bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring of blood clotting during bleeding
Authors: Ahmed A.
Published: July 2021

Background. The risk of bleeding and thrombotic events should be weighed before, during and after surgery. To facilitate this process, it is advisable to ask yourself the following questions: if we start the operation now, will the bleeding develop? If we delay the intervention, will a thrombotic event occur? Are the patient’s antithrombotic drugs effective?

Objective. To describe the blood coagulation monitoring system.

Materials and methods. Analysis of literature sources on this topic.

Results and discussion. Coagulopathy can be congenital and acquired, the latter including iatrogenic. The causes of congenital coagulopathies include hemophilia, von Willebrand factor deficiency, thrombocytopenia, and antiphospholipid syndrome. Antiplatelet drugs and direct oral anticoagulants are the main causes of iatrogenic coagulopathies. Other causes of acquired coagulopathies include hemostasis failure, disseminated intravascular coagulation syndrome, and post-surgical coagulopathies of various types. In order to treat bleeding in coagulopathies, desmopressin, tranexamic acid, coagulation factors, and protamine are administered. Laboratory tests needed to detect coagulopathies include prothrombin time, activated partial thromboplastin time, thrombin time, international normalized ratio, fibrinogen levels, and coagulation factors. The limitations of these tests include their non-dynamic nature, lack of ability to predict the risk of bleeding, time and financial costs, inability to understand the pathophysiological mechanism of bleeding. There may also be an error in the analysis due to the addition of citrate and calcium to the samples. Rapid tests to assess the hemostasis system include determination of activated coagulation time, Hepcon heparin monitoring system, thromboelastography and platelet mapping, platelet aggregometry using multiple electrodes, rotational thromboelastometry, and sonoreometry.

Conclusions. 1. For best results, coagulopathy should be anticipated, detected, and treated in a timely manner. 2. The strength of blood clots depends on platelets and fibrinogen. 3. It is advisable to use rapid tests to assess hemostasis and repeat them regularly, as bleeding and blood clotting are dynamic processes. 4. The effects of hemodilution, acid-base balance and temperature should be kept in mind.
Risks of work with cytotoxic drugs
Authors: Bosnak A.S.
Published: July 2021

Background. Cytotoxic drugs (CTD) are widely used in medicine for the treatment of tumors and other diseases. According to the definition, CTD are the drugs, which are toxic for cells, that is, interrupt their replication or growth. Effects of CTD are not targeted, that’s why when they get into the organism, they can harm not only target cells, but any other cells, and not only the patient, but also the other people who contact with them, especially, the healthcare workers (HCW).

Objective. To define the risks of work with CTD.

Materials and methods. Analysis of the literature data on this topic.

Results and discussion. In case of breaking the safety rules, HCW may contact CTD. They can be exposed via skin contact, inhalation of aerosols or swallowing of the particles of CTD, via needle injuries. Actions and procedures, which can be accompanied by the contact of HCW with CTD, include drug preparation and administration, handling of drug containers and waste materials, handling the biological liquids of CTD-treated patient, cleaning of the spills or items, polluted by biological liquids. Exposure to CTD can result in the abdominal pain, hair loss, vomiting, liver injury, nasal sores, contact dermatitis and allergic reactions, miscarriages and fetal malformations (in pregnant women), changes in total blood analysis, mutations appearance. It is not proven that long occupational exposure to CTD leads to cancer, despite it is known that the majority of CTD have genotoxic, cancerogenic and mutagenic effects. Tactics of risk minimization in work with CTD includes definition of risk groups (pregnant women, newbies), assessment of the potential harms of used drugs, written fixation and often reassessment of risk estimation, HCW education. The latter must include methods of CTD preparation, peculiarities of CTD usage and waste handling, correct usage of individual protective equipment (IPE) etc. CTD must be prepared exclusively by the HCW, who underwent the adequate training, and in the specialized settings (HEPA-filtered exhaust systems, negative pressure rooms, absorbing surface covers). IPE must include vinyl or nitrile gloves, waterproof long-sleeved robe or overall with elastic cuffs, goggles or face shield, respirator, shoe covers. Potentially polluted by CTD waste must be collected into the polypropylene or polyethylene bags with the appropriate labeling.

Conclusions. 1. CTD may harm not only target cells, but also the other cells, and not only patients, but all the other exposed people. 2. CTD exposure may lead to the abdominal pain, hair loss, vomiting, contact dermatitis, miscarriages and fetal malformations, etc. 3. There is a spectrum of protective measures to protect HCW from CTD exposure (IPE, equipment of specialized working places for CTD solutions’ preparation, correct waste handling).
Abnormal uterine bleeding: the role of office hysteroscopy
Authors: Medvedev M.V.
Published: July 2021

Background. Abnormal uterine bleeding (AUB) is any menstrual cycle disorder that does not meet normal parameters of regularity, frequency, duration, and intensity. AUB are divided into acute and chronic. According to modern paradygm, when describing menstrual disorders, terms “AUB”, “heavy menstrual bleeding”, “intermenstrual bleeding”, “postmenopausal bleeding” should be used.

Objective. To highlight the role of office hysteroscopy in the treatment of AUB.

Materials and methods. Analysis of literature sources on this topic.

