Репозиторий Университета

© 2018 Media Sphera Publishing Group.All rights reserved.  Contribution of diseases of the circulatory system to total mortality of the population remains high. Therefore it is necessary to study factors with most substantial impact on regional morbidity and mortality for elaboration of targeted programs of preventive measures aimed at definite population groups. Purpose of this study was to perform analysis of differences of mortality from cardiovascular diseases (VVD) of Moscow region inhabitants of various gender and age. Materials and methods. Data on 2016 mortality of Federal Service of State Statistics (Rosstat) and territorial service of state statistics of the Moscow Region were used in this analysis. Analysis was conducted for men and women divided in age groups ≤50, 50-59, 60-69, and ≥50 years. Diseases were classified in accordance with 10 th Revision of International Statistical Classification of Diseases (ICD10). Results. Population of the Moscow Region territory on January 1, 2016, amounted 7 318 647 (men 46.2, women 53.8%, persons of working age 58.9%). Contribution in the mortality structure of chronic ischemic heart disease (IHD) and cerebro-vascular diseases in women was greater than in men (80 vs. 68%, respectively, р<0.0001). Contribution of acute IHD, IHD unrelated heart diseases, and vascular diseases in men was significantly greater than in women (30 vs. 18%, respectively, р<0.0001). In the age group over working age mortality indexes were substantially higher compared with those in working age. In men these indexes became 10-20 times while in women - 30-130 times higher. Conclusion. Despite positive dynamics of mortality from diseases of the circulatory system (45.3% lowering from 2008 to 2016) it is necessary to strengthen efforts directed to correction risk factors of IHD and implementation of timely diagnostics and correction of IHD unrelated diseases.

© 2018, Media Sphera Publishing Group. All rights reserved. Antidepressants are among the most commonly prescribed drugs due to their effectivenes in treating depression and anxiety disorders. One of the reasons for early discontinuation of taking antidepressants are side-effects. Agomelatine is a relatively novel antidepressant with high efficacy and good tolerance. Clinical effects of agomelatine include a reduction in symptoms of depression, anti-anxiety and hypnotic effects, as well as the rapid elimination of anhedonia, which determines high adherence to therapy, restoration of normal social functioning, and complete remission of disease.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Most patients with arterial hypertension (AH) for successful long-term blood pressure (BP) control require combination of antihypertensive drugs acting on various target organs. Accumulated experience shows that about 30% of patients require combination therapy with 3 drugs from different pharmacological classes. Efficacy of BP control in real clinical practice with the use of various doses of perindopril, indapamide, and amlodipine as components of taken once-daily triple fixed combination was assessed in the 3-months prospective observational open-label PETRA study. In this study data of office BP measurements and 24-hour ambulatory BP monitoring (ABPM) were obtained from 11209 ambulatory patients (47.6% women) with AH. Initial mean office BP (BPmoff) was 156.58±16.10/91.56±9.33 mm Hg, AH duration - 9.48±7.19 years. After switching to triple fixed dose combination of perindopril, indapamide, and amlodipine BPmoff decreased by 24.81±15.47/11.41±9.90 mm Hg (p<0.0001). Doses of perindopril, indapamide, and amlodipine in combination at the final visit were 5/1.25/5, 10/2.5/5, and 10/2.5/10 mg. 24-hour ambulatory BP monitoring (ABPM) was carried out in 76 patients. Mean 24-hour BP lowed from mean 155.51±17.43/85.28±11.48 down to 134.63±12.51/77.83±8.99 mm Hg (p<0.0001). Clinically relevant improvement of a number of parameters of metabolism occurred after 3 months of the study (in particular, lowering of levels of total and low-density lipoprotein cholesterol [-8.6 and - 11.4%, respectively], triglycerides [-12,1%], fasting blood glucose [-6.6%]). Thus, results of the PETRA study confirmed 24-hour long antihypertensive efficacy of triple fixed dose combination of perindopril, indapamide, and amlodipine. This drug combination can present novel possibility in treatment of patients with AH who have not achieved target BP values on preceding dual combination therapy and fully corresponds with the single pill concept for formation of adherence to therapy.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. In this article we present a clinical case of a quick recovery and restoration of pulmonary function after withdrawal of amiodarone in a patient with drug-associated acute lung injury induced by intake of amiodarone for two months.

