Vol 26, No 4 (2025): Опубликован 30.12.2025

Ursodeoxycholic acid is a hepatoprotective agent frequently prescribed in clinical practice. Previous studies have demonstrated its pharmacological effects, including anti-inflammatory, cholelitholytic, and antioxidant actions, as well as its potential to limit the progression of liver fibrosis. This study analyzed the pharmaceutical market of ursodeoxycholic acid preparations, identifying differences in the composition of excipients between the original drug and its generic versions, as well as variations in the cost of pharmacotherapy depending on the manufacturer. From 2023 to 2025, 186 patients in the gastroenterology department hospitalized with hepatobiliary pathology and receiving ursodeoxycholic acid were monitored. The study revealed a practice of insufficient dosing regimens during inpatient care, which required adjustment upon continuation of therapy in the outpatient setting.

The problem of antibiotic resistance is relevant all over the world. Antimicrobial resistance of hospital strains of microorganisms in intensive care units is of the greatest importance in clinical practice. Insufficiently effective antimicrobial therapy for infectious complications has a negative effect on the course and outcomes of the disease, and increases the social and economic burden on society as a whole. In intensive care units of the neurosurgical profile, the problem of microbial resistance is aggravated by the limited choice of anti-microbial drugs, the use of which is possible for infections of the central nervous system. An analysis of local microbiological monitoring in the neuro-intensive care unit of the Voronezh Regional Clinical Hospital No.1 for 2023-2024 demonstrated the predominant importance of gram-negative microorganisms with an increasing proportion of strains of multidrug-resistant microbes. The contribution of gram-positive cocci to the development of infectious complications is minimal, amounting to 10-12%. At the same time, there is a tendency to increase the proportion of fungi of the genus Candida in the structure of pathogens. The results of microbiological monitoring should be taken into account when creating local protocols for empirical antimicrobial therapy in patients of the intensive care unit of the neurosurgical profile.

Proton pump inhibitors are frequently prescribed medications for treating gastrointestinal conditions caused by excess acid production. While proton pump inhibitors are generally effective and safe, some individuals exhibit suboptimal responses to treatment or develop undesirable side effects. Variations in treatment response among patients can be partly attributed to genetic differences in the CYP2C19 gene. This gene belongs to a family of enzymes responsible for metabolizing various drugs, including proton pump inhibitors. This review article examines the absorption, distribution, metabolism, and excretion (pharmacokinetics) and mechanisms of action (pharmacodynamics) of currently available proton pump inhibitors, focusing on the role of CYP2C19 in their breakdown. It highlights how variations in the CYP2C19 gene can influence the effectiveness of proton pump inhibitors therapy, underscoring the potential benefits of tailoring treatment based on an individual's genetic makeup. Extensive research has documented the impact of CYP2C19 gene variability on proton pump inhibitors efficacy and its implications for personalized medicine. However, incorporating these pharmacogenetic insights into routine clinical practice is not yet widespread. Further studies are necessary to refine our understanding and ensure accurate application. Nevertheless, it is highly probable that considering a patient's CYP2C19 genotype when prescribing proton pump inhibitors will become more common in the future. This approach holds promise for optimizing treatment outcomes and minimizing the risk of adverse effects associated with proton pump inhibitors use.

Early repolarization syndrome is a genetic disorder of cardiomyocyte ion channel function (channelopathy). Pulmonary embolism is the occlusion of the pulmonary artery or its branches by thrombotic masses, leading to life-threatening pulmonary and systemic hemodynamic impairment. This condition has no clinical manifestations and cannot be diagnosed based on the specific symptoms and complaints presented by the patient. In this clinical case, we can assume a relationship between the development of pulmonary embolism and early ventricular repolarization syndrome, as it may indirectly contribute to its development through the following mechanisms: rhythm disturbances and thrombus formation. In rare cases, the syndrome may be associated with ventricular arrhythmias (e.g., ventricular fibrillation, polymorphic ventricular tachycardia). Severe arrhythmias may reduce cardiac output, leading to blood stasis, and increase the risk of thrombus formation in the right side of the heart (e.g., with atrial fibrillation).

The mortality rate in the delayed period after myocardial infarction (MI) in Russian registers ranges from 6%-25.1%, which determines the medical and social significance of the problem. The long-term prognosis of the course of post-infarction cardiosclerosis is influenced by many factors, one of which is patient adherence to treatment. In this study, we assessed the presence of a history of infectious disease as a factor of low adherence. The presence of conditions comorbid in relation to coronary artery disease, among which the previous coronavirus infection is of leading importance in the modern population, determines new areas of research. Objective of the study: to assess adherence according to the history of COVID-19 in patients with myocardial infarction. Materials and methods: a prospective study included 49 patients diagnosed with I25.2 (post-infarction cardiosclerosis) who were on dispensary observation. A MMAS-4 scale was used to assess adherence. The study found that more than 18% of patients who have had a myocardial infarction have low adherence to therapy within the first year. When comparing the two groups, there were no significant differences, which allows us to exclude a history of COVID-19 from the factors affecting adherence to therapy.

Introduction. Currently, there is a problem both in outpatient and inpatient settings regarding the timely diagnosis of undetected hypocalcemia (a decrease in calcium levels corrected for albumin—less than 2.1 mmol/L). This leads to complications related to phosphorus-calcium metabolism and contributes to early disability, especially among patients with diabetes mellitus and dyslipidemia. The prevalence of cardiovascular diseases (CVD) in combination with chronic kidney disease (CKD) is high, and the risk of progression to end-stage renal disease increases due to the association with mortality from acquired complications (vascular calcification, cardiac remodeling).Timely and accurate laboratory diagnostics to identify disturbances in calcium corrected for albumin can help prevent cardiovascular complications—such as calcium salt deposits in the endothelium of vessels of various calibers and tissues—as well as mineral and bone disorders associated with diabetic nephropathy and type 2 diabetes mellitus.

