Some methodological aspects of conducting and evaluating adult health check-up: a systematic review of regulatory public health documentation in the Russian Federation

Background. The Constitution of the Russian Federation and federal laws define the main postulates of the methodology for preventive measures as a priority in the field of public health. Sectoral regulatory legal acts, namely, orders of the Ministry of Health of Russia present the methodology as a system of principles and methods for organizing preventive activities, including health check-ups of the adult population. The effectiveness of the largest preventive measure of the Russian health care system — health check-ups of certain groups of the adult population — depends on the quality and validity of the methodological provisions of the regulatory legal act.Objective. To assess the completeness and objectivity of methodological approaches to conducting and evaluating medical check-ups of certain groups of the adult population, reflected in regulatory legal acts.Methods. The research methodology involved a systematic review of the regulatory documentation of the Russian Federation in the field of health care from January 2012 to December 2022 to verify the basics of the methodology for conducting and evaluating preventive measures for certain groups of the adult population. The information was searched in the database of the ConsultantPlus legal reference system and on the official website of the Ministry of Health (Russian Federation), as well as in the electronic databases of the CyberLeninka and eLIBRARY.RU scientific electronic libraries. The study involved the methods of content analysis, analytical generalization, analogies, and formalization. Data analysis was focused on the organization of the health check-up of the adult population, the evaluation of its performance and effectiveness in accordance with regulatory legal acts, as well as the assessment of the quality of data obtained during the check-up.Results. A dynamic retrospective study of the regulatory framework, including the orders of the Ministry of Health of Russia, both those that have expired and those that are currently in force, identified methodological shortcomings in conducting and evaluating medical check-ups. The methodology for health check-ups of the adult population is reflected in regulatory acts. However, their number exceeds one or several documents, thereby creating a certain complexity in their interpretation and use in practice. The methodology for assessing and monitoring the implementation of health check-ups appears to be poorly defined, since it is based on a single indicator — coverage of the population with preventive check-ups and clinical examinations, thereby failing to reflect the real effect of the largest preventive measure of the state health care system. The issue requires new methodological approaches to conducting and evaluating health check-ups as a whole. The study and evaluation of check-up results is based on the statistical data analysis with imperfect methodology for collecting the data. This negatively affects the quality of statistical data, thereby leading to inadequate interpretation of the data and, as a result, to erroneous management decisions made at all levels of the executive branch.Conclusion. It is advisable to develop general methodology for conducting medical check-ups, and to consider the feasibility of creating an integral indicator for evaluating them. Specialists in the field of health care, as well as in related fields, should be involved for this purpose. A medical health officer should be assigned to coordinate the development of a methodology for organizing, conducting and evaluating health check-ups

Фармакоэкономическая эффективность химиотерапии злокачественных новообразований бронхов и легкого

