248 research outputs found
The development of Russian health-care system: problems and prospects
Thus, the implementation of the above mentioned points will assist the efficiency of a modem health-care system in general. It also helps to provide affordable and quality medical service on the basis of common requirements and approaches according to the latest achieve ments of scientific and technical progress, which will be guarantee of sustainable socioΒ economic development of Russia in the long ter
Separate and parallel training as a factor of preserving the health of schoolchildren
In the article the results of comparative analysis of diagnostic classes separately, parallel studies that showed significant differences between the classes of boys and girls, which allows the teacher to consider gender various mechanisms of knowledge of pupils, allows boys and girls to realize the opportunities of his psyche, which is incorporated in them by natureΠ ΡΡΠ°ΡΡΠ΅ ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π² ΠΊΠ»Π°ΡΡΠ°Ρ
ΡΠ°Π·Π΄Π΅Π»ΡΠ½ΠΎ-ΠΏΠ°ΡΠ°Π»Π»Π΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠ΅ ΠΎΡΠ»ΠΈΡΠΈΡ ΠΌΠ΅ΠΆΠ΄Ρ ΠΊΠ»Π°ΡΡΠ°ΠΌΠΈ ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ² ΠΈ Π΄Π΅Π²ΠΎΡΠ΅ΠΊ, ΡΡΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³Ρ ΡΡΠΈΡΡΠ²Π°ΡΡ Π³Π΅Π½Π΄Π΅ΡΠ½ΠΎ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΠΏΠΎΠ·Π½Π°Π½ΠΈΡ ΡΡΠ°ΡΠΈΡ
ΡΡ, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΌΠ°Π»ΡΡΠΈΠΊΠ°ΠΌ ΠΈ Π΄Π΅Π²ΠΎΡΠΊΠ°ΠΌ ΡΠ΅Π°Π»ΠΈΠ·ΠΎΠ²Π°ΡΡ ΡΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠ²ΠΎΠ΅ΠΉ ΠΏΡΠΈΡ
ΠΈΠΊΠΈ, ΠΊΠΎΡΠΎΡΡΠ΅ Π·Π°Π»ΠΎΠΆΠ΅Π½Ρ Π² Π½ΠΈΡ
ΠΎΡ ΠΏΡΠΈΡΠΎΠ΄
Characterization of mechanical properties by inverse technique for composite reinforced by knitted fabric. Part 2. Experimental evaluation of mechanical properties by frequency eigenvalues method
This paper is the second part of the research work dedicated to evaluation of mechanical properties of polymer composites reinforced by knitted fabric. Three different approaches were applied for the task. Two of them: a) FEM analysis using Solid Works combined with structural modeling based on experimentally-determined mechanical and geometrical properties of the reinforcement and matrix, and b) direct measurement of mechanical properties (described in Part 1). Present investigation (Part 2) is based on application of vibrational analysis. Modal testing in combination with the mathematical optimization procedure were used for evaluation of elastic properties of a layered material. It is worth mentioning that the application of this approach for materials with high damping ability (laminated composites reinforced by knitted fabric) is still poorly investigated. The inverse technique exploited in this work is based on the direct orthotropic plate free vibration measurements and subsequent mathematical optimization procedure (the planning of experiments or response surface technique), which is based on minimization of error functional. Finally, elastic constants established by the inverse technique were discussed and compared with the results obtained in Part 1
ABC-Π°Π½Π°Π»ΠΈΠ· ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°
Aims. To analyze the costs of pharmacotherapy in children hospitalized with bronchial asthma exacerbations. Materials and methods. The data from 336 medical reports were used. In this study, patients with severe bronchial asthma were analyzed separately from those with moderate asthma. The economic analysis of pharmacotherapy was carried out in accordance with the ABC guidelines for an international non-proprietary name. In relation to the field of medicinal use, the analyzed drugs were distributed into three classes (A, B and C) according to the selected criteria. In the present study, the selection criterion was the amount of expenses needed to purchase the given medicine. Results. The ABCanalysis showed that about 80% of the amounts spent for the treatment of moderately severe asthma were due to the costs of medications. Among them, Montelukast β 31.27%; Budesonide β 28,49%; Umifenovir β 5.69%; Azithromycin β 5.50%; Salmeterol / fluticasone propionate β 4.74%; Formoterol / budesonide β 3.32%; Ipratropium bromide / fenoterol hydrobromide acetylcysteine β 3.20%; (In total, the percentage amounts to 82.15%). In the treatment of severe asthma, the same 