Objective. The aim of the study was to investigate the compliance, social and psychological profile and satisfaction of elderly and senile patients with cardiological care in a 24-hour in-patient hospitalization. 

Materials and methods. 400 elderly and senile patients were hospitalized in the District Hospital of Kostroma District No 1 and randomized in the study. Compliance of patients and social and psychological profiles were evaluated. The types of temperament of patients, valuable orientations and skills to communicate were determined. The individual strategy and tactics of patients’ behavior in a conflict situation and the level of motivation of patients for success in treatment were investigated. 

Results. Senile patients are more critical than elderly people in assessing the medical care provided and are more likely to have extreme levels of compliance, which can be expressed either in the "blind" implementation of doctors recommendations, or in their partial or complete disregard for and lack of confidence in medical appointments. Social and psychological factors that negatively affect the formation of satisfaction of patients of elderly and senile age with the cardiological care in hospital conditions are melancholic type of temperament, extreme levels of communicability, opposing style of behavior in conflict, suspicious style of interpersonal relations, and high level of motivation for success in treatment. 

Conclusion. When working with patients, their personal characteristics should be taken into account, stage-by-stage psychological counseling should be carried out with the formation of the psychological portfolio of the patient.

Objective. To compare the effectiveness of managing late proximal deep vein thrombosis with different endovascular methods. 

Materials and methods. The treatment efficacy of 45 patients with proximal DVT was analyzed. The patients were split into three statistically valid groups, each consisting of 15 patients. The first group patients were treated with mechanical transcutaneous thrombectomy. The second group had catheter-guided thrombolysis therapy using Urokinase. In the third group the thrombolysis therapy and the thrombectomy were combined. Patients were given Rivaroxabane before, during, and after the therapy continuously for 6 months. The complications of thrombectomy and thrombolysis therapy were monitored during the treatment. After 12 months in order to reveal deep vein patency and the degree of venous outflow disturbance, the ultrasonography and clinical assessment were done. Venous lumen recanalization was scored in the following way. The minimal recanalization was considered as less than 50% of the lumen. The partial one was 50 to 99%. The restoration of 100% lumen patency was referred to as the complete one. 

Results. Recurrent DVT was found in 3 (6.7%) patients, 2 of whom belonged to the first and 1- to the second group. External hemorrhage after popliteal vein puncture and Urokinase injection developed in 1 patient from the second and 1 from the third group. Hemorrhagic complications after Rivaroxabane intake occurred equally in 6 (13.3%) patients from each groups. The complete restoration of the lumen patency is detected in 6.7%, the partial one - in 53.3%, and the minimal one - in 40% of first group patients, 20%, 53.3% and 26.7% in the second and 40%, 46.6% and 13.3% of the third group patients respectively. Severe venous congestion developed in 40% of first group patients, 20% in the second, and 6.7% of the third group patients respectively. Moderate venous congestion developed in 33%, 26.6 % and 13.6% of patients respectively. Mild congestion was in 20%, 33.4% and 40% of patients. 

Conclusion. The combined treatment of late DVT with transcutaneous thrombectomy and catheter-guided thrombolysis therapy accompanied by long-lasting anticoagulation therapy with Rivaroxabane is an option of choice.

The objective of the experiment is to investigate the morphological structure of dental tissues in people of different age groups suffering from tissue hyperesthesia. 

Materials and methods. The morphological structure was studied by scanning electron microscopy. We studied 57 teeth that had been removed for medical reasons in 45 adults. With the help of microscopy, hard tissues (enamel, dentin and cement) of teeth were studied. The study involved intact and pathologically altered teeth. Intact teeth were removed for orthodontic indications. In older people, removal was performed due to exacerbation of chronic periodontitis and periodontitis. 

Results. The revealed morphological changes in dentin are due to the main pathology: whether hyperesthesia is associated with the loss of tooth hard tissues or developed without it. Non-carious lesions of hard dental tissues (erosion and wedge-shaped defects) during morphological examination are caused by a violation of the integrity of the cement, cracks and chips of enamel. It was found that in patients the increased tooth sensitivity and morphological changes develop due to the presence of carious and non-carious processes in the dentin and are independent of gender and age. 

