bluuebunny/crossref_metadata_2025 huggingface dataset:
ANALYSIS OF QUALITY AND AVAILABILITY OF MEDICAL-SOCIAL CARE (ON THE RESULTS OF SOCIOLOGICAL RESEARCH)
Authors: M.E. Kolomiychenko
Published: September 2021

For older people and people with disabilities, not only medical, but also social assistance is extremely important. As a result of sociological surveys of the population of the Russian Federation in 2015, 2017, 2019, it was determined that the share of respondents (people over working age and people with disabilities) who are provided with social services free of charge (almost half of those surveyed in 2019) is increasing. However, the share of respondents who are completely satisfied with the quality of social services is declining. The share of respondents who are only partially satisfied with the quality is increasing. The vast majority of respondents (persons above working age and people with disabilities) have gained the necessary facilities at their own expense, with an equal proportion among the urban and rural population. An analysis of responses about an individual program of medical rehabilitation measures developed for a people with disabilities revealed an increase in the proportion of respondents who are suitable for this program, taking into account their health status (from 57.1% in 2015 to 65.2% in 2019). There is a decrease in the share of respondents who indicated the presence of deficiencies in the provided technical means of rehabilitation and/or the procedure for obtaining them (from 31.0% in 2015 to 28.2% in 2019). As the main shortcomings, the respondents indicated: "difficulty and laboriousness of obtaining", "inadequate quality", "waiting time for receiving funds". Relatives (acquaintances) are sources of necessary medical or sanitary and hygienic procedures for people over working age and disabled people; the overwhelming majority of those surveyed are satisfied with such procedures.
ANALYSIS OF THE RESULTS OF SOCIOLOGICAL STUDIES OF THE QUALITY AND AVAILABILITY OF HEALTH CARE
Authors: A.L. Lindenbraten , M.E. Kolomiychenko
Published: September 2021

Sociological research is an important tool for assessing the social effectiveness of medical care, it allows you to analyze the quality of the organization of medical care and social satisfaction of consumers. This study is an analysis of the results of "Selective observation of the quality and availability of services in education, health and social services, employment promotion." This statistical observation has several advantages: complex procedure for forming a sample, coverage of the population in all constituent entities of the Russian Federation, including urban and rural population, ensure that the data is representative, and allow for complex analysis in the dynamics. As a result of sociological surveys of the population of the Russian Federation in 2015, 2017, 2019, it was determined that the share of respondents satisfied with the work of health center and diagnostic services remains low (less than half of the respondents). When interviewing respondents, the reasons for dissatisfaction with the work of the health center were highlighted, the “leader” among which is “the length of waiting in queues”. Moreover, the share of respondents who choose “the work of medical specialist” and “the lack of necessary equipment and drugs” as negative aspects in the provision of medical care on an outpatient basis is increasing. About half of the respondents are satisfied with the comfort of their stay, the availability of drugs and modern equipment in the hospital. Analysis of the main negative phenomena observed in the provision of medical care to the population made it possible to determine the leading trends, which remain the high cost of drugs and an increase in the volume of paid medical care. More than half of respondents noted a decline in the quality of medical services, insufficient equipment of health center and hospitals.
REGULATORY LEGAL FRAMEWORK FOR PROVIDING PALLIATIVE MEDICAL CARE IN THE RUSSIAN FEDERATION
Authors: R.U. Khabriev , M.E. Kolomiychenko
Published: September 2021

Palliative care as a separate type of medical care was enshrined in legislation 10 years ago. However, the law-making process is still ongoing. The guidelines for this type of medical care for adults and children have been approved twice. It must be noted amendments to the Federal Law in 2019 (which significantly expanded the definition and consolidated the "varieties" for the provision of palliative care), and the interdepartmental Regulation on the organization of the provision of this type of assistance was approved (which now includes not only the guidelines for this type of medical care for adults and children, but also provides for the guidelines for interdepartmental interaction). In addition, since 2019, regional programs for the development of palliative care in the constituent entities of the Russian Federation are being developed. Together with these documents, an action plan was approved for the implementation of the Strategy for the Development of Healthcare of the Russian Federation for the period up to 2025, in which the development of palliative care is designated as activities; action plan has been approved ("road map") "Improving the quality and availability of palliative care" until 2024 was approved, among the tasks of which: improving legal regulation, increasing the availability and quality of painkillers, developing infrastructure for providing palliative care in the constituent entities of constituent entities of the Russian Federation, training of specialists (medical personnel, clinical psychologists, social workers), public awareness about the provision of this type of medical care, the implementation of a multidisciplinary approach. This publication includes an overview of the legislation governing the functioning of the palliative care system in the Russian Federation.
INTERDISCIPLINARY APPROACH IN ASSISTING PATIENTS WITH PATHOLOGY OF THE MAXILLOFACIAL REGION IN THE CENTER OF MAXILLOFACIAL SURGERY
Authors: M.V. Lebedev , I.Yu. Zakharova
Published: September 2021