Results and discussion. According to the etiology, AUB are classified with the help of PALM-COEIN system: P – polyp, A – adenomyosis, L – leiomyoma, M – malignancy and hyperplasia (causes of structural disorders), C – coagulopathy, O – ovulatory dysfunction, E – endometrial dysfunction, I – iatrogenic causes, N – causes not established (causes not related to structural disorders). At different ages, the main causes of AUB are different (in childhood – injuries, infections, ovarian tumors, in childbearing age – anovulation, pregnancy, endocrine disorders, in old age – endometrial cancer). When examining patients with AUB, one should carefully collect a history, carry out physical and gynecological examination, determine the condition of the thyroid gland, exclude coagulopathy and pelvic diseases. Office and even portable hysteroscopy is a modern method of visual diagnosis of AUB. Techniques for hysteroscopic removal of intrauterine pathological formations include curettage under the control of a hysteroscope, removal with forceps or laser, hysteroresectoscopy, intrauterine morcelation. Office hysteroscopy can successfully detect and treat polyps, leiomyomas, isthmocele, chronic endometritis, hyperplasia. AUB is often accompanied by iron deficiency anemia (IDA). In severe cases or in the case of planned surgical interventions, IDA require treatment with intravenous iron preparations. Clinical data show that patients with preoperative anemia treated with iron preparations before surgery do not require blood transfusions in the postoperative period. Sufer (“Yuria-Pharm”) is a trivalent iron for intravenous administration. The dose is calculated individually for each patient based on the level of hemoglobin and the severity of iron deficiency. In case of severe blood loss during the operation, it is advisable to use tranexamic acid (Sangera, “Yuria-Pharm”), which is 10 times more effective than ethamsylate and 26 times – than aminocaproic acid. In a multicenter, randomized, double-blind, placebo-controlled WOMAN study of 20,000 women with postpartum haemorrhage, tranexamic acid reduced fatalities by more than 30 % and the need for urgent surgery for hemostasis by more than 35 %.

Conclusions. 1. AUB can have different etiology, which largely depends on the age of the patient. 2. Office hysteroscopy is a promising method of visualization diagnosis and treatment of AUB. 3. Intravenous iron preparations can be used to correct anemia after AUB, and tranexamic acid – to stop an excessive bleeding.
L-arginine as a medication
Authors: Medved V.I.
Published: July 2021

Background. L-arginine takes part in the ornithine cycle, in which ammonia is neutralized with urea formation. Accordingly, in the absence of L-arginine, toxic ammonia accumulates in the organism.

Objective. To describe the use of L-arginine as a medication.

Materials and methods. Analysis of literature sources on this topic.

Results and discussion. Nitric oxide (NO) is a universal mediator in the regulation of cellular functions and intercellular communication. Deficiency of this substance is a key element of endothelial dysfunction. In the human body, NO is produced from L-arginine and performs an extremely important function of vasodilation due to the relaxation of vascular smooth muscle cells. Other physiological functions of NO include the transmission of neural signals in the central and peripheral nervous system, nervous activity, histamine secretion by mast cells, intestinal peristalsis, erection, killer action against bacteria and cancer cells. Arginine deficiency occurs in hypertension, coronary heart disease, obliterating disease of peripherl arteries, primary pulmonary hypertension, obstetric and perinatal pathological conditions. Potential ways to eliminate NO deficiency include the administration of its precursor – L-arginine (Tivortin, “Yuria-Pharm”) or its donors (molsidomine, nitrates). Tivortin has antioxidant and detoxifying effects, reduces endothelial dysfunction, activates urea synthesis, promotes glucose utilization, increases blood insulin.

Conclusions. 1. NO deficiency is a key element of endothelial dysfunction. 2. Physiological functions of NO are vasodilation, transmission of neural signals, intestinal motility, etc. 3. In the human body NO is formed from L-arginine. 4. Arginine deficiency occurs in hypertension, coronary heart disease, obliterating disease of the peripheral arteries, primary pulmonary hypertension, obstetric and perinatal pathological conditions. 5. L-arginine (Tivortin) prescription is one of the ways to eliminate NO deficiency. 6. Tivortin has antioxidant and detoxifying effects, reduces endothelial dysfunction, and promotes glucose utilization.
Endothelial protection of the microcirculatory tract in obstetrics
Authors: Nosenko O.M.
Published: July 2021

Обоснование. Эндотелиальные клетки различных сосудистых зон имеют разные форму и набор рецепторов, что позволяет им быть функционально гетерогенными. Функциями эндотелия являются транспортная, гемостатическая, вазомоторная, рецепторная, секреторная, сосудообразующая и барьерная. Для обеспечения каждой из этих функций эндотелий вырабатывает вещества, отвечающие за диаметрально противоположные функции. Состояние дисбаланса между медиаторами, в норме обеспечивающими оптимальное течение всех эндотелийзависимых процессов, получило название эндотелиальной дисфункции (ЭД).

Цель. Охарактеризовать защиту эндотелия и возможности коррекции ЭД в акушерстве.

Материалы и методы. Анализ данных литературы по этому вопросу.

