpatient stage allows us to identify a high-risk group for the development of osteoporosis when BAT exceeds BA > 5 years and T-criterion values in the range from -1,5 SD up to -2,5 SD, which requires more in-depth examination and observation by specialized professionals.
Key words: остеопения, саркопения, ультразвуковая денситометрия, костный возраст, ожирение
CLINICAL AND INSTRUMENTAL FEATURES OF PATIENTS WITH ACUTE PANCREATITIS OF THE SMOLENSK REGION
Karuk Marina V., Banenis Gintasovna B., Ivanishkina Elena V., Rodin Anton V., Tsareva Valentina M.
UDC: 616.37-002:616.12-073.97-7
Abstract: Objective. To analyze the clinical and functional features of the acute pancreatitis, ECG results of patients from Smolensk region for optimization of diagnosis, treatment and prophylaxis. Methods. Analysis of clinical features of acute pancreatitis in modern conditions was conducted in 58 patients of Smolensk region, who was on hospitalization in the general surgery department of Smolensk regional clinical hospital (42 men and 16 women) in age of 30-60 years old (average age 46,0±3,7), Results. As risk factors of developing acute pancreatitis patients of Smolensk region, we revealed alcohol abuse, tobacco smoking, malnutrition fatty foods, overeating. For a part of patients, the reason of pancreas lesion is the pathology of the biliary system. Clinical manifestation of acute pancreatitis is very variable and combined with a clinic of biliary system disorders. The dominative symptom is pain localization in epigastric area, encircling character or with irradiation in spine with high intensity. In clinical blood count was noticed neutrophil leukocytosis, lymphopenia and increased sed rate. Within biochemical syndromes dominated cytolytic and cholestatic syndromes. Also noted the increase of amylase, urea, creatinine and hyperglycemia in blood serum. In ECG research was detected non-specific changes in rhythm and conduction, signs of hypertrophy of left ventricular, changes in myocardial depolarization were revealed. Conclusion. The study of general clinical and functional characteristics of patients with acute pancreatitis, as well as the role of the main risk factors are the prime necessity in early diagnostic of disease and modern correction factors, influencing the effectiveness of therapy.
Key words: ОП, факторы риска, клинико-лабораторные показатели, электрокарди-ографическое исследование
EVALUATION OF THE EFFECTIVENESS OF THE MONITORING PROGRAM OF ACTUAL NUTRITION AND PHYSICAL ACTIVITY IN CHILDREN WITH BRONCHIAL ASTHMA AND OBESITY
Yacheykina N.A., Alimova I.L.
UDC: 616.248-07-053.2:613.2
Abstract: Objective. To evaluate the effectiveness of the developed program for monitoring actual nutrition and physical activity in children with bronchial asthma and obesity. Methods. A computer program "Program for monitoring actual nutrition and physical activity in children" was created. 32 children with moderate asthma and obesity of the 1st and 2nd degree aged 12 to 14 years were examined, including 20 children who were active users of the program (the main group) and 12 children who did not use the program (the comparison group). The evaluation of the effectiveness of training was carried out according to the dynamics of the nature of nutrition, physical activity using the developed program; SDS BMI, PSV according to peak flowmetry; asthma control using the AST test. Results. After 3 months from the start of training, the children of the main group recorded a decrease in all indicators of nutrition components and an increase in the number of steps in relation to the initial data and in comparison with similar indicators of children of the comparison group. After 6 months, the children of the main group showed stabilization of nutrition indicators and the number of steps per day compared with the indicators after 3 months, but statistically significant differences remained in relation to the initial data and indicators of the children of the comparison group. After 3 months, the children of the main group recorded a decrease in the SDS BMI index compared to the baseline data and a similar indicator of the children of the comparison group. After 6 months, a stabilization of the decrease in SDS BMI was revealed compared to the indicator after 3 months, but the indicator remains lower compared to the same comparison group. The children of the main group showed an increase in PSV during the observed period after 3 and 6 months, while no statistically significant differences between the groups were obtained. When assessing disease control using the AST test in children of the main group, an improvement in disease control was also revealed in the dynamics of follow-up after 3 and 6 months. Conclusions. The effectiveness of the developed computer program in children with bronchial asthma and obesity is shown in the form of weight loss due to changes in the nature of nutrition and physical activity and improved control over bronchial asthma.
Key words: бронхиальная астма, ожирение, дети, питание, физическая активность
NEW-ONSET TYPE 1 DIABETES IN CHILDREN AND ADOLESCENTS IN UNFAVORABLE EPIDEMIOLOGICAL SITUATION CAUSED BY THE COVID-19 DELTA STRAIN
Demyanenko A.N., Ageev A.V., Bezruchenkova A.V., Igolkina M.V.
UDC: 616.379-008.64-053.2+616.98:576.858
Abstract: Objective. To study the features of the course of newly diagnosed type 1 diabetes mellitus in children and adolescents in an unfavorable epidemiological situation caused by the COVID-19 delta strain. Methods. We examined 82 patients with newly diagnosed type 1 diabetes mellitus during the COVID-19 pandemic. Patients were divided in 2 groups: 1st - with the onset of diabetes mellitus during the spread of the delta strain (n=39), 2nd - with the onset of diabetes mellitus during the spread of the COVID-19 beta strain (n=43). Clinical and laboratory examination and treatment according to federal standards were carried out, as well as a study of the level of IgG and IgM to COVID-19 or a PCR study on COVID-19. Results. Patients of both groups were comparable in age (group 1 - 9 years [5-11], group 2 - 8 years [7-10], p>0,05), gender and at the time of the onset of diabetes mellitus had no chronic somatic, endocrine, neurological pathology and differences in the assessment of physical development indicators. The level of glycemia at admission to the hospital (group 1 - 19,6 mmol/l [15,5-25,7], group 2 - 20,9 mmol/l [16,5-25,7]) and the level of glycated hemoglobin (group 1 - 12,7% [11,7-13,9], group 2 - 12,0% [10,9-13,5]) did not differ, as did the duration of symptoms of diabetes mellitus before diagnosis. Асute respiratory infections was observed with the same frequency in both groups (9 (23%) and 16 (37%)). In 8% of patients of the 1st group, RNA of the SARS-CoV-2 virus was detected and in 8% of IgG to SARS-CoV-2, in the 2nd group, IgG and IgM to SARS-CoV-2 were detected in 4%. Ketoacidosis was more often diagnosed in group 1 patients (33 (85%) and 27 (63%), p=0,044). The frequency of hospitalization in the intensive care unit (15 (38%) and 20 (47%)) and the duration of stay in it (group 1 - 1,0 day [1,0-1,8], group 2 - 1,0 day [1,0-1,5]) were comparable (p > 0.05). Patients of the 1st group rarely reached the target glycemic values (20 (51%) and 32 (74%), p=0,030). Conclusions. In conditions of the spread of the COVID-19 delta strain, ketoacidosis is more common in children and adolescents at the onset of type 1 diabetes mellitus, patients less often achieve glycemic targets.
