Vol 22, No 2 (2023)
- Year: 2023
- Published: 15.06.2023
- Articles: 37
- URL: https://ogarev-online.ru/2225-6016/issue/view/24119
MEDICO-BIOLOGICAL SCIENCES: ORIGINAL ARTICLES
THERMOGRAVIMETRIC METHOD OF CONTENT RESEARCH OF WATER FRACTIONS - A NEW METHOD FOR ASSESSING THE SEVERITY OF ACUTE HYPOXIA AND ITS PREVENTION BY CHEMICAL COMPOUNDS IN AN EXPERIMENT
Abstract
Objective. To test the thermogravimetric method for studying the amount of water fractions on the model of acute hypoxia with hypercapnia (AH+Hc) to estimate the degree of its severity, as well as in the conditions of prevention of AH+Hc with metal-containing complex compounds. Methods. To assess the antihypoxic effect, the AH+Hc model was used. Determination the structure of aqueous fractions in the blood was carried out by thermogravimetric method. Results: In experiments on mice 12 new metal-containing complex compounds relating to physiologically compatible antioxidants were studied. The protective effect of 4 of them was confirmed under the conditions of AH+Hc (πQ1311, πQ2830, πQ2853, πQ2856). At the same time, the highest efficiency of the substance πQ2853 was noted. It has been established that AH+Hc causes changes in the amount of water structural fractions. A significant increase in the level of structured water (by 50,0%) and decrease in the level of free water (on 6,9%) were observed in the blood of animals at the first signals of hypoxia. In the study of the blood of mice with stable apnea, there was a decrease in associated water (by 27,6%) and increase in free water (by 5,3%) with an almost normal total water amount. Prophylactic administration of πQ2853 compound at a dose of 25 mg/kg during the formation of AH+Hc promoted to the increase in the amount of associated water in the blood on 26,1% compared to the group undergoing hypoxia alone. At the same time, the level of free water in the group receiving πQ2853 decreased by 3,9% and the total water amount did not change. Conclusions. Qualitative changes in the structure of biomacromolecules due to the adaptive response of the organism to hypoxia were established. In comparison with the intact group, differences in the fractional composition of water were revealed for the group of mice that experienced of AH+Hc in its pure form and the group that received prophylactically the antihypoxant πQ2853. It was suggested that the indicators of associated and free water amount can be used in the future as an indicator of the depth of the hypoxic state, the body's ability to experience of AH+Hc as well as the efficiency of antihypoxic agents.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):5-13
5-13
EFFECT OF CRYOTHERAPY ON THE BIOELECTRIC ACTIVITY OF THE FRONTAL AND CENTRAL REGION OF THE BRAIN
Abstract
Objective. To evaluate the effect of short-term general cooling (cryotherapy) on the bioelectrical activity of the frontal and central regions of the brain. Methods. The analysis of the Robinson index and the bioelectrical activity of the frontal and central regions of the brain was carried out in 19 males aged 20 to 23 years after a short-term general cooling. Results. In the frontal region of the left hemisphere, the amplitude of the β1 rhythm increased after a course of cold exposure, and in the right hemisphere, the amplitude of the δ1 rhythm decreased after 15 days. Changes in the electroencephalogram of the central region after a short-term general cooling are characterized by an increase in the amplitudes of β1- and β2-rhythms, after 15 days this trend persists. Interhemispheric asymmetry in the frontal region was detected only by the δ1 rhythm 15 days after the termination of the course, and in the central region it was expressed by the δ2-rhythm, and after 15 days by the δ1-rhythm. Conclusions. Carrying out the procedure of short-term general cooling of the body changes the bioelectrical activity of the brain, which can affect the adaptive mechanisms and mobilization of functional systems.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):14-19
14-19
INFLUENCE OF NEW ALFA-CYANOTHIOACETAMIDE DERIVATIVES ON BIOCHEMICAL PARAMETERS IN MODELING METABOLIC DISORDERS
Abstract
Objective. To study the dynamics of biochemical blood parameters in Wistar rats under the influence of alimentary load and glucocorticoid intake, followed by pharmacological correction of metabolic disorders with new alpha-cyanothioacetamide derivatives. Methods. The experiment was carried out on 72 mature Wistar rats, the average weight of which was 234,9±5 g. After modeling metabolic disorders by applying a high-fat load for 8 weeks and subsequent administration of dexamethasone for 13 days, the stage of pharmacological correction followed. For 14 days, alpha-cyanothioacetamide derivatives were used at a dosage of 1 mg/kg of animal body weight. After each stage of the experiment, when the animals were hatched, blood was taken for the subsequent determination of the concentration of glucose, total cholesterol, triglycerides, ALT, AST, total bilirubin. Results. The development of metabolic disorders was reflected in the biochemical parameters of the blood of animals as follows: an increase in the levels of glucose, total cholesterol, triglycerides, ALT, AST, total bilirubin. The use of new alpha-cyanothioacetamide derivatives as a pharmacological correction led to a decrease in glycemia, lipids, hepatic blood markers. Conclusions. It was established that new alpha-cyanothioacetamide derivatives are promising in terms of pharmacological correction of carbohydrate and lipid metabolism disorders, which requires their further preclinical studies.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):20-27
20-27
PHARMACOECONOMICAL AND PHARMACOEPIDEMIOLOGICAL METHODS IN EVALUATING THE EFFECTIVENESS OF CEPHALOSPORINS PROTECTED BY BETA-LACTAMASE INHIBITORS
Abstract
Objective. To evaluate the pharmacoeconomical efficacy of cephalosporins protected by beta-lactamase inhibitors in the treatment of patients with purulent-septic infections. Methods. Information on the purchase of medicines in 2022 was obtained from electronic invoices of a stationary pharmacy of a multidisciplinary hospital providing emergency medical care to the population of a large industrial city. The assessment of the distribution of finances was carried out using ABC, VEN analysis, drug consumption was studied by the pharmacoepidemiological methodology for determining DDD. Results. ABC analysis showed that in 2022, 35% of all money allocated for the purchase of antimicrobial drugs was spent on the purchase of inhibitor-protected cephalosporins. At the same time, the largest part of the funds, equal to 25.3%, is directed to the purchase of various commodity items with INN - cefoperazone/sulbactam. Another inhibitor-protected cephalosporin, cefepim/sulbactam, with a share of expenses amounting to 1.7%, was identified in the group of average financial attraction. It was noted that cefepim/sulbactam had the highest cost of a single dose (660 rubles) and the lowest indicator of the average daily doses used (DDDs). The cost of a 10-day course of treatment with cefepine/sulbactam turned out to be 1.5 times more expensive than the drug cefoperazone/sulbactam. It was found that a greater number of patients were treated with cefoperazone/sulbactam according to the results of DDDs. This indicator, characterizing the use of cefoperazone / sulbactam for the main purpose, turned out to be 41 times higher than the similar cefepime/sulbactam. Conclusions. The ratio of costs for the purchase of cefoperazone/sulbactam and its DDDs confirms its economic advantages in choosing a priority protected cephalosporin for the treatment of patients with nosocomial gram-negative infections of various localization. Preference for other protected cephalosporins may be dictated by clinical and bacteriological prerequisites.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):28-33
