Vol 24, No 3 (2023): Опубликован 27.09.2023

Articles

SYSTEMATIC APPROACH TO PLANNING THE ASSORTMENT OF A PHARMACY ORGANIZATION

Afanasyeva T.G., Makhinova E.N., Novikova M.D., Kushnir A.Y., Tkachuk A.S.

Abstract

The management of the pharmacy organization is based on the competent management of the main business processes, among which the leading position is occupied by assortment planning. Many pharmaceutical workers form the structure and volume of the assortment based on the indicators of the previous period by averaging. This approach does not take into account the dynamism of the market of medicines: seasonal fluctuations in demand, changes in legislation, marketing activity of manufacturers and consumer preferences depending on it, as well as other factors. The use of a systematic approach in the formation of the assortment of pharmacy by the method of two-factor ABC- and XYZ-analysis allows you to quickly and flexibly respond to the most significant changes in the pharmaceutical market, contributing to the maintenance of liquidity, profitability and efficiency of the pharmacy. This method of analysis is applicable to various pharmacotherapeutic groups.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):5-10
pages 5-10 views

ABC/VEN – ANALYSIS OF DRUG PROVISION OF SMALL CELL LUNG CANCER CHEMOTHERAPY REGIMENS

Berezhnova T.A., Moshurov I.P., Shinkarev S.A., Lunyova E.A., Borisov V.A.

Abstract

This work is aimed at conducting a pharmacoeconomical analysis of chemotherapy for small cell lung cancer using ABC/ VEN analysis to identify the most expensive chemotherapy regimens. A retrospective evaluation of chemotherapy regimens for small cell lung cancer at various stages of the disease was carried out, presented in 408 case histories of patients who were treated from January 2021 to December 2021 in oncological dispensaries of the Voronezh and Lipetsk regions. During the study, the main regimens used in chemotherapy were identified and the most expensive treatment regimen for small cell lung cancer was determined, for which 50-70% of the budget is spent – this is the scheme: etoposide + carboplatin and the least expensive group of drugs, for which 5-10% of the budget is spent – this is scheme 3: cyclophosphamide 1000 mg/m2 in the 1st day + doxorubicin 50 mg/m2 on day 1 + vincristine 1.5 mg/m2 on day 1.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):11-18
pages 11-18 views

PREDICTION OF THE RISK OF ANTIBIOTIC RESISTANCE OF UROPATHOGENS IN PATIENTS WITH URINARY TRACT INFECTIONS

Smolyaninova D.S.

Abstract

Urinary tract infection is the most common disease in urological practice. The growth of antibiotic resistance in general and in urological practice in particular determines the need to develop methods for determining the risks of the presence of microflora resistance to antimicrobial drugs. The article discusses the existing methods for predicting the resistance of microorganisms to antibiotics, as well as the risk factor for antibiotic resistance developed by the author in community-acquired urinary tract infections. This indicator takes into account the individual characteristics and clinical and laboratory data of the patient with urinary tract infections that occur against the background of urolithiasis.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):19-29
pages 19-29 views

Differentiated choice of therapy regimen for acute poisoning with topical decongestants in children using a medical decision support system

Karpushkina E.S.

Abstract

Introduction. Acute poisoning in children is a major public health issue worldwide. Clinical Decision Support System (CDSS) is designed to improve quality of medical care by integrating scientific knowledge and research with information technology.

Aim. Analyze clinical features of poisoning, identify unintentional differences in drug therapy and create a CDSS for individual choice of therapy for acute poisoning in children.

Materials and methods. This study includes 178 children hospitalized with acute drug poisoning in Voronezh Regional Children's Clinical Hospital No. 1 from 2016 to 2022. The CDSS for poisoning with topical decongestants includes an algorithm for determination of the case severity depending on the patient's complaints, state of the central nervous system, cardiovascular system, and autonomic nervous system.

Results. Most frequently poisoning in young children (under 5 years old) was caused by topical decongestants - 31 people (17.1%). After implementation of information technologies there was a significant decrease from 87.5% to 62.5% in the frequency of prescription of laboratory tests and infusion therapy in young children (p<0.05). Decrease of glucocorticosteroid therapy in young children from 50% to 12.5% (p<0,05).

Conclusion. Information technologies implemented in the form of CDSS make it possible to carry out diagnosis and take therapeutic measures with consideration to individual features of the patient, reduce frequency of laboratory tests and drug load.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):30-36
pages 30-36 views

Study of the analgesic activity of new partially hydrogenated pyridines, α-cyanothioacetamide derivatives in the pharmacological tail heat immersion test on white rats

Bocheva A.A., Bibik E.Y., Krivokolysko S.G.

