bluuebunny/crossref_metadata_2025 huggingface dataset:
MALAKOPLAKIA OF THE BLADDER MIMICKING MALIGNANCY: REPORT OF CASES AND REVIEW OF THE LITERATURE
Authors: K.B. Lelyavin , L.V. Zaitseva , L.Yu. Raevskaya , A.K. Lelyavina
Published: September 2021

Malakoplakia is a rare granulomatous disease associated with an infectious etiology, usually involving the urinary tract. Clinical presentation malakoplakia is often non-specific, but is typically characterized by recurrent urinary tract infections and hematuria. The etiology of malakoplakia has not been fully elucidated. Frequent association of bladder malakoplakia with urinary tract infection suggests an infectious etiologic agent Malakoplakia of the genitourinary system is more common in women than in men. It is usually observed between the fifth and seventh decades of life. We report a rare case of isolated bladder malakoplakia in a 25-year-old female patient who presented with lower urinary tract symptoms without any hematuria. Clinically, a 15,0 х 11,0 15,0 mm mass was detected in the bladder, which was confirmed by ultrasound scan and magnetic resonance imaging. Malakoplakia is complicated diagnostic problem, since it occurs very rare and can manifest in a different way. Only histological research allows to determine the correct diagnose. The final diagnosis is confirmed by the presence of Michaelis-Gutmann bodies. The majority of patients after being precisely diagnosed can be successfully cured by the lasting treatment of antibiotics in a smaller dose. Represented clinical observation illustrates highly rare case of malakoplakia of bladder. It demonstrates the possibility of usage low invasive surgery not only for diagnostic, but also for therapy. This case made possible to receive the macro preparate for histological research of excellent quality. Histology is essential, not only to diagnose malakoplakia, but also to exclude other important differential diagnoses, such as malignancy. Histopathological examination of the tumor-like mass revealed malakoplakia. Postoperative course was uneventful. This condition should be included in the differential diagnosis of bladder tumors.
THERAPY OF COPIOUS MENSTRUAL BLEEDING IN A FEMALE PATIENT OF REPRODUCTIVE AGE
Authors: O.B. Kalinkina
Published: September 2021

Women's lack of awareness of the problem (OMC) and lack of understanding of the importance of discussing this problem with an obstetrician – gynecologist may limit women's access to specialized medical care. Currently, there is no accurate data on the reliable number of women with heavy menstrual bleeding. OMK significantly reduces the quality of life of a woman, both in the physical and emotional sphere, so the goals of OMK therapy are to reduce blood loss during menstruation, normalize and stabilize iron (in some situations - ferritin) and clinically significant improvement in the quality of life. The described clinical case of the management of a patient with copious menstrual bleeding without organic causes allowed us to demonstrate a positive effect on OMC of a combined oral contraceptive (COC) containing estradiol valerate in combination with dienogest with a dynamic dosage regimen (Clair's drug). This was confirmed both by the improvement of hematological parameters, such as hemoglobin, hematocrit and ferritin, and the quality of life of the patient. This drug can be recommended for use in women with this pathological process – heavy menstrual bleeding without organic causes. Multicenter randomized clinical trials, as well as real clinical practice studies, have proven the effectiveness of Clyra in women with OMC. The long-term use of Clyra has also been proven to be safe in relation to the risks of venous thromboembolism. An analysis of the published data showed that the use of the Claira combination for up to 5.5 years (on average for 2.1 years) was accompanied by the same or even lower risk of VTE compared to other COC and EE/LNG.
PATIENT INFORMATION CULTURE AS A FACTOR IN THE TIMELINESS OF CANCER CARE
Authors: E.L. Funticova , V.A. Kozlov , D.L. Mushnikov , L.G. Ananyina , A.A. Khmel
Published: September 2021

Information and its quality have always been important conditions for making the right decisions. The issues of methodical assessment of patient awareness, quality of organization and medical information in the public and private health sector remain unresolved. At the same time, there are very few scientific papers devoted to the research of the information culture of cancer patients. The aim of the study is to develop proposals to improve it on the basis of an assessment of the current state of the information culture of cancer patients. Research base: GBUS IWOOD. Time of the study 2020. Methods: sociological, analytical, documentary. The study program included the use of a survey method on a specially developed questionnaire "A map of social and hygienic research of patient information culture", which included 15 questions of a closed type. The unit of observation is a patient of cancer profile. The sample population, formed by random selection, was 400 patients. Based on the analysis of the medical records, patients were divided into groups, depending on the timeliness of seeking medical care for cancer. The t-Student criterion was used to determine the validity of the difference in the comparison groups. Differences between the groups were considered reliable at p<0.05. According to the results of the study, 5 components of the patient information culture have been identified, its important role in ensuring the timeliness of cancer care has been established, the levels and nature of the reduction in assessments of its current condition have been determined, and measures to improve the information culture of cancer patients have been proposed, which can be demanded by practical doctors, management of medical institutions, health authorities in shaping the areas of hygiene education and education of the population. As a result of the implementation of the proposals, positive dynamics of assessments on all components of patient information culture have been achieved.
IMPROVEMENT OF THE PROCESS APPROACH IN THE ROUTING OF PATIENTS WITH MALIGNANT MALIGNANCES OF THE MAXILLOFACIAL REGION IN THE TERRITORY OF THE PENZA REGION IN 2021
Authors: M.V. Lebedev , K.I. Kerimova , I.Yu. Zakharova
Published: September 2021

