Vol 24, No 2 (2024)

Aim – to determine the prevalence of preeclampsia and HELLP syndrome among patients hospitalized in surgical departments with complaints of pain in the epigastrium, right hypochondrium and/or nausea and vomiting.

Material and methods. An analysis was carried out of visits of pregnant women over 20 weeks to the surgical department in 2023 and 42 cases of hospitalization of pregnant patients with suspected acute surgical pathology hospitalized in surgical departments No. 6 and No. 7 of the Samara City Clinical Hospital No. 1 named after N.I. Pirogov. The following parameters were assessed: age, gestational age, complaints at the time of admission, general blood and urine test data, the condition of the fetus according to ultrasound, Doppler ultrasound, CTG, presence of obstetric and gynecological pathology and somatic diseases.

Results. Patients with acute appendicitis (7 out of 42 pregnant women) were excluded from the study. Of the remaining 35 patients, the diagnosis of severe preeclampsia, HELLP syndrome was made in 3 cases (8.6%), in 2 cases, gestational hypertension or protineria (5.7%) – the main group. Cholelithiasis, acute cholecystitis – in 2 cases (5.7%), in other cases the diagnosis of acute pancreatitis was made – 28 patients (80.0%). The work provides a comparison of clinical and laboratory parameters of patients in two groups, with obstetric and surgical pathology. A clinical case of a combination of severe PE with the development of HELLP-syndrome and cholecystitis is also presented.

Conclusions. Differential diagnosis between obstetric complications such as PE and HELLP-syndrome and acute surgical pathology still remains a pressing interdisciplinary problem. Severe forms of PE can take the form of acute pancreatitis, acute cholecystitis, or other diseases. According to the results of our observation, this phenomenon occurred in 15% of patients hospitalized in surgical departments. Only timely diagnosis allows choosing adequate routing and specialized care for this complication.

Aim – to identify potential independent routine laboratory predictors of lethal COVID-19 in critically ill patients admitted to the ICU.

Material and methods. This single-centered study included 120 critically ill adult patients with COVID-19 admitted to ICU of the Samara Regional Clinical Hospital named after V.D. Seredavin from August 1 to October 31, 2021. Data on demographics, chest computed tomography, echocardiography, lower extremity venous ultrasound, laboratory tests upon admission to ICU, and clinical outcomes were collected. Data of laboratory tests between survived and deceased patients were compared to identify risk factors of lethality. Univariable and multivariable logistic regression analyses were performed to examine the association of different laboratory parameters with mortality.

Results. As a result of our study, we obtained a multiple logistic regression model that can predict lethal outcomes (AUC=0.820) with relatively high sensitivity (85%) and specificity (85%).

According to our model, elevations in LDH (OR, 0.99; 95% CI, 0.99-1.2), Urea (OR, 0.82; 95% CI, 0.68-0.96), Glucose (OR, 0.99; 95% CI, 0.84-1.15), ASAT (OR, 0.97; 95% CI, 0.94-0.99), and also lymphopenia (lymphocytes count <3.00 × 10⁹/L, OR, 2.53; 95% CI, 0.99-6.93) were predictive for lethal outcome of critically ill COVID-19 patients. Besides, by previously reported data, older age, a high percentage of lung damage on CT, and low heart output also were associated with high mortality risk.

Conclusion. Thus, LDH, Urea, ASAT, Glucose, and lymphocyte levels in COVID-19 patients upon ICU admission should be considered by physicians as independent predictors of the negative outcome.

In 70% of cases, post-traumatic brachial plexopathy is a consequence of a road traffic accident; the remaining cases are due to sports, industrial, domestic injuries, as well as shrapnel and mine-explosive wounds received during military operations. Even successful microsurgical reconstruction followed by medical therapy and rehabilitation does not guarantee complete recovery, which prompts the search for new ways to restore patients with post-traumatic brachial plexopathy. This work demonstrates the capabilities of a domestic development: the passive exoskeleton of the upper limb "EXAR-34".

