Vol 23, No 1 (2024)

Objective. To develop an additional objective quantitative method for assessing the addictiveness index based on the analysis of the effects of amphetamine, morphine and ethanol on self-stimulation of the lateral hypothalamus in rats. Methods. We used the method of self-stimulation of the lateral hypothalamus (unconditioned reinforcement) in Wistar rats to develop additional quantitative criteria for dependence on psychoactive drugs. All animals (n=78) were divided into several groups, which received intraperitoneal doses in 4 doses: 1) saline (control; 0.1; 0.2; 0.4; 0.8 ml/rat), 2) psychomotor stimulant amphetamine (phenamine) hydrochloride (0.5; 1; 2; 4 mg/kg); 3) narcotic analgesic morphine hydrochloride (1; 2; 4; 8 mg/kg), 4) ethanol (0.5; 1; 2; 4 g/kg). Results. When all the studied substances were administered, an increase in the number of pedal pressings was recorded, although it did not always depend on the dose. The dose dependence was recorded only after the administration of amphetamine, when the number of pedal presses increased to 33-66%. At the same time, the “mismatch coefficient” decreased from 0.60 to 0.34. Both of these indicators indicate that amphetamine activates the rewarding systems of the brain. Based on these indicators, the “addiction coefficient” was calculated, which also increased in direct proportion from 2.22±0.03 to 4.88±0.09 in comparison with the control (1.15±0.02). The effects of morphine and ethanol on self-stimulation were less pronounced, although in all cases an increase in the “addiction coefficient” was recorded: with the introduction of morphine up to 32-61%, with the introduction of ethanol - up to 68-142%. Conclusion. It is concluded that the “addiction coefficient” of a psychoactive substance as the ratio of the increase in pedal pressings to the value of the “mismatch coefficient” is advisable to use as an additional quantitative method in assessing self-stimulation of the lateral hypothalamus. The “addiction coefficient” depends on the initial level of self-stimulation and is most appropriate for comparison within a group of related psychoactive compounds, for example, separately among opiates, barbiturates, benzodiazepines, psychostimulants, rather than between different groups.

Objective. To evaluate the dynamics of the etiological structure and qualitative properties of wound pathogens in polytrauma victims, the massiveness and duration of colonization by microorganisms of the blood and internal organs of rats with traumas and wounds to improve antibiotic therapy. Methods. In the experiment, the microbial contamination of the internal organs of rats after injuries and wounds was studied; after the introduction of P. aeruginosa to animals, and a high risk of death in experimental traumatic disease associated with the presence of pseudomonas infection was shown. To clarify the etiological structure of wound infections and the contribution of P. aeruginosa to the structure of purulent-septic complications in patients with polytrauma in real clinical practice, bacteriological studies of wound discharge in patients with traumatic disease treated in 2014-2022 were carried out in the multidisciplinary hospital of emergency medical care in Omsk. The sensitivity of pathogens to antibiotics was determined by the disco-diffuse method on a Muller-Hinton medium in accordance with CLSI standards. Results. In the experiment, 1 day after the injury, the number of infected rats was 67.5%. The microbial contamination of the lungs, spleen, and liver of animals reached 40.3%. After 30 days, bacteremia was observed in every fifth, colonization of internal organs in every third, and brain in every sixth animal. Infection of injured animals with P. aeruginosa led to an abundant growth of pathogens in the lungs, liver, spleen, lymph nodes, and brain. Predominantly gram-negative bacteria (66.5%) were detected in the wound contents of polytrauma victims, while gram-positive bacteria accounted for 31.0%. The most common were E. coli, K. pneumonia, S. aureus, S. epidermidis, P. aeruginosa. E. coli was highly sensitive to cefoperazone/sulbactam, imipenem/cilastatin, meropenem, ertapenem, K. pneumonia - to polymyxin, S. aureus - to all antistaphylococcal agents, except benzylpenicillin. Conclusion. Experimental data revealed the absolute necessity of prescribing antibiotics in case of polytrauma. Due to the revealed features of the etiology and localization of infectious complications, the antimicrobial spectrum of etiotropic therapy should be wide, including P. aeruginosa. The leading pathogens of wound infections in real clinical practice were E. coli, K. pneumoniae S. aureus, S. epidermidis, P. aeruginosa.