80% of the costs consisted of: Montelukast β 28.13%; Salmeterol / fluticasone propionate β 25.54%; Formoterol / budesonide β 13.51%; Acetylcysteine 6.64%; Budesonide β 5.67% (in total, the percentage amounts to 79.48%). In moderately severe asthma, the largest part of the costs is due to inhaled glucocorticosteroids β budesonide (28.42%), while in severe cases, it is due to combined salmeterol / fluticasone propionate (25.54%) and formoterol / budesonide (13.51%). In the treatment of asthma of moderate severity, a certain part of segment A is taken by macrolide antibiotics of the azithromycin group (they account for 5.50% of the total costs) and antiviral drugs β umifenovir (5.59%). The introduction of antibiotics and anti-viral drugs is rationalized by asthma exacerbations developing on the background of viral and / or bacterial, often βatypicalβ infections. Conclusion. This pharmacoepidemiological analysis shows that the costs of treatment with Montelukast of moderate (31.27%) and severe (28.13%) bronchial asthma are comparable. For other drugs, the treatment costs significantly differ between the moderate and severe asthma therapies.Β .Π¦Π΅Π»ΡΡ Π΄Π°Π½Π½ΠΎΠΉ ΡΠ°Π±ΠΎΡΡ ΡΠ²ΠΈΠ»ΠΎΡΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΠΠ‘-Π°Π½Π°Π»ΠΈΠ·Π° ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Π°ΠΌΠΈ Π΄Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΡΠ»ΡΠΆΠΈΠ»ΠΈ Π΄Π°Π½Π½ΡΠ΅ 336 ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Ρ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠ΅ΠΌ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ. ΠΠ½Π°Π»ΠΈΠ· ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π±ΡΠ» ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ΠΎΡΠ΄Π΅Π»ΡΠ½ΠΎ Π΄Π»Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ ΠΈ ΠΎΡΠ΄Π΅Π»ΡΠ½ΠΎ β Π΄Π»Ρ ΡΡΠ΅Π΄Π½Π΅ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π°ΡΡΠΌΡ. ΠΡΠ½ΠΎΠ²Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ²ΠΈΠ»ΡΡ ΠΠΠ‘ β Π°Π½Π°Π»ΠΈΠ· ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ, ΠΊΠΎΡΠΎΡΡΠΉ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΏΠΎ ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΠΎΠΌΡ Π½Π΅ΠΏΠ°ΡΠ΅Π½ΡΠΎΠ²Π°Π½Π½ΠΎΠΌΡ Π½Π°Π·Π²Π°Π½ΠΈΡ. Π ΠΏΡΠΈΠ»ΠΎΠΆΠ΅Π½ΠΈΠΈ ΠΊ ΡΡΠ΅ΡΠ΅ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ Π²ΡΠ±ΡΠ°Π½Π½ΡΠΌ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈΡΡ Π½Π° ΡΡΠΈ ΠΊΠ»Π°ΡΡΠ° (Π, Π ΠΈ Π‘). Π ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅ΠΌ Π²ΡΠ±ΠΎΡΠ° Π±ΡΠ»Π° Π²Π΅Π»ΠΈΡΠΈΠ½Π° Π·Π°ΡΡΠ°Ρ Π½Π° ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ². Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Ρ
ΠΎΠ΄Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ ΠΠΠ‘-Π°Π½Π°Π»ΠΈΠ·Π° ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ 80% Π·Π°ΡΡΠ°Ρ Π² ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π°ΡΡΠΌΡ ΡΡΠ΅Π΄Π½Π΅ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠΎΡΡΠ°Π²Π»ΡΡΡ Π·Π°ΡΡΠ°ΡΡ Π½Π° ΠΌΠΎΠ½ΡΠ΅Π»ΡΠΊΠ°ΡΡ β 31,27%; Π±ΡΠ΄Π΅ΡΠΎΠ½ΠΈΠ΄ β 28,49%; ΡΠΌΠΈΡΠ΅Π½ΠΎΠ²ΠΈΡ β 5,69%; Π°Π·ΠΈΡΡΠΎΠΌΠΈΡΠΈΠ½ β 5,50%; ΡΠ°Π»ΠΌΠ΅ΡΠ΅ΡΠΎΠ»/ΡΠ»ΡΡΠΈΠΊΠ°Π·ΠΎΠ½Π° ΠΏΡΠΎΠΏΠΈΠΎΠ½Π°Ρ β 4,74%; ΡΠΎΡΠΌΠΎΡΠ΅ΡΠΎΠ»/Π±ΡΠ΄Π΅ΡΠΎΠ½ΠΈΠ΄ β 3,32%; ΠΈΠΏΡΠ°ΡΡΠΎΠΏΠΈΡ Π±ΡΠΎΠΌΠΈΠ΄/ΡΠ΅Π½ΠΎΡΠ΅ΡΠΎΠ»Π° Π³ΠΈΠ΄ΡΠΎΠ±ΡΠΎΠΌΠΈΠ΄ Π°ΡΠ΅ΡΠΈΠ»ΡΠΈΡΡΠ΅ΠΈΠ½ β 3,20%; (Π² ΡΡΠΌΠΌΠ΅ ΠΏΡΠΎΡΠ΅Π½Ρ Π·Π°ΡΡΠ°Ρ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 82,15%). Π ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π°ΡΡΠΌΡ 80% Π·Π°ΡΡΠ°Ρ ΡΠΎΡΡΠ°Π²Π»ΡΡΡ Π·Π°ΡΡΠ°ΡΡ Π½Π° ΠΌΠΎΠ½ΡΠ΅Π»ΡΠΊΠ°ΡΡ β 28,13%; ΡΠ°Π»ΠΌΠ΅ΡΠ΅ΡΠΎΠ»/ΡΠ»ΡΡΠΈΠΊΠ°Π·ΠΎΠ½Π° ΠΏΡΠΎΠΏΠΈΠΎΠ½Π°Ρ β 25,54%; ΡΠΎΡΠΌΠΎΡΠ΅ΡΠΎΠ»/Π±ΡΠ΄Π΅ΡΠΎΠ½ΠΈΠ΄ β 13,51%; Π°ΡΠ΅ΡΠΈΠ»ΡΠΈΡΡΠ΅ΠΈΠ½ β 6,64%; Π±ΡΠ΄Π΅ΡΠΎΠ½ΠΈΠ΄ β 5,67% (Π² ΡΡΠΌΠΌΠ΅ ΠΏΡΠΎΡΠ΅Π½Ρ Π·Π°ΡΡΠ°Ρ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 79,48%). ΠΡΠΈ ΡΡΠ΅Π΄Π½Π΅ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ Π°ΡΡΠΌΡ Π½Π°ΠΈΠ±ΠΎΠ»ΡΡΡΡ Π΄ΠΎΠ»Ρ Π·Π°ΡΡΠ°Ρ Π² Π±Π°Π·ΠΈΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠΎΡΡΠ°Π²Π»ΡΡΡ ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΡΠ΅ Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΡΡΠ΅ΡΠΎΠΈΠ΄Ρ β Π±ΡΠ΄Π΅ΡΠΎΠ½ΠΈΠ΄ (28,42%), Π² ΡΠΎ Π²ΡΠ΅ΠΌΡ ΠΊΠ°ΠΊ ΠΏΡΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ β ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ: ΡΠ°Π»ΠΌΠ΅ΡΠ΅ΡΠΎΠ»/ΡΠ»ΡΡΠΈΠΊΠ°Π·ΠΎΠ½Π° ΠΏΡΠΎΠΏΠΈΠΎΠ½Π°Ρ (25,54%) ΠΈ ΡΠΎΡΠΌΠΎΡΠ΅ΡΠΎΠ»/Π±ΡΠ΄Π΅ΡΠΎΠ½ΠΈΠ΄ (13,51%). Π ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π°ΡΡΠΌΡ ΡΡΠ΅Π΄Π½Π΅ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΡ Π΄ΠΎΠ»Ρ Π² ΡΠ΅Π³ΠΌΠ΅Π½ΡΠ΅ Π Π·Π°Π½ΠΈΠΌΠ°ΡΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΈ ΠΌΠ°ΠΊΡΠΎΠ»ΠΈΠ΄Π½ΠΎΠ³ΠΎ ΡΡΠ΄Π° Π³ΡΡΠΏΠΏΡ Π°Π·ΠΈΡΡΠΎΠΌΠΈΡΠΈΠ½Π° (Π½Π° Π½ΠΈΡ