Abstract

Experimental study of pain helps to understand its mechanisms, features and physiological manifestations, which is essential for physiology, practical biomedicine and pharmacology.

The new derivatives of di- and tetrahydropyridines synthesized in the research laboratory "Chemex" on the basis of Lugansk State University named after Vladimir Dahl were subjected to virtual bioscreening using the Swiss Target Prediction software package. Biological screening conducted in vivo, in a thermal tail immersion test on white rats, for new, partially hydrogenated pyridines, derivatives of α-cyanothioacetamide, showed the presence of the most pronounced analgesic activity (with intra-gastric using at a dose of 5 mg / kg of body weight of a laboratory animal) in four compounds with laboratory ciphers cv-091, cv-095, cv-099, cv-142.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):37-43
pages 37-43 views

MUTUAL MODIFICATION OF EFFECTS OF METABOLICS AND IMMUNOMODULATORS

Zemskova V.A.

Abstract

Metabolics, antioxidants, immunomodulators of various origins and mechanisms of action are able to realize a wide range of effects on the pathogenetic units of chronic pyelonephritis. Clinical manifestations in patients with exacerbation of the disease dynamics of normalization of the level of cellular, humoral markers of inflammation, T-B-dependent and cytokine units of immunity, as well as enzymatic and non-enzymatic mechanisms of the antioxidant system (AOS) are subject to correction.

The implementation of these effects is differentiated, dependent on the combination of used metabolic and immunotropic drugs. It specifically includes the possibility of modification by metabolites (Mk, Ml) of the properties of the immunomodulator (If) and immunomodulators (Bf, Sl) of the characteristics of the metabolic (Gp).

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):44-51
pages 44-51 views

COMPARATIVE ASSESSMENT OF THE RISKS OF FATAL AND NON-FATAL CARDIOVASCULAR EVENTS USING THE SCORE/SCORE-2 SCORE IN PATIENTS WITH CARDIOVACULAR PATHOLOGY

Lagutina S.N., Zuikova A.A., Esina E.Y., Dobrynina I.S., Muravitskaya M.N., Khanina E.A., Shevtsova V.I., Shevtsov A.N., Korchagina N.S., Chizhkov P.A.

Abstract

The main morbidity and mortality in the world is associated with pathologies of non-infectious origin, most of which are accounted for by diseases of the cardiovascular system. For the purpose of screening, a rating scale is currently used - SCORE. In 2021, the forecasting model was improved - the SCORE2 rating scale was released, which allows you to predict the risk of complications at an early stage using additional criteria. The purpose of the study: analysis of the risk assessment of cardiovascular events using the SCORE / SCORE - 2 scales. Materials and methods. A retrospective analysis of 140 patients' medical records was carried out. The inclusion criterion was the age of more than 40 years, the absence of concomitant cardiovascular diseases. Results. There were significant differences in Score (Men=9.5 points, Interwomen=3 points, p<0.001) and SCORE2 (Men=22 points, Interwomen=18 points, p=0.049) between men and women aged 50 to 70 years old. When calculating, it turned out that most patients are at moderate risk of cardiovascular complications according to the SCORE scale, at very high risk according to the updated SCORE2 algorithm. Conclusion. In the course of comparing the 10-year risk of cardiovascular events calculated using the new SCORE2 algorithm, significant differences with the SCORE scale in digital values were revealed. All smokers, regardless of age and gender, were at very high risk, which absolutely increases the risk of complications.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):52-60
pages 52-60 views

Outpatient use of the kansas questionnaire for patients with cardiomyopathy (kccq) and comparing its results with the shock scale

Shevtsova V.I., Kolpacheva M.G., Zuikova A.A., Salamatova V.N.

Abstract

The data obtained during the assessment of the subjective state of patients suffering from CHF FC III-IV, using the Kansas questionnaire for patients with cardiomyopathy (KCCQ), and the assessment of the objective state of patients using the SHOCK scale are compared.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):61-64
pages 61-64 views

CLINICAL CASE OF FAMILIAL TUBEROUS SCLEROSIS

Filina G.R., Filin A.A., Fedotova T.V., Mashneva E.Y., Chibisova N.A.

