Clinical-economic analysis of valproate microsphere form in focal epilepsy in adults (real world evidences)

Clinical and economical results of switching from original valproate - Depakine Chronosphere - to generic tablets of prolong action in adult patients with focal epilepsy has been performed. Methodology: In 127 patients duration of Depakine Chronosphere usage before switching, it’s dosage, efficacy, drug of switching, it’s dosage, dynamic of epilepsy seizures during half of the year after were fixed. Also were calculated total amount of out-patients visits, emergency calls, admission to hospitals, disability days before and after switching. Direct costs, including pharmacotherapy, hospitalization, out-patients visits etc., have been summarized. And total expenditures for one patient were calculated with cost-effective ratio during half of the year before and after switching were ensured. Results: Adult patients with focal epilepsy (127 pts) have been switched by doctors for technical, non medical, reasons to receive valproate Gxs instead previous treatment with Depakine Chronosphere. Patients have switched to Convulex (n=79.), Encorat (n= 27), Valparin ХР (n=21). After Convulex switching the total amount of patients in remission is less than in Depakine treatment. Absolute Risk of seizures is increased on 16,5%, relative risk - on 27,7%. Total amount of out-patients’ visits increased on 47,2% by the less Convulex efficacy as well as necessity in hospitalization has been occurred, and disability days count was 3,35 in average after switching. Total expenditures after switching from Depakine Chronosphere to Convulex were increased, and cost-effective ration for Depakine Chronosphere was less on 80,4% in compare with Convulex. In other cases of switching from original to Gxs valproate results were similar - efficacy was less and cost was increased. Conclusion: Switch from Depakine Chronosphere to valproate Gxs in focal epilepsy in adults is not justified from clinical point of view and more expensive from economic point of view

Investigation of wound healing activity of the flavonoid schaftoside isolated from Lychnis chalcedonica

Study for the first time shows a pronounced wound healing effect from aqueous solution of the flavonoid schaftoside from Lyсhnis chalcedonica on the model of a plane skin wound in mic

Implementation of Youth Initiatives of Youth with Disabilities

The purpose of the article is to study the opinions of young people with disabilities regarding the possibility of realizing themselves, their capabilities and initiatives. To achieve this goal, the methods of theoretical analysis, questionnaires of young people with restricted health opportunities (All-russian society of the deaf) were used. the survey results showed that youth with organic health opportunities in their localities need youth organizations. The main goals and functions of youth organizations for young people with disabilities difficult life situations.Целью статьи является изучение мнения молодежи с ОВЗ относительно возможности реализовать себя, свои возможности и инициативы. Для достижения поставленной цели применены методы теоретического анализа, анкетирование молодежи с ОВЗ (ВОГ). Результаты опроса показали, что молодежь с ОВЗ в свих населенных пунктах нуждается в молодежных организациях. Основные цели и функции молодежных организаций для молодежи с ОВЗ (ВОГ): оказание содействия молодым инвалидам в решении вопросов, связанных с трудо-устройством, организацией досуговых мероприятий и решением сложных жизненных ситу-ций

Применение категорий Международной классификации функционирования при организации медицинской реабилитации больных, перенесших новую коронавирусную инфекцию COVID-19

The objective was to determine the most significant categories of ICF that allow us to provide objective information about the biopsychosocial state of patients who have suffered a new coronavirus infection COVID-19 and to choose the most effective methods of rehabilitation based on the rehabilitation diagnosis of each group of patients.Methods and materials. On the basis of the clinic of the Pavlov University, a course of medical rehabilitation was conducted for 2 weeks for patients who had suffered a new coronavirus infection in severe and moderate degree of course. 2 groups were formed: EG1-25 people participating in the rehabilitation program with the use of physical exercises and EG2 — 39 people with the use of physical exercises and physiotherapy. A categorical rehabilitation profile of patients by ICF domains was compiled.Results. As a result of the application of the medical rehabilitation program, a statistically significant improvement in the indicators in EG 2 was revealed. The respiratory function (the Barbell test) improved by 14.6%, the functional state of the cardiovascular system according to the DBP indicator by 3.9%. The analysis of the results of the ICF category «activity and participation» revealed a statistically significant improvement in the motor test parameters (6MSHT) in both groups: by 11.9 % in EG2 and by 20.6 % in EG1.Conclusions. The results of the study indicate the positive impact of the proposed program of medical rehabilitation and confirm the relevance of the problem, unsolved problems and prospects for scientific research on this topic.Цель — определить наиболее значимые категории Международной классификации функционирования (МКФ), позволяющие дать объективную информацию о биопсихосоциальном состоянии пациентов, перенесших новую коронавирусную инфекцию COVID-19, и выбрать наиболее эффективные методы реабилитации на основании реабилитационного диагноза каждой группы больных.Методы и материалы. На базе клиники ПСПбГМУ им. И. П. Павлова в течение 2 недель проведен курс медицинской реабилитации пациентам, перенесшим новую коронавирусную инфекцию в тяжелой и среднетяжелой степени течения. Сформированы две группы: ЭГ1 — 25 человек, участвующих в программе реабилитации с применением физических упражнений, и ЭГ2 — 39 человек с применением физических упражнений и физиотерапевтического лечения. Составлен категориальный реабилитационный профиль пациентов по доменам МКФ.Результаты. В результате применения программы медицинской реабилитации выявлено статистически значимом улучшение показателей в ЭГ 2. Функция дыхания (проба Штанге) улучшилась на 14,6 %, функциональное состояние сердечно-сосудистой системы по показателю ДАД — на 3,9 %. Анализ результатов категории МКФ «Активность и участие» выявил статистически значимое улучшение показателей двигательной пробы (6МШТ) в обеих группах: на 11,9 % в ЭГ2 и на 20,6 % в ЭГ1.Заключение. В результате применения программы медицинской реабилитации выявлено достоверное улучшение показателей двигательной, дыхательной и сердечно-сосудистой функции, особенно в ЭГ2. Таким образом, данные исследования подтверждают актуальность проблемы, нерешенные задачи и перспективы научных изысканий по данной теме