Conclusion. Both in the carious process and in non-carious lesions of the teeth, no relationship was established between the severity of hyperesthesia of the teeth and the degree of obliteration of the dentinal tubules.

Currently, there is no effective clinical treatment for ischemic reperfusion damage to the myocardium. However, several new therapeutic strategies are being considered, including the use of incretin mimetics. Although the main physiological functions of including glucagon-like peptide-1 (GLP-1) are associated with glycemic control, more and more evidence suggests that GLP-1 can also play an important role in the cardiovascular system. The review focuses on the experimental results of the cardioprotective effects of incretin mimetics, GLP-1 analogues and dipeptidyl peptidase (DPP-4) inhibitors, and discusses the potential mechanisms underlying their action. There is an assumption that they may be associated with the indirect influence of the GLP-1 receptor on the activation of a number of PI3K/Akt, p44/42 and PKA kinases, preventing apoptosis and death of cardiomyocytes. In addition, GLP-1 can protect the myocardium from ischemia, being a pharmacological preconditioning mimetic, influencing ATP-dependent potassium channels (K+ATP). Recent studies have shown that GLP-1 agonists can reduce oxidative stress by lowering the levels of reactive oxygen species (ROS) or by decreasing NADPH-oxidase activity. At the same time, the cause and mechanisms of the observed positive effect of incretinmimetics on cardioprotection in experimental studies continue to be studied.

The problem of infertility due to endometrial hypoplasia is very relevant, due to the difficulty of diagnosis, since there are no uniform morphometric and immunohistochemical criteria for this condition. 

The aim of this study is to assess the endometrial condition of patients with endometrial hypoplasia and infertility, using morphometry and microscopy, taking into account the severity of expression of receptors for estrogen, progesterone, VEGF, CD34, LIF and LIFR. 

Materials and methods. Morphometric, immunohistochemical and statistical analysis of endometrial samples of 34 women with infertility due to thin endometrium and 29 healthy fertile women was carried out. 

Results. Fibroplastic transformation of the stroma in women with infertility was recorded 1.9 times more often. A significant decrease in the relative number of abundant pinopodia in the group of women with infertility was found. Immature pinopodia in the group of women with thin endometrium were recorded almost 10 times more often, and mature ones - 4 times less than in fertile women. An immunohistochemical study found a decrease by 43% in the level of progesterone receptors expression by stromal cells in women with thin endometrium, as well as in VEGFR3 expression by 48% and 84%, both by gland cells and stromal cells. The number of capillaries in the field of view in women with thin endometrium was reduced by 2 times. 

Conclusion. In women with thin endometrium and infertility, a decrease in the area of the integumentary epithelium with pinopodia was established, with the predominance of their immature forms; a moderately reduced expression of progesterone receptors by stromal cells, a decrease in LIF expression and an increase in LIFR expression by glands and stroma, as well as a decrease in the level of VEGF and CD34 expression, which indicates the impaired endometrial receptivity and neoangiogenesis processes, which subsequently lead to a decrease in endometrial height and inferior cytotrophoblast invasion.

Neurodegenerative diseases of the brain and eyes have high medical and socio-economic significance. The leading among them - Alzheimer's disease (AD) and glaucoma share similar epidemiological characteristics, common molecular mechanisms of patho- and morphogenesis. A number of facts testify in favor of the pathogenetic relationship between glaucoma and AD: their frequent combination; thinning of the layer of nerve fibers of the retina both in patients with neurodegenerative diseases and in patients with glaucoma; the possibility of transporting neurotoxic metabolites in the brain-eye system; amyloid deposits in the retina in patients with AD, as well as the formation of neurotoxic forms of amyloid in the head of the optic nerve with intraocular hypertension, deposits of β-amyloid and tau protein in the lateral geniculate bodies in the binocular glaucoma model; reduction in cognitive functions in glaucoma patients, etc. These facts are consistent with the modern concept of the "glymphatic system" (GLS), which gave rise to a new stage of studying the neurodegeneration pathogenesis. GLS is a set of formations ensuring liquor exchange between the brain and the eye, and includes a number of spaces near the vessels: paravascular (between the vascular pial-adventitia sheath and the glial limiting membrane) and perivascular (between the pial sheath and the adventitia of arteries and arterioles, as well as between the vascular tunica media and the common pial-adventitia sheath). An important factor determining the glymphatic transport is the state of arterial and venous blood flow, which also successfully correlates with the basic theories of glaucoma pathogenesis. The review presents literature data on the relationship between cerebral and ocular neurodegeneration, pathogenesis of glaucoma, structural and functional features of the glymphatic system, possible pharmacotherapeutic approaches and neuroprotection for neurodegenerative pathology and glaucoma.

