Magazine " Medical Almanac» is a scientific and practical peer-reviewed journal that forms an information space that unites healthcare organizers, scientists and practical doctors for the development of medical science, the introduction of advanced methods and technologies in practical medicine.
The publications of the journal deal with topical problems of diagnosis and treatment of the main nosological forms of diseases, topical issues of epidemiology, healthcare organization, as well as the pharmacoeconomic foundations of pharmaceutical science. Journal, publishes original articles on all aspects of clinical medicine with original and fundamental research with clinical significance, modern analytical reviews, as well as materials of clinical cases.
The editorial board of the journal conducts an examination of incoming manuscripts for each thematic section and attracts authoritative scientists from Russia and abroad to review materials, which ensures the selection of the most high-quality and scientifically significant works for publication.
Thematic materials create an information platform in which a mutually enriching dialogue is presented, taking into account the opinions and awareness of different parties and participants, providing a balanced approach to addressing the issues of healthcare modernization and the development of medical technologies.
Magazine "Medical almanac" is included in the list of peer-reviewed scientific publications in which the main scientific results of dissertations for competition should be published degree Candidate of Sciences, for the degree of Doctor of Sciences (list of the Higher Attestation Commission). Code of the group of scientific specialties: 14.01.00 - clinical medicine.
The growing interest of readers and experts in the publications of the journal "Medical Almanac" is confirmed by the indicators of the bibliometric evaluation of the journal "Medical Almanac". According to the Russian scientific citation(RSCI) for 2017 on the topic "Medicine and healthcare » the journal ranks 43rd in the SCIENCE INDEX ranking (SI index as of 04/29/2018 is 1.56), 10-year Hirsch index 15
All journal publications assigned DOI code international registration agency crossref.
Current issue
HEALTH ORGANIZATION AND PUBLIC HEALTH
14-19
20-23
46-50
The review of the literature discusses the issues of studying the quality of life of patients of the older age group after cardiac surgery for the treatment of heart disease. In recent years, the elderly population has increased significantly in many countries. As a result of this phenomenon, cardiologists and cardiac surgeons are increasingly faced with older patients in their practice. There are peculiarities in the management of elderly cardiological and cardiac surgical patients, due to both the specifics of the underlying disease and concomitant diseases. With the advent of new options for evaluating the effectiveness of various methods of surgical correction of heart disease in aged patients, new questions arise that require evidence-based consideration and an optimal answer. The opinions of specialists about the appropriateness of surgical interventions in the elderly are often different. The urgency of the problem is due to the recent increase in the number of heart operations in the group of age-related patients. The study of the quality of life of patients in the postoperative period helps to determine the most rational and optimal method of surgical treatment, not only from the point of view of a cardiac surgeon, but also from the standpoint of assessing the patient himself. In addition, frequent postoperative complications and relapses of diseases force specialists to focus on the quality of life of patients after surgery, which makes the problem extremely relevant.
51-54
Anticoagulant therapy is the basis for the treatment of any variant of pulmonary embolism and is indicated for patients in 100% of cases. In real clinical practice, the use of warfarin for treatment and prevention, associated with the need for regular monitoring of laboratory parameters, constant dose adjustment, has always become difficult for patients, and doctors were not surprised when they stop treatment on their own. The last decade has been marked by the advent of direct oral anticoagulants (DOACs), selective factor Xa inhibitors and direct thrombin inhibitors, which provide a predictable mechanism of action, a standard dosage regimen, no need for laboratory control, and a minimum of food and drug interactions. In clinical practice, it is very important to try to balance the risk and benefit when choosing a new anticoagulant, which leads to a comparative analysis of the efficacy and safety of all currently registered DOACs. The purpose of this work is to analyze the available literature on the safety and efficacy of anticoagulants in both the short and long periods of their use. It should be understood that the large studies conducted convincingly show the efficacy and safety of DOACs before warfarin, however, it should be borne in mind that patients with indications for thrombectomy, reduced kidney function with a glomerular filtration rate of less than 30 ml / min did not participate in these studies. In this regard, the assessment of the actual efficacy and safety of DOACs, as well as the identification of risk factors for non-compliance in real clinical practice, are still important and are based not only on the frequency of dosing, but also on motivation, understanding, socio-economic patient status.