Aim: to conduct a pharmacoeconomic analysis of chemotherapy taking into account the types of malignant neoplasms of the bronchi and lung, and to calculate pharmacoeconomic efficiency.Materials and methods. The materials for the study were the data of the Moscow Cancer Hospital n.a. D.D. Pletnev for 2019. The cost of drugs was calculated according to the data of the website aptekamos.ru (for June 2019).Results and discussion. For 300 patients with squamous non-small cell lung cancer, it is required 3205.5 courses of chemotherapy of I (1747.5) and II (1458) lines. For 200 patients with non-small cell non-squamous EGFR positive lung cancer, it is required 1,413.1 courses of chemotherapy and targeted therapy. For 70 patients with non-squamous cell non-small cell lung cancer with ALK mutation, it is required 450.2 courses of chemotherapy and targeted therapy. For 280 patients with non-squamous cell non-small cell lung cancer lung cancer without mutations, it is required 7515 chemotherapy courses. For 150 patients with small cell lung cancer, it is required 1,656.8 courses of chemotherapy. Thus, a total sample of 1000 patients, excluding the type of malignant neoplasm of broncus and lung are required 14,239.8 chemotherapy courses. The determined cost of 67,000 rubles for the average chemotherapy course per patient takes into account the necessary colony stimulating factors, antiemetic, infusion solutions, etc.; in the case of treatment with erlotinib (the length of the course is 8 months), the cost is 663,408.0 rubles; in the case of treatment with crizotinib (the length of the course is 11 months course), the cost is 2044110.0 rubles. The average cost of drug therapy for one patient with malignant neoplasm of bronchus and lung is 1136155.9 rubles.Conclusion. We determined the pharmacoeconomic dependence of a chemotherapy on the type of malignant neoplasms of bronchus and lung and the main anticancer drug used. The median of the overall survival rate of patients with malignant neoplasms of bronchus and lung was 42 months. The average cost of drug therapy was 27051.3 rubles per month. The median survival rate without therapy is 3 months. Thus, therapy can extend the patient’s life by an average of 39 months. The cost of a month of a saved life is 29132.2 rubles. Цель – проведение фармакоэкономического анализа химиотерапии с учетом типов злокачественного новообразования бронхов и легкого, расчет фармакоэкономической эффективности.Материалы и методы. Материалами для исследования послужили данные онкологического стационара ГБУЗ ГКБ им. Д.Д. Плетнева Департамента здравоохранения г. Москвы за 2019 г. Стоимость лекарственных препаратов рассчитана по данным aptekamos.ru (июнь 2019 г.).Результаты и обсуждение. На 300 пациентов с плоскоклеточным немелкоклеточным раком легкого потребуется 3205,5 курсов химио терапий I (1747,5) и II (1458) линий. На 200 пациентов с немелкоклеточным неплоскоклеточным EGFR положительным раке легкого необходимо 1413,1 курсов химиотерапии и таргетной терапии. На 70 пациентов с немелкоклеточным неплоскоклеточным раком легкого с АЛК-мутацией приходится 450,2 курсов химиотерапии и таргетная терапия. На 280 пациентов с немелкоклеточным неплоскоклеточным раком легкого без мутаций потребуется 7515 курсов химиотерапии. На 150 пациентов с мелкоклеточным раком легкого необходимо 1656,8 курсов химиотерапии. Таким образом, на общую выборку из 1000 пациентов без учета типа злокачественного новообразования бронхов и легкого потребуется 14239,8 курсов химиотерапии. Определена стоимость среднестатистического курса химиотерапии в расчете на одного пациента – 67000 руб. (с учетом необходимых колониестимулирующих факторов, противорвотных, инфузионных растворов и т.д.); при лечении эрлотинибом (курс 8 месяцев) – 663408,0 руб.; кризотинибом (курс 11 месяцев) – 2044110,0 руб. Средняя стоимость медикаментозной терапии одного пациента со злокачественным новообразованием бронхов и легкого составила 1136155,9 руб.Заключение. Проведен фармакоэкономический анализ химиотерапии в зависимости от типа злокачественных новообразований бронхов и легкого и используемого основного противоопухолевого лекарственного средства. Медиана общей выживаемости пациентов со злокачественными новообразованиями бронхов и легкого составили 42 месяца. Средняя стоимость медикаментозной терапии – 27051,3 руб./месяц. Медиана выживаемости без терапии – 3 месяца. Таким образом, терапия позволяет продлить жизнь пациента в среднем на 39 месяцев. Стоимость месяца сохраненной жизни составит 29132,2 руб.

Synthesis of High-Purity Silica Nanoparticles by Sol-Gel Method

Colloidal silica (silica sol) nanoparticles were synthesized by ammonia- and hydrochloric acid-catalyzed hydrolysis of tetraethoxysilane with subsequent condensation and polymerization. Silica particles with the size of 12‒160 nm were obtained at different temperatures and ratios of the initial reactants and studied by means of TEM, AFM, IR spectroscopy and zeta-potential measurements. The reaction conditions providing the minimum particle size in the final product of the most complete hydrolysis were determined. At pH above 8.5, an increase in the SiO2 content of the sol to 23 wt.% did not change the particle size. At a low (~ 1.8 wt.%) SiO2 content of the sol, a wide variation in pH also did not exert a significant effect on the particle size. Stability of the silica sols synthesized in an alkaline medium was enhanced by the replacement of alcohol with water during evaporation at pH 8.5‒9.5. The possibility to produce silica sols with the required characteristics (particle size, pH, stability, purity, and SiO2 content in an aqueous or alcohol medium) makes them applicable in various industries