Objective: to evaluate the morphological characteristics of a residual tumor of breast.

Materials and methods. A histological examination of breast tumor biopsy samples before treatment (core-biopsy) and surgical material after neoadjuvant therapy was conducted in 113 breast cancer patients receiving Taxane containing regimens. The samples were compared case-by-case to biopsy, residual tumor and axillar lymph node metastasis. 

Results. The degree of grading of the primary breast tumor was estimated using the Nottingham system and the significance of changes in the components of Grade residual tumor, the morphological characteristics of the “tumor bed” and the percentage of achievement of the pathologic complete response (pCR). Primary tumor regression was detected in 20.4% (n=23) cases, however, 2 cases (21.7%) were not attributed to pCR due to the presence of metastases in regional lymph nodes, thus, pCR was achieved in 18.6% (n=21). When evaluating a residual tumor, a statistically significant change in the degree of malignancy (Grade) was not detected (p=0.593), however, a statistically significant change in the assessment of nuclear polymorphism was 46.67% (p=0.000). 

Conclusion. The anatomical criteria for determining the stage of the breast tumor coincide both in the clinical classification (cTNM) and in the pathology (pTNM), thus restoring the residual tumor after neoadjuvant treatment in accordance with the AJCC (TNM) classification approaches clearly and reliably allows to evaluate the response breast tumors in the form of a reduced stage.

The purpose of the study is the choice of the pharmaceutical substance rabeprazole sodium with the optimal structure and technological characteristics for the development of Rabeprazole tablets. 

Materials and methods. The study was conducted on samples of pharmaceutical substances rabeprazole sodium of two manufacturers Changzhou Koni Pharmaceutical Co. Ltd., China - RAB 20131102 Series (Sample 1) and Nosh Labs Pvt. Ltd., India - of RS 0280311 (sample 2) and RS 0120914 (sample 3). Microphotographs were obtained on a TM-1000 electron microscope, Hitachi. Powder X-ray diffraction patterns were obtained on a Bruker D8 Advance automatic X-ray diffractometer. To identify the crystalline phases, the PDF-2 Powder Diffractometry Database and the Cambridge Crystal Structural Database were used. The flowability of pharmaceutical substances was determined according to OFS 1.4.2.0016.15, the fractional composition was determined by sieve analysis; to evaluate compressibility, the Carr and Hausner indices were calculated. 

Results. Samples of rabeprazole sodium 1 and 2 are amorphous in nature and are characterized by the presence of two amorphous halo in the range of angles 2θ of 4-7 ° and 18-24 °. Sample 3 is probably a mixed version, in which an amorphous and crystalline component is presented. The studied samples differ in bulk density and fractional composition. Samples 2 and 3 are more uniform compared to sample 1, their bulk density is acceptable for the process. 

Conclusion. Pharmaceutical substance rabeprazole sodium of manufacturer Nosh Labs Pvt. Ltd. (India) has a more uniform fractional composition and acceptable bulk density. However, the processes used by this manufacturer do not exclude the formation in some cases of a crystalline component in a pharmaceutical substance, which can lead to a significant change in the physicochemical and mechanical characteristics of the pharmaceutical substance in different batches.