The worldwide concern about oncological morbidity is due to the steady increase in the detection rate of malignant neoplasms, which has a tendency to increase. More than 7 million people die from oncology every year in the world. The system of organizing the provision of medical care to the population with oncological diseases in the Russian Federation is currently undergoing a stage of improvement. New programs are aimed at early diagnosis and prevention of malignant neoplasms. Each region has the right to create and implement routing taking into account the territorial characteristics and the existing material and technical base and personnel. The routing system, created for a specific region, determines the order of treatment of patients and the functions of all links in the system of providing medical care to patients with oncopathology. An optimized system for routing patients according to the "Oncology" profile for patients with malignant neoplasms of the maxillofacial region should be structured in accordance with the regional healthcare system. A complex system of interaction, an information system capable of containing and processing a set of information, a trained interested staff dictate the need for making management decisions in the direction of optimizing the oncological service. Management decisions and technologies should be focused on improving the quality and speed of patient admission, providing highly qualified medical care using modern equipment and algorithms. The staff, in turn, determines the basis of the health care system, in connection with which it is necessary to continue education, identify and search for specialists that a specific organization needs, on which the functioning of the entire service for providing medical care to patients with oncopathology of the maxillofacial region depends. In general, the optimization of the system of providing medical care to patients with malignant neoplasms of the maxillofacial region dictates the need to combine organizational measures and a clinical approach. Unambiguously, the multi-component system of integration of various directions and departments in the process of organizing an oncological service predetermines the need to use modern management technologies and the use of all available resources in order to improve the quality of medical care.
PRODUCTIVITY OF INTERDISCIPLINARY INTERACTION IN TREATMENT OF PATIENTS WITH HEAD AND NECK DISEASES (RESULTS OF AN ORGANIZATIONAL EXPERIMENT OF 2021)
Authors: M.V. Lebedev , I.Yu. Zakharova , K.I. Kerimova
Published: September 2021

In 2021, an organizational experiment was conducted to improve the provision of specialized care to patients with head and neck pathology using the example of the Center for Maxillofacial Surgery at the N. N. Burdenko. The chief freelance specialist of the Ministry of Health of the Penza region, the head and doctors of the department, the deputy chief physician for the medical and surgical part, doctors of the quality control department of the N. N. Burdenko evaluated the treatment and diagnostic measures, the feasibility of attracting consultants of related specialties. Taking into account the results obtained, in 2021, on the basis of the Center for Maxillofacial Surgery, an organizational experiment was conducted to optimize the provision of medical care to patients of all ages with head and neck pathology, followed by an assessment of its effectiveness. The organizational experiment consisted of an interdisciplinary approach in the treatment of 15 patients in the conditions of the Center for Maxillofacial Surgery of the N.N. Burdenko. Doctors of related specialties (otorhinolaryngologist, plastic surgeon, oncologist, endoscopist, psychiatrist) participated in the provision of specialized care. The hospitalization of the patient and his treatment are provided at the optimum time by the same specialists. As a result of the experiment, patients saved time, received an integrated approach, reduced risks of postoperative complications, full work capacity or faster recovery and rehabilitation. The experiment showed that for one inpatient treatment, the patient receives an integrated approach to the problem, subject to close interaction of specialists from medical organizations, with the possibility of using specialized equipment without the cost of purchasing it for a medical organization. The conducted organizational experiment improves and improves the quality of care for patients with head and neck pathology. This experiment should be implemented in multidisciplinary medical organizations providing assistance in the field of "maxillofacial surgery".
THE INFLUENCE OF THE LEVEL OF EDUCATION ON THE BEHAVIORAL PATTERNS ASSOCIATED WITH THE ACCESS TO MEDICAL CARE OF THE POPULATION OF OLDER AGE GROUPS
Authors: S.N. Cherkasov , O.I. Polozkov , A.V. Fedyaeva , Yu.O. Kamaev
Published: September 2021

The purpose of the study: to study the influence of the level of education on the behavioral patterns associated with medical care of the population of older age groups. Materials and methods of research. The results of an anonymous survey of 1,045 people of both sexes aged 60 years and older were analyzed. The questionnaire included a question about the reasons for visiting medical organizations. The results were evaluated separately for men and women in two age groups of 60–74 years and 75 years and older. Results. There were no significant gender differences in the characteristics of medical activity among the studied cohorts of older age groups. The most common form of behavior regardless of gender was the reactive type, when seeking medical help occurred as a result of health problems. A high level of education contributes to a change in behavior towards a greater prevalence of active behavior in relation to the reasons for seeking medical help. These patterns are observed regardless of gender and are more pronounced in the age group of 75 years and older. Men and women with a low level of education are more likely to choose a reactive type of behavior when seeking medical help occurs after the appearance of health problems. The frequency of passive behavior does not depend on the level of education and is more often recorded in the age group of 60–74 years.
STUDY OF THE DYNAMICS OF REPRODUCTION OF M. LEPRAE UNDER THE CONDITIONS OF APPLICATION OF ANISEED LOFANT EXTRACT OBTAINED FROM SUPERCRITICAL FLUID EXTRACTION METHOD
Authors: E.A. Yurtaeva , S.A. Luzhnova , A.G. Tyrkov
Published: September 2021

