ANTIOXIDANT, ANTI-RADICAL, CHELATING PROPERTIES OF MEXIDOL AND PYRIMIDINE DERIVATIVE PIR-4 IN EXPERIMENTAL CEREBRAL ISCHEMIA OF THE RAT BRAIN
Shabanova N.B., Gerashchenko A.D., Lysenko T.A., Voronkov A.V.
UDC: 547.853:615.225:616.13
Abstract: Objective. To study the antioxidant, anti-radical and chelating activities of a new pyrimidine derivative-PIR-4 in experimentally simulated focal cerebral ischemia in rats. Methods. The study was carried out on male Wistar rats weighing 220-240 gr. 4 equal groups of 10 individuals each were formed. The first group - falsely operated animals, the second - a group of negative control rats, both received a suspension of water purified with twin-80 in an equivalent volume. The third group is represented by rats receiving a reference drug-Mexidol (50 mg/kg). The fourth group was administered an experimental compound under the code PIR-4 (50 mg/kg). All the studied objects were injected intraperitoneal immediately after the ischemia simulation and within 3 days. Local cerebral ischemia was modeled by coagulation of the left middle cerebral artery (anesthesia-chloral hydrate, 350 mg/kg)). Results. The results showed that against the background of simulated cerebrovascular pathology, the number of free radical oxidation products (diene conjugates (DC) and Malon dialdehyde (MDA)) increases with a decrease in the first-line antioxidant defense enzymes (AOS) (superoxide dismutase, glutathione peroxidase, catalase). Intraperitoneal administration of Mexidol (50 mg/kg) allowed to correct these violations by increasing the activity of the antioxidant and anti-radical protection system and reducing the products of lipid peroxidation. The introduction of the experimental substance PIR-4 also allowed to reduce the amount of DC and MDA, providing a direct antioxidant effect, while not affecting the endogenous AOS system, which significantly minimizes the risks of developing disorders of cerebral hemodynamics. Conclusions. In the course of the study, it was found that the PIR-4 compound shows a direct antioxidant effect, not only reducing the hyperproduction of free radicals, but also showing anti-radical and chelating properties, while not affecting the enzymes themselves protecting the antioxidant system and its effect is not inferior to the comparison drug Mexidol.
Key words: фокальная ишемия головного мозга, нарушения церебральной гемодинамики, антиоксидантная активность, антирадикальная активность, хелатирующие свойства, мексидол, производные пиримидина
COMPARATIVE EVALUATION OF THE EFFECTIVENESS AND TOXICITY OF THE METAL-COMPLEX COMPOUND ΠQ2721 AND THE ANTIHYPOXANT AMTISOL
Evseev A.V., Surmenev D.V., Evseeva M.A., Pereverzev V.A., Belenky A.E., Danilov A.I., Sosin D.V.
UDC: 616-001.8:615.355
Abstract: Objective. To study in comparison the indicators of the effectiveness (ED) and toxicity (LD) of the selenium-containing metal-complex substance πQ2721 and the aminothiol antihypoxant amtizole. Methods. In the experiments, 40 male CBF1 mice weighing 25-30 g were used. Average efficiency (ED) and average toxicity (LD) were determined according to the method of V.B. Prozorovsky et al. (1978). A model of acute hypoxia with hypercapnia (AH+Hc) was used to estimate the ED. A pair of mice injected with substances according to the scheme of V.B. Prozorovsky et al. as well as the control group after 60 minutes incubations were placed in sealed glass transparent containers with a volume of 0.25 l. and monitored their condition until the moment of death. The safety level of πQ2127 and amtizole was assessed by calculating the therapeutic index (LD/ED) which makes it possible to determine the therapeutic range of action for the substances. Results. The LD for πQ2127 was 163.0 mg/kg with an ED - 25.8 mg/kg with a therapeutic index of 6.31. For the antihypoxant amtizole the same indicators were 708.0 and 56.4 mg/kg respectively with a therapeutic index of 12.55. Conclusion. Thus, despite the acute toxicity high in comparison with the antihypoxant amtizole, the substance πQ2127 can be recommended for further study with the prospect of use as a protector of acute hypoxic conditions of the exogenous origin. The advantages of the substance include the rapid development of a protective effect, as well as the ability to guarantee a higher level of resistance of the body to acute hypoxia compared to known aminothiol antihypoxants.
Key words: редокс-активные вещества, антигипоксанты, токсичность, мыши
ANALYSIS OF THE PRACTICE OF SELF-MEDICATION WITH NON-STEROIDAL ANTI-INFLAMMATORY DRUGS AMONG STUDENTS OF SMOLENSK STATE MEDICAL UNIVERSITY
Khaikina E.V., Yakushina A.O., Saakyan A.O., Kabankov V.V., Khaikin A.M.
UDC: 615.276(470.332)
Abstract: Objective. To study self-medication practice of nonsteroidal anti-inflammatory drugs (NSAIDs) among students of Smolensk State Medical University. Methods. A one-stage, prospective study was performed, which consisted in conducting a voluntary and anonymous survey of the students of Smolensk State medical university on self-medication with drugs of the NSAID group, adherence to the regimen, the frequency of occurrence of adverse drug reactions (ADR), factors influencing the choice of drugs in this group. Results. 210 respondents were interviewed, including: students of the Faculty of Pediatrics, Faculty of Medicine and Faculty of Pharmacy. The most popular NSAIDs used for self-treatment were ibuprofen, paracetamol, metamizole, ketorolac (which accounted for 82.8%, 82.3%, 54,2 and 42,3% of references). Metamizol and Ketorolac took a leading position as analgesics (59.8% of cases). About 57% of the respondents start independent NSAIDs at subfebrile body temperature. Most of the survey participants prefer medicinal forms of NSAIDs for systemic use (87%). Personal experience of use drug, cost, and advertising in the media play a significant role in the chose NSAIDs. Only 12% of the respondents listen to the pharmacist’s advice and 30% of the respondents study the instructions for use of the drug before taking it. Conclusion. An insufficient level of awareness of the medical students in matters of self-medication of NSAIDs was revealed, which consists in the choice of potentially dangerous drugs, non-compliance with the regimen, long-term uncontrolled use of drugs.
Key words: самолечение, НПВС, анкетирование, студенты медицинского университета, безопасность терапии
FEATURES OF TARGETED THERAPY IN ONCOLOGICAL PRACTICE
Danilov A.I., Slivkin M.D., Evseev A.V., Fomin S.G., Shukil L.V.
UDC: 616-006 + 615.03
Abstract: Objective. To study the possibilities of using molecular targeted drugs (MSTP) in oncological practice. Methods. The work was carried out as part of the study of the clinical picture and treatment of oncological diseases in the Russian Federation. During the preparation, data published in the modern scientific literature were used. Results. The targets of MNTP are growth factors and their receptors, primarily receptors of epidermal growth factor and vascular endothelial growth factor, proteins carrying out mitogenic signals from receptor molecules, non-receptor tyrosine kinases, Ras family proteins, cyclin-dependent kinases, molecules controlling apoptosis (Bcl2, p53, etc.) and angiogenesis. Conclusions. Over the past couple of decades, MNTP has confidently entered the arsenal of modern antitumor chemotherapy and has become an integral component of the combined therapy of hemoblastoses and a number of solid tumors, primarily breast cancer with overexpression of HER2 and GIST, for which the use of these drugs is vital.
Key words: таргетная терапия, опухоли, онкологическая практика
DYSTROPHIC CHANGES OF RAT CEREBRAL NEURONS
Bon Elizaveta I., Malykhina Alina V.
UDC: 616.831.31-005.4.-092.913:618.33
Abstract: Objective. Generalization and systematization of literature data on dystrophic changes in neurons in the rat cerebral cortex. Methods. The basis of this study was a review of the literature on this topic. Results. Dystrophic changes constitute an extensive group of neuronal disorders and are manifested at the morphological level by deformation of the perikarions and neuropil, wrinkling or swelling of the cell, and changes in the chromatophilia of the cytoplasm. At the electron microscopic level, disorganization of organelles is observed, reflecting gross violations of the vital processes of the neuron. Conclusion. Further study of dystrophic changes in neurons at the histological, ultrastructural and molecular levels will serve as a fundamental basis for the search and improvement of new ways of preventing and correcting diseases of the nervous system.