28-33
MICROORGANISMS ISOLATED IN CASE OF SUSPECTED PERIPROSTHETIC INFECTION, THEIR SENSITIVITY
Abstract
Objective. The study of etiological agents that cause periprosthetic infections in adults with the determination of its antibiotic susceptibility to improve the effectiveness of treatment. Methods. The biomaterial was studied by a special method to detect periprosthetic infections; it was necessarily subjected to a quantitative bacteriological study. Shadler agar was incubated with an increased concentration of carbon dioxide. The antibiotic susceptibility of the isolated strains was determined by the standard disc method in accordance with clinical guidelines. Results. All patients were admitted from all regions of Kazakhstan with periprosthetic infections to the Republican State Enterprise on the REM "National Scientific Center of Traumatology and Orthopedics named after academician Batpenov N.D." under the Ministry of Health of the Republic of Kazakhstan Astana for the period 2019 - 2022. Our study of microorganisms isolated from patients with suspected periprosthetic infection after providing orthopedic trauma care to patients during this time showed the following features. In 2019, 372 studies of biomaterial with this nosological form were conducted, of which 182 studies were negative, which is 48.9%. In 2020 257 studies were conducted, 128 (49.8%) negative results were detected In 2021 479 studies with 37.8 % negative results, and in 2022 - 500 studies and 35.4% negative results. During the four years of study, 27 types of microorganisms were identified in patients with peri-implant infection, which we grouped into 5 main groups: Staphylococcus aureus, Staphylococcus spp., the Enterobacteriaceae family, NGOB - non-fermenting gram-negative bacteria and other microorganisms. Conclusion. The studied biomaterial with suspected periprosthetic infections was sterile in 32%-49% of cases. In 2/3 of the total number of all identified microorganisms, staphylococci were isolated. All isolated staphylococci showed 100% sensitivity to Vancomycin and Linezolid, which indicates a rare use of these antibiotics in the treatment. The group of microorganisms Enterobacteriaceae had 100% sensitivity to carbapenems only in the period of 2019-2021, in the dynamics of four years, resistance (the presence of ESBL) increased by more than 20% and reached almost 40%, which indicates a poor prognosis in the possibility of treating this group of microorganisms. The strains included in the NGOB group have good sensitivity only to two antibiotics: Amikacin, Doripenem, but they do not have 100% sensitivity.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):34-42
34-42
MEDICO-BIOLOGICAL SCIENCES: REVIEWS
MODERN PHARMACOLOGICAL DEVELOPMENTS OF PROMISING ANTI-TUBERCULOSIS DRUGS
Abstract
Objective. Analysis of the results of clinical studies of promising pharmacological compounds with antitubercular activity and possible targets for their effect on the causative agent of tuberculosis. Results. Collection and evaluation of materials of scientific studies of pharmacological compounds with antituberculusis activity, which, as of April 2023, are at the stage of randomized clinical trials of phases I and II. The medical databases PubMed, Mendeley, as well as the website (newtbdrugs.org) of the working group on the creation of anti-tuberculosis drugs (ATD) and the register of clinical trials - clinicaltrials.gov were used as sources of information. The analysis of scientific publications for the last five years (2018-2022) was carried out. Conclusion. Among the new potential drugs with antitubercular activity, several promising compounds of different chemical structures with high clinical efficacy were identified. The study of their pharmacodynamics showed that along with the known mechanisms of suppression of the vital activity of mycobacteria (inhibition of the synthesis of mycolic acids, protein on ribosomes), some compounds affect other targets. Thus, diarylquinoline derivatives (TBAJ-876, TBAJ-587, TBAJ-587) and imidazopyridine derivative (Q203) block energy processes in the mycobacterial cell, imidazooxazole derivatives (delamanide and pretomanide) inhibit the synthesis of proteins and lipids of the cell wall, ethylenediamine derivative (SQ109) inhibits the transport protein mMpl3. Compounds with other promising mechanisms of anti-tuberculosis activity were identified: DNA binding (Pyrifazimine), inhibition of cholesterol catabolism (GSK-286), inhibition of the transcription regulator EthR (BVL-GSK098). Such compounds are of particular interest, because due to the originality of the mechanism, there are no resistant strains of Mycobacterium tuberculosis (MBT) to them yet, which makes them very promising for the development of new ATD. The introduction into clinical practice of new ATD with different mechanisms of action on the causative agent of infection, unlike the drugs used today, will contribute to improving the effectiveness of pharmacotherapy of tuberculosis, primarily caused by MBT strains with multiple and broad drug resistance.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):43-51
43-51
Clinical Medicine: Original Articles
PECULIARITIES OF AUTONOMIC REGULATION OF CARDIAC ACTIVITY IN WOMEN WITH CORONARY HEART DISEASE AND PAROXYSMAL ATRIAL FIBRILLATION
Abstract
Objective. To assess autonomic regulation of cardiac activity in women with coronary heart disease and paroxysmal atrial fibrillation in postmenopause. Methods. The study involved 88 patients with coronary heart disease (CHD) and paroxysmal atrial fibrillation (AF) (Group I) and 35 women with CHD without arrhythmia (Group II). Group I was divided into 2 subgroups: 1A - who maintained sinus rhythm during 6 months of follow-up (n=38); 1B - who had paroxysm(s) of AF during this time period (n=50). All patients underwent Holter ECG monitoring ("Myocard-Holter", Russia). The following parameters were assessed: SDNN, SDANN, PN50%, RMSSD. Data were statistically processed using STATISTICA 10.0 software package. Results. The total effect of autonomic regulation (SDNN) in group I was significantly reduced by 12.5 ms (p<0.05) compared to group II. In group I, almost half of the patients (47.7%) had SDN in the range from 120 to 130 ms. Women with SDNN <120 ms were significantly more common (by 18.2%) in the group with AF (p<0.005 according to the bilateral Fisher criterion). At the same time, patients with SDNN 120-130 ms were registered in both groups without significant differences (χ2=0.23; p=0.6). Women with SDNN >130 ms were more likely (by 23%) to be in group II (χ²=6.4 ; p=0.012).The value of SDNN<120 ms was more common (by 24.2%) in the subgroup of patients who had AF paroxysms during 6 months of follow-up compared with the alternative group (χ²=4.97 with Yates correction; p=0.026).SDNN values >130 ms were significantly more common (by 24.8%) in the group of women who maintained a sinus rhythm for 6 months (χ²=6.2 with Yates correction; p=0.013). Conclusion. Women with postmenopausal CHD are 3.25 times more likely to have paroxysmal AF and 3.6 times more likely to have recurrent AF within 6 months with SDNN<120 ms.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):52-59
52-59
CLINICAL CASE OF CROHN'S DISEASE
Abstract