Every year there is a significant increase in combined anomalies and deformities of the maxillofacial region, congenital pathologies, malignant tumors, severe inflammatory diseases of the face and neck. Almost every patient who underwent surgery on the maxillofacial region develops secondary deformities of the maxillofacial region, adentia of the teeth of the jaws, impaired occlusion and speech, skeletal anomalies, which requires a comprehensive interdisciplinary approach of doctors of different profiles.
The aim of the work was to improve the provision of specialized care to patients with pathology of the maxillofacial region through the introduction of an interdisciplinary approach in the treatment of patients in the center of maxillofacial surgery at the N.N. Burdenko Penza Regional Clinical Hospital (N.N. Burdenko ).
Material and methods. The study was carried out on the basis of the Center for Maxillofacial Surgery of the State Budgetary Healthcare Institution "Penza Regional Clinical Hospital named after V.I. NN Burdenko ". A retrospective analysis of outpatient patient records, case histories, electronic databases, regulatory and legal documentation from 2010-2020 was carried out.
Results and its discussion. Until November 2020, in the Penza region, medical care for patients with diseases of the maxillofacial region was provided in the department of maxillofacial surgery of the N.N. Burdenko State Budgetary Clinical Hospital. When analyzing the reporting and regulatory documents, it was concluded that it is necessary to improve the quality of specialized care in the field of maxillofacial surgery. We propose to employ the following specialists on the staff of the department: dentist-therapist for adults and children, gnathologist, dentist-orthodontist, otorhinolaryngologist, speech therapist.
Conclusion. The materials presented in the article reflect the need for an integrated approach and close interaction between the doctors of the center. This stage begins during the preoperative preparation and planning of the operation. Rehabilitation of patients with pathology of the maxillofacial region is aimed at maximum aesthetic and anatomical recovery and requires an individual approach. To solve this problem, it is necessary to introduce interdisciplinary interaction of specialists in the center of maxillofacial surgery.
WARNING ON THE FULL REPORT OF HEALTH CITIZENS IN THE RUSSIAN FEDERATION
Authors: A.V. Oleynik , D.L. Mushnikov , N.A. Sadovnikova , R.M. Gareev , O.V. Sobolevskaya
Published: September 2021

In the context of civil society development, citizens themselves have an important place in controlling the full implementation of rights. One of the principles of health is the "priority of child health." A study was conducted to examine the views of patients on the implementation of the principles of health care in the Russian Federation. The basis of the study was children's clinics. The sample total, formed by the method of random selection among those who applied to the clinic within a month, amounted to 1,250 mothers. The collection of information was carried out by the method of sociological survey on a specially compiled questionnaire. It has been established that in public health children face a formal attitude, lack of infrastructure of health care, and need legal assistance. The survey showed that the principle of "priority of children's health" declared by the state has some problems in practical implementation, both in the health sector and in the part of non-health-related entities. It has been established that in public health, mothers of children, as their legal representatives, often face a formal attitude, lack of infrastructure of health care, and experience an unrealized need for legal assistance. The general problems of reducing accessibility are the lack of necessary specialists, long waits for admission, but for single-parent families more significant than for full families is the factor of time of admission of specialists. The findings provided the basis for the following proposals to improve the implementation of the principle of "priority of child health": 1. It is necessary to ensure that the public is informed widely and multi-channel about the directions and measures taken by the state (programs, plans, activities, legislation) to ensure the implementation of the principle of "priority of child health"." Public monitoring should be established with the participation of civil society representatives of the degree of practical implementation of the principle of "priority of child health" by public bodies and officials. 3. Create the conditions for public discussion of specific measures to improve the implementation of the "priority of child health" principle. To make information more accessible to parents raising children, provide additional distance counseling and information opportunities through the Internet.
TOXIC EFFECTS OF ANTICANCER THERAPY
Authors: S.A. Gelfer , V.V. Semenova
Published: September 2021

The generally accepted practice of medical technology is to record the first time sick, the results of dynamic observations of patients (follow-up). The first research groups for the study of malignant neoplasms (MNO) in children appeared in the United States in 1955. The article describes the importance of early rehabilitation of patients who have undergone cancer on the example of a clinical case. Advances in the treatment of cancer patients have resulted in a higher percentage of people cured. But very early after the start of the use of anticancer therapy (POT), doctors began to observe manifestations of an iatrogenic nature due to the use of toxic drugs and radiation. At the moment, the influence of genetic factors on the development of complications of chemotherapy and radiation therapy is being actively studied. The molecular mechanisms of the development of abnormally pronounced toxic effects in most cases are associated with disorders in the DNA repair system. To minimize the risk of severe toxic effects, these factors should be taken into account when choosing a treatment strategy. On the example of patient N., 18 years old, the condition after the end of treatment for rhabdomyosarcoma of the temporal region, the duration of remission is 12 years, one can see how the treatment can iatrogenically affect the patient's life in adulthood, having undergone treatment in childhood. With an early start of rehabilitation and timely identification of the long-term consequences of anticancer therapy, it is possible to improve the patient's quality of life. With the accumulation of observation data on the domestic cohort of children and adolescents who completed therapy 15-20 years ago, it will become possible to assess the burden of national health care in the structure of morbidity, disability, and the development of second tumors.
EFFICACY OF ACNE THERAPY IN PATIENTS WITH OVARIAN HYPERANDROGENISM
Authors: O.B. Kalinkina , Yu.V. Tezikov , I.S. Lipatov , O.R. Aravina
Published: September 2021