55-58
Stroke develops due to ineffective anticoagulant therapy or lack of such therapy. With the advent of new oral anticoagulants, everything has changed. Here is what the latest research on this topic shows. According to available literature sources, it is known that atherogenic dyslipidemia is a risk factor for plaque failure in the coronary arteries. Persistent atrial fibrillation, diagnosed with long-term Holter monitoring, is also a risk factor for stroke. One of the methods to diagnose embolism is transcranial Doppler scanning. The method also helps in choosing the tactics of endovascular closure of the left atrial appendage. As for the etiology, one of the common causes of cardioembolic stroke is embolism itself. For embolism that occurred in the long term after myocardial infarction, the term "embolic stroke of unknown source" (ESUS) was introduced, the causes of which are currently being investigated. Recent clinical trials have shown that ESUS may occur in patients with subclinical atrial fibrillation (AF). Evidence indicates that a left atrial thrombus can lead to thromboembolism even in the absence of AF. Many aspects for the prudent management of patients at risk of developing cardioembolic stroke are reflected in this review.
Network publication scientific and practical "Medial Magazine" designed for professionals in the medical and pharmaceutical industries. The publication contains: analytical articles and reviews on problems in the field of demography, public health, prevention, clinical examination and organization of healthcare; implementation materials modern methods management and quality control of medical and medicinal care; about the spiritual and moral foundations of health; official data of federal and regional health authorities; results practical research specialists; news of science in the field of medical technology and pharmacy; review of medical conferences and competitions.
The editorial board of the journal conducts an examination of incoming manuscripts for each thematic section and attracts authoritative scientists from Russia and abroad to review materials, which ensures the selection of the most high-quality and scientifically significant works for publication.
Thematic materials create an information platform in which a mutually enriching dialogue is presented, taking into account the opinions and awareness of different parties and participants, providing a balanced approach to addressing the issues of healthcare modernization and the development of medical technologies.
All articles of the journal are published in full in the Scientific electronic library(RSCI system) - http://elibrary.ru .
it provides:
- availability and quality of information in various medical fields for readers;
- increase in the citation index due to information exchange in the scientific community and between practitioners for authors.
Current issue
EPIDEMIOLOGY
7-18 260
19-21 173
Purpose of the study: prevention of infectious complications in the field of skin grafting by immobilization of relevant for this medical organization bacteriophages in the area of the recipient wound.
Materials and methods. A method of skin grafting has been developed, in which bacteriophages are immobilized in a given area using a hydrogel dressing prepared ex tempore. To control the viability and effectiveness of bacteriophages in a hydrogel dressing, bacteriological studies in vitro and in vivo were performed.
Results. It was revealed that bacteriophages retain their viability, bioavailability and lytic activity in a hydrogel dressing for 4-5 days. The possibility and safety of using bacteriophages to protect the split autodermal graft from hospital infection has been confirmed.
conclusions. The use of bacteriophages for the prevention of local infectious complications in free skin grafting is promising and technically possible.
22-24 152
The article is devoted to the analysis of the qualitative composition and dynamics of the microbiological landscape in the treatment of chronic soft tissue wounds.
Purpose of the study: study of changes in the quantitative and qualitative composition of pathogens of wound infection in the treatment of patients with chronic soft tissue wounds in a surgical hospital.
Materials and methods. In order to study changes in the quantitative and qualitative composition of wound infection pathogens in the treatment of patients with chronic soft tissue wounds, a retrospective analysis of bacteriological studies was performed in 206 patients with chronic soft tissue wounds.
results. After the closure of the wound defect by free skin grafting with a split graft, the pathogen changed on the 4-5th day in 59% of cases. Lysis and fusion of the graft in the group of patients with a change in microflora were noted in 37.5% of cases. Most often, these complications were associated with the presence of St in the wound. pyogenes and non-fermentative Gram-negative bacteria.
conclusions. In patients with chronic soft tissue wounds, associations of microorganisms are detected in 13.5% of cases, the main causative agent among monocultures of microorganisms is S. aureus (32.5%). The presence in the wound discharge Ps. aeruginosa, Acinetobacter spp., Streptococcus pyogenes (serogroup A) is a contraindication to skin plastic surgery.