Objective. To analyze the medical history of a patient with Crohn's Disease. Methods. Interview, physical examination; analysis of medical records, data of laboratory and instrumental methods of investigation. Results. This article presents a clinical case of Crohn's disease in a 19 year old female patient. Patient D. considers herself ill for 7 years. In 2015 she was examined and diagnosed with total, moderately active ulcerative colitis. Therapy was prescribed. The patient felt satisfactory for 2 years on an ongoing basis. In 2017 and 2018, episodes of deterioration were observed. In 2018, the patient was referred to the NICHD for further observation and modification of therapy. According to the results of the examination, there was a progression of the inflammatory process in the intestinal mucosa, due to which a course of genetically engineered therapy with TNF-alpha inhibitor Adalibumab was initiated. In 2019, the patient was hospitalized and was diagnosed with colonic Crohn's disease, inflammatory form, low/moderate activity, continuous recurrent course. The patient was last hospitalized in 2020 for examination and correction of therapy. Clinical diagnosis: Crohn's disease of upper and lower gastrointestinal tract, inflammatory form, moderate degree of activity, continuous relapsing course, exacerbation. After being treated in the hospital, the patient was discharged under the observation of a gastroenterologist at her place of residence in a stable condition. At present the patient is on Adalimumab therapy, dynamic observation will be continued. Conclusion. This clinical case illustrates the development of typical Crohn's disease pattern in a patient previously diagnosed with ulcerative colitis.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):60-66
60-66
OSTEOPOROSIS: ASSESSMENT OF DIAGNOSTIC TECHNIQUES FOR DRUG THERAPY ADMINISTRATION
Abstract
Objective. Analysis of the results of various methods of diagnosis of osteoporosis before the appointment of anti-osteoporotic therapy. Methods. The medical records of patients receiving medical care at the Federal Center for Traumatology, Orthopedics and Endoprosthetics of the Ministry of Health of the Russian Federation (Smolensk), who underwent femoral neck densitometry, as well as an assessment of the 10-year risk of osteoporotic fractures using the FRAX technique, were analyzed. Statistical processing of the material was performed using the Microsoft Office Excel 2016 program using the "Data Analysis" add-ins and AtteStat 12.0.5. These age values are presented as the mean ± standard error of the mean, the T-index - as the mean ± standard deviation (SD), the data in percentages - as the mean ± mean quadratic sample deviation of the fraction. Results. The methodology of 4 diagnostic schemes of osteoporosis before the appointment of anti-osteoporotic therapy is analyzed. The largest number of people is calculated based on the results based only on the values of densitometry, the smallest - based on the results of the FRAX method according to the recommendations of the RAOP. A group of patients has been identified who are recommended anti-osteoporotic therapy, regardless of the chosen method of diagnosis of osteoporosis. In it, the average age of the patient is 68.0± 1.5 years, the average T-index is -3.3±0.8 SD, the 10-year probability of major osteoporotic fractures without an MPC value is 20.1±9.7%, hip fracture is 5.2±5.4%. Conclusion. Depending on the method of diagnosis of osteoporosis, the number of patients who are recommended medication has significant differences. It was found that the use of the FRAX method in conjunction with densitometry data increases the accuracy of the prognosis of osteoporosis, which makes it possible to better identify patients who need anti-osteoporotic therapy.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):67-73
67-73
RELATIONSHIP OF CARDIOVASCULAR DISEASES WITH THYROID DISEASES
Abstract
Objective. To show the relationship between cardiovascular diseases and thyroid diseases. Methods. 262 patients with diseases of the cardiovascular system, combined with thyroid diseases, were examined. Statistical analysis was carried out according to the StatTech v. 2.8.8 program (Stattech LLC, Russia). Quantitative indicators were evaluated for compliance with the normal distribution by the Shapiro-Wilk criterion (>50) or by Kolmogorov-Smirnov (<50). Quantitative indicators having a normal distribution were described using arithmetic averages (M) and standard deviations (SD), the boundaries of the 95% confidence interval (95% CI). In the absence of a normal distribution, quantitative data were described using the median (Me) and the lower and upper quartiles (Q1-Q3). Results. The data obtained by us when analyzing the age group depending on euthyroid diseases, allows us to establish significant differences (p=0.012) (according to Pearson Chi-squared). When analyzing the age group depending on hypothyroidism, thyrotoxicosis, we were unable to identify significant differences (p=0.495, p=0.422, respectively) (according to Pearson Chi-squared). Conclusions. The results of experimental and clinical studies suggest that thyroid hormone therapy can improve the clinical status of patients with CVD and hemodynamic parameters with minimal risk of complications, primarily arrhythmias.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):74-81
74-81
ROLE OF HORMONE-ACTIVE BREAST MILK PROTEINS IN THE PROGRAMMING OF EATING BEHAVIOR
Abstract
Objective. To evaluate the effect of breast milk hormones on the growth and development of infants and their contribution to the programming of children's eating behavior. Methods. 103 mother-infant pairs were examined. In the mother's breast milk (BM) serum, the level of hormones leptin and insulin-like growth factor-1 (IGF-1) was determined three times (at 10-14 days, 1 month and 3 months) using an enzyme immunoassay kits from Mediagnost Germany and DBC Diagnostics Biochem Canada. Inc. Canada, respectively. The child's eating behavior was assessed using a questionnaire BEBQ (Development and factor structure of the Baby Eating Behaviour Questionnaire in the Gemini birth cohort, Clare H. Llewellyn et al., London, 2011). Results. We studied the relationship between the concentrations of breast milk hormones - leptin and IGF-1factors of eating behavior of breastfed infants. It was found that the high growth rate in infants in the first month of life is combined with lower indicators of growth at birth and an imbalance in the hormonal composition of BM in mothers: a significantly higher level of BMleptin and a reduced level of IGF-1 were revealed, which leads to a decrease in sensitivity to food and, on the one hand, to a decrease in energy intake, and, on the other hand, to an inhibition of energy consumption for growth, which leads to its storage in adipose tissue, as evidenced by an increase in thickness of skin folds in children with high growth rate. Conclusions. Thus, it can be assumed that the BMhormones leptin andIGF-1 are responsible for the degree of saturation of an infant, influencing eating behavior. Further study of the factors affecting the hormonal composition of BM opens up prospects for influencing the developmental model of the child's body at an early age, thus preventing the development of non-communicable diseases in the future.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):82-90
82-90
CHARACTERISTICS OF THE CARDIORESPIRATORY SYSTEM AND HEMOGRAMS OF CHILDREN WITH CHRONIC ADENOIDITIS OF DIFFERENT TYPES OF CONSTITUTION
Abstract
