Vol 24, No 1 (2025)
- Year: 2025
- Published: 20.05.2025
- Articles: 41
- URL: https://ogarev-online.ru/2225-6016/issue/view/24111
MEDICO-BIOLOGICAL SCIENCES: ORIGINAL ARTICLES
REACTION OF CORTICOLIBERIN IN THE BRAIN OF RATS TO FORCED ADMINISTRATION OF PSYCHOACTIVE SUBSTANCES
Abstract
Objective: to evaluate the expression of corticoliberin mRNA in modeling elements of dependence in rats by administering psychoactive substances in increasing doses. Methods. All animals were divided into 6 groups, which were administered intraperitoneally for 4 consecutive days one of the pharmacological agents in increasing doses: physiological solution (control; 0.1-0.2-0.4-0.8 ml/rat), 15% ethanol (0.5-1-2-4 g/kg), β-phenylisopropylamine (PHENIPA; 0.5-1-2-4 mg/kg); morphine hydrochloride (1-2-4-8 mg/kg), pentobarbital (2.5-5-10-20 mg/kg) or decadron (0.5-1-2-4 mg/kg). To assess the reinforcing properties of the studied pharmacological agents and the dynamics of dependence formation, the self-stimulation reaction of the lateral hypothalamus was used. Two hours after the last administration of the drug, the rats were decapitated, the brain was removed, the hypothalamus and amygdala were isolated, and the level of corticoliberin mRNA, normalized relative to the level of β-actin mRNA, was determined using the PCR method. Results. Forced administration of drug narcotics (ethanol, PHENIPA, morphine, pentobarbital, and decadron) for 4 days in increasing doses revealed a number of characteristic features. On the 1st day of administration of substances in normal (average) doses, only PHENIPA (0.5 mg/kg) caused activation of the self-stimulation reaction, the "mismatch" coefficient decreased, and the "addictivity" coefficient increased. On the 2nd day of administration (double doses of substances), an activating effect was found in PHENIPA (+38%) and decadron (+33%). On the 3rd day of administration (4-fold doses of substances), the psychoactivating effect was observed for FENIPA (+43%), morphine (+27%) and ethanol (+22%). On the 4th day of administration (8-fold doses of substances), the self-stimulation activating effect was retained only for PHENIPA (increased to +66%) and morphine (+31%). The highest values in the expression of corticoliberin mRNA in the amygdala were recorded after the administration of decadron (0.48±0.13 conventional units) and significantly lower values after the administration of pentobarbital (0.08±0.03) and morphine (0.04±0.02). In the hypothalamus, increased mRNA expression was determined after the administration of pentobarbital (0.85±0.14), ethanol (0.38±0.10) and morphine (0.04±0.02). PHENIPA did not activate mRNA expression in either the amygdala or the hypothalamus. Conclusion. Forced gradual administration of psychoactive drugs (PHENIPA, morphine, ethanol, pentobarbital, decadron) in increasing doses causes typical elements of drug dependence, manifested by changes in the response of the brain's reinforcement system. At the same time, they selectively increase the expression of corticoliberin mRNA in the hypothalamus and amygdala.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):5-12
5-12
DOMINANT ROLE IN THE ETIOLOGY OF PERIPROSTHETIC INFECTION IS PLAYED BY STAPHYLOCOCCAL COLONIZATION AND THE EVOLUTION OF THEIR RESISTANCE
Abstract
Objective. Study of changes in the population of staphylococci in infections of prosthetic joints, analysis of resistance to improve the effectiveness of antibacterial therapy Methods. To detect infection after joint replacement surgery, the patient's biological material was subjected to a special microbiological study. In particular, it was placed in a nutrient medium (Schadler agar) with an increased concentration of carbon dioxide and bacteria were grown. After that, the phenotype of the strain, the number of grown bacteria, and the sensitivity of the bacteria to various types of antibiotics were determined. Results. All patients were admitted with periprosthetic infections to the Republican State Enterprise on the REM "National Scientific Center of Traumatology and Orthopedics named after academician Batpenov N.D." Ministry of Health of the Republic of Kazakhstan Astana for the period 2020 - 2024, which applied from all regions of Kazakhstan. Our study of microorganisms isolated from patients with suspected periprosthetic infection after providing orthopedic trauma care to patients during this period showed the following. In the dynamics of five years, the biomaterial was studied with the following frequency: 257 studies were conducted in 2020, 479 studies in 2021, 500 studies in 2022, 653 studies in 2023, 819 studies in 2024 (10 months); 31,7% of negative results were identified during the study period. During the five-year study of patients with peri-implant infection, 74 types of microorganisms were identified. The typing made it possible to identify five main groups of pathogens: Staphylococcus aureus, coagulase-negative staphylococci, the Enterobacteriales family, non-fermenting gram-negative bacteria and other microorganisms. Conclusion. The study found that staphylococci are the dominant etiological agent of periprosthetic infection, accounting for 64.3% of the total number of isolated microorganisms. The results of the study indicate the need to review existing antibacterial treatment regimens for periprosthetic infections caused by staphylococci, taking into account the growing resistance of pathogens
Vestnik of the Smolensk State Medical Academy. 2025;24(1):13-20
13-20
ASSESSMENT OF LIPID PEROXIDATION INDICES IN PATIENTS WITH NON-ALCOHOLIC STEATOHEPATITIS WITH CONCOMITANT CHRONIC NON-CALCULOUS CHOLECYSTITIS AND OBESITY UNDER THE INFLUENCE OF THE PROPOSED THERAPY
Abstract
Objective. To study the effect of a combination of phosphatidylcholine with glycyrrhizic acid and artichoke extract on the state of lipid peroxidation in patients with non-alcoholic steatohepatitis with concomitant chronic non-calculous cholecystitis and obesity. Methods. We examined 121 patients with chronic pathology of the hepatobiliary system in the form of non-alcoholic steatohepatitis (NASH) and chronic non-calculous cholecystitis (CNC) with concomitant obesity aged 24 to 47 years. The first group - 67 people, the second group - 54 patients. In addition to the standard examination, lipid peroxidation (LPO) parameters were studied in all patients. The activity of lipid peroxidation processes was studied spectrophotometrically based on the concentration of intermediate and final lipid peroxidation products in the blood serum. Patients of the first group, in addition to standard treatment, received a combination of drugs phosphogliv and artichoke extract. Patients from the second group received only standard therapy. Results. Before the start of treatment, the examined patients had clinical symptoms of exacerbation of chronic pathology of the hepatobiliary system. In patients who received a combination of phosphatidylcholine with glycyrrhizic acid and artichoke extract as part of the treatment complex, complete normalization of lipid peroxidation indices was noted, while in patients of the second group, the studied indices remained above normal. Conclusions. The data obtained indicate a positive effect of phosphogliv and artichoke extract on the activity of lipid peroxidation indicators, which makes it possible to consider justified in pathogenetic and clinical terms the inclusion of the proposed drugs in the complex treatment of patients with NASH with concomitant chronic hepatitis and obesity.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):21-26
21-26
COMPARATIVE STUDY OF ANTIHYPOXIC EFFECTS OF TWO THIOBENZIMIDAZOLE DERIVATIVES
Abstract
Objective. The most well-known compound of thiobenzimidazole derivatives is 2-ethylthiobenzimidazole, produced by the domestic industry under the name metaprot. 2-ethylthiobenzimidazole is positioned as an actoprotector and antihypoxant and chemically is a hydrobromide salt of 2-ethylthiobenzimidazole. Objective. To compare the antihypoxic effects of 2-ethylthiobenzimidazole hydrobromide and 2-ethylthiobenzimidazole succinate in models of normobaric hypoxia in mice. Methods. Mice were randomized into 3 groups (n=10-12 mice each) that were subjected to normobaric hypoxia: 1 - control (hypoxia), 2 - hypoxia + 2-ethylthiobenzimidazole hydrobromide 100 mg/kg, and 3 - hypoxia + 2-ethylthiobenzimidazole succinate 100 mg/kg 1 h before hypoxia. Acute normobaric hypoxia was created in mice using a hermetically sealed gas chamber for laboratory research (KGEL-1) manufactured by GEROPRO Research Institute, St. Petersburg, Russia. The chamber allows modeling hypoxia by changing the oxygen concentration in the gas mixture from 21% to 2% by displacing it with nitrogen. Results. Both compounds in the acute normobaric hypoxia model showed an antihypoxic effect for all studied parameters, and this effect was comparable. Thus, the life span of mice after intraperitoneal administration of 2-ethylthiobenzimidazole hydrobromide increased by 58%, and after 2-ethylthiobenzimidazole succinate - by 46%, statistical differences between these values were not noted. The life span at critical oxygen concentrations (6-2 vol%) in these groups increased by 135% and 108%, respectively. The threshold oxygen concentration at which mice survived decreased from 4.56±0.16 vol% in the control to 2.97±0.30 vol% after administration of the hydrobromide salt and to 3.23±0.26 vol% - of the succinate salt of 2-ethylthiolbenzimidazole. Finally, the hypoxia resistance score changed from 4.0±0.5 in the control to 9.5±0.8 and 8.8±0.7 points after the administration of 2-ethylthiobenzimidazole hydrobromide and succinate salts, respectively. Conclusion. 2-Ethylthiobenzimidazole hydrobromide and succinate have an antihypoxic effect similar in direction and magnitude in the normobaric hypoxia model in mice. The degree of protection of mice from acute normobaric hypoxia is 46-135%, which is also typical for other antihypoxants (amtizole, hypoxen).