Abstract

Relevance. Tuberous sclerosis is a genetic disease with an autosomal dominant type of inheritance, characterized by the presence of benign tumors in various organs, a progressive course leading to disability and a decrease in life expectancy.

Clinical case. The pregnant's MRI of the brain revealed the presence of tubercles in the area of the cerebral cortex. At the time of 34 weeks of pregnancy, the presence of endocardial nodular formations in the fetus was revealed prenatally. MRI of the fetal brain showed the presence of a subependimal node in the area of the basal nuclei on the left. Postnatally: MRI-picture of multiple cortical-subcortical tubers, subependimal nodes, ECHO-CG-picture of multiple formations in the cavities of the heart. DNA diagnostics: the extended deletion of the TSC2 gene was determined.

Discussion. During ultrasound of the 3rd screening of the fetus, large endocardium formations were found, which made it possible to suspect tuberous sclerosis. During the examination of the newborn, the diagnostic assumptions identified prenatally were confirmed. Since tuberous sclerosis has an autosomal dominant type of inheritance, it can be assumed that the pregnant has a high probability of having the same diagnosis.

Conclusion. An integrated approach to the diagnosis of this disease allows you to pay attention to the patient in a timely manner and choose the appropriate treatment tactics.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):65-69
pages 65-69 views

DOES MUSIC AFFECT THE UNBORN CHILD?

Zagorodnikova K.A., Zagorodnikov S.V., Zazerskaya I.E.

Abstract

During pregnancy, the level of concern about the possibility of harming the development of the fetus is usually high in both pregnant women and their doctors. Household influences, such as music, may also be perceived as beneficial or dangerous depending on their nature. In the above review, an attempt is made to analyze the degree of actual scientific background on this issue. Evidence of the possibilities of the influence of external sounds on the state of the fetus, known facts of the long-term consequences of such an impact are given, an analysis of the possible difference in the effect exerted by music of different musical genres is carried out.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):70-78
pages 70-78 views

CLINICAL CASE OF CARDIORESPIRATORY MONITORING TO CONTROL SUPPLEMENTAL OXYGEN THERAPY IN PREMATURE INFANT

Trapeznikova A.Y., Ivanov D.O.

Abstract

One of the most common respiratory pathologies in infants born prematurely is bronchopulmonary dysplasia (BPD). Pulmonary hypertension is considered a formidable and difficult to diagnose complication of BPD. Maintaining the proper level of oxygen saturation is an integral part of nursing such patients. To diagnose respiratory pauses and episodes of desaturation during sleep, children undergo cardiorespiratory monitoring (KRM) aimed at recording episodes of apnea and hypopnea. The article discusses a clinical case of cardiorespiratory monitoring during sleep in a hospital and outpatient setting to monitor additional oxygen therapy in a premature baby suffering from bronchopulmonary dysplasia and BPD-associated pulmonary hypertension.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):79-84
pages 79-84 views

ANALYSIS OF RISK FACTORS AND MORBIDITY IN PREMATURE CHILDREN WITH VERY LOW AND EXTREMELY LOW BODY WEIGHT

Korotaeva N.V., Ippolitova L.I., Volkova E.N.

Abstract

Introduction. Currently, one of the leading problems in neonatology and obstetrics is premature birth, which requires high economic and social costs. Children born prematurely require long-term intensive therapy and various other advanced treatment methods, for which significant financial and human resources must be allocated. The consequences of premature birth will be clinically manifested throughout all age periods (in infancy, adolescence and adulthood). Currently, a sufficient amount of data has been accumulated confirming the fact that children born prematurely are most committed to various respiratory diseases, hypertension, type 2 diabetes and other chronic diseases.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):85-93
pages 85-93 views

HEALTH STATUS OF NEWBORN CHILDREN FROM MOTHERS WITH GESTATIONAL DIABETES MELLITUS IN THE EARLY NEONATAL PERIOD

Ippolitova L.I., Kogutnitskaya M.I., Chistotinova T.G., Sulina M.V., Kolganova A.I., Aladkina T.A.

