bluuebunny/crossref_metadata_2025 huggingface dataset:
TAX ASPECTS OF WITHDRAWAL FROM CIRCULATION AND DESTRUCTION OF MEDICINES BY PHARMACIES
Authors: A.A. Teodorovich , E.E. Loskutova , A.I. Smirnov
Published: May 2024

Strict regulation of the quality of medicines, as well as the establishment of expiration dates for them, are risk factors for commodity and financial losses of pharmacies associated with the withdrawal from circulation and destruction of medicines that are unusable for further sale. As taxpayers of taxes in force in the Russian Federation, pharmacies must take these transactions into account when they determine their tax obligations. Understanding the tax aspects of the withdrawal from circulation and destruction of medicines allows, at the stage of organizing these procedures, to minimize tax risks, and, consequently, the financial losses of pharmacies associated with their implementation in the form of additional charges of taxes, fines and penalties. The purpose of the study was to identify possible tax risks arising when medicines are withdrawn from circulation and to identify possible ways to reduce them. To achieve this goal, an analysis of legislative requirements, explanations of authorized bodies and current judicial practice on the issue under consideration was carried out. The analysis showed that operations for the withdrawal from circulation and destruction of medicines are a source of tax risks for pharmacies in terms of income tax and VAT. It was revealed that tax risks for income tax are associated, first of all, with incorrect documentation of the withdrawal of medicines from circulation. They are also possible due to the refusal to identify those responsible for the damage or their absence, the failure to file claims against the guilty parties and their lack of compensation for losses, and write-off before the expiration date. Tax risks for VAT arise if a pharmacy does not have evidence of disposal of medicines for reasons beyond the will of the owner and without transfer to other persons. To help reduce tax risks will be the inclusion in the internal regulations on the withdrawal of medicines from circulation and their destruction of provisions that take into account the norms of tax legislation and arbitration practice, as well as monitoring their compliance.
PRIMARY DISABILITY DUE TO MALIGNANT NEOPLASMS IN DIFFERENT AGE GROUPS OF THE ADULT POPULATION (REGIONAL ASPECT)
Authors: I.А. Dzhioeva , A.Е. Mamieva , Z.R. Alikova , V.G. Sabanova
Published: May 2024

Relevance. A significant level of morbidity significantly exacerbates the medical and social significance of oncopathology, leading to high mortality and disability of the population. In terms of the prevalence of disability, malignant tumors occupy the second rank after the circulatory system. The increase in advanced stages of malignant tumors associated with problems in early detection of the oncological process leads to a heavier disability group.
Objective:. To analyze the prevalence and age structure of disability of the adult population due to malignant neoplasms in the Republic of North Ossetia-Alania.
Materials and methods. Primary disability due to malignant neoplasms in 2020-2022 was studied using the accounting and reporting form No. 7-sobes. A comparative analysis of the structure and indicator of disability due to malignant neoplasms in the Republic of North Ossetia-Alania, the North Caucasus Federal District, and the Russian Federation was carried out. Results. The age structure of malignancy disability shows stable growth dynamics in all age groups, especially noticeable among young people. At the same time, the indicators of disability for malignant neoplasms among people of retirement age prevail over similar indicators among middle-aged and young people. In the structure of disability, taking into account the classes of diseases among IDPs due to malignant neoplasms, disability group I in 2022 amounted to 40.9%, group II 35.1%, group III 13.3%. The significant prevalence of disability group I among those recognized as disabled for the first time is prolonged during the study period, thus confirming the high relevance of the problem of malignant neoplasms. During the spread of the COVID-19 coronavirus epidemic, the growth dynamics of the disabled of the I disability group in 2021 and 2022 is noted. There was no significant impact on the indicators of disability groups II and III in this period.The indicators of primary disability due to malignant neoplasms in the Republic of North Ossetia-Alania are lower than in the Russian Federation and the North Caucasus Federal District, but have the same upward trend.
Conclusion. The data obtained indicate a negative dynamics in the growth of disability indicators for malignant neoplasms and an aggravation of the degree of disability. In the current situation, the analysis of indicators and the age structure of disability due to malignant neoplasms in dynamics makes it possible to identify the priorities of medical and social expertise and becomes important when developing age-oriented, differentiated rehabilitation programs for the disabled. Given the high correlation between the severity of disability and the neglect of the oncological process, early diagnosis and adequate treatment tactics for patients with malignant neoplasms will undoubtedly contribute to improving disability indicators, allowing timely medical and social examination.
READINESS OF DENTISTS TO USE NAVIGATIONAL SURGICAL TEMPLATES IN DENTAL IMPLANT PLANNING
Authors: D.V. Mikhalchenko , V.N. Naumova , E.G Dorozhkina , A.D. Mikhalchenko
Published: May 2024

Dental implantation surgery is becoming an increasingly demanded dental procedure. Along with the growing number of installed dental implants, the number of complications inevitably increases, including those associated with planning errors in both the surgical intervention itself and subsequent orthopedic treatment. Despite the wide awareness among practicing dentists about the possibilities of navigational surgery, its prevalence remains insufficient. This paper analyzes the frequency of use and reasons for refusal to use navigational surgical templates among dental surgeons and orthopedists from different regions of Russia working in both public and private healthcare systems.
INFLUENCE OF RHEUMATOID ARTHRITIS ON THE COURSE OF PERIODONTAL DISEASES
Authors: E.G. Borisova , T.V. Dubrovina
Published: May 2024

