MEDICO-BIOLOGICAL SCIENCES
ORIGINAL ARTICLES
EFFECT OF ALCOHOL CONSUMPTION LEVEL ON BLOOD PLASMA AMINO ACID POOL
Razvodovsky Y.E., Smirnov V.Y., Doroschenko E.M., Schuriberko A.V., Pereverzev V.A.
Abstract: Objectives. To study the features of the stock of amino acids and their derivatives in the blood plasma of people with different levels of alcohol consumption. Methods. The concentration of amino acids and their derivatives in blood samples of 50 men and 50 women aged 15-65 years was determined. The blood was obtained from the laboratory of the medical advisory center, where it was submitted for routine biochemical analysis. The analysis of amino acids and their derivatives was carried out on an Agilent 1100 chromatograph using reverse phase chromatography. Statistical data processing was performed using the Statistica 10.0 program for Windows (StatSoft, Inc., USA). Results. It has been established that in the blood plasma of men who abuse alcohol, the content of glutamic acid is higher, while the level of glutamine is lower compared to abstinent men. In addition, in the blood plasma of men who abuse alcohol, higher levels of taurine were noted compared to moderate drinkers. In the blood plasma of women who abuse alcohol, an increased content of cysteine sulfinate and glutathione was found in comparison with abstinents, as well as in the level of taurine - in comparison with moderate drinkers. In the blood plasma of moderate drinkers, the content of phosphoserine and symmetrical dimethylarginine (SDMA) is higher than in abstinence drinkers. Conclusion. Abnormalities of the amino acid fund of blood plasma, depending on the level of alcohol consumption, were found. Alcohol abuse causes changes in the content of a number of amino acids and their derivatives in both men and women. Gender features of the influence of the level of alcohol consumption on the amino acid fund of blood plasma were revealed. Moderate alcohol consumption causes an amino acid imbalance in the blood plasma of women, without affecting the content of amino acids and their derivatives in the blood plasma of men.
Keywords: alcohol consumption; amino acids; blood plasma
THE EFFECT OF NEW DERIVATIVES OF α-CYANOTHIOACETAMIDE ON MOTOR AND REFLEX REACTIONS IN TESTS WITH EXTERNAL EXPOSURE TO HIGH TEMPERATURE
Oleinik I.S.
Abstract: Objective. The aim of the study was to evaluate the effect of new α-cyanothioacetamide derivatives on motor and reflex responses in the hot plate and thermal tail immersion tests on white rats, indicating the presence of antinociceptive activity in the spectrum of their pharmacodynamic effects. Methods. The experiment was carried out on 100 white male rats, the average weight of which was 250-280 g. The rats were divided into control, reference and 8 experimental groups. Determination of analgesic activity was carried out using classical hot plate and tail immersion tests based on the behavioral responses of animals controlled by supraspinal structures in response to pain stimulation. 1.5 hours before the formation of nociceptive reactions in rats, intragastric administration of the reference drug (metamisole sodium at a dose of 7 mg/kg) and new derivatives of α-cyanothioacetamide (at a dose of 5 mg/kg) was carried out. Results. Most of the studied new derivatives of α-cyanothioacetamide in comparison with sodium metamizole showed an increase in the latency period before the start of jumping from the surface of the hot plate of rats and the reaction time of tail retraction. No lethal outcomes of laboratory animals were detected during the experiment. Conclusions. It was found the prospects of searching for new painkillers based on derivatives of α-cyanothioacetamide.
Keywords: derivatives of α-cyanothioacetamide; thermal immersion of the tail; hot plate; analgesic activity; pain; analgesic drugs
FLUOROQUINOLONES EFFECT ON THORACIC AORTA MECHANICAL STRENGTH AND SERUM MAGNESIUM IN LABORATORY RABBITS
Izmozherova N.V., Zaytsev D.V., Bakhtin V.M.
Abstract: Objective. Evaluation of the relationship between laboratory rabbits thoracic aorta strength under uniaxial stretching and serum magnesium level against background of ciprofloxacin and levofloxacin. Methods. 20 rabbits "Soviet chinchilla" at the age of 5 months were randomized into three groups: group 1 (6 animals received placebo for 14 days), group 2 (7 animals received ciprofloxacin 150 mg/kg for 14 days), group 3 (7 animals received levofloxacin 150 mg/kg for 14 days). On the 15th day, the animals were withdrawn from the experiment, thoracic aorta samples were subjected to mechanical test for uniaxial tension. Sample tensile strength, maximum deformation, elasticity modulus, and destruction work were determined. Serum magnesium level was analyzed. Results. Ciprofloxacin use did not change aorta strength. In levofloxacin group, there was significant decrease in aorta destruction work (21.1±10.2 mJ versus 46.6±17.4 mJ in control group, p = 0.011). Serum magnesium levels did not change with both of fluoroquinolones (p > 0.050 for both drugs). The dependence of magnesium concentration and aortic strength was found only in the control group; it was not detected when using fluoroquinolones. Conclusion. Levofloxacin showed the most dramatic damaging effect on thoracic aortic wall strength properties. Studied drugs did not reduce serum magnesium levels. Fluoroquinolones, most probably, contribute to the magnesium redistribution from tissues to blood, resulting in a normal content of Mg2+ in serum, but there is its metabolism violation in the aortic wall.
Keywords: aorta; fluoroquinolones; levofloxacin; ciprofloxacin; mechanical testing; uniaxial tension; magnesium
CLINICAL AND MICROBIOLOGICAL EFFICACY OF SIMPRAZOL® (ORNIDAZOLE + CIPROFLOXACIN) IN PATIENTS WITH SKIN AND SOFT TISSUE INFECTIONS
Teplova N.V., Romashov O.M., Umutkuzina D.A.
Abstract: Objective. To evaluate the clinical and microbiological efficacy of the combined preparation Simprazol® (ornidazole+ciprofloxacin) in patients with skin and soft tissue infections. Methods. In a prospective study conducted in a multidisciplinary hospital in the period from February to May 2023, patients with purulent wounds of skin and soft tissues of various genesis and localization were studied. Patients with extreme severity of the infectious process, decompensation of the cardiopulmonary system were not included in the clinical study. Resistance and sensitivity of isolated strains to antibiotics were evaluated in patients with analysis points after 7 or 14 days. Patients with sensitive strains to ciprofloxacin were included. Results. The study involved 60 patients within the framework of complex surgical treatment (hospital). Clinical and laboratory studies showed that the combined preparation consisting of ciprofloxacin and ornidazole showed high clinical and bacteriological efficacy (95% and 96.7% of cases, respectively) in the treatment of patients with purulent wounds of skin and soft tissues of aerobic and anaerobic etiology, provided the pathogen was sensitive to ciprofloxacin and regardless of the presence of an anaerobic component. Tolerability of the drug in 99% of cases was good and no adverse drug reactions were noted. Conclusions. The combined preparation Simprazol® containing 500 mg ciprofloxacin and 500 mg ornidazole has a wide spectrum of action and original mechanisms of action on microbes. It is an effective and safe drug in the treatment of skin and soft tissue infections from both clinical and microbiological points of view.
Keywords: skin and soft tissue infections; antibiotic therapy; ornidazole+ciprofloxacin; clinical and microbiologic efficacy
PHARMACOECONOMICAL ANALYSIS OF COMBINED ANTI-INFECTIVE THERAPY OF BACTERIAL VAGINOSIS
Piletskaya U.V., Makarov K.Yu., Karabintseva N.O., Sokolova T.M., Tihomirova Yu.I.