Vestnik of the Smolensk State Medical Academy. 2025;24(1):27-32
27-32
THE EFFECTIVENESS OF A TRIAZINE-INDOLE DERIVATIVE IN THE TREATMENT OF MOTION SICKNESS: A RANDOMIZED CLINICAL TRIAL
Abstract
Objective. To investigate the effectiveness of a triazine-indole derivative in treating motion sickness under the Coriolis acceleration cumulative test. Methods. During the randomised double-blind clinical trial individuals from the experimental group were administered a single dose of a triazine-indole derivative (trisan) 250 mg per os. Individuals from the control group received placebo followed by the Coriolis acceleration cumulative test and a psychophysiological examination. Follow-up tests were done 1, 2 and 3 weeks after the initial trial. 59 apparently healthy males aged 18-20. 19 were excluded for not meeting the inclusion criteria. 40 subjects included in the trial (randomized into experimental group (n=26) and control group (n=14) had no more than 2 min. tolerance of cumulative Coriolis acceleration. There were no refusals or replacements. Interventions: administration of a single dose of a triazine-indole derivative 250 mg per os. Main Outcomes and Measures: a single administration of 250 mg. of a triazine-indole derivative is expected to improve functional state and performance of subjects under the Coriolis test. Results. Individuals from the experimental group demonstrated a 29.4% improvement in Coriolis tolerance time (from 72.4±6.1 to 93.7±5.8) with simultaneous reduction in vestibulo-sensory, vestibulo-vegetative and vestibulo-somatic reactions. Conclusions. the obtained data make it possible to recommend a single administration of a triazine-indole derivative 250 mg per os to improve vestibular performance in individuals controlling high-speed and high-manoeuvrability vehicles and craft. An improvement in the tolerance of high-acceleration stimuli overall holds promise for prospective studies into the anti-motion sickness effectiveness of a triazine-indole derivative under different dosing regimen.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):33-39
33-39
MEDICO-BIOLOGICAL SCIENCES: REVIEWS
NEPHROTOXICITY OF ANTIMICROBIAL THERAPY IN PATIENTS WITH INFECTIVE ENDOCARDITIS AND POTENTIAL POSSIBILITIES OF ITS PREVENTION
Abstract
Objective. To highlight the potential problem of developing nephrotoxicity when prescribing antimicrobial therapy to patients with infectious endocarditis. Methods. Based on the conducted studies, data are presented indicating the risk of developing nephrotoxicity when prescribing standard antimicrobial therapy regimens to patients with infectious endocarditis. Results. The problem of infectious endocarditis is relevant in many countries of the world. According to foreign studies, the incidence of infectious endocarditis is 3-10 cases per 100,000 people per year. The most common combinations of antimicrobial drugs in patients with infectious endocarditis are combinations of beta-lactam antibiotics and glycopeptides with first and second generation aminoglycosides. Conclusions. Given that patients with infectious endocarditis have potentially multiple organ failure, including renal failure, the appointment of standard antimicrobial therapy regimens contributes to a high risk of developing nephropathy. This is confirmed by the fact that recently more and more works have appeared in the medical literature, according to which the effectiveness and reduction of the risk of nephrotoxicity have been proven when using potentially safer combinations.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):40-43
40-43
IMPORTANCE OF FLUOROQUINOLONES IN MODERN TREATMENT OF COMPLICATED PYELONEPHRITIS
Abstract
Objective. To present generalized information on the potential use of fluoroquinolones in patients with complicated pyelonephritis. Methods. Based on the available data in free use, the current aspects of the current importance of fluoroquinolones in choosing antimicrobial therapy for complicated pyelonephritis are summarized and presented. Results. Urinary tract infections occupy a leading place among neurological pathology and infectious diseases in general. Pyelonephritis, which occurs against the background of an existing urological pathology, as well as many other somatic diseases such as diabetes mellitus or connective tissue diseases, is considered complicated. The basic principle of treatment of complicated pyelonephritis is to eliminate the complicating factor (correction of glycemia, urine derivation in ureterohydronephrosis, immunocorrection, removal of foreign bodies, etc.). Optimal antimicrobial therapy depends on the severity of the disease, as well as on the level of antibiotic resistance in the region and the specific factors of the patient (allergy). Conclusions. Empirical therapy for patients with complicated pyelonephritis usually includes fluoroquinolones and cephalosporins. However, the situation is complicated by the ever-increasing resistance of microorganisms to antimicrobial drugs. The most rapidly this process affects drugs of the fluoroquinolone group.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):44-48
44-48
Clinical Medicine: Original Articles
TRANSFORMATION OF THE COURSE OF PULMONARY AND HYPERTENSIVE SYNDROMES IN COMBINED CARDIORESPIRATORY PATHOLOGY DURING THE REHABILITATION PROCESS IN COAL MINERS
Abstract
Objective. To analyze the transformation of pulmonary and hypertensive syndromes in combined cardiorespiratory pathology in coal miners during rehabilitation activities. Methods. The study included 73 hypertensive patients (all men) with dusty chronic obstructive pulmonary disease (COPD). Patients of group 1 (n=38) received only a basic rehabilitation cardiorespiratory complex, and representatives of group 2 (n=35) additionally 15-day sessions of interval normobaric hypoxic therapy (INBHT). Results. Transformation of the course of pulmonary syndrome in hypertensive patients with dust COPD against the background of cardiorespiratory rehabilitation using 15-day sessions of hypoxic therapy compared to the standard program was characterized by an additional decrease in the frequency of dry and wet cough, mixed dyspnea, dry wheezing, velocity and diffusion indices of the lungs. Modification of the course of hypertensive syndrome in the group with INBGT was characterized by a decrease in the frequency of cephalgia, cardialgia, moderate tricuspid and pulmonary regurgitation, pulmonary hypertension, a more intense decrease in average daily blood pressure. Conclusion. The inclusion of 15-day sessions of INBGT as a component of complex cardiac rehabilitation in comparison with the traditional complex allows not only to reduce the clinical manifestations of respiratory and hypertensive syndromes, but also to improve bronchial patency and the diffusion capacity of the lungs.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):49-55
49-55
VALIDATION OF ULTRASOUND CRITERIA FOR THE SEVERE FORM OF CLOSTRIDIUM DIFFICILE COLITIS
Abstract
Objective. To assess the validity of the developed ultrasound criteria of severe Clostridium difficile ( Cl. difficile ) colitis. Methods. 90 people (27 men and 63 women), aged 20 to 92 years, with a verified diagnosis of Cl. difficile colitis were examined. Of these, 28 patients had a severe course of clostridial infection (CDI) and 62 patients had a mild or moderate clostridial enterocolitis. The previously developed criteria for ultrasonic diagnosis of Cl. difficile colitis severity were used. Internal validation of the prognostic regression model and the cut-off value of colon wall thickness ultrasound sign was performed by a cross-validation using the main group according to TRIPOD guidelines and the PROBAST algorithm. Results. The internal validation of ultrasound criteria for severe CDI by k-fold cross-validation revealed that the training regression models and the cut-off value of colonic wall thickness perform well in the corresponding test datasets. These results confirm the good generalisability of the proposed prognostic model and the cut-off value of colonic wall thickness. Conclusions. The determined ultrasound criteria of severe course of clostridial enterocolitis, the main of which was a total colon wall thickening with a maximum value of more than 7.2 mm and the detection of any of the additional signs (presence of free fluid in the abdominal cavity; increased echogenicity and volume growth of pericolic fat surrounding the inflamed colon; broken intestinal wall stratification; thickening of the small intestine wall more than 3.0 mm; dilatation and paralysis of the colon; toxic megacolon) are valid and can be effectively used in real clinical practice.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):56-64
