Northern State Medical University

This paper presents the results of the implementation of the drug circulation system, in particular, drug provision, in the medical information system. The role of a clinical pharmacologist in the formation of algorithms for using the basic principles of the drug circulation system at various levels (procurement department, pharmacy, clinical departments to provide medicines to a medical organization) is shown.

A blind comparative pilot study was conducted to evaluate the quality of simulation scenarios generated by generative artificial intelligence (AI) models compared to human-generated scenarios. The objectives of the study were to test the feasibility of generating scenarios by AI models, compare their quality with human-generated scenarios, and assess the ability of experts to determine authorship. Three models (Grok, ChatGPT and DeepSeek) were used to generate scenarios based on a standardized prompt, and the ROSOMED competition case served as the reference standard. Five independent experts evaluated four scenarios using the original scale of assessment of a simulation scenario (SASS). The ChatGPT scenario (average score of 3.4) outperformed the human scenario (2.9). The AI evaluator generally ranked the scenarios similarly to the human experts, but it showed bias towards its own work when self-evaluating.

Introduction. The original article presents the results of an experimental study conducted using the method of high-performance thin-layer chromatography (HPTLC) on plant samples – rhizomes with roots of Dioscorea caucasica Lipsky and Dioscorea nipponika Makino. These species of Dioscorea are used in various fields of medicine as fungicides, antimicrobials, and anti-sclerotic agents. The HPTLC method is used at the screening stage of plant samples for preliminary identification and densitometric quantitative determination of diosgenin in plant extracts. Aim. Development of a HPTLC methodology for quantitative assessment of diosgenin content after acid hydrolysis of extracts in air-dried raw materials – rhizomes with roots of Dioscorea caucasica Lipsky and Dioscorea nipponika Makino. Materials and methods. The extracts were obtained by preliminary degreasing and depigmentation of air-dried rhizomes with roots of the studied Dioscorea species using high-purity dichloromethane, followed by double extraction. The first extraction was carried out in a 50 % aqueous solution of isopropanol with ultrasonication, followed by acid hydrolysis of O-glycosidic bonds and evaporation. The second extraction was carried out by redissolving the dry residue in methanol; it was purified from suspended particles by filtration through syringe filters with a perforation diameter of 20 μm. HPTLC was performed on a «CAMAG» (Switzerland) apparatus using HPTLC Aluminum sheets Silica gel 60 F254 20 × 20 cm, which were cut to a size of 20 × 10 cm. Results and discussion. After performing scanning densitometry at 366 and 542 nm, it was established that the chromatography of methanol extracts in a toluene-chloroform-acetone solvent system (2 : 8 : 2 v/v) allows for satisfactory separation and subsequent densitometric quantitative determination of diosgenin. The tracks of plant extracts from the rhizomes and roots of Dioscorea caucasica Lipsky and Dioscorea nipponika Makino were compared with a standard sample of diosgenin. Conclusion. The study found that the content of the steroid sapogenin diosgenin in air-dried Dioscorea nipponica Makino raw material (286,4–296,3 μg/g) slightly exceeds its content in Dioscorea caucasica Lipsky raw material (257–277,1 μg/g). The quantitative values obtained, calculated separately for peak height and area, show good convergence, confirming the correctness of the method. The developed method of high-performance thin-layer chromatography with densitometric detection of diosgenin can be recommended for routine quantitative analysis of this compound in plant raw materials.

Rationale. The aim of the study is to analyze the associations of regional characteristics with the individual risk of comorbidity in the elderly population in the subjects of the Russian Federation. Materials and methods. The material of the cross-sectional study «Epidemiology of cardiovascular diseases in the regions of the Russian Federation» (ESSE-RF-3), conducted in 2020—2022, was used as individual data. The analysis included 10535 men and women aged 60—74 years. The presence of comorbid conditions was assessed using 4 methodological approaches: 1 — according to the Order of the Ministry of Health of the Russian Federation dated 07/01/2021 No. 698n.; 2 — according to the Eurasian guidelines; 3 — according to the Charlson index; 4 — in accordance with the recommendations on the organization of prioritization of patients in the framework of follow-up. To describe the regional living conditions, an integral index assessment was used, which was previously performed using the principal component method. The association of comorbidity with regional indices was assessed using logistic regression analysis, with the calculation of odds ratios (OR) and a 95% confidence interval. Results. The deterioration of economic living conditions and the shift in the age structure of the region’s population towards older age is associated with comorbidity, regardless of the method of its assessment. An increase in the industrial development of the region is associated with a decrease in the probability of comorbidity, calculated according to the «Charlson index» OR=0.93 (0.90—0.97) and according to the «Methodological Recommendations» OR=0.94 (0.90—0.97). Conclusion. The conducted study demonstrated the influence of economic, industrial and demographic regional living conditions on the individual probability of comorbidity.

