Aim. To compare features of pharmacotherapy of patients with chronic heart failure (CHF) with a reduced ejection fraction of the left ventricle (LV EF) who were admitted in a specialized department ...of the multidisciplinary hospital in Saratov before and after the publication of the Russian National Recommendations (4 revision) on the diagnosis and treatment of CHF (2012). Material and methods. A pharmacoepidemiological retrospective study was conducted. The object of the study was the medical records of inpatients (form 003/y) with the diagnosis "Heart failure" (ICD-I50), that consecutively admitted to the cardiology department of the multidisciplinary hospital in Saratov from April 28, 2009 to January 19, 2010 (n=52) and from February 19, 2014 to May 20, 2015 (n=95). Patients over 18 years of age with diagnosis of CHF (NYHA II-IV) and LV EF <45% were enrolled into the analysis. For each patient, an individual registration card was filled in which the patient's clinical and demographic characteristics, prescribed medications, their daily dose, the frequency of administration, the route of administration were indicated. Pharmacoepidemiological analysis was carried out for the drugs prescribed at the 1st day of hospitalization, at the 3rd-6th day (the time of stabilization of the patient's condition, which was evaluated by the reduction in dyspnea and increase in the tolerance to physical loads). The recommendations given by the physicians at discharge of the patients from the hospital were also considered. Results. In 2014-2015 years, compared to 2009-2010 years, the number of identified arrhythmias and severe forms of arterial hypertension significantly (82.1 vs 77%; р<0.05) increased. In 2014-2015 the frequency of the prescriptions of ACE inhibitors decreased (77.8 vs 86.5%; p<0.05). The frequency of the prescriptions of angiotensin II receptor blockers, antagonists of mineralocorticoid receptors (AMCR), diuretics, oral anticoagulants, clopidogrel increased (p<0.05). In the structure of combination therapy in 2014-2015, the frequency of the prescription of the ACE inhibitor+beta-blocker and ACE inhibitor+beta-adrenoblocker+AMCR combinations decreased significantly (18.9 vs 26.9%, p<0.05 and 22.1 vs 42.3%, p<0.05, respectively). At the same time prescription frequency of the ACE inhibitor+beta-blocker+AMCR+diuretic combination increased (25.2 vs 11.5%, p<0.05). Conclusion. Pharmacotherapy of CHF in hospital in 2014-2015 is consistent with the Russian National Recommendations (4 revision) and is significantly different from the CHF therapy in 2009-2010. Keywords: pharmacoepidemiology, chronic heart failure, treatment.
Beekeeping is one of the essential branches of agriculture in Ukraine, the main activity of which is aimed at breeding bees and obtaining honey and other products beneficial for human health. ...Maintaining the physiological state of bee colonies at the proper level is one of the essential tasks of veterinary medicine doctors and beekeepers. Compliance with veterinary and sanitary requirements at bee farms is the basis of preventing infectious pathologies in bee colonies. Since the body of insects has a fast metabolism, any infectious pathology quickly acquires a massive manifestation. One indicative symptom of infectious damage to the “gut” of bees is dyspepsia. Diarrhea, anorexia, and loss of productivity are observed in bees in this condition. The market of means to prevent such pathological manifestations in beekeeping is relatively narrow. The healing and favorable properties of honey, manifested in pain-relieving, antimicrobial and anti-inflammatory effects, have been known since ancient times. Sunflower honey differs from other types in a wide range of components, particularly phytoncides, which inhibit the growth of pathogenic microorganisms. Therefore, the main goal of the experiment was a laboratory study of the effect of different concentrations of sunflower honey sieve on the mixed microbial association isolated from bees with signs of dyspepsia. The activity of sunflower honey in laboratory conditions was studied by the disco-diffusion method in Petri dishes on MPA medium (meat-peptone agar). To obtain syrup from sunflower honey, sunflower honey was diluted with distilled water in a ratio of 1:1, working solutions were prepared from sunflower honey syrup in dilutions of 1:2, 1:4, 1:10, 1:100. The data analysis indicates the bacteriostatic activity of the syrup from sunflower honey in all studied concentrations concerning the mixed microbial association. Moreover, the largest diameter of the growth inhibition zone of the studied microorganisms was noted when the syrup from sunflower honey was diluted in a ratio of 1:10 (19.2 ± 0.42 mm). In turn, the antagonistic effect of the syrup from sunflower honey was observed in all dilutions concerning the mixed microbial association, where the largest diameter of the antagonism was 19.6 ± 0.27 mm when the disc was impregnated with the native working solution. Thus, it is promising to accumulate and identify a pure culture antagonist concerning a mixed culture of bacteria isolated during bee diarrhea to further create a pharmacological agent for preventing infectious pathologies of bees in unhealthy apiaries.
