Therapeutic Drug Monitoring for Evaluation of the Efficacy and Safety of Vancomycin in Patients with Orthopaedic Infections

Vancomycin is a drug of choice for the infections caused by methicillin-resistant strains of staphylococci. Its use requires individualised dosing and renal function monitoring.The aim of the study was to evaluate, using therapeutic drug monitoring (TDM), the frequency of reaching target trough serum concentrations (TSCs) and the frequency of renal function impairment in orthopaedic infection patients receiving vancomycin therapy.Materials and methods: the authors carried out a retrospective analysis of vancomycin TSC test results of 457 patients admitted to a purulent osteology department in 2019–2021. The results were grouped according to the number of TSC determination performed as part of TDM (tests 1, 2, and 3). Each of the 3 groups was further divided into 4 subgroups according to the TSCs of vancomycin: ≤9.9 µg/ml (extremely low), 10–14.9 µg/ml (recommended for mild infections), 15–19.9 µg/ml (recommended for bone and joint infections), ≥20 µg/ml (potentially toxic). The results obtained in each group were analysed separately.Results: according to the 1st TDM test, only 9.6% of patients achieved the TSCs of vancomycin recommended for bone and joint infections. Extremely low TSCs, insufficient for treatment of the infections, were found in 64.8% of patients. According to the 2nd and 3rd TSC determinations, dose corrections decreased the percentage of patients with extremely low TSCs to 49.9% and 41.2%, respectively. Potentially toxic TSCs of vancomycin were detected in 48 (10.5%) patients, but renal dysfunction was observed only in 8 (1.75%) of them. The authors exemplify the use of TDM to control the efficacy and safety of vancomycin in patients with pronounced signs of renal function impairment by two clinical cases.Conclusion: with a standard dose of vancomycin, the concentrations recommended for bone and joint infections were reached only in every tenth patient. There was a large percentage of patients with extremely low serum concentrations of the medicinal product (64.8%), but it decreased after dose adjustments. Monitoring of vancomycin concentrations allows for individualised dosing, efficacy control and significant reduction of the risk of adverse kidney reactions

Socio-economic burden of atrial fibrillation in the Russian Federation: dynamics over 12 years

Relevance. Diseases of the cardiovascular system remain one of the main causes of death worldwide. The incidence of cardiovascular and circulatory diseases increased by one third between 1990 and 2010. The prevalence of atrial fibrillation (AF) ranges from 2.5–3.5% in the general population of patients to 9–17% in individuals aged 80 years and older.The aim of the study is to analyze the costs of the Russian healthcare system for various types of treatment of atrial fibrillation.Materials and methods. The assessment of the present economic burden of AF included an assessment of such direct costs as inpatient treatment, outpatient visits, treatment in a day hospital, medical support, treatment of complications of AF.Results. The socio-economic burden of AF in the Russian Federation for 2022 without surgical treatment amounted to 196.44 billion rubles per year, compared to 2010 and 2018, costs increased by 77% and 73%, respectively

EFFECT OF ADDITIONAL HYDROGEN ALLOYING ON STRUCTURE AND PHASE COMPOSITION FORMATION IN Ti2AlNb BASED ALLOY

В работе проводилось исследование влияния легирования водородом на структуру и фазовый состав сплава на основе интерметаллида Ti2AlNb при различных температурах нагрева. Установлены температурные интервалы существования фазовых областей в орто-сплаве.Effect of hydrogen alloying on structure and phase composition in Ti2AlNb based alloy is studied at different heating temperatures. Temperature ranges of the phase regions in the orthorhombic alloy are determined.Работа выполнена на оборудовании ресурсного центра коллективного пользования «Авиационно-космические материалы и технологии» МАИ

Approaches to Assessing the Safety of Medicines during the COVID-19 Pandemic Using the Example of Azithromycin

Most of the medicines used to treat the novel coronavirus infection (COVID-19) are either approved under an accelerated procedure or not approved for the indication. Consequently, their safety requires special attention.The aim of the study was to review methodological approaches to collecting data on the safety of medicines, using COVID-19 treatment regimens involving azithromycin as a case study.Materials and methods: PubMed® (MEDLINE), Scopus, eLIBRARY, and Cyberleninka databases were searched for publications on azithromycin as part of combination therapy for COVID-19 in 2020–2021. Search queries included names of the medicinal product or its pharmacotherapeutic group and words describing adverse drug reactions (ADRs) during treatment.Results: the analysis included 7 publications presenting the results of studies covering the use of azithromycin as part of COVID-19 combination therapy in more than 4000 patients. Most commonly, the patients receiving COVID-19 therapy including azithromycin developed cardiovascular ADRs (up to 30% of azithromycin prescription cases). In 3 of the analysed publications, safety information was collected through spontaneous reporting and active identification based on the findings of laboratory and instrumental investigations performed during the clinical studies; in other 3, only spontaneous reports were used; and in the last one, ADR database information was studied.Conclusion: currently, information on ADRs associated with the use of medicines is mainly gathered via spontaneous reporting. Direct sourcing of information on personal experiences with a certain product from patients, among other means through social media analysis, opens a promising direction towards the improvement of existing approaches to collecting safety data

