Journal «MEDICINA» 3/2019

The permeability of cell membranes in the crystalline lens, as with all other cells, with respect to polar molecules and ions is determined by their sorption coefficients in the membrane matrix, assuming that the viscosity remains constant under all conditions that do not lead to cell death. Unfortunately, there are external factors leading to aging of the matrix and to the viscosity increase. The resistance to the viscosity increase in the matrix is associated only with the reaction of the formation of lipids with unsaturated fatty acids (FA) catalyzed by desaturases. The presence of desaturases in the cell membranes together with coenzymes leads to the formation of continuous cycles that prevent aging of the matrix. Two types of desaturases are possible and, accordingly, there are two types of cycles that lead to cell division, while others do not. All the cycles are aimed at maintaining the mobility of the agents and viscosity in the matrix. In nonproliferating cells, the mobility of desaturase remains constant as long as the membranes have lipids with saturated FA. In these cells, lipids with unsaturated fatty acids up to 30-70% accumulate in the membranes, which inevitably ends with the formation of cataract. In cycles associated with the division of crystalline lens cells, not only the recovery of agent mobility and viscosity in the matrix is observed, but also the content of lipids with saturated fatty acids in the membranes, allowing for unending cell division. Naturally, the process keeps the living systems young, but if it does not stop, it can be the cause of formation and growth of cancer tumors. There is a need to regulate this process, one of the mechanisms of which is determined by a change in water balance in the lens, associated with selectiveness of membrane permeability and the presence of water flows, depending on the chemical potential in them in relation to the external environment.

Key words: crystalline lens, matrix, desaturase, fatty acids, cataract

Aim: Experimental evaluation of the acute toxicity and neurotoxicity of a new amide derivative of valproic acid and 1,3,4-thiadiazole. Materials and Methods: The acute toxicity of N-(5-ethyl-1,3,4-thiadiazol-2-yl)-2-propylpentanamide (valprazolamide) was evaluated by probit analysis in experiments in mice. Neurotoxicity was determined in a rotating rod test and pull-up bar test in mice. The effect of valprazolamide on the exploratory behavior of mice in "open field" test and in a "dark/light transition" test was evaluated. Results: The DL ₅₀ and TD₅₀ values of valprazolamide (intraperitoneally) for mice were 924.8 (756.9-1063.7) mg/kg and 456.7 (325.4–603.6) mg/kg, respectively. Conclusion: A new amide derivative of valproic acid and 1,3,4-thiadiazole (valprazolamide) belongs to the group of low-toxic substances.

Key words: antiepileptic drugs, valproic acid, 1,3,4-thiadiazole, acute toxicity, neurotoxicity

Constant search for new healthcare technologies and their integration in educational system helps to save and improve children’s health, decrease prevalence of school-associated diseases and increase back-up capabilities of their body. The aim of the study is to determine modern methods for creation of healthy educational environment. Scientific reports of national and foreign researchers for the period from 2011 to 2018 have been analyzed. As a result, principal healthcare technologies for modern school have been determined. The problems of their implementation were indicated. Some perspectives for wider implementation of healthcare technologies, their finetuning according to the type of school and search for the most valid efficiency evaluation methods are presented.

Key words: healthcare technologies, healthy educational environment, innovation, physical activity, school meals

Currently, the prevalence and detection of melanoma, as well as other forms of cancer, tends to increase. Due to the intensity of the disease, malignant skin tumors have an unfavorable treatment prognosis and cause an increasing number of deaths. This necessitates the development and implementation of new diagnostic methods. In this regard, the purpose of this review is to systematize ideas about the instrumental diagnosis of melanoma. Currently, there are quite a few methods of melanoma verification, but most of them are morphological and/or based on the use of expensive unique equipment. This minimizes the prospects of their use as a screening technology. The solution of this problem may be a new diagnostic method based on near-field resonance microwave sensing of the skin, which demonstrated high diagnostic informativity, together with the speed of the study and the mobility of the complex.

Key words: melanoma, diagnostics, instrumental examination, near-field resonance microwave sensing

The main cause of mortality in all economically developed countries and in countries with transition economy are chronic non-infectious diseases (CNID). Prophylactic medical examination is aimed at timely revealing risk factors for developing chronic non-infectious diseases. It’s proved that by reducing the risk factors, it’s possible to reduce mortality from CNID in average by 55%. 5-year work with prophylactic checkups in Urupinsk region population yielded following results. Most often were cases with one or more risk factors present (58.2% - 76.3%), on the second place – unhealthy nutrition (45.5% - 66.6%), the third place – overweight (15.8% - 55.1%), the fourth place – inadequate physical activity (17.2% - 30.7%), the fifth place – obesity (15.2% - 25.6%) cases. During the whole period 1232 cases of CNID were diagnosed, amounting to 2% of total population examined. Every year from 1.5 till 2.6% different CNID are newly diagnosed. Among them on the first place there are blood circulatory diseases (80-170 cases a year), followed by different types of cancer. In 2017 cancer moved BCD to the second place (120 cases of precancerous and malignant neoplasms detected).