Acute dysfunction of vital organs is the hallmark of critical illness. The Sequential Organ Failure Assessment (SOFA) score, the most widely adopted approach to describe organ dysfunction, has not been updated in 30 years and therefore may not appropriately capture current clinical practice and outcomes. To inform the data-driven component of an updated score (SOFA-2) in varied geographical and resource settings (stages 6-8) after expert input via a modified Delphi process (stages 1-5). A federated analysis was performed on data collected from adult patients admitted to 1319 intensive care units (ICUs) in 9 countries (Australia, Austria, Brazil, France, Italy, Japan, Nepal, New Zealand, United States) between 2014 and 2023. Four representative multicenter cohorts containing data from 2 098 356 patients were used for data-driven score development and internal validation. External validation was performed on 6 cohorts containing data from 1 241 114 patients. Content validity for organ dysfunction identified through the modified Delphi process should be reflected by predictive validity using the area under the receiver operating characteristic (AUROC) curve of the score measured on the first ICU day (higher scores indicate worse organ dysfunction). Of 3.34 million patient encounters, 270 108 (8.1%) died in the ICU (range, 4.5% to 20.5% across the 10 cohorts). SOFA-2 modified the 6 organ systems of the original SOFA score (brain, respiratory, cardiovascular, liver, kidney, hemostasis), including new variables and revised thresholds that better describe the organ dysfunction distribution from 0 to 4 points and their associated mortality (SOFA-2 AUROC, 0.79; 95% CI, 0.76-0.81; SOFA-1 AUROC, 0.77; 95% CI, 0.74-0.81). Evaluation of sequential SOFA-2 data from ICU day 1 to day 7 maintained its predictive validity. Insufficient data and lack of content validity precluded incorporation of gastrointestinal and immune dysfunction scores into SOFA-2. The SOFA-2 score, updated to include contemporary organ support treatments and new score thresholds, describes organ dysfunction in a large, geographically and socioeconomically diverse population of critically ill adults.

Relevance: Inflammatory periodontal diseases (IPD) is an urgent problem of domestic and world dentistry. The main role in the treatment of IPD is assigned to symptomatic therapy. When examining inflamed periodontal tissues, an increased content of neutrophils, monocytes and fibroblasts can be detected. The study of these cells is important for the search for new means of treating IPD. Goal: The study of the cellular composition of the buccal epithelium of Wistar rats in the treatment of experimental gingivitis with topical drugs. Materials and methods: The work was performed on 40 white laboratory rats with experimental gingivitis, counting inflammatory cells before and after the use of topical agents for its treatment (on days 10 and 16). Results: The average number of cell elements in all groups on the 10th day of the experiment did not differ. On the 16th day, the highest value of all cellular elements was revealed in the “Asepta” group. In the “Arctivit-dent” group, a higher value was revealed. In the Stomatofit group, the value of cellular elements in the cytological preparation is significantly lower compared to other experimental groups. Conclusion: The results of using preparations containing MPH allow us to continue studying the effectiveness of using these substances for treating gingivitis.

ABSTRACT This study focuses on the bottom sediments of the Northern Dvina, the largest river in North-Eastern Europe, which plays an important role in the transportation of pollutants to the White and Barents seas. The purpose of the study is to evaluate the spatial distribution, sources and ecotoxicological significance of trace elements (Pb, Cd, Cu, Zn, Ni, Cr, As, Hg) and priority polycyclic aromatic hydrocarbons (PAHs). The study revealed that concentrations of trace elements do not correlate significantly with distance to urban agglomerations, which indicates that natural (geogenic) sources dominate their input. The predominance of high molecular weight PAHs (e.g. fluoranthene, pyrene, benzo[a]pyrene) and isomer ratios (e.g. Flt/(Flt+Pyr) > 0.5) indicate a pyrogenic origin (i.e. coal or biomass combustion) rather than a petroleum source. The analysis revealed the presence of strong correlations within groups of trace elements (for example, Cu-Zn, r = 0.87; Pb-Cd, r = 0.79). However, no correlation was observed between trace elements and PAHs, which confirms the differences in their accumulation mechanisms. Based on the calculated m-ERM-Q index the ecological risk in the studied river system is associated specifically with trace elements, but not with the spread of anthropogenic PAHs.

Relevance. The leading indicator reflecting the state of physical development of children is body weight, which characterizes the development of the musculoskeletal system, subcutaneous fat, and internal organs. Objective: to assess the formation of body weight in schoolchildren aged 7–17 in forty constituent entities of the Russian Federation. Materials and methods. The study included 40 regions of the Russian Federation located in all Federal Districts. The regions were selected in such a way that almost every age and sex group would be presented with body weight indicators (kg) for at least 100 schoolchildren aged 7–17. Results and discussion. The analysis of age-sex curves of body weight showed that in almost all 40 regions there is a smooth increase in body length with age in both boys and girls, which is consistent with biological patterns such as directionality, gradualness, irreversibility, heteromorphism and heterochrony. In boys, in almost all age groups and at the time of completion of growth processes, the body weight indicator reliably (p≤ 0.05) exceeds the indicators in girls, which is consistent with such a pattern as the dependence of growth and development on sex (sexual) dimorphism. Conclusion. We can discuss the harmonious flow of growth and development processes in the analyzed regions.