Результаты и их обсуждение. Оксид азота (NO) играет важнейшую роль в физиологическом функционировании эндотелия во время беременности. Субстратом для синтеза NO выступает L-аргинин. При недостатке NO возникает ЭД, которая в сочетании с дефективной глубокой плацентацией является главной причиной развития основных акушерских осложнений (преэклампсии (ПЭ), синдрома задержки внутриутробного роста плода, преждевременных родов, преждевременной отслойки плаценты, привычного невынашивания). При ПЭ можно отметить изменение эндотелия различных сосудов, в том числе печеночных и мозговых. Выявление ЭД до беременности требует прегравидарной подготовки с помощью донаторов NO (L-аргинина). Накопление в крови беременных метилированных аналогов последнего ведет к снижению биодоступности NO и развитию ЭД. В результате запускается своеобразный порочный круг: ЭД усиливает ишемию и способствует образованию свободных радикалов, которые, в свою очередь, вызывают ЭД. Включение L-аргинина в комплексную фармакологическую профилактику и лечение перечисленных акушерских синдромов с целью преодоления патогенетических эффектов метилированных аналогов L-аргинина, прежде всего асимметричного диметиларгинина (ADMA), является патогенетически оправданным. Успешность данного подхода подтверждена в ряде исследований. Введение большого количества экзогенного L-аргинина вытесняет ADMA и восстанавливает эндогенный синтез NO до физиологического уровня. Тремя основными средствами для устранения ЭД в акушерстве выступают ацетилсалициловая кислота, препараты кальция и L-аргинин (Тивортин, «Юрия-Фарм»). Применение последнего позволяет предотвратить развитие ПЭ у женщин высокого риска, улучшить маточно-плацентарный кровоток, нормализовать объем околоплодных вод.

Выводы. 1. ЭД – основное звено патогенеза акушерских осложнений. 2. Основной молекулой, необходимой для нормального функционирования эндотелия, является NO. 3. Тивортин как субстрат для образования NO способствует устранению ЭД и улучшению маточно-плацентарного кровотока.
Safety and efficacy of the port-catheter systems during intensive intravenous chemotherapy in patients with multidrug-resistant tuberculosis and tuberculosis with extended resistance
Authors: Senko Yu.O.
Published: July 2021

Background. Yu-Port (“Yuria-Pharm”) is an implanted system for long-term infusions. This system allows multiple access to vessels for parenteral administration of drugs, fluids and nutrient solutions.

Objective. To describe the safety and efficacy of the port-catheter systems during intensive intravenous chemotherapy in patients with multidrug-resistant tuberculosis (TB) and TB with extended resistance.

Materials and methods. Analysis of the literature on this issue.

Results and discussion. Prolonged venous access is required in case of long-term infusion therapy or chemotherapy, as well as with the use of drugs that irritate the veins. Routine methods of vascular access have a number of disadvantages: the needle of the system damages the vessel with each injection; infusion cannula should be replaced every 3-5 days; the central venous catheter cannot be installed permanently (on average, for 1 week). Therefore, port systems consisting of a titanium port and a vascular catheter have long been used for long-term venous access. When installing the port system, the catheter is in the vein, the port is under the skin, and the needle is brought out. The advantages of the Yu-Port system include a large silicone membrane, fluid flow rate of 5 ml/s, compatibility with magnetic resonance imaging, and the absence of latex and polyvinyl chloride. The Yu-Port package contains installation instructions and all the necessary tools. The silicone membrane allows repeated piercing only with a special Yu-Port needle or the included needle. After the puncture, the membrane is tightened, because due to a special sharpening needle does not tear the membrane material, but pushes it apart. Jugular or subclavian access is most often used to install ports. The advantages of using port systems in chemotherapy include low traumaticity, painless injections, no discomfort, ease of drug administration and blood sampling for analysis, lower risk of developing phlebitis, long use duration (several years). Our own experience with port systems (56 patients in 2019-2020) showed significantly fewer premature treatment terminations due to side effects than in the group of standard infusion therapy (12.50 % vs. 22.6 %).

Conclusions. 1. Port systems consisting of a titanium port and a vascular catheter have long been used for long-term venous access. 2. The advantages of using port systems in chemotherapy include painless injections, no discomfort, ease of drug administration and blood sampling for analysis, lower risk of phlebitis, long use duration. 3. In patients who need long-term or multicomponent chemotherapy, for example, in multidrug-resistant TB, it is advisable to use port systems.
Chemotherapy and radiation therapy in locally advanced oropharyngeal cancer
Authors: Seriogina N.M.
Published: July 2021

Background. About 650,000 new cases of head and neck cancer are diagnosed worldwide each year. About 66 % of these patients already have a common stage of the disease. Mortality up to one year is 38.8-44.4 %. The male/female ratio is 3.4:1. Smoking, alcohol consumption, human papillomavirus (HPV) infection, and herpes viruses are the main risk factors for the developing oropharyngeal cancer (OPC).

Objective. To identify the features and to describe the treatment of OPC.

Materials and methods. Analysis of literature data on this issue.

Results and discussion. HPV-associated OPC is characterized by the favorable survival rates. 60-80 % of patients with such OPC are non-smokers and do not abuse alcohol, the average age is 45-55 years. The main principles of diagnosis and treatment of locally advanced forms of OPC include the use of modern imaging methods, staging depending on HPV status, definitive chemoradiation therapy, dose escalation (66-72 Gray), the use of integrated boosts on the tumor and affected lymph nodes, radiation therapy (RT) without a break, the use of the adaptive RT method. It has been shown that RT split courses reduce local tumor control by 13 %, while increasing the risk of late radiation complications by 18-40 %. RT with modulated dose intensity is accompanied by the reduction in the risk of all-cause mortality by 21 %, as well as the risk of cancer-specific mortality, and by the reduction of the number of aspiration pneumonia cases. Adaptive RT is a modern RT technology that involves adjusting the radiation plan during the course of treatment due to the changes in the anatomy of the tumor and surrounding tissues. The main stages of adaptive RT are obtaining the current data from the megavolt computed tomography, recalculation of the dose distribution, comparison with the plan before treatment, and adaptation of the plan. The results of chemotherapy should be evaluated no earlier than 12 weeks after its completion. Rehabilitation after chemoradiation therapy (prevention of trismus) involves massage and training of the jaw muscles, maintaining proper posture, oral hygiene.