Key words: medical examination of certain groups of adult population, risk factors, chronic non-infectious diseases, cardiovascular pathology

A model of screening for diabetic retinopathy, proposed by the Orenburg branch of S. Fyodorov Eye Microsurgery Federal State Institution of the Ministry of Health of the Russian Federation is described. The model includes photographic recording of the eye fundus with a portable fundus camera followed by the analysis of the obtained pictures. The economic effect of treatment and diagnostics of diabetic retinopathy using this model has been calculated.

Key words: diabetic retinopathy, screening, economic effect

The first cases of identifying consumers of cannabimimetics MDMB-2201 during urine testing for narcotic substances in the Russian Federation were registered in March-April 2019 in the cities of Tyumen, Yekaterinburg, and Kurgan., 15 main metabolites and markers of the cannabimimetic MDMB-2201 were identified in the urine of consumers of smoking mixtures using solid-phase extraction and gas chromatography with mass spectrometric detection. Mass spectra of electronic ionization of the identified metabolites of MDMB-2201 were obtained, the results of calculations of several physicochemical characteristics and the degree of conjugation of metabolites to establish the facts of taking the cannabimimetic MDMB-2201 in the analysis of obtained biologic objects are presented.

Key words: MDMB-2201, cannabimimetics, metabolites, urine, solid-phase extraction (SPE), gas chromatography - mass spectrometry (GC-MS)

The paper examines trends in changes in the contingent of health care staff studying information technology at the advanced training courses in recent years, in particular, changes in the age, gender composition and level of education; it also analyzes the problems arising as the consequences of the trends. The data of 1420 health professionals trained in 2014-2018 are reviewed. It has been shown that among the healthcare staff the share of elderly students increases, women make up the majority and their share increases, the proportion of nurses reaches half of the trainees and is also on the rise. The problems associated with changes in the contingent of health professionals attending advanced training courses require new approaches to teaching disciplines of the informatics block. Addressing the problem requires adjustments of content and methodological levels of teaching. Possible solutions to emerging problems are outlined.

Key words: contingent of trainees, postgraduate education, medical informatics, improvement courses, trends, age, gender, education level

The article is a review of the monograph of I.V. Ponkin and A.A. Ponkina «Pravovoe regulirovanie palliativnoi meditsinskoi pomoshchi [Legal regulation of palliative care» (Moscow, GEOTAR-Media, 2019). The review shows the significance and relevance of this topic. The author investigates the quality of the indicated scientific monograph, shows its structure and its main advantages.

Key words: medical law, medicine, palliative care, pain, rights of an incurable patient

The main objective of the study was to evaluate the efficacy and tolerability of the tumor necrosis factor thymosin 1 alpha recombinant (Refnot) drug in the complex treatment of HER2/neu and ER/PR negative (triple negative) metastatic breast cancer that had not previously received antitumor treatment. A total of 276 patients (women 30–70 years old, ECOG 0–2) were included in the study and distributed by simple randomization into one of the observed comparison groups. The study group (N = 136) with the inclusion of Refnot received an AC + Refnot drug therapy regimen (doxorubicin 60 mg / m² iv on day 1 + cyclophosphamide 600 mg/m² iv on day 1. Refnot 14-21-th day – at a dose of 200 thousand units (1 ml) once a day, s/c every 21 days for 6 cycles). The control group (N = 140) received an AС regimen (doxorubicin 60 mg/m² iv on day 1 + cyclophosphamide 600 mg/m² iv on day 1 every 6 days for 6 cycles). The primary endpoint was progression-free survival, secondary endpoints: overall response (CR + PR), overall survival. Additionally, the safety profile of therapy was evaluated. Results: median progression-free survival was significantly higher in the Refnot group and was 8>4 months versus 5?8 months in the control group (p = 0.001). The overall response was also significantly higher in the group with the inclusion of Refnot (72% versus 55% in the control group, p = 0.05). Both treatment regimens had a similar safety profile. Manifestations of non-hematologic toxicity were comparable in both groups. Conclusions: AC + Refnot therapy regimen is safe and significantly improves treatment outcomes for triple-negative metastatic breast cancer.

Key words: triple-negative breast cancer, immunotherapy, tumor necrosis factor alpha, tumor necrosis factor - thymosin 1 alpha recombinant