The most common chronic systemic autoimmune disease of connective tissue is rheumatoid arthritis, the incidence of which is up to 50% (in Russia). The etiology of rheumatoid arthritis is still not known for certain. Scientists pay special attention to searching and studying the factors influencing the occurrence of this disease. Researchers are interested in periodontitis as a likely factor in the development of rheumatoid arthritis. The literature presents limited data on the study of the characteristics of the course of dental diseases in patients with rheumatoid arthritis, which indicates the need for further study of this issue and clarification of the relationships between the intensity of caries, the condition of periodontal tissues and the temporomandibular joint in this category of patients. The study of these issues is of scientific and practical interest, as it allows us to improve the methods of diagnosis and monitoring of patients with rheumatoid arthritis by a dentist. The purpose of this study is to determine the effect of rheumatoid arthritis on the course of periodontal diseases.
Materials and methods. The methodology of the scientific research is based on the analysis of domestic and foreign literature in the eLIBRARY databases; basic and additional methods of examining the patient were carried out. During the clinical examination, we assessed the general condition of the patient with rheumatoid arthritis, his dental and periodontal status.
Results and discussion. A clinical examination of a patient with somatic pathology was carried out. Microorganisms of periodontal pockets were determined, the data obtained were compared with a patient who does not have a systemic disease. Conclusions. Patients with rheumatoid arthritis generally have a thin gingival biotype. Immunological parameters of oral fluid (IgA) in rheumatoid arthritis decrease, which indicates a lack of local and general immunity and leads to damage to periodontal tissue. In the future, this scientific research will help us develop optimal methods for diagnosing and treating patients with autoimmune disease.
IMAGING OF PERITONEAL METASTASIS: LITERATURE REVIEW AND OWN EXPERIENCE
Authors: S.V Zinchenko , K.R. Ishmuratova
Published: May 2024

Peritoneal metastasis is typical for malignant neoplasms of the ovary, stomach, intestines and other localizations. Metastases can mimic other pathological changes. Ambiguous conclusions about the effectiveness of certain methods of visualization and differentiation of peritoneal metastasis given in the scientific literature explain the lack of a unified approach in its diagnosis. Imaging of the peritoneum directly impacts tumor burden assessment, prognosis, and treatment planning. Purpose of the study: to analyze the information content of modern methods of visualizing peritoneal metastasis, based on literature data and our own experience. Materials and methods. The study was carried out on the basis of a literature analysis of publications of the electronic search system PubMed. We also conducted our own research on the comparative effectiveness of visualization methods implemented in the conditions of the Republican Clinical Oncologic Dispensary of Ministry of Health of the Republic of Bashkortostan. Results: analysis of the literature showed that all visualization methods have certain capabilities and limitations. Diagnosis of metastases located in the small intestine and lesions less than 5 mm in size is significantly difficult. Adhesive processes in the abdominal cavity, difficult to differentiate confluent tumor masses and inflammatory changes also affect the examination results. Our own experience demonstrates the admissibility of using a combination of pelvic magnetic resonance imaging and abdominal computed tomography for preoperative visualization of peritoneal metastases. Imaging results using instrumental methods were comparable to surgical assessment. In addition to the diagnostic limitations stated in the scientific literature, we identified difficulties in interpreting the results due to the lack of criteria for assessing peritoneal pathology by radiologists. Conclusion. Thus, according to the literature, the standard for diagnosing peritoneal metastases has not been defined. Computed tomography and magnetic resonance imaging methods are relatively accessible methods for visualizing peritoneal metastasis and complement each other, taking into account the diagnostic limitations and capabilities of each. To improve the assessment of the tumor burden at the preoperative stage, it is worth considering the possibility of creating uniform protocols for describing peritoneal metastases by abdominal region by radiologists, which will significantly facilitate the assessment and treatment planning in the future.
ASSESSMENT OF PROSPECTS FOR THE USE OF RAW MATERIALS OF FILIPENDULA IN PHARMACY AND MEDICINE
Authors: D.V. Shokot , N.V. Nesterova , A.N. Kuzmenko
Published: May 2024

An analysis of the scientific literature has shown a significant interest of researchers around the world in the study of medicinal plant raw materials and new sources of herbal preparations of various pharmacological effects. One of such promising objects is the vyazolistnaya meadowsweet or labaznik, an unpretentious plant widely distributed on the territory of the Russian Federation.
Due to its diverse chemical composition, labaznik has a wide range of properties necessary for the manufacture of various drugs with high pharmacological activity. The main group of biologically active substances of meadowsweet are phenolic compounds. The essential oil has noticeable antimicrobial and antifunginal activity.
Today, being a pharmacopoeial plant in the Republic of Belarus, France and the United Kingdom, in the Russian Federation, meadowsweet does not have the appropriate regulatory documentation, which makes it difficult to use this plant as a source of medicines. In addition, the presence of a number of dietary supplements on the pharmaceutical market, which include different types of raw materials of meadowsweet, also requires the availability of appropriate regulatory documents.
The pharmacological activity of different types of raw materials has been confirmed in a significant number of studies by scientists from different countries, however, the plant is still of interest for further testing, especially in the Russian Federation for the formation of regulatory documentation. In this article, the authors conducted a systematic analysis of scientific research on the pharmacological activity of various types of raw materials of the labasnik and assessed the prospects for its use in Russian pharmaceutical practice.
FEATURES OF ENDODONTIC TREATMENT CONSIDERING CANDIDA ALBICANS IDENTIFIED IN THE ROOT CANAL SYSTEM
Authors: A.L. Ermolovich , E.G Borisova , A.F Spesivets , V.A. Zheleznyak
Published: May 2024