Key words: сахарный диабет, дети, кетоацидоз, коронавирусная инфекция
PREDICTION OF COMPLICATED EARLY NEONATAL PERIOD IN SMALL FOR GESTATIONAL AGE NEWBORNS
Prylutskaya V.A., Sukalo A.V.
UDC: 616-053.34-056.2-07-036:618
Abstract: Objective. The aim of the study is to develop a method for predicting the complicated course of the early neonatal period in small for gestational age (SGA) newborns in order to increase the efficiency of medical care for this category of children. Method. The study was conducted at the Republican Scientific and Practical Center "Mother and Child" in Minsk and included a group of 298 newborns: 77 newborns with body weight at birth less than the 10th percentile and 221 children with physical development corresponding to the gestational age. Results. The predicted event was considered a complicated course of the early neonatal period in patients who had SGA, which was determined by the presence of one or more diseases in the newborns. Based on multivariate regression analysis, it was found that the most significant prognostic factors associated with the risk of maladjustment of SGA newborns are maternal pregravid body weight, fetal growth restriction, gestational age, mean corpuscular volume erythrocyte, z-score body weight at birth. A mathematical model was developed for determining the probability of a complicated course of the early neonatal period in SGA and its threshold value was calculated. A classification scheme has been created that allows, on the basis of scoring, to classify an infant as a risk group for a complicated course of the early neonatal period for timely correction of the examination and treatment program. Conclusion. It is shown that a multivariant mathematical model and a classification scheme can be used in healthcare organizations at various levels of perinatal care.
Key words: новорожденные, маловесный для гестационного возраста, ранний неонатальный период, факторы риска, прогностическая модель
PREDICTING THE COURSE OF DEPRESSION OF CONSCIOUSNESS SYNDROME IN HYPERAMMONEMIA IN NEWBORNS AND YOUNG CHILDREN
Kolchina A.N., Khaletskaya O.V., Borisova V.N.
UDC: 616-056.7-008.9-053.2:616.8-009.83
Abstract: Objective. To develop approaches to predicting the course of the syndrome of depression of consciousness in newborns, infants and toddlers at the onset of hyperammonemia, depending on the presence or absence of inborn errors of metabolism (IEM) to determine the tactics of patient management. Methods. 20 patients with hyperammonemia were examinated. The patients were retrospectively randomized into 2 groups: the main group - patients with hyperammonemia caused by IEM, the comparison group - patients with transient hyperammonemia. The following age groups were distinguished: newborns (from 0 to 28 days of life) and a group of infants and toddlers (from 29 days of life to 3 years). All patients underwent clinical and laboratory examination, including the assessment of the presence of the following syndromes: vomiting, seizures, depression. Results. It was established that in the neonatal period, the syndrome of hyperammonemia caused by IEM debuts earlier than transient hyperammonemia; the opposite trend was found in the age group of patients older than 1 month. In the clinical picture, depression syndrome prevails (in 87.5% and 66.7% of cases, respectively). The maximum values of the ammonia level in patients with IEM were higher (p=0.050). The median in the main group was 286.0 [198.5; 286.0] μmol/L, in the comparison group - 130.7 [104.4; 194.6] μmol/L. Taking into account the presence of a direct correlation between the level of ammonia and the degree of depression of consciousness (ρ=0.720; p=0.001), an ROC-analysis was carried out. The value of the ammonia level at the cut-off point was 268.7 μmol/L, which determines the risk of coma in patients with hyperammonemia syndrome. Conclusion. Hyperammonemia caused by IEM is accompanied by higher levels of ammonia in the blood plasma. A direct correlation was established between the degree of depression of consciousness and the level of ammonia in the blood (ρ=0.720; p=0.001). The results of the ROC-analysis made it possible to establish the threshold value of the ammonia level, which determines the risk of coma in patients with hyperammonemia syndrome, which was 268.7 μmol/L.
Key words: гипераммониемия, синдром угнетения, аммиак, новорожденные, нарушения цикла мочевины, вторичная гипераммониемия, наследственные болезни обмена
CLINICAL CASE OF MULTI-VALVE PROSTHETICS IN A PATIENT WITH RHEUMATIC HEART DISEASE
Chudaeva O.V., Vasekin A.I., Stepochkina R.V., Ageenkkova O.A.
UDC: 616.126.5-089
Abstract: An increase in the life expectancy of the population is associated with an increase in the incidence of cardiovascular pathology, including acquired heart defects. Medical therapy of valvular defects does not always allow achieving compensation, as a result of which such patients undergo valve replacement. Purpose. To analyze the medical history of a patient with multivalve prosthetics in case of rheumatic heart disease. Methodology. Interview, physical examination of the patient; analysis of medical records, data from laboratory and instrumental investigation methods. Results. The article presents a rare clinical case of multivalve prosthetics in a patient with rheumatic heart disease. A 13-year-old patient was diagnosed with rheumatism for the first time. In 1985, atrial fibrillation, a permanent form, was diagnosed. In 1987 she suffered an acute cerebrovascular accident (ACVA), signs of heart failure began to increase. In this connection, surgical treatment was recommended. In 1992, mitral valve replacement and open tricuspid commissurotomy were performed. The patient's state of health remained stable until 2009. At the Scientific Center for Cardiovascular Surgery (NC SSH named after Bakulev), the patient was diagnosed with aortic defect, critical stenosis and insufficiency. In 2011, the aortic valve was replaced with a mechanical prosthesis MICS No. 23, the tricuspid valve was replaced with a biological prosthesis Biolab No. 28. Since 2016, dysfunction of the tricuspid valve bioprosthesis was noted - stenosis and degree 4 insufficiency. In 2020, she was consulted at the Scientific Center of the Union of Artists named after I. A.N. Bakulev and surgical treatment was recommended. In December, a transcatheter implantation of a tricuspid valve using the “valve-to-valve” method was performed at the National Medical Research Center for Cardiology (NMRC of Cardiology). Conclusion. Thus, valve replacement is considered the main method of treating patients with lesions of the valve apparatus, providing prevention of heart failure and its progression, improving the quality of life and its duration.
Key words: ревматическая болезнь, клапаны, пороки, протезирование
HEMODYNAMICS PECULARITIES OF MIDDLE-AGED AND ELDERLY PATIENTS WITH SARCOPENIA
Ustinova N.A., Savkin A.L., Airapetov K.V., Golovanova E.D.