25-27 152
Successful treatment of peritonitis due to gastrointestinal perforation remains a challenge even in the era of modern surgery. The incidence of infectious and non-infectious complications remains high, as does mortality. Rapid diagnosis, effective surgical intervention, and assessment of the adequacy of the sanitation of the infectious focus are the most important cornerstones of any treatment algorithm.
The purpose of the study was an analysis of the significance of procalcitonin in the diagnosis of complicated secondary peritonitis.
Materials and methods. The article presents data from a study of 51 patients with an intraoperative diagnosis of secondary peritonitis as a complication of perforation of the hollow abdominal organs of an inflammatory nature. The level of procalcitonin was assessed intraoperatively, as well as on the 1st, 2nd, 3rd day of the patient's stay in the hospital. Depending on the outcome of the disease, patients were divided into two groups. All patients initially had an increase in the level of procalcitonin more than 0.5 ng/ml. In 54.9% of the subjects, the level of procalcitonin exceeded 10 ng/ml. The median concentration of PCT on the first day was 10.7 (0.87; 190.4).
results. As a result of the study, it was found: 1. In the case of adequate sanitation of the infectious focus in the abdominal cavity, a significant decrease in the level of procalcitonin in the blood was recorded already on the first day of observation. 2. In patients whose procalcitonin level in dynamics on the 1st-2nd day remained at the initial level or an increase was noted, the continuation of the infectious-inflammatory process required repeated relaparotomies and additional sanitation. In all cases of an unfavorable course of the disease, high procalcitonin test values were recorded, which can be considered as an unfavorable prognostic sign.
THESES
PEDIATRICS
42-46 137
Purpose of the study: assess the relationship of mineral composition drinking water and content of bioelements in substrates in children. Materials and methods. To identify the dependence of children's health indicators on the chemical composition of drinking water, the following were selected: the territory of environmental risk (Kazanka River basin) and comparison areas, which differ in terms of water supply and the mineral composition of drinking water. The content of trace elements (ME) in biological fluids was determined by atomic absorption spectrophotometry using an AAS-SA 10 MP apparatus.
results. The features of the ecological status of the territory of the Kazanka river basin are established. Significant relationships were identified (r=0.7; p<0,01) между показателями минерального состава питьевой воды и содержанием МЭ в волосах, что обусловлено меньшей лабильностью МЭ состава данного биосубстрата.
Conclusions. The influence (F=5.1; p=0.001) of indicators of the chemical composition of drinking water on the ME status in children was proved. It has been established that with the help of regression analysis it is possible to predict the development of ME imbalance, based on studies of the mineral composition of drinking water. Moreover, the data obtained in the study of TE in hair can be used with the greatest reliability.
SURGERY
47-53 229
Due to the increase in the number of vehicles, modernization and rapid development of traumatic industries, the number of traumatic injuries of the spine is progressively increasing. Injuries to the cervical spine account for 55-80% of all injuries of the spinal column. The article examines in detail the epidemiology and social significance of whiplash injury of the cervical spine. The main causes and mechanism of development of trauma of the cervical spine are considered. Possible etiological factors leading to the development of pain syndrome are identified. The clinical picture of whiplash injury of the cervical spine is thoroughly described. Theories of the pathogenesis of the development of diverse and polymorphic clinical manifestations of whiplash injuries of the neck, such as coordinating disorders of movements and postural control, vestibular and oculomotor disorders, vegetative, affective, behavioral and cognitive disorders were analyzed. This scientific work describes in detail the treatment of this type of pathology, based on a number of studies. Relatively reasonable therapeutic recommendations in the acute period of whiplash can be considered only measures for the early activation of the patient and the restoration of the physiological range of motion in the cervical spine. The lack of unified algorithms for the diagnosis and treatment of whiplash injury of the cervical spine requires additional research.