The subject of the study was to study the properties of basic means for irrigation and physical methods of influencing the microflora of the root canal system against identified Candida Albicans. The purpose of the work was to review and analyze the features of endodontic dental treatment, taking into account the identified Candida Albicans in the root canal system. A search was conducted in domestic publications and foreign sources for studies containing information on various methods of influencing root canal biofilms during endodontic treatment. A comparison was made of the activity of various irrigants and physical methods of root canal treatment in relation to the identified microflora containing bacteria such as yeast-like fungi of the genus Candida and others. Sodium hypochlorite solution (NaOCl) is a mandatory antiseptic agent included in the recommended endodontic treatment protocol used in modern dentistry. To achieve a successful result, we consider it necessary to perform high-quality mechanical treatment of root canals, competent selection of irrigants, as well as the use of additional physiotherapeutic methods (ultrasound or laser technologies). A bacterioscopic examination of the contents of the root canals was carried out for the presence of yeast-like fungi of the genus Candida. A temporary exposure of a suspension of the drug “Fluconazole” on a paper point was introduced into the root canals at the first stage of endodontic treatment, and the drug “Fluconazole” was prescribed orally at a dose of 150 mg on the first day. Then, in the absence of exudate or odor in the root canals, as well as confirmation by bacterioscopic examination of the absence of yeast-like fungi of the genus Candida, the root canals were filled with permanent material. But despite following all clinical recommendations, in some cases it is not possible to achieve the required effect due to the resistance of biofilms containing Candida albicans, Prevotella melaninogenica, Enterococcus faecalis, Bacteroides fragelis in the root canal system to the effects. Despite the wide variety of endodontic treatment methods and drugs for influencing representatives of the root canal microflora, it is not always possible to achieve complete elimination of biofilm during irrigation and medicinal or physical influence on them. It is especially important to look for ways to modify treatment and make it easier to use and accessible in order to avoid subsequent complications.
METHOD OF MEDICAL SUPPORT FOR PATIENTS AFTER DENTAL REPLANTATION
Authors: E.G. Borisova , K. Sh. Azizov
Published: May 2024

Modern dentistry is aimed at using minimally invasive interventions to preserve dentition. This fact determines the need for wider use of various types of tooth-preserving operations. In modern conditions, tooth-preserving operations are increasingly being carried out with a predictable successful outcome. Treatment of dental trauma involves complex endodontic or surgical treatment protocols. An important aspect in the rehabilitation of dental injuries is the development of clear diagnostic tactics both at the initial appointment and at all stages of treatment. We observed 127 patients from 2012 to 2022 with diagnoses: complete, incomplete tooth dislocation, uncomplicated or complicated by fractures of the coronal part of the teeth, men and women aged 18 to 40 years. The first group consisted of 66 people with traumatic dislocations of teeth, who sought medical help within 24 hours after the injury, who underwent tooth replantation surgery, endodontic treatment, a complex treatment developed aimed at stopping an acute inflammatory reaction of a post-traumatic nature, and carrying out the necessary splinting measures. The second group consisted of 61 people with traumatic dislocations of teeth who sought medical help after 24 hours or later. Patients in each group were divided into subgroups; in the control subgroups, traditional treatment and rehabilitation after dental replantation were carried out; in the main subgroups, the technique we developed using M-Chip nanomatrices and LED radiation was used. All patients underwent macrohistochemical examination and measurement of dentogingival attachment using a periodontal probe. The results of a macrohistochemical study 7 days after replantation showed that in groups 1b and 2b, whose patients received complex treatment according to the developed method, the area of inflammation of the mucogingival complex was smaller than in patients in groups 1a and 2a, who were treated according to the traditional method. Results of probing of the dentogingival attachment found that in groups 1b and 2b, whose patients received complex treatment using the developed method, the dentogingival attachment corresponds to normal indicators of a healthy periodontal complex than in patients in groups 1a and 2a, who were treated using the traditional method. The inclusion in the complex of rehabilitation measures after dental replantation surgery of drugs that have antiseptic, reparative, hemostatic and immunoadjuvant effects, using LED radiation, increases the effectiveness of these measures by 2-3 times.
MATHEMATICAL MODELS AND NUMERICAL METHODS IN CARDIOLOGY: OWN EXPERIENCE
Authors: N.G. Lozhkina , P.P. Lozhkin , H.A. Sabanchieva , M.Zh. Chochaeva
Published: May 2024