56-64
RELATIONSHIP OF SOME QUANTITATIVE INDICATORS AND QUALITATIVE CHARACTERISTICS OF OSTEOARTHRITIS PROCESS
Abstract
The study of synovial fluid is of great importance for the diagnosis of joint pathology. However, confirmation of the diagnostic informativeness of this type of laboratory tests requires a serious evidence base. Objective. The purpose of this work was to determine the biochemical parameters reflecting the course of the osteoarthritis process and the clinical factors influencing them. Methods. The biochemical characteristics of the synovial fluid of 46 patients with osteoarthritis of the knee joint (gonarthrosis) were studied. We determined such biochemical parameters of the synovium as the concentration of total protein (biuret method), the composition of protein fractions (Paragon electrophoresis device from Becman), as well as the amount of hexuronic acids, the total amount of sialic acids and the concentration of sulfates. Biochemical indicators of synovial fluid formed a correlation matrix, which also included clinical signs of osteoarthritis, presented in it according to the sign criterion. Results. The most significant active factors among the biochemical parameters of synovial fluid in terms of the frequency of associations with clinical data were the amounts of sulfated sulfur, sialic acids and protein fractions. The strongest correlations are characteristic of such clinical characteristics as: age, gender of the patient, as well as the stage of development of the degenerative process. Conclusions. Thus, against the background of the development of degenerative-dystrophic changes in the joints, stable factors are observed that link the characteristics of the biochemical composition of the synovial fluid and the clinical manifestations of the osteoarthritis process, which may be important not only for diagnosis and the most probable prognosis, but also for determining reasonable treatment tactics.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):65-70
65-70
STRUCTURE OF COMPLICATIONS IN CHILDREN WITH CONSTITUTIONAL-EXOGENIC OBESITY
Abstract
Objective. To study the most common complications in 186 children with overweight and constitutional exogenous obesity in comparison with 186 children in the control group according to extracts from medical records of inpatients (f. 003-u) of the Regional Children's Clinical Hospital in Astrakhan for the period from 1994 to 2020. Methods. A retrospective analysis of complications was conducted based on the results of extracts from the inpatient medical records (f. 003-u) of 186 children (90 boys, 96 girls) with overweight and constitutional-exogenous obesity and 186 children in the control group using a random sampling method. The median age of children with CEO is 13 years [Q1:10; Q3:16], without obesity - 14 years [Q1:11; Q3:15]. All children were examined at the Regional Children's Clinical Hospital in Astrakhan from 1994 to 2020. In the main group, 37 overweight children were observed; 57 children with stage I obesity; 49 children with II degree obesity; 31 children with grade III obesity; 12 children had IV degree obesity. Results. In first place in the structure of complications of overweight and constitutional exogenous obesity in children was the hypothalamic syndrome of the pubertal period (49.0%), in second place was metabolic syndrome (21.0%), in third place was delayed/impaired sexual development (10.7%). The median age of children with hypothalamic syndrome was 14 years [min 5; max 17 years], and the “peak” incidence occurred at the age of 16-17 years. The incidence of metabolic syndrome increased with the degree of obesity. Thus, with obesity of III - IV degree, the incidence of metabolic syndrome was 2-3 times higher compared with overweight and obesity of I-II degree. When comparing boys and girls, a significant predominance of sexual development disorders was revealed in obese boys. Conclusion. Children with constitutional exogenous obesity have a high incidence of complications with gender characteristics. Thus, boys were 2 times more likely to have multiple complications compared to girls (17.8% in boys and 8.4% in girls). The number of multiple complications increased with the degree of obesity. The most common complication is obesity with pink stretch marks, metabolic syndrome is in second place, and puberty disorders are in third place. The noted features make it possible to predict the natural course of the disease and timely carry out preventive and therapeutic measures.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):71-79
71-79
STRUCTURE OF CHILDHOOD DISABILITY IN THE RUSSIAN FEDERATION
Abstract
Objective. To study the structure of childhood disability in the Russian Federation. Methods. This study is an analysis of the level of childhood disability in the period from 2017 to 2023, an assessment of the distribution of children under 18 years of age recognized as disabled for the first time and repeatedly by the predominant main types of persistent impairments of human body functions, nosologies. We analyzed the data of the Federal State Statistics Service; statistical, analytical methods, as well as the method of monographic description were used. Results. Detailed data on the structure of childhood disability in the Russian Federation, on the distribution of persistent impaired functions over 5 years were obtained. Rank positions for nosologies leading to childhood disability, leading to persistent dysfunctions of the body have been established. Conclusion. Disability is an important medical and social problem that allows determining the level of socio-economic development of society, the quality of medical care. The results obtained can be used in planning medical care, developing preventive measures, the work of the bureau of medical and social expertise, in predicting the disability of the country's population and the associated economic damage.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):80-86
80-86
DIFFERENCE IN THE LENGTH OF THE LOWER EXTREMITIES IN PATIENTS WITH COXOVERTEBRAL SYNDROME
Abstract
Objective. This article analyzes the results of a study conducted on patients with coxo-vertebral syndrome who underwent total hip replacement. Methods. One of the main criteria for inclusion in the group was the initial shortening of the limb length by more than 3 cm. Results. As a result of the study, it was revealed that the results of the operation were divided into 3 variants. In the first case, the correction of the limb length was effective, in the second case the difference remained, although it decreased slightly, and in the third case it became larger. As a result, the majority of patients in the second and third groups assessed the results of the intervention as unsatisfactory, since they retained physical activity restrictions and pain syndrome. Conclusion. As a result, the majority of patients in groups 2 and 3 rated the results of the intervention as unsatisfactory, as they still had physical activity limitations and pain syndrome. The reason for this situation lies in the influence of a number of factors - the initial significant difference in limb length, the presence of spinal pathologies and degenerative-dystrophic spine diseases (hereinafter referred to as DDSD), as well as diagnostic errors.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):87-93
87-93
DISORDERS IN THE MICROCIRCULATION SYSTEM IN PANCREATIC NECROSIS
Abstract
Objective. Study of the dynamics of blood microcirculation indicators in various forms of pancreatic necrosis. Methods. Laser Doppler flowmetry was performed on the forearm and anterior abdominal wall in the projection region of the pancreas. The study involved 58 patients with an abortive variant of the disease and 47 with a complicated one. The studies were conducted on days 1, 7 and 14 of treatment using a portable LAPMA PF analyzer. Blood microcirculation index, level of nutritive blood flow and amplitudes of active and passive microcirculation control factors, as well as shunt index were evaluated. Results. With edematous pancreatitis on day 1, the blood microcirculation on the forearm decreased compared to the norm (4.33±0.78 pf.u. and 5.19±0.78 pf.u. p = 0.037, respectively). In pancreatic necrosis, this value decreased to 3.58±0.22 pf.u. The level of nutritional blood flow on the forearm decreased by almost half in both the group with abortive and complicated pancreatic necrosis (p = 0.021 and p = 0.007, respectively). A significant decrease in total and nutritional blood flow was found on the anterior abdominal wall in patients with pancreatic necrosis (p = 0.008 and p = 0.04, respectively). On day 7, the blood microcirculation index increased to 4.34±1.69 pf.u. with edematous pancreatitis and 4.44±0.64 pf in pancreatic necrosis. After 14 days, pancreatic necrosis on the forearm showed an increase in blood microcirculation and nutritional blood flow (by 1.26 pf.u. and 0.34 pf.un. respectively). Basal blood flow increased on the anterior abdominal wall (by 1.19 pf.u.), and its nutritional component continued to decrease (from 2.18±0.3 pf.u. up to 2.05±0.35 pf.u., p>0.05). Conclusion. With a destructive version of the disease, capillary perfusion of tissues is more stable and can persist for up to two weeks, even with syndromic therapy and stabilization of central hemodynamics.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):94-100
94-100
SYSTEMATIZATION OF COMPLICATIONS OF ACUTE PANCREATITIS
Abstract
Objective. To systematize complications of acute pancreatitis and assess their prevalence based on the analysis of literature data and evaluation of CT images. Methods. At the first stage of the work, data from the world literature were used. At the second stage, medical records of 923 inpatients with a referral diagnosis of acute pancreatitis (AP) for 2023 were studied. Of these, 472 were with an established diagnosis of acute pancreatitis. Eighty-eight patients were included in the study who fulfilled the inclusion criteria: 1) Clinical picture of acute pancreatitis; 2) Three times exceeding the upper limit of normal values of amylase or lipase; 3) Abdominal CT scan with intravenous contrast enhancement with CT signs of acute pancreatitis and its complications. CT scan was performed not earlier than 72 hours from the onset of clinical picture of acute pancreatitis. Results. At the first stage, 11 groups of AP complications were identified depending on localization. At the second stage, when analyzing CT images in our work, group A (pancreatic) complications were the most common, accounting for 55.1% of the total number of complications. The second most common were pulmonary (group C) complications (37%). The lowest prevalence was vascular (group B) (6.2%) and gastrointerstitial (group D) (1.5%). Conclusion. The systematized table of AP complications clearly demonstrates the polysystemic nature of its complications, allows clinical and diagnostic doctors to better understand the versatility of AP, simplifies statistical data processing, and expands knowledge about the complications of this disease. The problem of pancreatogenic syndromes plays the leading role among all variety of these complications, each syndrome can be concretized by characteristic complications, which represents an important practical significance for practising physicians.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):101-111
101-111
RESULTS OF CONVERSION IN LAPAROSUCTION LAPAROSCOPIC CHOLECYSTECTOMY
Abstract
Objective. To evaluate the results of conversion for laparoscopic cholecystectomy in the treatment of cholelithiasis and to identify factors influencing the decision to convert. Methods. Data from 3065 patients who underwent laparoscopic cholecystectomy between 2018 and 2020 were included in the study. Conversion to open cholecystectomy was performed in 61 patients (main group). For comparative evaluation, 62 patients in whom surgery was performed without conversion (control group) were noted. The factors influencing the outcomes of operations were evaluated using medical, laboratory and instrumental diagnostic methods. The groups were constructed according to sex, age, and duration of the disease. Results. Analysis of medical history showed that the necessity of conversion to the open method was caused by two cases of complications at the time of the operation, and in 59 by various morphofunctional changes in the hepatoduodenal area. Out of 61 patients with conversion after the operation 9 (14,7%) had complications at the place of the performed operation, including 2 wound complications, the repeated operation was required in 3 patients. In the control group only 2 out of 62 had postoperative complications. Conclusion. When conversion was used, there was an increase in the duration of surgery and longer hospital stay. Of those operated on for cholelithiasis, conversion was required in 2%. At conversion, the duration of operation decreases, complications make 14, 7% and longer period of hospitalization is noted.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):112-116
112-116
CHRONIC DIFFUSE LIVER DISEASES COMBINED WITH OBESITY ON THE BACKGROUND OF RECURRENT HERPES INFECTION
Abstract
Objective: To study the indicators of phagocytic activity of monocytes in patients with chronic diffuse liver diseases combined with obesity and recurrent herpetic infection against the background of the use of a combination of arginine glutamate and bioflavonoid quercetin. Methods. There were two groups of patients with liver pathology under observation, who were randomized by age, gender, severity and duration of the course of the chronic process in both the liver and recurrent herpetic viral infection. Indicators of phagocytic activity of monocytes were studied in both groups. Results. Before the start of treatment, there were similar shifts in the phagocytic activity of monocytes in both groups, which indicated a decrease in the phagocytic reaction. The administration of a combination of arginine glutamate and bioflavonoid quercetin in the treatment complex contributed to an increase in the phagocytic activity of monocytes. Conclusions. The appointment of a combination of arginine glutamate and bioflavonoid quercetin in the complex of treatment in patients with chronic diffuse liver diseases against the background of obesity and recurrent herpetic infection contributes to an increase in the phagocytic activity of monocytes.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):117-122
117-122
Clinical Medicine: Literature Reviews
MODERN IDEAS ABOUT THE EFFECT OF HYPERHOMOCYSTEINEMIA ON THE BODY OF PREGNANT WOMEN AND NEWBORN CHILDREN
Abstract
Objective. Analysis and generalization of available new data on the effect of hyperhomocysteinemia on the body of pregnant women and newborn children. Methods. A review of the literature of domestic and foreign scientific publications from 2019 to 2024 was conducted. The search was carried out using the Pubmed biomedical research database and the RSCI. More than 10,000 publications were found by keywords. Results. An increase in homocysteine in the body is associated with the course of many diseases. Hyperhomocysteinemia primarily has a negative effect on the state of the vascular endothelium, as well as on the hemostasis system. One of the main causes of hyperhomocysteinemia is a number of genetic defects of the enzyme methylenetetrahydrofolate reductase - MTHFR. High levels of homocysteine during pregnancy can lead to complications such as repeated miscarriage, preeclampsia, premature birth, low fetal weight, placental abruption. In newborn children, hyperhomocysteinemia is most often associated with pathology of the nervous system, as well as with pathology of hemostasis. Conclusion. Considering that hyperhomocysteinemia leads to a variety of adverse conditions, the study of this problem is a promising direction. The identification of patterns with simultaneous genetic research and the study of homocysteine levels in a mother-newborn pair will help to better understand the ways of early diagnosis of diseases of newborn children and take measures to prevent their occurrence.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):123-130
123-130
Clinical Cases
SUCCESSFUL SURGICAL TREATMENT OF LEFT VENTRICLE ECHINOCOCCAL CYST COMPLICATED BY FEMORAL ARTERY EMBOLISM IN A CHILD WITH MULTIFOCAL ECHINOCOCCOSIS
Abstract