UDC: 616.-053.9-056.52
Abstract: Objective. To examine variants of hemodynamic findings of middle-aged and elderly patients depending on the presence or absence of sarcopenia to increase the effectiveness of antihypertensive therapy. Methods. We examined 141 patients at the therapeutic area at the age of 40-59 years (n = 42) and at the age of 61-74 years (n = 99) with various comorbid pathologies. Indicators of the central (CO-cardiac output, SO-stroke output), peripheral hemodynamics (SP-systolic pressure, DP-diastolic pressure, MAP-mean arterial blood pressure, Pulse pressure, PVR-peripheral vascular resistance), and some parameters of heart rate variability (HRV) were examined by means of pulse wave analysis of the bioelectrical impedance an (BIA) analyzer "Multiscan BC-OXi" (Russia). The presence of sarcopenia was determined by the criteria of EWGSOP 2010 (muscle mass and muscle function were examined - the strength of "hand compression" and gait speed). Results. 4 variants of findings in central and peripheral hemodynamics were identified: Type 1 - with normal CO and PVR (31.5%), Type 2 - with low CO and high PVR (30%); Type 3 - with high CO and normal PVR and (16.8%); Type 4 - with normal CO and high PVR (21.7%). In patients with sarcopenia, both in middle age and in old age, the most unfavorable variant of hemodynamic findings of Type 2 was significantly more common (p<0.05) than in patients without sarcopenia, and the greatest changes in HRV parameters were also associated with it. Hemodynamic findings at Type 3 and 4 in patients with sarcopenia were evident in increasing of CO and SO, which will affect the effectiveness of antihypertensive therapy in prescribing various options for combined antihypertensive therapy with beta-blockers and calcium antagonists. Conclusions. The presence of sarcopenia in outpatients over the age of 40 years affects changes in the parameters of central and peripheral hemodynamics, which should be taken into account when selecting antihypertensive therapy.
Key words: гемодинамика, саркопения, биоимпедансометрия, зрелый, пожилой возраст
FORMATION OF METHODS OF EXTRACARDIAL MYOCARDIAL REVASCULARIZATION IN ISCHEMIC HEART DISEASE (BACKGROUND)
Zainiddinov F.A., Borshchev G.G., Ulbashev D.S., Stepanov D.V.
UDC: 616.12-089
Abstract: Objective. To analyze the development of views on extracardial myocardial revascularization in patients with coronary heart disease. Methods. Collection, systematization and analysis of historical and scientific data on the problems of extracardial myocardial revascularization in ischemic heart disease. Results. The article is devoted to the historical stages of the formation of methods of stimulation of extracardial blood supply in patients with coronary heart disease. The article analyzes the difficulties of surgical treatment of patients with diffuse distal coronary artery disease, shows the modern possibilities of overcoming the above problem. The review describes a specially developed surgical and biotechnological method of «YurLeon», proposed by Academician Shevchenko Y.L., based on the principle of stimulation of angiogenesis in order to form anastomoses between the coronary bed and arterial systems of various tissues surrounding the heart. Conclusions. For decades, the methods of surgical care for patients with coronary heart disease have undergone significant transformation. Forgotten methods of treatment have regained their relevance, rapid development of cellular technologies has made it possible to improve and supplement the methods of induction of neoangiogenesis.
Key words: ИБС, экстракардиальная реваскуляризация сердца, ЮрЛеон, неоангиогенез, коронарное шунтирование
TACTICS OF ACUTE ARTERIAL OBSTRUCTION OF THE LIMB TREATMENT IN PATIENTS WITH CORONAVIRUS COVID-19
Kamolov R.S., Gaibov A.D., Abdusamadov K.A., Shakhsavorbekov A.Sh., Shaimonov A.Kh., Avgonov N.K.
UDC: 616.134.1/4-007.271-036.11-02-07-08; 616.9:578.834.1:614.4
Abstract: Objective. To determine treatment tactics in patients with acute arterial obstruction of the extremities suffering from coronavirus infection - COVID-19. Methods. The study included 52 patients with acute arterial obstruction of the extremities, identified against the background of COVID-19, hospitalized in the Department of Vascular Surgery of the Republican Scientific Center for Cardiovascular Surgery from April 2020 to November 2021. There were 37 men and 15 women in the study. The age of the patients ranged from 22 to 85 years. Results. Acute arterial insufficiency of the upper limb was detected in 8 patients, that of the lower limb - in 44 patients. Lesions of the aorto-iliac segment were detected in 4 patients, femoral arteries - in 27, popliteal-tibial - in 12, brachial artery - in 8. In 1 case, arterial thrombosis was combined with venous thrombosis in the ilio-femoral segment. Conservative treatment was carried out in 16 patients. In 32 cases, amputation of the upper or lower limbs was performed, in 4 cases - embolectomy. Conclusion. These data show the severity of the course of acute arterial obstruction of the extremities in patients suffering from COVID-19, as well as the inefficiency of open operations. At the same time, complex anticoagulant, anti-inflammatory and activating therapy are considered more effective. Surgical intervention should be carried out only in cases of extreme necessity, as well as with the progression of ischemia against the background of ongoing therapy.
Key words: острая артериальная непроходимость конечностей, коронавирусная инфекция, COVID-19, артериальный тромбоз
CORRECTION OF THE INFLAMMATORY REACTION SYNDROME IN PERITONITIS OF VARIOUS ORIGINS
Aliev M.Zh., Akeshov A.Zh., Abdiev A.A., Turatbekova K.T.
UDC: 617:55:616.381-002-031.84-089
Abstract: Objective. To assess the results of the developed approach to the correction of the systemic inflammatory response syndrome in patients with diffuse peritonitis of various origins. Methods. (prospective study). The results of the correction of the systemic inflammatory reaction syndrome in 54 patients are presented, of whom 20 were diagnosed with peritonitis, which developed on the basis of complications after operations performed on the abdominal organs, in 22 it was caused by perforation of a stomach ulcer or duodenal ulcer (12 people) and perforation of an echinococcal cyst liver (10 people) and 12 had peritonitis due to acute pancreatitis. In assessing the severity of the syndrome, clinical indicators were used (increase in body temperature> 38 °, pulse rate above 90, respiration (more than 20 or apnea) and laboratory indicators (leukocytes, leukocyte index of intoxication and procalcitonin). The study was carried out before and after the operation as soon as possible. The choice of the method of correction was approached taking into account the genesis of peritonitis, but at the time of the operation, all of them underwent regional lymphatic stimulation, immunocorrection, and after the operation, anti-inflammatory, detoxification therapy, taking into account the revealed disorders of organs and systems. Infrared irradiation of the wound area is used to reduce wound complications. Results. Before the operation, regardless of the genesis of peritonitis, the majority showed 3-4 clinical signs of (SIRS - Systematic Inflammatory Response Syndrome) syndrome, and in the postoperative period there was a gradual decrease in the frequency of signs and the level of procalcitonin, except for two with postoperative peritonitis and in one pancreatitis progression could not be prevented, out of 54 died 3 (5.6%). Conclusion. The use of a differentiated approach (regional antibiotic-lymphotropic stimulation in combination with immune correctors) to the correction of the inflammatory response syndrome confirms its effectiveness.