Вackground. In the era of digital transformation in medicine, which is radically changing the way patient information is stored, processed and used, medical professionals need new tools and approaches that can efficiently process and interpret data for fast and accurate decision making. These methods also enable the creation of personalized treatment approaches, taking into account individual patient characteristics and risks. In this article, the authors share their own experience in applying numerical methods in cardiology.
Purpose of the study. To develop methods of effective risk assessment of cardiovascular outcomes in different categories of patients.
Characteristics of patients and methods of the study. Three variants of outcome prediction were included in the study. The 1st - assessment of the total risk of one-year cardiovascular outcomes after myocardial infarction with ST-segment elevation, the 2nd - assessment of the risk of postinfarction chronic heart failure, the 3rd – assessment of the risk of progressive course of atherosclerosis.
Statistical analysis methods included the free cross-platform visual programming system Orange, the SPSS 22.0 package, and the C programming language console.
Results and Conclusion. The conducted study has shown that the application of different approaches: regression analysis, machine learning, Excel programming capabilities, C programming language and console interface allows to develop models of cardiovascular outcomes prediction with high accuracy.
TWO WAYS OF MODELING THE RISK OF PROGRESSIVE ATHEROSCLEROSIS
Authors: N.G. Lozhkina , O.A. Parkhomenko , H.A. Sabanchieva , M.Zh. Chochaeva , P.P. Lozhkin
Published: May 2024

Background. Relevance Progressive atherosclerosis has attracted researchers for the last decade due to the fact that it is associated with unfavorable clinical outcomes. Application of modern methods of mathematical modeling will allow to identify patients with such extreme risk of cardiovascular events and optimize their management.
Purpose of the study. To develop a mathematical model of the risk of progressive atherosclerosis using the free cross-platform visual programming system Orange and to compare it with the method of nonlinear regression model of logistic type implemented in C++ programming language.
Materials and Methods. Female and male patients diagnosed with coronary heart disease (CHD) were included in the study, 100 of them had signs of progressive course of atherosclerosis, 102 - its spontaneous course. Risk models were built using the free cross-platform visual programming system Orange, SPSS 22.0 package, and C++ console.
Results and conclusion. The author's proposed approaches to assess the risk of progressive atherosclerosis using regression analysis and machine learning have good prognostic accuracy; both methods are recommended by the authors for application in practice.
ASSESSMENT OF DIETS OF PRE-UNIVERSITY STUDENTS FOR THE CONTENT OF INDOLE-CONTAINING PRODUCTS
Authors: A.A. Subach , V.Yu. Reshetnyak , D.A. Dobrokhotov , T.Yu. Degtyarevskaya , N.G. Zakharova
Published: May 2024

Annotation. A sociological study conducted by the authors showed that the nutritional intake of indoles through the use of vegetable products of the cabbage family Brassicaceae among respondents - medical students - is at a low level. Analysis of the questionnaires showed that only 35% of respondents use cabbage family vegetables in their diet, providing the daily intake. At the same time, 10% of students do not use this group of products in food at all, which proves the absence of indoles in the body. According to the survey, white cabbage, broccoli and cauliflower are most often used in the diet. Brussels sprouts have the highest level of glucosolate content, but unfortunately this vegetable was not noticed in the diet of students, perhaps this is due to the fact that the vegetable is not popular enough in the Moscow region. For proper nutritional intake of the recommended amount of indolic substances, it is necessary to regularly use cabbage family vegetables in the diet, preferably raw or with minimal heat cooking in portions of 50-100 grams at a time. Of particular concern is the fact that all respondents are medical students and, as expected, should be more attentive to their health. There is an obvious urgent need to introduce additional elective hours into training programs, during which students need to be introduced to the principles of forming a food set that provides not only the supply of nutrients, but also has a functional property due to the content of biologically active compounds. Due to the importance of indole consumption and the survey results - about low consumption of vegetables, the next stage of work we plan to develop a diet for students taking into account the norms of indole consumption.
DEVELOPMENT OF AN IDENTIFICATION METHOD AND DETERMINATION OF ESSENTIAL OIL IN THE SHOOTS OF THE WESTERN THUJA (THUJA OCCIDENTALIS)
Authors: E.D. Kopytova , D.A. Dobrokhotov , E.A. Dorovskikh , N.G. Zakharova , I.N. Avertseva
Published: May 2024