Objective. Evaluation of the effectiveness of pharmacological neuroprotection and the prospects for its clinical use in ischemic brain lesions. Methods. Collection, systematization and analysis of literature data and the results of our own research on the experimental and clinical study of pharmacological neuroprotection in ischemic brain lesions. Results. The first part of the work presents an analysis of the results of scientific research on the physiological mechanisms of neuroprotection, as well as the main pathogenetic pathways of the ischemic cascade leading to structural and functional disorders in the central nervous system. It has been revealed that physiological neuroprotection is realized by induction of such processes as neuroplasticity and neurotrophy, the leading triggers of which are neurotrophic factors. The key factors of the ischemic cascade, acting as inducers of subsequent pathophysiological changes in brain structures and the development of neurotoxicity, are glutamate excitotoxicity and oxidative stress. At the same time, many researchers reasonably consider glutamate excitotoxicity to be the main cause of neuronal death in cerebral ischemia as a result of necrosis and apoptosis. There is a natural interest in medicines that can prevent the development or reduce glutamate excitotoxicity. Conclusion. The mechanisms of neuroplasticity and neurotrophy, as fundamental biological processes constantly occurring in the central nervous system, can be considered as physiological targets for pharmacological neuroprotection. Potential pathogenetic targets for pharmacological regulation in cerebral ischemia may be processes associated with the development of glutamate excitotoxicity and oxidative stress. The choice of physiological and pathogenetic targets for pharmacological neuroprotection is a promising direction in the development of pharmacotherapy strategies for ischemic brain lesions.

Objective. To assess the survival of hospitalized patients with COVID-19 using recommended etiological, pathogenetic and antimicrobial therapy. Methods. Our approach is based on a case history of 385 patients of Smolensk Clinical Hospital №1 with confirmed coronavirus infection complicated with double pneumonia and admitted from June 1st to August 31st in 2021.The article gives a sample of patients treated with one or another medicinal product and calculates the survival rate for each sample. Results. The median duration of hospitalization was 17.4±0.5 days. The overall survival rate is 78.4% (n=302), the survival rate for patients with severe and extremely severe disease cases is 43.4% (n=36). Survival with the use of favipiravir does not differ significantly from survival without its use - 77.9% and 80.0% respectively (p=0.33). A discontinuation of treatment with glucocorticoids (dexamethasone) is a significant risk factor for dying from COVID-19 with severe and extremely severe cases (RR=1.9; 95% CI: 1.51-2.28). The survival rate of patients receiving olokizumab does not differ significantly from patients who did not receive this drug and is 73.6% and 80.8% respectively (p=0.06). The survival rate of patients receiving tocilizumab (50.0%) is significantly lower than that of patients not receiving the drug (79.5%, p<0.01). The group of patients receiving low-molecular-weight heparin (enoxaparin, nadroparin) shows a high survival rate of 89.9% compared to the control group that does not receive heparin therapy (69.2%, p=0.02). When using unfractionated heparin, survival rate (75.8%) does not differ significantly from survival rate of patients without heparin therapy (p=0.3). The survival rate of patients receiving a course of selective factor Xa inhibitors (apixaban, rivaroxaban) is 85.7% (control group survival = 78.3%, p=0.3). The survival rate of people with various types of antimicrobial therapy does not differ significantly from other patients, with the exception for the group receiving meropenem and cefepime. Conclusion. Low-molecular-weight heparins (enoxaparin and nadroparin) are the most important pharmacotherapeutic agents for patient survival. The use of glucocorticoids (dexamethasone) significantly reduced the risk of death in patients with severe and extremely severe COVID-19.

