Pharmacological evaluation polysaccharide complex flowers tansy

From flowers tansy extracted polysaccharide complex. Installed its qualitative and quantitative composition, have developed a technique standardizing the content of reducing sugars. By thin layer chromatography and high pressure liquid chromatography after acid hydrolysis installed monosaccharide composition: glucose, xylose, arabinose, galactose and mannose. It is proved that the polysaccharide has a high content of uronic acid, which allows it to include the class of pectin. The investigation of gastroprotective activity of polysaccharide in the prophylactic administration at model destruction of the gastric mucosa to indomethacin. Introduction polysaccharide prevents various types of erosive and ulcerative destruction. According to anti-ulcer activity of the drug is superior to ranitidine and comparable to omeprazol

Clinical Signs and Medical History as Predictors of Enalapril-Associated Dry Cough in Cardiovascular Patients

Angiotensin-converting enzyme inhibitors (ACEIs) are among the most prescribed and effective medicinal products for the treatment of several cardiovascular diseases. According to a number of studies, 30% of patients taking ACEIs develop adverse drug reactions (ADRs), and treatment discontinuation is often required as a result. The most common ADR associated with ACEIs is a dry (non-productive) cough. Nevertheless, the clinical signs and medical history predictive of this ADR in cardiovascular patients are still understudied.The aim of the study was to analyse the clinical signs and medical history predictive of cough in patients with cardiovascular conditions treated with enalapril.Materials and methods. The study was carried out in 2019–2022 and enrolled 224 patients with essential hypertension (grades 2 and 3) treated with enalapril at a dose of 10–20 mg/day. The patients were assigned to 2 groups: Group 1 included 113 patients with enalapril-associated cough, while Group 2 (control group) comprised 104 patients without this ADR. At screening, all the patients underwent a general examination and a check of their allergy and medication history. Using the data obtained, the authors analysed the association of the clinical signs and medical history with the ADR of interest (dry cough).Results. In contrast to the control group, the group with ACEI-associated dry cough included more patients with a history of drug-induced toxicoderma (OR=5.639, CI 2.234–14.236, χ2=15.845, and p<0.001) or type 2 diabetes mellitus (OR=3.409, CI 1.461–7.953, χ2=8.7472, and p<0.01), a family history of bronchial asthma (OR=4.141, CI 2.066–8.299, χ2=17.417, and p<0.001), and a close family history of severe allergic reactions (OR=3.714, CI 1.720– 8.018, χ2=12.137, and p<0.001).Conclusions. A family history of allergy increases the probability of dry cough in patients taking ACEIs. In order to improve the safety of ACEI therapy, patients with cardiovascular conditions should be asked more detailed questions about their personal or first-degree family history of allergy

The prevalence of serological markers of viral hepatitis among labor migrants arriving in the Russian Federation

Aim. To determine of the prevalence of viral hepatitis A, E, B, C and D markers in migrant workers.Materials and methods. Blood serum samples from 1,333 migrant workers recently arrived in Russia from Uzbekistan (n = 464), Tajikistan (n = 415), Ukraine (n = 308) and Moldova (n = 146) were analyzed. Anti-HAV IgG, anti-HEV IgM and IgG, HBsAg, anti-HBV and anti-HCV were tested using commercial ELISA tests.Results. The frequency of HBsAg detection was significantly higher among migrants from Tajikistan and Uzbekistan (5,3% and 5,2%, respectively) compared to migrants from Ukraine (1,0%) and Moldova (3,4%). No anti-HDV was detected in any positive HBsAg sample. The rate of anti-HCV detection was high regardless of the country of origin: 4,5% (Uzbekistan), 4.8% (Tajikistan), 3,9% (Ukraine), 4,8% (Moldova). Anti-HEV IgG was significantly higher in migrants from Uzbekistan and Tajikistan compared to those from Ukraine and Moldova (25,4% and 43,1%, vs. 7,8% and 12,3%, respectively, p <0,05). Anti-HEV IgM, indicative of current or recent infection, was detected in migrants from Uzbekistan, Tajikistan, Ukraine and Moldova with similar frequency – 3,9%, 7,8%, 5,8% and 6,8%, respectively. AntiHAV IgG positivity rate was significantly lower in migrants from Ukraine compared to those from Moldova, Uzbekistan and Tajikistan (70,1% versus 91,8%, 98,7%, 99,8%, respectively, p <0,05).Conclusion. The high prevalence of hepatitis B and C serologic markers in labor migrants, as well as anti-HEV IgM, suggests a high probability of the importation of HCV, HBV and HEV in the Russian Federation. Thus, inclusion of hepatitis B, C and E testing into routine screening of labor migrants might be beneficial