Abstract

Gestational diabetes mellitus is closely associated with the risk of obstetric and neonatal complications, which may be due to higher birth weight in the child, and is also increasingly recognized as a risk factor for cardiometabolic diseases in expectant mothers and their children. An increase in the number of pregnant women with gestational diabetes mellitus increases the risk of complications during pregnancy and childbirth, and also has an adverse effect on the physical development of the fetus, and may also adversely affect the course of early adaptation. The object of the study are newborns from mothers with gestational diabetes mellitus. The study includes an analysis of the developmental histories of 70 newborns from mothers with GDM, who were under observation in the Perinatal Center of the city of Voronezh. Most children from mothers with gestational diabetes mellitus have normal indicators of physical development, which can be explained by the improvement and change in approaches to the diagnosis of carbohydrate metabolism disorders during pregnancy and the effectiveness of the therapy during pregnancy.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):94-99
pages 94-99 views

Dynamic Monitoring of Immunobiochemical measurements in Patients with Novel Coronavirus Infection having therapy with Favipiravir

Kostenko S.M., Tulinova I.A., Zemskov A.M., Dushkina N.V., Mukha T.A., Kostenko D.S., Zotova E.E.

Abstract

Delayed innate and adaptive immune response lay behind the pathogenesis of the novel coronavirus infection. COVID-19 is a multisystem disease affecting various human organs. More than a third of the patients have hepatic impairments. This can be caused by both direct cytopathic effect and immune-mediated mechanisms. In the Russian Federation, favipiravir, a DNA-Dependent RNA Polymerase inhibitor, is recommended for etiotropic therapy of the novel coronavirus infection. Research shows that the medication can reduce the viral load and the length of hospital stay. However, the affect of favipiravir on the immune response remains uncertain.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):100-106
pages 100-106 views

INTESTINAL MICROBIOME. EPILEPSY AND THE POSSIBILITY OF EXPANDING ALTERNATIVE THERAPIES

Bogdanova N.M., Kravtsova K.A.

Abstract

The development of sequencing technology indicates a key regulatory role for the gut microbiota in several neurological disorders, including epilepsy. The microbiota-gut-brain axis refers to the bi-directional communication between the gut and the brain and regulates gut and central nervous system homeostasis through neural networks, neuroendocrine, immune and inflammatory pathways. The present review discusses the relationship between the gut microbiota and epilepsy, possible pathogenic mechanisms of epilepsy in terms of the microbiota-gut-brain axis, and alternative therapies targeting the gut microbiota. A better understanding of the role of the microbiota in the gut–brain axis will help investigate the mechanism, diagnosis, prognosis, and treatment of intractable epilepsy.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):107-121
pages 107-121 views

USE OF INDIVIDUAL PREDICTION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE EXACERBATIONS IN OBESE PATIENTS DURING DISPENSARY OBSERVATION

Fateeva O.V., Prozorova G.G., Kozhevnikova S.A., Tribuntceva L.V.

Abstract

COPD is one of the main public health problems. 40.0% of all COPD patients tolerate at least 1 moderate or severe exacerbation within a year, and up to 16.0% - 2 or more. GOLD (2022) proposed for clinical practice a strategy based on "treatable traits," the key of which are exacerbations and persistent shortness of breath, but there are other numerous pulmonary and extrapulmonary features, the definition and consideration of which is useful when leaving individual management algorithms for patients with COPD.

Purpose. To evaluate the clinical effectiveness of the use of individual prediction of COPD exacerbations in obese patients during clinical observation.

Materials and methods. 106 people diagnosed with COPD between the ages of 18 and 80 were examined. The patient examination included an assessment of the number of outpatient exacerbations and hospitalizations to medical organizations over the past 12 months, a BMI calculation, a comprehensive assessment of COPD symptoms with CAT, the functional status of patients, and an assessment of biochemical blood parameters. Results. According to the examination results and BMI calculation, 80 patients (75.5%) were overweight (55 patients) or obese of various degrees (grade 1 obesity - 21 patients, grade 2 - 1 patient and grade 3 - 3 patients). According to GOLD (2023), all patients were classified as "high risk of exacerbations" - group E. The probability index of COPD exacerbation was calculated over the next 12 months using regression analysis. To prevent predicted exacerbations of COPD, individual treatment and rehabilitation programs were developed for patients, designed for use for 12 months of follow-up: treatment modification, personalized programs for optimizing physical activity, dietary recommendations, vaccination against influenza and pneumococcal infection, course therapy with melatonin, consultation with an endocrinologist. At the end of 12 months, compliance with the recommendations of the index of the probability of exacerbation of COPD for the next 12 months was low.

Conclusions. In patients with frequent exacerbations of COPD, in order to achieve disease control, it is advisable to develop individual treatment and rehabilitation programs within the framework of clinical observation, given the "treatable signs," the correction of which has a significant positive effect on the course of COPD, achievement of control and prognosis of the disease.

Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ). 2023;24(3):122-130
pages 122-130 views

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