Congenital heart defects in children of Chelyabinsk: regional aspects of the 20-year monitoring

The problem of congenital heart defects (CHD) in children, it is determined not only by a severe course, early development of disability, high-cost methods of treatment, but also by regional peculiarities. On the basis of the register of CHD in children in Chelyabinsk, the monitoring of prevalence and morbidity indicators from 2000 to 2020, calculated per 1000 children’s population, taking into account its average number, was carried out. During the analyzed period, there was an almost 3-fold increase in the total number of children with CHD: from 691 people in 2000 to 1903 people in 2020. A stable growth of this pathology was revealed in the first year of their life: 3.9 % in 2000, 11.0 % in 2012, 12.3 % in 2020.The prevalence and primary incidence of CHD over the past 20 years have been characterized by a steady increase: from3.68 and 0.72 in 2000 to 8.04 and 1.48 in 2020, respectively. Septal defects and open ductus arteriosus occupy leading positions in the structure of all CHD, accounting for 61 % in 2000 and 74 % in 2020. An increase in the number of early surgical interventions, especially during the first year of a child’s life (from 11 % in 2000 up to 31 % in 2020) is associated with a decrease in disability (from 15.7 % in 2000 to 4.8 % in 2020). Monitoring of registry data, especially at the regional level, can be a useful mechanism for assessing the situation of CHD, monitoring the effectiveness of both conservative and cardiac surgical treatment