Objective. To characterize the cardiorespiratory system and hemogram indicators of 4-6 years old children with chronic adenoiditis of different types of psychosomatic constitution. Methods. All children were divided into introverts, centroverts and extroverts by questioning their parents on a scale of mental activity orientation. Further, the indicators of the cardiorespiratory system and the features of the hemogram of 4-6 years old children with chronic adenoiditis of different types of constitution were studied. Results. In children of extreme types of psychoconstitution, there are differences in the functioning of the cardiorespiratory system. Introverts are characterized by bradyarrhythmia, with a decrease in pressure and vital capacity of the lungs, lengthening of the PQ interval, bradypnea, and lymphocytosis, eosinophilia and netropenia predominated in the hemogram. For extroverts, on the contrary, tachycardia, with increased pressure and VC, shortening of the PQ interval, tachypnea. Centroverts had average values of indicators of the cardiorespiratory system. In addition, for children of introverts in the blood test, lymphocytosis with netropenia and eosinophilia is characteristic, the highest indicators of total protein, potassium, cortisol and urea were found in extroverts; the minimum level of total protein, glucose, cortisol and the maximum activity of alkaline phosphatase and insulin in introverts. Conclusion. Identified functional disorders should also be taken into account when drawing up a treatment plan for these children. Given the data obtained, in the case of the development of chronic adenoiditis, it is possible to reduce the risk of complications, the frequency of exacerbations and prevent surgical treatment.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):91-97
91-97
CLINICAL CASE OF AUTOIMMUNE HEPATITIS IN AN 8-YEAR OLD CHILD
Abstract
Objective. To study the features of the course and clinical manifestations of autoimmune hepatitis, to identify factors contributing to the development of this disease.Methods. Patient N. aged 8 has chronic autoimmune hepatitis. We conducted physical, clinical, laboratory, instrumental examination and treatment in accordance with the standards of medical care for the profile of the disease.Results. A clinical case of patient N., 8 years old, is presented. The patient was hospitalized in the pediatric department N2 of the Smolensk Regional Clinical Hospital with a clinical diagnosis of chronic autoimmune hepatitis type 1, drug remission. Concomitant diseases are calomasia, encoparesis.Conclusion. Currently, timely diagnosis of autoimmune hepatitis plays an important role in finding the etiology and effectiveness of the treatment of the disease, which helps to achieve the desired results.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):98-103
98-103
LONGITUDINAL STUDY OF THE DYNAMICS OF FERTILITY AND THE QUALITY OF LOW BIRTH WEIGHT OFFSPRING
Abstract
Objective. To study the dynamics of fertility and the quality of low birth weight offspring, weight categories of children from very early preterm births with ELBW and VLBW. Methods. In the course of the research, the analysis of statistical indicators, data of 25 accounting forms was carried out; 32. Data for 2016-2020 were analyzed, covering the period after the entry into force of new regulations governing the criteria for the fetus. Results. The average number of premature babies in the Republic of Tajikistan over the past five years has a clear stable dynamics of the indicator, the fluctuations of which do not exceed 0.6% (between 5.7 and 5.1%). The five-year analysis shows a slight downward trend in the number of children born by 2442. The number of premature births for 5 years remains stable at 13898 babies (5.5%). Conclusions. With a tendency to decrease by 2442 the total number of children born, the number of PRs over 5 years remains stable (5.5%) in 2016 and (5.1%) in 2020. Among children with VLBW and ELBW, over five years there is a decrease in the total number of antenatal losses: in 2017 - 48.2% (937 children); in 2020 41.2% (740 children). In the structure of stillbirth, there is a steady decrease in the proportion of prenatally dead fetuses. The ratio of live births with EBMT and VLBW in 2016 was 1: 3, in 2020 - 1: 2 times.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):104-110
104-110
COMBINED COMPLICATIONS OF PEPTIC ULCER DISEASES AS A SURGICAL PROBLEM FAR FROM BEING RESOLVED
Abstract
Objective. Consideration of the features of the clinical picture, diagnosis and treatment of patients with concomitant complications of peptic ulcer disease on the example of their own clinical observation. Methods. The article describes the treatment of a patient delivered to the emergency department of a surgical hospital with a clinical picture of a hollow organ perforation. Intraoperatively, a chronic giant ulcer of the duodenal bulb was detected, complicated by perforation, penetration into the hepatoduodenal ligament, the head of the pancreas with the formation of a choledocho-duodenal fistula, bleeding into the lumen of the gastrointestinal tract and the development of local non-delimited serous fibrinous peritonitis. The patient underwent gastric resection according to Billrot-2 (in the modification of the Chamberlain-Finsterer), drainage of the choledochus according to Ker, sanitation and drainage of the abdominal cavity. Results. The combination of various complications of peptic ulcer disease has a significant impact on the course of the disease and prognosis in this category of patients. Despite timely medical treatment and surgical treatment, the absence of intra-abdominal complications in the postoperative period, severe concomitant pathology, the elderly age of the patient and, as a consequence, a decrease in the compensatory capabilities of the body caused an unfavorable outcome of the disease. Conclusion. Despite the success of drug treatment of patients with peptic ulcer disease, the number of patients with its complicated form (including with combined complications) is growing. At the same time, the number of cases in which a combination of three or more complications is observed dominates. The treatment of this category of patients is a complex task and requires not only a high level of the operating surgeon, but also the careful work of a qualified multidisciplinary team in the postoperative period.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):111-117
111-117
CLINICAL ASSESSMENT OF THE CONDITION OF A HEALED BURN WOUND AFTER USING EMOLLIENT IN CHILDREN
Abstract
Objective. To conduct a clinical assessment of a healed burn wound after using emollient in children. Methods. A prospective clinical study was conducted. 100 children were examined after thermal trauma with a burn area of 0.5-25%, I-II (1 degree according to ICD 10) degrees, who used emollient and baby cream after wound healing for daily skin treatment. The clinical result was evaluated before the cream treatment and at the end of the course of use according to the following criteria: dry skin, hyperemia, sleep disturbance, itching and excoriation. Control points (assessment of the condition of the post-burn wound): statement, in 1 month. At each examination, the amount of points was determined and compared with the previous examination. Patients who used GLUDERM emollient also filled out a questionnaire consisting of 3 sections, where the cosmetic effect, clinical efficacy, and safety were evaluated. The evaluation of the effectiveness of cosmetics, both by the doctor and patients, was also carried out on the basis of the international satisfaction scale Global Aesthetic Scale. Results. After the burns heal, there is dryness and pigmentation of the skin. Emolent reduces the manifestations of dry skin, reduces itching and anxiety of the child, normalizes sleep, but does not have a pronounced effect on skin hyperemia. The emolent has clinical efficacy, which is confirmed by a decrease in negative changes in the wound area in relation to the control group. Conclusions. The emolent has clinical efficacy, proven safety profile and can be recommended for basic care of post-burn wounds within 1 month after their epithelization.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):118-124