The purpose of the study is to develop methods for identifying terpenoids and assessing the quantitative content of essential oil in the shoots of western thuja (Thuja occidentalis). The object of the study was samples of thuja occidentalis shoots. The raw materials were used fresh. To carry out qualitative reactions, well-known methods were selected that are most often used in the analysis of essential oil raw materials. Identification of essential oil components was carried out by TLC on Silufol plates. A solution of α-pinene was used as a standard. The quantitative content of essential oil in the raw materials was determined by steam distillation in accordance with the GPM method 1.5.3.00010.15 Determination of the content of essential oil in medicinal plant raw materials and medicinal herbal preparations. The authors proposed qualitative reactions for identifying terpenoids in raw materials, which can be used to form the “Authenticity” section for a new type of raw material - thuja occidentalis shoots. α-pinene was identified by TLC. A quantitative assessment of the essential oil content in raw materials was carried out. Qualitative reactions were experimentally selected to confirm the presence of terpenoids in alcoholic extracts from thuja occidentalis shoots, as well as for unsaturated compounds in essential oil obtained by steam distillation. Using TLC, α-pinene was identified in the analyzed samples. The presence of additional 8 adsorption zones in the essential oil samples was also revealed. Assessment of the quantitative content of essential oil in raw materials, carried out according to method 2 OFS.1.5.3.00010.15 “Determination of the content of essential oil in medicinal plant raw materials and medicinal herbal preparations.” The data obtained during the experiment allows us to recommend the inclusion of an essential oil content of at least 2.84% in the quality indicators of western thuja shoots.
STUDY OF ERYTHROPOIETIN SECRETION IN PATIENTS WITH HIV INFECTION WITH ANEMIA OF CHRONIC DISEASES, IRON DEFICIENCY ANEMIA AND A COMBINATION OF TWO TYPES OF ANEMIA
Authors: V.T. Sakhin , E.V. Kryukov , S.P. Kazakov , A.V. Gordienko , A.V. Sotnikov , O.A. Rukavitsyn
Published: May 2024

Aim. To compare the secretion of erythropoietin in patients with infection caused by human immune deficiency virus (HIV infection) with anemia of chronic diseases (ACD), iron deficiency anemia (IDA), and their combination.
Material and methods. 125 patients with HIV infection were examined: 101 with anemia (55 males, 46 women, 39.4±9.6 years), 24 - a control group of patients with HIV infection without anemia (13 males, 11 women, average age 37.6± 7.37 years). In all patients, the number of red blood cells, the concentration of hemoglobin, ferritin, C-reactive protein (CRP), transferrin saturation index (TSI) and erythropoietin were examined. All patients with anemia after determining TSI, CRP, ferritin based on Van Santen and Worwood criteria were divided into three groups depending on the type of anemia: group 1 - 36 patients with ACD (19 males, 17 women, average age 41.7 ± 11, 8 years, TSI 16.9[IQR, 10.2-23.1]%, ferritin 638.7[IQR, 326-861] μg/l, CRP 54.5 [IQR, 4.8-103.3] mg/l), group 2 – 30 patients with a combination of ACD/IDA (18 males, 12 women, average age 41.2±10 years, TSI 13.2[IQR, 9.8-14]%, ferritin 156.2 [IQR, 123-235] mcg/l, CRP 5.9 [IQR, 0.5-8.2] mg/l), group 3 – 35 patients with IDA (18 males, 17 women, average age 35.4 ±7.1 years, TSI 11.1[IQR, 4.7-13.7]%, ferritin 29[IQR, 4.2-38.9] µg/l, CRP 2.9[IQR, 0.4 -1.6] mg/l). For quantitative indicators, the median (Me), standard error of the mean (m), and interquartile range (IQR) were calculated. The significance of differences between several unrelated groups was determined using the Kruskal-Wallis test.
Results. In the ACD group, a lower number of red blood cells was detected (3.3(2.7-3.8)×1012/l), compared to the group of patients with IDA (3.8(3.7-4.1)×1012/l ). Also, in the group of patients with ACD, the maximum concentration of erythropoietin was detected (28.5[11.2-28.5], U/ml), significantly higher than the concentration of this indicator in the ACD/IDA groups (14[8.1-16.3], U/ml), IDA (15.8[6.2-27.4], U/ml) and patients in the control group (6.3[4.9-7.8], U/ml).
Conclusions. In the present study, ACD in isolated form or in combination with IDA was diagnosed in 65.3% of patients with HIV infection and anemic syndrome. In patients with ACD, an increased concentration of erythropoietin is combined with the lowest number of red blood cells in comparison with other groups of patients with anemia (p<0.05). The results obtained indicate a compensatory increase in erythropoietin secretion in response to suppressed erythropoiesis, or to reduced sensitivity of erythropoietin receptors. Further study of the importance of erythropoietin in the pathogenesis of chronic disease in patients with HIV infection is necessary, including to improve its treatment.
EVALUATION OF THE INTERLEUKIN PROFILE IN NASAL FLUSHES IN CHILDREN WITH ALLERGIC RHINITIS
Authors: I.M. Farber , N.S. Tataurshchikova , O.M. Zimovets , E.V. Aseeva , P.V. Berezhansky
Published: May 2024