Морфолого-анатомічне вивчення листя Rhododendron luteum sweet

Topicality. Rhododendrons are one of the most popular plants that are widely cultivated in most European countries as ornamental, essential oil, honey and insecticidal plants. Rhododendron luteum Sweet is a polymorphic species found in Ukraine as a wild-growing and ornamental plant. The chemical composition of yellow rhododendron is represented mainly by essential oils, flavonoids, hydroxycinnamic and organic acids, and triterpene and coumarin substances. Leaves are widely used in folk medicine as a diuretic, diaphoretic, astringent, wound healing, anti-inflammatory and analgesic. As a result of the study of the morphological and anatomical structure of the yellow rhododendron leaves, its structurally foliar characters under the conditions of this ecotype growth in Ukraine were studied according to a preliminary analysis of published data. Our studies were carried out with the aim of using macroscopic and microscopic traits of leaves of this species to standardize medicinal plant materials and develop quality control methods.Aim. To identify the leaves of Rhododendron luteum (L.) Sweet by macro and microscopic characteristics. Set the main diagnostic signs of leaves.Materials and methods. The objects of the study were samples of yellow rhododendron leaves collected during the mass flowering period. Microscopicstudies were performed on raw materials fixed in a mixture of  alcohol-glycerolwater (1 : 1 : 1). We used an OLYMPUS Lens FE-140 camera, an MBI-6 microscope, and a Biola-M microscope.Results and discussion. The main morphological and anatomical signs of yellow rhododendron leaves were determined. Macroscopic features include simple short-leaved leaves with a leathery, hollow leaf blade, with a solid edge, a pointed tip, a wedge-shaped base, cirrus venation; microscopic is dorsoventrally type of leaf blade structure. The cells of the upper epidermis are large, thin-walled, sinuous, without stomata, covered with a thick layer of cutin; cells of the lower epidermis are slightly tortuous; stomatal apparatus of the paracitic type, typical of the abaxial epiderm, covering and glandular trichomes are present. Ferruginous club-shaped emergenes on a multicellular stand, the cells of which accumulate a yellowish-brown secretion, the secreting head is oval-cylindrical, multicellular, with dark contents. Covering hairs is of three varieties: 1-2-cell, long, curled, spiky prevail, straight-walled hairs with an expanded base and long, straight-walled, thin-walled hairs are less common. The cut is round-triangular in cross section, the angular collenchyma is underlying the epidermis; in parenchymal cells, frequent crystals of calcium oxalate - druses and prismatic crystals.Conclusions. The results of macroscopic and microscopic study characteristics of yellow rhododendron leaves will be used to standardize medicinal plant materials and develop quality control methods.Актуальность. Рододендроны являются одними из популярнейших растений, которые широко культивируются в большинстве стран Европы как декоративные, эфиромасличные, медоносные и инсектицидные растения. Rhododendron luteum Sweet – полиморфный вид, который встречается в Украине как дикорастущее и декоративное растение. Химический состав рододендрона желтого представлен, преимущественно, эфирными маслами, флавоноидами, гидроксикоричными и органическими кислотами, веществами тритерпеновой и кумариновой природы. Листья широко используют в народной медицине как мочегонное, потогонное, вяжущее, ранозаживляющее, противовоспалительное и болеутоляющее средство. Предварительный анализ литературных данных показал, что в результате исследования морфолого-анатомического строения листьев рододендрона желтого изучены его структурно-фолиарные признаки в условиях произрастания этого экотипа в Украине. Наши исследования проводились с целью использования макроскопических и микроскопических признаков листьев этого вида для стандартизации лекарственного растительного сырья и разработки методики контроля качества.Цель работы. Провести идентификацию листьев Rhododendron luteum (L.) Sweet по макро- и микроскопическим признакам. Установить основные диагностические признаки листьев.Материалы и методы. Объектами исследования были образцы листьев рододендрона желтого, собранных в период массового цветения. Микроскопические исследования проводили на сырье, фиксированном в смеси спирт-глицерин-вода (1 : 1 : 1). В работе использовали фотоаппарат OLYMPUS Lens FE-140, микроскоп МБИ-6, микроскоп Биола-М.Результаты и их обсуждение. Определены основные морфолого-анатомические признаки листьев рододендрона желтого. К макроскопическим признакам отнесены простые короткочерешковые листья с кожистой, целостной листовой пластинкой с цельным краем, заостренной верхушкой, клиновидной основой, перистым жилкованием; к микроскопическим – дорзовентральный тип строения листовой пластинки. Клетки верхней эпидермы крупные, тонкостенные, извилистостенные, без устьиц, покрытые толстым слоем кутина; клетки нижней эпидермы слабо извилистостенные; устьичный аппарат парацитного типа, типичный для абаксиальной эпидермы, присутствуют кроющие и железистые трихомы. Железистые булавовидные эмергенцы на многоклеточной подставке, клетки которой накапливают желтовато-коричневый секрет, секретирующая головка овально-цилиндрическая, многоклеточная с темным содержимым. Кроющие волоски трех разновидностей: преобладают 1-2-клеточные, длинные, загнутые, остроконечные, реже встречаются прямостенные волоски с расширенной основой и длинные, прямостенные и тонкостенные. Черенок округло-треугольный на поперечном разрезе, эпидерму подстилает угловая колленхима; в паренхимных клетках частые кристаллы оксалата кальция – друзы и призматические кристаллы.Выводы. Полученные результаты изучения макроскопических и микроскопических признаков листьев рододендрона желтого будут использованы для стандартизации лекарственного растительного сырья и разработки методики контроля качества.Актуальність. Рододендрони є одними з найпопулярніших рослин, що широко культивуються у більшості країн Європи як декоративні, ефіроолійні, медоносні та інсектицидні рослини. Rhododendron luteum Sweet – поліморфний вид, який зустрічається в Україні як дикоросла та декоративна рослина. Хімічний склад рододендрону жовтого представлений переважно ефірними оліями, флавоноїдами, гідроксикоричними та органічними кислотами, речовинами тритерпенової та кумаринової природи. Листки широко використовують у народній медицині як сечогінний, потогінний, в`яжучий, ранозагоювальний, протизапальний та болетамувальний засіб. Попередній аналіз літературних даних показав, що в результаті вивчення морфолого-анатомічної будови листків рододендрону жовтого виявлені його структурно-фоліарні ознаки щодо умов зростання цього екотипу в Україні. Наші дослідження проводилися з метою використання макроскопічних та мікроскопічних ознак листків цього виду для стандартизації лікарської рослинної сировини та розробки методики контролю якості.Мета роботи. Провести ідентифікацію листків Rhododendron luteum (L.) Sweet за макро- та мікроскопічними ознаками. Встановити основні діагностичні ознаки листя.Матеріали та методи. Об’єктами дослідження були зразки листків рододендрону жовтого, зібраних у період масового цвітіння. Мікроскопічні дослідження проводили на сировині, фіксованій у суміші спирт-гліцерин-вода (1 : 1 : 1). У роботі використовували фотоапарат OLYMPUS Lens FE-140, мікроскоп МБИ-6, мікроскоп БІОЛАМ-М.Результати та їх обговорення. Визначені основні морфолого-анатомічні ознаки листків рододендрону жовтого. До макроскопічних ознак віднесено – прості короткочерешкові листки з шкірястою, цілісною листковою пластинкою з цілісним краєм, загостреною верхівкою, клиноподібною основою, перистим жилкуванням; до мікроскопічних – дорзовентральний тип будови листкової пластинки; клітини верхньої епідерми великоклітинні, тонкостінні, звивистостінні без продихів, вкриті товстим шаром кутину; клітини нижньої епідерми слабко звивистостінні; продиховий апарат парацитного типу, типовий для абаксіальної епідерми, наявні криючі та залозисті трихоми. Залозисті булавоподібні емергенці на багатоклітинній підставці, клітини якої накопичують жовтувато-брунатний секрет, секретуюча головка овально-циліндрична, багатоклітинна з темним вмістом. Криючі волоски трьох різновидів: переважають 1-2-клітинні, довгі, загнуті, гострокінцеві, рідше зустрічаються прямостінні волоски з розширеною основою та довгі, прямостінні і тонкостінні. Черешок округло-трикутний на поперечному розрізі, епідерму підстеляє кутова коленхіма; в паренхімних клітинах часті кристали оксалату кальцію – друзи та призматичні кристали.Висновки. Отримані результати вивчення макроскопічних та мікроскопічних ознак листків рододендрону жовтого будуть використані для стандартизації лікарської рослинної сировини та розробки методики контролю якості