Abstract: Objective. Evaluation of the pharmacoeconomical feasibility of treating bacterial vaginosis with a combination of a polyvalent bacteriophage drug with anti-infective agents. Methods. . Surrogate and endpoints were used to assess the effectiveness of pharmacotherapy. During the pharmacoeconomic analysis, an integral indicator of effectiveness was calculated. To determine the cost of treating BV, the method of determining the cost of the disease was used. In parallel with the evaluation of the effectiveness of treatment, the total costs in each group were determined for further calculation of the cost-effectiveness ratio. Results. The highest efficiency of pharmacotherapy in all respects is observed in the group of patients who received combination therapy with Fagogin, the maximum efficiency - in the subgroup of patients treated with Elzhina and Fagogin. In this group of patients, side effects of antibiotic therapy were also not observed. Relapses occurred less frequently in groups of patients receiving combination therapy with Fagogin. The cost of BV pharmacotherapy was the lowest when using Elzhina in combination with Fagogin, the highest was in the group using Hexicon and Femilexem. According to the results of the study, the most pharmacoeconomically effective combination of drugs for the treatment of BV is the combined use of Elzhina and Fagogin. Conclusions. The lowest costs for achieving effective therapy are typical for the group of patients who received combination therapy with the Fagogin polyvalent bacteriophage preparation. The most pharmacoeconomically effective combination of drugs for the treatment of BV was shown by the joint administration of Elzhina and Fagogin.
Keywords: bacterial vaginosis; antibacterial therapy; efficacy pharmacoeconomics
CLINICAL MEDICINE
ORIGINAL ARTICLES
ON THE RELATIONSHIP BETWEEN AGE AND LIPID PROFILE
Aliyeva D.Z., Abdulkadyrova S.O., Aselderova A.Sh.
Abstract: Objective. To identify the relationship between age and lipid profile based on the results of the analysis of the lipid spectrum of the blood of the population. Methods. The results of the concentration of OHS, TG, HDL and LDL cholesterol were analyzed. A correlation analysis of the relationship between age and lipid profile was carried out for subsequent statistical processing of the obtained digital material. A total of 262 people were examined. Statistical analysis was carried out using the StatTech v program.2.8.3 (Stattech LLC, Russia). Results. Correlation analysis of the relationship between age and the indicator «Triglycerides» on the Cheddock scale showed that the age of triglycerides is p= 0.314, the closeness of the Cheddock relationship is moderate. With an increase in age by one year, an increase in the «Triglycerides» indicator by 0.018 should be expected. The resulting model explains 5.4% of the observed variance of the «Triglycerides» indicator. Conclusions. The results of our research allow us to suggest that with an increase in age by one year, an increase in the «Triglycerides» indicator should be expected. With an increase in age by one year, a decrease in the «HDL» indicator should be expected. With an increase in age by one year, an increase in cholesterol should be expected.
Keywords: lipid metabolism; blood screening; cholesterol; triglycerides; correlation analysis; age relationship; Dagestan; Makhachkala
USING A POLYETHYLENE WRAP-CONDOM FOR MASS SCREENING WITH AN INDIVIDUAL FINGER PULSE OXIMETER
Odnokozov I.A., Husakova N.V., Bichan N.P.
Abstract: Objective. Evaluation of the possibility of using an individual pulse oximeter for saturation screening when isolating the skin of patients with a polyethylene wrap-condom. Methods. Comparison of saturation parameters when measured with an individual finger pulse oximeter according to the routine method and after preliminary isolation of the skin or directly by the pulse oximeter with a plastic wrap in 130 volunteers. Questioning of researchers to determine the optimal way to put on a polyethylene wrap. The significance of differences in related groups was determined using a t-test. Results. When comparing saturation indicators measured both by the routine method and using a polyethylene wrap-condom, no significant differences were found. The method of using a plastic wrap directly on the patient's finger is preferable to the method of using a wrap on a pulse oximeter. Conclusion. The use of a disposable polyethylene wrap expands the possibility of using a personal pulse oximeter for screening in compliance with sanitary standards and anti-epidemic measures.
Keywords:disinfection; pulse oximetry; saturation; screening; polyethylene wrap-condom
FEATURES OF THE CONTROL OF BRONCHIAL ASTHMA IN COMORBIDITY WITH SIMPLE OBESITY IN SCHOOL-AGE CHILDREN
Alimova I.L., Yacheykina N.A., Pleskachevskaya T.A., Novikova O.B.
Abstract: Objective. To study the features of bronchial asthma control in comorbidity with simple obesity in school-age children. Methods. 96 patients from 7 to 14 years old with bronchial asthma were examined. Two groups were identified among them: 1st - children with bronchial asthma and obesity (n=35), 2nd - with bronchial asthma without obesity (n=61). The diagnosis of obesity was established on the basis of WHO criteria. The groups were comparable in gender, age, and severity of bronchial asthma. The assessment of the level of control of bronchial asthma was carried out with the help of a doctor's opinion (the number of daytime symptoms more than 1 time per week, restriction of physical activity, the use of medications to relieve symptoms more than 1 time per week, the presence of night awakenings/coughing due to asthma over the past 4 weeks were estimated) and a test for asthma control in children up to 11 years (The Childhood Asthma Test). Results. According to the evaluation of the disease control by the doctor, it was revealed that control was worse in patients of group 1 (restriction of physical activity was more often noted (in group 1 in 15 (42.9%) and in group 2 in 14 (23.0%), p=0.041), more frequent and prolonged symptoms of the disease during the day (cough: in group 1 in 8 (22.9%) and in group 2 in 11 (18.0%), p=0.376; difficulty breathing: in group 1 in 12 (34.2%) and in group 2 in 9 (14.8%), p=0.036, shortness of breath: in group 1 in 14 (40.0%) and in group 2 in 12 (19.7%), p=0.031)). Optimal control was observed in 14 (40%) patients of group 1, they were more likely to have an uncontrolled course of the disease with a comparable amount of basic therapy (6 (17%)). According to the number of points on the AST test, children aged 7-11 years and older than 12 years of the 1st group more often (p>0.05) had an uncontrolled course of the disease. When analyzing symptoms using the AST test, it was revealed that in children of group 1, symptoms occurred with the same frequency according to the answers to all questions (p>0.05). Conclusions. In children with bronchial asthma and obesity, the uncontrolled course of the disease, both according to the doctor's conclusion and according to asthma control tests and subjective patient data, was significantly more common than in children with bronchial asthma and normal weight, which requires additional treatment and rehabilitation programs in the management of this category of patients.
Keywords: bronchial asthma; obesity; control; school-age children
LEVELS OF NEUROSPECIFIC PROTEINS IN NEWBORN CHILDREN WITH ABO AND RH ISOIMMUNIATION
Pryshchepenka O.A., Patapava V.E., Malashkova V.A.
Abstract: Objective. The aim of the study is to assess the levels of neurospecific proteins in the blood serum of newborns with ABO and Rhesus isoimmunization. Method. The level of neuron-specific enolase, brain-derived neurotrophic factor and S100B protein was determined in 73 newborns, who were divided into groups: isoimmunization according to the ABO and Rhesus systems, neonatal jaundice, hypoxic-ischemic encephalopathy and the control group - practically healthy newborns. Determination of the levels of neurospecific proteins was carried out by ELISA. Results. A statistically significant increase in the level of neuron-specific enolase in blood serum was found in newborns with isoimmunization compared with practically healthy newborns and patients with neonatal jaundice. BDNF levels are statistically significantly reduced in newborns with hemolytic disease compared with neonatal jaundice and controls (p<0.05), and do not differ from patients with hypoxic-ischemic encephalopathy (p>0.05). Also, there was a statistically significant increase in the level of S100B protein in the blood serum in patients with isoimmunization according to the AB0 and Rh systems compared with patients of other groups (p<0.05). Conclusion. The data obtained may indicate that patients with ABO and Rhesus isoimmunization have brain damage. The study of neurospecific proteins provides additional opportunities for diagnosing brain damage in patients with isoimmunization, as well as for predicting early and long-term development of children.
