Novosibirsk State Medical University

Coordination polymers n(Pipy)^2+[Ag_4(citr)_2]_n^2-·2nH_2O (1) and [Ag(bpy)]+[Ag2(citr)(bpy)2]–n·10nH2O (2) are formed by the interaction of silver acetate with citric acid (H3citr) and piperazine (Pipy) / 4,4′-bipyridine (bpy) during slow diffusion. Their structures are determined by the single crystal X-ray diffraction (XRD) analysis. According to the single crystal XRD data, both compounds are ionic polymers. In the complexes, the Ag+ cations and bridging COO-groups of citric acid form eight-member cycles (–Ag–O–C–O–Ag–O–C–O–) with argentophilic interactions. Unlike complex 1 in which protonated piperazine fragments Pipy2+ occupy the outer-sphere positions, bpy coordinates to the complexing agent in 2, forming [Ag(bpy)]+ cationic chains. In the coordination polymers, the system of hydrogen bonds and π–π interactions participate in the additional stabilization of the structures. Simultaneous thermal analysis (STA) data show that complex 2 is the highly stable compound.

Introduction. The high prevalence of iron deficiency in women with abnormal uterine bleeding (AUB) requires optimizing therapeutic approaches. Aim: to evaluate the clinical efficacy and safety of therapy with iron fumarate in combination with folic acid in reproductiveage patients with AUB complicated by iron deficiency anemia (IDA) and latent iron deficiency (LID). Materials and М ethods. There were retrospectively analyzed 75 outpatient patient records (2021–2025) stratified as follows: 40 patients with IDA (hemoglobin level < 120 g/L) and 35 patients with LID (ferritin content < 30 ng/ml). Patients received iron fumarate 163.56 mg (equivalent to 50 mg iron) + folic acid 540 μg (equivalent to 500 μg dry matter) for a course of 12 weeks. Treatment efficacy was assessed according to the hemoglobin, ferritin and sideropenic syndrome severity scales. Results. A statistically significant increase in red blood parameters in all groups (p < 0.001) was recorded during treatment. The following changes were found: in IDA group median hemoglobin and ferritin level increased from 110 to 123 g/L and from 12 to 21 ng/ml, respectively; in LID group – from 123 to 136 g/L and from 22 to 34 ng/ml, respectively. Conclusion. Combination therapy with iron and folic acid preparations demonstrates high efficacy and safety in correcting anemic and sideropenic syndromes in patients with AUB, which justifies the expediency of its inclusion in the management standards for this category of patients.

Tocilizumab (TCZ) is widely used in rheumatoid arthritis (RA) and may be administered using different dosing regimens, including the standard dose (SD) of 8 mg/kg and regimens involving dose reduction or escalation depending on the clinical response. Under current healthcare conditions, assessment of the clinical and economic feasibility of drug-dosing strategies is particularly relevant. Objective : to evaluate, from the perspective of the Russian healthcare system, the clinical and economic feasibility of a TCZ dose de-escalation strategy (DDS) from 8 to 4 mg/kg after remission is achieved and a dose escalation strategy (DES) from 4 to 8 mg/kg if remission is not achieved, compared with the SD of 8 mg/kg in patients with RA. Material and methods . A decision-tree model with 1and 3-year time horizons was developed to compare the three TCZ dosing strategies. Costminimization analysis, budget impact analysis, and one-way sensitivity analysis were performed. Results and discussion . Over a 1-year time horizon, DES provided savings of 169,850 rubles (28.1%) per patient compared with SD, whereas DDS provided savings of 58,188 rubles (9.6%). Over a 3-year time horizon, savings amounted to 168,849 rubles (10.3%) and 95,848 rubles (5.8%) for DES and DDS, respectively. According to the budget impact analysis, transferring a proportion of patients to DES could reduce costs by 1.0–1.7 billion rubles over 3 years, whereas transition to DDS could reduce costs by 0.6–1.0 billion rubles. Conclusion . Within the adopted assumptions, the model demonstrates a potential reduction in direct drug costs when using strategies involving controlled dose reduction or initiation at a lower dose followed by escalation. Owing to the limited availability of direct comparative data and regulatory restrictions in the Russian Federation, the results should be regarded as a scenario-based pharmacoeconomic assessment requiring validation using Russian data.

BACKGROUND:In recent years, key TB indicators have improved in the Siberian and Far Eastern federal districts (FDs) of Russia, but these regions still face the challenge of reducing the numbers of patients with drug-resistant-TB and TB/HIV co-infection. TB care and support interventions recommended by the WHO have been implemented, such as home-based and outpatient treatment, use of digital technologies and provision of psychosocial support. METHODS:The study used a short survey to assess the influence of these interventions on patient adherence to treatment during the period 2018-2022 in the Siberian and Far Eastern FDs. The survey was sent to the heads of TB clinics in the 21 regions. RESULTS:Of the 21 regions invited to take part in the study, 20 returned answers; 14 of these completed the survey fully, and the other six only partially (as some of the data requested are not routinely collected in those regions). The results show that TB care and support interventions, especially psychosocial interventions, are associated with a reduction of number of patients lost to follow-up and the number of TB cases. CONCLUSION:Care and support interventions have only been implemented for a relatively short period, and their use needs to be continued, along with the creation of a data repository to enable monitoring and further studies to meet targets on TB control.

Introduction. One of the important components of the diagnosis of “adenoid hypertrophy” and the determination of treatment tactic is to determine the significance of the negative impact of adenoids on the life quality of a child. However, to collect medical history from preschool children is a difficult task even for teachers, because preschool children are hardly to describe their complaints and sensations. Children under 5 years old cannot clearly express their feelings. To date, the assessment of quality of life in pathological conditions has not been widely used in otorhinolaryngology. Aim. To investigate the quality of life of preschool children with adenoid hypertrophy and its changes after surgical treatment. Materials and methods. The object of the study is 66 patients aged 3–7 years with a diagnosis of “Adenoid hypertrophy”, who underwent a questionnaire survey using the PedsQLtм4.0 (Pediatric Quality of Life Inventory) before surgical treatment. In the postoperative period, the same patients were surveyed as part of 3 equal groups of observation: Group 1: patients after adenotomy performed by mechanical dissection with a Backman adenotome. Group 2: patients after cold plasma adenoid coblation. Group 3: patients after molecular resonance adenotomy. The questionnaire was repeated 10 days and one month after surgical treatment. Results and discussion. The initial level of physical functioning in the examined patients is lower than in healthy children of the same age. In the postoperative period, emotional functioning is restored quickly, and the restoration of physical functioning is closely correlated with the experienced pain syndrome. Conclusions. The physical and emotional functioning of children who undergo adenotomy due to adenoid hypertrophy is below the age norm. Adenotomy is accompanied by a significant improvement or normalization of emotional functioning in the first 10 postoperative days. One month after surgical treatment, physical functioning was normalized in 90.9% of patients after curettage adenotomy, and in 50% of patients after adenotomy with high-frequency currents in the cold-plasma and molecular-resonance ranges.