Medico-social rationale for adaptation of regional drug supply systems to personalized pharmaceutical care for persons of different ages

In this study, we identified indicators of the state of personalized pharmaceutical care for target population groups at the regional level, in a model region, with the aim to develop a differentiated approach to such care. The rationale for the choice of Moscow Region as a model region is based on its specific socioeconomic indicators and a comparison of these with respective average Russian values. A need was shown to modernize patient-oriented pharmaceutical care, especially for certain population groups, such as children, women of working age (mothers), and the elderl

Пандемия коронавируса как основание ограничения прав и свобод человека

The subject. The article analyzes the phenomenon of the COVID-19 pandemic and its impact on the human rights and freedoms. It emphasizes that some information about the corona-virus infection was available several decades ago. At the same time, the specialists unfortunately weren’t ready for the possible mutation of this virus, which has now exposed a large-scales threat to the population of the whole world.The purpose of the article is to identify the problems of the implementation of the citizens’ rights and offer proposals for improving the Russian and Belarusian legislation and the practice of its implementation in the field of combating the coronavirus infection.The methodology. The authors take into account the practice of the European Court of Hu-man Rights and the constitutional control bodies of Russia and foreign countries. They make a conclusion on the legitimacy and necessity of the taken restrictive measures. The article is based on the dialectical method, as well as at the logical, historical, systemic methods. Methods of analysis and synthesis were of particular importance. The authors have applied the functional method to research the main areas for ensuring a reasonable balance of private (individual) and public interests.The main results, scope of application. Modern constitutions, including the Russian and the Belarusian ones, contains the most important principles of the rule of law, enshrine human rights and freedoms as the highest value. Human rights and freedoms continue to be are at the epicenter of many disputes and discussions. The modern system of rights and freedoms is constantly developing; the legal status of a person receives new content as the human civilization develops and the paradigm of values changes. For example, we see how information technology and other advances affect the scope of rights and freedoms. Rights, freedoms and obligations are interconnected and interdependent. All groups of rights are currently in the field of view of international organizations. The problem of equality, the elimination of discrimination, the restoration of violated rights, the assessment of the limits of the state's invasion in human rights and freedoms continues to be relevant nowadays.The article focuses on the international and national standards for the possible restriction of rights and freedoms in order to protect the health of the population. The international law rules on human rights oblige states to take measures to protect health and provide medical assistance to those in need.Conclusions. One of the constant problems is the relationship between the rights of a particular person and the rights of other persons, group or society as a whole and the state. At the same time, the coronavirus pandemic forced the public authorities to determine the balance of the priority of human rights and freedoms or the protection of the life and health of citizens. The coronavirus pandemic is the factor that affects the content of the legal regulation of relations in the field of human rights and freedoms. The measures taken by the state affect the right to health protection, freedom of movement, the right to education, right to have sport activity, right to work, freedom of assembly and others.The article proposes to inform the population more fully about the measures taken by the state and society in this direction, about the wider use of information technologies, about the possible responsibility for non-compliance with the requirements for the use of per-sonal protective equipment and the self-isolation regime.Предметом исследования являются правоотношения, складывающиеся в условиях пандемии коронавируса COVID-19, в рамках которых возникают основания для ограничений прав и свобод человека и гражданина. Поставлена цель провести анализ динамики развития пандемии коронавируса с позиций ее влияния на права и свободы граждан. Методологической базой исследования является диалектический метод научного познания, а также логический, исторический, системный методы. Особое значение имели методы анализа и синтеза. Применен функциональный метод для исследования основных направлений обеспечения разумного баланса частных (индивидуальных) и публичных интересов. Акцентировано внимание на международных и национальных стандартах возможного ограничения прав и свобод в целях защиты здоровья населения. Внесен ряд предложений по совершенствованию российского и белорусского законодательства и практики его применения в сфере противодействия коронавирусной инфекции

Preparation of alumina nanoparticle suspensions with narrow particle size distribution