Key words: разлитой перитонит, синдром системной воспалительной реакции, региональная лимфостимуляция, иммуннокоррекция, инфракрасное облучение, дифференцированный подход к коррекции синдрома
PATHOGENETIC FEATURES OF CHRONIC RHINITIS, DEPENDING ON THE ETIOLOGY
Smirnova O.V., Goncharova N.S.
UDC: 616.211-002.2/616-092
Abstract: Objective: To study the pathophysiological, morphological, histological and clinical features of chronic rhinitis depending on their phenotypes at the present stage, using the analysis of literature data. Methodology: Using the words "chronic rhinitis, chronic atrophic rhinitis, chronic allergic rhinitis, chronic vasomotor rhinitis, metaplasia of the nasal mucosa", a search was made for scientific publications in the bibliographic and abstract databases eLIBRARY.RU, Scopus, PubMed, RSCI, Google Scholar for the latest 10 years. Results: Data on the prevalence of chronic rhinitis depending on the etiology, modern classification, pathogenesis features of chronic rhinitis depending on their phenotype are presented. Conclusion: Chronic rhinitis is a worldwide disease that affects the quality of life of patients. Chronic allergic rhinitis is the most common, of non-allergic rhinitis, vasomotor rhinitis is the most common form, and atrophic rhinitis is less common. A number of authors consider chronic atrophic rhinitis as a precancerous disease. Accurate diagnosis of chronic rhinitis by phenotype is one of the urgent and socially significant problems. Currently, for potentially malignant epithelial dysplasia, there are no exact criteria for predicting their transition to cancer; the search for available, reliable, and minimally invasive markers for the control of patients with chronic atrophic rhinitis is relevant.
Key words: хронический ринит, патогенез, фенотипы, воспаление, диагностика, предраковые заболевания
POSSIBILITIES OF MORPHOLOGICAL VERIFICATION OF THYROID NODULES UNDER ULTRASOUND NAVIGATION
Solovyev V.I., Kartysheva T.I., Semkina E.N., Zuy V.S.
UDC: 616-441-006.5
Abstract: Objective. To compare the results of fine needle aspiration puncture biopsy under ultrasound navigation with subsequent cytological examination of the resulting aspirate with the conclusion of a postoperative histological examination. Methods. The analysis of the results of ultrasound examination of the thyroid gland and surgical treatment of 383 patients with malignant and nodular formations of the thyroid gland for a 3-year period (2018-2020) was performed. The data of fine needle aspiration puncture biopsy and intraoperative examination were compared with the results of histological examination of the surgical material. Results. Upon examination, only 25% (383 out of 1522) underwent a cytological examination under ultrasound navigation, which were informative in 27,2% (104 patients) - a malignant neoplasm was established. Of these, 39,4% (41 people) received surgical treatment in the Smolensk regional oncology dispensary, 60,6% outside the oncological dispensary. False positive results of cytological conclusions on thyroid cancer were recieved in 5 (12,2%) patients, false negative results - in 6 (14,6%) patients, and suspicions cancer in 5 (12,2%). The resemblance coincidence of pre- and intraoperative diagnostic data with postoperative planned histological examination was in 73,1% for thyroid cancer. Conclusion. The conducted study confirmed difficulties in preoperative verification of the thyroid gland even under ultrasound navigation. The complex application of preoperative fine needle aspiration puncture biopsy of the thyroid gland with ultrasound navigation followed by mandatory intraoperative cytological examination contributed to the accuracy of diagnosis of prostate cancer and choice of the optimal type and extent of surgical treatment.
Key words: щитовидная железа, узловые образования щитовидной железы, тонкоигольная аспирационная биопсия, ультразвуковая навигация
POSSIBLE RISK FACTORS OF PNEUMOTHORAX IN NEWBORNS
Dmitriev I.V., Ignatova N.B., Abrosimov S.Yu., Moiseenkova S.D., Golenkova N.V., Firsova O.A.
UDC: 16-091.219-053.31
Abstract: Objective. To identify possible factors contributing to the progress of pneumothorax in children in the neonatal period. Methods. A complete non-randomized, comparative, retrospective research of 584 autopsy protocols of children was conducted for those who died from 2012 to 2020 in the early and late neonatal periods. The study of the deceased was carried out in the department of pediatric pathology in “Smolensk Regional Institute of Pathology” located in Smolensk. Based on the objectives of this research, all children were divided into 4 groups: group 1 - children with pneumothorax, born with a gestation period from 22 to 36 weeks and 6 days inclusively; group 2 (control for the first group) - children without pneumothorax, born with a gestation period of 22 to 36 weeks and 6 days inclusively; group 3 - children with pneumothorax born with a gestation period of 37 to 40 weeks inclusively; group 4 (control group for the third group) - children without pneumothorax, born with a gestation period of 37 to 40 weeks inclusively. The control groups were formed from the same population and in the same period of time. Herewith, both cases with pneumothorax and control groups were selected regardless of the effect to be studied. Results. The children who were mainly affected by pneumothorax (67.6%) had weigh less than 2500 grams, especially if they had sepsis. Regarding the genesis of pneumothorax, compared to control groups, there were no statistically significant differences for such factors as the nature of the underlying disease (with the exception of sepsis), as well as the pathology of the mother and placenta. And there is no relationship between the localization of pneumothorax (right, left or on both sides) and the body weight of children at birth. But for children with pneumothorax who were born at a gestational age of 22 to 37 weeks, the diagnosis of various types of inflammation of the placenta was morphologically confirmed in 97.4% of cases, and for those born with a gestation period of 37 to 40 weeks - in 58.2% of cases. And that is more than in the control groups. Regarding maternal pathology, the indicators of the threat of termination of pregnancy in the first and third groups exceeded the indicators of the control groups. In control groups artificial ventilation of the lungs was less frequent by ten percent before the progress of pneumothorax, but the differences were statistically unreliable. Conclusions. In our study, there were no statistically significant links between the progress of pneumothorax and the nature of the child's disease (with the exception of sepsis), the pathology of the mother and the pathology of the placenta. It is possible to realize the influence of a certain effect through several intermediate factors in the genesis of pneumothorax that are currently unknown or not taken into consideration in studies. The indicators of blood gases, gas mixtures and other parameters of artificial ventilation of the lungs were not studied in this research, which was not the purpose of this work, but the only fact of artificial ventilation of the lungs before the progress of pneumothorax was analyzed. Therefore, those researchers who talk about the importance of the characteristics of artificial ventilation of the lungs on the day of development of pneumothorax could be right. Although it is possible that it has influence only in a certain part of cases. However, there are very few studies on this issue (according to literature data). According to the results of the study, many questions arose about the genesis of pneumothorax in newborns, which indicates the need to continue studying the influence of other endo- and exogenous factors, including indirect ones, affecting or leading to the occurrence of pneumothorax. In particular, the existing management schemes of such newborns and drug effects should be analyzed.