One of the ways to solve the problem of drug resistance in the therapy of infectious diseases is to develop herbal preparations with high antibacterial activity, which have a good drug safety profile, is extremely significant for long-term therapy, the use of which could complement and improve the used combination therapy regimens. The aim of our study was to study the anti-leprosy activity of lofant anise extract obtained by supercritical fluid extraction using CO2 containing phenolic compounds such as gallic acid, coumarin, umbelliferon, luteolin, quercetin, taxifolin, rutin. Materials and methods. The anti-leprosy activity had been studied on Shepard's model. Blood parameters were examined on a SYSMEX XT – 2000i hematological analyzer (Japan). Conclusion. Lofant anise extract, obtained by supercritical fluid extraction using CO2, has a bacteriostatic effect on M. leprae, which is not only comparable to the effect of dapsone, but also with a more prolonged course exceeding it. Unlike the drug of choice (dapsone), the extract, when administered for 30 days, does not cause changes in red blood parameters and does not cause neutropenia. The identified effects actualize further research of the extract for the development of dosage forms based on it for practical health care.
RESEARCH OF ACUTE TOXICITY OF FIXED DOSE COMBINATION TABLETS OF CITICOLINE AND MEMANTINE
Authors: D.K. Salakhetdinov , B.B. Sysuev
Published: September 2021

The development and study of the fixed dose combination tablets of citicoline and memantine is the relevant problem. The purpose of this study was the assessment of acute toxicity and local irritating effect of the new combined drug, the modified release tablets (citicoline 500 mg + memantine 10 mg). Material of research: fixed dose combination of modified release tablets (citicoline 500 mg + memantine 10 mg) (NovaMedica Innotech, Russia). The tested drug was administered intragastrically to males and females of half-plant outbred rats at a dose of 2000 mg/kg in the amount of active substances. According the research results, the death of animals was not noted. As it was found the value of LD50 for the test drug in the intragastric administration is>5000 mg/kg in accordance with OECD Test No.423. The tested drug can be attributed to the 5th grade of toxicity on the international classification of GHS, because LD50> 5000 mg/kg (V/g) and to 4 class of low-toxic compounds as per Hodge and Sterner classification: 500 <d50 ≤ 5000 mg/kg (V/g). No clinical signs of intoxication in males and females of autumn rats against the background of a single intragastric administration of the test drug was detected visually, There were no changes in animals behavior in the direction of oppression or excitement. The test drug in a single intragastric introduction in a dose of 2000 mg/kg in the amount of active ingredients did not cause a local irritant action. Thus, the drug does not have a toxic and local irritating action in one-time introduction.
INFLUENCE OF THE LEVEL OF EDUCATION ON THE DEGREE OF COMPLIANCE OF THE POPULATION OF OLDER AGE GROUPS
Authors: S.N. Cherkasov , O.I. Polozkov , A.V. Fedyaeva , V.N. Avsadzhanishvili
Published: September 2021

The purpose of the study: to study the influence of the level of education on the degree of compliance of the population of older age groups. Materials of research. Data from a survey of 1,045 people of both sexes aged 60 years and older were used. The proposed questionnaire included three questions that characterize the level of compliance with medical recommendations, as well as the attitude to self-medication. The results were evaluated for men and women separately in two age groups of 60–74 years and 75 years and older. Results. Women are more compliant with the doctor's prescriptions, as they are more likely to perform them in full. With increasing age, the degree of compliance significantly increases in both men and women, and therefore, the differences between the sexes are leveled. The level of education affects the behavior in relation to the fulfillment of doctor's appointments only in men in the age group of 75 years and older and does not affect the age group of 60–74 years. In women, there was no significant effect in both age groups. Men and women with higher levels of education are more likely to make doctor's appointments only in some cases. A greater proportion of non-respondents, that is, doubters, is also observed in the group of men and women with a high level of education, regardless of age. The results of responses to specific questions concerning the degree of compliance confirmed earlier conclusions about the greater degree of compliance of older women compared to men. A large proportion of doubting men and women with a high level of education, regardless of age, requires a more attentive attitude to them in terms of providing additional information about the need and importance of following doctor's prescriptions.
POSITIVE EFFECT ON THE MANIFESTATION OF SEXUAL DYSFUNCTION IN WOMEN OF COC CONTAINING ESTRADIOL VALERATE IN COMBINATION WITH DIENOGEST WITH A DYNAMIC DOSAGE REGIMEN
Authors: O.B. Kalinkina
Published: September 2021