Key words: нейроны, дистрофические изменения, кора головного мозга, крысы
ASSESSMENT OF THE IMPACT OF SMOKING ON THE QUALITY OF LIFE OF STUDENTS OF SMOLENSK STATE MEDICAL UNIVERSITY
Tikhonova N.K., Pleshkova E.M., Pleshkov V.V., Beliaev I.O., Arshanskiy M.M.
UDC: 614.2
Abstract: Objective. The study was conducted to assess the quality of life of smoking and non-smoking students of Smolensk State Medical University. Methods. The study was carried out with the participation of 310 1-6 year students of Smolensk State Medical University, 225 (72.6%) women and 85 (27.4%) men, using a questionnaire of respondents with a validated WHO QL-26 questionnaire recommended by WHO. The work with the data was carried out in the Microsoft Excel 2007 tabular editor using the AtteStat 12.0.5 program. The following data were entered from the questionnaire of each respondent: gender, course, presence or absence of smoking, the number of points for each area and the total number of points as an indicator of the overall quality of life (QOL). Using the Kendall correlation criterion, the interdependence of addiction to smoking and 4 areas of QOL were assessed: "Mental and physical well-being", "Self-perception", "Microsocial support", "Social well-being" with a given 95% confidence interval. The reliability of differences in the level of QOL depending on the gender and course of study of respondents with a given confidence interval of 95% was determined using the Fisher angular transformation coefficient (φ). Results. It was found that the proportion of smoking students among men is greater than among women. A weak inverse correlation was revealed between addiction to smoking and the level of mental and physical well-being of medical students. A weak direct correlation was found between addiction to smoking and microsocial support of students. The proportion of smokers among students with high scores in the field of "Self-perception" was higher than among students with middle and low scores in this field. Conclusion. Smoking does not affect the level of the overall quality of life of medical students, but has a negative impact on the subjective assessment of their mental and physical well-being. Addiction to smoking increases the level of subjective assessment by medical students of their microsocial support and self-perception, being a significant factor of socialization in the youth environment. To reduce addiction to smoking among medical students, it is necessary to develop comprehensive measures to improve adaptation to study at a medical university, including all elements of the student cluster: learning environment, social well-being, recreation, accessibility of elements of a healthy lifestyle.
Key words: курение, качество жизни, студенты медицинского вуза
BLOOD INSULIN CONTENT AND FUNCTIONAL ACTIVITY OF PANCREAS BETA CELLS IN YOUNG WOMEN WHO DO NOT USE AND USE ALCOHOL
Blazhko A.S., Pereverzev V.A., Evseev A.V., Pravdivtsev V.A., Yurenya E.V., Eremeychik S.M., Shimanets S.V., Razvodovsky Yu.E., Pereverzeva E.V.
UDC: 616.37-008.64-055.2-056.83-056.85
Abstract: Objective. The aim of this work is to study the content of insulin in the venous blood plasma and its dynamics in young people (women) who consume alcohol in a mode and doses of low risk, under different physiological conditions (hunger and satiety) with an indirect assessment of their state of functional activity (FA) β-pancreatic cells and insulin sensitivity of peripheral target cells according to the corresponding indices ("Insulinogenic", "HOMA-Ir", QUICKI ","CARO", etc.) Methods. The study was carried out with the voluntary participation of 24 young women 18-29 years old, drinking alcohol (n = 16), and teetotalers (n = 8). Each subject had 11 determinations of the glucose content in capillary whole blood taken from the fourth finger of the non-working hand, and whole venous blood taken through a catheter from the median cubital vein of the same non-working hand: initially (on an empty stomach, after a night of 10-12 hours of fasting (1st), after 1 (2nd), 2 (3rd), 3 (4th), 4 (5th), 5 (6th) and 6 (7th) hours of mental work on an empty stomach, as well as after 30 (8th), 60 (9th), 90 (10th) and 120 (11th) minutes after taking 75 g of glucose dissolved in 200-250 ml of water (oral glucose tolerance test / OGTT /). The glucose content was determined by the glucose oxidase method with amperometric detection. All 24 women also had a larger amount of blood (at least 10 ml) taken 4 times to determine the level of hormones: initially, after 6 hours of mental work, 60 and 120 minutes after taking glucose. Hormone content: insulin (four times); gonadotropins - FSH and LH (once, initially), as well as estradiol and progesterone (once, initially) for endocrinological confirmation of the phase of the monthly cycle - was determined by electrochemiluminescence immunoassays on an automatic analyzer for immunological tests "Cobas e411" * with the appropriate reagents to determine: "Elecsys Insulin cobas e"*; «Elecsys Progesterone III cobas e»*; "Elecsys FSH cobas e"*; "Elecsys Estradiol III cobas e"*; "Elecsys LH cobas e"*; "Elecsys Cortizol cobas e"*. The obtained results of determining the content of insulin in serum (plasma devoid of fibrinogen and other proteins of the coagulation system) of venous blood, as well as serum glucose in capillary whole blood and serum glucose in whole venous blood after their conversion to plasma glucose in capillary and venous blood were used to calculate the indices , characterizing (albeit indirectly) the state of the functional activity of β-cells of the pancreas (index "HOMA-β" in our modification and "Insulinogenic" index) and insulin sensitivity of target cells (indices: "HOMA-Ir", "QUICKI", "CARO", "Matsuda", "The ratio of the areas under the curves of plasma glucose and insulin with OGTT" "Stages of insulin resistance syndrome according to V.A. Didenko"; the ratio "plasma glucose venous / insulin")peripheral organs and tissues. The results of the study were statistically processed using the methods of parametric and nonparametric analysis during the accumulation, correction and systematization of the results obtained in Microsoft Office Excel (2016) spreadsheets using the STATISTICA 10 program (developed by StatSoft.Inc). The results obtained were taken as significant at р≤0.05 or the inequality for the coefficients of variation (CV): (CV1 - CV2) / (square root of the sum {mCV12 + mCV22})> (3 + 6 / {N-4}). Results. Alcohol consumption in young women in a low-risk regimen causes a significant distribution of cases of fasting hyperinsulinemia under conditions of relative functional rest (19%) and, especially, is expressed during saturation during OGTT (in 75% / p=0.005 / - 80% / p=0.003 / cases), as well as an increased insulin response (in 68.75% of cases / p <0.001 /) after taking 75 g of glucose. The estimated relative risk of hyperinsulinemia and increased insulin response in young women drinking alcohol during OGTT after 16-18 hours of fasting was 2.133 (χ=4.154; p=0.042; df=1) and 5.500 (χ=6.750; p=0.014; df=1), respectively, in relation to similar indicators among teetotalers. The possibility of the development of functional immunoresistance of cells in young women, revealed by the intake of glucose after 16-18 hours of the fasting period and mental work on an empty stomach (in the last 6 hours of fasting), was confirmed. Drinking alcohol in a low-risk mode additionally and significantly reduces their insulin sensitivity in 87,5% of cases and increases the insulin resistance of cells and tissues, which is accompanied by disturbances in carbohydrate metabolism and glycemic regulation. On this basis, the calculations of the indicators of the regimen and doses of low risk of alcohol consumption by young women made it possible to establish their new values, namely: 1 point (but not 1-7) on the “AUDIT” test scale for the low-risk regime; less than 20 ml / time and 20 ml / month (but not 200 ml / month) for low-risk doses at a frequency of less than 1 time / month (but not 5 times a week). Conclusion. The effect of ethanol consumed in a low-risk regimen and doses on the level of insulin and insulin sensitivity of target cells and tissues was established in the form of fasting hyperinsulinemia in 19% of the respondents and an increased insulin response to carbohydrate load in 69% -80% cases among young women who drink alcohol due to the higher functional activity of β-cells of the pancreas in them compared with teetotalers; decreased insulin sensitivity of target cells, detected by OGTT in the majority (87.5%) of sober respondents with the formation of insulin resistance in most of them with a share of 43.8% (according to the indices "HOMA-Ir" + "MATSUDA") - 81.3% (according to the ratio "Plasma Venous Glucose / Insulin" or according to the index "Stages of insulin resistance according to VA Didenko, 1999").
Key words: алкоголь (этанол), доза, режим употребления, глюкоза, инсулин, кровь, плазма
DAMAGE TO THE CARDIOVASCULAR SYSTEM IN COVID-19
Kravtsiva A.V., Gulyaeva A.A., Golovanova E.D., Ayrapetov K.V.