Efficiency of treatment of laryngopharyngeal reflux with proton pump inhibitors depending on the <i>CYP2C19</i> polymorphism

Introduction. A treatment for LFR for many years, the superiority of PPIs over placebos is still controversial. Of particular clinical importance is the metabolic rate of PPIs in hepatocytes using the cytochrome P450 system with the participation of the isoenzyme CYP2C19 and partially CYP3A4Аim. We set a goal to study the efficacy of omeprazole 20 mg in the treatment of LFR symptoms without esophageal syndrome in patients with gastroesophageal reflux (GERD), depending on the polymorphism of the CYP2C19 genotype.Мaterials and мethods. After the exclusion criteria, 100 people took part in the study, 94 people completed the study.Results. According to the results, 26.6% of patients in the study group (residents of the Moscow region) with LFR symptoms without esophageal syndrome belong to fast metabolizers of CYP2C19, 4.2% to ultrafast metabolizers, 52.1% to normal metabolizers, 16% to intermediate metabolizers and 1.1% to slow CYP2C19.Conclusions. In patients with a rapid metabolism, within 1 month after discontinuation of omeprazole, it is necessary to increase the amount of omeprazole 20 mg intake up to 2 times a day in the morning and in the evening and reduce the duration of treatment to 6 weeks

Анализ структуры бактериемий и чувствительности к антибиотикам микроорганизмов, выделенных в отделениях реанимации и интенсивной терапии в скоропомощном стационаре в период с 2003 по 2021 г.: ретроспективное наблюдательное исследование

АКТУАЛЬНОСТЬ: Создание протоколов эффективной эмпирической антимикробной терапии невозможно без анализа актуальных данных чувствительности к антибиотикам. ЦЕЛЬ ИССЛЕДОВАНИЯ: Анализ изменения этиологической значимости ведущих возбудителей бактериемий в отделении реанимации и интенсивной терапии (ОРИТ) в период с 2003 по 2021 г. и их чувствительности к антибиотикам; изучение типов карбапенемаз у наиболее актуальных возбудителей — Klebsiella pneumoniae и Acinetobacter baumannii. МАТЕРИАЛЫ И МЕТОДЫ: В анализ были включены все клинически значимые микроорганизмы, выделенные из крови пациентов, находившихся ОРИТ общего профиля, рассчитанном на 12 коек, в скоропомощном стационаре г. Москвы в период с 2003 по 2021 г. Идентификацию микроорганизмов и определение чувствительности к антибиотикам проводили в автоматическом анализаторе PHOENIX и стандартизированным диско-диффузионным методом. Детекцию карбапенемаз осуществляли методом полимеразной цепной реакции. РЕЗУЛЬТАТЫ: Исследовано 17 034 образца крови, из которых было выделено 6372 микроорганизма. В указанный период доля грамотрицательных микроорганизмов увеличилась с 21,0 до 52,8 %, преимущественно за счет K. pneumoniae (1,0–24,5 %) и A. baumannii (0–9,1 %). Устойчивость этих микроорганизмов к карбапенемам с 2008 по 2021 г. значительно увеличилась: K. pneumoniae — с 2,3 до 70,3 %, A. baumannii — с 7,5 до 99,5 %. Штаммы K. pneumoniae продуцировали следующие типы карбапенемаз: OXA-48 (73,8 %), KPC (6,2 %), NDM (1,5 %), NDM + OXA-48 (15,4 %), KPC + OXA-48 (3,1 %). Все штаммы A. baumannii продуцировали карбапенемазы OXA-40. Продуценты карбапенемазы OXA-48 были устойчивы к колистину и тигециклину в 14,6 и 44,8 % случаев соответственно, к цефтазидиму/авибактаму — в 4,2 % случаев. ВЫВОДЫ: Увеличение уровня антимикробной резистентности в последние годы среди доминирующих в бактериемии грамотрицательных микроорганизмов является очень значимой проблемой в ОРИТ. Большинство штаммов K. pneumoniae характеризуются множественной резистентностью и около 10 % — экстремальной, или панрезистентностью. Практически все штаммы A. baumannii относятся к категории экстремально резистентных

ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ КАРБАМИДА С ИНГИБИТОРОМ УРЕАЗЫ НА КАРТОФЕЛЕ

In the he article are presented the research result on effectiveness of application new form of urea on potato. New urea form is urea with urease inhibitors. This fertilities type allow to reduce losses of nitrogen in ammonium form. Field experiment was carried out in 2017 on solonetc light chestnut soils with heavy granulometric compound in the conditions of the Volgograd region in the experimental polygon of the lower Volga agricultural research Institute – branch of Federal state budgetary scientific institution "Federal scientific center for agro-ecology, integrated land reclamation and protective afforestation wounds". As an object of research used potatoes mid-early table varieties Nevsky. The advantage of a new fertilizer form is the yield increase and improvement of tubers quality. Urea UTEC application leads to formation bigger and uniform tuber size. The use of urea UTEC provide the potato yield of 56.4 t/ha, with marketable tubers fraction up to 54.82 t/ha, the total yield increase to the control – 35.6%, in monetary terms this amounted to 245887.0 RUB/ha additional profit. Under these conditions, was obtained lowest amount of non-marketable yield – 0.16 t/ha, which is 2.65 times less than in the control variant. The advantage of urea UTEC application in comparison with ammonium nitrate was the increase in the yield of marketable potatoes by 5.1 t/ha and an additional profit up to 76.8 thousand rubles/ha. The Assessment of the potato quality showed that the best treatment was also the treatment with UTEC urea, the starch content in tubers was 9.22%. Note that almost the same value of the indicator in the variant with the use of urea (option 2), and the lowest starch content was noted when using ammonium nitrate – 9.05%.В статье приведены результаты исследований по эффективности карбамида с добавкой ингибитора уреазы – UTEC на посадках картофеля. Полевой опыт был заложен в 2017 году на солонцеватой светло-каштановой почве тяжелого гранулометрического состава в условиях Волгоградской области на экспериментальном полигоне Нижне-Волжского НИИСХ – филиал ФГБНУ «Федеральный научный центр агроэкологии, комплексных мелиораций и защитного лесоразведения РАН». В качестве объекта исследований использовали картофель среднеранний столовый сорта Невский. Выявлено преимущество новой формы удобрения в повышении урожая клубней и улучшения их качества. При использовании карбамида UTEC формируется урожай клубней с наилучшим соотношением фракций. Применение карбамида UTEC обеспечило получение урожайности картофеля 56,4 т/га, масса товарных клубней составила 54,82 т/га, общая прибавка урожая к контролю – 35,6%, в денежном выражении это составило 245887,0 руб/га дополнительной прибыли. В этих условиях отмечен наименьший выход фуражной продукции 0,16 т/га, что в 2,65 раз меньше, чем в контрольном варианте. Выявлено преимущество применения карбамида UTEC в сравнении с аммиачной селитрой, получено увеличение урожая товарного картофеля на 5,1 т/га и дополнительной прибыли 76,8 тыс. руб/га. Оценка качества картофеля показала, что наилучшим вариантом был также вариант с использованием карбамида UTEC, содержание крахмала в клубнях составило 9,22%. Отметим, что практически такая же величина показателя в варианте с применением карбамида (вариант 2), а наименьшее содержание крахмала отмечено при использовании аммиачной селитры – 9,05%