Vitamin-like compound S-methyl-L-methionine (SMM, historically called vitamin U) is a metabolic agent, affects metabolic processes, which causes a wide variety of effects. The data of the studies demonstrating gastroprotective effect, hypolipidemic and antioxidant effect, participation in regulation of adipocyte function, homocysteine exchange are presented. SMM is involved in all methylation reactions in which another activated form of methionine, S-adenosylmethionine, normally participates. The results of the observed studies indicate a possible expansion of the clinical use of S-methylmethionine.

© 2018 American Leather Chemists Association. All rights reserved. Classification, mechanism of action, features of pharmacodynamics and pharmacokinetics, and indications for use of chondroprotectors (drugs promoting the regeneration of cartilage tissue) are presented. Comparative analysis of experimental and clinical studies of main representatives of this group of drug has been performed.

AIM: Efficiency assessment of Granulotec (PD) endodontic sealer for root canal permanent obturation in patients with apical granuloma basing on clinical and radiological data. MATERIAL AND METHODS: Endodontic treatment of 35 teeth with apical granuloma was performed in 22 patients with root canal obturation by means of lateral condensation with Granulotec sealer. Bone remodeling in periapical area has been estimated in 1, 3, 6 and 8 months with PAI index. RESULTS: Endodontic post-operative pain has been observed in 5 (14.3%) cases of 35, pain duration varied 1 to 5 days, NSAIDs use hasn't been required. During observation period 2 teeth have been excluded from the test group (one case of periapical abscess with sinus tract and one case periapical abscess without sinus tract). In the end of observation period complete bone remodeling was observed in 30 cases, the periapical lesion size significant reduction was achieved in 2 cases, periapical lesion stabilization - in 1 case. The overall success rate was 91.4%. The mean PAI value decreased from 4.2±0.2 to 1.4±0.2. CONCLUSION: The Granulotec (PD) use for one visit chronic apical periodontitis treatment allows achieving positive results with low complications risk.

The purpose of our study was to identify false xerostomies in students of different nationalities studying at the Faculty of Dentistry of the Sechenov University and to assess the effectiveness of Splat Oral Care Foam 2 in 1 against xerostomia stress-induced. Based on the results of Fox test 40 people were selected who used Splat Oral Care Foam 2 in 1 for three weeks. The participants were divided in 4 groups of 10 depending on the nationality. Oral hygiene was assessed by OHI-S and Silness-Loe indices and saliva was collected by the method of M.M. Pozharitskaya to determine salivation rate. It was found that the use of Splat Oral Care Foam 2 in 1 significantly improves the level of oral hygiene and positively affects the rate of salivation, thereby improving the quality of life.

For the purpose of studying the possibility of labor functions development for public health and healthcare during training in the educational organizations the comparative analysis of provisions of the professional standard with the materials stated in textbooks and national manuals of the corresponding profile was carried out. It was found that in the development of Federal state educational standards of higher education in dentistry (specialization level), updating educational methodological publications on dentistry and public health, the formation of a unified database of evaluation tools for accreditation of specialists and obtaining or confirming qualification categories, it is necessary to take into account the content of labor functions of the professional standard in each discipline.

© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To study clinical characteristics of depression in women and men. Material and methods. One hundred and twenty women, aged from 18 to 65 years, and 67 age-matched men with the diagnosis of recurrent depressive disorder (RDD) (ICD-10 F33) were examined using a specially developed survey. Results. Differences in the clinical picture and course of RDD in women and men were found. RDD in women develops at an earlier age, the number of attacks is greater but remissions are longer. However, complete remission is achieved more frequently in men. Most typical effect in the structure of depression in women is anxiety whereas melancholy prevails in men. Daily mood fluctuations and suicidal thoughts are characteristic of women. Motor retardation and decreased motivation are more frequent in men. Ideas of self-blame, avoidance of contacts with other people, adynamia, persistent sense of fatigue are more common in women. Sleep disorders are equally common in men and women but falling asleep disturbance and lack of sleep feeling are more common in women. Somatic symptoms of depression are generally more common in men as well as concomitant diseases of cardiovascular, respiratory and genitourinary systems. Men are more likely to abuse alcohol and other psychoactive substances. Conclusion. The identified characteristics of depression in women and men allow more accurate diagnosis and treatment recommendations.