The aim of the study was to show the effectiveness of treatment of acne with moderate severity in women with ovarian hyperandrogenism. A total of 25 female reproductive voerast patients with moderate acne and ovarian hyperandrogenism who were not planning pregnancy were examined. All patients were examined, which included a consultation with a gynecologist with a gynecological examination, ultrasound examination of the pelvic organs, a study of the hormonal status, a biochemical blood test, as well as a dermatological examination with the determination of the dermatological index of acne (DIA). After the examination, the patients underwent complex therapy using the external treatment recommended by the dermatovenerologist (skin cleansing, gel with azelaic acid and / or gel with adapalene), as well as the appointment of a combined oral contraceptive (COC) Jes Plus. Based on this study, it can be concluded that complex therapy, including local treatment and taking Jes Plus, is the first choice in the treatment of androgen-dependent dermopathy, manifested by moderate acne, in patients with ovarian hyperandrogenism due to PCOS. Such therapy contributes not only to the formation of a pronounced clinical result, but also causes a low probability of side effects. The administration of COC containing drospirenon and the active form of folate, in the form of the calcium salt levomefolate, allows a favorable effect on the metabolic processes in the body as a whole, and in particular, provides a positive effect on the skin, the cardiovascular system, reduces the risk of systemic and local inflammation, relieving the state of hyperhomocysteinemia, providing prevention of cardiometabolic risks.
RESTORATION OF TEETH BASED ON THE CONCEPT OF «PRE-POLISHING OF THE COMPOSITE DENTIN LAYER”
Authors: A.M. Kovalevsky , Yu.B. Vorobieva , D.D. Malysheva
Published: September 2021

After studying various methods of restoring teeth in the oral cavity, we came to the conclusion that no one technique is perfect. This article describes clinical cases, as well as laboratory studies that allow us to judge the effectiveness of dental restoration based on the concept of "pre-polishing of the dentin layer of the composite". The quality of the surface characteristics of the restorations of the anterior group of teeth made of pre-polymerization composite materials was analyzed. The aesthetic restoration of teeth was performed using the classical method of layer-by-layer application and photopolymerization of the composite, as well as the proposed method based on the concept of pre-polishing of the dentin layer of the composite material. After adequate anesthesia and odontopreparation, a portion of the composite material that recreates the dentine layer is introduced into a pre-prepared and isolated from the oral fluid cavity, adapted to the hard tissues of the tooth, and then photopolymerized with a dental lamp. Next, the created layer is polished to a mirror shine and re-adhesive treatment with a self-etching adhesive system, photopolymerization. The next transparent layer of the composite material, imitating enamel, is applied to the "petal" of the polished dentine (inner) layer of the material to the enamel-dentine border with the obligatory imitation of mamelon and the surface structure of the restored tooth and its cutting edge is formed in a generally accepted way. After the final photopolymerization, the final grinding and polishing is carried out. The proposed method of aesthetic restoration of teeth, based on the concept of pre-polishing the dentine layer of the composite material, allows you to achieve a higher quality of restoration, and guarantees long-term preservation of color, gloss and edge fit of the restoration of the frontal group of teeth.
PERIPHERAL HEMODYNAMICS PECULIARITIES IN YOUNG AND MIDDLE-AGED MEN WITH A RECIDIVATING MYOCARDIAL INFARCTION
Authors: A.V. Golikov , S.Yu. Epifanov , V.A. Reiza
Published: September 2021

