Influence of social and economic development of the region on the functioning of the regional banking system

The article is devoted to the analysis of the influence of the indicators of regional economic and social functioning on the results of the regional banking system’s activity. The authors chose the indicators of social and economic development of the Rostov region and commercial banks operating in its financial market as objects for the study. In the article the authors analyzed the methodologies that focus on assessing the impact of macroeconomic indicators on the banking system of the region. Besides, on the basis of econometric modeling quantitative and qualitative patterns of interrelations between the indicators of social and economic development of the regional economy and banking in the region are defined. As a result of the study, the authors concluded that the determining socio-economic factors that have a significant positive impact on the development of the banking system in the region are: the number of advanced technologies used; per capita monetary income; the transport infrastructure development level; the level of human capital; internal expenditures on research and development; gross regional product; value of fixed assets; fixed capital investment; retail trade turnover.peer-reviewe

Acute poisoning in children: Etiology, structure, treatment tactics and outcomes

Introduction: Acute poisoning is often observed in children and can have serious consequences since it is characterized by rapid development of symptoms and obvious disfunction of vital organs. Materials and methods: Retrospective analysis of the case histories of the children with acute poisoning admitted to Voronezh Regional Children’s Clinical Hospital No. 1 in 2016–2019 was carried out. Anamnesis, clinical and laboratory studies and effective treatment criteria were entered into electronic spreadsheets and served as the basis for a database on children’s poisoning. Results and discussion: Analysis of 183 case histories of children with intoxication aged 4 months to 17 years old was performed. Distribution per age showed bimodal peaks at 1–2 years and 13–14 years. Poisoning was accidental in 96.2% of the cases, and 3.8% of the adolescents reported suicide cases. In the group of young children, acute drug poisoning is more frequent in girls (P < 0.05). In the older groups, there is no gender difference in frequency of poisoning cases. Early call for medical help is typical for the adolescent age group. Correlation between time of help-seeking and children’s age is statistically significant (correlation coefficient r = 0.38, P < 0.05). Conclusion: Study of poisoning issue in children will allow to carry out targeted preventive measures to reduce the number of poisoning cases, prevent their consequences and to determine the most rational modus operandi for medical personnel for effective and safe pharmacotherapy. Graphical abstract In pediatric practice, intoxication by poisons and drugs is among the most common reasons for seeking medical help and hospitalization in intensive care units. It is important to study and record dynamics, structure and frequency of acute poisoning with subsequent development of prevention and treatment methods

MONITORING OF THE INDICATORS OF PHARMACODYNAMICS AND THE CLINIC EFFICIENCY OF THE ESSENTIAL PHOSPHOLIPIDES IN THE COMPLEX THERAPY OF PATIENTS WITH IHD

The necessity of checking the indicators of the lipides peroxide exidation and antioxidant system of the patients with stenocardia has been justified for the revealation of the peculiarities of the individual reaction to the reception of the essentiale and lipostabile. For the first time it has been shown, that the introduction of the essential phospholipides in the complex therapy of the IHD can increase the activity of the peroxide processes of the number of patients, to deepen the deficiency of the antioxidant system, which correlates with the functional indicators of the cardiovascular system.Available from VNTIC / VNTIC - Scientific & Technical Information Centre of RussiaSIGLERURussian Federatio

COMPLEX THERAPY OF CHRONIC PANCREATITIS COMPLICATED BY ANXIO-DEPRESSIVE DISORDERS IN RAILROAD WORKERS

Psychic disorders in patients, who suffer from chronic somatic diseases for a long time, can be grouped into one category called psychosomatic pathology. Co-morbid - psychosomatic - disorders are considered to be predictors of unfavourable prognosis significantly aggravating patients’ condition, quality of life and professional activity. It is important to timely diagnose and perform pharmacological correction of affective pathology. Special attention should be paid to patients, whose profession is associated with the operational activity. 110 railroad workers admitted to the in-patient department of the Non-state Health Care Facility “RoadHospital the Station Voronezh-1of JSC “Russian Railways” with the diagnosis “Chronic pancreatitis, recurrent” were examined in the study. On admission all patients were questioned using specialized diagnostic scales and questionnaires aimed at revealing of anxio-depressive disorders. The authors have found out negative impact of anxio-depressive disorders on the course of chronic pancreatitis with the development of stable pain syndrome, gastro-intestinal disorders, resistance to the performed pharmacotherapy, and decrease of reaction rate to presented stimuli. Examination of the patients suffering from chronic pancreatitis demonstrated that patients with MADD had more severe course of the disease. This manifested in more intensive pain syndrome, apparent symptoms of nausea, bitter taste in the mouth and diarrhea; these symptoms exceeded number of similar complaints in patients with chronic pancreatitis without MADD in 1.6 – 2.1 times. Tranquilizer “Adaptol” and anxiolytic “Afobazol” in combination with basic therapeutical medications efficiently eliminate gastroenterological and anxiety symptoms. However, “Adaptol” decreases rate of visual-motor reactions, whereas “Afobazol”, on the contrary, increases reaction rate to presented stimuli