Conclusions. 1. HPV status is an important parameter in predicting the course of OPC. 2. HPV-associated OPC is characterized by the favorable survival rates. 3. The planned RT must be held without an interruption. 4. RT with modulated dose intensity is accompanied by the reduction in all-cause mortality by 21 %, as well as the risk of cancer-specific mortality. 5. The main area of research in HPV-associated OPC is the de-escalation of treatment regimens.
Gold standards of CT-diagnostics of cancer
Authors: Tytorenko R.S.
Published: July 2021

Background. Methods of diagnostics and staging of the disease in oncology can be divided into physical, laboratory, endoscopic, cytohistological, molecular, and radiation methods. Radiation diagnostics allows to establish the localization of the pathological process and to stage it. Medical imaging methods include ultrasound diagnostics, X-ray diagnostics, computed tomography (CT), magnetic resonance imaging, scintigraphy, single-photon positron emission CT, positron emission tomography. The choice of the imaging method depends on the specific clinical situation.

Objective. To describe the standards of CT diagnostics of cancer.

Materials and methods. Analysis of recommendations and literature sources on this topic.

Results and discussion. The advantage of multislice CT (MCT) is the possibility of one-step study of several anatomical areas. Thus, the study of the thoracic cavity includes the assessment of pathological conditions of the lungs, mediastinum, chest, visible neck, bones, as well as the assessment of the vascular bed (if contrast is used). Examination of the abdominal cavity allows to detect pathology of the digestive system, pelvis, retroperitoneal space, visible parts of the chest, bones and vascular bed (if contrast is used). Another advantage is the absence of “dumb” zones, as it is possible to estimate changes in different planes (coronary, sagittal, oblique) and in the three-dimensional image. When imaging tumors, contrast agents should always be used. Contrast testing is the gold standard of diagnosis worldwide because it improves organ and tissue differentiation. The main risk factors for post-contrast acute kidney damage are chronic kidney disease, kidney surgery, proteinuria, hypertension, diabetes, myeloma. In patients with risk factors, non-contrast MСT should be considered and, if this is not possible, the patient should be pre-hydrated (sodium bicarbonate solution or saline). The hydration protocol is selected individually based on a benefit/risk assessment. In order to prevent complications, it is advisable to use low- or isoosmolar contrast agents. After the contrast study, hydration should be continued according to the protocol and the glomerular filtration rate determined in 48 hours.

Conclusions. 1. Imaging studies in oncology are extremely informative. 2. The advantages of MСT include the option of one-time study of several anatomical areas and the absence of “dumb” areas. 3. When imaging tumors contrast agents should always be used. 4. Patients at risk of post-contrast acute renal injury may undergo the visualization in settings of pre- and post-contrast preparation/management.
Complications of ventral hernia alloplasty: treatment and prevention
Authors: Feleshtynskyi Ya.P.
Published: July 2021

Background. Postoperative ventral hernias (PVH) account for 22.4-25.0 % of the total number of abdominal hernias. Complications of PVH alloplasty are divided into general (abdominal compartment syndrome (ACS), acute intestinal obstruction, pneumonia, pulmonary embolism) and local (seroma, hematoma, suppuration, marginal skin defect, calcification, fistula).

Objective. To describe the treatment and prevention of complications of PVH alloplasty.

Materials and methods. Analysis of literature data on this topic.

Results and discussion. ACS occurs after alloplasty of giant PVG as a result of a steady increase in intra-abdominal pressure (IAP) >12 mm Hg within 6-12 hours after surgery. ACS is caused by the excessive tension of the supporting structures of the abdominal wall and a decrease in the volume of the abdominal cavity. The growth of IAP leads to compression of large vessels, kidneys, increased intrathoracic pressure with the development of heart and lung failure, so during and after surgery it is necessary to monitor this parameter with the help of Foley catheter. Prevention of ACS is carried out by the optimal choice of the method of compartment separation. In the postoperative period, anesthesia (paracetamol – Infulgan, “Yuria-Pharm”), oxygen therapy, abdominal bandaging, nonsteroidal anti-inflammatory drugs (NSAID), medications for the correction of water-electrolyte metabolism (Reosorbilact, “Yuria-Pharm”) are prescribed. Among wound complications seroma is the most common (30.8-60.4 %). Methods of its treatment include vacuum drainage, puncture, antibiotics and NSAID. In presence of localized limited infection in the tissues of the abdominal wall around the mesh, excision of the mesh area with granulomas within healthy tissues, washing of the wound with Dekasan solution (“Yuria-Pharm”) and defect plastics are indicated. Antibiotic therapy is performed according to sensitivity. In the presence of a widespread infection in the tissues of the abdominal wall along the perimeter of the mesh, its explantation is indicated. Repeated direct alloplasty in such cases is contraindicated. Prevention of wound complications includes antibiotic prophylaxis (ceftriaxone 2 g), adequate choice of alloplasty, washing of the surgical wound with Dekasan solution at the different stages of surgery, vacuum drainage and ultrasound monitoring.

