Regulatory framework the implementation of the digital educational space in Russia

В статье рассмотрены основные нормативные документы, регламентирующие внедрение цифровой образовательной среды в образовательных организациях (школ, ССУЗов, ВУЗов).The article deals with the main normative documents regulating the introduction of the digital educational environment in educational institutions (schools, Colleges, Universities)

Analysis of the placental tissue transcriptome of normal and preeclampsia complicated pregnancies

Preeclampsia is one of the most severe gestational complications which is one of the leading causes of maternal and perinatal morbidity and mortality. A growth in the incidence of severe and combined forms of the pathology has been observed in recent years. According to modern concepts, inadequate cytotrophoblast invasion into the spiral arteries of the uterus and development of the ischemia-reperfusion syndrome in the placental tissue play the leading role in the development of preeclampsia, which is characterized by multipleorgan failure. In this regard, our work was aimed at studying the patterns of placental tissue transcriptome that are specific to females with PE and with physiological pregnancy, as well as identifying the potential promising biomarkers and molecular mechanisms of this pathology. We have identified 63 genes whose expression proved to differ significantly in the placental tissue of females with PE and with physiological pregnancy. A cluster of differentially expressed genes (DEG) whose expression level is increased in patients with preeclampsia includes not only the known candidate genes that have been identified in many other genome-wide studies (e.g., LEP, BHLHB2, SIGLEC6, RDH13, BCL6), but also new genes (ANKRD37, SYDE1, CYBA, ITGB2, etc.), which can be considered as new biological markers of preeclampsia and are of further interest. The results of a functional annotation of DEG show that the development of preeclampsia may be related to a stress response, immune processes, the regulation of cell-cell interactions, intracellular signaling cascades, etc. In addition, the features of the differential gene expression depending on preeclampsia severity were revealed. We have found evidence of the important role of the molecular mechanisms responsible for the failure of immunological tolerance and initiation of the pro-inflammatory cascade in the development of severe preeclampsia. The results obtained elaborate the concept of the pathophysiology of preeclampsia and contain the information necessary to work out measures for targeted therapy of this disease.

Aspects of lifelong learning of children with restricted health possibilities using with distance education technologies

The article outlines the problems of teaching children with disabilities. The advantages of training such persons with the use of distance learning technologies are consideredВ статье обозначены проблемы обучения детей с ограниченными возможностями здоровья. Рассматриваются преимущества обучения таких лиц с использованием дистанционных образовательных технологи

Debating capabilities of biochemical markers of liver function in patients with alcoholic liver cirrhosis

Introduction. The diagnosis of alcohol-related liver disease is limited by the lack of a tool to reliably identify whether the present deterioration in the patient’s condition is due to alcohol consumption or other causes.Purpose. to conduct a comparative assessment of the clinical and diagnostic significance of liver function biochemical indicators (AST, ALT, GGT, ALP) and their calculated derivatives (AST/ALT, GGT/ALP, GGT/GGTn, ALP/ALPn) as markers of alcohol consumption in patients with alcoholic liver cirrhosis.Material and methods. The observational study included 112 men over 18 years of age with alcohol-related liver cirrhosis. The patients were assessed the severity of liver cirrhosis according to the Child-Pugh scale, performed general and biochemical blood tests, coagulation test, assessment of the fact of alcohol consumption by the level of phosphatidylethanol. An analysis was made of the relationship between alcohol consumption and changes in laboratory parameters of liver function, with the determination of their sensitivity and specificity.Results. Patients with Child-Pugh B cirrhosis who consumed alcohol on phosphatidylethanol had higher levels of plasma albumin, GGT, and lower values of creatinine, direct and total bilirubin, urea, and aPTT compared with patients who did not drink alcohol (p < 0.05). Alcohol-drinking patients with class C cirrhosis have higher ALT levels compared with abstinent patients with the same severity of cirrhosis (p < 0.05). The relationship between the fact of alcohol consumption, determined by the level of phosphatidylethanol, and the ratio of GGT of patients to the normal GGT value, as well as between the ratio of GGT to alkaline phosphatase and the degree of increase in GGT, turned out to be statistically significant. To assess the fact of alcohol consumption, the level of serum GGT > 65 IU/ l (75.5%) has the highest sensitivity, the highest specificity is the ratio of the patient’s GGT to the normal value of GGT > 2 (82.9%).Conclusion. Compared with the known 100% sensitivity and > 92% specificity of Peth as a alcohol biomarker, among the biochemical indicators of liver function and their calculated derivatives, GGT > 65 IU/l have the greatest sensitivity or specificity (respectively, 75.5% and 65%) and GGTnorm. > 2 (37.7% and 82.9%, respectively), which makes it possible to use the totality of these parameters as an indicator of the continued impact on the patient of the main etiological factor of alcohol-related liver cirrhosis in the routine practice of most medical organizations of the Russian Federation