Objective. Hepatopulmonary syndrome (HPS) is a complication found in patients with chronic liver disease, the only treatment for which is liver transplantation. As one of the main diagnostic criteria for the diagnosis of HPS, data from an invasive, expensive study - echocardiography with intravenous contrast, which is available only in some clinical centers in Russia, are used. In this regard, it is necessary to search for simpler methods and markers for the diagnosis of this syndrome. Methods. A prospective study was conducted at the Department of Internal Medicine with a Course of Cardiology and Functional Diagnostics of V.S. Moiseev Russian Friendship University from October 2022 to May 2023. The study included 91 patients with cirrhosis of the liver. All patients underwent a comprehensive clinical and instrumental examination. In the presence of a combination of three signs (orthodoxia, platypnea and alveolar-arterial oxygen gradient (AaO2) ≥15 mmHg (or ≥20 mmHg if over 64 years of age and hypoxemia), a probable HPS diagnosis was established. Results. The diagnosis of probable HPS was established in 19 patients (21%), according to the selected criteria. It was revealed that in patients with probable HPS, the level of Sat O2 (p<0.001), fibrinogen (p<0.01) was significantly lower than in patients without this syndrome (p=0.014). The Child-Pugh and MELD scores were higher in patients with probable HPS (p<0.05). All patients underwent a 6-minute walking test (T6MX). It was positive in 78.9% of patients with probable HPS, which is significantly higher than in patients without GPS (4.2%). Conclusion. In the course of the study, it was demonstrated that T6MX makes it possible to suspect a probable HPS without using echocardiography with contrast. Markers of probable HPS have been identified: Sat O2, PaO2, AaO2, MELD scores, the presence of nevi. There were no differences in hospital mortality in patients with and without probable GPS.

Objective. To identify the features of cerebral blood flow in children aged 7-11 years living in social institutions for minors who have suffered chronic intrauterine hypoxia in the antenatal period. Methods. The children of the orphanage aged 7-11 years (n=75) were taken for the study. Of these, 45 children who experienced chronic intrauterine hypoxia made up the main group, the comparison group included 30 children without a history of chronic intrauterine hypoxia. The assessment of cerebral hemodynamics was based on REG data recorded at rest and in a sitting position on the device "REO-SPECTRUM-3 6-channel computer rheograph". Statistical analysis was carried out using application programs on a personal computer. Results. As a result of the examination in children of both groups, the rheographic index in FMD and FMS leads in the main group was significantly lower than in the comparison group. There were no significant differences in this indicator in OMD and OMS leads between the main group and the comparison group. At the same time, a significantly more frequent decrease in pulse blood filling in the basin of the internal carotid arteries on the right and left was revealed in the main group compared with the comparison group. In the vertebral artery basin, a decrease in pulse blood filling is significantly more often observed only on the left, while no significant differences were found on the right. At the same time, the value of the amplitude-frequency index in the main group in the FMD and FMS leads is significantly lower than in the comparison group, and no significant differences were found in the OMD and OMS leads. The coefficient of asymmetry in FMD/FMS and OMD/OMS leads in the main group is significantly higher than in the comparison group, and significant asymmetry of blood filling in both basins of the internal carotid arteries and vertebral arteries in the main group is also significantly more often detected than in the comparison group. The dicrotic index in the main group is significantly higher in all leads than in the comparison group. The venous outflow index in the FMD, FMS and OMS leads was significantly higher in the main group than in the comparison group, and no significant differences were found in the OMD lead. In parallel, in the main group, obstruction of venous outflow in both basins of the internal carotid arteries and vertebral arteries on the right and left was significantly more often diagnosed than in the comparison group. The rate of rapid blood filling in the FMD and FMS leads is significantly lower, and in the OMD lead is significantly higher than in the comparison group. According to the OMS lead, no significant differences in the indicator were found. At the same time, it was revealed that significantly more often in the main group, the tone of the distribution arteries was increased in the basin of the internal carotid arteries on the right and left than in the comparison group, while in the basin of the vertebral arteries, there were no significant differences in the increase or decrease in the tone of the arteries on the right and left between the two groups. The rate of slow blood filling in the FMD and FMS leads is significantly lower in the main group than in the comparison group, and in the OMD and OMS leads, the indicator value does not significantly differ. An increase in the tone of the resistance arteries in the basin of the internal carotid arteries on the right and left was significantly more often detected in the main group than in the comparison group. There was also a significantly more frequent increase in the tone of the resistance arteries in the right vertebral artery basin in children of the main group, although there were no significant differences in the rate of slow blood filling in the OMD and OMS leads. There were no significant differences in the value of the modulus of elasticity in all leads between the two groups. Although significantly more deviations from the norm in the elastic properties of the arteries were detected in the basin of the internal carotid artery on the left in the main group than in the comparison group. In the basin of the vertebral arteries on the right and left, as well as in the basin of the internal carotid artery on the right, there were no significant differences between the two groups in the elastic properties of the arteries. Conclusions. In children with a history of chronic intrauterine hypoxia, features of cerebral blood flow were revealed, which mainly concern the basin of the internal carotid arteries. They had a decrease in the intensity of blood filling in the basin of the internal carotid arteries, which is confirmed by lower values of the rheographic index and a higher frequency of manifestations in comparison with children without chronic intrauterine hypoxia. At the same time, an increase in the tone of the distribution and resistance arteries in the basin of the internal carotid arteries on the right and left is characteristic, with lower rates of rapid and slow blood filling. At the same time, there was a violation of the elastic properties of the arteries only on the left in the basin of the internal carotid arteries. For such children, pronounced interhemispheric asymmetry is also characteristic. And there is also a more pronounced tendency to the occurrence of chronic cerebral circulatory disorders of the angiospastic type with values of REG indicators characteristic of the hypertensive type, especially for the basin of the internal carotid arteries.