A single-center study examined the efficacy of immunomodulatory therapy with Derinat in the treatment of aphthous stomatitis in children aged 1-3 years after ARI. Sixty patients were randomized to the study group (standard therapy + Derinat) and the control group (standard therapy only).

The results demonstrated a statistically significant advantage of the combination therapy. The study group demonstrated a significantly faster reduction in aphthae diameter and a 2.6-day reduction in the average time to complete epithelialization (5.8 ± 1.2 days vs. 8.4 ± 1.6 days in the control group; p < 0.001). By day 7 of therapy, complete reepithelialization was achieved in 93.3% of patients in the study group vs. 66.7% in the control group. Cytological analysis confirmed the pronounced reparative effect of Derinat, manifested by a significant increase in the epithelial repair index and the proportion of young epithelial cells. Rapid relief of subjective symptoms and a favorable safety profile were also noted.

These data suggest the inclusion of Derinat in the combination therapy of aphthous stomatitis in young children to accelerate healing and relieve clinical symptoms.

The relevance of the research is due to the high prevalence of respiratory viral infections, the peculiarity of their effect on the placental system of a pregnant woman with a high risk of fetal hypoxia. The article presents an analysis of the course of pregnancy, childbirth, and the early neonatal period in children born to mothers who suffered a respiratory viral infection (ARVI, influenza, or COVID-19) at the end of the third trimester of gestation. The study included 211 pregnant women, and there was noted the negative impact of viral infection on the course of pregnancy, fetal and newborn health. The analysis revealed an increase of obstetric complications (pathological childbirth and cases of fetal distress), a decrease in anthropometric indicators of newborns, deterioration of Apgar scores, and the occurrence of hypoxic brain damage, most pronounced after coronavirus infection. The article describes in detail the pharmacotherapy, taking into account the etiological factor and the severity of the disease, and shows approaches to the choice of drugs for pregnant women, depending on the viral infection and clinical course.

Idiopathic pulmonary hemosiderosis is a rare disease of unclear etiology with the development of alveolar-hemorrhagic syndrome. The presented clinical case demonstrates the difficulties in diagnosing this clinical condition in a patient with concomitant cardiovascular pathology.

HCV leads to a chronic course of the disease in 55-85%. Liver cirrhosis develops in about 20-30% of patients within 25-30 years. Cirrhosis of the liver remains one of the top 10 causes of death. Approximately 160 million people worldwide suffer from cirrhosis, and approximately 0.8 million cirrhosis patients die each year. Cirrhosis of the liver is scarring of the liver in which scar or fibrous tissue replaces healthy liver tissue over time. Fibrogenesis is stimulated by myofibroblasts, originating mainly from liver stellate cells and portal fibroblasts, which acquire fibrogenic, proliferative, immunomodulatory, contractile, and angiogenic properties in response to liver damage. Of all the immune cells, macrophages make the main contribution to liver fibrogenesis. They have dual profibrogenic and antifibrogenic functions in the progression and regression of fibrosis, respectively. In addition to macrophages, changes in other populations of innate immune cells, including dendritic cells, neutrophils, and mast cells, have been described. IL-6 is considered a pleiotropic cytokine due to its numerous physiopathological functions. During aging, inflammation, or other pathological conditions, especially in the liver, IL-6 levels rise significantly and are crucial for the progression of inflammation, fibrosis, and carcinogenesis. The aim of the study was to study the role of interleukin 6 in the course of HCV liver cirrhosis. The study included 50 patients with CP in the outcome of HCV. The Child-Turcotte-Pugh classification was used to assess the severity of the condition of patients with CP. The study showed that IL-6 plays an important role in decompensating liver cirrhosis in HCV outcome. An increase in its concentration in blood serum above 16 pc/ml is a biomarker of poor prognosis in patients with this disease. The number of peripheral blood lymphocytes and monocytes can be used as predictive markers of severity. The revealed correlations of IL-6 with various indicators of metabolism and leukocyte count, hemostasis may indicate an important role in the occurrence of various complications in patients with cirrhosis of the liver. Decompensation stage is more common in patients with cirrhosis of the liver caused by hepatitis C virus with blood group A and B antigens.

The conditions of service of employees of the Ministry of the Interior (MVD) imply the presence of risks of injuries and injuries. Having the skills to recognize the severity of the clinical condition and the ability to provide assistance in the conditions of special tasks, knowledge in the field of tactical medicine can reduce the severity of injury and save the life of the victim.

Employees of the Federal State Healthcare Institution "Medical and Sanitary Unit of the Ministry of Internal Affairs of Russia in the Voronezh Region" in collaboration with the Department of Tactical and Special Training of the Voronezh Institute of the Ministry of Internal Affairs of Russia are doing a lot of work to teach tactical medicine.

Along with a significant coverage of trained police officers, over two years this is more than 1,500 people, training problems have been identified and measures have been formulated to eliminate them.

This article is dedicated to a unique scientist, exceptional teacher, and talented physician – Rimma Ivanovna Kitaeva. Her work and life were inextricably linked with the Department of Pharmacology at N.N. Burdenko Voronezh State Medical University. The faculty remembers this outstanding teacher with warmth and respect and preserves the scientific works and documents he left behind during his lifetime.