UDC: 616.127:638.154.2
Abstract: Objective. To study the features of the damage to the cardiovascular system after the coronavirus infection, to establish the main variants of cardiovascular complications (CVD), to assess the frequency of their prevalence and the impact of concomitant pathology on them. Methods. A retrospective analysis of outpatient records of patients for 2020-2021 who had COVID-19 confirmed in the laboratory was carried out. The study was conducted on the basis of the Polyclinic No. 3. The data of outpatient records were analyzed according to the points of the developed questionnaire aimed at collecting data on the state of the cardiovascular system after infection caused by SARS-CoV-2. The study included patients of both sexes from 18 to 93 years old with a diagnosed viral lesion of the cardiovascular system. The analysis included 105 outpatient cards in accordance with the inclusion/exclusion criteria. The average age of the subjects on the basis of medical documentation data was 60.4±10.3 years. Results. The main symptoms presented by the patients were pain in the heart (62.9%) and increased blood pressure (61.9%). The most common MTRS in postcovid syndrome were transformation of the form of coronary heart disease (41.9%), rhythm and conduction disorders (29.5%), development of a hypertensive crisis (33.3%). The severe course of COVID-19 is a predictor of the development of the transformation of the form of coronary heart disease into a more severe one (p<0.05), the development of chronic heart failure (CHF) (p<0.05) and myocarditis (p<0.05). The presence of diabetes mellitus (DM) and dyslipidemia contributes to the development of rhythm and conduction disorders in the long-term period (p<0.05). Taking anticoagulants during COVID-19 treatment significantly reduces the risk of transformation of the form of coronary heart disease (p<0.05). Conclusions. According to the study, the most frequent complication from the cardiovascular system is the progression of the form of coronary heart disease (41.9%). It was found that COVID-19 can cause both primary cardiac pathology and aggravate existing diseases of the cardiovascular system.
Key words: новая коронавирусная инфекция, COVID-19, SARS-CoV-2, сердечно-сосудистые осложнения, хроническая сердечная недостаточность, артериальная гипертензия, вирусный миокардит
СLINICAL CASE OF HEART TRANSPLANTATION IN A PATIENT WITH LEFT VENTRICULAR ANEURYSM WHO HAS SUFFERED MYOCARDIAL INFARCTION
Chudaeva O.V., Titova N.E., Chudaeva E.I., Ageenkova O.A.
UDC: 616.12-089.843-06
Abstract: Objective. To analyze the medical history of a patient with left ventricular aneurysm who had myocardial infarction and who needed orthotopic heart transplantation. Methods. Interview, physical examination of the patient; analysis of medical records, data from laboratory and instrumental research methods. Results. A clinical case of a patient who underwent orthotopic heart transplantation at the Shumakov National Research Medical Center of the Russian Academy of Medical Sciences is presented. This patient suffered a myocardial infarction in 2017, during the next 2 years he noted a deterioration in health. On re-examination, the diagnosis of ischemic heart disease was made. Postinfarction and atherosclerotic cardiosclerosis and occlusion of the anterior interventricular branch of the left coronary artery were also diagnosed. The complications are as follows: heart failure IIA stage, III functional class; left ventricular apical thrombus. The patient was admitted to the cardiology department at the Shumakov National Research Medical Center of the Russian Academy of Medical Sciences, where he was diagnosed with left ventricular aneurysm, stenotic lesions of the coronary arteries and end-stage congestive heart failure. On the basis of the results of the studies carried out, the patient underwent orthotopic heart transplantation. According to laboratory and instrumental examination methods, the graft function is satisfactory, the patient returned to normal lifestyle and physical activity. Conclusions. Orthotopic heart transplantation proved to be the only radical treatment for this patient, as a result of which his quality of life and prognosis were significantly improved.
Key words: хроническая сердечная недостаточность, ортотопическая трансплантация сердца, имммуносупрессорная терапия, наблюдение после пересадки сердца
PECULIARITIES OF VASCULAR LESIONS AND THE COURSE OF MYOCARDIAL INFARCTION IN PATIENTS OF WORKING AGE
Mitrohina R.V., Kljagina V.A., Bazina I.B., Kozyrev O.A., Pavlova M.V., Zubkov S.K.
UDC: 616.127-002; 616.13
Abstract: Oblective. To study coronary and brachiocephalic vascular lesions as well as peculiarities of myocardial infarction course in individuals of working age. Methods. The material from medical records of 74 patients aged under 60 years old undergoing treatment in the cardiology department of Smolensk Regional Clinical Hospital with the diagnosis "CHD: acute myocardial infarction" was analyzed. All patients underwent coronarography, percutaneous coronary intervention (stenting), ultrasound examination of the brachiocephalic arteries and echocardiography. Results. Among risk factors, arterial hypertension stage 3 was noted in 100% of patients. Body mass index was 29,6±9,8. 70% of patients had BMI over 25. 50% of patients were smokers. Diabetes mellitus type 2 was revealed in 13,5% of patients. Repeated MI was noted in 9.5%. Stroke was suffered by 4.1%. By localization anterior MI was registered in 58.1% of patients, inferior MI - in 39.2%, circular MI - in 2.7%. Ventricular and supraventricular extrasystoles, ALVF and atrial fibrillation were the most frequent among MI complications. Patients with myocardial infarction under 60 years old have hemodynamically significant changes in only one vascular basin - coronary arteries. The degree of vascular narrowing of the brachiocephalic arteries was about 20%. Conclusions. Multifocal atherosclerosis was not detected in patients with myocardial infarction under 60 years old. Biochemical changes correspond to the activity of the pathological process (atherosclerosis, myocardial infarction) and are associated with decreased parameters of central and peripheral hemodynamics, which reflects worsening prognosis of myocardial infarction in patients of working age.
Key words: атеросклероз, селективная коронарография, брахиоцефальные артерии, дислипидемия
INDICATORS OF HAND STRENGTH IN CHILDREN AGED 11-14 YEARS, TAKING INTO ACCOUNT GENDER, AGE AND FAMILY TYPE
Svoboda P.N., Bogormistrova V.A., Shestakova V.N., Udovenko A.A., Sosin D.V.
UDC: 611.976:616-053.2-053-055
Abstract: Objective. The study of indicators of hand strength in children of secondary school age, brought up in families of various types, for a tactical approach to the development of functional capabilities and physical fitness. Methods. To achieve this goal, the collection of material was carried out by copying primary information from the history of the child's development (f. 112/y), a medical school card (f. 026/y). The clinical assessment of the state of health was carried out in accordance with the methodological recommendations developed at the Research Institute of Hygiene of Children and Adolescents. The distribution of children by health groups was carried out in accordance with the orders of the Ministry of Health of the Russian Federation N621 of 30.12.2003 and N514n of 10.08.2017. Observations were recorded by researchers during training sessions. The measurements were carried out using a wrist medical dynamometer. According to the results of testing, the interpretation of the obtained indicators was carried out. The object was children of 11-14 years of age. The main group consisted of 25 children raised in substitute families. The comparison group included 30 children from single-parent families, and the control group included 50 children from complete well-off families. Statistical processing of the obtained data was carried out using a standard software package using parametric and nonparametric criteria at values of p<0.05. Results. It was found that as the children grow older, the indicators of hand strength tend to increase and are closely related to the child's gender, age and type of family. Children of secondary school age living in well-off full-fledged families have higher strength indicators than children who are brought up in dysfunctional families. Their strength qualities correspond to the average indicators of children in the Russian Federation. The lowest indicators of wrist strength were recorded in children brought up in substitute and dysfunctional families. Girls living in such families have lower hand strength indicators than boys, which is important to take into account when developing physical education programs and individual classes in sports sections, taking into account their physical exertion. Conclusion. Children raised in full families have better strength qualities than children raised in dysfunctional families. With age, indicators of wrist strength tend to increase. Girls have less wrist strength than boys that depends not only on gender, but also on age characteristics, as well as the type of family, which is important to take into account when compiling physical education programs. As you know, the development of strength affects not only all aspects of physical fitness, but also has great applied importance, therefore, great attention should be paid to the development of this physical quality, especially when preparing the younger generation and novice athletes.
Key words: дети среднего школьного возраста, различные типы семей, показатели кистевой силы, пол и возраст ребенка
CLINICAL CASE OF PSEUDOHYPOALDOSTERONISM TYPE 1 IN A NEWBORN CHILD
Alimova I.L., Ibatulin A.G., Demyanenko A.N., Tsvetnaya I.N., Beldin N.V.