Keywords: isoimmunization; newborn; brain damage; neuron-specific enolase; brain-derived neurotrophic factor; S100B protein; neurospecific biomarkers
RATING OF REHABILITATION MEASURES USING THE "SMALL GROUP" METHOD IN CHILDREN BORN WITH EXTREMELY LOW BODY WEIGHT BY THE AGE OF THREE YEARS
Sherbakovva V.P., Mozzhukhina L.I., Ermolina E.A., Ivanova I.V.
Abstract: Objective. To assess the level of psychomotor development of children born with extremely low body weight who underwent rehabilitation in the outpatient department of the perinatal center by the age of three years. Methods. This is a retrospective cohort study that included 120 children born with extremely low birth weight in the Yaroslavl region from 2012 to 2018 and observed up to the age of three in the outpatient department for young children of the Regional Perinatal Center. The children were divided into two groups. The first group included patients (n=87) who underwent rehabilitation in an outpatient department and a day hospital according to individual programs; the second group included children (n=33) who received rehabilitation activities in an outpatient department and a day hospital according to individual programs, and at the 2nd and 3rd years of life, in addition to individual rehabilitation programs, they also participated in classes according to the "small group" method. Results. By the age of one year, a large number of children born with extremely low body weight had a delay in psychomotor development, determined by the CAT/CLAMS scale, for their corrected age. They tend to "catch up with their peers" by the age of three, with the exception of speech development. By the age of three, in the compared groups, the increase in the development coefficient on the CLAMS scale (language/speech) was higher in the second group of children who continued rehabilitation in the second and third years of life “in small groups”. Conclusion. Children born with extremely low body weight require longer rehabilitation measures. Rehabilitation according to the methodology of classes "in small groups" shows the best result in speech development.
Keywords: children; premature; extremely low body weight; psychomotor development
REPRODUCTIVE POTENTIAL OF GENERATION Z - IS THERE ANY HOPE?
Pokusaeva V.N., Avchinnikova D.A., Fridman T.Yu., Pleshkov V.V.
Abstract: Objective. To study the reproductive plan of medical students, as a well-informed cohort of the population, having not only a general, but also a professional presentation on reproductive health, reproductive realization, family planning. Methods. Questionnaire of 225 1st year students (158-70.22% of girls and 67-29.78% of boys). The questionnaire contained questions regarding gender, age, the number of children in the parent family, the number of planned children in their own family, the planned birth age of the first child, the main life values at the moment, the main reason for the unwillingness to give birth to the first child under 25 years old. Results. Medical students overwhelmingly plan to become parents in the future and have at least one child. Gender differences in reproductive plans are insignificant, but the available ones indicate less childbearing of medical girls. The model "child-free" was chosen by 12% of respondents. Most of the students were born into small families, which determines the planned number of births. Medical students are focused on the acceptable (25-30 years), but not the optimal age of the first childbirth. Family and children as values are inferior in most cases to pragmatic orientations of career and material wealth, which correlates with the plans for the birth of children: only 17.8% are family-oriented, and they also want to have 2 or more children in the future. Conclusion. Measures aimed at increasing the birth rate should be developed for the long term, taking into account their positive impact on the formation of value orientations and reproductive plans of subsequent generations. Teachers of the university, directly in contact with medical students in the optimal age "window of reproductive opportunities," should take into account the information received to build a trajectory of educational measures aimed at implementing the concept of demographic development of the country.
Keywords: generation Z; reproductive plans; life values
ONE-STAGE MULTI-GRAFT ORAL URETHROPLASTY FOR PANURETRAL STRICTURES OF THE SPONGIOUS URETHRA
Rizoev Kh.Kh., Khojamuradov G.M., Ziyozoda S.S., Tolibov A.Kh.I., Aliev B.S.I., Rabiev K.R.I.
Abstract: Objective. Evaluation of the effectiveness of one-stage multi-graft oral urethroplasty for panurethral urethral strictures. Methods. The data of the examination and treatment of 48 men with extended and panurethral strictures, who underwent one-stage multigraft augmentation urethroplasty using the oral mucosa from 2010 to 2021, are presented. The age of the patients ranged from 22 to 72 years (median 42 years). Results. The length of the stricture ranged from 8 to 21 cm (median 14 cm). Stricture in 27 (61.1%) cases of observation was localized in the penile part with meatostenosis, in 9 (38.9%) - simultaneously in the penile and bulbous parts of the urethra. During pericatheter urethrography on the 28th day, 41 (85.42%) patients had complete consolidation of the urethra, only 7 (45.58%) had extravasation of the contrast agent in the periurethral space. Of the long-term complications, stricture recurrence was noted in 14% of patients. In 7 patients, there was a narrowing of the external opening of the urethra, "annular" narrowing of the urethra at the entrance and exit of the superimposed graft in 5 (distal in 2 and proximal in 3 cases) and total narrowing of the entire area of the graft in 3 (6.25%) cases. In 4 cases, dilatation of the urethra was performed, in 3 cases, meatotomy, in 5 cases, internal optical urethrotomy was performed, in 3 cases, repeated plastic surgery of the urethra with oral grafts. Conclusion. The technique of one-stage urethroplasty using two and three grafts of the buccal mucosa allows to achieve good rates of efficacy and safety in the treatment of panurethral urethral stricture for a long time.
Keywords: urethroplasty; multigraft oral urethroplasty; multigraft augmentation urethroplasty; panurethral urethral stricture; urethrotomy; transplant; grafts
ANALYSIS OF SCIENTIFIC RECOMMENDATIONS ON DRUG THERAPY OF SLEEP DISORDERS
Soltangishieva A.A., Bat N.M., Nikiforova E.B.
Abstract: Objective. To establish the main recommendations for drug therapy of sleep disorders according to the analysis of modern scientific literature sources. Methods. Scientific data published on electronic resources eLibrary, PubMed were used for information and analytical search. The search was carried out by keywords: sleep, sleep disorders, insomnia, insomnia, therapy of sleep disorders. The work was carried out by content analysis of modern scientific works of sleep disorder therapy. Results. Sleep disorders act as a cause and as a consequence of many diseases and physiological conditions. The therapy of these disorders is divided into non-medicinal and medicinal. Priority is given to non-drug therapy, but more often the choice is made in favor of drug therapy, it includes a wide arsenal of modern drugs: benzodiazepines, non-benzodiazepine agonists of benzodiazepine receptors (Z-hypnotics), histamine H1 receptor antagonists, melatonin-containing drugs, sedatives of plant origin, rum preparations, barbiturates, Fabomotizol, under certain conditions conditions may be prescribed antidepressants with sedative effect, neuroleptics, dopaminergic drugs, anticonvulsants, Aminophenylbutyric acid and some trace elements. The article also discusses the features of the treatment of sleep disorders in elderly patients and children. Conclusions. Analysis of the results of scientific research on the treatment of sleep disorders has shown that sleep is one of the fundamental processes that support the quality of human life, while dissatisfaction with sleep occurs in more than 45% of the population. It is noted that sleep disorders according to ICD-10 are classified into many types, and their occurrence is associated with a number of factors that cause problems in the field of drug therapy, according to which the decision on recommendations and treatment tactics should be made by a doctor taking into account the physiological characteristics of the patient in each case (age, gender, presence of concomitant diseases, pregnancy status, individual susceptibility, etc.).
Keywords: sleep; sleep disorders; insomnia; sleeplessness; drug therapy
THEORETICAL ASPECTS AND PRACTICAL SIGNIFICANCE OF THE USE OF MEANS OF PHYSICAL REHABILITATION IN A NEW CORONAVIRUS INFECTION
Sokolov D.S., Fedorova N.I., Fedoskina E.M., Aloina O.S.