Key words: новорожденные, пневмоторакс, факторы риска
MODERN RANGE OF TRANSDERMAL DOSAGE FORMS IN THE PHARMACEUTICAL MARKET OF RUSSIA
Losenkova S.O., Tunina E.D., Pavluchenkova N.A., Losenkov P.V., Emelyanov A.A., Machotina M.V.
UDC: 615.454
Abstract: Objective. Study of the nomenclature of transdermal dosage forms (transdermal gels, patches, transdermal therapeutic systems) registered on the pharmaceutical Russian market. Methods. A content analysis of the State Register of Drugs of Russia (as of 03.10.2021) was carried out with the subsequent quantification of the data obtained. The number of international non-proprietary names (INN) of drugs (MP) for which transdermal MF is registered, the number of transdermal MF and the total number of drugs in transdermal form, taking into account dosages, were calculated. Results. The analysis of the State Register of Drugs in 2021 revealed 24 trade names of drugs in various transdermal forms and dosages: gels (4.2%), transdermal patches (25%), transdermal therapeutic systems (70.8%). In comparison with the range of registered transdermal MF in 2013, there is no change in the number of names, but in comparison with 2012, the number of names of registered transdermal MF increased by 1.7 times. Analysis of the regulated lists showed that 9 trade names of drugs in the form of TDTS, as well as 1 name of drugs in the form of a transdermal patch, contain in the composition of the substance of list II of the list of narcotic drugs, psychotropic substances subject to control in the territory of the Russian Federation (fentanyl, buprenorphine). Fentanyl and rivastigmine in the form of TDTS are included in the list of vital and essential drugs. At the same time, in the List of the minimum range of drugs necessary for the provision of medical care, MP in transdermal MF are not represented. Conclusion. Transdermal delivery of drugs has great prospects as an alternative to oral, intramuscular and intravenous methods of administration of drugs, especially during the pandemic in conditions of limited availability of medical care to the population. The transdermal method of delivery allows to reduce the frequency of drug usage and increase the compliance of patients to the therapy.
Key words: трансдермальные лекарственные формы, номенклатура, ТДТС, трансдермальные пластыри, российский фармацевтический рынок
DEVELOPMENT OF A SPECTROPHOTOMETRIC METHOD FOR THE ANALYSIS OF MEROPENEM
Kukureka A.V., Siplivaya L.E., Shormanov V.K., Beskhodarnaja M.I.
UDC: [54.062+543.422.3-76]:577.182.99
Abstract: Objective. Development of spectrophotometric methods for the analysis of meropenem in substance and injectable dosage form. Methods. For spectrophotometry, solutions were prepared with concentrations from 0.00001% to 0.005% meropenem using a universal buffer mixture and 0.2 M sodium hydroxide solution with pH values in the range from 2 to 12, borate buffer solution with pH 8.0, as well as distilled water as a solvent. The optical density values of solutions of the analyte in the solvent were measured using an SF-2000 recording spectrophotometer; quartz cells with a working layer thickness of 10 mm were used for measurements. Based on the results of measuring optical densities at the points of absorption maxima, a calibration graph was constructed to calculate the concentration of the test solution. Under optimal conditions, a quantitative determination was performed in the substance and dosage form of meropenem, and statistical processing of the results was carried out. Results. The optimal conditions for spectrophotometric quantitative determination have been substantiated: the use of a borate buffer with pH 8.0, analytical wavelength of 301 nm. As a result of calculations, the value of the molar absorption index is 10510.9 and the specific one - 274.1. The methods were validated. The detection limit for meropenem is 1.8 μg / ml, the minimum opening is 45 μg. The relative error of determination in the substance does not exceed 0.78%, in the dosage form - 1.13%. Conclusions. The developed methods of spectrophotometric analysis of meropenem can be recommended for use in the practice of pharmaceutical analysis.
Key words: спектрофотометрический метод, меропенем, количественное определение
DETERMINATION OF KLOBAZAM AND ITS METABOLITES IN URINE DURING FORENSIC CHEMICAL AND CHEMICAL-TOXICOLOGICAL EXAMINATION
Volkova A.A., Kalekin R.A., Orlova A.M., Moskaleva N.E., Markin P.A., Astashkina O.G.
UDC: 615.91
Abstract: Purpose. Development of a new technique for detecting clobazam and its metabolites in urine during forensic chemical and chemical-toxicological examination by HPLC-TMS with BP using Orbitrap technology Methodology. The method of liquid-liquid extraction after hydrochloric acid hydrolysis was chosen as the method of isolation. During the experiment, the retention times of metabolites - hydroxyclobazam, desmethylclobazam and clobazam after oral administration were studied under optimal chromatography conditions and characteristic ions were determined when studying the mass spectra of these compounds. Results. The selected gradient sweep, temperature regime and chromatography conditions, which made it possible to reduce the number of coeluating compounds from urine and ensure high-quality results. Clobazam and its metabolites, hydroxyclobazam and desmethylclobazam, have been identified. Identification was carried out by retention times and after analysis of characteristic ions by mass spectra of these compounds. The obtained full spectra of the studied substances with dissociation of the ion mass spectra characteristic of the fragments of the molecule in various functional groups allowed us to isolate 8 characteristic ions. Conclusion. A method for identifying clobazam in urine extracts by HPLC-TMS with BP using Orbitrap technology as a confirmatory method during forensic chemical and chemical-toxicological studies has been developed. The validation evaluation of the developed methods indicates their suitability for forensic chemical and chemical-toxicological analysis.
Key words: клобазам, гидроксиклобазам, десметилклобазам, высокоэффективная жидкостная хроматография, судебно-химическое исследование, химико-токсикологический анализ, моча
STUDY OF MINERAL COMPLEX OF ROOTS OF COMMON ROOP
Dyakova N.A.