New methods to detect early manifestations of adverse side effects of glucocorticosteroids in children

Introduction: The article focuses on the early manifestations of adverse side effects in children with nephrotic syndrome receiving glucocorticosteroids. The search for criteria of early side effect manifestations is a real challenge nowadays. The authors developed new diagnostic criteria for early detection of pharmacotherapeutical side effects in children with nephrotic syndrome. Objective: The aim of the study was to develop integral quantitative diagnostic criteria for early detection of side effects of glucocorticosteroids when treating nephrotic syndrome in children. Materials and Methods: The study included 58 in-patients, aged 1-18. All the children had been thoroughly examined and their parameters had been investigated: height and body mass by calculating Z-scores (WHO ANTHRO Plus) and body mass index (BMI), a biochemical blood test, a full blood count by studying the total number of leukocytes, the percentage of neutrophils and monocytes in peripheral blood, systolic and diastolic blood pressure. Results and Discussion: The parameters that changed in the patients with nephrotic syndrome taking corticosteroids are referred to as diagnostic criteria. They included leukocytes, neutrophils and monocytes parameters in the full blood count, blood glucose and amylase level, patients’ body mass, BMI, systolic and diastolic arterial pressure. The authors defined the change range of the parameters under study in the children with nephrotic syndrome based on the obtained findings. Conclusion: The authors conclude that application of the developed indices will make it possible to diagnose early metabolic, cardio-vascular and immunologic changes in patients with nephrotic syndrome taking glucocorticoids and perform their individual pharmacological correction in a timely manner

COMPLEX THERAPY OF CHRONIC PANCREATITIS COMPLICATED BY ANXIO-DEPRESSIVE DISORDERS IN RAILROAD WORKERS

Psychic disorders in patients, who suffer from chronic somatic diseases for a long time, can be grouped into one category called psychosomatic pathology. Co-morbid - psychosomatic - disorders are considered to be predictors of unfavourable prognosis significantly aggravating patients’ condition, quality of life and professional activity. It is important to timely diagnose and perform pharmacological correction of affective pathology. Special attention should be paid to patients, whose profession is associated with the operational activity. 110 railroad workers admitted to the in-patient department of the Non-state Health Care Facility “RoadHospital the Station Voronezh-1of JSC “Russian Railways” with the diagnosis “Chronic pancreatitis, recurrent” were examined in the study. On admission all patients were questioned using specialized diagnostic scales and questionnaires aimed at revealing of anxio-depressive disorders. The authors have found out negative impact of anxio-depressive disorders on the course of chronic pancreatitis with the development of stable pain syndrome, gastro-intestinal disorders, resistance to the performed pharmacotherapy, and decrease of reaction rate to presented stimuli. Examination of the patients suffering from chronic pancreatitis demonstrated that patients with MADD had more severe course of the disease. This manifested in more intensive pain syndrome, apparent symptoms of nausea, bitter taste in the mouth and diarrhea; these symptoms exceeded number of similar complaints in patients with chronic pancreatitis without MADD in 1.6 – 2.1 times. Tranquilizer “Adaptol” and anxiolytic “Afobazol” in combination with basic therapeutical medications efficiently eliminate gastroenterological and anxiety symptoms. However, “Adaptol” decreases rate of visual-motor reactions, whereas “Afobazol”, on the contrary, increases reaction rate to presented stimuli

CHANGES IN URINE MICROFLORA IN CHILDREN WITH COMMUNITY-ACQUIRED URINARY TRACT INFECTION ADMITTED TO HOSPITAL BETWEEN 1990 AND 2015: A RETROSPECTIVE FULL-DESIGN STUDY OF CASE SERIES

Background. It is necessary to study the microbial spectrum of urine in order to determine the features of the urinary tract infection (UTI) course and to make the right choice of a therapeutic approach. Objective. Our aim was to study the structure of urine microflora in children with community-acquired UTI and its change in the period from 1990 to 2015.Methods. We conducted a continuous analysis of case histories of children admitted to hospital with UTI (pyelonephritis, cystitis, non-site specific urinary tract infection) in 1990, 2000, and 2015. We studied the results of triple (in succession) urine cultures. Shedding in a concentration of ≥ 103 cfu/ml for primary pathogens, ≥ 103 cfu/ml in boys and ≥ 104 cfu/ml in girls for secondary pathogens, ≥ 105 cfu/ml for doubtful pathogens considered to be a diagnostically significant one.Results. Members of the family Enterobacteriaceae were the main causative agents of the UTI in 1990 (found in 90.4% of 502 samples), 2000 (in 79.7% of 632 samples), and 2015 (in 67.6% of 801 samples, df = 2, p &lt; 0.001). Escherichia coli remained the most common microorganism, the isolation rate of which decreased from 79.9% in 1990 to 39.5% in 2015 (p &lt; 0.001). In the period from 2000 to 2015, there was a decrease in the frequency of urine detection of Enterobacter spp. (from 5.9 to 2.5%; p &lt; 0.001) and Citrobacter spp. (from 5.2 to 1%; p &lt; 0.001) and, on the contrary, an increase in the isolation rate of Proteus spp. (from 7.8 to 11.7%; p = 0.005), Klebsiella spp. (from 2.8 to 12.9%; p &lt; 0.001) and Enterococcus spp. (from 1.8 to 19.1%; p &lt; 0.001); the latter two — due to more frequent shedding in boys (by 10.5 and 19.9%, respectively).Conclusion. The Enterobacteriaceae members, mainly E. coli and Enterococcus spp., remained the predominant UTI pathogens in children in 1990, 2000, and 2015. The isolation rate of E. coli has declined significantly in recent years, whereas that of Klebsiella spp. and Enterococcus spp. has increased