Economic benefit of using testosterone gel (used externally) in men with diabetes mellitus and testosterone deficiency

BACKGROUND: High prevalence of type 2 diabetes mellitus (T2DM) and its input to the increase of mortality indicate that social and economic value of this disease and financial burden are great. Testosterone replacement therapy (TRT) enhances the effectiveness of T2DM treatment. A research was conducted to assess if Androgel® therapy in diabetic men is cost-effective. OBJECTIVES: Defining of economic benefit of adding “Androgel” to the T2DM treatment in men with testosterone deficiency. MATERIALS AND METHODS: Economic modeling and results of other clinical studies were used in the analysis. A guildeline of The Scottish Intercollegiate Guidelines Network (SIGN) was used for clinical study selection, development of economic modelling and study design, assessment of study quality. The study analyzed clinical effects (fasting morning glycemia, glycosylated hemoglobin, HOMA index) and mortality reduce. RESULTS: It was shown that TRT can help to reduce costs of glycemic control, to increase efficiency in terms of cost-effectiveness analysis. Target HbA1c value can be reached by additional cost of 569.39 roubles for every patient. There is a possible additional income from 454.100 to 8.896.186 rubles though reduced mortality. CONCLUSION: Thus, testosterone replacement therapy was shown as cost effective due to reduced costs. The analysis demonstrated HbA1c target achievement and, as a result, reduction of the T2DM outcomes and reduced mortality. There is a possible additional income from 454.100 to 8.896.186 rubles per year

Clinical efficacy of drugs based on probiotic strains of Saccharomyces boulardii

Intestinal microflora in terms of the integral body of knowledge about its importance for the human body is now considered as an additional “virtual” organ, producing many biologically active compounds that affect the various properties and functions of the macroorganism: fermentation of non-digestible food polysaccharides, maintenance of the optimal values of the intra-lumen pH and “intestinal barrier”, the activity of the immune system, vitamin status, energy homeostasis, angiogenesis. Saccharomyces boulardii is not a representative of the natural microflora of the human intestine, but, used as a probiotic, interacts with it, restoring the balance of short-chain fatty acids, reducing the levels of bacterial toxins, acting as a surrogate normal microflora until it is restored and replaced by natural representatives. S. boulardii has immunostimulating and anti-inflammatory activity. The results of clinical studies have demonstrated the effectiveness of S. boulardii in correcting pathological conditions associated with Helicobacter pylori, Clostridium difficile, Candida albicans, Salmonella typhimurum, Yersinia enterocolitium, protozoa Entamoeba and in treating irritable bowel syndrome and antibiotic-associated diarrhea. The efficacy of a drug containing S. boulardii has been demonstrated in the article by clinical studies and a clinical example. This drug has proven to be a highly effective and safe probiotic agent for the prevention and treatment of a number of diseases of the gastrointestinal tract with physiologically optimized pharmacodynamic effect that simulates the protective properties of normal human intestinal microflora. When using a drug containing S. boulardii, both adults and children do not have serious side effects, which increases the possibility of its safe use in clinical practice

NSAID-induced damage to the gastrointestinal tract: new opportunities for the prevention of gastro- and enteropathies

Nonsteroidal anti-inflammatory drug is one of the most commonly prescribed drugs for the treatment of inflammatory and pain syndromes in the clinical practice of doctors of various specialties. The popularity of this pharmacological group is increasing due to over-the-counter dispensing condition, but at the same time, the significance of issues of likelihood, prevention and treatment of severe adverse drug reactions during intake that is controlled and uncontrolled by medical personnel is increasing. This review is devoted to the issue of non-steroidal anti-inflammatory drug-induced damage to the gastrointestinal tract and to the current possibilities to prevent and manage such damage. The drugs that can increase the production of prostaglandins and mucus in the digestive tract and have a general anti-inflammatory effect raise significant hopes. Rebamipide draws particular attention due to numerous pleiotropic effects, including stimulation of secretion of newly formed prostaglandins and glycoproteins in the mucous membranes, inhibition of synthesis of oxidative stress products, inflammatory cytokines and chemokines by intestinal epithelial cells. The authors considered the effectiveness of prophylactic use of rebamipide in comparison with other strategies for the use of drugs to prevent the development of stomach ulcers, duodenal ulcers and distal small bowel ulcers. They described the mechanisms of prophylactic action and its debatable aspects for proton pump inhibitors, H2-histamine receptor blockers, misoprostol. The clinical efficacy of rebamipide is illustrated by a clinical example. The absence of effects on cytochrome P450 enzyme activity, which minimizes the risks of drug interactions and changes in bioavailability, biotransformation and excretion of the drug itself during its course use is an additional advantage of rebamipide