UDC: 615.322
Abstract: Objective. To study the macro- and microelement composition of the roots of the common bladder. Methods. The preparation of medicinal plant raw materials was carried out in the fall in the Voronezh State Natural Biosphere Reserve. The microelement composition of the vegetable drug was determined by inductively coupled plasma mass spectroscopy on an ELAN-DRC device. Results. It was revealed that the content of the microelement complex is 4.8% in terms of absolutely dry raw materials, 59 elements were determined. Macroelements make up 94.67% of the total elemental composition of the roots of the common bladder. The macronutrients are based on potassium (about 32 mg/g), as well as calcium (more than 6 mg/g). Essential trace elements make up 2.67% of the total mineral complex of the roots of the common bladder. Among them, the highest content was noted for silicon (more than 0.6 mg/g), iron (more than 0.5 mg/g). The content of regulated heavy metals and arsenic in the roots of the bladder complies with the requirements of regulatory documentation. The share of toxic and little-studied elements in the total mineral complex of the roots of the common bladder is 2.67%. The highest content was observed for aluminum (1036.8 μg/g), strontium (157.9 μg/g), barium (38.36 μg/g), titanium (36.75 μg/g), rubidium (7.36 μg/g), tin (2.86 μg/g). Conclusion. The results of the study showed a rich macro- and microelement composition of the roots of ordinary burdock, which can be used in the medical and pharmaceutical practice of creating drugs and biologically active additives for correcting physiological norms of the content of elements in the human body.
Key words: корни лопуха обыкновенного, микроэлементы, макроэлементы
DIURETIC ACTIVITY OF RED RASPBERRY SUBTERRANEOUS ORGANS
Gulyaev D.K., Boyarshinov V.D., Belonogova V.D., Yushkova T.A., Bokov D.O., Bessonov V.V.
UDC: 615.322+615.254.1
Abstract: Introduction. Raspberry’s fruits are used as a diaphoretic in scientific medicine. Red raspberry is widespread in the undergrowth, where it does not bear, but can be a source of subterraneous organs widely used in traditional medicine. Objective. The aim of the study is to investige the composition and diuretic activity of dry extract of red raspberry roots and rootstocks. The object of this paper is to explore the composition and diuretic activity of a dry aqueous extract of red raspberry roots and rootstocks. The raw materials were the red raspberry’s roots and rootstocks, collected on the territory of the Ilyinsky district of the Perm region in September. The content of phenolic compounds and saponins was determined by high performance liquid chromatography. The study of the diuretic activity of the obtained extract was made on male white rats. The increase of diuresis was calculated by comparison between the laboratory and control animals. The concentration of elements in the urine was determined by the X-ray fluorescence method. Results. As a result, 9 substances of the phenolic nature were identified in the extract of red raspberry roots and rootstocks. The saponins content in the extract of raspberry roots and rootstocks was 1.52 ± 0.03%. It was found that the dry extract of raspberry roots and rootstocks at a dosage of 50 mg / kg has diuretic activity, increasing diuresis in comparison with the control. At a dose of 150 mg / kg, diuresis decreased by 29% in comparison with the control, which indicates its antidiuretic effect. The administration of the extract of red raspberry subterraneous organs at doses of 50 and 150 mg / kg led to a decrease of sodium concentration and an increase of potassium concentration in the urine. Conclusion. Dry extract of red raspberry roots and rootstocks contains phenolic substances and saponins. The extract at a dosage of 50 mg/kg has a potentially high diuretic activity, significantly increasing diuresis in comparison with the water control. The extract at a dosage of 150 mg/kg, has an antidiuretic effect: a decrease of sodium concentration and an increase of potassium concentration in the urine.
Key words: малина обыкновенная, корневища с корнями, ВЭЖХ-УФ, фенольные соединения, сапонины, диуретическая активность
THE MICROSCOPIC ANALYSIS HERB OF CARDAMINE QUINQUEFOLIA (M.BIEB.) SCHMALH
Fedotova Victoria V.
UDC: 582.683.2:581
Abstract: Objective. Implement microscopic analysis herb of Cardamine quinquefolia (M.Bieb.) Schmalh . The genus Cardamine has only 4 species in the flora of the Caucasus: С. quinquefolia, С. microphylla, С. bipinnata and С. bulbifera . Starting the study of the Cardamine genus in the North Caucasus (Russia), we selected as the first object Cardamine quinquefolia (M.Bieb.) Schmalh . (syn. Dentaria quinquefolia M. Bieb .) since its anatomical description has already begun and some data are available on its chemical composition, it includes alkaloids, organic acids, ascorbic acid. Methods. The herb of C. quinquefolia was harvested during flowering in Pyatigorsk, Stavropol region. As research methods, macro- and microscopic analysis were used. Results. The whorled arrangement of leaves under the inflorescence is the main distinguishing macroscopic sing of the herb of C. quinquefolia . The main microscopic signs of C. quinquefolia are: heavily sinuous walls of cells of the upper and lower epidermis, stomata anisocytic type, unicellular trichomes with thick walls. On the cross section of the leaf are visible epidermis, mesophyll palisade and spongy, collenchyma, parenchyma, collateral vascular bundle. The cross-section of the stem is characterized by collateral, open vascular bundles arranged in a circle. The lignified parenchyma takes place between the vascular bundles. The sclerenchyma is located near the phloem. The diagnostic signs of a flower are polygonal cells of the sepal and petal epidermis, stomata of anisocytic type of sepal outgrowths on the edge of the petal. Conclusions. Introduction to the pharmaceutical practice of new plants is a promising direction in expanding the methods of herbal medicine.
Key words: Cardamine quinquefolia, колленхима, поперечный срез, мезофилл, устьица анизоцитного типа, волоски, проводящий пучок
MICROSCOPIC RESEARCH OF THE HERB LEONURUS DEMINUTUS V. KRECZ
Sokolova Ya.V., Mirovich V.M.
UDC: 615.322+582.949.2+581.8
Abstract: Objective. Research of anatomical and diagnostic features of the herb Leonurus deminutus V. Kreсz. and their quantitative characteristics. Methods. The stems, leaves and flowers of L. deminutus blooming in the Irkutsk region and the vicinity of Irkutsk in July 2021 were used as the object of the research. Preparation of surface preparations and cross sections was carried out in accordance with the requirements of the OFS.1.5.3.0003.15 of the State Pharmacopoeia of the XIV edition. The study was carried out using a digital microscope «Levenhuk D870T», anatomical and diagnostic features were recorded with a built-in camera, the images were processed in the program «Levenhuk ToupView (Levenhuk Image Editor) 3.7.». Results. The distinctive microscopic features the herb of L. deminutus have been established: epidermal cells with a characteristic low and strongly sinuous walls on leaves and flowers, four-cell glandular trichomes, capitate trichomes with a rounded head in all structures, capitate trichomes oval head on the sepals, multicellular trichomes from the falling cells on the upper lip of the flower, the presence of prism crystals of calcium oxalate in the structures of the corolla and round pollen with a groove in the middle. Conclusions. The conducted research can be used to establish the authenticity of medicinal plant raw materials, as well as to develop regulatory documentation for the introduction of the herb L. deminutus into pharmaceutical practice.