UDC: 616.612-002
Abstract: Objective. To present a clinical case of type 1 pseudohypoaldesteronism in a newborn child. Methods. A clinical case of type 1 pseudohypoaldesteronism in a newborn child observed by the authors is presented. The analysis of the materials of the inpatient card, the results of clinical, laboratory, instrumental examination methods was carried out. The native and foreign literature on the problem of pseudohypoaldesteronism was analyzed, a comparative analysis of clinical and laboratory parameters, characteristics of therapy and outcomes in the previously described clinical cases of this pathology with the results obtained during the presented observation was carried out. Results. Pseudohypoaldosteronism belongs to the group of genetically determined electrolyte balance disorders resulting from impaired reabsorption of sodium ions in the tubules due to the low sensitivity of the tubular epithelium receptors to aldosterone. The clinic is variable, the disease can occur with a threat of death due to severe loss of salt and severe hyperkalemia. The main manifestations include polyuria, polydipsia, delayed physical development, arterial hypotension, episodes of dehydration. We present the features of the clinical course of pseudohypoaldesteronism type 1, as well as the dynamics of laboratory parameters before and during treatment in a newborn child. Conclusion. In newborns, if persistent hyperkalemia is detected against the background of progressive malnutrition, pseudohypoaldesteronism should be excluded. The presented clinical case will allow clinicians to broaden their view of the problem of hyperkalemia, features of the clinical manifestations of rare tubulopathies, which will makes it possible to diagnose them in time and choose the right management tactics.
Key words: псевдогипоальдестеронизм, гиперкалиемия, новорожденные, гипотрофия, тубулопатии
PNEUMOMEDIASTINUM AND SUBCUTANEOUS EMPHYSEMA IN PATIENTS WITH NEW CORONAVIRUS INFECTION (COVID-19): PREVALENCE, PROBABLE CAUSES, DIAGNOSIS AND TACTICAL SOLUTIONS
Myakonky R.V., Kaplunov K.O., Krayushkin S.I., Ryndina Yu.A.
UDC: 616.5-003.217
Abstract: Objective. To analyze the frequency and causes of pneumomediastinum and subcutaneous emphysema as complications of new coronavirus infection (COVID-19), to consider methodological approaches to their diagnosis and treatment tactics. Methods. Comprehensive study of literature data and analysis of a series of own observations obtained on the basis of the Volgograd Regional Clinical Hospital No. 3, which has been operating since March 2020 as an infectious (COVID) hospital. Results. The study made it possible to assess the incidence and causes of pneumomediastinum and subcutaneous emphysema, in combination with or without pneumothorax, in patients with COVID-19-associated pneumonia. The authors propose a methodically correct and statistically accounting term alveolar-perfusion interstitial pneumomediastinum, which makes it possible to make the considered complications into an independent type of complications of severe COVID-19 with pulmonary manifestations. A study of the literature data and a series of own observations did not reveal a clear relationship between the appearance of pneumomediastinum and changes in laboratory blood parameters, nor reliable relationships between ongoing drug therapy and the frequency of occurrence of this complication have been established. In addition, the authors proposed an expanded classification of pneumomediastinum and tactical solutions for subcutaneous emphysema of the neck, pneumomediastinum and (or) pneumothorax, depending on the volume of air. Conclusion. The development of pneumomediastinum and subcutaneous emphysema should be considered as a specific complication of pneumonia associated with COVID-19. Currently, tactical approaches to the treatment of pneumomediastinum in patients with COVID-19 are not unambiguous and have not been definitively determined, which requires the activation of scientific research and the increase of statistical power in this direction.
Key words: осложнения новой коронавирусной инфекции COVID-19, подкожная эмфизема, альвеолярно-перфузионный интерстициальный пневмомедиастинум, синдром утечки воздуха
FEATURES OF THE FORMATION OF VARIOUS FORMS OF ACUTE APPENDICITIS IN CHILDREN, TAKING INTO ACCOUNT GENDER, AGE AND HEALTH STATUS
Shestakova V.N., Bogormistrova V.A., Svoboda P.N., Udovenko A.A., Tarasov A.A., Labuzov D.S., Sosin D.V.
UDC: 616.346.2-002.1-053.2-053-055
Abstract: Objective. To study the frequency of the development of various forms of acute appendicitis in children, taking into account the child's gender, age characteristics and health status for a tactical approach to preserve and strengthen health. Methods. The collection of material was carried out by copying primary information from the history of the child's development (f. 112/y), the medical school card (f. 026/y), the patient's history. The clinical assessment of the state of health was carried out in accordance with the methodological recommendations developed at the Research Institute of Hygiene of Children and Adolescents. The distribution of children by health groups was carried out in accordance with the orders of the Ministry of Health of the Russian Federation N621 of 30.12.2003 and No. 514n of 10.08.2017. Observations were recorded before the operation, in the postoperative period and in the dynamics in subsequent years. Based on the results of the inspection, testing, and surveys, the interpretation of the obtained indicators was carried out. The object was children of 7-15 years of age. The main group consisted of 197 children who underwent surgical intervention. The comparison group included children who had not undergone surgical correction (n=247). Statistical processing of the obtained data was carried out using a standard software package using parametric and nonparametric criteria according to the Pearson's22 - criterion with Yates correction, at values p<0.05. Results. Among children aged 7-10 years who underwent surgery for acute appendicitis, the phlegmonous form (52.9%) of acute appendicitis was more common than gangrenous (21.4%, p=0.04), perforative (15.7%, p=0.03) and catarrhal (10.0%, p=0.02). Phlegmonous (67.8%) and catarrhal (14.9%) forms of acute appendicitis were more often detected in children from 11 to 15 years, gangrenous (9.2%) and perforative (8.0%) were less common, which is important to take into account when children are admitted at the pediatric surgical department, deciding on the tactics of observation and the timing of surgical intervention. In girls of primary school age, the gangrenous form of acute appendicitis was by 1.4 times less common than in boys. Catarrhal form of acute appendicitis was detected in all patients with group I of health, while acute phlegmonous form of appendicitis was significantly more often formed in children with groups II and III of health (91.2% and 81.1%, respectively). In the main observation group, the loss of health was 21,3%; 12,7%; 16,8%; 18,3% accordingly, in the group of children who were not subjected to surgery - 16.2%; 9.7%; 8.5%; 6.5%, respectively, which indicated the highest rates of health loss in children undergoing surgery. As the time after the surgical intervention passes, the rate of health disorders decreases. Conclusion. In children with group III of health, only destructive forms of acute appendicitis occur, in children with functional disorders, the phlegmonous form is more common (91.2%), and in healthy children - only catarrhal one (100%). In children from 11 to 15 years, phlegmonous (67.8%) and catarrhal (14.9%) forms of acute appendicitis are more often detected, and in children aged 7-11 years phlegmonous (52.9%), gangrenous (21.4%) and perforative (15.3%), which is important to take into account when children are admitted to the pediatric surgical department, deciding on the tactics of observation and timing of surgical intervention. In boys and girls, catarrhal and gangrenous-perforative forms of acute appendicitis are formed with the same frequency. While phlegmonous and gangrenous forms are significantly more common in boys (p=0.02). More pronounced deviations in the state of health occur in children who have undergone surgery for destructive forms, which is important to take into account when monitoring this category of children both before and in subsequent years after surgery. Children with health group III are a high-risk group for the formation of acute appendicitis, especially those who have combined chronic diseases.
Key words: формы острого аппендицита, группы здоровья, пол ребенка
ENDOSCOPIC ASSESSMENT OF LARGE INTESTINE IN PATIENTS WITH IRRITABLE BOWEL SYNDROME
Akulyonok E.V., Rodin A.V., Ivanishkina E.V., Nankevich I.N.