Aim – to substantiate the safety of using a laser beam with a wavelength of 445 nm during stapedoplasty by means of an experimental physical model.

Material and methods. Together with physicists from the Russian Engineering Club LLC, a physical experimental model was created to theoretically substantiate the use of a surgical laser with a wavelength of 445 nm during stapedoplasty at its various stages.

Results. Based on the physical calculations carried out during our study, we came to important conclusions regarding the effect of laser radiation on the structures of the inner ear during the stapedoplasty process. It was found that even if the value of the parasitic (damaging) radiation energy is 10 W (maximum value) with an average pulse duration used for perforation of the footplate of the stirrup is 0.15 s, its effect will not lead to any significant thermal effect on the perilymph.

Conclusions. The obtained data serve as a basis for further research and improvement of laser technologies in the field of otosurgery. As part of our study, we anticipate the need for additional histological analysis based on the results obtained. Despite encouraging findings regarding the safety of parasitic laser radiation in the context of thermal exposure to perilymph, histological examination represents an important next step for a deeper understanding of structural changes in the tissues of the inner ear.

Aim – to assess the use of oral hygiene products by consumers as a method of primary prevention of the development of dental diseases, as well as to study their motivation when choosing personal oral hygiene products.

Material and methods. The study was carried out using an individually developed and validated questionnaire. The questionnaire included 21 questions. Respondents were selected by random selection. Respondents filled out questionnaires manually on paper or online using Google forms. The questionnaire data was processed using the Microsoft Excel 2016 and Statistica Version 10 software siutes.

Results. Established a low level of hygiene education of respondents (34% of respondents to the questionnaire visit a dentist twice a year or more, the main criterion for choosing toothpaste for 36% of respondents is the possibility of using the whole family, 53.5% of respondents do not matter the content of fluoride in the toothpaste, 89.1 do not use other sources of fluoride, less than 50% of those surveyed use additional means of oral hygiene. The results of the questionnaire showed that about 40% of respondents acquire oral hygiene products in a pharmacy and need professional consultations of specialists on the composition of toothpaste and its effectiveness, the right choice of toothbrush, which determines the area of knowledge, that a pharmaceutical worker should own.

Conclusion. Have been identified the information needs on oral hygiene products.

The need for training in proper oral care and orientation to timely treatment of the dentist for preventive purposes and at the first symptoms, as well as information on primary prevention measures to preserve the dental health of the population.

It is important to raise public awareness of the role of fluoride in the prevention of the development of caries, as well as to use additional means of oral hygiene products and fluoride sources. One way to improve public hygiene awareness is for a pharmacist to provide competent advice to pharmacists and to increase the level of completeness in the use of oral hygiene products by the consumer.

Fractures of the femoral neck hold a significant place in traumatology and orthopedics and represent a serious problem. Without surgical treatment, this pathology leads to complications and death of the patient within a year. Hip replacement is the choice of treatment method that allows the injured patient to be mobilized as early as possible. This promotes and has a positive effect on the timing and effectiveness of rehabilitation measures and minimizes the risk of developing possible complications.

The article demonstrates a successful experience of treating a patient with a fracture of the right femoral neck with displacement of fragments using the endoprosthetics method.

Aim – to justify the need for a routine examination of the function of the parathyroid glands in all patients before thyroid surgery.

Material and methods. The analysis of 249 patients who underwent thyroid surgery was carried out. All patients were divided into 2 groups. The main criterion for division is a routine assessment of the function of the parathyroid glands before thyroid surgery. In each group, we assessed the need for interventions on the parathyroid glands.

Results. In 3 patients of group I, in the period 3–5 months after thyroid surgery, an “unreasonable” increase in blood calcium levels was revealed. Upon further examination, laboratory and clinical signs of primary hyperparathyroidism were revealed in them. These patients (2.1%) required surgery on the parathyroid gland. There were no such patients in the second group.

