FISHBURNE's METHOD AND THE CLASSICAL METHOD OF PHARMACOECONOMIC ANALYSIS IN THE EVALUATION OF ANTIBIOTIC TREATMENT OF ACUTE AND RECURRENT BRONCHITIS IN CHILDREN

Objective: This study was performed in order to estimate clinical effectiveness of antibiotic therapy in acute and recurrent obstructive bronchitis. For estimation the following was used: the Fishbern method of antibiotics distribution according to clinical effectiveness levels with the help of weighted coefficients and classical cost–efficiency†pharmacoeconomic analysis of the given antibiotic therapy. Then, for the first time ever, the obtained results of both methods were combined.Methods: Materials were presented by the data on antibiotic therapy, given for patients who were hospitalized to the in-patient medical facilities due to acute or recurrent obstructive bronchitis. Medical records of 2 259 patients were included in the study. The patients were 0 to 18 y old. In order to determine the weighed coefficients of each used antibiotic with subsequent distribution according to the levels of clinical effectiveness the Fishbern method was applied. Three levels of clinical effectiveness were used in this study, i.e. high, medium and low. The cost–efficiency†pharmacoeconomic analysis was applied to combine costs and efficiency of the compared therapy courses in acute and recurrent obstructive bronchitis.Results: Finally we found out that the highest probability of positive effect of cephalosporins group agents was associated with the use of Cefotaximum. (Biosynthesis). From the pharmacoeconomic point of view the most effective in treating acute and recurrent obstructive bronchitis in children in the in-patient facilities was Ceftriaxonum (Synthesis). Out of protected penicillins group, we used Amoxicillin/clavulanic acid–original drug Augmentin (Smithkline Beecham Pharmaceuticals) and generic drug Amoxiclav (Lek d. d). Augmentin effectiveness was 0.591, and Amoxiclav effectiveness–0.530. Cost of Augmentin treatment course was 106.26 rub. (1.68 US$), cost of Amoxiclav treatment course–103.50 rub.(1.63 US$). Augmentin use turned out to be the most reasonable. Augmentin treatment course was characterized by lower ICER coefficient versus Amoxiclav. We found out that from the pharmacoeconomic point of view Azitromicin (Vertex Ltd.) treatment turned out to be the most reasonable of the whole macrolides antibiotics for treatment of acute and recurrent obstructive bronchitis. However, according to the Fishbern clinical effectiveness classification this antibiotic belonged to the group with medium effectiveness level. The group with high effectiveness level included Sumamed, Azitral, Hemomicin, Clacid, Zitrocin and Clabax. Clacid and Clabax were excluded during the pharmacoeconomic analysis. The highest value of ICER coefficient was obtained for Sumamed and made up 39,367.50 rub. (621.53 US$). The highest level of clinical effectiveness was characteristic for Sumamed as well. Besides Sumamed was an original drug of azitromicin. According to the obtained data Azitral and Hemomicin had the lowest values of ICER coefficient (1151.67 rub. (18.18 US$) and 1812.22 rub. (28.61 US$) respectively). Therefore based on the clinical economic analysis these medical agents turned out to be the most suitable.Conclusion: The results of the pharmacoeconomic analysis showed that the most effective drugs in treatment of acute and recurrent obstructive bronchitis in children in in-patient facilities appeared to be the following: out of cephalosporins-Ceftriaxonum (Synthesis), out of protected penicillins-Augmentin (Smithkline Beecham Pharmaceuticals), out of macrolides-Azitromicin (Vertex Ltd.). According to the Fishbern classification, these drugs belonged to the group with medium level of effectiveness.Â

ROLE OF "ATYPICAL" MICROORGANISMS ON THE FORMATION OF BRONCHIAL ASTHMA IN CHILDREN WITH ACUTE AND RECURRENT OBSTRUCTIVE BRONCHITIS

Objective: This study was undertaken to determine the link between the presence of atypical†infections in patients with acute obstructive andrecurrent obstructive bronchitis (AOB/ROB) and bronchial asthma (BA) development based on the concept of risk.Methods: The materials for the study were the data records of patients hospitalized with AOB or ROB and whose analysis was performed to identifyantibodies to atypical†microflora (796 patients). The study period was 4 years from 2008 to 2011. In the analyzed period, immunosorbent assay forthe detection of antibodies to atypical†microflora (Chlamydophila pneumoniae, Mycoplasma pneumoniae, Mycoplasma hominis) was performed. Theconcept of risk identification was based on the determination of the absolute risk, attributable risk (AtR), relative risk, population attributable risk, aswell as on the definition of the standard errors for each type of risk and the confidence interval.Results and Conclusion: Methodical aspects of determining the relationship between the presence of atypical†infections in patients with AOBor ROB and BA development were based on the concept of risk. The analysis showed a direct link between the increase of cases of BA formationagainst the backdrop of atypical†infections. Therefore, the performed analysis of atypical pathogens influences on BA occurrence in patients withAOB/ROB which indicates direct dependence increase of BA incidence on atypical infection. In experimental group, Frequency of event is 14.84% inexperimental group. Frequency of event is 1.67% in control group. The risk factor increases probability of event by 13.17%, the risk factor increasesprobability of event by 13.17%. Presence of atypical infection leads to increase of BA incidence by 8.9 times. Number needed to harm (NNH) is 7.59,i.e., in the presence of atypical infection in patients with AOB/ROB, each eighth exposed person develops BA in addition to background level of BAincidence.Keywords: Acute obstructive bronchitis, Recurrent obstructive bronchitis, Bronchial asthma, The concept of risk, Risk factor, The absolute risk,Relative risk, Attributable risk, Population attributable risk, Number needed to harm