ΠΏΡΠΈΡ
ΠΎΠ΄ΠΈΡΡΡ 5,50% ΠΎΠ±ΡΠΈΡ
Π·Π°ΡΡΠ°Ρ) ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΈΡΡΡΠ½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ β ΡΠΌΠΈΡΠ΅Π½ΠΎΠ²ΠΈΡ (5,59%). ΠΠ°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΈΡΡΡΠ½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΡΠ²ΡΠ·Π°Π½ΠΎ Ρ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Π°ΡΡΠΌΡ Π½Π° ΡΠΎΠ½Π΅ Π²ΠΈΡΡΡΠ½ΡΡ
ΠΈ/ΠΈΠ»ΠΈ Π±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ
, Π·Π°ΡΠ°ΡΡΡΡ Β«Π°ΡΠΈΠΏΠΈΡΠ½ΡΡ
Β» ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π Ρ
ΠΎΠ΄Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π·Π°ΡΡΠ°ΡΡ Π½Π° ΠΌΠΎΠ½ΡΠ΅Π»ΡΠΊΠ°ΡΡ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΡ ΠΏΡΠΈ ΡΡΠ΅Π΄Π½Π΅ΠΉ (31,27%) ΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΉ (28,13%) ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ. ΠΠ»Ρ ΠΎΡΡΠ°Π»ΡΠ½ΡΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² Π΄ΠΎΠ»Ρ Π·Π°ΡΡΠ°Ρ Π² ΠΎΠ±ΡΠ΅ΠΉ ΡΡΡΡΠΊΡΡΡΠ΅ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΠΎΡΠ»ΠΈΡΠ°Π΅ΡΡΡ.
ΠΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ: Π½Π΅ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΊΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·ΠΎΠ²
The article presents the results of traditional pharmaco-economic analysis (the βcost-effectivenessβ method) and socio-economic analysis of pharmaco-therapeutic regimens in a chronic disease.The specific aim was to compare the methods of pharmaco-economic and socioeconomic analyses when applied to the treatment of children with chronic asthma exacerbations.Materials and methods. The data on basic therapy of asthma exacerbations in children hospitalized in 2014-2015 were used (total 608 cases).Results. The combination of an inhaled glucocorticosteroid and long-acting Ξ²2-agonists proved to be the most optimal therapy as far as pharmaco-economics is concerned. The ways to calculate the coefficient of incremental costs of therapeutic regimens are shown. The discrepancy between the results of pharmacoeconomic analysis, on the one hand, and the data on socio-economic losses, on the other hand, was documented. The addition of montelukast (a leukotriene receptor antagonist) in the treatment regimen leads to an increase in medical costs from 873.00 rubles to 1515.39 rubles, and to a decrease in the average number of hospitalizations per year. In this case, the number of days of absence from work for a parent also decreases, which contributes to a higher GDP. As exemplified in this model group of 1000 patients, an increase in the direct medical costs by 734 thousand rubles leads to a decrease in the socio-economic losses (saving 34 million rubles.)Π‘onclusion. The traditional pharmacoeconomic analysis is the ideal instrument to compare between the original and generic drugs, and to evaluate the treatment of acute diseases. With respect to chronic diseases, this pharmaco-economic analysis should be used with caution. Without taking into account the effectiveness of the analyzed pharmacotherapy in treating possible exacerbations, or the transition to a more severe / mild form of the disease, the clinical component of the pharmaco-economic analysis may be missed. And if so, only the economic component of the selected therapy will play the major role in the final assessment. In this case, the results of the entire pharmaco-economic analysis may become less significant as they will reflect the least expensive treatment only, leaving behind the clinical aspects, e. g. the number of positive outcomes.Β Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½Ρ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ ΠΊΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Β«Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΒ» ΠΈ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΡΡ
Π΅ΠΌ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ.Π¦Π΅Π»ΡΡ ΡΠ°Π±ΠΎΡΡ ΡΠ²ΠΈΠ»ΠΎΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ° Π½Π° ΠΏΡΠΈΠΌΠ΅ΡΠ΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ°ΡΡΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΡΠ°ΠΊΡΡΡΠ΅ ΠΊΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·ΠΎΠ².ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈΡΡ Π΄Π°Π½Π½ΡΠ΅ Π±Π°Π·ΠΈΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΡ Π°ΡΡΠΌΡ Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ° Π·Π° 2014-2015 Π³Π³. (Π΄Π°Π½Π½ΡΠ΅ 608 ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΡ ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΡΡΠ΅ΡΠΎΠΈΠ΄Π° ΠΈ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎ Π΄Π΅ΠΉΡΡΠ²ΡΡΡΠ΅Π³ΠΎ Ξ²2 -Π°Π³ΠΎΠ½ΠΈΡΡΠ° Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½Π° Ρ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΊΠΈ Π·ΡΠ΅Π½ΠΈΡ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ°ΡΡΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ Π°ΡΡΠΌΡ Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°. ΠΠΎΠΊΠ°Π·Π°Π½Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΊΠΎΡΡΡΠΈΡΠΈΠ΅Π½ΡΠ° ΠΈΠ½ΠΊΡΠ΅ΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
Π·Π°ΡΡΠ°Ρ ΡΡ
Π΅ΠΌ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ Π½Π΅ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΠΈ Π°Π½Π°Π»ΠΈΠ·Π° ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΡΠ΅ΡΡ. ΠΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ Π² ΡΡ
Π΅ΠΌΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π°Π½Π°ΡΠ°Π³ΠΎΠ½ΠΈΡΡΠ° Π»Π΅ΠΉΠΊΠΎΡΡΠΈΠ΅Π½ΠΎΠ²ΡΡ
ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
Π·Π°ΡΡΠ°Ρ Ρ 873,00 ΡΡΠ±. Π΄ΠΎ 1515,39 ΡΡΠ±., ΠΈΠΌΠ΅ΡΡΠΈΡ
ΠΌΠ΅ΡΡΠΎ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ°ΡΡΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡ
Π΅ΠΌ, Π²ΠΊΠ»ΡΡΠ°ΡΡΠΈΡ
ΠΌΠΎΠ½ΡΠ΅Π»ΡΠΊΠ°ΡΡ, ΡΡΠ΅Π΄Π½Π΅Π΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΉ Π·Π° Π³ΠΎΠ΄ ΡΠ½ΠΈΠΆΠ°Π΅ΡΡΡ. Π ΡΡΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ ΡΡΠΌΠΌΠ°ΡΠ½ΠΎΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π΄Π½Π΅ΠΉ Π½Π΅ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ Π½Π° ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΡΠΎΠ΄ΠΈΡΠ΅Π»Ρ ΡΠ΅Π±Π΅Π½ΠΊΠ° ΡΠ°ΠΊΠΆΠ΅ ΡΠ½ΠΈΠΆΠ°Π΅ΡΡΡ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠΌΠ΅Π½ΡΡΠ°Π΅ΡΡΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΏΡΠΎΠΏΡΡΠ΅Π½Π½ΡΡ
ΡΠ°Π±ΠΎΡΠΈΡ
Π΄Π½Π΅ΠΉ, ΡΡΠΎ ΡΠ²ΡΠ·Π°Π½ΠΎ Ρ Π²ΠΊΠ»Π°Π΄ΠΎΠΌ Π² ΠΠΠ. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, Π² ΠΌΠΎΠ΄Π΅Π»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ Π² 1000 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΠΏΡΡΠΌΡΡ
ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
Π·Π°ΡΡΠ°Ρ Π½Π° 734 ΡΡΡ. ΡΡΠ±. ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ ΡΡΠΎΠ²Π½Ρ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ- ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΡΠ΅ΡΡ (ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡ 34 ΠΌΠ»Π½ ΡΡΠ±.).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΈΠ΄Π΅Π°Π»Π΅Π½ Π΄Π»Ρ ΡΠΎΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΡ ΠΎΡΠΈΠ³ΠΈΠ½Π°Π»ΡΠ½ΡΡ
ΠΈ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡ
Π΅ΠΌ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΡΡΡΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ. Π ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΊ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° Π½ΡΠΆΠ½ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΠΈΡΡ ΠΎΡΡΠΎΡΠΎΠΆΠ½ΠΎ, ΠΏΠΎΡΠΎΠΌΡ ΡΡΠΎ, Π½Π΅ ΠΏΡΠΈΠ½ΠΈΠΌΠ°Ρ Π²ΠΎ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΡΠ΅ΠΌΠΎΠΉ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π½Π° ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΎΠ±ΠΎΡΡΡΠ΅Π½ΠΈΠΉ, Π½Π° ΠΏΠ΅ΡΠ΅Ρ
ΠΎΠ΄ Π² Π±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΡΡ/Π»Π΅Π³ΠΊΡΡ ΡΡΠ΅ΠΏΠ΅Π½Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΌΠΎΠΆΠ½ΠΎ ΠΏΠΎΡΠ΅ΡΡΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°. Π Π²ΡΠ±ΡΠ°Π½Π½Π°Ρ ΡΡ
Π΅ΠΌΠ° ΠΎΠΊΠ°ΠΆΠ΅ΡΡΡ Π±ΠΎΠ»Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ Π»ΠΈΡΡ ΠΏΠΎ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠ΅ΠΉ. Π ΡΡΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΡΠ΅ΡΡΡΡ ΡΠ²ΠΎΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ ΡΠ΅Π½Π½ΠΎΡΡΡ ΠΊΠ°ΠΊ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π½Π΅ ΠΏΡΠΎΡΡΠΎ Π½Π°ΠΈΠΌΠ΅Π½Π΅Π΅ Π·Π°ΡΡΠ°ΡΠ½ΠΎΠΉ ΡΡ
Π΅ΠΌΡ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π½ΠΎ ΠΈ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΊΠΈ Π·ΡΠ΅Π½ΠΈΡ ΠΏΠΎ Π΄ΠΎΡΡΠΈΠ³Π°Π΅ΠΌΠΎΠΉ ΡΠ°ΡΡΠΎΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ².