Combined oral contraceptives (COC), as drugs containing hormones, can negatively affect sexual function in women of reproductive age. Various causes of sexual dysfunction when taking COC have been studied: a decrease in the concentration of testosterone in the blood due to an increase in globulin, which binds sex steroids, under the influence of oral contraceptives. This mechanism is realized due to the action of two components of COC, both estrogenic and progestogenic. Female sex hormones are known to play an important role in the physiology of sexual desire and behavior. The importance of the most important of them, estrogens, in the sexual behavior of women is to prevent atrophic processes in the vagina, enhance vaginal and vulvar blood circulation, as well as to maintain sensory peripheral perception and the beneficial effect of these processes on the central nervous system. The presented clinical case demonstrates the positive effect of Claira (a drug that is a COC containing estradiol valerate in combination with dienogest with a dynamic dosage regimen) on sexual function. The content of this oral contraceptive of estrogen, identical to natural, eliminates the negative impact of COC on sexual function. Estradiol and estriol, formed during the metabolism of estradiol valerate, actively bind to receptors and have their effects in the tissues of the urogenital tract, having a positive effect on the manifestations of sexual dysfunction. Switching to the drug Clair from other COCs can normalize the condition of women who have decreased sexual function when taking a contraceptive of a different composition and mechanism of action, which was confirmed by this clinical study.
PULMONARY CIRCULATION IN YOUNG AND MIDDLE-AGED MEN WITH ACUTE KIDNEY INJURY DURING MYOCARDIAL INFARCTION
Authors: A.V. Gordienko , A.S. Balabanov , B.B. Tassybayev
Published: September 2021

Relevance. Hemodynamics changes of the pulmonary circulation in myocardial infarction complicated by acute kidney injury are not well understood.
Aim. To evaluate the characteristics of pulmonary circulation in men under 60 years old with acute kidney injury in myocardial infarction to improve prevention and outcomes.
Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative analysis of pulmonary circulation parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of the risks of developing acute kidney damage and chronic heart failure in the selected groups were performed.
Results. The study group differed in a lower heart rate (HR1) (66.3±12.2 from the control group (75.8±18.8; p=0.003). It showed a tendency towards lower the mean pulmonary artery pressure (MPAP) and total pulmonary resistance (TPR) at both points of the study. In both groups, there was a similar dynamic of decrease in the MPAP and TPR levels, more pronounced in the control group (MPAPII: -14.3%; MPAPI: -6.1 %; TPRII: -29.9%; TPRI: -21.8%; p<0.0001) and multidirectional - for HR: in the study group, an increase in HR was noted by 0.9% (p<0.0001), and in the control - its decrease by 8.4% (p<0.0001). Risk markers of the acute kidney injury developing were MPAP1˂30.4 mm Hg, HR1˂67 per minute and TPR1˂622.8 dyne•s•cm-5, the presence of chronic heart failure and cardiac asthma among the disease complication. The predictors of chronic heart failure in the study group were MPAP1≥26.9 mm Hg and HR1≥62 min.
Conclusions. In case of acute kidney injury, lower levels of pulmonary circulation indicators are noted, their lower dynamics during the observation period, and a greater frequency of observation of chronic heart failure in comparison with the control group. The above listed values of the pulmonary circulation parameters have been assessed as a risk marker of the acute kidney injury and chronic heart failure development.
RESULTS OF OPTIMIZATION OF THE MEDICAL CARE SERVICE FOR THE ADULT POPULATION OF THE PENZA REGION IN THE PROFILE "MAXILLOFACIAL SURGERY" IN 2021
Authors: M.V. Lebedev , K.I. Kerimova , I.Yu. Zakharova
Published: September 2021

The increase in the number of patients with pathology of the maxillofacial region necessitates improving the quality of medical care provided to the population in the field of "Maxillofacial surgery". Anatomical and physiological features of the maxillofacial region, the prevalence of pathology determine the implementation of organizational measures, the involvement of narrow specialists, the need for medical organizations in modern material and technical equipment. The indicators of medical care mainly depend on a full-fledged diagnosis, and are also determined by the availability, quality and speed of specialized medical care. In modern conditions of the development of the health care system, an integrated approach to the organization, the introduction of new methods of providing medical care and rehabilitation of patients is required. Optimization of the maxillofacial surgery service within a multidisciplinary medical organization, the introduction and development of an outpatient polyclinic link, the training of highly qualified personnel contribute to improving the quality of diagnosis, treatment and timely detection of pathology.
This article presents the results of optimizing the service for providing medical care to patients with pathology of the maxillofacial region. In the Penza region, the full-fledged, high-quality functioning of the service is realized through the organization of the Center for Maxillofacial Surgery on the basis of the State Budgetary Healthcare Institution «Penza Regional Clinical Hospital named after N.N. Burdenko». The structure of the Center for Maxillofacial Surgery ensures the continuity and complementarity of specialists of a medical organization in the treatment and diagnostic process. Optimal conditions have been created for the diagnosis, treatment and rehabilitation of patients with pathology of the maxillofacial region, in order to provide the population with affordable and high-quality medical care, regardless of the category of citizens. The creation of the Center for Oral and Maxillofacial Surgery contributes to an increase in the structural efficiency and medical efficiency of the health care system of the Penza region. The results of the measures and innovations carried out can be used to eliminate the existing shortcomings in the organization of medical care for patients with pathology of the maxillofacial region in other regions.
OPINION OF PEDIATRICIANS AND PARENTS OF GIRLS AND TEENAGE GIRLS ON THE PERFORMANCE OF IMPROVING THE REPRODUCTIVE HEALTH SYSTEM OF GIRLS AND ADOLESCENT GIRLS
Authors: O.V. Lukasheva , V.A. Bortsov , Y.V. Khmelnitskaya
Published: September 2021