According to the results of preoperative examination in group II, an increase in parathyroid hormone levels was detected in 32 (28%) patients. Parathyroid adenomas were confirmed in 9 (28%) of 32 patients with hyperparathyroidism. At the same time, according to ultrasound, adenomas were visualized only in 5 (56%). In retrospective analysis, all 9 patients showed signs of damage to target organs without pronounced clinical manifestations. All these 9 patients underwent simultaneous intervention on the thyroid and parathyroid glands. In this group of patients, the frequency of simultaneous operations was 8% (p < 0.001).

Conclusion. Before performing surgery on the thyroid gland, it is advisable for all patients to conduct a routine examination of blood calcium and parathyroid hormone to determine the indications for surgery on the parathyroid gland. With this approach, laboratory and clinical signs of primary hyperparathyroidism can be detected in 8% of patients with thyroid pathology, which requires simultaneous operations.

Aim – development of a methodological solution for optimizing the management strategy of the assortment policy of a pharmaceutical company based on inventory control.

Material and methods. The study was conducted using the example of the pharmaceutical company Bayer and is based on the principles of positivistic philosophy and a deductive approach. The research materials include primary data from an interview with a pharmaceutical logistics manager and secondary data from prescriptions. The collected data were analyzed by calculating a number of values (economic order volume, reorder point, safety stock, average assortment level) using ABC analysis and cycle counting methods. According to the collected initial information, the assortment portfolio of the analyzed company includes 400 pharmaceutical products.

Results. The article presents the author's methodological approach to optimizing the product range portfolio of a pharmaceutical company. The proposed approach is based on data on inventory control under conditions of uncertain demand for pharmaceutical products using a continuous analysis policy. A quantitative and qualitative assessment of the product range status for individual drug names was conducted and an adapted product range management strategy was recommended, aimed at improving the efficiency of the product range policy while minimizing overall costs.

Conclusion. The accuracy of the product range dynamics accounting process is improved by using the cyclic counting method and ABC analysis of products.

Aim – conduct an analysis of the Russian market of educational programs in the field of additional professional education for specialists of pharmaceutical companies.

Material and methods. The analysis of the market of educational programs was based on the data of the annual reporting of a number of institutions of higher education for the period from 2017 to 2021. Based on the data obtained, the share indicators of educational organizations in the Russian market of educational programs in the field of additional education of specialists from pharmaceutical enterprises were determined. The share indicator was used to determine the concentration of the educational programs market and the level of competition in the market using the concentration index and the Herfindahl – Hirschman index, respectively. In addition, in the course of the work, such analysis methods as generalization, methods of logical, classification analysis were used when combining ongoing programs of additional professional education into groups of systemic and comparative analysis when assessing both the overall profitability of the market by year and the profitability of individual universities.

Results. Based on the analysis, data were obtained on the profitability of the market for additional professional education services for pharmaceutical industry specialists; the presence of a high level of concentration of educational services in the market of additional professional education with a slight level of competition was established; the features of the implementation of additional professional training for specialists in the pharmaceutical industry are determined.

Conclusion. The importance of additional professional education for specialists in the pharmaceutical industry has been confirmed. The further direction of development of the sphere of additional professional education for workers of pharmaceutical enterprises has been determined. The increase in the Russian market of additional educational programs based on current data on the development of the industry was justified. Recommendations have been formulated to expand the currently implemented programs of additional professional education based on the growing needs of the pharmaceutical market.

Aim – to carry out a morphological and anatomical study of Crataegus flabellata (Bosc ex Spach) K. Koch.

Material and methods. Leaves, shoots and flowers of the Crataegus flabellata collected at the flowering stage in the Botanical Garden of Samara University were used in the work. Micro-preparations of air-dry raw materials were immersed in an alcohol-water-glycerin mixture (1:1:1). Microscopic examination was carried out in transmitted and reflected light using a Carl Zeiss Primo Star 415500-0057-000 digital microscope (Imaging Software for Microscopy ZEN core V2.7).