Conclusions. 1. Optimization of prevention of wound complications during non-purulent surgical interventions is reached by washing of the surgical wound with Dekasan solution. 2. Optimization of prevention of wound complications during conditionally clean (non-purulent) surgical interventions is reached by antibiotic prophylaxis and washing of the surgical wound with Dekasan solution at various stages of surgical dissection.
Pathophysiology of coagulation during bleeding
Authors: Fenger-Eriksen C.
Published: July 2021

Background. Analysis of 99 studies found that the predictor properties of various tests to determine the blood coagulation condition, including the newest ones (thromboelastography, rotational thromboelastometry), regarding the risk of intra- and postoperative bleeding are low. The results of prothrombin time or activated partial thromboplastin time measurements can be very variable depending on the concentration of reagents and the characteristics of the analysis. That is why standard methods of screening to assess the condition of the coagulation system in all patients in the preoperative period are not recommended.

Objective. To describe the features of perioperative blood clotting and management of patients.

Materials and methods. Analysis of literature data on this topic.

Results and discussion. Before performing invasive procedures, a careful history should be taken to determine the presence and severity of previous bleeding and to ask about antithrombotic medications. If the general hemorrhagic history is favorable, further determination of coagulographic parameters is not required. If the history is unfavorable or there is evidence of potential risk factors for bleeding (e. g., liver disease), a comprehensive coagulation study should be performed. Bleeding coagulopathy is a component of the so-called lethal triad, which also includes hypothermia and acidosis. Active administration of infusion solutions can deepen or provoke coagulopathy due to hemodilution. The use of balanced infusion solutions reduces the risk of this complication. According to some authors, the fibrinogen level <2 g/L is the predictor of bleeding probability. The causes of this condition include hyperfibrinolysis, dysfunctional fibrinogen in case of the administration of colloid solutions, increased decomposition of fibrinogen due to acidosis. Colloidal solutions (hydroxyethyl starch) increase the risk of reoperation and the need for transfusions, so their routine use is not currently recommended. Hyperfibrinolysis is a condition in which the rate of blood clot breakdown exceeds the rate of blood clot formation. As a result, hemorrhagic shock worsens and coagulopathy develops. Hyperfibrinolysis develops due to fibrinolytic agents and hypoperfusion. Tranexamic acid is used for heavy bleeding, in particular, postpartum. The WOMAN study involved 20,600 women with postpartum haemorrhage who received 1 g of tranexamic acid or placebo. Mortality due to bleeding in the tranexamic acid group was 1.2 %, and in the placebo group – 1.7 % (p=0.008).

Conclusions. 1. Routine use of colloid solutions should be avoided during bleeding. 2. It is necessary to detect and eliminate anemia, hypothermia and acidosis. 3. Detection and elimination of deficiency or dysfunction of coagulation factors, hyperfibrinolysis, thrombocytopenia is an important component of bleeding prevention. 4. Reducing bleeding and improving blood clotting leads to the less need for transfusions and better outcomes for the patient.
Pathogenetic syndrome management of a patient with COVID-19
Authors: Khodosh E.M.
Published: July 2021

Background. In case of coronavirus pneumonia, the virus damages the cells of bronchi and alveoli, as well as triggers a powerful inflammatory response that disrupts the surfactant and prevents the adequate oxygenation. These pathogenetic links lead to the development of acute respiratory distress syndrome, multiorgan hypoxia and disseminated intravascular coagulation syndrome.

Objective. To find out the main pathogenetic links that can be affected by coronavirus disease (COVID-19) treatment.

Materials and methods. Analysis of literature sources on this topic.

Results and discussion. Hypoxia is one of the main backgrounds of coronavirus organ damage in COVID-19. The consequences of hypoxia include the imbalance between aerobic and anaerobic glycolysis, increased lipid peroxidation, acidosis, microcirculation disorders, edema. Pathologically active inflammation is another background. It leads to the damage of pulmonary capillaries, microcirculation disorders and the development of acute respiratory distress syndrome with increased hypoxia. Since the reactive oxygen species are the main inducers of apoptosis and mitochondrial dysfunction, it is necessary to prescribe antioxidant therapy. Edaravone (Ksavron, “Yuria-Pharm”) quickly neutralizes lots of free radicals, inhibits lipid peroxidation and activates the own antioxidant defense. Other components of the pathogenetic therapy of COVID-19 may include Tivortin and Tivorel (“Yuria-Pharm”). L-arginine (Tivortin) is a nitric oxide donor. Its administration has vasodilating, immunostimulating, membrane stabilizing, cytoprotective and antioxidant effects. Tivorel also contains L-carnitine, which inhibits apoptosis, has antioxidant and cardioprotective effects. In case of pneumonia, it is advisable to use Reosorbilact (“Yuria-Pharm”), which prevents pulmonary edema and restores microcirculation.

Conclusions. 1. Hypoxia and hyperinflammation are the main elements of the COVID-19 pathogenesis. 2. Edaravone (Ksavron) neutralizes free radicals and activates own antioxidant defense. 3. L-arginine (a component of Tivortin and Tivorel) has vasodilating, immunostimulating, membrane stabilizing, cytoprotective and antioxidant effects. 4. Reosorbilact prevents pulmonary edema and restores microcirculation.
Trends of ex tempore drug preparation in Ukraine. Ways of their introduction into the practice
Authors: Heorhiiants V.A.
Published: July 2021

Background. Advantages of the ex tempore formulation include the ability to provide the drug in the form and dosage, not available on the pharmaceutical market, but necessary for a particular patient; the ability to include the required ingredient in any desired form; the option of combining drugs; the manufacture of drugs without flavorings, preservatives and stabilizers; the possibility of adjusting of the drug taste; the possibility of manufacturing drugs that are in short supply on the market; no possibility of counterfeiting; production of specific drugs.