The problem of maintaining the reproductive health of the population is acute. In order to determine the need, scope and direction of improving the reproductive health system of girls and adolescent girls, sociological studies were carried out on 400 parents of girls and 86 pediatricians. According to the results of a survey of parents, it was revealed that the parents of girls are convinced that sex education of children should be carried out mainly in the family, with the participation of health professionals and teachers. The interviewed parents of girls often have questions about reproductive health and behavior from their children and need to obtain objective and reliable information for the implementation of correct and timely sex education, but they do not have the opportunity to receive it in sufficient volume from doctors in a polyclinic or teachers. A study of the opinion of pediatricians on the level of their involvement in the process of protecting the reproductive health of girls revealed that pediatricians do not have enough time and resources to carry out high-quality and full-fledged preventive work on reproductive health and behavior with girls and their parents. As a result, the respondents agree on the need to improve the organization of reproductive health care for girls and adolescent girls by creating an electronic resource containing preventive information on reproductive behavior and reproductive health for girls and their parents.
THE RESURGENCE OF INTRAUTERINE CONTRACEPTION
Authors: Yu.A. Petrov , G.Yu. Spiridenko , T.V. Bragina
Published: September 2021

The topic of intrauterine contraception remains relevant for a very long time. The active search for optimal and safe means of intrauterine contraception began in the last century and is gaining more and more momentum in the modern world. The importance of this issue is due to the continuing need of the population of reproductive age to control childbearing, the popularization of data on various methods of birth control and the desire to use safe, effective, environmentally friendly methods of contraception. The presented topic touches on the aspects of family planning and pre-gravidar training, so it is not only a significant medical, but also a social problem. This leads to the constant need to study new mechanisms of systemic and local effects of intrauterine contraceptives on the female body. This article discusses the use of intrauterine contraceptives, the features of their impact on the endometrium, the reproductive potential of women, as well as the positive and negative aspects of their use. There are also groups of women for whom intrauterine contraception is the method of choice for birth control. The indications for the extraction of an intrauterine contraceptive are described. Among them, there are menstrual disorders of the type of hypermenorrhea lasting more than 6 months in the absence of the effect of the use of non-steroidal anti-inflammatory drugs, the end of the period of use of an intrauterine contraceptive, the desire and need of a woman, the desired pregnancy, expulsions, the postmenopausal period. Knowledge of all aspects of intrauterine contraception allows the obstetrician-gynecologist to correctly select a certain type of IUD, to explain to the woman all the risks of its use, to diagnose and correct complications in a timely manner.
NEW CORONOVIRUS INFECTION: CLINICAL AND PATHOGENETIC ASPECTS OF COVID-19 IN PREGNANT WOMEN
Authors: D.Z. Allakhyarov , Yu.A. Petrov , V.V. Chernavsky
Published: September 2021

This article presents reviews of literature sources on the clinical and pathogenetic aspects of the course of a new coronovirus infection in pregnant women, in order to analyze the features of the course of COVID-19 in pregnant women and to assess the impact of infection on the body of a woman and a fetus. Pregnancy is a special physiological condition, during which a number of changes occur in the body, not only in the hormonal status, but also in the immune system. The urgency of this problem is due to the high prevalence of new coronavirus infection among the population. On March 12, 2020, the World Health Organization (WHO), as a result of the dynamic development of the epidemic in many countries and continents, declared a global pandemic of the contagious disease COVID-19 caused by the SARS-CoV-2 virus. According to available studies, pregnant women are more susceptible to a more severe course of infectious diseases affecting the upper respiratory tract. According to various studies, a new coronavirus infection can lead to premature birth, miscarriage, and preeclampsia. Separate studies show increased mortality in pregnant women diagnosed with COVID-19. The SARS-CoV-2 virus does not have a direct teratogenic effect on the fetus, but it can indirectly lead to harmful effects on the developing organism. Special attention should be paid to the issue of vaccination of pregnant women against a new coronavirus infection, at the moment there is no accurate data on the effect of the vaccine on the body of the pregnant woman and the fetus. In this regard, the question of the impact of a new coronavirus infection on the course of pregnancy has become relevant.
ASSESSMENT OF THE PROBABLE RELATIONSHIP OF EXACERBATIONS OF CARDIOVASCULAR DISEASES WITH THE METEOROLOGICAL SITUATION
Authors: T.A. Berezhnova , Ya.V. Kulintsova , O.V. Maslov , N.M. Kolyagina , E.Yu. Ponomaryova
Published: September 2021