ΠΠ΅ΡΠΎΠ΄ Β«Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΒ» Π² ΠΎΡΠ΅Π½ΠΊΠ΅ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π±ΡΠΎΠ½Ρ ΠΈΡΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°
Study objective: pharmacoeconomic evaluation of cephalosporins, protected penicillins and macrolides, most commonly used in the treatmentΒ of acute obstructive bronchitis.Materials and methods. data file of hospitalized patients with acute obstructive bronchitis treatedby antibiotic.Β The study included 2259 patientβs data files. The age of patients ranged from 0 to 18 years old. Β«Cost-effectivenessΒ» analysis was used forΒ comparing of the costs and effectiveness for courses of antibiotics, used in therapy of acute obstructive bronchitis.Results. It is shown that a pharmacoeconomic standpoint, Ceftriaxone (Sintez) was the most effective antibiotic of the cephalosporin group in the treatment of acute obstructive bronchitis in children. The original drug Augmentin (Smithkline Beecham Pharmaceuticals) and generic Amoxiclav (Lek d.d) were used from the group of protected penicillins (combination amoxicillin / clavulanic acid). The effectiveness of Augmentin (0.591) and Amoxiclav (0.530) was comparable. The Augmentinβs course of therapy characterized by a lower value CER in comparison with Amoxiklav. From the pharmacoeconomic point of view treatment course of Azithromycin (Vertex) was the most appropriate of the macrolide antibiotic in the therapy of acute obstructive bronchitis,. The highest value ICER ratio was obtained for Sumamed (Teva), and it amounted to 39 367.50 rubles. Sumamed was characterized by the highest clinical efficacy. Besides Sumamed is original azithromycin. Azitromicin generics Azitral and Hemomitsin had the lowest ICER after Azithromycin (1151.67 rubles and 1812.22 rubles, respectively).Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΡΠ΅Π½ΠΊΠ° Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² Π³ΡΡΠΏΠΏ ΡΠ΅ΡΠ°Π»ΠΎΡΠΏΠΎΡΠΈΠ½ΠΎΠ², Π·Π°ΡΠΈΡΠ΅Π½Π½ΡΡ
ΠΏΠ΅Π½ΠΈΡΠΈΠ»Π»ΠΈΠ½ΠΎΠ² ΠΈ ΠΌΠ°ΠΊΡΠΎΠ»ΠΈΠ΄ΠΎΠ², Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΠΌΡΡ
Π² ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π±ΡΠΎΠ½Ρ
ΠΈΡΠ°.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Π°ΠΌΠΈΒ Π΄Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ»ΡΠΆΠΈΠ»ΠΈ Π΄Π°Π½Π½ΡΠ΅ ΠΏΠΎ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ Ρ ΠΎΡΡΡΡΠΌ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΡΠΌ Π±ΡΠΎΠ½Ρ
ΠΈΡΠΎΠΌ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ ΠΈΡΡΠΎΡΠΈΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ 2259 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎΡΡΠ°Π²ΠΈΠ» ΠΎΡ 0 Π»Π΅Ρ Π΄ΠΎ 18 Π»Π΅Ρ. ΠΠ»Ρ ΡΠΎΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΡ Π·Π°ΡΡΠ°Ρ ΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΡΠ°Π²Π½ΠΈΠ²Π°Π΅ΠΌΡΡ
ΠΊΡΡΡΠΎΠ² ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π±ΡΠΎΠ½Ρ
ΠΈΡΠ° Π±ΡΠ» ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ ΠΌΠ΅ΡΠΎΠ΄ Β«Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΒ».Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ Ρ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΊΠΈ Π·ΡΠ΅Π½ΠΈΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅Β ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΠΈΠ· Π³ΡΡΠΏΠΏΡ ΡΠ΅ΡΠ°Π»ΠΎΡΠΏΠΎΡΠΈΠ½ΠΎΠ² ΠΏΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π±ΡΠΎΠ½Ρ
ΠΈΡΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ° ΡΠ²Π»ΡΠ»ΡΡΒ Π¦Π΅ΡΡΡΠΈΠ°ΠΊΡΠΎΠ½ (ΠΠΠ Π‘ΠΈΠ½ΡΠ΅Π·). ΠΠ· Π³ΡΡΠΏΠΏΡ Π·Π°ΡΠΈΡΠ΅Π½Π½ΡΡ