118-124
LONG-TERM PAIN RELIEF AFTER GENICULAR NERVE RADIOFREQUENCY ABLATION IN KNEE OSTEOARTHRITIS
Abstract
Objective. To evaluate the efficacy and safety of radiofrequency ablation (RFA) of genicular nerves in symptomatic knee arthritis. Methods. This prospective observational study involved 31 patients with chronic (≥3 months) pain due to knee osteoarthritis that was unresponsive to conservative management. Radiofrequency thermal neurotomy of the genicular nerves was done under fluoroscopy. The outcome measures included visual analog scale (VAS), Western Ontario and McMaster Universities Index (WOMAC) and Likert scale for patient satisfaction and complication rate in the 1st,3rd, 6th and 12th months. Results. Knee pain was reduced significantly: in 6 and 12 months mean VAS score reduction was 3,97±1,87 и 3,06±1,55 when comparing to pretreatment values (p<0,001). Pain relief of 50% or greater was achieved in 74% of patients, improved Global Perceived Effect was observed in 77,4% of cases, mean reduction in WOMAC score was -19,5 (p<0,001). No patient reported procedure-related adverse events (e.g. sensory loss, hematoma, burn or infection). Conclusions. The study demonstrated that RFA is an effective and safe long-term therapeutic option for managing pain and improving physical function in patients with symptomatic knee OA.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):125-133
125-133
ROLE OF ACCOMPANYING THERAPY IN THE PREVENTION OF ADVERSE REACTIONS DURING CHEMOTHERAPY IN PATIENTS WITH OVARIAN CANCER
Abstract
Objective. To analyze the structure and frequency of adverse reactions when using the TS scheme (carboplatin + paclitaxel) in patients with ovarian cancer who were treated in the chemotherapy department No. 1 of the Smolensk Regional Oncology Dispensary (SOOCD) for the period 2020-2021. Methods. The data of the official accounting and reporting medical documentation of the chemotherapeutic department No. 1 of the OGBUZ SOOKD and the territorial carcine register of the Smolensk region for the time interval 2020-2021 were analyzed. Results. Analysis of the result of treatment of patients with ovarian ZNO showed that accompanying therapy is an integral part in the chemotherapeutic treatment of ovarian cancer. Adverse reactions of chemotherapeutic treatment were noted in 35 people (29.66%) out of 118 who received chemotherapy according to the TS regimen (carboplatin + paclitaxel). The main side effect was myelodepression. According to our data, the treatment indicators in the chemotherapy department No. 1 were better than according to studies in Russia, given in the work of Penzin O.V. Hematological reactions, such as anemia, were noted in 20.34% of patients, in the Russian Federation - in 60-70%; leukopenia was observed in 2.54%, in the Russian Federation - in 50-70%, thrombocytopenia - in 1.69% of cases, in the Russian Federation - in 20%. Drug damage to the liver was noted in 10.16%, in the Russian Federation - in 40-50% of cases. Dose reduction was not performed. Interruption of HT courses was noted in 1.69% of cases. Conclusion. The results obtained by us confirm the high efficiency and necessity of using accompanying therapy drugs in the treatment of OC with platinum and taxane preparations. Prognosis, competent assessment of developed complications and timely correction made it possible to carry out the planned number of courses of HT in compliance with intervals and doses, which improves the quality and effectiveness of treatment.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):134-139
134-139
GASTROESOPHAGEAL REFLUX DISEASE AND CHRONIC COUGH
Abstract
Objective. To study the problem of reflux-associated cough, including the frequency of occurrence, mechanisms of occurrence, features of modern diagnosis and treatment of chronic cough associated with gastroesophageal reflux disease (GERD). Methods. Review of modern domestic and foreign literature on the diagnosis and treatment of GERD and reflux-associated cough, in particular the clinical recommendations of the Russian Gastroenterological Association, original articles, including materials from PubMed, Elibrary.ru databases. Results. The most significant extraesophageal manifestation of GERD is reflux-associated cough. In real clinical practice, diagnosis can be a challenge and requires a number of additional studies. Daily pH-impedance measurement is the "gold standard" in the diagnosis of extraesophageal manifestations of GERD, as it allows you to identify the relationship of symptoms with reflux. The main treatment options for reflux-associated cough are similar to those for the treatment of typical esophageal manifestations of GERD and include proton pump inhibitors (PPIs), esophagoprotectors, prokinetics, antacids, alginates, as well as lifestyle modification. Conclusion. A chronic cough of unclear genesis may turn out to be an extraesophageal manifestation of GERD. The absence of signs of esophageal lesion in esophagogastroduodenoscopy (EGDS) does not exclude the diagnosis. Daily pH-impedance monitoring in some cases helps to diagnose GERD and identify the association of cough episodes with gastroesophageal reflux.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):140-145
140-145
STUDY OF TOPICAL ASPECTS OF TREATMENT AND DIAGNOSIS OF DIFFUSE LARGE B-CELL LYMPHOMA BASED ON ASSESSMENTS OF CLINICAL STUDIES CONDUCTED WITH THE PARTICIPATION OF PATIENTS OF DIFFERENT AGE CATEGORIES
Abstract
Objective. To present general information on diffuse B-large cell lymphoma, modern approaches to diagnosis and targeted therapy. Methods. Data from open sources of information are presented. Results. There are many different types of B-cell lymphomas. Diffuse B-large cell lymphoma is considered the most aggressive. In this type tumor cells are located in all areas of the lymph node, that is, diffusely, so the lymphoma is called "diffuse". The effectiveness of the detection of diffuse B-large cell lymphoma is complicated by the fact that patients often do not pay attention to enlarged lymph nodes, a slight rise in temperature, weight loss, as a result of which treatment begins untimely when the disease progresses significantly. Conclusion. In medical practice, diffuse B-large cell lymphoma is considered the most malignant type of all known lymphomas, characterized by survival in the absence of treatment for an average of about a year. The rate that determines the development and growth of the disease is aggressive. The basis of the treatment of the lymphoma is the immunochemotherapy scheme, the so-called R-CHOP, which includes cyclophosphamide, doxorubicin, vincristine and prednisolone with the addition of an antitumor agent belonging to the group of monoclonal antibodies - rituximab. However, for certain categories of patients (elderly and very elderly people, as well as patients with a highly aggressive form of the disease), the clinical effect of therapy remains unsatisfactory, despite the obvious positive improvement in survival rates among patients. Thus, further study of the methods of diagnosis and treatment of the lymphoma has important medical and social significance. The article provides general information about diffuse B-large cell lymphoma, modern approaches to diagnosis and targeted therapy, and also defines the main problems of the disease in clinical practice.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):146-153
146-153
FEATURES IN COURSE OF COVID-19 IN PATIENTS WITH AN IMMUNOSUPPRESSIVE CONDITION CAUSED BY ONCOHEMATOLOGICAL DISEASES
Abstract