The problem of treatment of mycotic infections today is still relevant. Etiotropic therapy is an essential component of the pharmacotherapy of mycoses. A general criterion for the effectiveness of the use of antimycotics is the disappearance of clinical and instrumental signs of infection, as well as the eradication of the pathogen from the lesion. The purpose of this review is to analyze the main directions of searching for new compounds (groups of compounds) with antifungal activity for practical medicine, and the most important problems arising from these studies. The main difficulties arising from these studies is the high economic cost of such projects: significant financial investments are accompanied by a possible limitation of the circulation of these drugs due to their introduction into the reserve, as well as the spread of resistant strains against the background of the short duration of patent protection. The article presents the most commonly used classification of antifungal agents and their main mechanism of action. The main strategies for the development of new antifungal agents are highlighted: reprofiling the existing drugs that were previously used for a different purpose; modification of the existing antifungal drugs to increase effectiveness and reduce toxicity; the creation of new antifungal molecules by chemical synthesis or the identification of agents of natural origin that have a detrimental effect on fungal microbiota. The review presents data on compounds of various origins exhibiting antimycotic activity, obtained and described in recent decades. The characteristic of the mechanism and the spectrum of their action is given. Substances with a traditional mechanism of action associated with the influence on the cell wall of fungi (effect on the ergosterol system, impaired synthesis of 1,3-b-D-glucan) join the molecules that block the exchange of sphingolipids of the fungal cell, disrupting the synthesis of chitin, protein metabolism, etc.

The results of the complex study of the qualitative and quantitative composition of the aminoacids of the grass of three species of the genus Hedysarum growing in the territory of the North Caucasus are presented in the article. 

The objective of the work is to prepare the comparative aminoacid analysis in three samples of a species of Hedysarum growing in the territory of the North Caucasus. 

Materials and methods. Qualitative analysis of the amino acid composition was carried out by reaction with ninhydrin, and the quantification of free forms of amino acids was determined by photometric detection at a wavelength of 570 nm on an amino acid analyzer ААА-400. The content of free and bound amino acids was determined after staining the derivatives with ninhydrin and fixing their content at a wavelength of 440 and 570 nm. Analysis of the amino acid composition of these species Hedysarum daghestanicum, Hedysarum caucasicum, Hedysarum grandiflorum is given for the first time. 

Results. The comparative amino acid composition of the three studied specimens of the Hedysarum genus species growing on the territory of the North Caucasus showed that significant amino acids in the aboveground organs of the studied species were found, such as aspartic and glutamic acids, as well as proline, leucine, and phenylalanine. 

Conclusion. In conclusion, it should be noted that the bulk of the detected amino acids belongs to the group of essential amino acids, and in addition, the presence of proline and phenylalanine proves the presence of xanthones. The results of the study can be further used in the preparation of a comprehensive metabolic assessment of medicinal plant materials of species of the genus Hedysarum L.

In medical practice, the issue of the use of new domestic medicines becomes relevant, and the production of these medicines involves the development of regulatory documentation for their analysis. 

Objective: to develop the method of quantitative determination of Metronidazole and Clotrimazole in a soft medicinal form on titaniferous basis with the use of spectrophotometry method. 

Materials and methods. For analysis, we used substances, ethanol solutions of Metronidazole and Clotrimazole, an ointment under the conventional name Metroclotrimazole containing 1.0% of the preparations in Tizol gel. To carry out the research, spectrophotometry in the ultraviolet region was used with a SF-2000 device. 

Results. Studying the absorption spectra and performing the statistical processing of the analysis results, it was found that spectrophotometric determination of Clotrimazole and Metronidazole can be carried out at wavelengths of 260 nm and 312 nm, with a relative error of ± 1.88% and ± 1.57%, respectively. As a result of the study of the soft dosage form, it was found that the content of Metronidazole, found by the Fierordt method and the simplified system of equations, is in the range of 0.1028-0.1107 g, Clotrimazole - 0.0973-0.1117 g, which corresponds to acceptable standards. 

Conclusion. The studies conducted allowed us to develop and propose a method for the quantitative determination of Clotrimazole and Metronidazole in the ointment "Metroclotrimazole" spectrophotometrically, which enables to set the content of the drugs in the dosage form within the allowable regulatory deviations.