Results. The study of anatomical and morphological properties of dried flowering shoots showed that the most characteristic feature of the shoots Crataegus flabellata (Bosc ex Spach) K. Koch is the presence of multicellular glands and simple unicellular hairs along the edge of leaf plates, bracts and sepals. In addition, the number of stamens in the flower is from 5 to 12.

Conclusion. Microscopy of dried flowering shoots of the Crataegus flabellata (Bosc ex Spach) K. Koch was described for the first time. The morphological and anatomical analysis of flowering shoots of Crataegus flabellata (Bosc ex Spach) revealed similarities and differences with other species of the genus (Crataegus L.).

Aim – to study the influence of extraction factors on the extraction of hydroxycinnamic acids (HCAs) from dandelion roots.

Material and methods. The object of the study was air-dried dandelion roots. The HCAs content was determined using Arnov's reagent by spectrophotometric method according to the pharmacopoeic method. The influence of the nature, volume fraction of organic solvents, composition of extraction mixtures, temperature, duration, extraction frequency, medicinal plant raw material and extractant ratio, and medicinal plant raw material particle size on the HCAs yield from dandelion roots during extraction was established. Methanol, ethanol, propanol-1, propanol-2, acetone, acetonitrile, dimethyl sulfoxide, propylene glycol-1,2, ethylene glycol, glycerol and their aqueous solutions in volume fractions of 20, 40, 60 and 80% were used as extractants. A dispersion analysis of the influence of these factors on the yield of HCAs during extraction was performed. Results. Extraction conditions providing the maximum yield of HCAs in comparison with pharmacopoeial and literary methods were experimentally developed. The conditions are as follows: extractant – 60% propanol-1 or a mixture of 50% propanol-1 and 10% acetone; extraction temperature – 80˚C; extraction duration – 6 hours; medicinal plant raw material and extractant ratio – 1 to 25; extraction frequency – single and medicinal plant raw material particle size – 500 μm or less. It has been proven that the physicochemical characteristics of the extractants, their volume fractions in solutions and extraction parameters have a statistically significant effect on the yield of HCAs.

Conclusions. A statistically significant effect of the studied extraction factors on the yield of HCAs from dandelion roots has been proven. The developed extraction method statistically significantly increases the yield of HCAs by an average of 30% to 2.5 times in comparison with pharmacopoeial and literary extraction methods.

Aim – study of the fatty acid composition of the aerial parts of L. deminutus.

Material and methods. The objects of the study were samples of the aerial parts of L. deminutus harvested on the territory of the Irkutsk region during the mass flowering period (July 2021). The analysis of the fatty acid composition of raw materials of L. deminutus was carried out by Gas chromatography/Mass spectrometry (GC/MS) on the Agilent Technologies 5973/6890N MSD/DS device in 3 repetitions. The relative content of each fatty acid was determined as a percentage by weight of the total amount of fatty acids in the plant raw material (internal normalization method). The absolute content of fatty acids was calculated by the internal standard method.

Results. The component composition of the fatty acids of the aerial parts of L. deminutus was studied, 14 compounds were identified, of which 8 saturated fatty acids (5.10±0.12 mg/g) and 6 unsaturated fatty acids (13.41±0.25 mg/g). Palmitic acid (3.41±0.07 mg/g) and stearic acid (0.88±0.02 mg/g) prevail among saturated fatty acids. The dominant compounds among unsaturated fatty acids are linoleic (7.78±0.14 mg/g), α-linolenic (2.21±0.04 mg/g) and oleic (2.19±0.04 mg/g) acids.

Conclusion. The qualitative composition of fatty acids in the aerial parts of L. deminutus has been studied for the first time, their quantitative content has been established. L. deminutus is promising for use in medical practice and can be recommended as an additional source of linoleic and α-linolenic acids essential for humans.