PHARMACY
54-60 207
The review presents data on the chemical composition, structural diversity, abundance in nature, and biological activity of humic substances. The complexity of the structure of humic substances, the possibility of the formation of intermolecular and intramolecular bonds, and the features of biosynthesis are considered. The structural characteristics of humic substances are described, which allow them to participate in various biochemical reactions, form complex compounds, and influence photochemical processes. The uniqueness of the chemical properties of humic substances allows them to be used in various sectors of the national economy, including medical practice. In nature, there are no compounds with an identical set of the same important chemical and biological properties as humic compounds have. All this determines the prospects of using humic substances as potential medicines of a new generation. Research in the development of new biologically active compounds has shown that humic substances of various origins have immunomodulatory and anti-inflammatory effects, which allows them to be used for the prevention and treatment of chronic dermatosis, atopic dermatitis, allergic rhinitis and other diseases accompanied by inflammatory and allergic reactions. Promising is the use of humic substances as antifungal, antiviral agents. The natural origin of humic substances is a significant advantage over artificially synthesized drugs in the treatment of fungal and viral infections, since clinically they have practically no undesirable effects compared to their traditional counterparts. However, the biological activity of humic substances revealed in experimental studies does not allow them to be widely used in medicine. Manufacturers of products based on humic substances describe a wide range of medicinal properties that are not supported by the results of preclinical and clinical trials. There are no drugs based on humic compounds registered in the Register of Medicines of the Russian Federation, the main obstacle to which is the complexity of their standardization. The development of drugs at the preclinical stage involves establishing the structure of the active compound and determining the optimal methods and techniques for its standardization for quality control. Currently, knowledge about the composition and structure of humic substances is not enough to apply to them generally accepted in pharmacology and pharmacy ideas about the substances of medicines.
61-65 276
Introduction. This article discusses the composition of biologically active compounds in the aerial organs and bulbs of the Armenian muscari (Muscari armeniacum Leichtlin) of the Asparagaceae Juss family and the possible pharmacotherapeutic effects of preparations based on it.
Materials and methods. Various sources of information were used in this study: electronic search engines (Google, Google Academy), scientific literature, electronic databases (e-Library, Pubmed, Wiley, Springer, Science Direct, Scopus, Web of Science).
Results and discussion. In the course of the review, the composition of the main biologically active substances of various parts of M. armeniacum was established, among which anthoyanins (derivatives of iianidin and delphinidin), homoisoflavonoids, pyrrolizidine polyhydroxylated alkaloids (hyacinthacins A1, A2, A3, B3), oligoglycosides (muscarosides), ribosome-inactivating proteins (musarmines). The biological activity of M. armeniacum is also characterized by a significant diversity: for various extracts of M. armeniacum, antioxidant, antimutagenic, and specific glycosidase inhibitory activity was noted.
Conclusions. Based on the data studied, M. armeniacum can be recommended for the production of potential antitumor, antiviral, antidiabetic and anti-obesity drugs. It should be noted that additional pharmacological and pharmacognostic studies are needed to obtain additional information on the use of preparations based on this plant in clinical practice, as well as to develop methods for standardizing M. armeniacum raw materials.
The purpose of the study was a comparative study of the antidepressant activity and diuretic action of liquid extracts based on flowers, shoots, leaves and fruits of semi-soft hawthorn.
Materials and methods. To determine the antidepressant activity of liquid extracts based on flowers, fruits, shoots and leaves of semi-soft hawthorn, the Despair test was used. Diuretic activity was determined in chronic experiments, collecting 4 - and 24-hour portions of urine.
Results. The study of the comparative antidepressant activity of liquid extracts based on flowers, leaves, shoots and fruits of semi-soft hawthorn allowed us to identify antidepressant activity in all studied drugs, comparable to that of amitriptyline at a dose of 5 mg/kg. At the same time, liquid extracts of flowers, shoots and leaves of semi-soft hawthorn showed antidiuretic properties.
Conclusions. Liquid extracts based on flowers, leaves, shoots and fruits of semi-soft hawthorn have a neurotropic effect. The antidepressant activity of herbal preparations increases in the following series: liquid extract of semi-soft hawthorn leaves - liquid extract of semi-soft hawthorn fruits - liquid extract of semi-soft hawthorn shoots - liquid extract of semi-soft hawthorn flowers.