The inflammation markers in serum of tumor-bearing rats after plasmonic photothermal therapy

We report on plasmonic photothermal therapy of rats with inoculated cholangiocarcinoma through the intratumoral injection of PEG-coated gold nanorods followed by CW laser light irradiation. The length and diameter of gold nanorods were 41±8 nm and 10±2 nm, respectively; the particle mass-volume concentration was 400 μg/mL, which corresponds to the optical density of 20 at the wavelength 808 nm. The tumor-bearing rats were randomly divided into three groups: (1) without any treatment (control); (2) with only laser irradiation of tumor; (3) with intratumoral administration of gold nanorods and laser irradiation of tumors. An hour before laser irradiation, the animals were injected intratumorally with gold nanorod solutions in the amount of 30% of the tumor volume. The infrared 808-nm laser with power density of 2.3 W/cm2 was used for plasmonic photothermal therapy (PTT). The withdraw of animals from the experiment was performed 24 h after laser exposure. The content of lipid peroxidation products and molecular markers of inflammation (TNF-α, IGF-1, VEGF-C) was determined by ELISA test in serum of rats. The standard histological techniques with hematoxylin and eosin staining were used for morphological examination of tumor tissues. It was revealed that the significant necrotic changes were noted in tumor tissue after plasmonic photothermal therapy, which were accompanied by formation of inflammatory reaction with release of proinflammatory cytokines and lipid peroxidation products into the bloodstream

ПЭТ-КТ КАРТИНА ДИССЕМИНАЦИИ ДОБРОКАЧЕСТВЕННОЙ ЛЕЙОМИОМЫ

The ability to metastasize is considered to be one of the key features of malignant tumors. However, the literature describes the possibility of dissemination of histologically verified benign tumors – uterine leiomyoma. Diagnosis of metastatic leiomyoma is a challenging task for the doctor, due to the extreme rarity of this disease, at the same time revealing the purity of the process is determining the further tactics of treatment, significantly different from the treatment of malignancies. Case report. We presented a rare case of dissemination of benign tumors – leiomyomas. The female patient of 72 years old had signs of typical malignant tumors of the ovaries, such as nodules of the abdominal cavity, ascites and metastases in the body of the lumbar vertebra, increased level of CA-125. PET-CT revealed increased FDG uptake in soft-tissue neoplasm that destruct the body of the lumbar vertebrae and the nodules in the abdominal cavity with increased metabolic activity, typical for malignant tumors. However, histological examination with immunohistochemical verification confirmed the presence of dissemination of benign tumors. Conclusion. The presence of signs, typical for the malignant tumor, such as the presence of distant metastases of various localizations, a high level of CA-125 tumor marker, increased metabolic activity on PET scan in rare cases, may occur with benign tumors. Therefore, diagnosis of tumors should always be integrated, with the obligatory account all available clinical, laboratory and instrumental data.Актуальность. Способность к метастазированию считается одним из ключевых признаков злокачественных опухолей. Однако в литературе описана возможность диссеминации гистологически верифицированных доброкачественных опухолей – лейомиом матки. Диагностика метастазирующей лейомиомы является сложной задачей из-за исключительной редкости данной патологии, в то же время выявление доброкачественности процесса определяет тактику лечения, которая существенно отличается от подходов к терапии злокачественных новообразований. Описание клинического случая. Приводим наблюдение редкого случая диссеминации лейомиомы. У пациентки 72 лет имелись признаки, типичные для злокачественного образования яичников: узловые образования брюшной полости, асцит, метастаз в тело поясничного позвонка, высокий уровень СА-125. По данным ПЭТ-КТ в мягкотканном образовании, разрушающем тело поясничного позвонка, и крупнейшем образовании брюшной полости имелось повышение метаболической активности, типичное для злокачественных опухолей. Однако гистологическое и иммуногистохимическое исследования подтвердили диссеминацию доброкачественной опухоли. Заключение. Наличие признаков, свидетельствующих о наличии злокачественного новообразования, таких как отдаленные метастазы и высокий уровень онкомаркера СА-125, повышенная метаболическая активность по данным ПЭТ в редких случаях может наблюдаться при доброкачественных опухолях.