Objective. Study of a clinical case of management of a patient with an echinococcal cyst of the heart. Methods. The article presents a clinical observation of successful surgical treatment of an echinococcal cyst of the left ventricle of the heart complicated by embolism of the femoral artery in a 10-year-old child with multifocal echinococcosis. Results. Dopplerography of the lower limb vessels at the level of the left femoral artery revealed an embolus occluding the vessel. The child was urgently taken to the operating room. A piece of the chitinous membrane was removed from the lumen of the left femoral artery using a Fogarty catheter. After that, the blood circulation in the left lower limb was completely restored. The following day, an additional examination was performed to determine the source of the embolism. An area of cyst opening into the left ventricle was detected, measuring 10×0.8 mm. On the 10th day after the operation, the patient was transferred to the pediatric surgery department to decide on further treatment tactics for echinococcal cysts of the right lung, liver and left kidney. Conclusions. Due to the asymptomatic course, the diagnosis of echinococcal cysts of the heart and pericardium is somewhat difficult, but with timely treatment of patients, modern diagnostic methods allow for the correct diagnosis. This clinical case demonstrates that late treatment may result in complications that threaten the lives of patients.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):131-136
131-136
THE EFFECT OF INTERMEDIATE MUSCLE RELAXANT ON A CRITICALLY ILL PATIENT UNDERGOING EMERGENCY ABDOMINAL SURGERY
Abstract
Objective. To assess which muscle relaxant better fits a septic patient undergoing many abdominal surgeries. Methods. A critically ill patient diagnosed with aneurysm of right hepatic artery, aneurysm of infrarenal part of aorta, ischemia, necrosis of sigmoid colon, hematoma of right side of aorta primarily then later he became septic. He underwent many emergencies abdominal surgeries. Rocuronium Bromide which was normally being used as muscle relaxant proved to be staying longer in his body and the elimination frequency also was slow whereby the TOF watch was used to assess for NMB. Comparingly, atracurium benzilate was also used and it was proven that there was no residual NMB in the body. Results. The patient was extubated with no residual NMB and was able to carry out the three golden commands properly (bending his head forward, holding the doctor’s wrist firmly, agreeing that the laryngeal tube was disturbing him) and within 55 minutes maximum TOF result was 98% indicating that there was no residual muscle block. Conclusion. It is deemed that on critically ill patients diagnosed with severe sepsis undergoing emergency abdominal surgeries that atracurium benzilate is a better choice than rocuronium bromide.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):137-141
137-141
Pharmaceutical Sciences: Original Articles
STABILITY AND MICROBIOLOGICAL PURITY OF COMPOUNDING AQUEOUS CALCIUM CHLORIDE SOLUTIONS
Abstract
Objective. To establish the microbiological and chemical stability of a non-sterile extemporaneous preparation using the example of 1% and 10% calcium chloride solutions for oral administration before opening the bottle in accordance with the requirements of the Pharmacopoeia of the Eurasian Economic Union. Methods. The study involved aqueous solutions of calcium chloride prepared in a compounding pharmacy: three series at a concentration of 1% and three series at a concentration of 10%, packaged in glass bottles 50 ml (36 bottles in total). The vials were stored in a climatic chamber (Memmert, Germany) at a temperature of 25±0.1°C and a relative air humidity of 60±0.5%. The calcium chloride content was assessed on the first day of manufacture and then every five days of storage using pharmacopoeial express methods. The microbiological purity of the preparations was established on the day of manufacture and every five days of storage in accordance with the requirements of the Pharmacopoeia of the Union, art. 2.1.6.6. and 2.1.6.7 by surface inoculation of solutions onto culture media. The total number of aerobes (TAMC) and the total number of yeast and mold fungi (TYMC) in 1 ml were calculated for each sample under study. Results. After five days of storage, all solution samples met the requirements of the Pharmacopoeia of the Union, art. 2.3.1.2. "Requirements for the microbiological purity of medicinal products, pharmaceutical substances and auxiliary substances for their production". On the 10th day of storage, the microbial contamination of four of the six samples exceeded the pharmacopoeial standards established by the Pharmacopoeia of the Union and amounted to 4.2×102 CFU/ml; 8.9×102 CFU/ml; 2.9×103 CFU/ml according to the OKG indicator, 3,0×101 CFU/ml according to the OKG indicator. Conclusion. The microbiological purity of the analyzed samples of extemporaneous calcium chloride solution 1% and 10% complied with the requirements of the Pharmacopoeia of the Eurasian Economic Union during 5 days of storage. The chemical stability indicators (results of quantitative determination) were within the requirements of the State Pharmacopoeia of the Republic of Belarus throughout the entire shelf life.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):142-150
142-150
OPTIMIZATION OF THE METHOD OF PREPARATION AND METHODICS OF ANALYSIS OF THE DRUG "CRATAEGUS"
Abstract
Objective. Development of an analysis techniques of the tincture of the homeopathic matrix "Crataegus", obtained on the basis of fresh fruits of Crataegus monoqyna Jacq. Methods. The paper presents the results of a comparative study of the amount of flavonoids calculated on catechin in the settings of homeopathic matrix obtained on the basis of fresh and frozen fruits of Crataegus monoqyna Jacq. Results. Qualitative analysis methods for "Crataegus" tincture homeopathic matrix can be direct spectrophotometry with detection of a maximum absorbance at 282 nm in combination with thin-layer chromatography. Tincture homeopathic matrix "Crataegus" can be obtained both using fresh raw materials and raw materials after defrosting. Conclusions. The method of quantitative analysis for the tincture of the homeopathic matrix "Crataegus" may be a method for determining the content of flavonoids calculated of catechin. The content of the total flavonoids calculated of catechin in the obtained settings is within the limits 0,18-0,76%.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):151-156
151-156
MACROELEMENT COMPOSITION OF WILD MEDICINAL PLANTS OF NATURAL ECOTOPES OF VORONEZH REGION
Abstract
Objective. The purpose of the study is to study the features of the macroelement composition of various types of wild medicinal plant raw materials of natural ecotopes of the Voronezh region. Methods. Pharmacopoeial types of herbal raw materials were used as the objects of the study: mountain bird ( Polygonum aviculare L.) grass, nettle dioecious ( Urtica dioica L.) leaves, heart-shaped linden ( Tilia cordata Mill.) flowers, common burdock ( Arctium lappa L.) roots, medicinal dandelion ( Taraxacum officinale F.H.Wigg) roots, common tansy ( Tanacetum vulgare L.) flowers, plantain large ( Plantago major L.) leaves, wormwood bitter ( Artemisia absinthium L.) grass, motherwort five-lobed ( Leonurus quinquelobatus Gilib.) grass, yarrow common ( Achillea millefolium L.) grass. The element composition of the samples was studied by the mass spectroscopic method after acid-microwave decomposition. Results. Macroelements make up more than 84% of the elemental complex of medicinal plant raw materials. Potassium and phosphorus are highly accumulative macronutrients in all types of vegetable raw materials studied. The highest accumulating abilities in relation to potassium were found in burdock of ordinary roots, motherwort of five-lobed grass, tansy of ordinary flowers, plantain of large leaves and nettle of dioecious leaves, phosphorus - in nettle of dioecious leaves, motherwort of five-lobed grass and wormwood of bitter herbs, tansy of ordinary flowers. A high level of calcium accumulation can be noted for plantain of large leaves and nettle of dioecious leaves, magnesium - for nettle of dioecious leaves. Conclusion. The results of the study showed a rich macronutrient composition of the studied medicinal plant raw materials, which can be used in medical and pharmaceutical practice to correct the physiological norms of the content of macronutrients in the human body.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):157-163
157-163
INNOVATIVE APPROACH TO THE ISOLATION OF GLYCYRRHIZIC ACID FROM LICORICE ROOTS: THE USE OF LOW-TOXICITY SOLVENTS AND SIMPLIFIED EQUIPMENT
Abstract