Abstract: Objective. To determine the effectiveness of the method of physical rehabilitation developed by us for a new coronavirus infection at the recovery stage of treatment. Methodology. A method of physical rehabilitation was developed and put into practice; the effectiveness of the technique was determined by functional tests - a simplified sound test with the utterance of numbers on exhalation (tolerance to hypoxia) and an assessment on the Borg scale (tolerance to physical exertion), the reliability of the changes was evaluated by methods of mathematical statistics (Student's t-criterion). Results. The developed technique (dynamic physical exercises in combination with breathing exercises, clear recommendations on the rate of expansion of physical activity) proved to be effective for the rehabilitation of patients with a new coronavirus infection caused by Sars-CoV-2, as patients from the experimental group who were engaged in it demonstrated faster rates and higher quality indicators of improvement in all the studied tests (simplified sound test: on day 14; Borg scale: on day 14), in contrast to patients from the control group who used a standard technique, as a result of which the improvement in the condition of the studied parameters was noted later, and the qualitative changes were significantly inferior to the changes in the experimental group (simplified sound test: on day 21; scale Borg: on day 21), significant differences between the control and experimental groups were noted on day 21 for the simplified sound test and the Borg scale. Conclusion. The developed method of physical rehabilitation has proven its effectiveness and safety for the rehabilitation of patients with a new coronavirus infection, as patients from the experimental group who were engaged in it showed significant improvement in all the studied indicators.
Keywords: new coronavirus infection caused by SARS-CoV-2; Covid-19; physical rehabilitation; respiratory gymnastics
3D-MODELING AND PROTOTYPING IN THE SURGICAL TREATMENT OF COMPLEX FRACTURES OF THE ELBOW JOINT REGION
Lashkovskij V.V., Ivancov V.A., Vasilevich A.E.
Abstract: Objective. To demonstrate the value of 3D-modeling and prototyping for preoperative planning and subsequent surgical treatment of complex fractures of the elbow joint region using a clinical example. Methodology. The authors describe a clinical case of treatment of a patient with fracture 13-C3 of the elbow joint area with the use of 3D-modeling and prototyping in the preoperative period and the subsequent stable-functional osteosynthesis. Results. Patient G., 32 years old with pseudarthrosis of external condyle and capitulum humeri of the left humerus, malunion of the block fracture, extensor contracture of the elbow joint; comprehensive diagnostics was carried out, a 3D-model of the elbow joint was made. On the basis of the modeling we planned and performed a successful surgical intervention with subsequent restoration of the elbow joint function. Conclusion. Use of 3D-modeling and prototyping in the preoperative planning of the operative treatment of the complex fractures of the elbow joint region enables comprehensive visualization of the area of surgical interest, detailed planning and carrying out of the surgical treatment with the positive clinical result.
Keywords: 3D-modeling and prototyping; complex fractures of the elbow joint; surgical treatment
COMPONENTS OF DEFORMATION OF THE BONES FORMING THE KNEE JOINT AND THEIR ELIMINATION
Skvortsov A.P., Khabibyanov R.Ya., Maleev M.V., Gilmutdinov M.R.
Abstract: Objective. Determination of indications for surgical elimination of torsion deformity in patients with deformities of the bones that form the knee joint and development of a medical and technical solution for its elimination. Metods. In the period from 2010 to 2021, 29 adolescent patients with deformities of the bones forming the knee joint of various etiologies that occurred before the age of 13 were treated at the State Medical Institution "RCB" of the Ministry of Health of the Republic of Tatarstan. Of these, in 19 patients, frontal deformity exceeded 300 and was combined with the development of torsion pathology. It should be noted that in 12 of them, the cause of damage to the epimetaphyseal germ plate was acute hematogenous osteomyelitis, which they suffered in early infancy. In 6 of the observed patients, osteoepiphysiolysis of the distal femur was the cause of post-traumatic deformities. 18 patients out of 28 were operated using the Ilizarov CCOS method using the developed original prefixes to the device [8]. In 10 patients, deformation correction was performed according to the classical Ilizarov technique with a Ring-in-a-ring derotation system. Results. Deformations due to the metaepiphyses of the bones that form the knee joint are multiplanar and combined, and not eliminating one of its components leads to a recurrence of the disease. Surgical treatment of deformity of the bones forming the knee joint, accompanied by a torsion component using the hybrid Ilizarov apparatus, involves performing a corrective corticotomy in the metaphyseal region of the segments of interest with the formation of a distraction regenerate. In the process of correcting angular deformities, torsion deformity is eliminated, the neglect of which leads to the development of relapse. Conclusion. In case of deformation of the bones that form the knee joint, it is necessary to take into account all its components, one of which is torsion pathology. It is convenient to eliminate pathological torsion in parallel due to the proposed developed detorsion unit. The torsion component of the deformity is most pronounced in patients with a frontal deformity at the level of the knee joint of more than 25-300. This amount of frontal deformity is a risk factor for the presence of pathological torsion.
Keywords: deformities of the bones of the knee joint; surgical treatment
COVID-19-ASSOCIATED CHANGES IN THE STOMACH AND INTESTINE: ULTRASONOGRAPHIC AND MORPHOLOGICAL PARALLELS
Yurkovskiy A.M., Boyko M.A., Nazarenko I.V., Stoma I.O., Achinovich S.L.
Abstract: Objective. To study the possibility of using ultrasonography to diagnose COVID-19-associated changes in the stomach and intestines by comparing ultrasonographic and morphological data. Methodology. A comparison was made of the results of morphological and ultrasonographic (in vitro) data obtained in the study of 11 subjects (average age 67.2±8.8 years) who died from various causes not related to COVID-19 (comparison group) and 11 subjects (mean age 64.6±10.1 years) who had clinical manifestations of COVID-19 and died from the specified infection (experimental group). Results. Ultrasonography in subjects who died from COVID-19 in the thickness of the mucous membrane and submucosa of the stomach and intestines revealed areas of reduced echogenicity with fuzzy and uneven contours, the pathomorphological substrate of which was lymphoid infiltrates, consisting of accumulations of T-lymphocytes, B-lymphocytes, NK -lymphocytes, macrophages and labrocytes. In the comparison group, the above-described areas of reduced echogenicity and associated histological and immunohistochemical changes in the wall of the stomach and intestines were not detected in any case. Conclusion. With COVID-19, changes in the thickness of the mucous membrane and submucosa of the stomach and intestines will be detected in all departments, however, the most pronounced and accessible for ultrasonography changes will be detected in the sigmoid and rectum. An ultrasonographic sign of gastric and intestinal damage in COVID-19 will be hypoechoic areas (locally found or widespread) in the thickness of the mucosa and submucosa. The obtained results allow us to recommend these criteria for testing in clinical practice.
Keywords: COVID-19; ultrasonography of the stomach and intestines
REVIEWS
PNEUMOCOCCAL INFECTION IN CHILDREN: WAYS TO SOLVE THE GLOBAL PROBLEM
Muravyev A.A., Bekezin V.V., Kozlova L.V.
Abstract: Objective. To analyze the results of scientific investigations, systematic reviews and meta-analysis in epidemiology, modern ways of treatment and specific prophylaxis of pneumococcal infection in children. Methods. Collection and estimation the main results of scientific investigations in pneumococcal infection in children using databases PubMed (https://pubmed.ncbi.nlm.nih.gov), Medscape (https://www.medscape.com/), search depth - 2014-2023 years. Results. S. pneumoniae is the most frequent bacterial agent in children, due to complex structure of the bacterial cell there are more 100 serotypes. Pneumococcal infection (PI) can be manifested in different nosology - healthy carriage, non-invasive and invasive forms. S. pneumoniae acquire antimicrobial resistance to different agents, which are used in routine practice, and AMR can complicate the treatment, extent the time of sick leave, increase the frequency of hospitalization, increase the frequency of mortality. Pneumococcal vaccination is acquiring more importance. But in a case of long-term and wide usage of pneumococcal vaccine the risk of vaccine serotypes replacement is elevated, which can lead to growing the incidence of PI in children. In this article we describe the main nosological entities of PI and mechanisms to prevent it in population of children. Conclusion. Pneumococcal infection is a vaccine-preventable disease, but because of replacement of serotypes and AMR, it is necessary to organize the interdisciplinary work in epidemiological monitoring of S. pneumoniae serotypes, AMR control, provide a wide coverage of vaccination and organize a new pneumococcal vaccines development and its implementation.