Dynamic light scattering (DLS) was applied to the study of the process of the preparing deaggregated water suspensions of alumina nanopowders with specific surface areas of 20-140 m2/g. Nanopowders were prepared by the electric explosion of wire and laser evaporation and, according to electron microscopy (TEM), consisted of nonagglomerated spherical nanoparticles with lognormal size distribution. According to DLS, nonsedimenting water suspensions of alumina nanoparticles, stabilized by sodium citrate at a 5 mM concentration, contain substantial fraction of aggregates. The dynamics of the change in the mean average size of aggregates under exhaustive ultrasound treatment of suspensions with 10 g/l concentration for 1.5-4 h by two types of ultrasonic processors was studied. It was shown that the mean average size of aggregates exponentially diminishes by 1.5-2 times and the fraction of individual particles in suspension enlarges from 45 to 85%. Sequentially centrifuging the suspension at 18000 g separates the remaining aggregates and results in suspensions of individual alumina nanoparticles. Particle size distributions in these suspensions obtained by TEM and DLS are the same within experimental error. © 2013 Pleiades Publishing, Ltd

SOCIO-ECONOMIC DAMAGE BY ACUTE CORONARY SYNDROME IN RUSSIAN FEDERATION

Aim. To estimate the economic damage by acute coronary syndrome (ACS) in Russia in 2006-2009. Material and Methods. Direct costs and economic losses associated with ACS were estimated. The structure of direct costs includes the costs of hospitalization, medical emergencies, out-patient visits, high-tech medical care, as well as drug therapy in outpatient treatment. Losses in the economy associated with ACS include loss of gross domestic product due to death in working-age, temporary disability and payments of disability benefits. Estimation of economic damage by cardio-vascular diseases was based on analysis of Russian Ministry of Health official statistics. Results. Approximately 520,000 cases of ACS are registered annually (36,4% - myocardial infarction, 63,6% - unstable angina). Trend to increased mortality from myocardial infarction, especially among women, was found during the analyzed period. From 2000 to 2009 this index rose from 34.9 to 41.1 per 100,000 of population among women, and from 52.3 to 55.9 per 100,000 of population among men. Total direct costs of health care for patients with ACS in 2009 amounted to almost 21 billion rubles, and indirect – 53.5 billion rubles. The total economic damage by ACS in Russia in 2008-2009 exceeded 70 billion rubles per year. Conclusion. ACS in Russia is connected with significant social and economic damage. Most part of this damage is indirect losses in economy due to premature mortality of working aged men

The theoretical and experimental investigation of the halogencyclenes' phosphorylation

The phosphorylation reactions of the oxygen- and nitrogen-containing halocyclenes - 3,4-dichloro-5-hydroxyfuranone, 3,4-dichloro-5-substituted pyrrolinon-2-ones and N-phenyl-4,5 dichloropyridazin-2-one by σ3-phosphorus compounds - trialkylphoshphites, triphenylphosphine, and some P-functionalized derivatives of the trivalent phosphorus are studied. The reactions' mechanisms are discussed; the possible and preferable reactions' routes and the relative thermodynamic stabilities of the products and intermediates are estimated via the quantum-chemical methods