Use of inosine pranobex in frequently ill children

The follow-up group of «frequently ill children» is formed on the basis of criteria formulated by domestic pediatricians A.A. Baranov and V.Yu. Al’bitskiy, due to the high relevance of medical, social and economic problems caused by the increased morbidity in this category of patients especially with acute respiratory infections, with likely development of severe complications or the manifestation of chronic respiratory diseases. In general, the state of the immune system in frequently ill children is characterized by decreased local immunity and increased stress of systemic immunity, and the features of the functional immunity activity in this category of patients determine the various possibilities to affect immunity during the prevention and treatment of acute respiratory infections. This article discusses the features of the functional activity of the immune system in frequently ill children, as well as the possibilities of drug management of its disorders and the benefits of using inosine pranobex to prevent and treat respiratory infections in this category of patients. According to the international classification of drugs maintained by the World Health Organization, the drug belongs to the groups of immunomodulators (L) and antimicrobial antiviral drugs (J) for systemic use. It is proved that inosine pranobex effectively increases cellular and humoral immunity, and reduces non-specifically the viral replication capacity. During clinical trials, the drug proved to be a highly effective and safe component of the complex treatment of acute respiratory infections in frequently ill children. The use of inosine pranobex reduces the duration and intensity of symptoms of infectious respiratory tract diseases. The drug can be recommended for children with concomitant chronic respiratory tract diseases

Rome IV criteria of functional gastrointestinal diseases in evaluation of drugs interchangeability: through the eyes of a clinical pharmacologist

The article analyses the factors likely leading to the lack of interchangeability of generic drugs for patients with functional gastrointestinal disorders (FGID). It substantiates the need for improvement of the legal basis and regulatory framework underlying drugs circulation in the Russia. Based on the modern classification of FGIDs, laid down in the article, and according to Rome IV criteria the authors formulated major concerns related to the reliability of non-adaptive assessment parameters of generics interchangeability. The article looks into genetically determined differences in the functional activity of the stomach and bowel in healthy people and people with FGIDs that preclude extrapolation of already established interchangeability to the population of patients with FGIDs. The article also highlights potential interaction of drugs that are prescribed to patients with FGIDs either for the treatment of the underlying disease or co-morbidities. It was shown that Rome IV criteria can be used (to a limited extent) in therapeutic equivalence studies of generic drugs used either as primary or concomitant medications in patients with FGIDs

Analysis of the Placental Tissue Transcriptome of Normal and Preeclampsia Complicated Pregnancies

abStract Preeclampsia is one of the most severe gestational complications which is one of the leading causes of maternal and perinatal morbidity and mortality. A growth in the incidence of severe and combined forms of the pathology has been observed in recent years. According to modern concepts, inadequate cytotrophoblast invasion into the spiral arteries of the uterus and development of the ischemia-reperfusion syndrome in the placental tissue play the leading role in the development of preeclampsia, which is characterized by multipleorgan failure. In this regard, our work was aimed at studying the patterns of placental tissue transcriptome that are specific to females with PE and with physiological pregnancy, as well as identifying the potential promising biomarkers and molecular mechanisms of this pathology. We have identified 63 genes whose expression proved to differ significantly in the placental tissue of females with PE and with physiological pregnancy. A cluster of differentially expressed genes (DEG) whose expression level is increased in patients with preeclampsia includes not only the known candidate genes that have been identified in many other genome-wide studies (e.g., LEP, BHLHB2, SIGLEC6, RDH13, BCL6), but also new genes (ANKRD37, SYDE1, CYBA, ITGB2, etc.), which can be considered as new biological markers of preeclampsia and are of further interest. The results of a functional annotation of DEG show that the development of preeclampsia may be related to a stress response, immune processes, the regulation of cell-cell interactions, intracellular signaling cascades, etc. In addition, the features of the differential gene expression depending on preeclampsia severity were revealed. We have found evidence of the important role of the molecular mechanisms responsible for the failure of immunological tolerance and initiation of the pro-inflammatory cascade in the development of severe preeclampsia. The results obtained elaborate the concept of the pathophysiology of preeclampsia and contain the information necessary to work out measures for targeted therapy of this disease