Keywords: children; pneumococcal infection; S. pneumoniae serotypes; antimicrobial therapy; antimicrobial resistance; pneumococcal vaccines
USING MICRONUCLEUS TEST FOR ASSESSING OCCUPATIONAL EXPOSURE: THE LEVEL OF EVIDENCE
Meshkov N.A., Valtseva E.A.
Abstract: Objective. The purpose was to study and perform a systematic analysis of methodological aspects affecting the quality, objectivity and level of evidence of studies devoted to occupational exposure to genotoxic factors using the micronucleus test. Methods. In search of relevant academic publications, we used PubMed/MEDLINE and eLIBRARY data for 1973-2022. Statistical processing was performed using Microsoft Excel 2016. We looked for correlations between variables using the correlation and regression analysis and chose Student’s t-test for assessing the significance of difference. Also, we assessed the genotoxic outcomes by the Genotoxicity Factor (GF). Results. In most of the publications we looked at the sample for calculating micronuclei (MN) included 2,000 buccal cells. Before the start of the HUMNxL international project, such publications totaled 50.0%, while after completion they amounted to 57.1% despite the recommendation to use 4,000 buccal cells. We found that by increasing the number of sample cells we can improve the accuracy (level of evidence) of the micronucleus test: this results in lower average frequency of MN (р = 0.0553) and average error (р = 0.0435). Study of confounding factors (age, gender and smoking habits) showed that the average frequency of MN was lower in older patients (R² = 0.987; р = 0.074). We also found that the number of MN was 2.5 times higher in men than in women (р = 0.079), and the frequency of MN was 12.6% higher in smokers than in non-smokers. The heterogeneity of genotoxic outcomes was high: the maximum GF was 16.8 times higher than the minimum one. GF was found to be lower for higher number of cells taken for calculating MN (R² = 0.991; р = 0.0046). Conclusion. The quality of publications included in the review remained unchanged despite the recommendations of the HUMNxL international project. Ignoring the recommendations results in high variability in the frequency of MN, which makes data from different studies incomparable. Influence of the confounding factors has not been given enough academic attention.
Keywords: micronucleus test; occupational exposure; genotoxic agents; confounding factors
PHARMACEUTICAL SCIENCES
ORIGINAL ARTICLES
SIMULATION OF THE MOLECULAR DYNAMICS OF THE RELEASE PROCESS OF AMINOPHENYLBUYARIC ACID FROM SODIUM ALGINATE
Polkovnikova Yu.A., Glushko A.A., Slivkin A.I.
Abstract: Objective . Molecular dynamics modeling of the release of aminophenylbutyric acid from sodium alginate into solvents: water, 0.01 M aqueous solution of hydrochloric acid. Methods. To simulate the release of aminophenylbutyric acid from polymeric carriers, the molecular dynamics method in the GROMOS 54a7 force field was used using the Gromacs 2019 program. Molecular models of the components of the simulated systems were built using the Hyper Chem 8.0.1 program and also obtained from the rcsb.org database. Based on the results of molecular dynamics modeling, the energies of the van der Waals interaction of aminophenylbutyric acid with collagen and with solvents were calculated in terms of 1 molecule of the substance. Results. Based on the results of the computational experiments, we calculated the average van der Waals energies of aminophenylbutyric acid binding with sodium alginate (alginic acid) and the solvent, as well as the average fraction of aminophenylbutyric acid molecules not bound to the carrier. It has been established that the average proportion of aminophenylbutyric acid molecules not associated with sodium alginate (alginic acid) is 1,97±2,52%, 13,90±3,39% at pH = 6,8 and 2,0, respectively. Conclusion. The data obtained during the computational experiment show that aminophenylbutyric acid is most effectively released into water at pH 2,0. In an aqueous medium at pH 6,8, a significant part of the aminophenylbutyric acid molecules remains associated with alginate, while the sodium alginate molecule acquires an unfolded conformation, which suggests the possibility of the formation of a colloidal system containing molecules of aminophenylbutyric acid associated with the polymer.
Keywords: aminophenylbutyric acid; microcapsules; alginic acid; sodium alginate; molecular dynamics
BIOPHARMACEUTICAL RESEARCH IN THE DEVELOPMENT OF THE COMPOSITION OF A TRANSDERMAL GEL WITH CHOLINE ALFOSCERATE
Tyunina E.D., Losenkova S.O.
Abstract: Objective. Compositions of a transdermal gel of two formulations with choline alfoscerate based on Ultrez 10 carbomer have been constructed according to the technological scheme for the production of gels, a method of biopharmaceutical method for studying transdermal gels with choline alfoscerate has been developed, biopharmaceutical studies of 4% of gel formulations have been carried out by in vitro dialysis. Methods. In order to develop the composition of a transdermal gel with the neuroprotector choline alfoscerate, the authors developed a method of biopharmaceutical dialysis in vitro of constructed gel compositions (dialysis medium - isotonic sodium chloride solution, temperature - 37±0.5°C, with convection of the dialysis medium and its return). Gel compositions were made in the laboratory of the drug manufacturer Ozon LLC (Zhigulevsk) according to the technological scheme for the production of gels developed by the authors. To determine the quantitative content of choline alfoscerate in dialysate samples, a validated method of high-performance liquid chromatography (HPLC) was used. Dialysate sampling was carried out within 48 hours of the experiment. The amount of drugs released and the degree of its release were determined. The results were subjected to statistical processing using Microsoft Excel. Results. Literature and own experimental data on the compatibility of ingredients were analyzed, compositions of 4% gel compositions with choline alfoscerate were constructed in order to create a transdermal dosage form (LF). According to the results of a biopharmaceutical study by in vitro dialysis, the maximum degree of release of choline alfoscerate was observed from 4% of gel composition No. 1 after 48 hours of the experiment (23.68%). Of the 4% gel composition No. 2, the degree of release was maximum after 6 hours of the experiment (15.64%). A single (1 time per day) application of a gel with choline alfoscerate of composition No 1 weighing 1.0 grams on a dialysis film provided a 20.75% release of choline alfoscerate after 24 hours of the experiment. Kinetic curves of drug release are constructed, which clearly simulate the nature of drug release from transdermal gels of two compositions. Conclusion. Gel base Carbomer Ultrez 10 provides a uniform and prolonged prolonged release of choline alfoscerate during 48 hours of the experiment (observation period) from composition N1 (composition N1: gelling agent carbomer Ultrez 10, 1M sodium hydroxide solution, nipagin, purified water).
Keywords: transdermal gel; choline alfoscerate; high-performance liquid chromatography method; dialysis method
DOSAGE FORM "ELIXIRS": THE CURRENT STATE OF THE PHARMACEUTICAL MARKET
Bolgov A.S., Gudkova A.A., Erigova O.A., Trofimova T.G., Karlov P.M., Lychagin A.P.