Objective. To develop a technology for the isolation of glycyrrhizic acid from licorice roots that does not require complicated equipment and based on low-toxicity solvents. Methods. To obtain a crude extract from licorice roots, a repeated maceration method was used. The possibility of purifying glycyrrhizic acid was investigated by developing technological processes characterized by simple equipment and the use of low-toxicity solvents. To confirm the suitability of the developed technology for the isolation of glycyrrhizic acid, the results of spectrophotometry and high-performance liquid chromatography of the trisodium glycyrrhizinate sample, obtained in accordance with the developed technology, and a standard sample were compared. Results. The technology for the isolation of glycyrrhizic acid from licorice roots has been developed. It includes the following stages: aqueous extraction of roots, precipitation of the target compound by acidification in a salting-out solution, its dissolution and precipitation in ethyl alcohol, precipitation with calcium hydroxide, dissolution and precipitation in isopropyl alcohol, dissolution in an aqueous solution of sodium chloride, solvent extraction in a two-phase system of isopropyl alcohol - aqueous solution of sodium chloride, dissolution and precipitation in ethyl alcohol, precipitation by acidification without salting-out. The spectral and chromatographic characteristics of trisodium glycyrrhizinate obtained using the developed technique, including the wavelength of the absorption maximum, the absorption spectrum and the retention time of the main peak on the chromatogram, are identical to those for the standard sample. Conclusion. The developed technology is characterized by a simplified equipment and the use of low-toxicity solvents. Acetone is not used in the purification stages, which increases the safety of the process compared to isolation technologies where it is used. There is no need to recrystallize the target component from glacial acetic acid. This allows avoiding its high losses. The introduction of salting-out into the acid precipitation process reduces the holding time and increases the product yield.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):164-172
164-172
METHODOLOGICAL APPROACH TO OPTIMIZING THE MANAGEMENT STRATEGY OF THE ASSORTMENT POLICY OF A PHARMACEUTICAL COMPANY BASED ON INVENTORY CONTROL
Abstract
Objective. To substantiate a methodological approach to confirming the feasibility of launching a new drug on the market, taking into account economic, market and regulatory factors based on a technical and economic analysis. Methods. The research materials include primary data obtained from interviews with pharmaceutical industry experts and secondary data containing marketing analytics, information on demand dynamics, competitive environment and regulatory requirements. The analysis was carried out using the methods of SWOT analysis, PEST analysis, calculations of projected profitability, assessment of potential market share and analysis of production and distribution costs. Results. The proposed methodological approach reflects the sequence of the main stages of the feasibility study development and is based on a comprehensive assessment of market factors, economic efficiency and the feasibility of launching the drug on the pharmaceutical market. A quantitative and qualitative assessment of the competitiveness of the drug, projected sales volume and necessary investments was carried out based on a number of sections of the feasibility study. Conclusion. As a result of the conducted research, methodological bases for making a balanced management decision on the economic feasibility of launching a drug on the market are proposed, allowing to optimize the processes of development, registration and commercialization of the product. The developed methodological approach is aimed at reducing economic risks and increasing the efficiency of introducing a new drug.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):173-179
173-179
DEVELOPMENT OF A SPECTROPHOTOMETRIC TECHNIQUE FOR THE QUANTITATIVE DETERMINATION OF FLAVONOIDS IN SHOOTS OF CRATAEGUS PINNATIFIDA BUNGE USING THE CENTRAL COMPOSITIONAL PLAN METHODOLOGY
Abstract
Objective. Development of a technique for quantitative determination of the flavonoids sum in shoots of Crataegus pinnatifida Bunge using differential spectrophotometry. Methods. The shoots of Crataegus pinnatifida Bunge collected in the flowering phase served as the objects of the study. Raw materials were collected from natural populations in Khabarovsk Krai in 2023. Differential spectrophotometry method was used for quantitative determination of flavonoids in terms of hyperoside. Optical density was measured on a UV-1700 spectrophotometer, Shimadzu (Japan). Ethyl alcohol was used as an extractant. Results. The optimal values of reaction factors for the formation of complexes of flavonoids of Crataegus pinnatifida Bunge with aluminum chloride were determined as a result of the studies. The optimal conditions for complete extraction of flavonoids from raw materials of Crataegus pinnatifida Bunge were established using a second-order type 22 central compositional plan: extractant - ethyl alcohol 83,5%; raw material to extractant ratio - 1:123. The error of the developed methodology does not exceed 5%. Conclusions. The methodology for determination of the sum of flavonoids in shoots of Crataegus pinnatifida Bunge in recalculation to hyperoside using differential spectrophotometry was developed.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):180-186
180-186
VERBENA OFFICINALIS AS A PROMISING SOURCE OF BIOLOGICALLY ACTIVE COMPOUNDS
Abstract
Objective. The search for opportunities to expand the range of potentially affordable and effective medicines through the use of promising plants with unlimited raw materials and rich chemical composition. Methodology. Analysis and systematization of data from domestic and foreign studies on the chemical composition and pharmacological activity of Verbena officinalis L. Results. Verbena extracts obtained using various extractants contain macro- and microelements, flavonoids, phenylpropanoids, vitamins, organic acids, iridoids and fatty acids. These extracts exhibit anti-inflammatory, antimicrobial, antioxidant, antitumor and other in vitro and in vivo activities. Conclusion. There is a need for further study of the promising medicinal plant Verbena officinalis L., its qualitative and quantitative chemical composition, timing and other rules for the collection, drying, storage of raw materials, features of the technology of production and manufacture of medicines based on it, conducting a number of studies to determine and clarify the pharmacological effects and safety of drugs in order to maximize its pharmacological potential, the development of regulatory documentation regulating the quality of raw materials.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):187-193
187-193
DEVELOPMENT OF AN ANALYTICAL TECHNIQUE FOR QUANTITATIVE DETERMINATION OF CHLOROPHYLL CONTENT IN URTICA DIOICA LEAVES
Abstract
Objective. Development of a methodology for the quantitative determination of chlorophylls isolated from Urtica dioica leaves and determination of the main validation characteristics. Methods. The optical density was measured by the KKK-3 "ZOMZ" photometry method in a cuvette with an absorbing layer length of 10 mm in the wavelength range of 550-750 nm. Sample preparation consisted in fractional extraction of raw Urtica dioica leaves in a water bath at a temperature of 85-100° C with 70% ethyl alcohol, combining the extracts and bringing the solvent used to 100 ml, followed by dilution of the resulting solution in a ratio of 2:25 with 95% ethyl alcohol. The quantitative determination included measuring the optical density of the solution relative to 95% ethyl alcohol at an absorption maximum of 663±5 nm, calculating the chlorophyll content as a percentage, in terms of completely dry raw materials. Results. A method has been developed for the quantitative determination of the content of chlorophylls isolated from Urtica dioica leaves, and an assessment of the main validation characteristics (specificity, analytical domain, linearity, correctness, precision) has been carried out. The specificity of the technique is confirmed by studying the spectral characteristics, at which peaks were established at 663±5 nm and 642±3 nm on a spectrophotometer. The method of quantitative determination is linear in the analytical domain in the range from 0.5 to 1.5 g, the relative error of a single determination is 10.53%. The precision of the technique is confirmed by a confidence interval (P=95%) of 0.2849±0.0256% and a standard deviation of 0.0245%. Optimal conditions for the extraction of chlorophylls from Urtica dioica leaves have been established: temperature 85-100°C, fractional extraction within an hour, the use of 70% ethyl alcohol for extraction and 95% for subsequent dilution of the solution obtained after extraction. Conclusion. The developed technique is valid and suitable for the quantitative determination of the content of chlorophylls isolated from Urtica dioica leaves.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):194-200