Key words: микроскопия, Leonurus deminutus V. Kreсz, анатомо-диагностические признаки, лекарственное растительное сырье
EXPERIENCE IN THE APPLICATION OF EDUCATIONAL TECHNOLOGY FOR THE FORMATION OF PROFESSIONAL COMPETENCE OF TEACHERS FOR PHARMACEUTICAL EDUCATION OF PRESCHOOL CHILDREN
Kuryljova M.A., Kirshhina I.A.
UDC: 615.5
Abstract: Objective. Development of methodological approaches to improving the professional competence of teachers in the implementation of educational tasks to develop the skills of safe handling of medicines and other pharmacy products in preschool children. Methods. The article analyzes the professional requirements for specialists of the pedagogical profile, methodological literature aimed at forming the foundations of the safety of children's life and the age characteristics of preschool children, which should be taken into account when forming the skills of pharmaceutical (drug) safety. In the process of analysis, a set of scientific methods was used - content analysis, the method of systematization and generalization of data, sociological (questionnaire), structural and logical. Results. The article presents the experience of using educational technology (conducting a seminar - training) in the methodological work of a preschool educational institution. The authors show the relevance of the problem of pharmaceutical education for preschool children. It has been established that it is advisable to start developing pharmaceutical safety skills from preschool age. The "professional problems" that arise in pedagogical workers when teaching children about pharmaceutical safety have been identified. It was noted that only half of teachers are ready to take part in the organization of educational events to increase the pharmaceutical literacy of children, which is due to the insufficient level of training of teachers on this topic. Conclusion. The authors have formed methodological approaches and developed organizational technologies aimed at improving the professional competence of teachers by forming additional professional competence - the readiness of teachers to pharmaceutical education of children and their parents/legal representatives in the framework of preschool education. The acquired pharmaceutical knowledge will allow teachers to implement educational tasks to develop the skills of safe handling of medicines and other products of the pharmacy range in preschool children. The system of work has been tested in preschool educational institutions of the city of Lobnya.
Key words: профессиональная компетентность, педагогические работники, дети дошкольного возраста, фармацевтическое просвещение, фармацевтическая безопасность, лекарственные препараты
ADAPTATION ANALYSIS OF YOUNG PHARMACISTS
Muslimova N.N., Garifullina G.X., Gribova Ya.V.
UDC: 615.1:378.046.4
Abstract: Objective. Consideration of issues of adaptation of young specialists-pharmacists (from 1 to 3 years professional activity) in pharmacy organizations of Kazan, RT. Methods. Implementation of an experiment to analyze and further improve the effectiveness of the adaptation of young pharmacists in practice in pharmacy organizations. Empirical, theoretical and experimental methods of research and analysis of the effectiveness of adaptation of young pharmacists were applied; personality-oriented approaches were applied. Results. A sociological study was conducted with young pharmacists in pharmacy organizations in Kazan, RT. A contingent of young professionals has been selected, starting with work experience from less than 1 year to 3 years. A questionnaire was developed that includes questions about the choice of specialty, work readiness, job satisfaction, adaptation moments in the profession and in the team, satisfaction with mentoring, etc. Conclusion. It was revealed that the majority of young pharmacists do not regret choosing a specialty and have an enthusiasm for work. However, on the issues of adaptation, young specialists note that they can not fully adapt and experience stress to some extent in certain periods (up to 48%); they are not completely satisfied with the mentoring system in this pharmacy organization (62%) and are not satisfied at all (29%). As part of the program for the adaptation of young professionals, a special memo has been developed for the young specialist, which will help both him and the mentor.
Key words: молодые специалисты-провизоры, адаптация, наставничество, удовлетворенность, подготовленность к труду, стресс
A LIFE DEDICATED TO PEOPLE (FOR THE ANNIVERSARY OF PROFESSOR VALENTINA EGOROVNA SHAROBARO)
Bekezin V.V., Peresetskaya O.V., Druzhinina T.V., Muravyev A.A., Vasilyeva I.A., Kozlova E.Yu., Koroleva A.E.
UDC: 929.61
Abstract: The article is devoted to the anniversary date of the birth of Professor Valentina Sharobaro of Smolensk State Medical University, in which a brief biography and scientific achievements are outlined; successes in medical activity and in the professional pedagogical field are reflected; her significant awards are listed.
Key words: Шаробаро Валентина Егоровна
NORDIC WALKING IN THE CORRECTION OF VEGETATIVE DYSTONIA SYNDROME IN ADOLESCENTS
Kuligin O.V., Nezhkina N.N., Nasonova O.L., Mitrofanova G.N., Bendin D.S.
UDC: 613.72: 616.839-008.6-053.6
Abstract: Objective. To evaluate the effectiveness of Nordic walking in non-drug correction of vegetative dystonia syndrome in adolescents. Methods. 50 adolescents aged 14-16 were examined, including 28 with vagotonic and 22 with sympaticotonic variant of vegetative dystonia syndrome. Heart rate variability and general physical endurance were analyzed in the dynamics of the Scandinavian walking course, which included 21 lessons of 45 minutes 3 times a week. Results. After a course of Nordic walking, adolescents had a decrease in the frequency of complaints and the number of symptoms of vegetative dystonia: vagotonics decreased headache, fatigue and respiratory discomfort, and arterial hypotension was significantly less frequently recorded in them. Sympathicotonics have been noted to have improved sleep, disappearance of tachycardia, normalization or decrease in blood pressure. When determining physical endurance, its significant increase after the course of Nordic walking was found in both groups of adolescents. Conclusion. The data obtained indicate an increase in the adaptive reserve of the autonomic nervous system and the alignment of the sympathetic-parasympathetic balance. Nordic walking classes in adolescents with vegetative dystonia syndrome contribute to improving their well-being, reducing the number of complaints and objective symptoms of a violation of the functional state of the autonomic nervous system, as well as optimizing vegetative balance and increasing physical endurance.
Key words: скандинавская ходьба, синдром вегетативной дистонии коррекция, подростки
EPIDEMIOLOGY, CLINICAL PICTURE AND THERAPY OF DYSMETABOLIC NEPHROPATHY IN CHILDREN LIVING IN AN ECOLOGICALLY UNFAVORABLE REGION
Pukhova T.G., Spivak E.M., Sitnikova E.P.