Objective. To study the categories of families registered in the medical and social assistance office of the children's polyclinic, to identify the dominant risk factors and to assess the dynamics for 2020-2022. Methods. A complete study with a mathematical and statistical analysis of performance indicators based on primary accounting and reporting medical documentation was applied. Tabular and graphical methods, calculation of absolute and relative values, data processing in the Microsoft Excel spreadsheet environment were used. Results. The categories of families registered in the office of medical and social assistance were studied. It was found that the largest number of families - 73.9% of the total number, falls on the share of families in a difficult life situation. Families with children under guardianship (12.7 per cent) and families at risk (11.3 per cent) occupy the second and third places. Families with a disabled child occupy the fourth place - 2.1%. It is noted that in 2022 the number of dysfunctional families decreased in comparison with 2021 and 2020 by 11.3% and 26.4% respectively. The dominant risk factors for children in each category of families were identified. Conclusion. Health care for disadvantaged families should be improved, carried out comprehensively, but individualized, taking into account factors that negatively affect the health of the child.

Objective. To study the features of the structure and dynamics of diseases among children in an orphanage for the period from 2020 to 2022. Methods. The study was conducted on the basis of the state government institution of the Astrakhan region «Specialized Children's Home «Kapelka» in Astrakhan. The structure and dynamics of nosological disorders in children were assessed according to the annual reports of the State Public Institution of JSC SDR Kapelka for the period from 2020 to 2022. Statistical processing of materials was carried out using the statistical software package STATISTICA 6.1 (StatSoft Russia, Russia), as well as Microsoft Excel, version 16.68 (Microsoft Corporation, USA). Results. For 3 years, a high level of morbidity among children has persisted. The highest morbidity rates were observed by class: respiratory diseases, congenital anomalies, chromosomal disorders, central nervous system, endocrine system diseases, nutritional disorders and metabolic disorders. Conclusion. The data obtained indicate a consistently high level and unchanged structure of general morbidity among orphans and children left without parental care, brought up in a specialized home. However, the observed upward trend in chronic and congenital pathologies over the past three years requires dynamic monitoring and the adoption of measures aimed at the prevention of these diseases and comprehensive rehabilitation from the first days of stay in the institution.

Objective. Development of a new method for determining the insulin resistance index. Methods. The studies were conducted on males in the age range of 45-60 years with different body weights. Blood sampling was carried out in the following groups: healthy, with insulin resistance with normal and overweight, with type 2 diabetes mellitus with normal and overweight. In the obtained blood plasma samples, the concentration of the hormone asprosin was determined using enzyme immunoassay. In addition, the concentrations of insulin, glucose and glycated hemoglobin were measured. To assess insulin resistance, the standard method for calculating the HOMA-IR index was used. Results. These patients were characterized by significant disturbances in carbohydrate metabolism in comparison with healthy ones. There was an increased content of insulin, glycated hemoglobin and a higher value of the HOMA-IR insulin resistance index. We propose to calculate the IR index (HOMA-AS) based on determining the concentration of insulin, glucose and asprosin in the blood plasma with subsequent calculation of its value using the formula: HOMA-AS= [insulin (μU/ml) × glucose (μmol/l) × asprosin (pmol/l]/225. The values of the insulin resistance index were calculated using the standard and our proposed methods. According to the calculations carried out to determine the IR index using the proposed method, the following values were obtained: in healthy people 1.06 (0.92; 1.22), in cases of carbohydrate metabolism disorders (CI) with normal - 6.23 (5.44; 6 .97) and overweight - 21.92 (19.92; 23.88), and for T2DM with normal - 36.70 (34.13; 40.03) and overweight - 76.95 (65. 69; 90.63). The obtained high values of the correlation coefficient between the proposed insulin resistance index and its value determined using the standard method reflect the close relationship between these parameters. Conclusions. The proposed method makes it possible to determine the severity of carbohydrate metabolism disorders, namely, insulin resistance, and can be used to assess its degree.