Objective. Assess the current situation and trends in the preparation of oncological drugs ex tempore.

Materials and methods. Analysis of the literature on this topic.

Results and discussion. In oncology the possibilities of ex tempore preparation include the manufacture of chemotherapeutic agents with individual dosage, of any adjuvant agents without excipients, of radiopharmaceuticals, combined and orphan drugs. In Ukraine, ex tempore formulation is not widespread: as of 2017, the percentage of drugs prepared in such way was 1.7 %, in 2018 – 1.43 %, in 2019 – 1.41 %. The situation is different in the European Union. For instance, in Poland the pharmacy receives a license only after creating the conditions for the manufacture of drugs, in Estonia any pharmacy must be able to produce non-sterile drugs, in Latvia 50 % of pharmacies have a license to manufacture drugs. The popularity of ex tempore preparation is also growing in the other countries (Australia, USA, Brazil, Jordan). The main areas of application of ex tempore drugs include hormone replacement therapy, analgesia, dermatology, chemotherapy, ophthalmology, treatment of orphan diseases, parenteral nutrition. Civilized countries often choose to develop the hospital pharmacy. However, there are a number of problems, including the lack of well-trained staff, the high cost of equipment and maintenance of sterile facilities, the constant changes in regulatory requirements and the need to gain the consumers’ respect.

Conclusions. 1. Ex tempore drug preparation has a number of advantages, in particular, the ability to provide the drug in the individual form and dosage, the ability to combine drugs and the manufacture of specific drugs. 2. Extemporaneous preparation of drugs is especially important for oncology. 3. In contrast to European Union countries, ex tempore drug preparation is not widespread in Ukraine. 4. Problems of ex tempore drug preparation include lack of the staff, high equipment costs, and constant changes in regulatory requirements.
Infusion therapy for sepsis
Authors: Glumcher F.S.
Published: July 2021

Background. Sepsis is a life-threatening organ dysfunction syndrome caused by the dysregulatory response of the organism to infection. Treatment of septic shock (SS) requires massive infusion therapy (IT), as it is necessary to restore volemia as quickly as possible. Other goals of IT are the restoration of electrolyte balance, normalization of acid-base state and organ perfusion.

Objective. To describe IT in sepsis.

Materials and methods. Analysis of literature sources on this topic; own multicenter prospective open research. 68 patients with abdominal SS source (intestinal obstruction, perforation of hollow organs, infected pancreatitis, etc.) who underwent IT were involved.

Results and discussion. In case of SS it is obligatory to start infusion of crystalloid solutions in a dose of 30 ml/kg during the first 3 hours of resuscitation. Current treatment guidelines suggest early aggressive fluid recovery within 6 hours of onset of shock. Delaying an increase in volemia cannot be allowed. If stabilization of the clinical condition cannot be achieved by initial fluid resuscitation, close monitoring should be initiated to avoid fluid overload, as both hypovolemia and hypervolemia increase mortality. Indicators such as blood pressure, heart rate, central venous pressure, dynamic parameters (lower extremity lifting test (LELT), volume load bolus test), lactate content, daily fluid balance should be monitored. Achieving a negative fluid balance during at least one of the first 3 days of SS treatment is a predictor of the favorable prognosis. According to the own study, LELT showed a weak correlation with the results of the infusion probe. This may be related to the increase in intra-abdominal pressure in the studied patients. Despite a number of disadvantages, crystalloids are the basis of SS treatment. The use of hydroxyethyl starch solutions in sepsis is not recommended; they can be used only in limited groups of patients. Albumin is the only safe colloid solution that can be used in patients with SS and hypoalbuminemia, but there is no evidence of the benefits of its routine use in sepsis. Analysis of patient data divided into Reosorbilact, Volutenz, Ringer malate and 0.9 % NaCl (all solutions – “Yuria-Pharm”) found that the most effective solutions for cardiac output were Reosorbilact and Volutenz.

Conclusions. 1. Treatment of sepsis and SS requires massive IT. 2. The goals of IT include the restoration of volemia, normalization of electrolyte balance and acid-base status, normalization of organ perfusion. 3. During the first 3 hours of resuscitation in SS, it is advisable to restore the fluid volume within 6 hours from the onset of shock. 4. If stabilization of the clinical condition has not been achieved, close monitoring should be initiated to avoid fluid overload. 5. The most effective solutions for the increase of cardiac output are Reosorbilact and Volutenz.
Emergency care for hypertensive crises: how to save a patient? Review of modern recommendations
Authors: Domoratskyi O.E.
Published: July 2021

Background. Arterial hypertension (AH) is a risk factor for stroke and myocardial infarction. In low-income countries, the prevalence of hypertension is 42 %. Hypertensive crisis (HC) is an acute increase in blood pressure – BP (systolic BP >200 mm Hg, diastolic BP >120 mm Hg), which is accompanied by the threat or progression of target organs damage and requires the immediate controlled reduction of BP.

Objective. To describe the emergency care for HC.