© 2018, Media Sphera Publishing Group. All rights reserved. A number of frequently discussed issues of clinical psychiatry include comparing the advantages and disadvantages of typical and atypical antipsychotics. It is believed that atypical antipsychotics are less likely to cause extrapyramidal disorders and have a more significant effect on the negative symptoms of schizophrenia compared to typical drugs. However, many randomized controlled and cohort studies, as well as systematic reviews and meta-analyses carried out on their basis, allow questioning the superiority of second-generation antipsychotics over their predecessors, in particular in terms of tolerability. Current scientific evidence provides sufficient evidence for the clinical use of chlorpromazine and other traditional antipsychotics, along with more recent medicines.

© 2018 Cardiovascular Therapy and Prevention. The article discusses the role of telmisartan in the treatment of arterial hypertension in patients with metabolic syndrome. Telmisartan is second-generation type 1 angiotensin II receptor blocker, which has unique pleiotropic effects due to partial affinity for receptors that activate the proliferation of subtype γ peroxisomes (PPARγ) located in adipose tissue. The interrelation of metaflamation, a specific chronic inflammatory process with pathogenetic mechanisms of development of cardiovascular diseases, including arterial hypertension, is also described in study. The role of the adiponectin peptide is considered, which synthesis is stimulated by partial PPARγ receptor agonists (as mentioned above - telmisartan). It has a positive effect on fat and carbohydrate metabolism, as well as cardioprotective properties. The conclusion contains the results of numerous randomized studies and meta-analyzes confirming the high efficacy of telmisartan in the treatment of arterial hypertension in patients with morbid obesity.

© 2018 Cardiovascular Therapy and Prevention. Modern appropriate treatment of hypertension involves the use of combination antihypertensive therapy. According to updated version of European Society of Cardiology 2018 guidelines, renin-angiotensinaldosterone system blockers must be used as first-line drugs, including in combination with hydrochlorothiazide. This article presents the algorithms for the management of patients with uncomplicated and asymptomatic (with target lesions) arterial hypertension. It also described the management of patients with concomitant cardiovascular, cerebrovascular, renal pathology and diabetes mellitus, and use of fixed combination of candesartan and hydrochlorothiazide. The article presents research data that confirmed not only the high antihypertensive efficacy of this combination, but also demonstrated its neutral metabolic profile, organ-protective effects, the ability to use in patients with chronic kidney disease, chronic heart failure, prior stroke, as well as high tolerability and treatment adherence.

© 2018 Authors. The authors substantiate the need to develop a scientific and methodical approach to modernizing business processes of a pharmacy using information technologies. IK FARM LLC pharmacy has been chosen as a model object of the study. The IDEF0 (Integrated Definition Function Modeling) method adopted as a state standard in the US and recommendations of the State Standard of Russia R 50.1.028-2001 have been used for the analysis, systematization and reorganization of business processes. The article offers methodology for optimizing the pharmacy's activities, which includes the building of two models for managing business processes - before and after modernization (AS-IS and AS-WILL). The structure of the AS-WILL model includes new functions: "Plan the pharmacy's activities" (set the goals and objectives of the organization, plan target sales for the next period) and "Monitor the pharmacy's activities" (control the compliance with the rules of drugs' storage and layout, sanitary regime, and rules of property operation). The complex automation of the pharmacy's trading activities ensures these functions through the Magister software. Estimated efficiency of business processes' modernization based on the net present value has indicated that automation of processes will increase net unreduced profit.

© 2018 Authors. This article presents the results of studies devoted to assessing the survival of students' knowledge, regardless of their basic training. The study was conducted based on two groups of specialists, recertified under the program "Pharmacy management and economics" at the Pharmacy Department of Sechenov First Moscow State Medical University. Some of the specialists of the experimental groups had been previously trained at the Pharmacy Department of Sechenov First Moscow State Medical University in 2012-2013 using a new devel-oped didactic tool named "Activity Book". According to the results obtained, the skills acquired by the specialists trained using on "Activity Book" in 2012-2013, were characterized by higher "survivability".