Direct Catalytic Reduction of SO2 by CH4 over Fe-Mn Catalysts Prepared by Granulation of Ferromanganese Nodules

The chemical, textural, structural and strength properties of ferromanganese nodules and granulated Fe-Mn catalysts containing such nodules were studied. It was found that the granulated catalysts have a developed pore structure, which is close to that of the starting material, and surpass the starting material in strength parameters. The catalysts were tested in desulfurization by methane at a stoichiometric ratio SO2/CH4 = 2. The testing showed that Fe-Mn catalysts with the oxide or sulfide form of active components are active in desulfurization by methane and can selectively reduce SO2 with a conversion above 80%

The dependence of cylindrical resonator natural frequencies on the fluid density

The article examines the dependence of cylindrical resonator natural frequencies (sensitive element) on the density (mass) of different fluids flowing through it. The cylindrical resonators are being widely applied in automatic control systems of technological processes as oscillating transducer density meter. The article presents the experimental results that prove the dependence of natural frequencies and vibration amplitude on the fluid density

Investigation of the Sorption Properties of Ore Materials for the Removal of Sulfur Dioxide from Exhaust Flue Gases of Power Plants

The prospects of using a natural material – ferromanganese nodules (FMN) from the Gulf of Finland – as the SO2 adsorbent are discussed. The starting material was studied as pellets and powder using X-ray fluorescence spectroscopy, XRD, BET, and mechanical strength analysis; dependences of physicochemical parameters of the material on heat treatment at 100-1000 ºC were found. FMN samples were tested in the process of SO2 sorption. The sorptive capacity of FMN samples for SO2 was found to increase with humidity of adsorbents; FMN samples with a humidity above 40% were shown to be promising for the removal of sulfur dioxide from gase

Антибиотикорезистентность уропатогенов у пациентов с нефролитиазом на фоне сопутствующей ишемической болезни сердца

Objective: to identify the main causative agents of chronic calculous pyelonephritis and determine their antibiotic resistance in patients with nephrolithiasis combined with coronary heart disease (CHD).Material and methods. A retrospective case-control study included 181 patients aged 57 to 82 years old who were treated at the urological center of branch no. 1 of Burdenko Main Military Clinical Hospital in 2014–2019. All patients long-term suffered from urolithiasis complicated by chronic calculus pyelonephritis in combination with CHD. Clinically significant results of bacteriological urine examinations (CFU≥103) were analyzed. The midstream urine specimen cultivation was performed sectorally on Endo agar. The minimum suppressive concentration of the test antibacterial preparations for each of the detected microorganisms was determined by dilution on a dense Müller–Hinton agar culture medium (BBL, USA). The results were processed using the Shapiro–Wilk, Kolmogorov–Smirnov, and χ2 Pirson criteria. The values of p≤0,05 were considered as statistically significant.Results. Specimen culturing revealed Escherichia coli – 24.8%, Klebsiella pneumoniae – 18.3%, Pseudomanas aeruginosa – 11%. Staphylococcus spp., and Enterococcus spp. were most important among gram-positive pathogens (total 26.6% of cases). The sensitivity of the detected infectious agents to basic antibacterial drugs turned out to be sharply reduced. It is noteworthy that 65% of P. aeruginosa strains were sensitive to meropenem.Conclusion. In patients with recurrent urolithiasis combined with CHD, the proportion of gram-positive coccas was increased on the background of calculous pyelonephritis with a simultaneous decrease in the proportion of poly-resistant gram-negative infectious agents (nosocomial strains of E. coli and K. pneumoniae).Цель: выявить основных возбудителей хронического калькулезного пиелонефрита и определить их антибиотикорезистентность у пациентов с нефролитиазом, сочетающимся с ишемической болезнью сердца (ИБС).Материал и методы. Проведено ретроспективное эпидемиологическое исследование по типу «случай–контроль», в которое вошел 181 пациент в возрасте от 57 до 82 лет, пролеченный в урологическом центре филиала № 1 Главного военного клинического госпиталя им. академика Н.Н. Бурденко в 2014–2019 гг. Все больные длительно страдали мочекаменной болезнью (МКБ), осложненной хроническим калькулезным пиелонефритом, в сочетании с ИБС. Изучены клинически значимые результаты бактериологических анализов мочи (КОЕ≥103). Посев средней порции мочи выполняли секторным методом на агаре Эндо. Минимальную подавляющую концентрацию исследуемых антибактериальных препаратов для каждого из выявленных микроорганизмов определяли методом разведения на плотной питательной среде агара Мюллера–Хинтон (BBL, США). При статистической обработке результатов использовали критерии Шапиро–Уилка, Колмогорова–Смирнова и χ2 Пирсона. Статистически значимыми считали значения р≤0,05.Результаты. При посеве у пациентов выявлены: Escherichia coli – в 24,8% случаев, Klebsiella pneumoniae – в 18,3%, Pseudomanas aeruginosa – в 11%. Среди грамположительных возбудителей наибольшее значение имели Staphylococcus spp. и Enterococcus spp. (суммарно 26,6% случаев). Чувствительность обнаруженных инфекционных агентов к основным антибактериальным препаратам оказалась резко сниженной. Обращает на себя внимание тот факт, что к меропенему чувствительными были 65% штаммов P. aeruginosa.Заключение. У пациентов с рецидивирующей МКБ в сочетании с ИБС на фоне калькулезного пиелонефрита увеличена доля грамположительных кокков с одновременным снижением доли полирезистентных грамотрицательных инфекционных агентов (нозокомиальные штаммы E. coli и K. pneumoniae)