Allergic rhinitis is one of the most urgent problems of allergology and immunology, since, despite the improvement of therapeutic and diagnostic approaches, the number of patients remains very significant. Allergic pathologies of various types occur in 25-30% of children. Allergic rhinitis is based on a multifactorial chronic inflammatory process of the nasal mucosa, which causes the presence of constant persistent inflammation and the progression of the disease, especially in childhood. Biological inflammatory mediators in nasal flushes help to determine the pathophysiological phenotypes of allergic rhinitis, which is of undoubted interest. The work carried out the determination of the level of cytokines: IL 1b, IL 4, IL 6, IL 10 and interferon gamma in nasal flushes in patients with allergic rhinitis, depending on the presence or absence of changes in the nasal mucosa based on rhinoscopy during diagnosis verification. Changes in the nasal mucosa directly depend on the production of cytokines, which form individual phenotypes of the disease. According to the results of the analysis, the data obtained are associated with the presence of persistent allergic inflammation, neurohumoral and anti-infectious, which make a significant contribution to the clinical manifestations of the disease. The study of the role and significance of the proliferation of major cytokines in the nasal secretion will help the practitioner in determining treatment tactics, duration of therapeutic and preventive measures and further marching of the patient.
LONG-TERM VASCULAR EFFECTS OF ENHANCED EXTERNAL CONTROPULSATION IN PATIENTS WITH CORONARY HEART DISEASE COMPLICATED BY HEART FAILURE
Authors: A.S. Lishuta , N.A. Nikolaeva , Yu.N. Belenkov
Published: May 2024

Aim. To study the long-term effect of complex therapy with the addition of enhanced external counterpulsation (EECP) on the structural and functional parameters of the cardiovascular system in patients with ischemic chronic heart failure (CHF).
Material and methods. Patients with ischemic CHF NYHA class II-III (n=59; median age 64.8 [57.6; 71.2] years; 81.4% men), receiving EECP in addition to optimal medical treatment (35-hour course every 6 months; compression pressure 220-280 mmHg) had an assessment of exercise tolerance (distance in the 6-minute walk test; 6MWT), structural and functional state of large vessels and microvasculature (computer video capillaroscopy of the periungual bed, photoplethysmography, applanation tonometry), assessment of echocardiographic parameters (volume dimensions, systolic and diastolic functions of the left ventricle) at baseline, after 12, 24 and 36 months. The follow-up period was 36 months.
Results. Significant stable positive dynamics of tolerance to physical activity (the distance in the 6MHT increased by 59.4%) was found. Functional parameters of the heart (LVEF from 40.6 [34.6; 43.2] to 49.2 [43.0; 52.7] %, p=0.003; NT-proBNP from 246 [167; 341] to 120 [93; 148] pg/ml), large (occlusion index by phase shift) and small (occlusion index by amplitude, percentage of perfused capillaries, percentage of capillary restoration) vessels significantly improved already in the first year of observation, while structural parameters (volume dimensions; indexed LV myocardial mass from 94.3 [79.4; 97.4] to 121 [109; 134] g/m2, p=0.010; radial augmentation index, stiffness index, occlusion index) began to change significantly by 2-3-years.
Conclusion. A stable positive effect of EECP treatment in patients with ischemic heart failure on the structural and functional parameters of the heart and blood vessels has been demonstrated. At the same time, the rate of improvement in functional indicators was much faster than that of structural parameters.
EXPERT ASSESSMENT OF THE QUALITY OF MEDICAL CARE FOR REDUCING REPRODUCTIVE LOSSES
Authors: N.V. Lazareva
Published: May 2024

The paper considers and highlights the modern principles and methods for assessing the quality of the process of providing medical care, as the most complex and least regulated component of the entire multicomponent system for assessing the quality of medical care. To date, two directions have been formed - theoretical and practical - to solve the problem of quality control of the medical care process. One, standardization, is based on previous medical experience - "method of choice", protocols of management. The second is the quality of the medical care process technology. Quality control of the result is carried out "post factum".
Purpose: introduction of effective methods for assessing the quality of medical care by trimesters of pregnancy to reduce reproductive losses. Material and methods: statistical, analytical, prognostic, epidemiological analysis. Results and discussion. The results of the analysis of the assessment of the quality of medical care received by a woman during pregnancy, based on a study of medical records, as well as a study of the opinions of pregnant women, are presented. Comparison of the data obtained makes it possible to reveal the correlation dependence of the results of an expert assessment of the quality of medical care on the timing of a woman's registration for pregnancy. Integral registration defects were determined in the collection of anamnesis data from the examined women in the process of dynamic observation of pregnancy at the outpatient stage. The study of the state of the quality of medical care provided to pregnant women, women in childbirth and puerperas, took place in a complex manner, including laboratory diagnostic studies, registration of medical documentation and possible errors in making a clinical diagnosis. It has been proven that errors in diagnosis and treatment, as a rule, negatively affect the patient's condition. The sub-optimal use of resources is reflected in the lack of respect and use of existing standards. In the study groups with the highest risk of providing medical care of inadequate quality, there were violations that are associated with the risk of worsening the condition of a pregnant woman and the development of gestational complications in the future.
ANALYSIS OF THE AUTHENTICITY INDICATORS OF THE LEAVES OF NUPHAR LUTEA L. AND ASSESSMENT OF THE PROSPECTS FOR THE USE OF THIS TYPE OF RAW MATERIAL
Authors: D.V. Arkova , O.V. Nesterova , N.V. Nesterova , S.V. Chernova
Published: May 2024