Relevance. The analysis of these scientific publications has shown the relevance of studying the problem of the influence of sudden changes in meteorological factors on the functioning of the cardiovascular system, exacerbation of its leading diseases – arterial hypertension, brain vascular lesions, cerebrovascular diseases, angina.
Aim: to identify the probable relationship of exacerbations of diseases of the cardiovascular system with the meteorological situation.
Material and methods. A sample of data on the daily number of cases of patients 'requests for medical care to the registry of the Voronezh City Polyclinic No. 18 for 2018 was conducted.
Results. At a temperature below-200C, which was registered on 27.02.2018, the number of requests for medical care due to hypertension without heart failure is 88 cases, with a diagnosis of brain vascular damage (specified) – 15, with a diagnosis of cerebrovascular disease-16, hypertension with heart failure-2, angina-0. The difference in the average daily temperature of more than 8 0C was recorded in 204 of 365 days. Out of 365 days, the atmospheric pressure drop of more than 6 mm Hg per day was recorded 52 times.
Conclusions. The most informative characteristic of the six meteorological indicators taken into account in the study is a sharp drop in atmospheric pressure during the day, with which the number of cases of patients with cardiovascular diseases seeking medical care is statistically significantly correlated.
THE SYSTEMIC CIRCULATION IN MEN UNDER 60 YEARS OF OLD WITH MYOCARDIAL INFARCTION AND ACUTE KIDNEY INJURY
Authors: A.V. Gordienko , D.V. Nosovich , B.B. Tassybayev
Published: September 2021

Relevance. Hemodynamics changes in myocardial infarction complicated by acute kidney injury are interpreted in different ways.
Aim. To evaluate peripheral hemodynamics changes in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes.
Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative assessment of circulation indices changes in first 48 hours (1) and the end of third week disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed.
Results. The study group differed from the control group in lower values of heart rate1 (66.3±12.2 and 75.8±18.8 (bpm), respectively; p=0.003) and higher - arterial pressure, systolic1 (155.6±24.0 and 139.5±28.9 (mm Hg); p=0.006), diastolic1 (98.0 ± 16.0 and 86.6 ± 18.9 (mm Hg); p = 0.002), mean1 (117.2±17.6 and 104.3±21.3 (mm Hg); p=0.001). In the study group compared in the control group, there was a greater decrease in blood pressure (mean: -18.3 and -8.3%, respectively) and total peripheral resistance (-33.5 and -26.3%) (p<0.0001). The risk markers of the acute kidney injury development were the mean arterial pressure1≥106.7, systolic1≥140.0, diastolic1≥90.0 (mm Hg) and heart rate1˂66 bpm.
Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by arterial hypertension and bradycardia in the first hours of the disease, as well as more pronounced decline dynamics of blood pressure and total peripheral resistance at the end of its subacute period. The listed above values of the circulation parameters should be used in the high-risk groups for the acute kidney injury development formation, as well as prognostic modeling.
СERVICAL INSUFFICIENCY AND GENITAL INFECTION
Authors: V.F. Dolgushina , E.S. Alikhanova , E.D. Grafova
Published: September 2021

Despite the availability of diagnostics and modern methods of treatment, preterm birth with cervical insufficiency occurs in 44-57% of cases, while early preterm birth reaches 38,8%. To date, there is no doubt about the connection of premature labor and intraamnial inflammation, the frequency of which in cervical insufficiency reaches 80%. Most researchers are unanimous in the opinion that the ascending route of infection in intraamnial infection is a priority. It has been proven that a decrease in the absolute and relative amount of Lactobacillus spp., A change in the species composition of lactoflora or atypical vaginal colonization associated with premature birth and premature rupture of membranes. Conditionally pathogenic microorganisms of the vaginal biotope with an insufficient number of lactobacilli are capable of producing various proteases that destroy collagen, constituting the basis of connective tissue and determining the elasticity of the membranes, which allows us to consider cervicovaginal infections as one of the mechanisms of premature remodeling of the cervix and rupture of membranes. In that way, it is relevant to study the frequency and structure of genital infection in cervical insufficiency. The analysis of medical literature data, presented in the electronic libraries Elibrary and Pubmed for the last 10 years, devoted to the study of genital infection in cervical insufficiency. The issue of the relationship of cervicovaginal infections with premature remodeling of the cervix of the uterus was discussed, as well as studies on the role of intrauterine infection in the genesis of preterm labor. The results of scientific studies are presented, indicating both the direct influence of cervical incompetence on the risk of intraamnial infection and the root cause of genital infection in the pathogenesis of cervical insufficiency. Convincing data are given that timely diagnosis and treatment of violations of the vaginal biocenosis is one of the significant links in the prevention of premature birth. It is necessary to further study the pathogenetic relationship of cervicovaginal infections and cervical insufficiency.
STUDY OF HEART RATE VARIABILITY IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION DURING PROPHYLACTIC TREATMENT OF METOPROLOL AND CORDARONE FOR ONE YEAR
Authors: T.A. Rybakova , V.V. Stolyarova , M.V. Gizova
Published: September 2021