194-200
ANALYSES OF THE FLAVONOID COMPOSITION OF THE ABOVE-GROUND PART OF GLYCYRRHIZA GLABRA L. BY CHROMATOGRAPHY-MASS SPECTROMETRY
Abstract
Objective. Study of the component composition of flavonoids in ethanol extracts from the above-ground part of Glycyrrhiza glabra L. Methods. Samples of dry extracts from dried raw material (herb) of Glycyrrhiza glabra L. were obtained by the method of percolation. Ethyl alcohol with a concentration of 70% was used as an extractant. The structure-group composition of the flavonoid fraction was studied by chromatography-mass spectroscopy using the Q-Exactive mass spectrometric complex, Waters UPLC. Results. A chromatographic-mass spectrometric study of the structure-group composition of flavonoids in alcoholic extracts from Glycyrrhiza glabra L. herb was performed. 46 individual compounds of flavonoid nature were identified and their quantitative evaluation was conducted. It was found that the basis of flavonoid fraction of the studied extracts were prenylflavonoids (9.33 wt. % of the extract) - glabranin, prenylnaringenin, flavanones (6.14 wt. % of the extract) - pinocembrin, naringenin, liquiritigenin; flavonols (4.11 wt. % of the extract) - quercetin, rutin, sophoroside and others. In addition, flavones, dihydroxychalcones, aurones, isoflavonoids were found - 4.11%, 0.03%, 0.22% and 3.77% respectively. Conclusion. Therefore, qualitative and quiantitative characteristics of flavonoids obtained from the above-ground part of Glycyrrhiza glabra L. are assessed for the first time using chromate-mass-spectrometry.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):201-208
201-208
DEVELOPMENT AND VALIDATION OF METHODS FOR QUANTITATIVE DETERMINATION OF CAROTENOIDS AND CHLOROPHYLLS IN ARONIA MICHURINA LEAVES
Abstract
Objective. Development and validation of a method for the determination of pigments (carotenoids and chlorophylls) in leaves of aronia Michurinia. Methods. The object of the study was dried Michurin's chokeberry leaves of the variety ‘Mulatka’, harvested from a cultivated plant in the Tambov region in 2023; air-shade drying (moisture content not more than 10%). Raw materials were collected at four stages of plant development: flowering phase, phase of the beginning of fruiting, phase of fruit maturity, phase of the beginning of leaf reddening. Development and validation of the methodology for determination of pigments (carotenoids and chlorophylls) in leaves of aronia Michurinia was carried out by direct spectrophotometry in the visible spectrum on a spectrophotometer SF-2000. Results. When selecting the optimal degree of grinding, the raw materials of 5 fractions were used, and the yield of carotenoids and chlorophylls increased with decreasing particle size. When selecting the extractant, the yield of substances was compared during extraction with ethanol at concentrations of 70 and 96% vol. as well as with hexane, but the best yield was observed when using ethanol 70% vol. as, according to literature data, carotenoids and chlorophylls are better extracted by water-alcohol mixtures. At selection of time, an increase in the yield of substances in extraction was observed with increasing duration of extraction with a maximum at 45 minutes. The yield of carotenoids and chlorophylls increased when the extraction multiplicity was increased to 2, decreasing when 3-fold extraction was used. The validation of the method was carried out according to such criteria as precision at convergence level, limit of detection, limit of quantification, linearity, analytical range of the method, and specificity. Conclusions. The optimum degree of grinding, at which the maximum yield of carotenoids and chlorophylls from raw materials is observed, is 0.5-1.0 mm, extraction is recommended to be carried out with ethyl alcohol 70% vol. at the ratio of raw materials:extractant 1 : 200 for 45 minutes twice. The developed method is valid and suitable for spectrophotometric determination of carotenoids and chlorophylls in leaves of aronia Michurinia.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):209-216
209-216
DETERMINATION OF QUANTITATIVE CONTENT OF TANNINS AND FLAVONOIDS IN THE HERBS OF POTENTILLA ARGENTEA, POTENTILLA ASTRACANICA AND POTENTILLA BIFURCA, GROWING IN THE VOLGOGRAD REGION
Abstract
Objective. Determination of the quantitative content of tannins and flavonoids in the raw materials Potentilla argentea herb», «Potentilla astracanica herb» and «Potentilla bifurca herb», growing in the Volgograd region, to assess the possibility of expanding the raw material base of medicinal plant raw materials. Methods. The objects of the study were herb samples of herbs Potentilla argentea of two populations No.1 and No.2, Potentilla astracanica and Potentilla bifurca, collected in May 2023 in Gorodishchenskij district of Volgograd region. The determination of moisture and quantitative content of tannins was carried out in accordance with the General Pharmacopoeial Article 1.5.3.0007 and General Pharmacopoeial Article 1.5.3.0008 of the State Pharmacopoeia of the Russian Federation XV edition. Flavonoid content was determined by UV spectrophotometry. Results. The content of tannins in the raw material of «Potentilla argentea herb» of population No.2 by permanganatometric titration was 6.7%; «Potentilla astracanica herb» - 14.8%; «Potentilla bifurca herb» - 6.39%. The highest content of tannins was found in the raw material «Potentilla argentea herb» of population No.1, which amounted to 21.8%. The content of the sum of flavonoids in terms of rutin by UV-spectrophotometry in the raw material of «Potentilla bifurca herb» was 1.3%; the content of the sum of flavonoids in terms of luteolin-7-glucoside (cynaroside) by UV spectrophotometry in the raw material of «Potentilla argentea herb» was 1.76% and in the raw material of «Potentilla astracanica herb» 1.71%. Conclusion. Analyzing the results, we can conclude that the studied raw material species contain sufficient amounts of tannins and flavonoids to consider these populations as promising sources of medicinal plant raw materials.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):217-222
217-222
STUDY OF RISKS OF DISTRIBUTION OF ANTINEOPLASTIC DRUGS IN THE FEDERAL AND LOCAL MARKETS OF GOVERNMENT PROCUREMENTS
Abstract
Objective. Rationale of pharmaceutical distribution anticancer drugs business model in the government procurement drugs system, study and assessment possibility risks. Materials and methods. As materials and methods, we are used methods of the comparative analysis, systematization, statistical methods of information analysis, content analysis of scientific publications, protocols of open auctions and requests for quotations from state institutions and health authorities of Russia for 2021-2023 years, methods of expert assessments. Results. In the result of the study the main business processes and risk groups for pharmaceutical distribution were identified during participating in government tenders for the supply of medicines. The highest risk category included next ones are the risk of the drug rejection by the customer during the acceptance control; the risk of the drug destruction , the risk of early termination of the contract, delay time in the delivery medicines process by the client bid , the risk of loss and/or damage to goods during receipt of the drug from a partner supplier, shutdown of refrigeration equipment due to emergency power outages, discrepancy of temperature modes of the drug storage, the low qualifications of the staff and the authorized person, the lowest one is the risk of expensive return costs. Conclusion. The results of the research can be the basis for improving and optimizing the methods are used at the realization of the state monitoring.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):223-231
223-231
THE BASIC PRINCIPLES OF TRAINING SPECIALISTS OF THE QUALITY ASSURANCE DEPARTMENT IN MODERN PHARMACEUTICAL ORGANIZATIONS
Abstract
Objective. To consider the main aspects of training specialists of the quality assurance department in modern pharmaceutical organizations. Methods. Collection and analysis of the results of scientific research by domestic authors on the relevant issue, analysis of the practical experience of modern pharmaceutical companies. Results. The basic principles of training specialists of the Quality Assurance Department are considered, such as: professional development, webinars, self-study. The main advantages and disadvantages of these methods are highlighted. Conclusion. A detailed analysis of the topic under study showed that in modern realities, the most popular methods of training employees of the Quality Assurance Department in pharmaceutical companies are: advanced training, webinars, trainings and self-study, as they allow employees to train the necessary knowledge and skills in a fairly short time without long separation from the workflow.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):232-238