In the article the author presents the results of studying the morphological and anatomical features in the raw material of the above-water leaves of Nuphar lutea using macroscopic and microscopic analyses, as well as the qualitative composition of the extract of the leaves of Nuphar lutea. The rhizomes of Nuphar lutea were selected as a pharmacopoeial raw material for comparison to confirm a similar component composition. The studies were conducted in accordance with the requirements of the general pharmacopoeia articles. The characteristic macroscopic and microscopic features of the leaves of Nuphar lutea were revealed, the qualitative composition was similar to the rhizomes of this plant. To assess the presence of certain groups of alkaloids, a method unusual for pharmacognostic analysis was proposed – microcrystalline analysis. When evaluating the prospects for use, it was revealed that the leaves of Nuphar lutea can potentially become a more environmentally friendly substitute for the pharmacopoeial raw materials of the rhizomes of Nuphar lutea, and also have a number of distinctive pharmacological properties
THE PROBLEM OF OBESITY IN CHILDREN AND ADOLESCENTS
Authors: M.S. Matevosova , L.I. Agapitov , L.A. Serebryakova
Published: May 2024

Currently, the problem of obesity and overweight in children and adolescents is a serious public threat, the prevalence of which continues to grow rapidly in many countries around the world. The occurrence of obesity depends on a combination of various and dangerous etiological factors. Obesity and overweight have many pathogenetic links that cause adverse and dangerous health effects, significantly impair the quality of life and reducing its duration. High prevalence, life-threatening consequences, unsuccessful therapy, large financial costs and social discrimination put obesity and overweight in a special place among modern problems of medicine and healthcare. This study is devoted to the study of etiology, pathogenesis and influence of overweight on human health, evaluating the outcomes in clinical studies of obesity in children and adolescents. The study of the problem of obesity in children and adolescents should be aimed at identifying the relationship between various components of pathogenesis and the development of adverse consequences of obesity, taking into account the role of etiology – genetic and environmental factors. It is necessary to systematically approach the treatment of obesity and its complications, taking into account the multifactorial etiology and pathogenesis of this condition. Such tactics will help to find potential targets for obesity therapy, individual approaches in the diagnosis, treatment and prevention of this disease, which is crucial in the fight against this global epidemic.
MODERN APPROACHES TO THE TRANSFORMATION OF CONSUMER BEHAVIOR OF COAL INDUSTRY WORKERS IN THE MARKET OF MEDICAL AND PHARMACEUTICAL GOODS AND SERVICES
Authors: A.G. Petrov , O.V. Khoroshilova , V.A. Semenikhin
Published: May 2024

In modern conditions, for pharmacy, as an integral part of healthcare, new concepts and technologies of pharmaceutical services and, in general, pharmaceutical care, aimed at consumers of medicines of different categories and professional groups, have become a powerful incentive for further development. Important importance in working with consumers of medical and pharmaceutical goods and services is attached to marketing research of consumer behavior; the study of preferences in the selection of goods factors influencing the decision to purchase. Of particular importance is the consumer behavior of modern pharmacy customers, which is changing due to an imbalance between the state of the pharmacy system's customer base and existing methods of customer counseling. There is a need to focus on different segments of consumers, each of which requires specific client technologies that contribute to the transformation of consumer behavior from "standard" to individual, corresponding to the status, mentality, financial capabilities, level of information literacy, typology of the buyer. Studying the assessments and opinions of respondents helps to identify patterns in consumer behavior and makes it possible to develop a more thoughtful strategy for information and advisory work with employees of the coal industry, paying special attention to issues of pharmaceutical consulting, information, attentive service, the use of new forms and methods of work that would increase consumer interest in purchasing effective and safe medicines. The consumer's decision-making process is considered, as a rule, as part of the following stages: consumer awareness of the problem, information search, evaluation and selection of purchase alternatives, purchase, use of purchase and evaluation of the solution. The factors of consumer behavior or purchasing decisions in relation to the buyer are conditionally divided into internal and external. Pharmaceutical organizations that sell medicines seek to influence consumer behavior by building their activities based on the concept of marketing. Knowledge of the basics of marketing is necessary to manage consumer behavior in the market.
SOCIOLOGICAL ASSESSMENT OF THE CONSEQUENCES OF COVID-19 CORONAVIRUS INFECTION IN PATIENTS WITH DIABETES MELLITUS
Authors: O.I. Pletner , E.V. Surskaya , A.A. Yurchenko
Published: May 2024

In the modern world, herniated intervertebral discs are one of the most common pathologies, often occurring among the working-age population. Protrusion of the intervertebral disc beyond the cross-section of the vertebra can lead to severe pain (even disability) due to mechanical compression of the nerve root and, with extrusion of the nucleus pulposus, inflammatory reactions. Thus, to date, pain syndrome that has developed as a result of a hernia occurs in 9% of the world's population. Thus, the treatment of intervertebral hernias is one of the pressing problems of the modern world. Radical treatment - surgical, is associated with a number of complications and does not always lead to the desired results. For this reason, surgical treatment should be carried out only if conservative methods are ineffective, among which physiotherapy occupies a special place.
The purpose of this work is a literary analysis of physiotherapy methods currently used for the treatment of herniated intervertebral discs and to determine their place in the complex therapy of this pathology.
The review examines the nature of intervertebral hernias, some of the physiological reactions they cause, in particular, the mechanisms of pain syndrome formation are indicated. We also described in detail the main methods of physiotherapy currently used for herniated intervertebral discs, such as electrophoresis, balneological procedures, spinal traction; the mechanisms of their influence on the damaged intervertebral disc are indicated, allowing to eliminate or reduce the intensity of the pain syndrome; The need for an integrated approach in the treatment of the pathology under study was determined.
FEATURES OF MANAGEMENT TACTICS IN CARRIING MUTATIONS IN THE BRCA GENES IN WOMEN
Authors: O.B. Kalinkina , U.V. Tezikov , I.S. Lipatov , M.O. Mayorova , N.A. Nikolaeva
Published: May 2024