UDC: 616.345-072.1
Abstract: Objective. To analyse the data of colonoscopy in patients with irritable bowel syndrome. It is necessary to identify the leading variant of dyskinesia with assessment of dominant syndrome and endoscopic changes of the colon that correlate with functional bowel disorders. It is especially important to eliminate the problem of overlooked organic pathology. Methods. Comprehensive observation was carried out in the regional hospital of 150 patients with irritable bowel syndrome, which was determined using Rome III Criteria, Rome IV Criteria, recommendations of the draft working protocol and explanations of changes in laboratory and instrumental examination. The results of irrigography and colonoscopy with biopsy are described in details. Results. Among the variants of the course of irritable bowel syndrome, diarrhoeal variant prevailed in 49.33% of cases among men with a dominant clinical picture of intestinal dysfunction in 45.3% of cases. 117 patients (78% of cases) had endoscopic modifications in the colon: inflammatory lesions, mucosal edema in 66.7% of cases, catarrhal sigmoiditis in the entire group of patients with diarrhoea variant of the disease. Hypertonus and hypotonus of the colon and rectum (19.3% and 6% of cases) confirmed the fact of violation of intestinal tone and peristalsis in clinical cases. The occurrence of organic pathologies did not exceed 10% of cases, functional - 16.5% for each species. Conclusions. In the first and dynamic examination of patients with colon dyskinesia the need for modernization clinical and instrumental methods - irrigography, rectosigmoidoscopy, flexible colonoscopy with biopsy should be emphasized. This is needed to exclude all types of disease signs and artefact detection. Inflammatory signs, proctosigmoiditis, ulcerative defects, neoplasms in the form of polyps should be obviated soon by prescribing the corrective treatment and appointing surgical endoscopic methods as fast as possible.
Key words: синдром раздраженного кишечника, толстая кишка, колоноскопия, ректороманоскопия
MAIN PREDICTORS AFFECTING THE QUALITY OF LIFE OF PATIENTS BEFORE AND AFTER CHOLECYSTECTOMY
Koishibayev Zh.M., Koishibayeva L.M., Turgunov E.M., Azizov I.S.
UDC: 616.366-089.87-089.168.1
Abstract: Objective. To determine the significant factors affecting the quality of life of patients before and 6 months after cholecystectomy. Methods. The influence of certain predictors on the indicators of the quality of life of patients before and 6 months after cholecystectomy was carried out using the Gastrointestinal Quality of Life Index (GIQLI) questionnaire. Results. Predictors such as disability, tachycardia on admission, leukocytosis, and, after 6 months, factors such as severe condition on admission, arterial hypertension on admission, anemia, and female sex directly affect the quality of life indicators of 382 patients before cholecystectomy. Conclusions. Identification of predictors of poor quality of life in patients undergoing cholecystectomy is necessary for the timely diagnosis and correction of postoperative complications and functional disorders.
Key words: холецистит, холецистэктомия, Gastrointestinal Quality of Life Index (GIQLI), качество жизни, предикторы
DEGREE OF SEVERITY OF THERAPEUTIC PATHOMORPHOSIS OF MALIGNANT RECTAL TUMORS AFTER COMPLEX TREATMENT IN THE SMOLENSK REGIONAL ONCOLOGICAL CLINICAL DISPENSARY
Solovyov V.I., Zuj V.S., Bruk S.L.
UDC: 616.351-006.6-059
Abstract: Objective. To determine the severity of the therapeutic pathomorphosis of malignant tumors of the rectum after the complex treatment, in the form of neoadjuvant chemoradiation therapy, followed by surgical treatment, depending on the degree of prevalence and histological structure of the tumor. Methods. Based on the data of the territorial cancer register of the regional state budgetary health care institution "Smolensk Regional Oncological Clinical Dispensary", the official registration and reporting medical documentation of patients with a morphologically confirmed diagnosis of rectal cancer in the period from 2017-2019, who were in hospital treatment, was studied with subsequent complex treatment in the form of neoadjuvant chemoradiation therapy, followed by surgical treatment, after which the surgical material was sent to the pathology department of the Smolensk Regional Oncological Clinical Dispensary for histological examination in order to make a final diagnosis and determine the severity of therapeutic pathomorphosis. Results. The severity of the therapeutic pathomorphosis of rectal tumors after neoadjuvant chemoradiation treatment was studied, depending on the prevalence and histological structure. In the Smolensk region, in the period from 2017 to 2019, there was a tendency towards an increase in the incidence of rectal cancer (2017 - 29.8%, 2018 - 37.5%, 2019 - 32.7%). The gender characteristics of the patients' morbidity did not differ significantly. Stage II rectal cancer prevailed among patients who received complex therapy and amounted to 84.45%. In the studied cohort, adenocarcinoma occurred more often than others, in 96.4% of cases, and it showed the best result for the complex treatment, in the form of therapeutic pathomorphosis (III degree - 21.4%, IV degree - 28.6%). Conclusion. The outcomes of complex treatment in patients with a confirmed diagnosis of rectal cancer directly depend on both the extent of the tumor process and the histological form of malignant tumors.
Key words: рак прямой кишки, частота встречаемости, лечебный патоморфоз, неоадъювантная химиолучевая терапия
INFORMATIVENESS OF RADIATION DIAGNOSTICS METHODS IN THE DETECTION OF LIVER HEMANGIOMAS
Najafova Vafa Nizami
UDC: 616.36-071.7
Abstract: Objective. Сomparative assessment of the capabilities of radiation methods in the differential diagnosis of liver hemangiomas in patients with overweight and obesity. Methods. To do this, we conducted a two-step study. The study included 22 patients with primary hepatic hemangioma without liver dystrophy and 18 patients with hemangioma and obesity. At the next stage of the study, the location and number of hemangiomas were studied in 25 patients with hemangioma, but without obesity in the liver, and in 15 people with hemangioma and obesity. The exogenousness of the liver was studied according to the results of ultrasound in patients without (34) and with fatty degeneration of the liver (27). Tatients underwent the following examinations: magnetic resonance imaging (MRT), computed tomography (CT) and ultrasound (USI). Results. The study showed that localization and hemangiomas in the liver with and without obstruction. In 11 of 22 patients identified by MRI there was only 1 hemangioma in the liver, which is 50% of the corresponding study group. Numerous hemangiomas were found in the liver in 3 out of 15 patients or in 20% of patients with grade II obesity. Results from MRT and KT studies indicate that patients with or without obesity in the liver are more likely to have single hemangiomas. With the help of ultrasound, it was revealed that in 31 out of 34 patients without steatosis, hyperechogenicity of the liver was observed. Conclusion. Certain prospects for early and differential diagnosis of focal liver neoplasms have opened up as a result of the development and subsequent introduction into clinical practice of radiation imaging methods - magnetic resonance imaging, ultrasound, and computed tomography. With a comparative assessment of the information content and sensitivity of methods of radiation diagnostics, in particular, ultrasound, CT, MRI, according to the obtained ultrasound data, comparable in information content with MRI and exceeding the information content of CT, it provides an accurate diagnosis of small capillary hemangiomas of the liver already at the initial stage of the examination. With the development of large cavernous hemangiomas, the CT method turned out to be more informative than other visual diagnostic methods. Thus, the analysis of the diagnostic capabilities of all methods used in the work in the timely detection and differentiation of various types of lesions in the liver showed that they all have different degrees of sensitivity and specificity, due to individual technical features and physical principles of obtaining diagnostic images. But in most cases, optimal diagnosis requires the use of the entire complex as a universal approach to liver studies.
Key words: ожирение печени, гемангиома, МРТ, КТ, МСКТ
IMMUNE MOLECULAR BIOMARKERS SHIFTS IN HERPES MIXED INFECTION IGG-POSITIVE INDIVIDUALS
Karavaeva T.M., Maximenya M.V., Epifantseva N.V., Parshina A.A., Skobova J.V., Chikicheva E.A., Chikicheva M.A.
UDC: 578.27: 612.017.11
Abstract: Objective. Quantification of the serum immunoglobulins (IgA, IgM, IgG) and cytokines (TNF-α, IL-1β, IL-10) in herpes-mixed-infection-IgG-positive individuals. Methods. We measured the total serum immunoglobulins (IgA, IgM, IgG) and cytokines (TNF-α, IL-1β, IL-10) in herpes-mixed infection-IgG-positive individuals (herpes simplex, Epstein-Barr virus, cytomegalovirus) without any clinical manifestation using ELISA method. Results. We revealed low total serum immunoglobulins and higher proinflammatory (TNF-α, IL-1β) and anti-inflammatory (IL-10) cytokines level in herpes-mixed infection-IgG-positive individuals without clinical manifestation in comparison to herpes-mixed infection-IgG-negative individuals. Conclusion. Variations of immune biomarkers can be observed in simultaneous infection with different Herpes viruses though the absence of clinical symptoms.