Objective. To summarize and present materials about the interaction of a new coronavirus infection and tumor hematological diseases. The authors highlight the issues of chemotherapy as a factor aggravating the condition of these patients. Methods. The search for relevant literature was conducted from September 2022 to February 2023. To ensure the greatest coverage of published Russian-language cases on the topic of interest we used Gooole Academy resources, analysis of clinical cases, textbooks, clinical recommendations. Results. The demonstrated data indicate that the combination of hemoblastosis with coronavirus infection requires further careful and in-depth study, because these patients pose a potential danger not only to themselves, but also to others, being a kind of reservoir for permanent mutation of the virus. Conclusions. In the course of the analysis of the literature, the fact of a more severe course of Covid-19 in patients with hemoblastoses was confirmed in comparison with other pathologies. In such patients, advanced forms are most often formed, ending in death and associated with the erroneous cancellation of chemotherapy. Thus, one should not abandon treatment by opting for less toxic courses of PCTs. The complications we identified and risk factors for Covid-19 disease are of little difference from those for other malignant neoplasms.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):154-161
154-161
HEREDITARY NEPHROPATHIES: AN UNDERESTIMATED CONTRIBUTION TO THE DEVELOPMENT OF CHRONIC RENAL FAILURE
Abstract
Objective. Generalization and systematization of data on hereditary nephropathies, clinic, diagnosis and treatment methods, progression to chronic renal failure. Methods.. The basis of the study was the analysis of literary sources over the past 15 years. Results. Currently, gene mutations have been identified that cause damage to different parts of the nephron and lead to the development of nephropathies, as a result. In most cases, they are severe, poorly amenable to drug therapy and, in the final stage, lead to chronic renal failure. The latter requires hemodialysis or kidney transplantation. The main idea of this literature review was to focus the attention of nephrologists on the fact that the contribution of hereditary nephropathies to the development of chronic renal failure is largely underestimated. Attention is drawn to a thorough history taking in order to identify hereditary kidney diseases in the next of kin. It is obvious that the great achievements of genetics in identifying defective genes are insufficiently taken into account in the treatment of specialized patients. This leads to an increase in the incidence of chronic renal failure with an extremely unfavorable outcome. Conclusion. Improving the methods of early diagnosis and selection of adequate therapy for hereditary kidney diseases are accompanied by a decrease in patient mortality and an improvement in the quality of life. In the end stage of chronic renal failure, replacement therapy and kidney transplantation play an important role.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):162-172
162-172
HEART FAILURE AS A CLINICALLY SIGNIFICANT COMPLICATION OF INFECTIVE ENDOCARDITIS
Abstract
Objective. To highlight the issues of pathogenesis, diagnosis, antimicrobial therapy and surgical treatment of infectious endocarditis accompanied by the development of heart failure. Methods. Based on domestic and international recommendations, the most pressing issues of managing patients with infectious endocarditis accompanied by the development of heart failure are presented. Results. Despite the established diagnostic algorithms and the use of modern antimicrobial drugs, infectious endocarditis is an extremely urgent problem due to the increasing frequency and unpredictability of outcomes. Heart failure is the most frequent complication of infectious endocarditis and the main indication for emergency and planned surgical treatment. Conclusions. The article presents the mechanisms and patterns of the development of heart failure in infectious endocarditis, the features of the introduction of patients with this pathology, the immediate and long-term prognosis of the disease.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):173-177
173-177
CHANGES IN BONE DENSITY IN OBESE CHILDREN ACCORDING TO THE RESULTS OF RADIATION DIAGNOSTIC METHODS
Abstract
Objective. To present current data on the relationship of changes in bone density in children based on the results of radiation diagnostic methods. Methods. The work uses materials of full-text articles available in open sources. Results. Obesity is one of the most common chronic diseases in the world reaching the scale of a non-communicable epidemic. One of the significant problems of modern medicine is osteoporosis that ranks fourth among non-communicable diseases after cardiovascular pathology, oncological diseases and diabetes mellitus. WHO considers osteoporosis to be one of the significant problems of pediatrics. Adipose tissue can have a beneficial effect on bone tissue. The positive relationship between body weight and bone mass can be associated with several possible mechanisms: an increase in body weight increases the mechanical load on the skeleton and contributes to its strengthening, the association of an increase in adipose tissue with increased secretion of bone-active, anabolic hormones beta cells of the pancreas and the secretion of bone-active factors from adipocytes. Conclusion. The main indicator of bone health is its density, which is maintained by a clear balance between the processes of bone formation and resorption. Bone density can be assessed by the following studies: radiography of the osteoarticular system, dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), ultrasound osteodensitometry. According to the results of current studies, violations of bone mineral density are more pronounced in obese children. Currently, data from various studies on the effect of adipose tissue on BMD differ, which requires further study of this issue.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):178-183
178-183
OBESITY AND BRONCHIAL ASTHMA IN CHILDREN
Abstract
Objective. To analyze the results of scientific investigations, systematic reviews and meta-analysis in epidemiology, pathogenesis and treatment of bronchial asthma in children with obesity. Methods. Collection and estimation of the main results of scientific investigations in bronchial asthma in children with obesity using databases PubMed (https://pubmed.ncbi.nlm.nih.gov), Medscape (https://www.medscape.com/),. The search depth is 2012-2023 years. Results. Bronchial asthma and obesity are concerned to be a global problem of modern healthcare worldwide. There is a connection between these conditions, but the reasons are not fully investigated. Obesity is one of the risk factors of BA in children, which can be manifested at any time during the life and it is a multifactorial disease, and it depends on sex, race, ethnicity, and allergic potential. Most of investigations confirm a specific obesity asthma phenotype, which can modify BA. There is some evidence in genetic-mediated combination obesity and BA. Obesity can reduce the principles of normal function of the respiratory system. Adipose tissue can cause a hypoxic process, producing monocytes and inflammatory cytokines. Corticosteroids have a less effect on obese patients with BA, which is the reason of changes of tissues in obesity. Specific diet is able to reduce the risk of BA and better control. Conclusion. Acombination of obesity and asthma is a neglected condition, which needs a continuous monitoring, and the understanding of the mechanism of this disease will help us in early diagnostics, reducing the exacerbations of BA and improving the quality of life.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):184-191