© 2018 Publishing House of the Union of Pediatricians. All rights reserved. The paediatric patient is considered to be a child. However, when it comes to communication with a patient, his consent, implementation of appointments, then the party of interaction is supposed to be an adult. In this regard, the paediatric patient is represented by a child-adult alliance, which allows us to speak of a 'complex patient'. At the same time, his personal agency (the ability to independently formulate a complaint, accept appointments and achieve compliance) changes with the age of a child, coming to him from an adult. This determines the efficacy of screening as well as the main tactics of interaction between the doctor and the patient, explanation, and compliance. Based on the theory of periodization of the personality development, answers are given to the questions: who, a child or an adult, formulates a complaint, who accepts the explanation and who is the subject to compliance? It has been shown that in early childhood (up to 3 years) the patient's subjectivity in the formulation of a complaint and a picture of the disease, the perception of prescriptions and adherence to compliance is provided by the parent. During the pre-school (3-7 years) and primary school (7-11 years) periods, the picture is mosaic: the doctor compares the opinion of the parent and his child to get a picture of the disease, he gives prescriptions to the parent and/or to the child, so both of them can be a subject to compliance. And only in adolescence (12-17 years) a child can be almost a completely independent subject in all aspects of interaction in the doctor-patient system.

© 2018 Media Sphera Publishing Group. All rights reserved. Aim. To perform a comparative analysis of anemia of chronic disease (ACD) and iron-deficiency anemia (IDA) in late middle-aged and elderly patients with chronic heart failure (CHF) by ferrokinetic parameters, inflammation indexes, and their associations. Materials and methods. 65 patients with ischemic heart disease were evaluated, including 35 patients with CHF and ACD, 10 patients with CHF and IDA, and 20 patients without CHF, ACD, and IDA (control group, CG). Results. Patients with CHF and IDA had true iron deficiency whereas 54% of patients with CHF and ACD had functional iron deficiency, and 46% of patients had no iron deficiency. Levels of acute phase proteins, ferritin and hepcidin, C-reactive protein (CRP), and interIeukin-6 (IL-6) were highly sig-nificantly different in patients with CHF and ACD and patients with CHF and IDA; positive and significant correlations were found for levels of IL-6 and ferritin, IL-6 and CRP, and CRP and hepcidin. In patients with CHF and IDA, levels of acute phase proteins, ferritin and hepcidin, CRP, and IL-6 were low and correlations of IL-6 with ferritin, IL-6 with CRP, and CRP with hepcidin were non-significant. Concentrations of erythropoietin were significantly higher in patients with CHF and ACD and patients with CHF and IDA compared to the control group; however, significant differences between them were absent.

Prevalence, risk factors of primary pancreatic tuberculosis, clinical symptoms and data of instrumental and laboratory diagnosis are reviewed in the article. The authors emphasized the peculiarities of differential diagnosis with pancreatic malignancies and advisability of the most informative methods - endoscopy and fine-needle aspiration procedure.

AIM: To analyze long-term outcomes of tracheal transplantation. MATERIAL AND METHODS: There were 1128 patients with cicatricial tracheal stenosis who have been operated at the Petrovsky Russian Research Center for Surgery and the Sechenov First Moscow State Medical University for the period 1963-2015. RESULTS: Operations have become safer. Postoperative morbidity and mortality reduced from 41.4% (1963-1980) to 5.6% (2001-2015) and from 21.9% (1963-1980) to 0.5% (2001-2015), respectively. Tracheal transplantation was performed in 2 cases and fundamentally different tracheal structures were applied. Donor thyreotracheal complex with restored blood supply through thyroid vessels was used in the first case (2006). Perennial experimental trials preceded clinical application of this technique. In the second case (2010) we applied scientific results of foreign colleagues (cellular technologies and methods of regenerative medicine to create artificial trachea). Patients are still alive after 12 and 8 years, respectively. Restoration of blood supply of donor trachea is possible through thyroid collaterals. This technique is successful in long-term period. Tissue-engineered trachea cannot be considered true trachea due to no all tracheal components. However, such trachea provides air-conducting, evacuation and protective functions. Tracheomalacia requires further researches as one of the main problems of tracheal transplantation.

Decision-making process is often complex, responsible and not always reflected in surgical protocol. Some surgeons usually prefer standard finishing of procedure; others talk about individual approach but they have some preferences; the third ones analyze all possible perioperative factors (pre- and intraoperative data) and seek to justify differentiated approach. Some aspects of these processes are discussed in this report.