Abstract: Objective. The purpose of the study is to analyze the range of medicines and dietary supplements represented by the dosage form of elixirs. Methods. The information base of the State Register of Medicinal Products, the Internet resource "AnalitPharmacy", pharmacological reference books, data from the State Register of dietary supplements of the EAEU were used in the work. The data obtained is current as of December 01, 2022 Results. The predominance of herbal preparations with a combined complex composition, with a significant proportion of flavonoids, as the main group of active substances, and a general strengthening orientation of the pharmacological action were established. It was revealed that in the pharmacy organizations of Voronezh there are mainly elixirs registered as medicines. BAA in the form of an elixir is represented on the regional market by only one name (Kedrovit). More than half of the elixirs sold in pharmacy organizations in Voronezh have a general tonic effect and account for 57%, which is typical for the all-Russian trend. Conclusion. As a result of the market research, the insufficient development of the regulatory framework in the field of quality control of drugs in the form of elixirs was revealed, the tendency of manufacturers to register formulations not as drugs, but in the form of dietary supplements due to the simplicity of the procedure and the lack of the need to develop a private pharmacopoeial article, which is also difficult gaps in normative documentation.
Keywords: elixirs; medicines; dosage form; biologically active additives
PHARMACOLOGICAL STUDIES OF THE DEVELOPED CORRECTED COMPLEX SOLUTION CONTAINING AN EXTRACT OF DOG ROSE HIPS AND WHITE MULBERRY
Akhmedov F.A.
Abstract: Objective. Compare the effectiveness of the drugs "Holaron" and "Holasas". Methods. Experiments to study the mechanism of choleretic action were carried out on guinea pigs. The use of rats was not possible due to the fact that they lack a gallbladder. The bile duct in guinea pigs was fistulated according to the method of Fischer and Vars (1961). In experimental and control animals, bile was collected during the 1st, 2nd, and 3rd hours of surgery after cannulation of the bile duct. Laboratory animals were divided into 5 experimental groups, 6 animals in each. 14 days before the operation, solutions were administered to guinea pigs using an intragastric probe. The manifestation of the choleretic effect was judged by the volume of secreted bile collected 1, 2, 3 hours after the bile duct was conciliated. In the experiments, animals of different weights 320-350 g were used, so the calculation of the volume of secreted bile was made in ml per 100 g of mass. Results. Pharmacological studies of the developed corrected complex solution containing the extract of dog rose hips and white mulberry "Holaron" (the ratio of liquid extract of dog rose hips and thick extract of white mulberry fruits is 15:85). Conclusion. "Holaron" significantly exceeds the control group by 27.51% and is more active than the comparison drug "Holosas" by 22.3%.
Keywords: mulberry; rosehip; liquid; thick extract; guinea pigs
IDENTIFICATION CHARACTERISTICS OF ALCHEMILLA MOLLIS (BUSER) ROTHM. HERB
Boyarshinov V.D., Zorina E.V., Anisimova A.G.
Abstract: Objective. To conduct a macro- and microscopic study of Alchemilla mollis herb and to identify characteristic signs that have diagnostic significance in the identification of raw materials. Methods. The objects of the study were samples of Alchemilla mollis herb cultivated in the Perm Krai. Harvesting of raw materials was carried out in 2020-2021 in the phase of mass flowering. The study of morphological and anatomical features was carried out by pharmacopoeia methods. Results. Morphological signs are of diagnostic importance, including the nature of the pubescence of the leaf blade and the flower, as well as the shape of the hypanthium, the size of the calyx and the pod of the flower. In the anatomy of the flower, the identification characteristics are the nature of pubescence and venation, the presence of druzes, in the anatomy of the leaf - the shape of cells and the nature of pubescence of the upper and lower epidermis, the size and location of stomata, calcium oxalate inclusions, in the anatomy of the petiole - the shape and number of conductive bundles, in the anatomy of the stem - the nature of the conductive system and pubescence. The combined diagnostic signs are the taste of water extraction and the presence of a chemotaxonomic feature of the species - the content of tannins. Conclusion. For the identification of raw materials, the expediency of using a set of morphological and anatomical features of vegetative, generative organs of the air parts Alchemilla mollis and qualitative characteristics of the chemical composition has been determined.
Keywords: morphology and anatomy; Alchemilla mollis; structure of the vascular tissue system
DEVELOPMENT OF TECHNOLOGY FOR TINCTURE OF THE HERB TRIPARTITE (Bidens tripartita L.)
Kochukova A.A., Shmygareva A.A., Knyazeva A.V.
Abstract: Objective. The purpose of the study is to develop methods for the technology of tincture of a series of tripartite and quantitative determinations of flavonoids in the resulting dosage form. Methods. Ethyl alcohol was used as the extractant. During the experiment, several methods for obtaining a tincture were compared: maceration in combination with percolation, vacuum extraction and ultrasonic extraction. The ratio of raw materials and extractant is standard according to OFS Tinctures - 1:5. Quantitative determination of the amount of flavonoids in the tincture in terms of rutin was calculated from electron UV spectra obtained using a UNICO 2800 ultraviolet spectrophotometer. Results. The optimal conditions for obtaining a tincture of the herb of a series of tripartite were determined: ultrasonic extraction with ethyl alcohol 70%, extraction time - 15 minutes in an ultrasonic water bath at 40°C. Conclusion. The most suitable technological method for obtaining a string tincture is ultrasonic extraction.
Keywords: Bidens tripartita L.; tincture; ultrasound extraction; flavonoids; spectrophotometry
IDENTIFICATION AND QUANTITATION OF FLAVONOIDS IN CHLORELLA BIOMASS (CHLORELLA VULGARIS IPPAS С-2019)
Mitishev A.V., Kurdyukov E.E., Semenova E.F., Fednina A.S., Evtushenko A.I.
Abstract: Objective. To develop methods for quantifying the amount of flavonoids in the biomass of Chlorella vulgaris IPPAS C-2019. To conduct research on the selection of optimal parameters for the extraction of chlorella biomass From 2019 in order to obtain extracts with a high content of BAС. Methods. The object of the study was the biomass of the strain Chlorella vulgaris Beyerinck IGF C-2019. To obtain extracts, 95% ethyl alcohol, hexane, acetone, heptane, petroleum ether were used. To prove the presence of flavonoids, qualitative reactions were carried out: cyanidin test (Shinoda test), reaction with sodium hydroxide, reaction with aluminum chloride. The quantitative content of the sum of flavonoids was carried out by the spectrophotometric method on the SF-201 Spectrophotometer. Results. Qualitative reactions have shown that all chlorella extracts of the C-2019 strain contain flavonoids. It was found that in the presence of aluminum chloride, a bathochromic shift of the electronic absorption spectrum of chlorella extracts was observed with an absorption maximum similar to the solution of CO rutin (413 nm). Therefore, when quantifying the amount of flavonoids in extracts from chlorella biomass, we selected rutin as a standard sample. The most complete extraction of flavonoids was observed when using 95% ethyl alcohol and petroleum ether as an extractant. Then the time parameters of extraction were determined, it was found that the maximum extraction of flavonoids from raw materials takes place within 60 minutes. In the course of statistical processing of data from five parallel measurements, it was revealed that the content of the sum of flavonoids, in terms of rutin, is 1.55-1.6%. Conclusions. The presence of flavonoids in the biomass of chlorella (Chlorella vulgaris IPPAS C-2019) has been proven using qualitative reactions. It was revealed that the content of flavonoids in chlorella raw materials, when using various extractants, varies in the range from 0.1 to 1.62%. Optimal conditions (extractant - ethyl alcohol 95%, ratio "raw material - extractant" - 1:50; extraction time - 60 minutes) were established for maximum extraction of flavonoids from chlorella biomass. A technique has been developed for the quantitative determination of the amount of flavonoids in terms of rutin.
Keywords: microalgae; Chlorella vulgaris; chlorella biomass; spectrophotometry; flavonoids
SYSTEMATIZATION OF THE NOMENCLATURE OF MEDICAL DEVICES FOR THE CARE OF GERIATRIC PATIENTS IN HOME CONDITIONS
Grigoreva I.A., Garifullina G.Kh., Egorova S.N.