ANALYSIS OF DYNAMICS OF ANTIBIOTIC RESISTANCE OF PATHOGENS IN PATIENTS WITH DIABETIC FOOT SYNDROME UNDERGOING IN-PATIENT TREATMENT

Persistent ulcers in patients with diabetic foot syndrome in 85% of cases lead to amputation because of secondary infection and growing gangrene that significantly worsen the prognosis. In the course of our study, the data were obtained on the role of the staphylococcus, Pseudomonas aeruginosa infections, Enterobacteriaceae isolates, and, in a small percentage of cases, Candida fungus in diabetic foot syndrome. It was shown that in case of incomplete eradication of the pathogen the structure of pathogens and its sensitivity to antibiotics undergo changes. In this case, methicillin-resistant staphylococci and Pseudomonas aeruginosa are detected. In this paper we discuss the approaches to the choice of antibiotic therapy, subject to the sensitivity of these microorganisms to antibiotic therapy in the surgical department of St. Joseph Belgorod Regional Clinical Hospital. The obtained data state that III-IV generation pseudomonas cephalosporins and fluoroquinolones can be used for empirical therapy. And, in case of staphylococcal infections, - vancomycin

Physicians’ knowledge and preferences in tactics of management and rational pharmacotherapy of arterial hypertension in pregnant women (PHYGEST study)

Introduction: The issues of rational antihypertensive therapy in pregnant women are always extremely relevant, since high blood pressure in a pregnant woman is associated with serious risks for a mother and a fetus. The aim of the study: To determine the knowledge and preferences of physicians in the management of pregnant women with arterial hypertension. Materials and methods: A multicenter study was conducted in 2018–2021 using an anonymous questionnaire among 411 doctors from 8 regions of Russia. Results and discussion: The levels of knowledge and preferences of specialists in the issues of diagnosing and formulating a diagnosis of arterial hypertension and preeclampsia in pregnant women, prescribing basic and additional drugs for the treatment and prevention of hypertension were revealed, and the degree of compliance with the current clinical guidelines was assessed. Conclusion: Due to the insufficient level of knowledge of specialists, it is required to pay increased and special attention to this problem, strengthen control over compliance with clinical guidelines, and introduce it into postgraduate recommendations and continuing education programs

Assessment of senior medical care majors’ knowledge in antimicrobial chemotherapy

Introduction: The resistance of microorganisms to antimicrobials has been gradually increasing since 2011 and is now recognized by the World Health Organization as a global biological threat. Causes of antimicrobial resistance must be actively addressed. Healthcare workers’ awareness of rational antimicrobial prescribing practices is of great importance. The increasing relevance of this issue is considered within this study, which started in 2014. Materials and methods: The article represents the results of anonymous prospective surveys within the framework of the KANT multi-centered research project aimed at assessing students’ knowledge of rational antimicrobial prescribing practices also known as “antimicrobial stewardship”. The survey involved 309 Medical Care majors in their fifth- and sixth- years in two Russian regional centers: Belgorod and Voronezh. The answers to four main questions of the survey were analyzed in this work. Results and discussion: According to the survey, 51.5% of the respondents properly identified a pharmacological group of an antimicrobial; 79.3% of the students would change an antibiotic if the desired therapeutic outcome was not achieved within two or three days of treatment; 29.8% of the students believed that an antimicrobial substitution was required even when a positive therapeutic outcome was achieved; and nobody could correctly identify all the proposed pharmacologically irrational combinations of antimicrobials. Conclusions: The survey showed that senior medical students have insufficient knowledge in antimicrobial stewardship. Appropriate use of antibiotics and antimicrobial prescribing practices need to be considered more thoroughly in Pharmacology, Clinical Pharmacology and Medical Care curricula. Likewise, educational activities on antimicrobial stewardship and best prescribing practices are of great importance for students as they will help with improving the knowledge of future doctors