UDC: 616.61 - 08 - 036.22 - 053.2
Abstract: Objective. To establish the features of epidemiology and clinical manifestations of dysmetabolic nephropathy with oxalate-calcium crystalluria in children living in an ecologically unfavorable region. Methods. The study was performed in 3 stages. The first of them studied the epidemiology of dysmetabolic nephropathy based on the analysis of annual reports of pediatric nephrologists for the period from 2001 to 2019. At the second stage, a comparative clinical and laboratory examination of 38 children living in areas with favorable and unfavorable environmental situation was carried out. During the third stage, the effectiveness of the inclusion of levocarnitine in the therapeutic complex was investigated. Results. The fact of an increase in the proportion of dysmetabolic nephropathies in the overall structure of diseases of the urinary system, as well as nephrological morbidity, was established. It is shown that environmental pollution leads to an increase in the frequency of this pathology by 4.5 times. In this category of children, the disease proceeds with more pronounced clinical and laboratory manifestations and with frequent violation of the concentration function of the kidneys. The therapeutic effect of levocarnitine has been proven, which contributes to the relief of the main clinical syndromes of the disease and a more pronounced decrease in the daily excretion of oxalic acid salts. Conclusion. In the last 2 decades, the share of dysmetabolic nephropathy in the structure of pathology of the urinary system organs in children has increased significantly, which is especially characteristic of areas with an unfavorable environmental situation. In these patients, the disease proceeds with more pronounced clinical and laboratory manifestations. Levocarnitine is an effective treatment option for dysmetabolic nephropathy in children.
Key words: дисметаболическая нефропатия, эпидемиология, клиника, лечение, дети
CLINICAL CHARACTERISTICS OF DISEASES OF URINARY SYSTEM ORGANS IN CHILDREN LIVING IN THE ZONE OF ECOLOGICAL DISTRESS
Pukhova T.G., Spivak E.M., Sitnikova E.P.
UDC: 616.6/62 - 053.2: 574
Abstract: Introduction. In the last 2 decades, the frequency of pathology of the urinary system organs in children has increased significantly, which is largely due to unfavorable ecology. Objective. The aim is to establish the clinical features of the most common nephropathies in children living in the zone of ecological distress. Methods. In accordance with generally accepted clinical protocols, 212 children aged 4-16 years with pyelonephritis (n = 90), congenital malformations of CHI (n = 71), dysmetabolic nephropathy (n = 38), glomerulonephritis (n = 13) were examined. Of these, 133 children (the main group) permanently lived in an area with a high level of soil contamination with heavy metal salts and air with benzapyrene. The comparison group consisted of 79 patients - residents of the district with a relatively favorable environmental situation Results. Comparison of clinical and laboratory indicators of patients showed that children of the main group more often had disharmonious physical development in the form of body weight deficiency and low growth, decreased immunobiological resistance, they had a high comorbidity index, layering of renal infection, impaired concentration, nitrogen excretion and evacuation functions of the kidneys. Conclusion. In children with pathology of the urinary system organs living in conditions of environmental pollution, deterioration of health parameters and kidney condition is recorded in the form of disharmonious physical development, high rates of acute morbidity, a greater number of comorbid conditions, as well as stratification of renal infection and impaired kidney function.
Key words: органы мочевой системы, заболевания, экология, дети
FEATURES OF AUTONOMIC REGULATION OF THE CARDIOVASCULAR SYSTEM OF ADOLESCENTS WITH PRIMARY ARTERIAL HYPERTENSION
Timofeeva L.N., Nikolaeva T.N.
UDC: 616.12 - 008.331.1: 616.839 - 053.7
Abstract: Objective. To establish the features of autonomic regulation of the cardiovascular system in primary arterial hypertension in adolescents based on the analysis of heart rate variability. Methods. 80 adolescents aged 11-17 years with primary arterial hypertension were examined in a specialized hospital. Clinical and anamnestic and laboratory data were analyzed, the type of initial vegetative tone was determined according to tables of summary vegetative manifestations, as well as heart rate variability using an active orthostatic test. Results. 57.5% of patients were diagnosed with isolated simpatikotonia, 42.5% had a mixed type of initial vegetative tone with a predominance of the sympaticotonic one. The severity of simpatikotonia was directly correlated with the average figures of systolic and diastolic blood pressure, its variability and indices of hypertension time. In this category of patients, the spectrum of neurohumoral regulation of cardio rhythm is dominated by fluctuations of low and very low frequency with a simultaneous decrease in the proportion of high-frequency waves. The results of the orthostatic test indicate an increased reactivity of the sympathetic system. In the group of adolescents with a mixed variant of the initial vegetative tone, there is a more balanced vegetative control with a high representation of high-frequency oscillations. Conclusion. In adolescents with primary arterial hypertension and isolated simpatikotonia, there are signs of the dominance of the sympathoadrenal autonomous regulation circuit with a more energy-intensive mode of functioning of the circulatory system.
Key words: первичная артериальная гипертензия, вегетативная регуляция, подростки
ASSESSMENT OF THE STATE OF THE AUTONOMIC NERVOUS SYSTEM IN FULL-TERM INFANTS BORN IN DIFFERENT CITIES OF THE RUSSIAN FEDERATION: CROSS-SECTIONAL STUDY
Derevtsov V.V., Kozlova L.V., Bekezin V.V., Ivanov D.O., Antonova L.K., Neudakhin Y.V., Shcherbakova M.Yu., Derevtsova A.V.
UDC: 616-053.3:618.3-06:616-008.6:612.89
Abstract: Objective. Assessment of the state of the autonomic nervous system in infants born in different territories (St. Petersburg, Smolensk, Tver). Methods. 244 full-time infants. 219 children were born from mothers with a burdened somatic and obstetric-gynecological history: 110 (gr. 1, St.-Petersburg), 109 (gr. 2, Smolensk). The control group (gr. 3, Tver) - 25 practically healthy children born to practically healthy mothers as a result of physiological birth. Children were examined in dynamics at the age of 1 (n=229), 3 (n=217), 6 (n=200), 12 (n=203) months. Modal amplitude zero, initial neurovegetative tone, neurovegetative reactivity were evaluated. Nonparametric methods of statistical analysis were used. Results. At the age of 1 month, the median AM in the sample of children of gr. 1 was 46, which is less than in the sample of children of gr. 2, there were features of changes in dynamics. In the studied age periods of growth and development in children gp. 1 and 2 the predominance of sympathicotonia with different detection frequencies (89 - 100%) and severity was proved. The presence of asympatocotonia in children of gr.1 and 2 рersisted until 12 months, and in children gp. 1 from 2-3 days (37%) up to 6 months (13%) of life decreased, and by 12 months it increased to 22%, at the same time in children gp. 2 from 2-3 days (34%) to 12 months (13%) decreased. There were structural features of the samples with a predominance of normal reactivity with varying degrees of severity, with the exception of 2-3 days and 12 months in children gp. 1 and 2-3 days in children gp. 2. Conclusion.Peculiarities of initial neurovegetative tone, neurovegetative reactivity and the median AMin children of gp. 1 and 2 was facilitated by the influence of the burdened somatic and obstetric-gynecological anamnesis of mothers, regardless of the city of birth and subsequently the health characteristics of children themselves. It is justified to conduct personalized medical measures in full-time children in the first year of life.
Key words: вегетативная нервная система, дети грудного возраста, метаболизм