Effect of ABCB1 Gene Carriage and Drug-Drug Interactions on Apixaban and Rivaroxaban Pharmacokinetics and Clinical Outcomes in Patients with Atrial Fibrillation and Deep Vein Thrombosis

Aim. To investigate the effect of ABCB1 gene carriage and interdrug interactions on apixaban pharmacokinetics and clinical outcomes in patients with atrial fibrillation and deep vein thrombosis.Material and methods. Patients hospitalized at Yudin State Clinical Hospital participated in the study. A total of 92 patients (50 patients received apixaban and 42 – rivaroxaban) with non-valvular atrial fibrillation and deep vein thrombosis were included. Genotyping was performed by real-time polymerase chain reaction. Direct oral anticoagulants concentrations were measured using an electrospray ionization mass spectrometer in positive ionization mode.Results. In our study we found that in patients carrying the CT+TT ABCB1 (rs4148738) C&gt;T genotype encoding the carrier protein (P-gp), the plasma concentration of rivaroxaban was statistically significantly higher p= 0.026. In addition, we found that patients taking apixaban together with a CYP3A4/P-gp inhibitor were 3.5 times more likely to have hemorrhagic complications than those without inhibitors p = 0.004.Conclusion. Our study revealed that the plasma concentration of rivaroxaban was higher in patients carrying the ABCB1 (rs4148738) C&gt;T polymorphism T allele. And patients taking apixaban together with CYP3A4/P-gp inhibitor had higher risk of hemorrhagic complications in comparison with patients not taking such drugs. Further studies are needed on the influence of pharmacogenetics and pharmacokinetics on the safety and efficacy profile of apixaban and rivaroxaban, taking into account the trend of systemic approach to optimization of anticoagulant therapy of direct oral anticoagulants based on pharmacokinetic, pharmacogenetic biomarkers

Риск развития послеоперационных венозных тромбоэмболических осложнений у пожилых больных