Objective. The aim was to study the effectiveness of a combination of antiviral drugs in patients with reactivation of chronic Epstein-Barr viral infection. Methods. In order to assess the functional activity of immunocompetent cells at various stages of disease, the antiviral therapy was evaluated in terms of the rate of lymphocyte-platelet adhesion (LPA). Results. In patients with reactivation of CHEBVI, a convincing tendency towards faster relief of the entire symptom complex was revealed when differential antiviral drugs were included in the basic therapy: Panavir® and meglumine acridone acetate (Cycloferon®). In the patients of the main group, the duration of manifestations of tonsillitis syndrome, enlargement and pain of peripheral lymph nodes, hepatomegaly, and the duration of the febrile period were significantly shorter. It was established that in patients receiving panavir+cycloferon, the number of outlet-forming lymphocytes increased to 11.9±1,2%, which is by 1.2 times more compared to the group taking acyclovir (8,9±0,9%). Conclusion. The use of panavir and cycloferon for EBVI was accompanied not only by a therapeutic effect but also the normalization of LPA indices which reflected stabilization of the pathological process and, accordingly, indicated a greater effectiveness of the therapy carried out with this antiviral drug.

Objective. Analysis of the potential effectiveness of perfusion CT in the differential diagnosis between malignant neoplasms and lung abscesses. Particular attention is paid to the potential of this method in identifying key diagnostic features that can contribute to the early detection and differentiation of these diseases, as well as in assessing its advantages and limitations in comparison with other diagnostic approaches. The article reviews clinical cases demonstrating the potential of perfusion CT in improving the quality of differential diagnosis between pulmonary consolidation of inflammatory and malignant etiologies, which, in turn, can significantly affect the choice of treatment strategy and prognosis for patients. Methods. A retrospective analysis of studies of perfusion blood flow in patients with malignant tumors and lung abscesses, verified by histological examination of biopsy material, was carried out. Results. The study provided significant data regarding perfusion CT in the context of the differential diagnosis of small cell carcinoma and lung abscesses. The results indicate that perfusion characteristics can serve as important indicators for distinguishing between these two diseases, which has high clinical relevance. Conclusion. Perfusion CT is an important tool for the differential diagnosis between small cell carcinoma and lung abscesses, allowing more accurate planning of therapeutic and surgical treatment approaches based on objective quantitative measurements of perfusion.

Objective. The search for a new minimally invasive method of surgical treatment of risarthrosis. Methods. In the period from 2016 to 2023, on the basis of the Department of Traumatology N2 of the Republican Clinical Hospital of Kazan, 28 patients with varying degrees of osteoarthritis of the 1st carpometacarpal joint were treated. Based on modern pathophysiological data on the development of osteoarthritis, we have proposed a new minimally invasive method of surgical treatment of osteoarthritis. The results were evaluated using a visually painful analog scale and a DASH questionnaire. Results. All patients were treated according to the method we proposed. The depth of the study was 1 year and showed good results at the 1st and 2nd radiological stages of osteoarthritis of the 1st carpometacarpal joint of the hand. At stages 3 and 4, a recurrence of the pain syndrome occurred by the 6th month, but had a lower intensity. Conclusion. Thus, our proposed method is a promising and minimally invasive method of treating osteoarthritis, justified from the point of view of the pathophysiology of osteoarthritis, helps to reduce pain and restore hand activity at stages 1 and 2 of the disease according to the classification of R.G. Eaton. At stages 3 and 4, this type of minimally invasive surgical treatment has a short-term therapeutic effect.

Objective. To analyze Russian and foreign research papers to understand the causes and estimate the probability of cerebrovascular complications of radiation therapy in cancer patients arising in the long term. Methods. We searched for relevant research papers in PubMed/MEDLINE, CrossRef. eLIBRARY/Russian Science Citation Index and CyberLeninka using the following key words: cancer, cerebrovascular complications, radiation therapy, age, and radiation dosage. We reviewed 85 research articles, selected 42 research papers, 12 of which met the entry criteria, and used Microsoft Excel 2016 for statistical processing. The probability of stroke after radiation therapy was estimated using relative risk and 95% confidence intervals. We looked for correlations between variables using the correlation and regression analysis and chose the c²criterion for assessing the significance of difference. The difference was considered statistically significant at p < 0.05. Results. Depending on the area exposed to radiation and cancer type, the highest risk of stroke in patients who received radiation compared to the non-irradiated group was found in patients with Hodgkin lymphoma (54.86; p<0.001). The risks in patients who underwent radiotherapy to the head receiving doses of 22 Gy and 50 Gy were 8.68 (p=0.014) and 7.93 (p<0.001), respectively. The risk of stroke in patients with Hodgkin lymphoma and lung cancer was 1.7 (p=0.029) and 3.17 (p=0.009) times higher than in patients who received cranial radiotherapy in childhood. After comparing patients who underwent cranial radiotherapy and received different doses, we found that the risk of stroke in those who received a dose of 64.14 Gy was 2.25 (p=0.003) and 3.51 (p<0.001) times higher than in those who received doses of 22 Gy and 50 Gy, respectively. Conclusion. Prevention of the long-term consequences of radiation exposure and reduction of their incidence is still an issue that needs to be addressed by developing up-to-date, targeted diagnosis, prevention and treatment strategies for patients with a high risk of cerebrovascular diseases.

Objective. To highlight the current trends in the epidemiology of infective endocarditis (IE). Methods. Based on the conducted studies, the most significant epidemiological aspects of infectious endocarditis are presented. Results. The incidence of IE varies from 46.3 to 150 people per 1 million inhabitants per year, increasing with age (in people over 50 years old - 150 cases, and in people over 80 years old - 220 cases per 1 million people). The share of primary IE has been growing in recent decades. Among the heart diseases predisposing to the development of secondary IE, there is an increase in the role of prosthetic heart valves and degenerative heart defects in the elderly. According to national statistics in 2010-2020, the hospital mortality rate from IE was 23.1%, in Moscow - 34.7%). Conclusions. The increase in the incidence of IE is due to an increase in the number of cardiac surgical interventions and other invasive medical procedures (installation of vascular catheters and performing therapeutic/diagnostic manipulations). In addition, a high proportion of IE associated with intravenous drug use remains in a number of countries.

Objective. To develop methods for isolating carbamazepine from biological fluids (blood serum, urine) and biological tissues (liver, kidney). Methods. To study the extraction of carbamazepine from aqueous solutions, a liquid-liquid extraction method was used on standard carbamazepine solutions with a concentration of 10 mcg/ml. Organic solvents were used as extractants: hexane, chloroform, diethyl ether, methyltretbutyl ether, ethyl acetate, a mixture of chloroform-propanol-1 (9:1), extraction was carried out from an alkaline medium (pH 9-10). An experiment to develop methods for isolating carbamazepine from blood serum and urine was carried out using model mixtures with carbamazepine concentrations of 1, 10, 100 mcg/ml. Chloroform and methyltretbutyl ether, were tested as extractants, the pH was 9-10. When studying the conditions for isolating carbamazepine from the tissues of internal organs, the liver and kidneys of intact laboratory animals (rats) were used to prepare model mixtures. To prepare the model mixtures, the biological sample was homogenized in distilled water (1:4) using an ultrasonic homogenizer. 250, 500, 1000 ml of carbamazepine aqueous solution with a concentration of 100 mcg/ml was added to 10 g of tissue homogenate (the introduced amount was 25, 50, 100 mcg). To extract the target substance from the tissue homogenate, water and acetonitrile acidified to pH 2 were tested. Next, the extraction was carried out with an organic solvent (chloroform, methyltretbutyl ether). The quantitative determination of carbamazepine in extracts from biological objects was carried out by high-performance liquid chromatography (HPLC). Results. The data obtained showed that chloroform and methyltretbutyl ether are promising for the development of methods for sample preparation of biological objects based on liquid-liquid extraction. Carbamazepine is more fully extracted from biofluids by chloroform. The results of studying the conditions for isolating carbamazepine from biological tissues (liver and kidney) showed that acidified polar solvents (water, acetonitrile) are effective as isolating agents for carbamazepine. Conclusion. It has been established that acetonitrile is the optimal solvent at the stage of carbamazepine isolation from biological tissues, and it is more expedient to use chloroform as an extractant to extract the substance from solutions.