Relevance. Hemodynamics changes in recidivating myocardial infarction and early postinfarction angina are not well understood. In recent years, the frequency of these complications has been increasing.
Aim. To evaluate peripheral hemodynamics changes in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes.
Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 102 patients; II - control, without it - 541 patients. A comparative assessment of hemodynamics changes in first 48 hours (1) and the end of third week disease (2), also risk analysis of recurrent ischemia and poor outcome in selected groups were performed.
Results. The study group was distinguished by a high level of total peripheral resistance1 (2055.5±965.2 (dyn×sec×cm-5)) from the control (2055.5± 965.2 (dyn×sec×cm-5); p=0.02). In both groups, a decrease in the values of all indicators was noted (p<0.05). A more pronounced decrease in total peripheral resistance was found in the study group, and in the parameters of blood pressure and heart rate - in the control group. The values of total peripheral resistance1 ≥1600 dyne×sec×cm-5 were the markers of the risk of ischemia recurrence. Predictors of poor outcome are blood pressure levels1 (systolic <97; diastolic <70; mean <93.3 (mm Hg)); total peripheral resistance1 <1746.2 dyne×sec×cm-5 and heart rate (˃92 per min).
Conclusions. Patients with recurrent ischemia are characterized by higher levels of total peripheral resistance in the first hours of myocardial infarction. For both groups, a decrease in all studied indicators is determined. The above values of hemodynamic parameters should be used in the formation of groups with a high risk of early recurrence of ischemia and an unfavorable outcome, as well as for prognostic modeling of these complications.
DEVELOPMENT OF THE COMPOSITION AND STANDARTIZATION OF THE COLLECTION FOR THE PREVENTION OF INFLAMMATORY PERIODONTAL DISEASES
Authors: A.A. Groznov , V.A. Kachulin , O.V. Nesterova
Published: September 2021

Taking into account the literature data, as well as the research conducted by the authors, the composition of the collection for the prevention of inflammatory periodontal diseases has been developed, which includes medicinal plant raw materials:medicinal pimenta fruits, medicinal sage leaves, yarrow grass, badan rhizomes in a ratio of 1:1:1: 1 by weight. The quantitative ratio of the components is determined in accordance with the results of the evaluation of the antimicrobial effect of the extract from the proposed collection. To confirm the composition of biologically active substances of the collection, pharmacopoeial qualitative reactions to flavonoids and tannins, as well as the TLC method, which allows identifying substances of a polyphenolic nature, are proposed. The quantitative determination of extractive substances, essential oil, tannins, and flavonoids in the studied collection was carried out and the norms of their content were proposed. The definition of commodity characteristics is carried out.
CEREBROVASCULAR DISORDERS: TYPICAL AND UNUSUAL CLINICAL PROBLEMS
Authors: L.R. Akhmadeeva , G.A. Bulyakova , A.T. Khairullin
Published: September 2021

There is a big number of patients with chronic brain ischemia both among in-patients and out-patients seen by neurologists. This is a typical clinical situation. Retino-cochleo-cerebral vasculopathy (also called Susac syndrome) is a rare autoimmune disorder affecting brain vessels, the 8th cranial nerve and retina. Chronic brain ischemia usually manifests as cognitive decline, affective (emotional) disorders and focal neurological signs. We studied a “portrait” of patients with chronic brain ischemia, admitted to the hospital As in-patient of rehabilitation unit. Here we present the typical case using as an example cerebral ischemic conditions and unusual ones describing retino-cochleo-cerebral vasculopathy as one of the conditions from the group of primary angiitis of central nervous system in adults. All the case were observed by us in neurological and neurorehabilitation wards. It is a pilot project with 43 patients as the total number of patients included into this study. Their mean age was 62.8 years. The mean duration of in-patient observation was 14 days at the hospital. In this paper we discuss the clinical characteristics of our cohort of patients. The least affected here was the short-term memory for numbers. The most affected domain included emotions, anxiety, and depression. We followed this situation in most of our cases. The unusual clinical case of Susac syndrome in a male patient of 59 years is described. The diagnosis was confirmed using modern instrumental tests such as magnetic-resonance tomography and fluorescent angiography of eye retina.
EXPERIENCE OF USING LASERS FOR VESTIBULOPLASTY IN PERY-IMPANT AREA
Authors: D.A. Trunin , S.I. Vyrmaskin , V.V. Afanasev
Published: September 2021

In this article authors raised the problem of the formation of an attached gum zone in the implant area. The important factors in the long-term and stable outcome of dental implantation are the availability of sufficient bone volume, adequate oral hygiene and correct positioning of the implant. Current studies point at the role of periodontal soft tissues in achieving an aesthetic result as a result of implant treatment. Review of the literature about the statistics of mucositis and peri-implantitis, problems of the dental implantation planning, alternative points of view on the recipient tooth socket, trauma of the donor site, etc. point at the immediacy of the problem. The problem of the advantages and disadvantages of methods and materials for gingival plastics continue to be relevant. The article presents the experience of the formation of a protective soft tissue buffer zone around the implant as a result of laser vestibuloplasty. Dental lasers are successfully used for the reconstruction of soft tissues in preparation for orthopedic treatment, plastic surgery of the oral cavity vestibule and frenulum. Laser application as a surgical instrument allows to make an incision more precisely and to overview the surgical area. Operative technique does not differ from the vestibuloplasty for the periodontal diseases. As a result of using an erbium or diode laser, the necessary vestibule of the oral cavity is formed. Features of the epithelialization of the oral mucosa and fixation of the movable edge of the wound make it possible to increase the area of the immobile gum. The authors presented a photo protocol describing the clinical case. According to indications, the use of the laser radiation allows to achieve the necessary clinical result for the long-term clinical and aesthetic success of dental implantation.
MINERAL HOMEOSTASIS OF THE ORAL FLUID IN CHILDREN AND ADOLESCENTS WHO HAVE UNDERGONE TREATMENT OF MALIGNANT NEOPLASMS
Authors: Yu.A. Obukhov , E.V. Zhukovskaya , A.F. Karelin
Published: September 2021