ΠΏΠ΅Π½ΠΈΡΠΈΠ»Π»ΠΈΠ½ΠΎΠ² ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΡΡ Π°ΠΌΠΎΠΊΡΠΈΡΠΈΠ»Π»ΠΈΠ½/ΠΊΠ»Π°Π²ΡΠ»Π°Π½ΠΎΠ²Π°Ρ ΠΊΠΈΡΠ»ΠΎΡΠ° β ΠΎΡΠΈΠ³ΠΈΠ½Π°Π»ΡΠ½ΡΠΉ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ ΠΡΠ³ΠΌΠ΅Π½ΡΠΈΠ½ (Smithkline Beecham Pharmaceuticals) ΠΈ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ β ΠΠΌΠΎΠΊΡΠΈΠΊΠ»Π°Π² (Lek d.d). ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΡΠ³ΠΌΠ΅Π½ΡΠΈΠ½Π° (0,591) ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠ° Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ ΠΠΌΠΎΠΊΡΠΈΠΊΠ»Π°Π²Π° (0,530). ΠΡΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΡΠ³ΠΌΠ΅Π½ΡΠΈΠ½ΠΎΠΌ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΠΎΠ²Π°Π»ΡΡ ΠΌΠ΅Π½ΡΡΠΈΠΌ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΡΡΡΠΈΡΠΈΠ΅Π½ΡΠ° CER ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΠΠΌΠΎΠΊΡΠΈΠΊΠ»Π°Π²Π°. ΠΡ ΠΏΠΎΠ»ΡΡΠΈΠ»ΠΈ, ΡΡΠΎ ΠΊΡΡΡ ΠΠ·ΠΈΡΡΠΎΠΌΠΈΡΠΈΠ½Π° (ΠΠΠ ΠΠ΅ΡΡΠ΅ΠΊΡ) Ρ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉΒ ΡΠΎΡΠΊΠΈ Π·ΡΠ΅Π½ΠΈΡ ΠΎΠΊΠ°Π·Π°Π»ΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠΌ ΠΈΠ· Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ²- ΠΌΠ°ΠΊΡΠΎΠ»ΠΈΠ΄ΠΎΠ² ΠΏΡΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π±ΡΠΎΠ½Ρ
ΠΈΡΠ°. ΠΠ°ΠΈΠ±ΠΎΠ»ΡΡΠ΅Π΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΡΡΡΠΈΡΠΈΠ΅Π½ΡΠ° ICER Π±ΡΠ»ΠΎ ΠΏΠΎΠ»ΡΡΠ΅Π½ΠΎ Π΄Π»Ρ Π‘ΡΠΌΠ°ΠΌΠ΅Π΄Π° (Teva) ΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ 39 367,50 ΡΡΠ±. ΠΠ»Ρ Π‘ΡΠΌΠ°ΠΌΠ΅Π΄Π° Π±ΡΠ»ΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΠΎ ΠΈ ΡΠ°ΠΌΠΎΠ΅ Π²ΡΡΠΎΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ. Π ΡΠΎΠΌΡ ΠΆΠ΅ CΡΠΌΠ°ΠΌΠ΅Π΄ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΠΈΠ³ΠΈΠ½Π°Π»ΡΠ½ΡΠΌ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ Π°Π·ΠΈΡΡΠΎΠΌΠΈΡΠΈΠ½Π°. ΠΠ·ΠΈΡΡΠ°Π» ΠΈ Π₯Π΅ΠΌΠΎΠΌΠΈΡΠΈΠ½ ΠΈΠΌΠ΅Π»ΠΈ, ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΠΌ Π΄Π°Π½Π½ΡΠΌ, Π½Π°ΠΈΠΌΠ΅Π½ΡΡΠΈΠ΅ ΠΏΠΎΡΠ»Π΅ ΠΠ·ΠΈΡΡΠΎΠΌΠΈΡΠΈΠ½Π° Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΠΊΠΎΡΡΡΠΈΡΠΈΠ΅Π½ΡΠ° ICERΒ (1151,67 ΡΡΠ±. ΠΈ 1812,22 ΡΡΠ±. ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ)
Detection of specific antibodies to Schmallenberg virus using microneutralisation test
The article presents data on microneutralization test for detection of specific antibodies to Schmallenberg virus. The method is characterized by high sensitivity and specificity. It can be used for analysis of blood sera of different species of animals
ΠΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°ΡΠΈΡ ΠΈ ΡΡΠ±ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΎΠ½Π½ΡΠΉ ΡΠΎΡΡΠ°Π² VEGFR2+ ΠΌΠΎΠ½ΠΎΡΠΈΡΠΎΠ² ΠΊΡΠΎΠ²ΠΈ ΠΈ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° ΠΏΡΠΈ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ
Aim. To identify disturbances of differentiation and subpopulation composition of VEGFR2+ cells in the blood and bone marrow associated with the features of the cytokine profile in the blood and bone marrow in patients with coronary artery disease (CAD) with and without ischemic cardiomyopathy (ICM).Materials and methods. The study included 74 patients with Π‘AD with and without ICM (30 and 44 people, respectively) and 18 healthy donors. In all patients with Π‘AD, peripheral blood sampling was performed immediately before coronary artery bypass grafting, and bone marrow samples were taken during the surgery via a sternal incision. In the healthy donors, only peripheral blood sampling was performed. In the bone marrow and blood samples, the number of VEGFR2+ cells (CD14+VEGFR2+ cells) and their immunophenotypes CD14++CD16-VEGFR2+, CD14++CD16+VEGFR2+, CD14+CD16++VEGFR2+, and CD14+CD16-VEGFR2+ was determined by flow cytometry. Using enzyme-linked immunosorbent assay, the levels of VΠGF-Π, TNFΞ±, M-CSF, and IL-13, as well as the content of MCP-1 (only in the blood) and the M-CSF / IL-13 ratio (only in the bone marrow) were determined.Results. The content of CD14+VEGFR2+ cells in the blood of CAD patients with and without ICM was higher than normal values due to the greater number of CD14++CD16-VEGFR2+, CD14++CD16+VEGFR2+, and CD14+CD16++VEGFR2+. In the bone