Key words: герпесвирусы, вирус Эпштейн-Барра, цитомегаловирус, микст-инфекция, иммуноглобулины, цитокины
THE PROBLEM OF TUBERCULOSIS AND HIV CO-INFECTION IN MODERN EPIDEMIOLOGICAL CONDITIONS
Lapshina I.S., Myakisheva T.V.
UDC: 616-002.5: [616.915+616.9-097]
Abstract: Objective. To assess the gender, age and social composition of patients with tuberculosis and HIV (TB/HIV) co-infection and its impact on the clinic, outcomes and treatment results in the context of improving the epidemiological situation of tuberculosis (TB). Methods. The incidence, prevalence of HIV and the incidence of TB/HIV in the Kaluga region in 2016-2020 were analyzed. based on the data of reporting forms N8, 33 and 61. Medical documentation (f.00/y, f.025/y) of the general population of patients with TB/HIV comorbidity (n=106) and TB patients newly diagnosed in 2015 were studied - 2019 (n=1159). Results. Kaluga Region belongs to the regions with a significantly improving TB epidemiological situation, but with an increase in the prevalence of HIV, no decrease in the incidence of TB/HIV co-infection, and an increase in the proportion of TB/HIV among newly diagnosed TB patients. Patients with TB/HIV are significantly more likely to be detected when seeking medical help (58.4%) compared to patients with TB (41.7%). Among TB / HIV patients, 2/3 are men, mostly aged 35-44 years. Among TB/HIV patients there are significantly more unemployed (68.8%) and homeless people (9%). In a clinic with co-infection, the proportion of generalized tuberculosis (4.7%), the presence of bacterial excretion (65%) and MDR of the pathogen (16%) is significantly higher. An effective course of treatment was significantly less frequently established among patients with TB/HIV co-infection (62.3%). The proportion of deaths is almost 3 times higher among TB/HIV patients who have not received ART. Conclusion: the combination of TB/HIV is negative and may have an adverse effect on the TB epidemiological situation in the future.
Key words: туберкулез, ВИЧ, коинфекция, эпидемиологическая ситуация
TUBERCULOSIS IN THE BACKGROUND OF COINFECTIONS: A MEDICAL AND SOCIAL PROBLEM IN THE SMOLENSK REGION
Novikov A.S., Krikova A.V., Dmitrieva E.V., Ignatova N.B., Bunkov K.V., Dmitriev I.V., Kireeva O.K., Danilov A.A.
UDC: 616-01/-099
Abstract: Objective. To study the problem of tuberculosis against the background of coinfections as a medical and social problem in the Smolensk region. Methods. A content analysis of the regulatory documents governing the prevention, detection, treatment of socially significant diseases, including tuberculosis for the period 2017-2018, was carried out. The analysis of data obtained from 20 autopsy protocols, who died in 2019 from tuberculosis against the background of coinfections, was conducted. Descriptive statistics method is a simple generalization of data obtained in the framework of a sample study (the basic methods of descriptive statistics include percentages, measures of central tendency, measures of variation and paired coefficients of communication, which allow to summarize the data available for the sample). Results. During the study, it was revealed that in most fatal cases of patients with tuberculosis in combination with coinfection, the most common ones are: HIV infection 4B phase of progression (without proper antiretroviral therapy), viral hepatitis C (as concomitant HIV and tuberculosis, i.e. as part of polypathies) with complications in the form of cachexia, tuberculous intoxication, cerebral edema, diffuse alveolar pulmonary edema and various metabolic injuries. The background for such a course of pathological processes is often chronic alcohol intoxication and drug addiction. At the same time, in the part of the medical records of inpatients, a lack of permanent work and stay in the places of confinement were mentioned (the evidence of an asocial lifestyle). Scientific contribution. Conclusion. The success of tuberculosis treatment largely depends on the patient himself: one should adhere to the treatment regimen indicated by the doctor and its recommendation, especially in cases when the situation is aggravated with the addition of coinfection. At the same time, national projects to combat tuberculosis are being successfully implemented in the Russian Federation to ensure the sanitary and epidemiological well-being of the population. To improve the situation, it is also necessary to introduce new methods of drug treatment, to carry out prevention and campaigning among the population about the danger of the disease. Statistical analysis and assessment of the mortality rate will help to find the optimal vector for the development of this area for the Ministry of Health of the Russian Federation.
Key words: туберкулез, ВИЧ-инфекция, коинфекция, медико-социальная проблема
ALTERATIONS OF PHOSPHORUS-CALCIUM METABOLISM REGULATORS IN DENTAL DECAY PATHOGENESIS
Putneva A.S., Mishchenko M.N., Karavaeva T.M., Maksimenya M.V., Tereshkov P.P.
UDC: 616.314-002:612.018
Abstract: Objective. To study the variations of phosphorus-calcium metabolism regulators in dental decay. Materials and methods. The clinical and laboratory examination were performed in young students (44 males aged 18-22), divided in two groups: severe dental decay and controls. Blood serum were collected and used for quantification of hormones (parathyroid hormone, calcitonin, thyroxine - T, free thyroxine, triiodothyronine - T), 25-hydroxyvitamin D (25(OH)D), calcium (Ca), inorganic phosphorus and alkaline phosphatase activity. Descriptive statistics data were analyzed and presented as median and interquartile range (25th;75th percentiles). MannWhitney U-Test was used to examine differences between two independent groups. Spearman's rank coefficient was used to assess the relationship between the measured parameters. Results. Proper oral hygiene was observed in both groups. The research revealed 10,6% decrease of T4 level (p=0,031), 55,04% - of 25(OH)D(p=0,01) and 30,4% increase of parathyroid hormone (p=0,008), also low level of 25(OH)Dwas observed in 90,9% students with severe dental decay. The Spearman's rank coefficient indicated positive correlation between Ca and 25(OH)D (r=0,60; р=0,021); between inorganic phosphorus and 25(OH)D(r=0,54; р=0,038). Negative correlation was determined between parathyroid hormone and calcium levels (r= -0,51; р=0,043). Conclusions. Systemic biochemical shifts resulting from thyroid and parathyroid glands disfunction and 25-hydroxyvitamin D deficiency could contribute to dental decay development in young individuals.
Key words: кариес, паратгормон, кальцитонин, 25(OH)D
PHARMACOLOGICAL STUDIES OF THE ANTIPYRETIC EFFECT AND WOUND-HEALING ACTIVITY OF VIBURNUM VULGARIS PREPARATIONS
Kadilaeva Z.A., Losenkova S.O., Stepanova E.F., Ogay M.A., Pozdnyakov D.I., Nam N.L., Zilfikarov I.N., Morozov Yu.A., Davydova V.V.
UDC: 615. 454.1
Abstract: Objective. Experimental study of the antipyretic effect of syrup and wound-healing activity of ointment with dry extract (1:1) from meal of viburnum fruit. Methods. Evaluation of the pharmacological activity of the developed dosage forms from the meal of viburnum fruits was performed on 100 male rats of the Wistar line weighing 220-240 g, obtained from the nursery of laboratory animals "Rappolovo" (Leningrad region). Experimental procedures and animal welfare were consistent (Directive 2010/63/EU of the European Parliament and of the council on the protection of animals used for scientific purposes, September 22, 2010). Evaluation of the pharmacological activity of the developed dosage forms from dry extract of meal of viburnum fruits was performed on 100 male rats of the Wistar line weighing 220-240 grams, obtained from the nursery of laboratory animals "Rappolovo" (Leningrad region). The study of the pharmacological activity of the developed LF from the meal of viburnum fruits included an assessment of the antipyretic (antipyretic) activity of the syrup and the study of the wound-healing properties of the ointment with dry viburnum extract. Results. Based on the study, it was established that the syrup developed by the authors with dry extract (1: 1) from the meal of viburnum fruits in doses of 1.5 and 2.0 ml/kg has a reliable antipyretic effect equivalent to the comparison drug (paracetamol at a dose of 5 mg / kg per os). In smaller doses (0.5-1 ml/kg per os), viburnum syrup did not have an antipyretic effect. The developed viburnum ointment with a course of single cutaneous use for 3 weeks contributes to a faster healing of a burn wound in an equivalent dose in comparison with the reference drug "Actovegin, ointment for external use". The use of ointment with dry extract from the meal of viburnum fruits reduces to a greater extent the severity of all clinical changes in the burn surface compared to the ointment with actovegin, as evidenced by a lower score of the MAPS scale. Conclusion. The results of pharmacological studies indicate the prospects of using medicinal syrup with dry extract from the meal of the fruits of viburnum vulgaris as an antipyretic agent in doses of 1.5 and 2.0 ml/kg per os, as well as ointments with a dry extract from the meal of the fruits of viburnum ordinary as a wound healing agent.