Annotation. The authors' study highlights the urgent problem of the development of toxic damage to the dentition under the influence of anticancer therapy in children and adolescents. The aim of the study was to study the violation of the homeostasis of the oral fluid and the severity of the carious process. Materials and methods. As part of a pilot study at the Russian Field Treatment and Rehabilitation Center, 63 children were studied the severity of mineral homeostasis disorders and damage to the dentoalveolar system. Results. In 67% of patients in the main group, there was an increased tendency to form carious cavities. 54.5% of them have complicated caries. One third of patients had more than five carious teeth. In the control group, carious lesions of the teeth in only three patients (20%), with the involvement of 1-3 teeth in the pathological process. Violation of enamel formation was diagnosed in 36% of children of the main group. There is a tendency for the accumulation of the studied microelements in the oral fluid, while in the blood serum there is a normal or insignificant decrease in their content. According to the literature, this may indicate destruction in the oral cavity. Deviations in the homeostasis of chemical elements in children who completed the treatment of malignant neoplasms and children in the control group were revealed. An increased content of osteotrophic microelements was found to correlate with the destructive processes of the teeth. Conclusion. It seems appropriate to study the severity of morphological changes in hard tissues of teeth and the electrolyte composition of mixed saliva in children and adolescents who have been cured of malignant neoplasms. The results of studies of gastric cancer, as an indicator of metabolic disorders, will make it possible not only to reveal the imbalance of macro- and microelements, but also to establish the effectiveness of adaptation mechanisms aimed at normalizing the elemental composition of the oral fluid.
SCREENING INVESTIGATIONS OF VITAMIN D CONTENT DIFFERENT POPULATION GROUPS OF BIG SOCHI
Authors: O.P. Chzhu , D.E. Araviashvili
Published: September 2021

Data on vitamin D metabolism suggest that it is a secosteroid prohormone. Current studies have shown that the mechanism of functioning of vitamin D is associated with a specific receptor of the hormonally active form of this vitamin (VDR). Receptors for vitamin D are identified in more than 40 target tissues of the body (bones, muscles, intestine, kidneys, heart, prostate gland, mammary glands, pancreas), in particular in most cells of the immune system and epithelial cells lining the mucous membranes which determines many of its biological effects. Vitamin D levels affect 172 major physiological indicators of human health [1,2]. Determining the optimal values for vitamin D connect in body plays a key role in establishment of recommendations for maintaining the normal status of this vitamin throughout the year, including winter months. In connection with the discovery of new extraskeletal (non-calcemic) functions of vitamin, as well as the influence on its content of geographical, ethnic and age factors, it became necessary to clarify the norms of physiological need for this vitamin based on regional conditions [2]. The work presented is a part of comprehensive research on optimizing the reference values of diagnostic systems and enzyme immunoassay systems, in particular, to definite human populations. The investigations presented out in this work revealed the most vulnerable groups in relation to D deficiency and revealed significant seasonal degradation of vitamin content, despite the fairly comfortable climate conditions of the coast of Greater Sochi.
THERAPEUTIC METHODS FOR TREATMENT OF DENTAL DISCOLORITIS
Authors: T.V. Melenberg , O.Yu. Titova , A.I. Burov , N.M. Levina , L.N. Linnik , S.K. Dajronas , E.G. Dajronas
Published: September 2021

The problem of discoloration of teeth, especially accompanied by increased sensitivity, does not lose its relevance in modern dentistry. Despite the presence in the arsenal of dentists of a significant number of means and methods for solving this problem, it does not go away, but, on the contrary, is overgrown with new complaints. In this work, we analyzed the frequency to analyze the frequency of choice of therapeutic methods for treating discoloration of teeth by patients of dental clinics. A questionnaire was developed for a dentist on the patient's choice of a therapeutic method for eliminating dental discoloration and a survey of 30 dentists (10 - therapists, 10 - orthopedists and 10 - general dentists) was conducted for 2019 and 6 months of 2020. It was found that during this period, 184 out of 331 patients who applied to dental clinics with this problem used therapeutic methods for eliminating tooth discoloration: tooth enamel coating with varnish ("Colordent" + adhesive "Single Bond") was carried out in 16.6% of patients, clinical bleaching of enamel in 32.6% of patients with tooth discoloration, intracoronal bleaching followed by direct restoration (replacement of existing fillings with new ones) in 53.8%. The analysis showed that therapeutic methods for eliminating discoloration of teeth predominate slightly, 55%. Of course, in choosing this direction, the doctor is guided by the clinical situation, IROPZ, taking into account the wishes of the patient and his capabilities. However, it seems necessary to develop and test new, gentle and resistant to mechanical stress methods for eliminating discoloration of economy-class teeth with the possibility of solving the problem of increased tooth sensitivity.
STUDY OF MORPHOMETRIC CHARACTERISTICS OF ALDER LEAVES OF PHARMACOPOEIAL SPECIES
Authors: G.V. Nesterov , T.M. Litvinova , L.A. Vasalatiy
Published: September 2021