Materials and methods. Analysis of current recommendations and literature data.

Results and discussion. HC are classified into uncomplicated (uHC) and complicated (cHC). Perioperative hypertension can be considered a separate subtype of HC. Risk factors for HC include uncontrolled hypertension, refusal to take antihypertensive drugs, emotional stress, excessive fluid and salt intake, alcohol abuse, smoking, physical overload, meteopathic factors, obesity. uHC require BP lowering within 2-6 hours; drugs are administered orally; there is no need for hospitalization. cHC requires BP lowering within 30-120 minutes; drugs are administered intravenously; the patient must be hospitalized. After maintaining the target pressure <160/100 mm Hg within 2-3 hours the patient can be transitioned to the oral drug administration. Therapeutic armamentarium for HC includes nitroprusside, nicardipine, clevidipine, esmolol, labetalol, nitroglycerin, urapidil, and phenoldopam. Labetalol, nicardipine, clevedipine and phenoldopam are not available in Ukraine. The choice of drug should be based on the dominant linjury of the target organ. In case of uHC it is expedient to use nifedipine, captopril, metoprolol, propranolol, clonidine (all of them orally). It should be noted that the parenteral administration of antihypertensive drugs can be carried out only by specially trained personnel with monitoring of BP and hemodynamic parameters, as well as in the presence of conditions for resuscitation. Esmolol (Biblok, “Yuria-Pharm”) is indicated for HC with renal failure, dissection of the aorta or pulmonary edema. It is also advisable to use Biblok in perioperative hypertension. The peculiarities of the Biblok use include the need of infusion into a large diameter vein, usage of lineamats or infusomats, use for no more than 24 hours, and no abrupt termination of the infusion.

Conclusions. 1. HC is an acute increase in BP, which is accompanied by the development or progression of damage of target organs and requires immediate controlled reduction of BP. 2. Risk factors for HC include uncontrolled hypertension, refusal to take antihypertensive drugs, emotional stress, excessive fluid and salt intake, alcohol abuse, smoking, exercise, meteopathic factors, obesity. 3. Esmolol (Biblok) is indicated for HC with renal failure, aortic dissection or pulmonary edema, as well as perioperative hypertension.
Gom cụm kết quả tìm kiếm video với hướng tiếp cận kết hợp đa đặc trưng
Authors: Phúc Nguyễn Quang
Published: July 2021

This paper aims to extend our previous researches on clustering web video search results, which reported in [1, 2, 3]. To search videos, users usually use online video search systems such as YouTube, Google Video. However, the returned search results of these systems may include many videos of different categories, and as a result, users find it difficult to locate video clips of interest. Therefore, clustering web video search results is necessary in order to improve the efficiency of searching. The main idea of paper based on analysing and combining the features extracted from video to find the set of appropriate features to improve the quality of video clusters.
The effect of Price and Brand Image on Purchase Decisions and their Implications on Consumer Satisfactory of Ebara Pump Products in Jabodetabek
Authors: Siregar Roy Harry Martin , Nurmahdi Adi
Published: July 2021

This research study highlights the role of purchase decisions in mediating price and brand image towards the customer satisfaction for Ebara pump. The population of this research is Ebara customers. The sample is taken using the purposive sampling method, consisting of 135 respondents. The research used a quantitative analysis approach. The data analysis methods using partial modelling with partial least squares determine how much independent variables affect the dependent variables. Research shows that the model influence on purchasing decisions is moderate and on customer satisfaction is strong, predictive capabilities are excellent, and the model performance between a structural model and a measuring model is fit. The hypothetical tests result in conclusions that there is a variable effect of brand image on purchase decisions, and the price perception affects the purchase decision. The brand image and price perception affect the customer's satisfaction. Indirectly, brand image and price affect customer satisfaction through purchase decisions.
EFFECT OF SOLID AND LIQUID ORGANIC FERTILIZER ON GROWTH, YIELD AND YIELD COMPONENTS OF ROSSELLE (Hibiscus sabdariffa L.) IN THE NIGERIAN SAVANNAH
Authors: Ladan K. M. , Abubakar M. G. , Suleiman J.
Published: July 2021

The Study was conducted to evaluate the effect of solid and liquid organic fertilizer on growth and yield of rosselle in 2016 cropping season at Institute of Agricultural Reserve Zaria, Samaru (11011’N 07038E and 686m) and Institute of Horticultural Research Farm Bagauda (12000’N 8031”Em 488m) in Northern Guinea Savannah and Sudan Savannah Ecological Zones of above sea level Nigeria. Treatments consisted of four levels of solid poultry manure (0.0, 1.0, 2.0 and 3.0) tons/ha and five levels of liquid organic manure from Grand Total Organic Fertilizer Limited (0.0, 0.5, 1.0, 1.5 and 2.9) litres/ha, which were factorially combined in a randomized complete block design (RCBD) and replicated three times. Data on growth parameter were collected on plant height (cm), plant dry weight (g), leaf Area index crop growth rate (CGR) Relative Growth Rate (RGR) and Net assimilation rate (NAR) while data on yield parameters like number of calyx per pant, 100 seed weight (g) and  calyx yield per hectare kg/ha were collected. Results showed that plant height, plant dry weight(g), 100 seed weight(g) and calyx dry yield kg/ha had a significant increase with application of 2.0 litres/ha of liquid fertilizer than other rates. While application of solid poultry manure at 3.0ton/ha significantly increases plant height, net assimilation rate, leaf area index and calyx dry weight when compared with other rates. From the results obtained, the combination of 2.0 litres/ha liquid organic fertilizer and 3.0 ton/ha solid poultry manure produce the highest calyx yield at both location.
EXPERIMENTAL STUDY OF ENERGY DISSIPATION IN A SINGLE STEP CONDITION OVER A BROAD CRESTED WEIR
Authors: Tanimu Bashir , Usman Aliyu Bamaiyi , Bello Al-Amin Danladi , Abdullahi Sulaiman Jamilu
Published: July 2021