Key words: калина обыкновенная, сироп, мазь, шрот, фитопрепараты
DEVELOPMENT OF A METHOD FOR CONFIRMING THE AUTHENTICITY OF A PHARMACEUTICAL SUBSTANCE BASED ON THE DERIVATIVE OF 3,7-DIAZABICYCLO[3.3.1]NONANE BY NMR SPECTROSCOPY
Brkich G.E., Pyatigorskaya N.V.
UDC: 615.074
Abstract: Objective. Development of a method for confirming the authenticity of the pharmaceutical substance based on the derivative of 3,7-diazabicyclo[3.3.1]nonane by NMR spectroscopy independently of a standard sample for its further use in pharmaceutical analysis. Materials and methods. The object of the study is a pharmaceutical substance with the chemical name IUPAC 6-[4-methoxy-3-(1H-pyrazole-1-ylmethyl) benzyl]-1,11-dimethyl-3,6,9-triazatricyclo [7.3.1.1] tetradecane-4,8,12-trione, based on the derivative of 3,7-diazabicyclo[3.3.1]nonane. The H NMR spectrum of the standard and sample solutions were recorded on a Bruker DPX-400 spectrometer, Germany, with an operating frequency of 400 MHz at a temperature of 28°C. The chemical shifts of the protons were measured in millionths of δ (m.d.) with respect to the residual amount of the solvent H of the solvent - deuterochloroform. The concentration in the deuterol-solvent was 5 mg/ml. Results. Based on a comprehensive analysis of NMR spectral data, a method was developed for determining the authenticity of the pharmaceutical substance in encapsulated dosage form, using the method of 1H NMR spectroscopy with documentary confirmation of the suitability of this technique. Conclusion. This technique can be used to determine the authenticity of the pharmaceutical substance based on the derivative of 3,7-diazabicyclo[3.3.1]nonane both separately and as part of the dosage form.
Key words: производное 3, 7-диазабицикло[3.3.1]нонана, ЯМР-спектроскопия
DEVELOPMENT OF A METHOD OF QUANTITATIVE ANALYSIS OF PENTOXYPHYLLINE IN MICROPARTICLES BY THE METHOD OF THIN-LAYER CHROMATOGRAPHY. VALIDATION OF METHODS
Timchenko T.V., Mezenova T.D., Kompantsev D.V., Markova O.M., Kompantsev V.A., Zyabliceva N.S., Sannikova E.G., Vasina T.M.
UDC: 543.544.943.3
Abstract: Objective. The development and validation of methods for the quantitative determination of pentoxifylline in microparticles obtained on the basis of poly-DL-lactide-co-glycolide (PLGA) by thin layer chromatography (TLC). Methods. In the preparation of microparticles, the substance pentoxifylline was used; PLGA was used as a biodegradable polymer. Scientific research was carried out using laboratory equipment of the Pyatigorsk Medical and Pharmaceutical Institute - a branch of the Volgograd State Medical University. Results. A method for the quantitative determination of pentoxifylline in microparticles, obtained on the basis of PLGA, was developed by TLC. The average value of the amount of pentoxifylline released from microparticles, determined by TLC, was 67.7 ± 2.7%. During the studies, the developed TLC technique was validated. The error of the technique in the experimental conditions is 4.0%. Conclusions. The developed method for the quantitative determination of pentoxifylline in microparticles by TLC, which meets regulatory requirements and is suitable for pharmaceutical analysis.
Key words: микрочастицы пентоксифиллина, количественный анализ, метод ТСХ, валидация
EXPERIMENTAL SELECTION OF OPTIMAL PROCESS PARAMETERS OF ULTRASONIC EXTRACTION OF INULIN
Dyakova N.A.
UDC: 615.322
Abstract: Objective. The aim of the study was to develop an express method for isolating and quantifying inulin from the roots of the common burdock (Arctium lappa L.). Methods. In order to accelerate the process of extracting biologically active substances from the roots of ordinary burdock, as well as increase the yield of inulin, it was decided to use an ultrasonic bath. Results. Varying the process parameters, it was possible to select the optimal conditions for extracting inulin from the roots of ordinary burdock in ultrasound treatment conditions: crushing of raw materials 0.2-0.5 mm, temperature - 80°C, extraction rate - 3, extraction duration - 40 minutes, ultrasound frequency - 25 kHz, ratio of raw materials and extractant - 1 g per 20 ml. Further increase of extraction time under ultrasonic bath conditions obviously leads to destruction of water-soluble polysaccharides. Also, optimal conditions for purification of the polysaccharide complex of the roots of the common bladder were selected to obtain pure inulin. Conclusion. The proposed method allows intensifying the process of production of inulin from the roots of common bladder and reducing the time spent on it to 7 hours, as well as increasing the yield of the product to 23.07 ± 0.32% in terms of absolutely dry raw materials. The procedure can be used for express analysis of the quality of the roots of ordinary burdock, as well as for industrial production of inulin from this kind of raw material.
Key words: водорастворимые полисахариды, инулин, ультразвук
DEVELOPMENT OF NUMERICAL QUALITY INDICATORS FOR STANDARDIZATION OF STEVIA LEAVES
Kurdjukov E.E., Semenova E.F., Vodop'yanova O.A., Ponomareva T. A., Bibyakova L.N., Finajonova N.V.
UDC: 615.322:543.422.3
Abstract: Objective. To develop numerical quality indicators for the standardization of the stevia leaves ( Stevia rebaudiana Bertoni.). Methods. Average samples from 5 batches of raw materials were analyzed. Such values as moisture, total ash, hydrochloric acid insoluble ash, pulverization, impurity content, determination of the content of extractive substances extracted by water were established for whole, crushed raw materials and powder according to the methods of the corresponding general pharmacopoeial articles of the State Pharmacopoeia 14th edition. Determination of the amount of flavonoids in terms of cinaroside was carried out by differential spectrophotometry, phenylpropanoids in terms of chlorogenic acid by direct spectrophotometry. Results. The results of merchandising and phytochemical analyses of stevia leaves allowed us to establish the following quality standards for whole, crushed and powdered raw materials: humidity not more than 13%, total ash content not more than 14%, ash content insoluble in 10% hydrochloric acid not more than 7%, extractive substances extracted by water not less than 30%, phenylpropanoids in terms of chlorogenic acid not less than 5%, flavonoids in terms of cinaroside not less than 1.0%. The degree of atomization for solid materials-particles passing through a sieve with a hole diameter of 7 mm, not more than 5%; for the crushed raw materials: particles not passing through a sieve with a hole diameter of 5 mm, not more than 5% of particles passing through a sieve with a hole diameter of 0.5 mm, not more than 5%; for powder raw materials: particles not passing through a sieve with a hole diameter of 2 mm, not greater than 5% of particles passing through a sieve with a hole diameter of 0.18 mm, not more than 5%. The content of impurities for whole and crushed raw materials: pieces of flowers and stems no more than 1%; organic impurities not more than 3%; mineral impurities not more than 1%. Conclusions. As a result of the research, new quality indicators of raw materials for stevia leaves were established, which allow for standardization of whole, crushed and powdered raw materials in accordance with the requirements of regulatory documentation.
Key words: стевия, цинарозид, влажность, содержание золы, экстрактивные вещества, фенилпропаноиды, флавоноиды
PHENOLIC COMPOUNDS OF (DC.) FREYN AND L., GROWING IN YAKUTIA
Kirillina K.S., Chirikova N.K.
UDC: 581.192
Abstract: Objective. A study of the qualitative and quantitative composition of biologically active substances of P. incarnata and P. rotundifolia growing in the Republic of Sakha (Yakutia). Methods. The samples were collected in Central Yakutia during flowering. To study the phytochemical composition, we used the method of qualitative analysis on the content of some biologically active substances, the method of determination of tannins, the method of quantitative determination of phenolic compounds by means of Folin-Ciocalteu reagent and method of quantitative determination of the amount of flavonoids. Results. The study showed that the above-ground parts of plants contain arbutin, amino acids, flavonoids, tannins, iridoids, catechins, triterpene and phenolic compounds. As a result of determination of the quantitative content of biologically active compounds in leaves of P. incarnata and P. rotundifolia the total content of tannins in aqueous extracts, flavonoids and phenolic compounds in alcohol and aqueous extracts were established. Differential spectra of the study objects were also obtained. Conclusion. After studying phytochemical composition of P. incarnata and P. rotundifolia it is possible to draw a conclusion that above-ground parts of objects of study are a source of valuable compounds providing protection against oxidative damage, therefore their use in folk medicine is justified.