Immunological features of allergic rhinitis in combination with chronic rhinosinusitis of bacterial etiology

Rhinitis is a socially significant and widespread disease. Often, various forms of rhinitis are combined, and thus cause severe clinical manifestations, insufficient effectiveness of drug treatment, as well as difficulties in differential diagnosis. It is known that a significant number of patients have a combination of allergic rhinitis (AR) with chronic rhinosinusitis of bacterial etiology. This condition is based on a chronic multifactorial inflammatory process of the nasal mucosa, which determines the steady progression of the disease. Of interest is the study of a number of allergo-immunological parameters in nasal secretions in order to assess local inflammation and changes in mucosal immunity in allergic rhinitis in combination with chronic rhinosinusitis of bacterial etiology (AR with HRSBE). Mucosal immunity and biological mediators determine local inflammation and pathophysiological response to etiological factors in the immunopathogenesis of AR with CRSBE. The work carried out the determination of the level of cytokines: IL-4, IL-10, TGF-â1, IFNã spontaneous and induced; immunoglobulins: IgA, IgM, IgG, sIgA in nasal secretions; leukotrienes: LT C4/ D4/E4 and LTB4 in plasma and total IgE in serum in patients with AR with moderate-severity HRSBE without exacerbation. It has been shown that the leading role in the formation of the inflammatory process in AR with CRSBE belongs to cytokines: IL-4, IL-10, TGF-â; immunoglobulins: IgM, sIgA; leukotrienes: LT C4/D4/E4 and LTB4 and total IgE. Induced cytokine production largely reflects the reserve capabilities of immunocompetent cells in response to the action of a pathogenic factor. The results obtained are associated with the persistent course of allergic and infectious inflammation and the progression of the disease. Thus, cytokines: IL-4, IL-10, TGF-â1; immunoglobulins: IgM, sIgA, IgE total and LT C4/D4/E4 and LTB4 make a significant contribution to pathogenetic mechanisms, determining the clinical course of AR with CRSBE, and can serve as biological markers of the activity of the pathological process. Undoubtedly, the immune mechanisms in the combined pathological inflammatory reaction from the mucosa in AR with HRSBE are complex and multifaceted. A personalized approach to the treatment of patients with AR with CRSBE is determined by the severity and intensity of the inflammatory reaction, as well as mucosal mucosal immunity disorders. The study of the role and significance of the production of leading cytokines, immunoglobulins in nasal secretions, as well as leukotrienes and total IgE in the blood will help the doctor in determining the tactics and duration of pharmacotherapy

Comparative Pharmacoepidemiological Assessment of Antihypertensive Drugs Administration Structure in Pregnant Women in Routine Medical Practice in Kursk and Chisinau

Aim. To study the structure of antihypertensive drugs prescription in pregnant women in routine practice in Kursk and Chisinau.Material and methods. The study design was observational descriptive cross-sectional. Authors conducted a survey of doctors in medical organizations in Kursk and Chisinau in 2017-2018.Results. Respondents from Kursk and Chisinau preferred methyldopa in prescriptions of central alpha-adrenergic receptor agonists. Doctors from Chisinau used clonidine in 14.3% of cases. The leading place in the group of calcium channel blockers belonged to short-acting nifedipine. Among beta-blockers in Kursk, doctors most often prescribed bisoprolol (43.3%), metoprolol (21.7%) and nebivolol (13.3%), while in Chisinau the preference was given to metoprolol (32.1%), atenolol (19.6%) and bisoprolol (16.1%). From the group of diuretics, Kursk doctors mainly prescribed hydrochlorothiazide (10%), indapamide (6.7%); in Chisinau, indapamide was the leader (19.6%), hydrochlorothiazide was used less frequently (7,1%). From the class of alpha-blockers, prazosin occupied the leading position among respondents in Kursk, and terazosin in Chisinau.Conclusion. The priority drug classes in both regions were calcium channel blockers, central alpha-adrenergic receptor agonists and beta-blockers. A small number of not recommended drugs prescriptions have been registered. In general, the prescribed treatment corresponded to the current guidelines and protocols for the management of patients with arterial hypertension during pregnancy