Mesoporous Carbon-Based Rhodium Catalysts for Benzene Hydrogenation

Two different carbons, namely CAS-P-500 and CRH-P-500, were prepared from apricot stones and rice husk by H3PO4-activation at 500 ºC and H3PO4/precursor (wt/wt) impregnation ratio of 2:1 followed by water washing and desilication by NaOH solution respectively. Elemental analyses of both samples using X-ray fluorescence spectroscopy and VARIO ELEMENTAR III elemental analyzer detected up to 1% of remained phosphorus and about 88% of carbon. SEM characterization and nitrogen adsorption data revealed that highly mesoporous materials were obtained. According to BJH scheme calculations, N2 BET-surface area and pore volume for CAS-P-500 reached the values of 2030 m2/g and 1.64 cm3/g, while for CRH-P-500: 1690 m2/g and 1.95 cm3/g respectively. Activated carbons CAS-P-500 and CRH-P-500 were used as catalyst supports for the conversion of small amounts of benzene into cyclohexane to obtain cleaner gasoline. According to Euro-3 standards, gasoline should contain less than 1% of benzene, since the incomplete combustion of gasoline, which contains benzene, leads to formation of benzopyrene- a powerful carcinogen in exhaust gases. The activity of rhodium catalysts based on the CAS-P-500 and CRH-P-500 allow complete conversion of benzene into cyclohexane at 40 atm and 80oC temperature and is comparable to those of based on conventional carbons: “Sibunit”, etc

A New and Fast Technique to Generate Offspring after Germ Cells Transplantation in Adult Fish: The Nile Tilapia (Oreochromis niloticus) Model

Background: Germ cell transplantation results in fertile recipients and is the only available approach to functionally investigate the spermatogonial stem cell biology in mammals and probably in other vertebrates. In the current study, we describe a novel non-surgical methodology for efficient spermatogonial transplantation into the testes of adult tilapia (O. niloticus), in which endogenous spermatogenesis had been depleted with the cytostatic drug busulfan. Methodology/Principal Findings: Using two different tilapia strains, the production of fertile spermatozoa with donor characteristics was demonstrated in adult recipient, which also sired progeny with the donor genotype. Also, after cryopreservation tilapia spermatogonial cells were able to differentiate to spermatozoa in the testes of recipient fishes. These findings indicate that injecting germ cells directly into adult testis facilitates and enable fast generation of donor spermatogenesis and offspring compared to previously described methods. Conclusion: Therefore, a new suitable methodology for biotechnological investigations in aquaculture was established, with a high potential to improve the production of commercially valuable fish, generate transgenic animals and preserv