marrow of the patients with ICM, the content of CD14++CD16-VEGFR2+, CD14+CD16++VEGFR2+, and CD14+CD16-VEGFR2+ was lower than in patients with CAD without ICM, and the number of CD14++CD16+VEGFR2+ cells corresponded to that in the controls. Regardless of the presence of ICM in CAD, a high concentration of TNFΞ± and normal levels of VEGF-A and IL-13 were observed in the blood. In CAD without ICM, an excess of MCP-1 and deficiency of M-CSF were revealed in the blood. In the bone marrow, the levels of VEGF-A, TNFΞ±, M-CSF, and IL-13 were comparable between the groups of patients against the background of a decrease in the M-CSF / IL-13 ratio in the patients with ICM.Conclusion. Unlike CAD without cardiomyopathy, in ICM, no excess of VEGFR2+ cells and MCP-1 in the blood is observed, which hinders active migration of CD14+CD16++VEGFR2+ cells from the myeloid tissue, and a decrease in the M-CSF / IL-13 ratio in the bone marrow disrupts differentiation of other forms of VEGFR2+ cells, preventing vascular repair.Π¦Π΅Π»Ρ: ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²ΠΊΠΈ ΠΈ ΡΡΠ±ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΡΠΎΡΡΠ°Π²Π° VEGFR2+ ΠΌΠΎΠ½ΠΎΡΠΈΡΠΎΠ² Π² ΠΊΡΠΎΠ²ΠΈ ΠΈ ΠΊΠΎΡΡΠ½ΠΎΠΌ ΠΌΠΎΠ·Π³Π΅ Π²ΠΎ Π²Π·Π°ΠΈΠΌΠΎΡΠ²ΡΠ·ΠΈ Ρ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΠΌΠΈ ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΈΠ»Ρ ΠΊΡΠΎΠ²ΠΈ ΠΈ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΡΠ΅ΡΠ΄ΡΠ° (ΠΠΠ‘), ΡΡΡΠ°Π΄Π°ΡΡΠΈΡ
ΠΈ Π½Π΅ ΡΡΡΠ°Π΄Π°ΡΡΠΈΡ
ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠ΅ΠΉ (ΠΠΠΠ).ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΎΡΠ»ΠΈ 74 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ‘, ΡΡΡΠ°Π΄Π°ΡΡΠΈΡ
ΠΈ Π½Π΅ ΡΡΡΠ°Π΄Π°ΡΡΠΈΡ
ΠΠΠΠ (30 ΠΈ 44 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ), ΠΈ 18 Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π΄ΠΎΠ½ΠΎΡΠΎΠ². Π£ Π²ΡΠ΅Ρ
Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ‘ Π·Π°Π±ΠΎΡ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΠ»ΡΡ Π½Π΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎ ΠΏΠ΅ΡΠ΅Π΄ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ΅ΠΉ ΠΊΠΎΡΠΎΠ½Π°ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ½ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ, Π° ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° β ΠΈΠ· ΡΠ°Π·ΡΠ΅Π·Π° Π³ΡΡΠ΄ΠΈΠ½Ρ Π²ΠΎ Π²ΡΠ΅ΠΌΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ. Π£ Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π΄ΠΎΠ½ΠΎΡΠΎΠ² Π·Π°Π±ΠΈΡΠ°Π»ΠΈ ΡΠΎΠ»ΡΠΊΠΎ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΡΡ ΠΊΡΠΎΠ²Ρ.Β Π ΠΊΠΎΡΡΠ½ΠΎΠΌ ΠΌΠΎΠ·Π³Π΅ ΠΈ ΠΊΡΠΎΠ²ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΡΠΎΡΠΎΡΠ½ΠΎΠΉ ΡΠΈΡΠΎΡΠ»ΡΠΎΡΠΈΠΌΠ΅ΡΡΠΈΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΡΠΈΡΠ»Π΅Π½Π½ΠΎΡΡΡ VEGFR2+ ΠΌΠΎΠ½ΠΎΡΠΈΡΠΎΠ² (CD14+VΠGFR2+ ΠΊΠ»Π΅ΡΠΎΠΊ) ΠΈ ΠΈΡ
ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅Π½ΠΎΡΠΈΠΏΠΎΠ² CD14++CD16-VEGFR2+, CD14++CD16+VEGFR2+, CD14+CD16++VEGFR2+, CD14+CD16-VEGFR2+, ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠΌΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π»ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ VΠGF-Π, TNFΞ±, M-CSF, IL-13, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ MCP-1 (ΡΠΎΠ»ΡΠΊΠΎ Π² ΠΊΡΠΎΠ²ΠΈ) ΠΈ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ M-CSF/IL-13 (ΡΠΎΠ»ΡΠΊΠΎ Π² ΠΊΠΎΡΡΠ½ΠΎΠΌ ΠΌΠΎΠ·Π³Π΅).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ CD14+VEGFR2+ ΠΊΠ»Π΅ΡΠΎΠΊ Π² ΠΊΡΠΎΠ²ΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ‘ Π±Π΅Π· ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ ΠΈ Ρ ΠΠΠΠ Π±ΡΠ»ΠΎ Π²ΡΡΠ΅ Π½ΠΎΡΠΌΡ ΠΈΠ·-Π·Π° Π±ΠΎΠ»ΡΡΠ΅ΠΉ ΡΠΈΡΠ»Π΅Π½Π½ΠΎΡΡΠΈ CD14++CD16-VEGFR2+, CD14++CD16+VEGFR2+ ΠΈ CD14+CD16++VEGFR2+ ΡΠΎΡΠΌ. Π ΠΊΠΎΡΡΠ½ΠΎΠΌ ΠΌΠΎΠ·Π³Π΅ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠΠ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ CD14++CD16-VEGFR2+, CD14+CD16++VEGFR2+ ΠΈ CD14+CD16-VEGFR2+ ΡΠΎΡΠΌ Π±ΡΠ»ΠΎ Π½ΠΈΠΆΠ΅, ΡΠ΅ΠΌ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ‘ Π±Π΅Π· ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ, Π° ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ CD14++CD16+VEGFR2+ ΠΊΠ»Π΅ΡΠΎΠΊ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΎΠ²Π°Π»ΠΎ ΠΈΡ