Investigation of the correlation of allele polymorphism of renin-angiotensin system genes, nitric oxide synthase and folate cycle with the severity of ischemic stroke

Aim. To study the frequency of polymorphic gene variants encoding proteins of renin-angiotensin system [AGT Thr174Met (rs 4762), AGT Met235Thr (rs699), AGTR1 A1166C (rs5186)], endothelial factors [NOS3 C786T (rs2070744)], and folate cycle enzymes [MTHFR C677T (rs1801133)] in patients with various ischemic stroke severity. Methods. 98 patients with ischemic stroke verified by magnetic resonance imaging and computed tomography scan of the brain, were examined. The severity of stroke was assessed by National Institutes of Health Stroke Scale. The allelic variants of genes were typified by polymerase chain reaction with the detection of amplification products in the «real time» mode. Results. The analysis of genetic polymorphism frequency of renin-angiotensin system did not reveal statistically significant differences in the study groups. The polymorphism of NOSC786T gene in the study was also not associated with the severity of ischemic stroke. Among the studied polymorphic variants, only the C677T polymorphism of MTHFR gene was revealed to be reliably associated with severe course of acute cerebral ischemia. Conclusion. C677T polymorphism of MTHFR gene is reliably associated with severe course of acute cerebral ischemia; carriage of 677T allele of MTHFR gene in the studied category of patients can cause an increased level of homocysteine and have an adverse effect on the course of acute cerebral ischemia

STUDIES ON THE ROLE OF CYTOKINES POLYMORPHISM IN PATHOGENESIS OF CHRONIC URTICARIA

Fifty patients with chronic autoimmune urticaria (CAU) and forty-eight patients with chronic idiopathic urticaria (CIU) have been examined. Blood serum contents of IL-4, IL-10 and IL-17A, spontaneous and induced cytokine production in blood cells, as well as polymorphism of IL-4 (C-589T), IL-10 (G-1082A), IL-17A (G-197A) cytokine genes has been studied. No differences have been detected when studying IL-4 levels, depending on genetic variants of IL-4 gene in patients with CAU and CIU. Increased IL-10 amounts in patients with CIU still did not show any correlations with IL-10 genotype (G-1082A). Increased IL-17A levels in patients with CAU were associated with homozygous genotype of AA in comparison to control group, and with heterozygous GA genotype, in comparison to CIU group. The revealed differences of cytokines` genes polymorphism in CAU and CIU provide a molecular-genetic evidence for different clinical forms of chronic urticaria

Development of Composition and Technology of Combination Drug with Neurally Mediated Action «Memofit»

Aim. The aim of this work is to develop composition of combination drug in the form of hard-gelatin capsules «Memofit», determine technological and microbiological parameters of intermediate products and ready medicinal product and develop of manufacturing process for capsules «Memofit».Methods of the research. Investigations presented in the article were performed in accordance with the procedures described by the State Pharmacopoeia of Ukraine (SPh Ukraine).The results of the research. Necessity of the development of dietary supplement to provide special dietary properties for the purpose of regulation of functions and systems of the organism within the physiologically normal states under the nervous system dysfunction was substantiated. Results of the study of pharmaco-technological and microbiological parameters of dry extracts that are included as a compound of hard-gelatin capsules «Memofit» were presented. Optimal technological parameters for manufacturing process of capsules «Memofit» were proposed. Results of mass balance for a batch of capsules «Memofit» proved rationality of selected manufacturing process were given. Technology of manufacturing process of capsules «Memofit» was introduced into the production on the TOV “DZ “GNCLS”.Conclusions. Possibility of the development of solid formulations in the form of capsules was established based on the obtained experimental findings of the determination of pharmaco-technological and microbiological parameters of dry extracts. It was shown that capsules «Memofit» are used in dietary food ration as additional source of biologically active substances for promoting normalization of brain function and sleep, improvement of attentiveness. This preparation has general tonic properties and improves mental and physical efficiency. Manufacturing process and process flow chart for this medication was substantiate