Aim
. To study the changes that have occurred in the pharmacotherapy of atrial fibrillation (AF) in the Saratov Region for 5 years by analyzing the antithrombotic therapy of patients who were ...admitted in a specialized department of the multidisciplinary hospital in Saratov in 2011-2012 and in 2016-2017.
Material and methods
. A pharmacoepidemiological retrospective study was conducted. The object of the study was the medical records of inpatients (Form 003/y) with the diagnosis “Atrial fibrillation” (ICD-X code I48), that consecutively admitted to the cardiology department of the multidisciplinary hospital in Saratov from January 1, 2011 to December, 31, 2012 (n=211) and from January 1, 2016 to December, 31, 2017 (n=227). Criteria for inclusion in the study: patients over 18 years of age, established diagnosis of non-valvular AF of ischemic genesis. Exclusion criteria from the study: non-ischemic cardiomyopathy, thyrotoxicosis, congenital heart defects, rheumatic heart damage, acute coronary syndrome, endocarditis, myocarditis, pericarditis, pulmonary thromboembolism, the presence of prosthetic heart valve. Pharmacoepidemiological analysis was carried out for the drugs prescribed during hospitalization and given by doctors at discharge of patients from the hospital. The risk of ischemic stroke was assessed using the CHA
2
DS
2
-VASc score, and the risk of bleeding – according to the HAS-BLED score.
Results
. When analyzing the risk of ischemic stroke, it was found that 100% of patients in 2011-2012 years and 98.2% in 2016-2017 years had indications for the prescription of oral anticoagulants (OAСs). In 2011-2012 there were no patients with a low risk of stroke (CHA
2
DS
2
-VASc=0). High risk of bleeding (HAS-BLED≥3) occurred in 4.7% of patients in 2011-2012 and in 10.6% in 2016-2017, however, due to the high risk of stroke, the refusal to prescribe OAC in these patients was inappropriate in accordance with the recommendations for the treatment of AF. In the group of patients with CHA
2
DS
2
-VASc=0 in 2016-2017 antiplatelet therapy was prescribed in 100% at the hospital stage and at discharge, which contradicts the guidelines, according to which antithrombotic therapy is not recommended to patients with CHA
2
DS
2
-VASc=0. In patients with CHA
2
DS
2
-VASc=1, a low percentage of anticoagulants prescription was noted. In 2016-2017 OACs were prescribed only in 12.5% of patients at all stages of observation. In 2011-2012 OAC alone was prescribed only to 1 person (20%) at the hospital stage, which does not comply with modern guidelines for the treatment of patients with AF, according to which patients with a risk score CHA
2
DS
2
-VASc=1 are recommended to receive OACs in the absence of contraindications. OACs prescription in group CHA2DS2-VASc≥2 occurred only in 15% of patients in 2011-2012 and in a third of patients in 2016-2017 (p<0.05). The frequency of isolated use of OACs significantly increased in 2016-2017 compared to 2011-2012 mainly due to the increase in the spectrum of direct OACs (DOACs) (p<0.05).
Conclusion
. For 5 years there have been significant changes in the antithrombotic therapy of AF in the Saratov Region. The frequency of prescribing OACs according to indications has increased mainly due to the introduction of the DOACs into clinical practice. However, prevention of stroke remains insufficient.
Article 64 of the Constitution of Ukraine defines a list of human rights and freedoms that may be restricted under martial law to protect the national security and territorial integrity of Ukraine, ...including the right to access information. This provision corresponds to Part 3 of Article 34 of the Constitution of Ukraine, Part 1 of Article 8 of the Law of Ukraine "On the Legal Regime of Martial Law".
Due to the military aggression of the Russian Federation against Ukraine, the dissemination of information about the activities of state authorities and their employees, including courts and justice system bodies, can impose a threat to their life and health, cause crimes to be committed and be a threat to national security, and therefore can subject to restrictions by law.
The article examines the grounds and conditions for restricting the right to access the public information under martial law; special attention is paid to the issue of restricting access to public information at the disposal of the courts and the State Judicial Administration of Ukraine.