EVALUATION OF CYTOKINE-MEDIATED MECHANISMS INVOLVED IN DEVELOPMENT OF RESPIRATORY MUSCLE DYSFUNCTION IN THE PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Respiratory muscle (RM) strength was studied in 85 men with exacerbations of chronic obstructive pulmonary disease (COPD). The strength indicators of expiratory (MEP) and inspiratory pressure (MIP, SNIP) in oral cavity were registered by means of the MicroRPM device (CareFusion, UK), as well as intranasal pressure levels by SNIP test. The measured MEP, MIP и SNIP values were compared to the proper indices. Serum concentrations of cytokines (IL-4, IL-6, IL-10, IL-17A, IL-21, TNFα, IFNγ and TGF-β) were determined. The results of the study were processed by means of canonical analysis and by clustering methods. Expiratory RM dysfunction was recorded in mild COPD, expiratory-inspiratory RM dysfunction was recorded in moderate COPD and the diaphragm dysfunction was recorded in severe COPD. Three groups of patients with different combinations of RM strength indicators and immune parameters were identified by means of cluster analysis. The cytokine profile in the first cluster was characterized by maximal concentrations of IL-17A, IL-21, TNFα and TGF-β, whereas RM strength indexes showed minimal values. In the second cluster, a decrease of RM strength indicators by 25-40% against control was associated with a sharp rise of IL-6, along with moderate increase of IL-21 and TGF-βconcentrations. In the third cluster, maximal levels of IL-6, IL-10 and IFNγwere registered, along with low levels of IL-17A, IL-21 and TGF-β concentrations, whereas MEP, MIP и SNIP values did not sufficiently differ from their levels in second cluster. The results of canonical and correlation analysis indicated to interconnections between either certain cytokines, or their pool with the RM strength indicators, dyspnea severity and functional state of COPD patients, thus suggesting involvement of cytokine-mediated mechanisms in pathogenesis of the respiratory muscle dysfunction

Phosphorylation of 3,4-dichloro-5-hydroxy-2(5H)-furanone with tributylphosphine

The reaction of 3,4-dichloro-5-hydroxy-2(5H)-furanone with 2 mol of tributylphosphine involves substitution of both chlorine atoms to form an unstable diphosphonium salt. The latter undergoes partial hydrolysis with cleavage of one of the P-C bonds, yielding finally a monophosphorylation product. A probable reaction pathway is considered in terms of quantum chemistry

Augmentation of pedicle screws using bone grafting in patients with spinal osteoporosis

The aim of the study was to develop a new method of vertebral augmentation based on autologous and allogeneic bone chips to be used in pedicle screw fixation and to compare this method with the technique based on polymethyl methacrylate (PMMA). Materials and Methods. This prospective non-randomized study included 164 patients with degenerative pathologies or traumatic injuries of the lumbar spine and transitional thoracolumbar segments; 153 of the operated patients were followed up for 18 months. In these patients, radiodensity of the cancellous bone tissue was below 110 HU by the Hounsfield scale. Patients with degenerative spinal disorders underwent pedicle screw fixation using transforaminal interbody fusion; patients with traumatic spinal injuries underwent intermediate pedicle screw fixation, and those with a loss of vertebral body height by \u3e50% underwent anterior fusion. The patients were divided into three groups: in group 1 (n=39), bone tissue augmentation was performed using PMMA; in group 2 (n=21), augmentation was done with bone chips; in group 3 (n=93), no augmentation was performed (control group). The follow-up period was 12 months; cases with fixator breakage or loosening were recorded. Results. After augmentation with PMMA, 11 cases (28.2%) of fixator destabilization were detected. With bone chips, fixator instability developed in 2 patients (9.5%) only, whereas in patients operated without augmentation, the instability was observed in 43 cases (46.2%). With PMMA augmentation, the incidence rate of fixator destabilization did not significantly differ from that in the control group (p=0.0801), while the use of bone chips resulted in a statistically significant decrease of this index compared to the control group (p=0.0023). A logistic regression analysis confirmed the superiority of the developed method over the PMMA-based vertebral augmentation. Conclusion. The use of bone chips for vertebral augmentation provides a statistically significant decrease in the incidence of pedicle screw fixator destabilization in the post-operative period. By reducing the risk of proximal loosening and eliminating the risk of bone cement drainage into the spinal canal and vascular bed, the proposed method may become especially effective in patients with impaired bone density

Epistemological models in understanding cultural and civilizational specificity

The article proposes a methodology for linking the formation-evolutionary, cultural-civilizational, ethnological, and cultural-anthropological models in understanding the changes of complicated sociocultural system