This work is devoted to the dynamic study of heart rate variability indicators for one year in patients with paroxysmal atrial fibrillation treated with antiarrhythmic drugs metoprolol and cordarone. The study found that patients treated with metoprolol monotherapy had a weakening of parasympathetic effects on the heart, due to a decrease in Mean by 12.9%, Mo by 13%, Amo by 29.4%, SDNN by 28.3% compared to the group of healthy individuals, but they differed in stable indicators of heart rate variability and 33% retained sinus rhythm during the year. With cordarone monotherapy, there was a curative effect of sympathetic and parasympathetic effects on the heart, as indicated by an increase in: Mean by 15.9%, Mo by 15.9%, IVR by 95.5%, Amo by 41.1% and a decrease in SDNN by 37.5%, compared with the group of healthy individuals at the initial stage. A year later, a negative dynamics was revealed - the predominance of sympathetic influences on the heart compared to the groups of healthy individuals and the control due to an increase in: IVR by 363.3% and 238.5%; VPR by 116.7% and 106%; Amo by 111.2% and 72.9; IN by 304% and 246.8%; PAPR by 92% and 79.1%, respectively. During the year, 39% of patients left the study due to the replacement of antiarrhythmic therapy and 16.5% due to the development of a permanent form of atrial fibrillation. In the remaining patients in the study, in comparison with their initial data, there was a predominance of sympathetic effects on the heart due to an increase in IVR by 137%. In combination therapy with metoprolol and cordarone, there were no significant changes in heart rate variability compared to the initial ones. Initially, there was a decrease in overall heart rate variability due to a decrease in SDNN by 28.4% and a decrease in parasympathetic effects on the heart due to an increase in Amo by 45.2% and a decrease in Delta X by 32.9% compared to the group of healthy individuals. After a year, 40% left the study due to the replacement of antiarrhythmic therapy and 30% due to the development of a permanent form of atrial fibrillation. During dynamic observation of patients, it was found that the following indicators have the most important prognostic value in the development of atrial fibrillation: SDNN, Delta X and RMSSD. Therefore, it is very important to register an ECG with the measurement of these indicators at least once every 3 months for timely correction of treatment.
INFLUENCE OF EARLY TERMINATION OF TREATMENT OF PATIENTS WITH TUBERCULOSIS ON ITS EFFECTIVENESS
Authors: A.A. Shurygin , E.A. Makarova
Published: September 2021

The effectiveness of a course of chemotherapy largely depends on the continuity and duration. An ineffective outcome of a course of chemotherapy, in addition to objective reasons, also has an additional factor that strengthens it – a break in treatment or its early termination. The aim of the work is to study the effectiveness of treatment of patients with pulmonary tuberculosis with preserved drug sensitivity of the pathogen with early termination of the course of chemotherapy. Materials and methods: A retrospective analysis of the outcomes of a course of chemotherapy of tuberculosis patients who prematurely interrupted treatment, registered for 1-2-3 chemotherapy regimens in the Perm Region, was carried out. Results: Interruptions in treatment or its early termination were present in 7.8% of patients registered for treatment with 1-2-3 chemotherapy regimens. At the stage of inpatient treatment, there is a separation from treatment in 3.5% of patients receiving treatment in the intensive phase of 1-2-3 chemotherapy regimens. Separation from treatment at the outpatient stage is noted in 7.9% of patients receiving treatment in the continuation phase of 1-2-3 chemotherapy regimens, these terms are insufficient for a full course of chemotherapy.. An additional unfavorable factor of intermittent treatment is the formation of secondary drug resistance of Mycobacterium tuberculosis. The ineffectiveness of the course of chemotherapy leads to an increase in the number of patients with tuberculosis and the tension of the epidemic situation. Conclusions: In the treatment of patients with drug-sensitive tuberculosis in the Perm Region, treatment is interrupted more often at the outpatient stage than at the inpatient stage (p=0.03), which requires further study of the reasons for preventing early termination of treatment. It was found that the termination of treatment prematurely in all patients led to the ineffectiveness of CT. Social factors (lack of income, unfavorable living conditions and distance from drug dispensaries, staffing of qualified medical personnel) can affect the adherence and effectiveness of treatment.
THE ROLE OF FAMILY IN PRESERVING OF HEALTH FROM THE VIEW OF THE YOUTH
Authors: D.P. Solodoukhina
Published: September 2021

The article is devoted to the analysis of views of the youth about health, factors contributing to health formation and the role of family in preserving of health. Methodology of work is a survey with electronic Google form. Attitudes and opinion of 430 people, citizens of Russia, mainly of the youngsters aged 18-24, have been studied. There was found that psychological and social components of health are the most important for young people, while the role of physical health in young age is underestimated. The majority of respondents (61,4%) defined healthy family as the one, where there are good sincere relationships between spouses and children. Half of the respondents (51,9%) marked the role of financial status of family in achievement of health. 34,4% of the respondents believe that in a healthy family parents devote much attention to self-development and education of their children. The majority of respondents (88,4%) realize that family is a key factor in formation of healthy behavior and healthy life style. Only half of respondents recognize the positive influence of family on their own health. The results of the study can be applied for development of regional and state programs in the field of public health and health promotion.
CLINICAL AND PROGNOSTIC CRITERIA FOR THE COMPLICATED COURSE OF NEW CORONAVIRUS INFECTION (COVID-19).
Authors: A.S. Sycheva , A.L. Kebina , А.L. Vertkin
Published: September 2021

