Journal «MEDICINA» 3/2022

Introduction. Phosphatidylethanol (PEth) is a phospholipid slowly forming in cell membranes as a result of the phospholipase D enzymatic reaction between phosphatidylcholine and ethanol. As a result of the analysis of published scientific papers, high performance liquid chromatography with mass spectrometric detection is used to determine phosphatidylethanol as a method with high specificity, accuracy, precision and the ability to determine substances at minimum concentrations, which is fundamental for clinical laboratory diagnostics when monitoring alcohol abuse in the population. Aim. The aim of the study was to develop and validate a method for the quantitative determination of a direct marker of alcohol abuse, phosphatidylethanol, in human blood. Materials and methods. Phospholipid was quantified by high performance liquid chromatography with tandem mass spectrometry. Results of the study and their discussion. The developed method was validated for the following parameters: selectivity, lower limit of quantitation, linearity, sample transfer, accuracy, precision, matrix effect, stability. The analytical range was 0.0025 µmol/L – 3.0 µmol/L; LPCO level PEth 16:0/18:1 0.0025 was equal to µmol/l. Conclusions. The developed method for the quantitative determination of phosphatidylethanol is suitable for use in laboratory diagnostics in order to monitor the population in the analysis of alcohol abuse. 

Key words: alcohol abuse biomarkers, phosphatidylethanol, HPLC-MS/MS, validation

The National guidelines «2022 Prevention of chronic non-communicable diseases in the Russian Federation» in the subsection «Pharmacotherapy of tobacco dependence» contain insufficiently correct statements about contraindications for use, efficacy and tolerability of cytisine. This paper presents a detailed analysis of these statements.

Key words: tobacco dependence treatment, cytisine, nicotine replacement therapy, varenicline

Optical coherence tomography (OCT) technology has determined the possibility of in vivo study of morphostructural and morphometric changes in the central zone of the retina, including epiretinal proliferation. Scanning laser ophthalmoscopy (SLO) allows assessing changes in the vitreoretinal interface and chorioretinal complex «at different depths», the use of this method for lamellar macular holes (LMR) can be used not only for diagnosis, but also for assessing changes and the extent of the process. Purpose. To determine the possibilities of SLO in diagnosing and assessing the prevalence of epiretinal proliferation in lamellar macular holes in comparison with OCT data. Material and methods. In a study conducted on the basis of S. Fyodorov Eye Microsurgery Federal State Institution, Saint Petersburg branch, 48 patients with an established diagnosis of LMR were included, while epiretinal proliferation was diagnosed in 27 (52.6%) patients by OCT. SLO was performed in 21 patients with epiretinal proliferation diagnosed by OCT. Results. The best visualization of epiretinal proliferation was achieved by processing the image with a decrease in the intensity of red and an increase in blue and green. With epiretinal proliferation, there was a lower maximum correctable visual acuity and pronounced structural changes in the retina: a foveolar tubercle in 6 (12.5%) patients, a violation of the ellipsoidal zone in 10 (20.8%) of 48 patients, while its length was 110.26±19.85 µm. An inverse correlation was established between the values of the epiretinal proliferation area and the index of the minimum retinal thickness (R=-0.7, P=0.005), which indirectly confirms the gradual loss of retinal tissue during LMR due to the development of epiretinal proliferation. Conclusion. The performance of SLO allows visualization of epiretinal proliferation and determination of its area, which can be useful both in the dynamic observation of LMR and in planning surgical treatment for this pathology.

Key words: scanning laser ophthalmoscopy, lamellar macular holes, epiretinal proliferation

Functional diagnostics is currently one of the rapidly developing areas of medicine. The instrumentation of functional diagnostics is of crucial importance for the efficiency and quality of the actual diagnostics. The aim of the work was to identify and analyze trends in the development of instrumental and software tools of physical research methods in functional diagnostics. It is shown that the following principal directions of development of the technical support of functional diagnostics can be considered: expansion of the range of measured physiological characteristics; increase in measurement accuracy; application of methods of simultaneous recording of several indicators; computerization and digitalization of functional diagnostics; use of artificial intelligence methods; application of non-contact measurements; transition to permanent monitoring; development of wearable devices; creation of complex systems for carrying out functional tests; improving the interface with medical staff and facilitating research; increase in the availability of functional diagnostic equipment for patients and its use in home telemedicine.

Key words: functional diagnostics, instrumentation, research methods, ways of development

A brief review of the hypotensive effect of prostaglandin analogs is presented. The history of the appearance of the molecule of the first of prostaglandin analogues, latanoprost, is touched upon. All groups of prostaglandin analogs presented on the Russian market, their mechanisms of action and positive effects are considered. Possible local side effects having a pronounced negative impact on compliance, as well as possible cosmetic defects, including issues affecting the duration and effectiveness of surgical treatment, are described in more detail.

Key words: prostaglandin analogs, hyperemia of the conjunctiva, eyelash growth, change in the color of the iris, prostaglandin-associated periorbitopathy

As a result of this study, some markers reflecting the level of body resistance and microecological disorder of the digestive tract of newborns according to the qualitative and quantitative characteristics of the microbiota of the oral cavity were identified. The study determined the bacterial and viral components, including representatives of the herpesvirus family (Epstein-Barr virus, herpes type 6, herpes simplex types 1 and 2) in combination with indicators of local immune resistance in the oral fluid in 173 newborns of I-II health groups. Determination of both herpesviruses in oral fluid of newborns and opportunistic bacterial microflora reflects the lack of general and local immune resistance. It makes it posible to classify such children as a risk group for the development of infectious pathology, in need for prescription of corrective and preventive measures.

Key words: digestive tract, oral cavity, herpesviruses, microflora

Results of the research presented in this article are based on many years experience of ultrasound examinations at the 1602nd Military Clinical Hospital of the Russian Ministry of Defense. Improvements of diagnoses at the primary stage as well as reductions of the number of diagnostic errors by means of a systematic and multidisciplinary approach to urgent ultrasound examinations are presented. These improvements are needed for accurate and rapid diagnosis of a wide range of diseases on the admission stage at a multiprofile hospital. Such a versatile patient examination allows hospital staff to apply therapeutic measures as quickly as possible. We present an analysis of the structure for a most common pathologies detected during ultrasound examinations for urgent indications as well as an algorithm for conducting urgent ultrasound tests. Demonstrative clinical cases that prove urgent importance for advanced diagnostic search are also discussed. These cases are believed to be important when conducting ultrasound diagnostics for complex and diagnostically «incomprehensible» patients.

Key words: ultrasound diagnostics, ultrasound researches, diagnostics for urgent indications, interesting clinical cases, advanced diagnostic search

The main quality indicators and criteria for their acceptance for a medicinal film containing succinic acid and CPC were determined in accordance with the requirements of the current regulatory documentation. The quality of the pilot batches of the medicinal film was assessed in accordance with the developed quality indicators. As a result of the research, a draft regulatory documentation for the studied dosage form was developed – «Medicinal gum film containing succinic acid and cetylpyridinium chloride».

Key words: succinic acid, cetylpyridinium chloride, medicinal films, thin layer chromatography (TLC), high performance liquid chromatography