184-191
Pharmaceutical Sciences: Original Articles
PHARMACEUTICAL DEVELOPMENT OF CORRECTED DOSAGE FORMS BASED ON PLANT OBJECTS
Abstract
Objective. Conducting pharmaceutical research for the development of corrected dosage forms (lozenges, syrup officinalis) based on extraction preparations from blood red hawthorn fruits, white mulberry fruits and dog rose hips. Methods. Lozenges were obtained in the laboratory in accordance with the requirements of the General Procedure "Lollipops" of the XIV edition on the basis of alcohol-water extraction from the fruits of blood-red hawthorn (1: 10) using citric acid as a preservative. Medicinal syrup was obtained in accordance with the requirements of the General Procedure Complex "Syrups" of the GF XIV edition based on the juice from the fruits of white mulberry and liquid extract of dog rose hips. The preservative was not used, since the condensed juice of mulberry fruits has bactericidal properties. Quantitative determination of the sum of flavonoids in terms of hyperoside in the analyzed samples of lozenges was carried out by differential spectrophotometry using the ND technique for hawthorn tincture (LLC "Hippocrates", Russia, Samara). The calculation of the quantitative content of the amount of flavonoids in lozenges was carried out using a standard sample of hyperozide (LLC "Phytopanacea", the content of 98.5%). Results. In the laboratory, corrected dosage forms (LF) were made - lozenges based on alcohol-water extraction from the fruits of blood red hawthorn and medicinal syrup based on condensed white mulberry juice and dog rosehip extract. The use of condensed juice from the fruits of white mulberry made it possible not to use a simple sugar syrup as a basis, but to use the prepared natural one, which contains a rich combination of not only sugars, but also macro- and microelements (iron, riboflavin, vitamins C and K, potassium, phosphorus, calcium, a significant amount of organic compounds, including anthocyanins, lutein, etc.). A method for analyzing the quantitative content of the sum of flavonoids in terms of hyperoside in the composition of lozenges by the method of differential spectrophotometry was developed. Conclusion. The conducted pharmaceutical research allowed the authors to develop technological schemes for the production of lozenges based on alcohol-water extraction from the fruits of blood-red hawthorn and medicinal syrup based on condensed white mulberry juice and dog rosehip extract in order to scale the process of their creation.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):192-199
192-199
STUDY OF STANDARD SAMPLES OF VITAMINS A AND D OBTAINED FROM NATURAL RAW MATERIALS: ANALYSIS OF THE UNIFORMITY INDICATOR
Abstract
Objective. The study of the basic metrological characteristics of the obtained substances of vitamins A and D for the purpose of using SS as a material. Methods. Fractions of fat-soluble vitamins obtained from natural material were used as the research material. The research methods were instrumental (HPLC) and generally accepted calculation methods. Results. According to the results of the conducted studies, the value of the characteristic "Error from heterogeneity" was studied on models of fat-soluble vitamins A and D of own production - applicants for SS with subsequent type approval. Conclusion. According to the results of the studies conducted to determine the heterogeneity of the obtained SS, it can be judged that the obtained samples of vitamins A and D are homogeneous. The obtained substances can be used in the creation of an approved type of CO.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):200-206
200-206
STUDYING THE PECULIARITIES OF ESSENTIAL OIL ACCUMULATION IN MEDICINAL PLANTS OF DIFFERENT ECOLOGICAL CONDITIONS
Abstract
Objective. The aim of the study is to study the peculiarities of the accumulation of essential oil in the herbs of bitter wormwood and common yarrow, harvested in environmentally diverse areas of the Central Black Earth Region. Methods. The purpose of the study is to study the peculiarities of the accumulation of essential oil in the herbs of bitter wormwood and common yarrow, harvested in environmentally diverse areas of the Central Black Earth Region. In the Voronezh region, 13 points of raw material procurement were selected to study the content of the quantitative content of essential oil and its qualitative composition. Correlation coefficients were analyzed to examine in detail the effects of basic heavy metals and arsenic on essential oil accumulation. Results. All the analyzed medicinal herbal raw materials were recognized as good quality according to the studied indicator. In general, for samples of control territories and agrobiocenoses, a higher content of essential oil can be noted than in samples of urbobiocenoses. Conclusion. The calculated correlation coefficient values showed a strong negative effect of lead, mercury, cadmium, nickel, cobalt, copper, zinc on the accumulation of essential oil. This allows us to conclude about the negative effect of urbanization of the workpiece site on the accumulation of essential oil in the herbs of bitter wormwood and common yarrow.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):207-214
207-214
PHARMACOGNOSTIC STUDY OF HERB OF TANACETUM VULGARE L. MEDICINAL PLANT RAW MATERIALS AND UNACCEPTABLE ADMIXTURE OF THE GENUS RANUNCULUS PLANTS RAW MATERIALS
Abstract
Objective. The aim of the research work is a pharmacognostic study of the medicinal plant raw materials of herb of Tanacetum vulgare, the determination of unacceptable impurities, the study of the antioxidant activity of its water and alcohol extracts. Also, the purpose of this study is to conduct a qualitative and quantitative analysis, identification of marker components and standardization of the raw material of herb of Tanacetum vulgare. Methods. The method of chromato-mass spectrometry was used for qualitative and quantitative analysis in the study of medicinal plant materials. The amperometric method was used to measure the total content of antioxidants. Results. More than 60 compounds were identified in alcohol extract from the herb of Tanacetum vulgare by chromato-mass spectrometry. The main identified compounds belong to the class of terpenoids, fatty acid esters, including oleic, linoleic, arachidonic and others, vitamin E, phytol and sterols (stigmasterol, gamma-sitosterol, alpha-amirin). The extract was found to be dominated by terpenoids, with both monoterpenes and sesquiteripenes. Conclusion. A pharmacognostic study of raw materials was carried out, unacceptable impurities were identified. Qualitative analysis showed that the main classes of active substances are terpenoids, marker substances are alpha-pinene, cineole, camphor, caryophyllene, cedren, germacrene. Standardization should be carried out on camphor. It is concluded that infusion of herb of Tanacetum vulgare has a high antioxidant activity.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):215-222
215-222
Comparative analysis of topical preparations compositions containing plant raw materials for psoriasis treatment
Abstract