Моделирование процесса нанесения покрытия на микросферы

The aim of this paper was to investigate the process of coating microspheres with Kollicoat MAE 100P film. In this study the influence of the main technological parameters of the coating process on the properties of coated microspheres was investigated. A mathematical model was developed using statistical methods of processing experimental data. This model allows calculating quantitatively the properties of coated microspheres on the basis of coating process parameters.Работа посвящена исследованию процесса нанесения пленочного покрытия Kollicoat MAE 100P на микросферы. В ходе данной работы исследовано влияние основных технологических параметров проведения процесса на характеристики покрытых микросфер. С помощью статистических методов обработки экспериментальных данных была получена математическая модель, позволяющая количественно определить свойства микросфер, исходя из технологических параметров процесса нанесения покрытия

INFLUENCE OF ERBIUM QUANTITY ON LUMINESCENCE PROPERTIES OF ER-DOPED GADOLINIUM OXIDE

The study focuses on the characterization of the gadolinium oxide and Er - doped gadolinium oxide powders prepared by coprecipitation of hydroxides. The specific surface of gadolinium oxide, the average size and oxides phase were determined. It was found that Er – doping improves luminescence

Исследование и оптимизация процесса инкапсулирования лекарственного вещества в полимерную оболочку в аппарате псевдоожиженного слоя

The drug encapsulation by enteric film fluid-bed coating has been investigated. Influence of each operation parameter on product quality has been estimated and optimal conditions included film thickness have been determined. The model drug release kinetics of encapsulation product has been studied.Исследован процесс инкапсулирования модельного лекарственного вещества в кишечнорастворимую полимерную оболочку в аппарате с псевдоожиженным слоем. Выявлен вклад каждого из параметров процесса в качество получаемого продукта, определены оптимальные условия для нанесения пленки, исследована кинетика высвобождения инкапсулированного препарата

SYNTHESIS, CRYSTAL STRUCTURE AND LUMINESCENT PROPERTIES OF CUBIC AND MONOCLINIC PHASES OF GADOLINIUM OXIDE

Работа выполнена при финансовой поддержке Минобрнауки РФ в рамках государственного задания №3.1485.2017/ПЧ

Влияние солегирования Ca2+ и Zr4+ на оптические характеристики монокристаллов Gd3Al2Ga3O12 : Ce

Scintillation materials that can convert absorbed high-energy particles into photons of visible radiation find many applications, in particular in modern methods of medical imaging. Gd3Al2Ga3O12 : Ce is promising single crystal for use as a detecting crystal element of the positron emission tomographs due to its unique properties: high density, high light output, radiation hardness, etc. However, its scintillation kinetics currently limit the use of this crystal. Changing of these kinetics by codoping becomes a priority task, which is considered in many papers. The literature data analysis showed that the optical characteristics of such codoped crystals were not well enough studied or were not investigated at all. In this regard, the spectral dependences of transmission, absorption and reflection are measured using optical spectroscopy for Gd3Al2Ga3O12:Ce, Gd3Al2Ga3O12 : Ce,Ca and Gd3Al2Ga3O12 : Ce,Zr. Dispersion dependences of refractive in dices are obtained by approximating the refractive indices measured using the Brewster method. The approximation was carried out using the Cauchy equation. The material constants of this equation are estimated.Сцинтилляционные материалы, способные преобразовывать поглощенные высокоэнергетические частицы в фотоны видимого излучения, находят множество областей применения, в частности в современных методах медицинской визуализации. Среди кислородсодержащих сцинтилляторов перспективным для использования в качестве детектирующего кристаллического элемента позитронно-эмиссионного томографа является Gd3Al2Ga3O12 : Ce за счет своих уникальных свойств: высокой плотности, высокого значения световыхода, радиационной стойкости и т. д. Однако его кинетические характеристики в настоящее время ограничивают использование кристалла для этих целей. Попытки изменения временных характеристик нарастания и спада люминесценции путем введения дополнительных примесей стали приоритетной задачей, которая рассматривается во многих работах. Анализ литературных данных показал, что оптические характеристики таких солегированных кристаллов исследованы недостаточно хорошо или вовсе не исследованы. В работе методами оптической спектроскопии в диапазоне длин волн 200—2200 нм исследованы кристаллы Gd3Al2Ga3O12 : Ce, солегированные Ca2+ и Zr4+. Измерены спектральные зависимости пропускания, поглощения и отражения, а также показатели преломления. Дисперсионные зависимости получены путем аппроксимации экспериментально измеренных показателей преломления методом Брюстера. Аппроксимацию проводили с использованием уравнения Коши. Оценены материальные константы этих уравнений для каждого из солегированных кристаллов