Abstract: Objective. Conducting an assortment analysis and systematization of the range of medical devices (Medi) used to care for geriatric patients, taking into account functional activity and household adaptation. Methods. Scales and indices for assessing the condition of patients depending on their functional independence, methods of content analysis of the State Register of MedI, comparative, structural and graphical analysis, and logical modeling were used. Results. An analysis of the trade names of Copper of different models and compositions registered in the Russian Federation, used at home according to the Register, was carried out: for patients with complete dependence on others, there are 1103 registered names of Copper; for patients with moderate addiction - 1177 registered items of Medicinal products; for patients with complete independence in the performance of all functions, 894 registered items of Medicinal products are registered. A database of medical devices used by different groups of patients at home based on the criteria for the possibility of meeting the needs of outpatients in care has been formed. There are 6 groups of copper (nutrition; bathing; dressing; personal hygiene; mobility; breathing; copper used for medical manipulations). When comparing the quantitative indicators of Copper used by the three selected groups of patients, in all groups there is a numerical prevalence of the Copper groups - "mobility", "Copper used for medical manipulations" and "personal hygiene". Conclusion. The nomenclature of copper used to care for geriatric patients is systematized, taking into account their functional activity and household adaptation, which can be used by guardianship and guardianship authorities in medical and pharmaceutical practice.
Keywords: geriatric patient; home care; medical devices
REVIEWS
PROSPECTS FOR THE USE OF PORTULACA OLERACEA L. IN HERBAL MEDICINE
Mikhaylova E.V., Popov S.S., Bredikhina T.A.
Abstract: Objective. Search for opportunities to expand the range of potentially available and effective medicines through the use of promising plants with unlimited raw materials and rich chemical composition. Methods. Analysis and systematization of data from domestic and foreign studies on the chemical composition and pharmacological activity of purslane (Portulaca oleracea L.). Results. Purslane extracts obtained using various extractants contain macro- and microelements, vitamins, polysaccharides, organic acids, polyunsaturated fats, a number of phenolic compounds, alkaloids, phytosterols, etc. These extracts exhibit hypolipidemic, antidiabetic, immunomodulatory, anti-inflammatory, antimicrobial, antioxidant, nephroprotective, hepatoprotective, antispasmodic, antitumor and other activities in vitro and in vivo. Conclusion. According to the data obtained during the systematization and analysis of modern domestic and foreign studies, there is a need for further study of the promising medicinal plant Portulaca oleracea L., its qualitative and quantitative chemical composition, timing and other rules for collecting, drying, storing raw materials, features of the technology of production and manufacture of medicines based on it, conducting a number of studies to determine and to clarify the pharmacological effects and safety of drugs in order to maximize its pharmacological potential, elaboration of normative documentation regulating the quality of raw materials.
Keywords: purslane (Portulaca oleracea); chemical composition; pharmacological properties
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTHCARE
SOME ASPECTS OF THE PROBLEM OF IATROGENISM: PAST, PRESENT AND FUTURE
Dmitriev I.V., Ignatova N.B., Abrosimov S.Yu.
Abstract: Objective. Evaluate historical and modern approaches to iatrogenic pathology and outline ways to reduce it. Methods. Study and subsequent analysis of several dozen works, including regulatory documents related to the quality of medical care. Results. The presented data on the quality of medical care indicate that there are still many areas in this problem, intensive work on which can give a good effect. Probably, a scientifically developed concept will be needed to coordinate this activity. It may be advisable to include in this concept such activities as conducting scientific research on the problem of the quality of medical care; changing programs and methods of training medical personnel; improving the motivation of medical workers to high quality of their work; changing the volume and structure of healthcare financing; increasing the number of public organizations of doctors, patients; introducing open case reporting causing harm to the patient's health when providing of medical care; formation of systems of independent rating of medical institutions and doctors; introduction of insurance of professional medical activity, including the use of a system of responsibility without fault; introduction of incentive systems for medical workers and medical institutions for self-publication of their cases of harm to the patient's health when providing of medical care; creation of a specialized state institution for quality management of medical care; optimization of digitalization of healthcare, including for monitoring cases of harm to the patient's health during the provision of medical care. Conclusions. The preferential use of only administrative and criminal law methods to reduce the number of cases of harm to the patient's health when providing of medical care does not give sufficient effect. Although this does not exclude the improvement of legislation on this issue. In particular, for a more differentiated approach, it is desirable to divide all cases of harm to the patient's health during the provision of medical care into four types: accident; error of a medical worker; iatrogenism and a defect in the provision of medical care, fixing these concepts in legislation. Perhaps the development of a multilateral concept to reduce the number of violations in the provision of medical care will reduce their number. But this concept must be approved at the state level and have the necessary funding. When discussing this strategy, it is important to achieve common views of medical professionals and patients on this problem. After all, they have one goal - to preserve health.
Keywords: iatrogenism; quality of medical care; medical error; defect of medical care
MATERIALS
of the conference in celebration of the 60-th anniversary of the faculty of dentistry
of Smolensk State Medical University
DEPARTMENT OF THERAPEUTIC DENTISTRY OF SMOLENSK STATE MEDICAL UNIVERSITY: HISTORY, ACHIEVEMENTS, PROSPECTS
Tsepov L.M., Nikolaev A.I., Petrova E.V., Turgeneva L.B., Levchenkova N.S., Nesterova M.M., Orekhova N.S., Galanova T.A., Shcherbakova T.E., Bunakova N.A.
Abstract: The anniversary article dedicated to the 60th anniversary of the Faculty of Dentistry of the Smolensk State Medical University. The history of the Department of Therapeutic Dentistry is described. The main directions of educational-methodical, scientific-research and medical-consultation activities of the staff of the department are highlighted. An analysis of the current state of the material, technical and methodological support of the educational process and medical-consultation activities was carried out. The prospects for the development of the department are described.
Keywords: Department of Therapeutic Dentistry; history; educational and methodological activities; research activities; medical and advisory activities
LEONID MAKAROVICH TSEPOV: 55 YEARS OF WORK AT THE SMOLENSK STATE MEDICAL UNIVERSITY (HISTORICAL ESSAY)
Nikolaev A.I., Levchenkova N.S., Nesterova M.M., Petrova E.V.
Abstract: Anniversary article dedicated to the 60th anniversary of the Faculty of Dentistry of the Smolensk State Medical University. The biography, educational-methodical, scientific-research and medical-advisory activities of professor Leonid Makarovich Tsepov is described. The analysis of his contribution to the development of the Department of Therapeutic Dentistry, scientific activities and achievements in periodontology, role in the leaning of highly qualified dentists was carried out. The awards and honorary titles received by L.M. Tsepov are listed.
Keywords: Department of Therapeutic Dentistry; history; Tsepov L.M.; educational and methodological activities; research activities; medical and advisory activities
TO THE ANNIVERSARY OF STOMATOLOGICAL FACULTY: THE HISTORY OF THE ORAL AND MAXILLOFACIAL SURGERY DEPARTMENT, THE CONNECTION OF TIMES AND GENERATIONS
Andryushenkova N.A., Kostyuchenkova Y.A., Andryushenkova M.Y.
Abstract: В The article is devoted to the history of the oral and maxillofacial surgery department of Smolensk State Medical University. This article is about the employees and coworkers of the department who have made a huge contribution to the development and formation of this structural unit, about the colleagues currently working at the department, about the connection of times and generations of teachers of the medical university.
Keywords: oral and maxillofacial surgery department; university teacher; coworkers; higher education
DEPARTMENT OF PEDIATRIC DENTISTRY WITH ORTHODONTICS COURSE (FOR THE 60TH ANNIVERSARY OF THE FACULTY OF DENTISTRY)
Ginali N.V., Kuzminskaya O.Yu.
Abstract: The article is devoted to the 60th anniversary of the Faculty of Dentistry of the Smolensk State Medical University. The history of creation of the Department of Pediatric Dentistry with Orthodontics course is described. The main activities of the department staff are highlighted: educational and methodological and research ones. Analysis of the current state of the material, technical and methodological support of the educational process is carried out. The prospects for the development of the department are described.
Keywords: Smolensk State Medical University; Department of Pediatric Dentistry with Orthodontics course; history; Faculty of Dentistry; educational and methodological activities; research activities
IN MEMORY OF PROFESSOR NIKOLAI GAVRILOVICH ABOLMASOV
Adaeva I.A., Kovaleva I.A., Chebotarenko O.Yu.
Abstract: This Article is devoted to lifejouney, scientific and teaching path of RAEN Academician, professor of Smolensk State Medical University prothetic and orthodontic dentistry, Honored Doctor of Russia, M.D. Abolmasov Nikolai Gavrilovich. He was one of the founders of Smolensk school of prothetic dentistry, whose 56 years of life were associated with training of doctors Dentists at the Smolensk Medical Institute (later Academy, now the University). Supervision of Nikolai Gavrilovich resulted in 7 candidate dissertations were protected, patents for inventions were obtained, more than 300 scientific works of various levels were published, including 2 monographs, 11 editions of the textbook “Orthopedic Dentistry”, 2 textbooks “Propaedeutics of Dental Diseases” and “Orthodontniya” ". His life and scientific path can serve as an example for students and young dentists.
Keywords: Smolensk State Medical University; history of dentistry; prothetic dentistry; dentistry study; professor N.G. Abolmasov
DEPARTMENT OF PROPAEDEUTIC DENTISTRY (FOR THE 60TH ANNIVERSARY OF THE FACULTY OF DENTISTRY)
Morozov V.G., Kovaleva O.V., Geletin P.N., Lozbenev S.N., Massarskii I.G., Verhovskii A.E., Semenova Y.A., Kovalchuk Y.O., Loputneva P.V.
Abstract: The article is devoted to the 60th anniversary of the Faculty of Dentistry of the Smolensk State Medical University. The history of creation of the "youngest" department of the faculty - the Department of Propaedeutic Dentistry is described. The main activities of the department staff are highlighted: educational and methodological and research ones. Analysis of the current state of the material, technical and methodological support of the educational process is carried out. The prospects for the development of the department are described.
Keywords: Smolensk State Medical University; Department of Propaedeutic Dentistry; history; Faculty of Dentistry; educational and methodological activities; research activities
HISTORY AND FUTURE OF ADDITIONAL PROFESSIONAL EDUCATION OF MEDICAL WORKERS
Shashmurina V.R., Mishutina O.L., Vasiltsova O.A.
Abstract: Smolensk State Medical University implements programs of additional professional education (DPO) for medical workers based on the principles of modular training, the introduction of internships, distance and simulation educational technologies.
Keywords: additional professional education; continuing medical education
ANALYSIS OF THE CAUSES OF REMOVAL AND THE TIMING OF THE FUNCTIONING OF TEETH COVERED WITH ARTIFICIAL CROWNS
Khudaleeva K.A., Abolmasov N.N., Massarsky I.G.
Abstract: Objective. Study of the terms of functioning and the reasons for the removal of teeth covered with artificial crowns. Methods. In total, the reasons for the removal of 320 teeth and roots covered with artificial crowns were analyzed in 185 patients. Results. As a result of carious destruction of the hard tissues of the teeth, 76 teeth were removed, 74 of them endodontically treated, 89 teeth as a result of apical periodontitis, 76 of them endodontically treated, 155 teeth had periodontal diseases, 77 of them were without traces of endodontic interventions. The terms of functioning of the teeth covered with crowns were: up to 1 year - 1 tooth (0.3%), from 1 year to 5 years - 24 teeth (7.5%), from 5 to 10 years - 183 (57,2%), 10 - 15 years -72 teeth (22.5%), more than 15 years - 40 teeth (12.5%). Conclusion. The average lifespan of teeth covered with artificial crowns from the moment of prosthetics to extraction is 5-10 years, while a longer lifespan (more than 15 years) was found in teeth without traces of endodontic interventions.
Keywords: tooth hard tissue; life span of fixed dentures; artificial crowns; reasons for tooth extraction
IATROGENIC DELICT TO BRING OCCLUSAL AND ARTICULATORY HARMONY OF TEETH IN A DENTAL PRACTICE
Verhovskij A.E., Morozov V.G., Loputneva P.V.
Abstract: Objective. Clinical and legal qualification of the problem of iatrogenic complications of the stage to bring occlusal and articulatory harmony in a dental practice. Methods. The review was carried out in the PubMed, Scopus, eLibrary databases by searching for literary sources on this topic. Of the selected publications, the most significant publications of recent years were used for analysis. Results. The article reveals the nature of the iatrogenic factors of traumatic occlusion, analyses predisposing features and the nature of the complication, and outlines promising ways to overcome the problem. Conclusions. The variety of modern dental materials and technologies increases the risk of iatrogenic complications in the form of occlusal and articulation disorders. It is possible to qualify iatrogeny as a medical injurious act in individual cases where the guilt and wrongfulness of the doctor's conduct are proven. In order to avoid possible unfavourable clinical and legal consequences of treatment and to ensure legal protection of the medical community, it is advisable to broaden the indications for the use of modern methods of computer-assisted occlusal monitoring at all stages of dental treatment, including follow-up monitoring.
Keywords: iatrogenic diseases; occlusal harmony; medical error; traumatic occlusion
PROBLEMS OF PREOPERATIVE DIAGNOSIS OF ADENOLYMPHOMA OF PAROTID SALIVARY GLAND
Kuz'mina E.V., Sotnikova M.V., Nakonechnyi D.A.
Abstract: Objective. To improve the results of diagnosis of parotid salivary gland adenolymphoma. Materials and methods. We conducted a retrospective analysis of 20 case histories of patients diagnosed with parotid salivary gland adenolymphoma who were treated in the department of maxillofacial surgery of the Smolensk Regional Clinical Hospital. Based on the results of the pathohistological examination of the postoperative material an analysis of the accuracy of clinical diagnosis, ultrasound and cytological examination was carried out. Results. Adenolymphomas are more common in elderly men and are localized in the parotid salivary gland. Due to its diverse histological structure, there can be a different clinical, ultrasound and cytological picture, therefore, the effectiveness of preoperative diagnosis is low. Conclusions. The informative value of ultrasound and cytological examination in adenolymphomas was 57% and 44%. It depends on the variant of the tumor structure and the qualifications of specialists. The complexity of the diagnosis of adenolymphoma requires the introduction of new methods of its preoperative verification to determine the correct treatment tactics. In case of doubtful results of cytological and ultrasound examination, a biopsy is recommended to determine the histological variant of the tumor.
Keywords: adenolymphoma; the parotid salivary gland; diagnosis
EXPERIENCE IN THE TREATMENT OF A PATIENT WITH REVERSE INCISIVE OCCLUSION (CLINICAL OBSERVATION)
Boykova E.I., Evnevich E.P., Evnevich K.A.
Abstract: Objective. To show the necessity and evaluate the effectiveness of early treatment of patients with reverse incisive occlusion. Methods. Based on the analysis of the clinical case, a variant of early treatment of a patient with reverse incisive occlusion is presented. Results. The analysis of the stages of orthodontic treatment of a patient with a neutral bite and reverse incisor occlusion was carried out. The effectiveness of the use of non-removable equipment - a 2X4 bracket system is demonstrated. Conclusion. The effectiveness of orthodontic treatment of patients with reverse incisor dysocclusion is shown, the value of early diagnosis and correction of this malocclusion pathology at the stage of early replacement bite is revealed. The joint work of dentists (orthodontist, pediatric dentist and surgeon) in the complex rehabilitation of patients with neutral bite and reverse incisor occlusion is recommended.
Keywords: mesial bite; reverse incisor overlap; orthodontic treatment; clinical case; bracket system