ΡΠΈΡΠ»Ρ Π² Π³ΡΡΠΏΠΏΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ. ΠΠ½Π΅ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π½Π°Π»ΠΈΡΠΈΡ ΠΠΠΠ ΠΏΡΠΈ ΠΠΠ‘ Π² ΠΊΡΠΎΠ²ΠΈ ΠΎΡΠΌΠ΅ΡΠ°Π»Π°ΡΡ Π²ΡΡΠΎΠΊΠ°Ρ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ TNFΞ±, Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΡΠΉ ΡΡΠΎΠ²Π΅Π½Ρ VEGF-Π ΠΈ IL-13; ΠΏΡΠΈ ΠΠΠ‘ Π±Π΅Π· ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ β ΠΈΠ·Π±ΡΡΠΎΠΊ ΠΠ‘Π -1 ΠΈ Π΄Π΅ΡΠΈΡΠΈΡ M-CSF Π² ΠΊΡΠΎΠ²ΠΈ. Π ΠΊΠΎΡΡΠ½ΠΎΠΌ ΠΌΠΎΠ·Π³Π΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ VΠGF-Π, TNFΞ±, M-CSF, IL-13 Π±ΡΠ»Π° ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠΎΠΉ ΠΌΠ΅ΠΆΠ΄Ρ Π³ΡΡΠΏΠΏΠ°ΠΌΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
Π½Π° ΡΠΎΠ½Π΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ M-CSF/IL-13 Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠΠ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π ΠΎΡΠ»ΠΈΡΠΈΠ΅ ΠΎΡ ΠΠΠ‘ Π±Π΅Π· ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ ΠΏΡΠΈ ΠΠΠΠ Π½Π΅ ΡΠΎΡΠΌΠΈΡΡΠ΅ΡΡΡ ΠΈΠ·Π±ΡΡΠΎΠΊ VEGFR2+ ΠΌΠΎΠ½ΠΎΡΠΈΡΠΎΠ² ΠΈ ΠΠ‘Π -1 Π² ΠΊΡΠΎΠ²ΠΈ, ΡΡΠΎ Π·Π°ΡΡΡΠ΄Π½ΡΠ΅Ρ Π°ΠΊΡΠΈΠ²Π½ΡΡ ΠΌΠΈΠ³ΡΠ°ΡΠΈΡ CD14+CD16++VEGFR2+ ΠΊΠ»Π΅ΡΠΎΠΊ ΠΈΠ· ΠΌΠΈΠ΅Π»ΠΎΠΈΠ΄Π½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ, Π° ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ M-CSF/IL-13 Π² ΠΊΠΎΡΡΠ½ΠΎΠΌ ΠΌΠΎΠ·Π³Π΅ Π½Π°ΡΡΡΠ°Π΅Ρ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²ΠΊΡ ΠΎΡΡΠ°Π»ΡΠ½ΡΡ
ΡΠΎΡΠΌ VEGFR2+ ΠΌΠΎΠ½ΠΎΡΠΈΡΠΎΠ², ΠΏΡΠ΅ΠΏΡΡΡΡΠ²ΡΡ ΡΠ΅ΠΏΠ°ΡΠ°ΡΠΈΠΈ ΡΠΎΡΡΠ΄ΠΎΠ²
Detection of tick-borne pathogens in wild birds and their ticks in Western Siberia and high level of their mismatch
Abstract: The Tomsk region located in the south of Western Siberia is one of the most high-risk areas for tick-borne diseases due to elevated incidence of tick-borne encephalitis and Lyme disease in humans. Wild birds may be considered as one of the reservoirs for tick-borne pathogens and hosts for infected ticks. A high mobility of wild birds leads to unpredictable possibilities for the dissemination of tick-borne pathogens into new geographical regions. The primary goal of this study was to evaluate the prevalence of tick-borne pathogens in wild birds and ticks that feed on them as well as to determine the role of different species of birds in maintaining the tickborne infectious foci. We analysed the samples of 443 wild birds (60 species) and 378 ticks belonging to the genus Ixodes Latraille, 1795 collected from the wild birds, for detecting occurrence of eight tick-borne pathogens, the namely tick-borne encephalitis virus (TBEV), West Nile virus (WNV), and species of Borrelia, Rickettsia, Ehrlichia, Anaplasma, Bartonella and Babesia Starcovici, 1893, using RT-PCR/or PCR and enzyme immunoassay. One or more tick-borne infection markers were detected in 43 species of birds. All markers were detected in samples collected from fieldfare Turdus pilaris Linnaeus, Blythβs reed warbler Acrocephalus dumetorum Blyth, common redstart Phoenicurus phoenicurus (Linnaeus), and common chaffinch Fringilla coelebs Linnaeus. Although all pathogens have been identified in birds and ticks, we found that in the majority of cases (75.5%), there were mismatches of pathogens in birds and ticks collected from them. Wild birds and their ticks may play an extremely important role in the dissemination of tick-borne pathogens into different geographical regions
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