Relevance. The pandemic of new coronavirus infection COVID-19 is the main topic and problem of modern medicine associated with the necessity of rapid diagnostics and medical care rendered to such patients Nowadays, individual pathogenetic mechanisms of infection COVID-19 are determined, however, clinical and epidemiological particularities of the disease are being intensively investigated, and new agents for prevention and treatment of infection COVID-19 are being developed. The determination of predictors of the severe disease course and exposure methods is definitely important. The studies have shown that the presence of various concurrent comorbid diseases in patients hospitalized with COVID-19 negatively affects the disease course and its prognosis.
Study objective: the analysis of the observation results and clinical outcomes of clinical course (clinical masks) of new coronavirus infection COVID-19 with the distribution by age, gender and incidence of somatic diseases, identification of the pattern of visceral organ damages in coronavirus infection caused by virus SARS-CoV-2.
Materials and methods: 110 patients with virus pneumonia caused by COVID-19 were enrolled to the study. The presence of risk factors of the severe disease course variants and intensity of the somatic disorder in necropsy of patients died were evaluated.
Study results: The found analysis data suggest that the most significant predictors of the severe course of COVID-19 are arterial hypertension with a high and very high cardiovascular risk, followed by a renal disorder, type 2 diabetes mellitus, obesity, hepatic and heart failure.
Conclusion. The found analysis data suggest that the most significant predictors of the severe course of COVID-19 are arterial hypertension with a high and very high cardiovascular risk, followed by a renal disorder, type 2 diabetes mellitus, obesity, hepatic and heart failure.
SELECTION OF COMPOSITION AND TECHNOLOGY OF GRANULES WITH GARDEN LEAVE STRAWBERRY EXTRACT DRY
Authors: O.V. Yaborova , E.A. Zamakhaeva , O.A. Oleshko
Published: September 2021

Garden strawberries (Fragaria ananassa) are widely cultivated on the territory of Russia on industrial plantations and private garden plots to obtain the fruits (berries) of this plant and their use as a valuable food product. When harvesting fruits, other parts of the garden strawberry are not used, however, its vegetative parts are a source of biologically active substances (BAS) and are of interest for the pharmaceutical and cosmetic industries [1, 4].
The biological activity of garden strawberry leaf extracts is due to the presence of secondary metabolites of a phenolic nature; their content in raw materials reaches more than 3% in some samples [2, 3].
Considering that the main group of biologically active substances of this raw material are flavonoids, the Department of Pharmacognosy with a course of botany conducted research to develop a method for quantitative determination of the amount of flavonoids in terms of rutin. Spectrophotometry was chosen as the optimal method for assessing the content of this group of substances in medicinal plant raw materials - leaves of garden strawberries, which allows determining the amount of flavonoids in terms of the dominant compound and obtaining reliable and reproducible results of quantitative analysis [8, 11].
The technological properties were studied and a therapeutic dose of dry strawberry extract was proposed, optimal compositions were selected and technologies of sachet-granules with dry strawberry extract were developed. The method for the quantitative determination of flavonoids in terms of rutin was validated.
The results of the study can be used in the future in the development of draft regulatory documents for sachet-granules with dry strawberry extract of garden leaves and the study of their pharmacological activity.
DEVELOPMENT OF THE COMPOSITION AND TECHNOLOGY OF SEDATIVE FILMS
Authors: E.A. Zamakhaeva , O.A. Oleshko , O.V. Yaborova , M.M. Smirnova , A.V. Kuritsyn
Published: September 2021

Herbal sedatives have been popular for several centuries, and the accumulated knowledge that has been passed down from generation to generation laid the foundation for the development of traditional medicine, and over time for such a science as herbal medicine. Herbal sedatives have a wide range of therapeutic effects, are well tolerated and have no serious adverse reactions, and are not addictive. According to statistical data on the incidence of the population by main classes and individual diseases for 2010-2018, the number of patients with diseases of the nervous system is growing annually, along with this, the need for sedative drugs is increasing. In this regard, the search and development of effective and safe medicines based on medicinal plant raw materials is an urgent area [1, 2].
Pharmaceutical infusions and decoctions, according to the order of the Ministry of Health of the Russian Federation No. 751n dated October 26, 2015, have a shelf life of 2 days, which significantly limits the possibility of their use. The production of films based on aqueous extracts from medicinal plant raw materials will make it possible to obtain more stable drugs, in addition, films have a number of advantages over other dosage forms.
Films containing biologically active substances of plant origin have received the unofficial name phytofilms, which are a type of transdermal therapeutic systems. Phytofilms are hydrophilic systems that swell when in contact with water (or biological fluid), absorbing it in a certain amount, which leads to the dissolution of biologically active substances. They differ from synthetic polymeric therapeutic systems in that phytofilms are made in the form of matrix transdermal therapeutic systems on carriers of natural origin (gelatin, collagen, sodium alginate, agar-agar, etc.), which makes them safer [3, 4].