To expand the raw material base of medicinal plant raw materials, a promising area of research is the study of additional types of raw materials that can be harvested from already used medicinal and food plants. Given the complexity of harvesting alder seeds, researchers are interested in the leaves of this plant, a wide range of biologically active substances that cause anti-inflammatory, astringent and antioxidant effects. The first stage of standardization of raw materials is the definition of morphologically significant features, based on the generalization of which the section "External features" is developed. The analysis of morphological features of freshly harvested, dried and frozen leaves of gray alder (Alnus incana Moench) and black alder (A. glutinosa Gaerth) harvested from wild plants in mixed forests of the Moscow region revealed diagnostically significant features and found that the method of conservation does not affect the occurrence of the identified features. Since it is planned to use both types of alder for the preparation of a new type of raw material "Alder leaves", a generalized formulation is proposed for raw materials that are a mixture of species.
INNOVATIVE CULTURE OF ONCOLOGY SERVICE
Authors: D.L. Mushnikov , V.A. Kozlov , E.L. Funticova , B.A. Polacov , V.M. Cherepov
Published: September 2021

The policy of the state, based on innovation and investment, stated in the policy documents of the President and the Government of Russia, should be reflected in the policy of specific organizations. It is necessary to evaluate the innovative culture of the organization before choosing innovative changes. No studies have been conducted on the comprehensive assessment of the state of the innovative culture of medical organizations of the oncology profile. The innovative culture of a medical organization is the level of implementation of the most advanced technological and structural solutions. In the innovative culture of the medical organization, three main components can be identified: personnel, logistical, technological. The aim of the study is to study the state of the innovative culture of the oncology service. The research base is the Ivanov Regional Oncology Dispensary of the Ivanov Region Health Department. The study programme involved the use of sociological, expert, mathematical, statistical and analytical methods. Surveillance units: medical worker (doctor, average medical worker) and logistical resources. The study was conducted in 2020. There has been a decrease in the innovative culture of the medical organization of oncology profile on all its components, including: personnel, logistics, technological. The decline in the innovative culture of medical professionals is due to a low culture of self-development, not the ability to adapt to change. The innovative culture of medical equipment is associated with a decrease in the accumulation rate of fixed assets, as well as its not full use for high-tech assistance. Technological culture has been reduced by disrupting the culture of communication in the process of assistance, ensuring uniqueness and convenience in its provision. Improving the organization's logistics base, as well as increasing the innovative commitment of medical personnel, especially mid-sized health workers, should be a priority in planning activities to enhance the innovative culture of the oncology organization.
FUNCTIONAL MAPPING OF THE MEDICINES’ QUALITY CONTROL SYSTEM PROCESSES IN THE SVERDLOVSK REGION
Authors: A.Y. Kantorovich , A.L. Petrov , G.N. Andrianova
Published: September 2021

The article describes the results of subject-object and risk-based mapping of the medicines’ quality control system. Identification and procedural structuring of key processes of drug quality control systems in Russia was carried out. The matrix of key procedures was formed in coordinates of agency, target, time, and level characteristics for qualitative mapping of the processes and procedures. To quantify the control measures modality in the coordinates "product-context", the structural coefficient of distribution of procedures was calculated for each section of the commodity distribution network: the product emphasis in the production/ manufacturing segment and the environmental emphasis in the system of market distribution of medicines. Based on the results of risk-based mapping, it was determined that the segments of wholesale and retail pharmaceutical activities are characterized by a shift in control measures to the segment of external reactive procedures, which seems to be a negative trend. It is shown that the production of medicines is the leading segment in the implementation of risk-based quality control procedures for medicines, while in the wholesale and retail trade segment this indicator is 95% lower. The key target for optimization measures is the regional wholesale and retail segment of the pharmaceutical market due to the risk-based selective approach to checking compliance with licensing requirements and a large number of control objects.
IMPROVEMENT AND OPTIMIZATION OF COMMODITY POLICY AS A WAY TO INCREASE THE COMPETITIVENESS OF PHARMACIES
Authors: E.S. Berezhnaya
Published: September 2021