In dermatological practice, psoriasis is one of the most common diseases that strongly affects the patients's quality of life. The search for plant raw materials for the drugs in the topical therapy of psoriasis is a scientific goal of research carried out by many scientists all over the world. Objective. The aim of the study was a comparative analysis of chemical composition and pharmacological action of plant raw materials in ointments (creams) used for psoriasis treatment. Methods. Data retrieval was implemented using information retrieval systems and library databases. Results. Most topical preparations containing plant raw materials comprise two types of medicinal herbs: killwort (Chelidonium majus) and/or bur beggar-ticks (Bidens tripartita L.) Conclusion. The pharmacological effect of killwort (Chelidonium majus) and bur beggar-ticks (Bidens tripartita L.) in psoriasis treatment is determined by the presence of berberin, sanguinarin, cheleritrin, caroten, flavonoids and ascorbic acid in their composition. The use of such plant raw material in the ointments composition can be a good alternative to hormonal drugs, taking into consideration the duration of psoriasis treatment.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):223-229
223-229
COMPARATIVE ANALYSIS OF DOMESTIC AND IMPORTED RAW MATERIALS OF STEVIA BY THE AMOUNT OF PHENYLPROPANOIDS
Abstract
Objective. To conduct a comparative phytochemical study of the amount of phenylpropanoids in stevia raw materials of various origins. Methodology. The research material was dried stevia leaves (Stevia rebaudiana Bertoni), grown in the Penza, Tver regions, the Republic of Crimea, Krasnodar Krai, and imported raw materials from Paraguay and India. The amount of phenylpropanoids was evaluated by direct spectrophotometry in terms of chlorogenic acid. To recalculate the content of phenylpropanoids extracted from stevia leaves for chlorogenic acid, we used the specific absorption index of chlorogenic acid at λ= 330 nm for direct spectrophotometry. Results. A study of the amount of phenylpropanoids in stevia raw materials of various origins was carried out. The analytical maxima of the studied compounds - 290 and 330 nm - were determined by direct spectrophotometry in extracts from stevia leaves. The results of statistical processing of the obtained results indicate that the error of a single determination with a 95% confidence probability is no more than ±1.0% when determining the amount of phenylpropanoids by direct spectrophotometry in terms of chlorogenic acid. Conclusion. It was determined that the content of phenylpropanoids in stevia varies is in the range from 6.73 to 10.51%. Domestic raw materials contain greater amounts of phenylpropanoids. The results obtained allow us to recommend stevia leaves as a source of phenylpropanoids along with well-known medicinal plants. It is advisable to assign the phenylpropanoid complex to the leading group of biologically active compounds of stevia leaves.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):230-234
230-234
Miscellaneous
USE OF ACTIVE FORMS OF LEARNING IN THE TRAINING OF PHARMACEUTICAL SPECIALISTS ON THE APPLICATION OF MEDICAL DEVICES
Abstract
Objective. Evaluation of the use of active forms of education at the postgraduate stage of training pharmaceutical specialists on the application of medical devices. Methodology. An active form of training in the form of a master class was used in the advanced training cycles in the system of continuous medical and pharmaceutical education. To evaluate the effectiveness of this form of training, we modeled situations and a checklist for assessing the actions of students. The pharmacists were asked to demonstrate their skills at the beginning of the training and at the end of the cycle. Statistical analysis included Wilcoxon criteria, correlation analysis. Results. At the initial stage, the average score for solving the proposed problem was 6.35±1.87 points. At the end of the training, the final solution of the problem on average was estimated at 13.80±1.22 points. Moreover, a positive correlation was noted with work experience - 0.66 (p=0.02) and with experience at the "first table" 0.64 (p=0.01). Conclusion. Practicing the skills of pharmaceutical consulting in the field of aplplication of medical devices using such a form of training as a master class is a good practice for further application in the context of continuous medical and pharmaceutical education.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):235-240
235-240
Anniversaries
HYSTORY OF THE OPHTHALMOLOGY DEPARTMENT OF SMOLENSK STATE MEDICAL UNIVERSITY (TO THE 100TH ANNIVERSARY)
Abstract
As a result of studying archival material, we found out that the Department of Eye Diseases was organized at the Medical Faculty of Smolensk University on November 1, 1923. Thus, the Department of Eye Diseases of the Smolensk State Medical University will celebrate its 100th anniversary on November 1, 2023. The essay reflects the history of the department from the moment of its foundation to the present.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):241-248
241-248
Proceedings of congresses and conferences
CORONARY ATHEROSCLEROSIS SEVERITY ASSESSMENT IN ASYMPTOMATIC PATIENTS WITH DIFFERENT THYROID HORMONAL STATES
Abstract
The work is devoted to the lipidemia analysis and assessment of the severity of coronary atherosclerosis in working-age individuals with different thyroid hormonal states. We examined 21 patients with subclinical hypothyroidism, 13 patients with hyperthyroidism, and 16 patients with normal thyroid function. According to CT coronary angiography, the total calcium score calculated by the Agatston method was higher in the groups of patients with subclinical hypothyroidism and hyperthyroidism than in the group without thyroid dysfunction: 136 (0-148) and 75 (0-126) versus 5 (0-46, respectively), p<0.05. There was a correlation between laboratory-confirmed subclinical hypothyroidism and atherogenic type of dyslipidemia (r=0.68; p<0.01), the presence of signs of atherosclerotic lesions of coronary system according to CT coronary angiography (r=0.51; p<0.05). The findings demonstrate the need for a more aggressive approach to cardiovascular risk prevention in comorbid patients.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):249-252
249-252
GRAFT DYSFUNCTION AS A CARDIOVASCULAR RISK FACTOR IN KIDNEY TRANSPLANT RECIPIENTS
Abstract
The article contains an assessment of indicators of the functioning of the kidney transplant, such as the frequency of acute graft rejection and a decrease in the estimated glomerular filtration rate, lipid profile and erythrocytosis in patients with adverse cardiovascular events and without them.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):253-255
253-255
LIPOCALIN-2 AS A PREDICTOR OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH MYOCARDIAL INFARCTION FOLLOWING ACUTE KIDNEY INJURY
Abstract
The study assesses the prognostic significance of lipocalin-2 for the development of chronic kidney disease in patients with ST-elevation myocardial infarction following an episode of acute ischemic kidney injury. The study included 173 patients with acute ST-elevation myocardial infarction, out of which 111 patients developed acute ischemic kidney injury, 62 patients - did not. Three months after myocardial infarction complicated by acute kidney injury, 17.1% (n=19) of patients were diagnosed with chronic kidney disease. It was established that measuring of the level of lipocalin-2 in the urine of patients with myocardial infarction and acute kidney injury would allow predicting the development of chronic kidney disease in the post-hospitalization period with high sensitivity and specificity.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):256-258
256-258
APPLICATION OF INNOVATIVE TECHNOLOGIES IN CARDIO-ONCOLOGY
Abstract
A predictive model for calculating the Simpsons ejection fraction during polychemotherapy with doxorubicin was proposed in this article. It became the basis for the development of a mobile application for calculating this indicator.
Vestnik of the Smolensk State Medical Academy. 2023;22(2):259-263
259-263