Key words: грушанка, биологически активные соединения, спектрофотометрический метод, ЛРС, суммарное содержание фенольных соединений, Pyrola incarnata, Pyrola rotundifolia
COMPARATIVE EVALUATION OF THE USE OF GOOGLE SERVICES AND THE WEBINAR.RU PLATFORM IN THE EDUCATIONAL PROCESS AT THE DEPARTMENT OF PUBLIC HEALTH AND HEALTHCARE
Klykov Alexey Igorevich, Dekhnich Svetlana Nikolaevna, Kosareva Elena Anatolyevna, Morozova Anastasia Sergeevna
UDC: 614.2+021.66
Abstract: Objective. To give a comparative assessment of the use of Google services and the platform Webinar.ru when delivering a lecture course on the discipline "Public health and healthcare, non-infectious epidemiology" for students of the Faculty of Foreign students training of the Smolensk State Medical University of the Ministry of Health of the Russian Federation Methodology. The study uses the method of expert assessments of the technical and organizational capabilities of using Google services and the platform Webinar.ru to deliver a full lecture course in the amount of 80 academic hours on the discipline "Public health and healthcare, non-infectious epidemiology" for students of the Faculty of foreign students training during 2020 - 2021 at the Department of Public Health and Healthcare. Results. According to the provided opportunities (accounting for lecture attendance, additional lecturer tools, speaker's capabilities in the process of lecturing, integration into corporate university services) application of the platform Webinar.ru provides better quality lectures compared to Google services. Conclusion. Service Webinar.ru according to its technical and organizational criteria, is more optimal in delivering lectures for the educational process on the discipline Public health and healthcare, non-infectious epidemiology for foreign students.
Key words: дистанционное обучение, иностранные учащиеся, общественное здоровье и здравоохранение
IMPLEMENTATION OF A COMPETENCY-BASED APPROACH IN TRAINING HIGHLY QUALIFIED PERSONNEL FOR THE PHARMACEUTICAL INDUSTRY
Taube A.A.
UDC: 615.072+ 65.015+378.147
Abstract: Objective. Study of new methodological approaches to the development of professional competence of undergraduates in regulatory science in the master's educational discipline "Fundamentals of drug registration." Methods. Research methods: systematization, classification, generalization of the data of the studied process, empirical analysis and synthesis of scientific categories, modeling of the educational process, content analysis of scientific and pedagogical literature. Results. The paper describes the experience of developing a new discipline of the master's program of training in the specialties: "Organization and management of biotechnological production", "Organization and management of chemical production". An algorithm for the formation of technology for teaching professional competence in the field of regulatory science in accordance with the new requirements of the Federal State Educational Standard is shown. A new approach to teaching on the master's program of the Department of Economics and Management of the Federal State Budgetary Educational Institution of Higher Education SPKhFU is proposed. The features of regulatory science are highlighted, in accordance with which the program is implemented. Conclusions. Competence is a multifactorial quality of an individual, manifested in the ability and willingness to use knowledge, skills and abilities in combination with personal characteristics. The formation of competencies in higher education is of an integrated nature and depends on educational skills and abilities that are integral parts of the concept of competence. Competence assessment should confirm the level of qualification of the student (master's student) upon completion of the master's educational program. However, pedagogical technologies for such an assessment have not yet been developed. The problem of modern education is that classical curricula based on the assimilation of a certain amount of information do not meet the requirements of a practically oriented competence-based approach in education. When developing a new discipline "Fundamentals of drug registration", the new approach of the Federal State Educational Standard and the peculiarities of regulatory science were taken into account. The construction of practical and independent lessons in the new discipline is focused on contextual learning and the problematic nature of the material presented. Undergraduates gain professional experience by simulating real situations that develop skills and abilities as components of professional competence. When creating the discipline program, the international experience of training specialists in this field was studied. After successfully completing this discipline, the graduate demonstrates competence in the field of drug registration, can answer any professional question at the current moment, depending on the situation, is able to find the necessary regulatory document. The training is based on information on the latest developments in the field of drug registration in real time. The student is encouraged to follow the work of regulatory bodies not only in the current moment, but also retrospectively, allowing to see the results of regulatory work. The formation of the target professional competence of PC 7.2 allows the optimal ratio of lectures, practical and independent studies.
Key words: фармацевтическая промышленность, компетентностный подход, регистрация лекарственных средств, магистратура, высшее образование, образовательная программа
INTEGRATION OF DIFFERENT SPECIALIZED KNOWLEDGE FOR THE DEVELOPMENT OF THE DISCIPLINE "PHARMACOLOGY" IN THE FRAMEWORK OF OBTAINING PHARMACEUTICAL SECONDARY VOCATIONAL EDUCATION
Rostova N.B., Yaborova O.V., Soloninina A.V., Belonogova V.D., Turyshev A.Yu.
UDC: 615.378.147
Abstract: Objective. The development of the program of the course "pharmacology" for the formation of professional pharmaceutical experience and design thinking have enrolled in the program of training of secondary level course "pharmacology", which will allow us to provide pharmaceutical care to meet the needs of patients and employers. Methods. In the process of investigation used a systematic approach, methods of situational, structural-logical, comparative and simultaneous analysis, summarizing and grouping, factor, and content analysis to study the following materials: fgos SPO specialty 33.02.01 pharmacy (secondary vocational education), work programs of professional modules of educational institutions of the Russian Federation of secondary vocational education. Results. The integration of specialized knowledge of the disciplines of management and economics of pharmacy, pharmacognosy and pharmacology within the framework of the study of the discipline "Pharmacology" helps the student to form a systematic thinking and skills for successful professional activity. Conclusion. As a result of mastering the discipline "Pharmacology" according to the program proposed by us, the student develops a professional pharmaceutical mindset, which will allow in practice to provide pharmaceutical care that meets the needs of patients and employers.
Key words: разработка программы, дисциплина «Лекарствоведение», комплексный подход, вопросы клинической фармакологии, управления и экономики фармации и фармакогнозии
THE STATE PHARMACOPOEIA OF THE RUSSIAN FEDERATION XIV IN THE SYSTEM OF TEACHING LATIN TO MEDICAL STUDENTS
Danilina N.I., Nosacheva M.I.
UDC: 615.11+81’373.46+811.124
Abstract: Objective. To analyze the changes in the rules of the construction of pharmaceutical terms, to analyze newly introduced terms without Latin equivalents, to give methodical suggestions for the introduction of new rules and terms into the educational process. Methods. The entire sample of the names of the medicinal plant raw material and its medical products from the Russia State Pharmacopoeia XIV, matching of these terms with the corresponding terms from the previous editions, the formulation of new rules determining the construction of pharmaceutical terms; the sample of the names of dosage forms, the determination of terms without recognized Latin equivalents, suggestions for their translation. Results. The sample of the names of dosage forms shows that Latin names with a long tradition of practical and educational use are grammatically correct. Some names don’t have Latin equivalents. Latin names, based on the European Pharmacopoeia, have to be corrected. The sample of the names of the medicinal plant raw material shows more consistent use of Latin two-term botanic names in comparison with the previous Pharmacopoeias; obligatory designation of producing parts of plants. The sample of the names of medical products demonstrates the refusal of the grammatical (the main word - the dependent word) in favour of the logical principle (general concept - particular concept) in the construction of pharmaceutical terms. Conclusion. The detected lack in the Latin group “Dosage forms” should be eliminated based on the European Pharmacopoeia with necessary grammar corrections. The expansion of the sphere of use of two-term botanic names requires the teaching students to use these units without the word-by-word translation. The change of the main principle of the construction of multiword pharmaceutical terms is a methodical problem, because it differs from the principle of construction of anatomical and clinical terms.
Key words: лекарственная форма, лекарственное растительное сырье, лекарственный препарат, фармацевтическая терминология, латинский язык