Gathering information is a key component of market research marketing. The search and analysis of marketing information is carried out through four auxiliary systems, namely, an internal reporting system, a system for collecting external current marketing information, a system of marketing research and analysis of marketing information. Based on the information received, marketing research of the drug market is carried out and the needs of the population for pharmaceutical products are studied. Among the many areas of marketing research on the activities of pharmacies, the study of the range of sold medical and pharmaceutical goods in order to determine ways to optimize it is of paramount importance. A prerequisite for marketing research is the study of drugs as a product, its main pharmacotherapeutic properties, indications for use, release forms and other merchandising characteristics. It is important to analyze the assessments of consumer properties and indicators of use for each name of medicinal products in the assortment of a pharmaceutical organization.
This article provides approaches to the definition of the assortment policy of the enterprise, gives the classification of the assortment of the enterprise «Pharmacy of low prices». The groups of drugs are identified depending on their effect on the pharmacy income. Based on consumer preferences, the main positions of the assortment of pharmacies, which are needed by consumers of the city of Penza and the Penza region, have been determined. Along with determining the optimal assortment of the pharmacy and the number of drugs for each pharmaceutical group on sale, it is important to determine the optimal ratio of drugs for each pharmaceutical group. An algorithm for the formation of a new assortment of the Low-Price Pharmacy enterprise has been developed. Recommendations for improving the assortment policy of the «Low Price Pharmacy» enterprise are offered. The features of pharmaceutical marketing of the market of non-prescription and prescription drugs have been studied. Optimization of the product policy of pharmacy organizations, taking into account the distribution of drugs by pharmaceutical trade groups, will ensure the survival of small-scale retailers in a competitive environment.
BIOPHARMACEUTICAL ASPECTS OF CHOOSING THE BASIS OF PENCILS OF MEDICINAL WOUND-HEALING ACTION
Authors: E.B. Nikiforova , N.A. Davitavyan , M.V. Gordienko
Published: September 2021

Damage to the skin is quite common in everyday life of a person and represents a loss of the integrity of the protective barrier of the skin, which can create conditions for the development of a local inflammatory process, as well as for the penetration of pathogens of various diseases into the human body. In order to more quickly restore the damaged area of the skin, it is important to accelerate wound healing through the use of combined drugs, including antiseptics and biologically active substances of natural origin, stimulating the natural local regenerative process. One of such rational combinations is the combination of chlorhexidine bigluconate and Japanese Sophora fruit liquid extract in the composition of the wound-healing preparation. Medicinal sticks are presented as the most rational dosage form for a wound-healing drug of the specified composition. The application of this dosage form to the treated surface leads to the formation of a thin, firmly adhering film, which evenly releases the active substances and protects the wound from external influences. The indicated positive properties of medicinal pencils are achieved due to the selection of a rational component composition of excipients with a set of necessary characteristics, among which the most significant is the ability to provide optimal release of active substances. In this regard, the purpose of this study was to conduct comparative biopharmaceutical studies to optimize the component composition of medicinal pencils with wound healing action containing chlorhexidine bigluconate and liquid extract of sophora fruit. The objects of research were Japanese Sophora fruits harvested in 2020 in the Krasnodar Territory that meet the requirements of regulatory documents; substance-solution of chlorhexidine bigluconate 20%; auxiliary substances of lipophilic and hydrophilic nature: solid paraffin, beeswax, cocoa butter, anhydrous lanolin, polyethylene oxide-400, polyethylene oxide-1500. To assess the degree of release of active substances from experimental compositions, the method of diffusion into agar was used, based on the diffusion of active substances from the dosage form into an agar gel containing a solution of ferric chloride as an indicator. It was found that the most suitable combination of auxiliary components of the dosage form, providing the best release of active substances, is a combination including solid paraffin (20 parts), beeswax (20 parts), anhydrous lanolin (20 parts), polyethylene oxide-1500 (10 parts), polyethylene oxide-400 (20 parts).
SURGICAL TREATMENT OF CHD PATIENTS WITH REDUCED CONTRACTILE ABILITY OF MYOCARDIUM OF THE LEFT VENTRICLE
Authors: A.K. Jalilov
Published: September 2021

The increased worldwide interest in performing coronary artery bypass grafting operations on a beating heart has made the question of the results of these operations in patients with low contractility of the left ventricular myocardium belonging to the high-risk category urgent. The aim of our study was a comparative assessment of the immediate results of surgical treatment of patients with reduced (LVEF <45%) and normal myocardial contractility, operated under MIRM conditions. Materials and methods. A comparative analysis of the immediate results of surgical treatment of 302 patients with coronary artery disease who underwent beating heart bypass surgery was carried out. Most of the patients were men (81.3%). The average age of the general group was 59.2 ± 7.4 years. The patients were divided into two groups - patients with LVEF less than 45% - 49 patients (16%) and patients with LVEF more than 45% - 253 people (84%). Results. Despite the fact that for a number of clinical indicators (concomitant diseases), we obtained a statistically significant difference - arterial hypertension, BCA lesion, mean LVEF, according to the main hemodynamic criteria, such as - unstable angina pectoris, middle class according to CCS and NYHA, the number of women in group, lesion of the trunk of the LCA and multivessel coronary artery disease, we did not reveal statistically significant differences between our groups. Nevertheless, the initial degree of operational risk according to EuroSCORE II was significantly higher in the first group of patients - with a low left ventricular ejection fraction. Conclusions. Our results of a comparative assessment of two groups of patients - with reduced LV ejection fraction (less than 45%) and with normal contractile ability, who underwent minimally invasive myocardial revascularization, showed the high efficiency of this type of surgical treatment.
DISADVANTAGES IN THE ORGANIZATION OF OUTPATIENT AND POLYCLINIC SERVICES IN THE FIELD OF MAXILLOFACIAL SURGERY FOR ADULTS AND CHILDREN IN THE GBUZ PENZA REGIONAL CLINICAL HOSPITAL NAMED AFTER V.I. N.N. BURDENKO FOR THE PERIOD 2018 -2020
Authors: M.V. Lebedev , I.Yu. Zakharova
Published: September 2021