The author analyzed statistical data on the number of submitted requests for obtaining public information, cases of filing complaints about illegal actions of managers of public information when considering requests since the introduction of martial law on the territory of Ukraine.
The article proves that since the Law of Ukraine "On the Legal Regime of Martial Law" does not provide for a direct possibility to establish any prohibitions or restrictions on the fulfillment of the duties of managers in considering requests or disclosing public information, when deciding the issue of limiting or providing access to that or other information in the conditions of martial law, the need to maintain an appropriate balance between the protected interest of a specific person and public interests and the application of the established practices to approve the request remain.
The article also explores the possibility of restricting the dissemination of restricted information during martial law, which is socially necessary, when the public's right to know this information outweighs the potential harm from its dissemination.
Стаття 64 Конституції України визначає перелік прав і свобод людини, які можуть бути обмежені в умовах воєнного стану задля захисту національної безпеки та територіальної цілісності України, до ...переліку яких відноситься і право на доступ до інформації. Це положення кореспондується з частиною 3 статті 34 Конституції України, частиною 1 статті 8 Закону України «Про правовий режим воєнного стану». Через військову агресію російської федерації проти України поширення інформації щодо діяльності органів державної влади, їхніх працівників, в тому числі щодо судів та органів системи правосуддя, може становити загрозу їх життю та здоров'ю, спричиняти скоєння злочини та бути загрозою національній безпеці, а тому може підлягати обмеженню в силу закону. В статті досліджуються підстави, умови обмеження права на доступ до публічної інформації в умовах воєнного стану, особлива увага приділена питанню обмеження доступу до публічної інформації, що знаходиться в розпорядженні судів, Державної судової адміністрації України. Авторами проаналізовані статистичні дані щодо кількості поданих запитів на отримання публічної інформації, випадки подання скарг на неправомірні дії розпорядників публічної інформації при розгляді запитів з моменту запровадження на території України воєнного стану. В статті доводиться, що оскільки Законом України «Про правовий режим воєнного стану» не передбачено прямої можливості встановлювати будь-які заборони чи обмеження щодо виконання обов’язків розпорядників з розгляду запитів чи оприлюднення публічної інформації, при вирішенні питання щодо обмеження чи надання доступу до тієї чи іншої інформації в умовах воєнного стану зберігається необхідність дотримання відповідного балансу між захищеним інтересом конкретної особи та суспільними інтересами, застосування так званого «трискладового тесту». В статті досліджується також можливість обмеження в період воєнного стану поширення інформації з обмеженим доступом, яка є суспільно необхідною, коли право громадськості знати цю інформацію переважає потенційну шкоду від її поширення.
The important role of honey bees has been known for a long time, as the successful work of Apis mellifera helps to maintain natural biogeocenoses and provides humanity with food and medicinal ...production. The massive loss of honeybee colonies in the southern and eastern border regions of Ukraine is putting a strain on beekeeping production in the north-western regions of Ukraine. To intensify apiaries, there is a need for systematic and regular monitoring research. Epizootic monitoring provides data on the health of honey bees in a specific geographical region that can be scientifically substantiated. To analyse the epizootic situation with contagious bee diseases in the Rivne region in 2017–2022, we used official data from the State Service of Ukraine on Food Safety and Consumer Protection in the Rivne region. In addition to epizootic monitoring, the aim of our study was to identify the most common bee diseases in this region. The analysis of the results shows that diagnostic tests for varroosis and nosema, acarapidosis, American and European foulbroods, and amoebiasis are planned and carried out systematically. From 2017 to 2021, the number of diagnostic tests for bacterial diseases of bees was increased. At the same time, in 2022, the activity of such research decreased by 6.4% in comparison to 2021. A different pattern was registered for parasitic diseases of bees. For example, there was an increase in the number of such studies from 2019 (1678 studies) to 2022 (3184 studies). It was found that the Rivne region has been safe from American and European foulbroods, acarapidosis, braulosis and amoebiasis for the last 6 years. Varoosis and nosema are registered annually in 2017–2022, with the infection rate for these diseases set at 11.06 % (2020) – 14.82 % (2022), respectively. This data is likely to indicate a change in the economic situation of beekeepers, which makes it impossible to prevent hives from being treated for certain diseases in a timely manner. Thus, the analysis of laboratory tests for contagious diseases of bees helps to detail the epizootic state of a particular region, which allows to determine the direction for veterinary and sanitary measures for a specific apiary.