232-238
DEVELOPMENT OF AN ALGORITHM FOR THE ACTIONS OF A PHARMACEUTICAL PHARMACY EMPLOYEE, IF NECESSARY, TO VISIT A DOCTOR WITH A PATIENT
Abstract
Objective. This paper will consider the problem of self-medication in our country, its consequences, the reasons why people resort to this method of treatment, debunking myths and fears of patients, the role of pharmacies in this case, and the development of an algorithm by which pharmacists and pharmacists will be able to refer a patient to a doctor. Conducting a survey of pharmaceutical workers from Russia and the LPR. Provide an example of a consultation algorithm for pharmacy visitors complaining about high blood pressure or requesting antihypertensive medications. Methods. The research was conducted using an individually developed questionnaire for pharmacy workers. An analysis of scientific publications presented in Russian and foreign publications available in the eLIBRARY library, as well as in open Internet sources, was carried out. The text editor Microsoft Word, as well as the software MS Excel, were used. Results. The study revealed statistics on consultations by pharmaceutical workers regarding diseases requiring diagnosis by a doctor, as well as the fears and myths of patients about receiving medical care. Conclusion. A scheme of actions for pharmaceutical workers during consultations with patients requiring referral to a medical institution was developed.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):239-245
239-245
ANALYSIS OF CONSUMPTION OF SEDATIVE DRUGS AT THE REGIONAL LEVEL
Abstract
Objective. To analyze the population consumption of drugs with sedative effect and the level of pharmaceutical counseling services among the population of the Voronezh region. Methods. Assessment of the opinion of consumers of medicines was carried out by means of face-to-face questionnaire survey method in the period of February - June 2024, the analysis of questionnaires was carried out taking into account the use of Microsoft Office Excel software package. In the course of the study the following methods were applied: logical, statistical, structural, mathematical. Results. During the survey, 376 participants were interviewed, based on the results of which a socio-demographic portrait of the consumer of sedative drugs was compiled. We identified the most frequent manifestations of body disorders caused by stressful events (anxiety - 60.1%, irritability - 52.1%, sleep disorders - 39.9%) and popular drugs (Valerian extract in tablets - 48.7%, Corvalol - 36.7%, Novo-Passit - 28.5%) with a sedative effect. At the same time, 28.2% of respondents (26.9% - dissatisfied, 1.3% - completely dissatisfied) are not satisfied with the level of information and consulting assistance provided when recommending and dispensing the studied group of drugs. Conclusion. Based on the results of the study, conclusions were made about the possibility of introducing a standard operating procedure regulating a clear algorithm of actions of specialists in the selection and dispensing of sedatives, and methodological materials were developed and proposed for pharmacy workers containing up-to-date information and practical recommendations for the implementation of pharmaceutical consulting services to the population.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):246-252
246-252
Pharmaceutical Sciences: Reviews
USE OF MEDICAL INFORMATION SYSTEMS DATA FOR DEVELOPING PERSONALIZED PHARMACEUTICAL INSURANCE PRODUCTS: ARCHITECTURAL MODELING
Abstract
Objective. To analyze the functional capabilities of modern medical information systems (MIS) and investigate the potential use of their data for developing personalized pharmaceutical insurance products. To propose an architectural model of a system for determining the individual configuration of such a product, and to identify prospects and risks in this area. Methods. A literature review was conducted using advanced search tools in text databases of medical and biological publications; sources older than 2010 were filtered out. During the review, a number of keywords were identified to locate studies dedicated to extracting information from MIS records and its application for improving and optimizing medical and pharmaceutical care. Results. Key directions for using MIS data to optimize healthcare processes were identified: extracting information from unstructured data to form patient phenotypes; applying MIS data in medical research; analyzing the impact of MIS on the quality of care and cost reduction; using data to improve forecasting accuracy and optimize treatment. An architectural model of a system for determining the individual configuration of a personalized pharmaceutical insurance product was proposed, taking into account modern methods of big data processing and machine learning. Conclusions. The use of MIS data for developing personalized pharmaceutical insurance products has significant potential. Personalized insurance contributes to improving the quality of medical care, optimizing costs, and effectively distributing resources of medical organizations. Solving existing problems is possible through the integration of MIS data and the development of architectural solutions, considering ethical aspects and ensuring the availability of insurance products. This approach allows medical organizations to create their own insurance offerings based on MIS data, which is especially relevant for specialized clinics with a specific target audience.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):253-261
253-261
Anniversaries
CENTURY PATH OF THE DEPARTMENT OF CLINICAL SURGERY (ON OCCASION OF THE 100TH JUBILEE OF THE DEPARTMENT OF CLINICAL SURGERY, SMOLENSK STATE MEDICAL UNIVERSITY)
Abstract
The article describes the history and milestones of the main stages of development of the Department of Hospital Surgery of the Smolensk State Medical Institute (now the University) from 1924 up to 2025. The article is based on information from available sources of medical information, archival sources, and memoirs of the department staff.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):262-283
262-283
284-285
286-287
Miscellaneous
EXPERIENCE OF THE INTERNSHIP OF A RUSSIAN NEUROSURGEON AT A LEADING AMERICAN CLINIC (UCSF) USA UNDER THE FULBRIGHT INTERNATIONAL EXCHANGE PROGRAM
Abstract
Objective. Description of the internship of a neurosurgeon from Russia at an American neurosurgical clinic for 5 months. Methods. Collection, systematization and analysis of personal observation data during a five-month internship at a leading neurosurgical clinic in the USA. Results. As a result of the work, the peculiarities of neurosurgeons training in residency and the practical work of doctors in the leading neurosurgical clinic in the USA were revealed. American academic neurosurgery, like Russian neurosurgery based on large centers, is characterized by subspecialization. New technologies used to treat patients with various neurosurgical pathologies, including intracerebral tumors (gliomas), are described in detail. Conclusion. A multi-month internship at the academic American Neurosurgical Department allows us to identify similarities and differences in the training of doctors during residency training, as well as compare approaches and refine new technologies in the treatment of complex neurosurgical pathology, including intracerebral tumors (gliomas).
Vestnik of the Smolensk State Medical Academy. 2025;24(1):288-295
288-295
THE HISTORY OF FORMATION OF THE SMOLENSK REGIONAL HOSPITAL FOR VETERANS OF WARS
Abstract
The article examines the history of formation and development of the Smolensk regional hospital for veterans of wars, who is the chief medical, rehabilitation and pharmaceutical support for the veterans and invalids of the great Patriotic war veterans, widows of the lost (died) veterans, victims of political repressions, participants of local wars, living on the territory of Smolensk region. The basic stages of development of medical facilities, its medical services and further prospects of their development.
Vestnik of the Smolensk State Medical Academy. 2025;24(1):296-299
296-299