Multicultural Teaching in Regions (Within Sustainability Conception in Education)

This research is dedicated to the study of the sustainability conception in education adopted by multicultural processes. The results of this research are analysed from a study conducted at Samara State University of Social Sciences and Education and Ludwigsburg Pedagogical Institute.  Multicultural teaching develops dynamically. It seems possible to develop an instrument to evaluate on an ongoing basis as to how to improve multicultural teaching further within regional policy. For this, we aim to demonstrate the importance of using Inter- and trans-disciplinary methods as a significant contributor in many countries to better understand perspectives to analyse multicultural teaching in regions. To further the ideas about the perspectives to develop multicultural teaching, we feel strongly that action-oriented and reflective and responsible methods are an important mediator to ensure multicultural teaching. Hence, in this research we speak about the integrative model, in particular, considering the relationship that exists between the educational practices to increase the role of education and the determinate needs of peoples of all nationalities and the new phenomenon of the regional policy. To do so, we use structural and functional approach. The ideas presented here attempt to visually organise the views upon which Russian intercultural experts have reached in particular considering the methods that exist to improve multicultural teaching

Morphofunctional Changes of the Retina and Optic Nerve in Optical Neuropathy of Various Genesis: A Literature Review

The retina is part of the central nervous system and has much in common with the brain’s physiological characteristics. Ophthalmological manifestations often precede the symptoms of central nervous system disorders and are used for their early diagnosis. Retinal imaging is simpler and more economical than the available central nervous system imaging methods. In this connection, the search for retinal biomarkers of neurodegenerative diseases is relevant. Optical coherence tomography is highly valuable both for routine clinical practice and for research purposes. Different patterns of structural changes of the optic nerve and retina in optical neuropathies of various genesis are due to differences in the pathogenesis of diseases (glaucoma optic neuropathy, non-arterial anterior ischemic optic neuropathy, optic neuritis associated with multiple sclerosis, and compression optic neuropathy). The identified biomarkers can be used for screening patients in primary healthcare institutions to provide a preliminary diagnosis of patients at risk

Initiatives and the process of the development of regional students’ cross-cultural communication skills

The article states the problem of preparing students for cross-cultural communication by some means of initiatives. The authors provide a detailed series of definitions and determine the necessity to consider regional specificities during the development of initiatives aimed at improving the students’ cross-cultural communication skills. Thus the following main prospects outline the design of the initiatives: the examination of the quantitative and qualitative analysis, which will enable to identify the students’ preparedness for the project; the review of research works and analytical data reflecting the role and importance of initiatives; the analysis of the mechanisms for initiatives’ implementation, one of which is a professional task. The main results are the determination of the value foundations of the mechanisms for students’ preparation, justification for the selection of the region taken for comparison and analysis, the experience of which is adapted to the conditions of the local region, consolidation of the main areas of students’ cross-cultural training implemented within the project framework, and the design of a predictive model of the initiative. Systematic and structural-functional approaches are used to fulfill the goal set (to expand the right understanding of the prospects for the design of initiatives during the development of cross-cultural communication)

ГЕЛЬМИНТОЗЫ РЕСПУБЛИКИ КРЫМ

In Russia, the most common helminthosis are enterobiosis and ascariasis, which are also the most common in the Republic of Crimea. The largest number of cases of infection with these helminthosis are among on the children’s population of the Crimea. Infections other helminthosis in the Crimea sporadically.На территории России самыми распространенными гельминтозами являются энтеробиоз и аскаридоз, которые также являются самыми распространенными на территории Республики Крым. Наибольшее количество случаев заражения данными гельминтозами приходится на детское население Крыма. Случаи заражения другими гельминтозами на территории Крыма спорадичны

Investigation of the Respiration Rate During Storage of Fruit Vegetables Under the Influence of Abiotic Factors

The aim of the work was to establish the influence of most important abiotic planting factors (temperature, precipitation quantity) on the respiratory rate of fruit vegetables at storage and also a possibility of correction of respiratory metabolism by post-harvest thermal processing by antioxidant compositions. Fruits of cucumbers of the hybrids Masha and Afina, bush pumpkins Kavili and Tamino, sweet pepper of the hybrids Nikita and Hercules, tomato of the varieties Novachok and Rio Grande Original were used for the studies. It was established, that the respiratory rate of pumpkin fruit vegetables is importantly influenced by the variety specificity. The respiratory level of pumpkin vegetables directly correlates with the sum of active temperatures of the period of fruits formation and reversibly – with precipitation and hydrothermal coefficient.The influence of the variety specificity for nightshade vegetables is leveled, and among meteorological planting conditions the important intense influence on the respiratory rate is realized by the sum of active temperatures of the period of fruits formation and ripening. Precipitation and hydrothermal coefficient have the important influence only on pepper fruits.It was established, that the use of post-harvest thermal processing by antioxidant compositions results in inhibition of respiratory processes in fruit vegetables at storage