This research study the experimental performance of broad-crested weir with single-step by introducing U/S and D/S round-nose and  analysing the parameters that have effect on the shape of the step and their effects on the flow characteristics and energy dissipation (E%) downstream (D/S) of the weir. Furthermore, empirical relations for E% and flow rate due to the influencing factors were derived. The results showed that the weir model with  = 1.000 gives a higher E% in comparison with other weir models. Flow regimes were observed i.e nappe flow for small discharges, transition flow for intermediate discharges and skimming flow for higher discharges. Two model equations were obtained, the first to dteremine the flow rate over the weir models and the second relation to estimate E% in terms of, and Froude number. The model () can be used in the design of prototype weirs in terms of energy dissipation
BRINE SHRIMP LETHALITY ASSAY AND LARVICIDAL ACTIVITY OF N-HEPTADECYL-N-(8-OCTA-1, 3-DIENE-6-YNYL)AMINE (C25H44N) ISOLATED FROM COMBRETUM MOLLE R.
Authors: Zakari Abdu , Al-Mubarak Adoum Umar , Aliyu Sani
Published: July 2021

The extracts of leaves of Combretum molle were tested against the larvae of Artemia salina, i.e. Brine Shrimp Lethality Test (BST) and Culexquinquefasciatus Say (filaria disease vector) i.e. Larvicidal Test, using crude ethanol, n-hexane, chloroform, ethyl acetate, and methanol extracts. The methanolic extract proved to be the most effective in inducing complete lethality at minimum doses both in the BST and the Larvicidal activity test. The LC50­ values obtained are 24.85 µg/ml and 0.4µg/ml respectively. The Bioactivity result was used to guide the column chromatography which afforded the pure compound ACM 2 which was not active in the BST with LC50 value of 1259 µg/ml but was active in the Larvicidal activity test with LC50 value 15.14 µg/ml.  ACM 2 was proposed to be N-heptadecyl-N-(8-octa-1, 3-diene-6-ynyl)amine (C25H44N).
ANALYSIS OF DISTRIBUTION PATTERN OF FUEL WOOD AND CHARCOAL IN ZARIA LOCAL GOVERNMENT AREA, KADUNA STATE, NIGERIA
Authors: Samira Bello  , Kibbon Adamu Usman , Akpu Akpu Benedine
Published: July 2021

Energy use is an essential requirement for socioeconomic development of any society. This research aimed at analyzing fuel wood and charcoal distribution pattern in Zaria Local Government Area Kaduna State Nigeria. The aim was achieved through the following objectives which are to: identify the distribution of fuel wood depots in the study area; analyse the distribution pattern of fuel wood in the study area and examine the seasonality, time and mode of fuel wood distribution in the study area. This research used both quantitative and qualitative method in data analysis. Findings from the research revealed two types of fuel wood vendor depots exists in the study area which are classified as either major or minor  types which shows that fuel wood vendor depots are mostly concentrated around the residential areas especially within the built-up land, also, charcoal is mostly sourced around Kachia and Lokoja Abuja Express way. Results from in-depth interview with the fuel wood vendors indicates that there are two types of fuel wood vendors: the mobile and the stationary vendors. It has been recommended in this study that the Government should come up with a policy guidelines to regulate and sanitise the number of minor fuel wood depots in the study area for a cleaner, safer and regulated environment. The relevant authorities should promulgate penalties for violators of the policy guidelines in order to ensure that the environment is kept safe from soil degradation as a result of the activities of the fuel wood depots and environmental pollution.
PENGARUH PEMAPARAN AIR LIMBAH KELAPA SAWIT TERHADAP KONDISI FISIK TANAMAN BAMBU AIR (Equisetium hymale)
Authors: Mubarak Fajriah , Mawardi Abdul. L , Elfrida Elfrida
Published: July 2021

Industri kelapa sawit berkembang dengan pesat dan dapat menyebabkan peningkatan limbah industri. Tanaman bambu air (Equisetium hymale) merupakan tanaman hias yang memiliki kandungan silikat yang tinggi memiliki fungsi mengikat partikel logam berat dalam limbah industri. Tujuan dari penelitian yaitu  mengetahui dampak pemarapan air limbah kelapa sawit yang mengandung logam berat timbal (Pb) terhadap kondisi fisik tanaman bambu air (Equisetium hymale). Sampel yang digunakan  berupa limbah cair kelapa sawit, proses pengambilan sampel diambil pada pengolahan limbah dalam kolam pembuangan limbah pertama dan kolam pembuangan limbah terakhir sebanyak 6000 ml, kemudian dimasukan kedalam jerigen plastik. Hasil uji menunjukan bahwa tanaman bambu air mengalami perubahan morfologi batang dari warna hijau menjadi hijau kekuningan yang disebabkan aktifitas kimiawi antara air limbah kelapa sawit yang mengandung senyawa Pb dengan tanaman.