Aim. To evaluate venous thromboembolic complication risk in elderly patients admitted to trauma and orthopedics departments, prevalence of comorbidity, its impact on the risk of thrombotic events, efficacy and safety of prophylactic anticoagulant therapy.Materials and methods. Authors performed a retrospective analysis of medical records of 120 patients aged 65 years and over. Analyzed data included demographic data, main diagnosis, co-existing pathology according to International Classification of Diseases X, type of surgery and anticoagulant prophylaxis. Risk of development of venous thromboembolic complications was assessed by the Caprini scale. Potential drug-drug interactions were checked using Drug Interaction Checker available, created by company Cerner Multum according to FDA recommendations.Results. The most frequent causes of hospitalization were destructive large joint arthritis (40%) and fractures of lower extremities (21.7%). Surgeries with an average duration of 87 ± 31.4 min were performed in 85% of patients, of which major surgery – 68.6%, minor – 31.4%. Comorbidity was detected in 90% of elderly patients admitted to hospital because of pathology of the musculoskeletal system. Pathology of musculoskeletal system most often was combined with cardiovascular diseases (81.7%). A moderate risk of venous thromboembolic complications was detected in 10% patients, high risk in 75%. Anticoagulant prophylaxis with a direct factor Xa inhibitor rivaroxaban or low-molecular weight heparin enoxaparine sodium was performed in 80% of patients.Conclusion. The study demonstrated that 75% of elderly patients with pathology of the musculoskeletal system are at high risk for the development of venous thromboembolic complications. The main risk factors include the type and duration of surgery and comorbidity.Цель исследования – оценить риск развития венозных тромбоэмболических осложнений у пожилых больных травматологического и ортопедического профиля, изучить распространенность и структуру коморбидности, ее влияние на риск тромбообразования, оценить эффективность и безопасность терапии антикоагулянтами.Материалы и методы. Проведен ретроспективный анализ историй болезни 120 пациентов старше 65 лет и 64 пациентов моложе 65 лет, поступивших в отделение травматологии и ортопедии многопрофильного стационара. Учитывали демографические данные, основной диагноз, сопутствующие заболевания согласно рубрикам Международной классификации болезней Х пересмотра, характер оперативного вмешательства и методы профилактики венозных тромбоэмболических осложнений. Риск развития тромбозов оценивали по шкале Caprini, возможные лекарственные взаимодействия – с помощью интернет-ресурса Drug Interaction Checker на сайте www.drugs.com.Результаты. Наиболее частыми причинами госпитализации пожилых больных являлись артрозы крупных суставов (40%), переломы пояснично-крестцового отдела позвоночника, бедренной кости и костей таза (21,7%). Оперативные вмешательства со средней продолжительностью (87 ± 31,4) мин выполнены 85% больным: большие операции – 58,3%, малые – 26,7%. Коморбидные состояния диагностировали у 90% больных. Чаще всего болезни костно-мышечной системы сочетались с болезнями системы крово- обращения (81,7%). Высокий риск венозных тромбоэмболических осложнений выявлен у 75% пациентов, умеренный – у 10%. Для фармакопрофилактики тромбозов 80% пациентам назначали прямой ингибитор фактора Ха ривароксабан или низкомолекулярный гепарин эноксапарин натрия. Пациентов моложе 65 лет госпитализировали по поводу артрозов и переломов, а также для коррекции внутрисуставных повреждений колена. Операции средней продолжительностью (58,4 ± 25,8) мин потребовались 51,6% больным: большие операции – 32,8%, малые – 18,8%. Коморбидные заболевания диагностировали у 73,4%, в основном болезни системы кровообращения. Высокий риск развития венозных тромбоэмболических осложнений выявлен у 29,7%, умеренный – у 50,0%; 73% больных принимали эноксапарин натрия или ривароксабан в течение (8,6 ± 4,2) дней. Заключение. У 85% пожилых пациентов с патологией костно-мышечной системы возрастает риск развития венозных тромбоэмболических осложнений. Основными факторами риска являются характер и длительность оперативного вмешательства и коморбидность

The rs11385942 and rs657152 variants are not associated with COVID-19 severity and outcomes in patients treated with favipiravir and remdesivir

Background. There is a mounting evidence in the scientific literature that susceptibility to SARS-CoV-2 infection could vary. The severity of COVID-19 symptoms can  range from asymptomatic to severe respiratory failure, requiring prolonged artificial ventilation. The underlying causes of this range of clinical manifestations remain unclear. Identification of the risk factors that may cause this variation in clinical symptoms is important for identifying the most susceptible populations at highest risk. This should help improve prevention measures, reduce hospitalizations, and decrease the mortality rate of the disease. Previously, an association has been found between the severity of COVID-19 and the genetic markers rs11385942 G&gt;GA and rs657152 A&gt;C.The aim. To assess the impact of carrying polymorphic markers rs11385942 G&gt;GA and rs657152 A&gt;C on the severity of COVID-19 in patients undergoing specific therapy. Materials and methods. A total of 240 patients hospitalized with a coronavirus infection were included in the study. All patients received therapy with favipiravir or remdesivir. The presence of the rs11385942 G&gt;GA and rs657152 A&gt;C variants was determined in all patients. The study compared the length of hospital stays, frequency of patient transfers to the intensive care unit (ICU), and frequency of clinical outcomes (recovery or death) among carriers of allelic variants of the markers under investigation.Results. There were no significant associations between the carriage of variants rs11385942 G&gt;GA and rs657152 A&gt;C and the duration of patients’ hospitalization, frequency of patient transfers to the ICU, and patient outcomes.Conclusion. The carriage of rs11385942 G&gt;GA and rs657152 A&gt;C variants did not affect the severity or type of clinical outcomes in patients with COVID-19

Drug-Induced Atrial Fibrillation / Atrial Flutter

Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR