Fluoroquinolones are the most commonly used drugs in everyday clinical practice. The prevalence and frequency of fluoroquinolones administration are justified by its therapeutic effects. The antimicrobial spectrum, mechanism of action, and pharmacokinetic features distinguish these medicines from drugs of other pharmacological groups. The 2019 sales data and a range of fluoroquinolones in a pharmacy chain of Veliky Novgorod and Pskov are studied. It has been established that Ciprofloxacin medicines (International nonproprietary names), produced in India and Russia, dominate in the pharmaceutical market. The comparative analysis of the results of an anonymous survey of 169 pharmaceutical specialists in Veliky Novgorod and 98 specialists in Pskov was held. The important significance of post-marketing surveillance of licensed medicines, namely, fluoroquinolones, is shown in this article. Pharmacists have more and more adverse drug reactions to medicines in the practice. The problem is that pharmacists rarely inform patients about adverse drug reactions and provide pharmaceutical services about antibacterial medicines to patients. The risk points of pharmaceutical counselling were identified, and was proved that pharmacists need educational programs on pharmacovigilance.

Due to the high morbidity and mortality rate, as well as the rapid spread of infection, COVID-19 is one of the most discussed topics in everyday life and the health care sphere. Etiotropic therapy is an important component of the treatment COVID-19 patients. According to temporary guidelines for the prevention, diagnosis and treatment of COVID-19, outpatient therapy of this disease is allowed. The priority scheme of medical treatment includes favipiravir. Favipiravir drugs entered the Russian pharmaceutical market relatively recently. At present four trade names have been registered. Various forms and packaging, range and price characteristics of favipiravir are analysed in the article.

The focus of the paper is to determine hepatoprotective properties of polyphenolic extracts of the fruits of cranberry (Vaccinium oxycoccus L.), blueberry (Vaccinium myrtillus L.), cranberry (Vaccinium vitis-idaea L.) and blueberry (Vaccinium uliginosum L.). The study was conducted on 70 male Wistar rats aged 7-8 months, weighing 210-230 g. Liver fibrosis was modeled by toxic damage with a solution of carbon tetrachloride (CCl4) – 0.2 ml/100g of body weight in refined olive oil (1:1). It has been proven that polyphenolic extracts of blueberry (Vaccinium myrtillus L.) (most pronounced), blueberry (Vaccinium uliginosum L.), cranberry (Vaccinium oxycoccus L.) and cranberry (Vaccinium vitis-idaea L.) (least pronounced) can reduce the severity of liver damage caused by CCl4. The obtained data suggest that the studied extracts can be used as correcting agents for fibrosis.

It was found that embryonic exposure to Gangleron and Metamyzil as exogenous ligands H- and M-cholinergic receptors leads to long-term effects in the activities of central nervous system in adult young rats. It decreases learning ability in young adult rats. Cognitive functions were studied in active avoidance test. The results obtained suggest that prenatal administration of Gangleron to pregnant rats on 9-11 and 12-14 days of gestation violated the ability to acquire and reproduce active avoidance reflex in adult offspring. In the similar situation, Metamizyl has a negative effect only on ability to reproduce active avoidance reflex. Thus, the long-term negative effect of cholinotropic compounds on learning and memory abilities in young adult rats can be realized through both M- and N- cholinergic mechanisms of the developing brain.

In the search for new pharmacological approaches to the therapy of atopic dermatitis (AtD), the authors emphasize the primary task of the present-day research activities. It is vital to study the integrative interaction of systemic homeostasis regulators such as immune, nervous and endocrine systems and how they maintain the homeostasis of the organism with the help of immuno- neuroendocrine integral regulation of functions. Such consideration correlates with the issues of modern pharmacotherapy of AtD, which goal is to open promising approaches to the treatment of this disease.

The aim of the study was to determine the correlation between the dynamics of age-related parameters of the cerebellum and the value of the brain index in mesocephals according to magnetic resonance imaging. The analysis of the results of a morphometric study of the brain using magnetic resonance imaging of 95 mesocephals (52 men and 43 women), aged 25-29 years and 78-83 years, without diseases and injuries of the central and peripheral nervous system, without a history of alcohol and drug addiction, with a predominance of the right hand (right-handed), as well as the absence of signs of pathology of the brain regions detected during the study. The head index and the transverse size of the cerebellum were determined. The assessment of the head index in the subjects revealed a statistically significant predominance of the width and length indices in men compared to women at a young age (p<0.01). In old age, statistically significant sex differences in the values of these indices were not established, while the trend towards the prevalence of index indicators in men remains (p > 0.05). In men, both in young and old age, there is a statistically significant predominance of the transverse size of the cerebellum in comparison with women (p < 0.01). There is a direct, high correlation between the indicators of the brain index and the transverse size of the cerebellum in both sexes (p = 0.988). The dependence of the features is statistically significant (p < 0.01). The obtained data can serve as a theoretical basis for performing magnetic resonance imaging studies of the brain and planning neurosurgical interventions.

The article provides a comparative analysis of the readiness for risk and the level of aerobic performance among professional athletes. The research considered the gender characteristics of athletes. Original data were obtained. The features of heart rate variability before and after performing the standard exercise functional test among athletes of both sexes with different readiness to risk were described. Highly qualified volunteer athletes took part in the experiment. All athletes shown a high level of general physical performance and the amount of oxygen consumption. The practical significance of research is the using in sports selection, orientation of athletes at various stages of training, as well as in the assessment of the functional state in order to prevent overtraining. In addition, the results of the research also have fundamental importance: among athletes of both sexes it was shown that the objective results (indicators of heart rate variability, maximum oxygen consumption, maximum work power) were ambiguously correlated with such a personal disposition as readiness for risk.

In an experiment on 40 female rats of the “Wistar” line, a study was carried out of the effect of acute emotional-immobilization stress during pregnancy on the development of obesity in offspring. Experimental studies were carried out in accordance with the "Rules for conducting research using experimental animals" of the Ministry of Health of the Russian Federation. In total, 2 series of experiments were carried out. In series I, in 20 animals during pregnancy, modeling of acute emotional-immobilization stress was not performed (standard indicators). There were 134 newborns. In series II, 20 animals were modeled for acute emotional-immobilization stress during pregnancy. The number of newborns was 123. The modeling of acute emotional-immobilization stress in pregnant rats and the assessment of its pathogenetic role in the development of AO was carried out according to our methodology. It was found that immediately after giving birth and one week after that, the body weight of the offspring was significantly higher in group I, where modeling of acute emotional- immobilization stress during pregnancy was not carried out (P <0.05). It should be noted that 2 and 3 weeks after delivery, with the introduction of additional complementary foods, a more rapid increase in the body weight of the offspring was noted in group II, where acute emotional-immobilization stress was simulated during pregnancy. At the same time, the indicators in group II did not significantly exceed the indicators in group I (P> 0.05). Starting from week 4, body mass indicators in group II significantly exceeded the results in group I (P <0.05). At the same time, the differences between the study groups progressively increased. 10 weeks after giving birth, the body weight of each of the offspring in series II, where acute emotional-immobilization stress was simulated during pregnancy, exceeded those in group I by 21.3 ± 1.6%. This indicated the development of alimentary obesity in series II. Further study is needed in this direction.

The role of adipocytokines in the hormonal regulation of insulin resistance is topical due to the wide spread of insulin resistance, which is recorded in 100% of cases of overweight and 80% of insulin-dependent diabetes mellitus, on the one hand, and its stressor pathology, on the other. It was found that when combined with type 2 diabetes mellitus with dyslipidemia, hyperuricemia, and hypertension, the incidence of insulin resistance increases to 95%. Also, the development of insulin resistance contributes to chronic neuropsychic and physical stress, the effect of unfavorable environmental factors that lead to hormonal and metabolic changes aimed at increasing energy education in order to ensure adaptive processes. Disorders of glucose metabolism in the liver are associated with a change in the spectrum of bioregulators at atherogenic type, increased hyperglycemia and hyperlipidemia. Adipocytokines play an important role in the functioning of adipose tissue in normal and pathological conditions, since inflammation is involved in the regulation of food needs and supports the homeostasis of adipose tissue. The new scientific knowledge on the regulation of adipocytocon metabolism in the development of insulin resistance opens the possibility of developing a method of preventing and correcting metabolic disorders by controlling the content of adipocytokines.

The analysis of the results of the study of endogenous intoxication after embolization of the uterine arteries (UAE) in 38 patients with the treatment of uterine fibroids was carried out. All women signed an informed consent to participate in the study and were familiarized with the purpose and design of the research. The indication for performing UAE was the presence of symptomatic uterine fibroids, regardless of the number and size of myomatous nodes. The criteria for the analysis were the features of the postoperative course and laboratory parameters characterizing endogenous intoxication in the postoperative period. The determination of endogenous intoxication was based on CASS / OA ratio, which reflects the ratio of quantitative indicators of nitrogen-containing compounds (ACC) and residual nitrogen (OA). In comparison with the results before UAE, a significant excess of residual nitrogen (P <0.05), nitrogen- containing compounds (P <0.05) and CASS / OA (P <0.05) indicators persists for more than 10 days. The results obtained indicated that, despite the lower trauma of UAE compared to laparoscopic conservative myomectomy, when choosing a method for treating uterine fibroids, it is necessary to take into account the risk of endogenous intoxication after UAE for a long time. It is advisable to continue research in this direction.

The case of a rare neurological syndrome in a 55-year-old patient was analyzed in the pathogenetic aspect. An analytical approach to diagnostic methods used in differential diagnostics in clinical neurology enabled us to develop an algorithm for recognizing rare encephalopathy syndromes, such as Susak's syndrome. The diagnosis of a certain or probable syndrome includes a detailed medical history, a thorough assessment of all probable explanations of the disease, neurological status, and verification of clinical data by neuroimaging techniques such as magnetic resonance imaging (MRI), fluorescence angiography, and audiometry. The qualification of the form of the disease, the type of course, the severity of the patient’s condition enables one to choose the tactics of rational pharmacotherapy.

The analysis of the results of treatment of infectious vaginal pathology in 162 women, depending on the local hypoxia of the vaginal walls, was carried out. With chronic infectious diseases of the vagina (chronic colpitis — 84, bacterial vaginosis — 78 women). All study participants signed informed consent and an additional bilateral agreement on non-disclosure of personal data and the specifics of the study program. Depending on the oxygen content in the vaginal wall, the patients were divided into 2 groups. Group I included 88 women, whose coefficient of oxygen content in the vaginal mucosa wall (K_mucus%) exceeded 97.0%. Group II consisted of 74 women, whose coefficient of oxygen content in the wall of the vaginal mucosa (K_mucus%) was lower than 97.0%. Accordingly, in group I K- mucus% was 98.3 ± 0.2%, and in group II — 96.9 ± 0.3%, while the differences in the coefficient K_mucus%, reflecting the oxygen content in the vaginal wall, were significant (P < 0.05). It was found that against the background of local hypoxia 14 days after the completion of treatment, leukocytosis was significantly more often detected in the material from the vagina (P <0.05), and the frequency of detecting “key cells” in the material from the vagina, the number of which exceeded the permissible threshold of 3.0 % in group II, where local hypoxia took place, was significantly higher than in group I (P < 0.05). Evaluation of the effectiveness of general and local ozone therapy, which provides a decrease in the intensity of hypoxia, in combination with lymphogenous administration of antibiotics, in the treatment of infectious vaginal pathology against the background of local hypoxia and local immunodeficiency, is a promising direction for further research.

A study was carried out on the change in sperm fertility in 46 men included in the in vitro fertilization program with preliminary indicators of normospermia under the influence of psychological stress against the background of COVID-19 quarantine. Before and after quarantine, all study participants had a negative PCR test for COVID-19. A comparative analysis of the Spielberger-Khanin test results showed that against the background of quarantine, there was a significant increase in the level of situational anxiety. An increase in the intensity of psychological stress was accompanied by a significant decrease not only in the number of sperm in the ejaculate (P < 0.05), but also in the number of normal sperm (P <0.05). Moreover, there was a significant decrease in both the number of progressively motile (P < 0.05) and the total number of motile sperm (P < 0.05), which indicated a decrease in sperm fertility against the background of psychological stress against the background of quarantine measures for COVID-19. It seems promising to continue research in this direction.

The two-way interaction between the structural and functional properties of heart ventricles and the arterial bed is usually defined as ventricular-arterial coupling and it describes overall cardiovascular efficiency. Cardiovascular diseases are accompanied by changes in the rigidity and function of all parts of the circulatory system, as a result of which both primary and interdependent dysfunctions of the ventricles and arteries occur. The ratio of the “functional stiffness” of different cardiovascular regions can be expressed mathematically as the ratio between arterial elasticity (Ea) and end-systolic elasticity (Ees) of the ventricle. Non-invasive assessment of ventricular-arterial coupling describes the harmony or, conversely, the maladjustment of these parallel changes and allows the use of the ventricular-arterial coupling index in clinical risk, prognosis and treatment efficacy assessment. This review summarizes the literature on this topic, with special emphasis on the pathogenetic mechanisms underlying disorders in the structural and functional properties of the ventricles of the heart and arterial bed.

The analysis of the results of the study of insulin resistance against the background of an increase in the intensity of PS is carried out. All participants in the research program signed an informed consent and agreement on the confidentiality of personal data and research features. Patients with high levels of situational anxiety according to the Spielberger-Khanin scale and the test for determining the level of stress by Yu.V. Shcherbatykh and without significant somatic pathology according to the medical examination and anamnesis, surgical interventions and psychologically traumatic events during the last year were selected for the research. It has been established that a long-term, increasing in intensity effect of PS has a pathogenetic significance in the development of IR, which is associated with an increase in the consumption of glucose in the central nervous system and its competition for the glucose with the rest of the cells of the body. The continuation of research in this direction is promising.

We studied the gene pool of the Novgorod region of Russia by using the detailed genome-wide Illumina array. Three studied populations from the Novgorod region (15 individual genomes) have been compared with many other groups from European Russia and Ural (259 genomes from 21 ethnic Russian populations and 442 genomes from 20 other ethnic groups). We found the peculiarity of the Novgorod gene pool: when the entire gene pool of European Russia was subdivided into 8 ancestral components, one of these components comprised the vast majority (91%) of the Novgorod gene pool while in other ethnic Russian populations this component comprised only about one third of the gene pool and in most other ethnic groups this component was nearby absent. This “Novgorod” ancestral component was also typical for the populations from Yaroslavl region: the autosomal gene pools of Novgorod and Yaroslavl regions were almost identical. The same genetic peculiarities were also found in genomes of some individuals from the Nizhniy Novgorod, whose genealogical medieval ancestors migrated from the Novgorod. This finding conforms that this ancestral component might reflect the ancient Novgorod gene pool. Analysis of 677 genomes from other populations revealed the presence of this “Novgorod” component in three other populations: in almost all studied individuals from the Lensky district of Archangelsk region, in most Komi-Permyak individuals, and in half of Vod individuals. We hypothesized this genetic strata descended from the Ilmen Slovene tribe’s gene pool, which in turn contained the genetic legacy of local pre-Slavonic inhabitants, which seemed to have more eastern (Volga-Finnic and Permic-Finnic speaking) than western (Baltic-Finnic-speaking) affinities. In this study we publish three out of eight ancestral genetic components, which we called “Novgorod”, “Karelian”, and “Pomor” ones. These maps allow humanitarians to analyze the roles of these three sources of gene pool of European Russia without dealing with the specifically genetic details.

We have analyzed the relationship between the stages of formation and development of type III reactions and coronavirus infection and the generality of pathogenesis. The etiological factor associated with the SARS-CoV-2 virus, genetic factors, inflammatory mediators, tissue damage, pharmacotherapy have much in common with this type of allergic reaction.

In the context of large-scale vaccination against the new coronavirus infection COVID-19, the study of possible complications after the introduction of the vaccine is of practical importance. To date, three vaccines against COVID-19 have been registered in the Russian Federation. The aim of this study was to analyze the first cases of coagulation disorders first reported after the introduction of the Gam-COVID-Vac (Sputnik V) vaccine. Cases of coagulation disorders that occurred in people of different ages, as well as changes in the biochemical blood test and general urine analysis, requiring additional research, were identified. An analogy is drawn with coagulogram disorders after vaccination against measles, rubella and mumps, and a hypothesis is proposed to explain the relationship of coagulation disorders with vaccination. The necessity and direction of further study are justified.

Based on the developed classification (2020) of adjuvant agents in phthisiology, the authors herein investigate the presence and importance of vitamin pharmaceuticals; primarily, in terms of their pharmacodynamic qualities and their place in the overall plan of individualized host-directed therapy of the phthisiatric patient. Research targets also include polyhypovitaminosis in humans with tuberculosis (TB); likewise, the mutual influences of hypovitaminosis and the pro- and antioxidant balance in tuberculosis lesions; and questions related to the pharmacological action of vitamins C and D. The pharmacodynamic aspects of the use of vitamin agents for further clinical implementation in terms of enhancing the positive (and reducing the undesirable) effects of modern TB therapy are substantiated.

A retrospective analysis of the treatment of 307 patients who underwent surgery for pelvic prolapse in the Coloproctology department of Surgut District Clinical Hospital in 2013—2019 was performed. The results obtained suggest that clinical manifestations of pelvic prolapse significantly reduce the quality of life (by an average of 55.0 ± 10.8%). At the same time, the symptoms of urinary dysfunction in patients have the most evident negative impact on their quality of life. Surgery of pelvic prolapse was performed using Pelvix and Urosling-1 mesh implants (Lintex, Russia), Prolift™ (Johnson & Johnson Company, USA). Control examinations were done from 3 to 12 months after surgery. A validated Pelvic Floor Distress Inventory-20 questionnaire was used for comparative assessment of quality of life. The analysis reliably demonstrated a 43.1% improvement in quality of life in patients after prosthetic reconstruction performed via vaginal access with use of meshes for pelvic prolapse.

Colorectal cancer is characterized by the most frequent localization among all oncological diseases both in Russia and around the world. In recent years, there has been a stable trend in the detection of a large number of cases of diseases with malignant neoplasms of the large intestine. This article discusses the main issues of carcinogenesis of malignant neoplasms of the large intestine, their morphology and epidemiology on the example of the Novgorod region. It was found that a large number of cases in the overall structure of morbidity account for BDU adenocarcinoma, and most often new cases of tumor development occur at the age of 60-70 years, which indicates a special risk for the adult population. Taking into account the dependence of morbidity on external environmental factors and the lifestyle of a person that can be affected, this topic is relevant from the point of view of the possibility of effective prevention and screening of colorectal cancer for the diagnosis and treatment of precancerous diseases of the colon.

Aim: to assess the dynamics of changes in the life quality of patients in the early recovery period after acute cerebrovascular accident. The method of continuous sampling was used to select 142 patients after ischemic stroke who were admitted from the hospital to the second stage of medical rehabilitation. All patients received a standardized rehabilitation package including physical exercises and physical methods. On the 21st day and 6th month from the beginning of rehabilitation, general cerebral symptoms and quality of life were assessed using the NНР questionnaire, Spielberger-Khanin questionnaire and a medical and sociological questionnaire. On the 21th day from the beginning of rehabilitation, the majority of patients showed a positive trend in the reduction of general cerebral symptoms, which persisted throughout the entire follow-up period. In the NНР survey, the most rapid positive effect (on the 21st day after its start) was achieved only in the "pain" indicator, but later this indicator did not change statistically significantly; The indicator "physical activity" did not change statistically significantly during the entire follow-up period, and a positive effect in the other NHP indicators appeared only at the 6th month of follow-up. The medical and sociological questionnaire also showed a delayed positive effect. According to the Spielberger-Hanin questionnaire, reactive anxiety improved on the 21st day of rehabilitation, but later this indicator did not change statistically significantly, while personal anxiety, which is a more stable indicator, showed a delayed positive effect on the 6th month of follow-up. Assessing the quality of life can significantly change our understanding of the effectiveness of rehabilitation programs in patients after stroke. The results obtained show the necessity of further studying the impact of medical rehabilitation programs on the quality of life of patients after stroke using a better study design.