The aim of the study is to study the features of management tactics in the case of BRCA gene mutations in women using the example of a clinical case. Risk-reducing salpingo-oophrectomy is usually offered to women with mutations in BRCA1, BRCA2, or both of them, because, according to research, it improves overall survival and reduces the number of deaths from serous cancer and breast cancer. In this case, a comprehensive examination was carried out in a timely manner in a patient with breast cancer, including a medical and genetic one, which made it possible to identify the presence of a highly oncogenic type of mutation in the BRCA 2 gene. According to large–scale studies, women carrying this type of mutation represent a risk group for developing bilateral breast cancer, as well as ovarian cancer. In addition, carriers of a mutation in the BRCA2 gene are threatened by the occurrence of pancreatic and biliary tract cancers, stomach, fallopian tubes and skin melanoma. Carrying out preventive mastectomy and bilateral ovariectomy in such patients reduces their risk of malignant neoplasms. Therefore, the patient's complex therapy included these stages of surgical treatment. In addition, the detection of such a form of breast cancer associated with mutations in the BRCA genes makes it possible to expand the range of diagnostic search for malignant neoplasms, including in-depth examination of both the patient herself and her closest relatives. Such tactics of management of this group of patients allows them to avoid the occurrence of repeated cases of malignant neoplasms associated with the carriage of mutations in the BRCA genes with timely preventive examination and follow-up.
MODERN TACTICS OF SURGICAL TREATMENT OF PATIENTS WITH VARICOSE DISEASE OF THE LOWER EXTREMITIES
Authors: Z.S. Kaitova , R.S. Rajabzoda , R.R. Bytdaev , E.L. Kovrizhkina , Sh.O. Kholiqova
Published: May 2024

Varicose veins are a very popular disease. It is observed in 10–15% of men and 20–35% of women and is often accompanied by long-term incapacity and subsequent disability of the patient. That’s why it’s not surprising that endovenosus laser ablation therapy (EVLT) is replacing surgery as the main treatment for varicose veins. Currently, laser radiation with wavelengths in the λ range from 0.45 to 2 is used for EVLT. A positive treatment result was achieved at all wavelengths that were used. The resulting differences in clinical applications in terms of pain levels, complications, and postoperative healing were rates largely subjective, leading to controversy regarding the choice of the most effective method. This was facilitated by the evolution of interpretations of the processes occurring during EVLT, which, from the authors’ point of view, is useful for their understanding. Endovasal methods have been proven to be cost-effective and safe and can be performed under local anesthesia on an outpatient basis. To date, this technique has become quite widespread in vascular surgery. This paper provides a review of the literature on the prevalence and pathophysiology of varicose veins of the lower extremities, the achievements of endovasal methods of treating varicose veins of the lower extremities, and studied modern methods of surgical correction of varicose veins. We analyzed and described the main issues related to endovenous techniques for obliterating varicose veins. Conducted on 20 case histories of patients with venous insufficiency of the lower extremities, operated on at the CHU “KB “RZD-Medicine” named after. N.A. Semashko” comparative analysis of modern surgical methods for the treatment of varicose veins of the lower extremities. The operation was performed on one lower limb in 18 patients, and on two lower limbs in 2 people. All patients underwent endovasal laser coagulation (EVLC) in combination with miniphlebectomy. The disadvantages and advantages of the modern surgical method of treating venous insufficiency of the lower extremities (EVL) have been identified.
THE FIRST NATIONAL MEDICAL PERSONNEL OF KABARDA AND BALKARIA
Authors: I.L. Semenova , D.A. Shukurova , M.Yu. Zabarova
Published: May 2024

сurrently, the study of the historical stages of the formation and development of medical personnel and the entire health care systemas a whole is one of the most relevant areas in the course of higher medical education. The significance of the problem makes us turn to the lessons of the past, namely, the history of the appearance of the first doctors, whose names and experience formed the basis for the formation and development of healthcare. The article attempts to restore the names of unfairly "forgotten" people who devoted themselves entirely to the cause of healing, as well as the history of the first national medical personnel in the region and their contribution to the prevention and treatment of the local population of the Nalchik district. The article is based on the biographical data carefully collected in the Archive Service of the Kabardino-Balkar Republic and other sources of the first well - known regional doctors from the indigenous inhabitants of Kabardino-Balkaria, as well as their contribution to the development of medical services in the region, which makes the work unique. The selfless work of the first doctors shows the history of the formation and development of traditional medicine and all health care in the Nalchik district of the Terek region in the pre-revolutionary period. Studying the history of regional healthcare development helps to better understand and evaluate positive experiences, and to anticipate the main directionsof its subsequent development.