Objective. To evaluate allergenicity and wound healing effect of Sextafag® drug plates on an experimental model of localized purulent skin wound. Methods. Preclinical study of allergenicity of Sextaphag®. drug plates was carried out using a test of skin applications on guinea pigs and rabbits. The skin reaction was counted daily using the skin test evaluation scale. The wound healing effect was evaluated in comparison with the official Levomekol ointment by the tensiometric method on white rats (model of "linear" aseptic wound) and by the planimetric method on the pharmacotherapeutic effectiveness of treatment of Chinchilla rabbits (model of "linear" purulent wound). Results. In the test of cutaneous applications it was established that the plates of the medicinal preparation Sextafag® have no allergizing properties. Daily application of the plates on the depilated skin area did not cause skin changes in rabbits and guinea pigs. Clinical manifestations (hyperemia, edema, peeling, itching, painful reaction at palpation, etc.) were not observed in laboratory animals during the whole period of the experiment. It was found that at application of Sextafag® medicinal plates in comparison with Levomekol ointment the scar strength increased and the number of infectious complications decreased, wound healing time was reduced: the index of acceleration of wound healing at treatment with Sextafag® medicinal plates in comparison with Levomekol ointment was 213,18%. Conclusion. As a result of experimental preclinical studies it was revealed that medicinal plates Sextafag® are non-allergenic, have a pronounced antibacterial and wound healing effect.

Objective. To compare the agar diffusion method and the bacterial bioluminescence assay in determining the antimicrobial activity of antibiotics. Methods. A comparative analysis of two methods was carried out - well diffusion in agar, which was carried out according to the methodology of the State Pharmacopoeia of the Russian Federation of the XIV edition by measuring the diameters of the growth inhibition zones of the test strain of microorganisms, and the bioluminescent method, which registers the antimicrobial effect of samples by changing the intensity of bacterial luminescence, under the action of antibiotics. P. leiognathi Sh1 was used as a test strain in the study. Comparison of methods was carried out by comparing the antimicrobial activity of 10 antibiotics of different chemical structures. Results. In the course of comparing the results of the antimicrobial activity of the studied antibiotics, obtained using bioluminescent analysis and well diffusion in agar, a high convergence of the data obtained, expressed by the Karl-Pearson coefficient, was revealed. Linear correlation coefficients between d and BLI were: -0.96, -0.83, -0.83, -0.80, -0.76, -0.74, -0.65 and -0.64 for tetracycline, cefotaxime, doxycycline, cefepime, penicillin G, gentamicin, streptomycin, and ceftriaxone, respectively. Conclusions. As a result, the applicability of the bioluminescent method for determining the antimicrobial activity of antibiotics for penicillin G, tetracycline, doxycycline, streptomycin, gentamicin, cefepime, ceftriaxone, and cefotaxime has been experimentally confirmed.

Objective. To conduct a structural analysis of the range of drugs in the anxiolytics group . Methods. To study the structure of the range of drugs of the pharmacological group «Anxiolytics», open information resources were used: the «grls.rosminzdrav.ru», Vidal pharmacological reference books, «rlsnet.ru» and the Internet resource «Analit.net». The data obtained is current as of December 1, 2023. Results. It was revealed that 17 international generic and 52 trade names are represented on the Russian pharmaceutical market of anxiolytic drugs. A total of 82 product lines are produced by 46 manufacturing companies, the majority of which are domestic (78%). It is shown that the drugs are presented in 11 different dosage forms, mainly in the form of solid dosage forms (tablets), making up 80% of the range. An assessment of the assortment in pharmacies in the city of Voronezh showed the presence of 30% of the drugs from the entire list presented on the Russian pharmaceutical market. Conclusion. As part of the study, it was revealed that the market of anxiolytic drugs in Russia is characterized by a wide range, mainly domestic production and a high level of information demand for individual drugs. However, availability issues in pharmacies may require additional attention and regulation.

On March 30, 2024, at the age of 85, Vyacheslav Vasilievich Reshedko, Candidate of Medical Sciences, Associate Professor of the Department of Pathological Physiology, died after a serious long-term illness. Vyacheslav Vasilyevich lived a bright and interesting life. His distinctive features were deep humanity, genuine intelligence, high professionalism, love of life and optimism.