To evaluate the prospects of duplex Doppler ultrasound for studying morphofunctional features of vertebral arteries, we investigated duplex Doppler ultrasound scanning of vertebral arteries in 279 patients with stages 1–2 arterial hypertension (149 patients with stage 1 hypertension and 130 patients with stage 2 hypertension). The control group included 196 subjects with normal blood pressure values. Duplex Doppler ultrasound included the following hemodynamic parameters of vertebral arteries: peak systolic velocity, pulsatility index, resistance index, and also the asymmetry of vertebral arteries diameters — the ratio of the diameter of the left vertebral artery to the diameter of the right vertebral artery; volumetric blood flow. The reactivity of the vertebral arteries was studied by assessing the response of hemodynamic parameters to head rotation. The severity of muscle sleeve fibrosis surrounding the vertebral arteries in the C5–C6 segments of the cervical spine was evaluated at 4 degrees (from 0 to 3). The study found differences in the morphology of the vertebral arteries as well as the ultrasound parameters of the muscle sleeve surrounding the vertebral arteries in the C5–C6 segments but the greatest differences were observed precisely in the indicator of the reactivity of the vertebral arteries on head rotation. Reactivity indicators were expressed as changes in the parameters of pulsatility index and resistance index. The results of the study showed that early changes in the muscle sleeve surrounding the vertebral arteries in the C5–C6 segments lead to changes in the diameters of the vertebral arteries and their reactivity during further traumatization of vessels and sympathetic fibers caused by rotation of the head. Reactive indicators express to a far greater degree on the left vertebral artery and their progression increase with the progression of hypertension occurred.

The analysis of clinical data of 457 patients who were treated for obstructive jaundice of non-neoplastic etiology was carried out. Depending on the duration of jaundice, all patients are divided into two groups: 1 — with cholestasis duration up to 10 days; 2 — with jaundice up to 3-6 weeks. All patients underwent a general blood test with the determination of the number of platelets according to Fonio, the indices of homeostasis, hemostasis, endogenous intoxication; parameters of the rheological properties of blood were studied. The functional state of the liver was assessed by the results of biochemical blood tests. It was revealed that with obstructive jaundice against the background of lipid metabolism disorders and endogenous intoxication, an increase in the viscosity, aggregation ability of erythrocytes, a decrease in their deformability, coagulation potential and an increase in the fibrinolytic activity of blood are observed. An increase in the fibrinolytic activity of the blood indicates the risk of bleeding in the postoperative period, and a decrease in thrombotic complications. All these changes are more pronounced in patients of the second group with prolonged obstructive jaundice, when, along with cholestatic, cytolytic processes develop and progress. Therefore, in terms of prevention and timely treatment of disorders, it is of great importance to identify, with the help of laboratory studies, the hidden mechanisms of the development of complications. Preoperative complex, conservative therapy should be aimed at correcting violations of the aggregate state of the blood and liver functions.

The article describes the correlations between age, gender, the presence of chronic diseases, and the condition of the walls and left ventricle of the heart according to the echocardiogram of the heart. When examining a group of people of 80 people (40 women and 40 men) of different age groups, it was found that with age there was an increase in the thickness of the free and posterior walls of the left ventricle (LVLV), an increase in the thickness of the interventricular septum (IVS) and a decrease in the end diastolic (EDD) associated with concentric remodeling of the heart, and in women, left ventricular myocardial hypertrophy was observed more often than in male subjects, which is associated with the cardioprotective effect of estrogens, the amount of which decreases in women after 45 due to the onset of menopause.