Monitoring of the effectiveness of drug therapy is one of the most debated issues in everyday clinical practice. The emergence of new drugs, methods of analysis, standards, management protocols, and ...clinical guidelines increases the information load on practitioners and requires a significant investment of time and efforts for self-education. The purpose of the review is to help practitioners in summary form to obtain the necessary information on the issue of control of antiplatelet therapy. The review brings together data from current clinical recommendations on antiplatelet therapy in patients with ischemic heart disease, gives information of existing approaches to control of antiplatelet therapy specified in the guidelines and the consensuses of experts. It presents information on the most common modern methods of monitoring of the antiplatelet therapy effectiveness.
The seasonal blood pressure variability (BPV) is known to demonstrate a typical winter peak. Recently, more attention is paid to the opposite situation: the summer BP levels being higher than those ...in winter. This phenomenon is called inverse BPV. The present article summarizes recent data on this topic. The data of the HOMED-BP project, as well as the results of the original prospective study in 770 hypertensive patients from two Russian Federation regions (mean follow-up duration 6.4 years), were used. According to the preliminary knowledge, the prevalence of inverse BPV in hypertensive patients is relatively high (15-25%). This phenomenon is more typical for treated patients, particularly for those on combination therapy, and is associated with beta-blocker intake. Higher duration of hypertension and higher levels of some risk factors (smoking) characterize the patients with inverse BPV. According to the HOMED-BP data, patients with inverse BPV had the highest overall cardiovascular risk (hazard ratio in comparison with the reference group of “minimal” “normal” BPV was 3.07; p=0.004). In summary, inverse BPV is a potentially unfavorable BP phenotype. However, its reproducibility and prospective value deserve further investigation. The absolute magnitude of seasonal BPV in these patients, calculated using different BP measurement methods, warrants special attention.
Aim. To estimate an efficiency of influenza vaccination in patients with circulatory system diseases diseases (CSD) under 3-year follow-up in outpatient clinics.Methods. The efficiency of influenza ...vaccination was investigated in CSD patients followed up at 2Ivanovo outpatient clinics and 2Saratov ones. The investigation enrolled 817 people, including 367 patients who consented to Grippol Plus influenza vaccination and 450 who refused.Results. During 36-month follow-up after being included in the study the vaccinated group showed a significantly fewer influenza and acute respiratory viral infections than the non-vaccinated group (28 and 442; р<0.0001). The vaccinated group had fewer CSD worsening cases per patient (p=0.04) and CSD-associated hospitalization rates (p=0.006) than the non-vaccinated group. In the vaccinated group, the total number of cases of cerebral stroke, myocardial infarction, deaths from cardiovascular diseases (CVD) was significantly less (17) compared with non-vaccinated (38), р=0.03. The risk of infectious diseases and acute cardiovascular event (myocardial infarction, stroke, death from CVD) was significantly lower in the group of vaccinated patients: by 36% (p=0.001) and by 59% (p=0.008), respectively.Conclusion. Influenza vaccination, as an essential component of complex medical prevention, leads to reduction in incidence of infectious diseases and of CSD worsening including myocardial infarction, stroke, and death from CVD in patients under 3-year monitoring in outpatient clinics
Experimental studies aimed at the modeling of interaction processes of sulfur-bearing metasomatic agents with mantle silicates and assessing the effect of sulfur concentration on olivine sulfidation ...were carried out in the Fe,Ni-olivine—sulfur system using the high-pressure multi-anvil apparatus BARS (1050 and 1450°C, 6.3 GPa, 40–60 h, sulfur concentrations (Xs) 0.1, 2, and 6 mol %). It has been established that as a result of the recrystallization of Fe,Ni-olivine in a sulfur melt, Fe and Ni are extracted from olivine into this melt, and formation of Fe,Ni-sulfides (or sulfide melts) and low-iron, low-nickel silicates takes place. The key indicator characteristics of the olivine sulfidation process are determined depending on the temperature and sulfur concentration, including characteristic phase assemblages, regularities in the evolution of the chemical compositions of mineral and melt phases, and structural features of olivine crystals. It has been experimentally established that reducing sulfur-bearing metasomatic agents, even in minimal concentrations and at relatively low temperatures, are capable of dissolving and transporting mantle silicates and sulfides, and can play an important role in sulfide ore formation in the mantle.
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