The availability and quality of medical care is determined by the state of primary health care. Optimization and development of outpatient care is the primary task of healthcare. For the Penza region, according to the resolution of the Government of the Penza region of 02.10.2013 N 743-PP, improving the quality of outpatient care in the field of maxillofacial surgery and increasing its availability is one of the primary tasks for our region. In this regard, the assessment of the work of the outpatient office of the Department of Maxillofacial Surgery of the Consultative Polyclinic of the State Budgetary Healthcare Institution of the Penza Regional Clinical Hospital named after V.I. N.N. Burdenko.
Aim: to analyze the work and effectiveness of a dentist - surgeon in the outpatient office of the consultative polyclinic GBUZ Penza Regional Clinical Hospital named after V.I. N.N. Burdenko.
Materials and methods. To achieve this goal, a retrospective analysis of the primary accounting and reporting medical documentation for 2018–2020 was carried out, a questionnaire survey of patients hospitalized through an outpatient office in the Department of Maxillofacial Surgery of the N.I. N.N. Burdenko. Statistical data analysis procedures were carried out using MS Office Excel 2010 spreadsheets and PASW Statistics 18 statistical software package.
Results. The analyzed accounting and reporting medical documentation for 2018–2020, the results of the questionnaire indicate the ineffective work of the doctor surgeon - dentist in the outpatient office of the consultative polyclinic GBUZ POKB im. NN Burdenko, the workload of the department with non-core hospitalizations, the increased workload on doctors - the department of maxillofacial surgery. The ways of solving the problem of replacing a dentist-surgeon with a doctor-maxillofacial surgeon are proposed; on the organization of a rehabilitation room for patients of the adult and pediatric population with pathology of the maxillofacial region; to create a single case history.
Conclusion. Carrying out the above changes will reduce the burden on doctors - maxillofacial surgeons of the Department of Maxillofacial Surgery, transfer some of the manipulations from the inpatient to the outpatient service (inpatient replacement technology), thereby improving the medical care service in the field of maxillofacial surgery in the Penza region.
PHARMACEUTICAL DEVELOPMENT OF A FIXED DOSE COMBINATION FORM OF MEMANTINE AND CYTICOLINE WITH MODIFIED RELEASE: RESEARCH OF TECHNOLOGICAL PROPERTIES OF SUBSTANCES
Authors: D.K. Salakhetdinov , B.B. Sysuev
Published: September 2021

The pharmaceutical development of a fixed dose combination form of citicoline and memantine for the treatment of cognitive disorders, which will improve compliance is a topical area of research. Purpose: to investigate the technological properties of the active pharmaceutical ingredients: memantine hydrochloride and citicoline monosodium salt in the framework of the development of a fixed dose combination modified release. The samples of pharmaceutical substances citicoline "Kyowa Hakko Bio Co., Ltd." (Japan) and memantine hydrochloride - Hetero Drags Limited (India) were used. Technological studies of the substances were carried out in accordance with the requirements of the State Pharmacopoeia of the RF XIV edition. It was revealed that the particles of the investigated substances show an anisodiametric shape, the anisodiametric shape of the analyzed particles indicates possible poor flowability of APIs, which predicts difficulties in dosing during the tablet compression process. The following characteristics were studied: the ability of the powder to compaction, the bulk density and compressibility index, Hausner ratio were established. It was found that, according to the USP classification, the flowability of substances can be characterized as very, very poor. Pharmaceutical substances of memantine hydrochloride and citicoline monosodium salt have unsatisfactory technological properties, which can complicate the processes of die filling and dosing of pharmaceutical substances during tableting tablet compression. To prevent these disadvantages, it is further recommended to provide research on the possibility of using wet granulation, or the usage in the composition of the tablet mass of excipients with a high bulk density and good flowability. Thus, within the framework of pharmaceutical development, the physicochemical properties of the pharmaceutical substances memantine hydrochloride and citicoline monosodium salt were investigated.