Russian Medicine Research Articles

ACTUAL ISSUES OF THE CELL TECHNOLOGIES APPLICATION IN RUSSIA PRACTICAL HEALTHCARE

Despite skepticism and mistrust, today cellular technology is one of the most rapidly developing areas of modern science of the 21st century. Unfortunately, the priority in the development of a biomedical cell product (BMCP) production in the world community belongs mainly to civilized countries. In Russia, the pace of development of cellular technologies is constrained by a number of reasons. This is largely due to insufficient legislative regulation, low funding, and the absence of a sufficiently large number of accredited laboratories. Despite this, recently in Russia, cell technologies are actively developing in research organizations, which leads to the need to solve problems and assess the prospects for the production of BMCP on an industrial scale. Medicine is constantly developing and its progress cannot be stopped, therefore, provided that pressing problems are solved, cell technologies will become an integral part of the life of mankind and its health. The purpose of this review: to study current problems and prospects for the development of cell technologies and the possibilities of their practical application in Russian practical medicine. Аn important problem in the development of the production of cellular products in Russia is the lack of an attractive investment climate due to incomplete legislation, as well as costly financing. At the moment, in Russia, obtaining, research, storage, transportation and use of biomedical cell products is carried out within the framework of federal laws. But, unfortunately, Russian doctors and scientists have faced a number of problems that hinder the development of the industry, while their Western colleagues have overcome these problems long ago. Mostly these problems are associated with an insufficiently developed regulatory framework and funding conditions.

FEATURES OF MODERN PHARMACOTHERAPY OF EPILEPTIC STATUS

In the presented review of the literature, the most significant problems of modern pharmacotherapy of status epilepticus are indicated. The urgency of treatment of status epilepticus is confirmed by its frequency and ineffectiveness of traditional drugs (benzodiazepines, hydantoins, barbiturates), which have a number of side effects from the cardiovascular and respiratory systems. In Russian intensive care medicine, treatment of status epilepticus is carried out in accordance with international standards and recommendations. For a number of years, the injectable form of valproate has proven its effectiveness, including in pediatric practice. In comparative studies, phenytoin, valproate and levetiracetam are safe and equally effective in treating status epilepticus. A particular difficulty in therapy is caused by benzodiapine-resistant status epilepticus and refractory, which requires consideration of the possibility of using a combination of antiepileptic drugs. The review of foreign and domestic sources presents the results of clinical studies that allow the use of new antiepileptic drugs, which can effectively stop status epilepticus already in the early stages. New antiepileptic drugs are especially relevant in the treatment of patients refractory to drug treatment. However, treatment with antiepileptic drugs does not always show its effectiveness in refractory and super-refractory status epilepticus, which requires new approaches in complex treatment. The tolerance of drugs and the frequency of side effects are important for patients, since most of them require long-term combined use. Correct selection of antiepileptic drugs increases the level of compliance. A special approach requires the treatment of status epilepticus in the context of palliative care and comorbid pathology. In the treatment and prevention of status epilepticus, surgical treatment and the use of a ketogenic diet can be considered.

Planning a Clinical Development Programme for Medicines for Bronchial Asthma

The need for development of a clinical trial guidance for medicines for bronchial asthma is brought about by the improvement of requirements for research programmmes for new medicines. The aim of the study was to develop a methodological approach to conducting clinical trials of bronchial asthma medicines in Russia in line with the existing international requirements. The authors analysed regulatory documentation on the development of medicines for treatment of bronchial asthma in adults taking into account the current clinical guidelines, and specific aspects of developing medicines for treatment of bronchial asthma in children. The paper also analyses some clinical research aspects related to the development of immunotherapy. The analysis of up-to-date Russian and international clinical guidelines for bronchial asthma treatment, which are focused on bronchial asthma management using basic therapy, revealed the need to use revised disease concepts and new criteria to assess the efficacy of asthma medicines. The authors formulated consistent approaches to planning a clinical development programme for medicines for bronchial asthma, and suggested methodology for conducting clinical research based on recommendations of the European Medicines Agency.

The 200 years of history of national clinic of internal diseases: the issues of periodization (the fifth and sixth stages)

This article completes series of three publications analyzing periodization of the history of the clinical internal medicine in Russia over the past 200 years. The discussion covers the fifth period (the second half of the 1950s - the mid-1970s), when the "landscape of diseases" changed, the differentiation of internal medicine into "narrow" specializations continued and the alterations of the state policy of the USSR in the field of health care was completed. During the sixth period (the second half of the 1970s and 1980s), the successful development of medicine in the USSR slowed down, the economic foundation of health care "failed" and indices of population health deteriorated. Ahead awaited the political and economic upheavals of the 1990s and total redesign of the internal medicine in organizational, economic and substantial aspects.

Analysis of changes in the pharmaceutical industry in Russia for 2020

The purpose of the study is to analyze the changes in the pharmaceutical industry in Russia in 2020. Recently, Russia has been facing an acute threat to the economic security of the pharmaceutical industry, due to the likelihood of increasing influence on the Russian industry by world players. Therefore, the analysis of the possibilities of innovative import substitution of foreign supplies to increase the level of security of the country in the field of drug supply has now become particularly relevant. The scientific novelty lies in the justification of the availability of opportunities for the development of innovative import substitution of medicines in Russia. As a result, the latest trends confirm the prospects for further effective development of the domestic pharmaceutical industry.

The problem of the synthesis of pedagogical strategy and moral practice in modern medical education (aspects of integrating international experience)

The article is devoted to the phenomenon of "medical humanities" as an independent interdisciplinary area of research, formed on the basis of the international experience integration as a reality. Тhe phenomenon is comprehended simultaneously in the field of Russian patristic tradition and medicine, since it focuses pedagogical strategy and moral practice. In the Russian spiritual tradition, it fits into the processes of educating humanity, which receives a modern consideration both in moral and religious categories, and in the categories of natural science, which are significant for medicine. Spirituality is the category of thinking that changes the idea of a person in the existing reductionist approach to his integrity in medicine. The action of the worldview of the individual is considered as a mandatory constant, which acts as a constructive mechanism for the transformation of the value foundations of thinking and ethical reflection. The fundamentals of spiritual and moral education and patristic experience make complex conditions for the restoration of humanitarian culture in medicine. The purpose of the process is to qualitatively change its anthropological, ethical and psychological components. Systemic humanitarian knowledge is main for medical education. The author reveals the significance of the positive convergence of the humanities for medicine.

Foreign Medical Students in Eastern Europe: Knowledge, Attitudes and Beliefs about Medical Cannabis for Pain Management.

Objective: To assess the knowledge, attitudes, and beliefs of foreign students toward the use of medical cannabis (MC) for pain management. Methods: This study uses data collected from 549 foreign students from India (n = 289) and Middle Eastern countries mostly from Egypt, Iran, Syria, and Jordan (n = 260) studying medicine in Russia and Belarus. Data collected from Russian and Belarusian origin medical students (n = 796) were used for comparison purposes. Pearson’s chi-squared and t-test were used to analyze the data. Results: Foreign students’ country of origin and gender statuses do not tend to be correlated with medical student responses toward medical cannabis use. Students from Russia and Belarus who identified as secular, compared to those who were religious, reported more positive attitudes toward medical cannabis and policy change. Conclusions: This study is the first to examine the attitudes, knowledge, and beliefs toward medical cannabis among foreign students from India and Middle Eastern countries studying in Russia and Belarus, two countries who oppose its recreational and medicine use. Indian and Middle Eastern students, as a group, tend to be more supportive of MC than their Russian and Belarusian counterparts. These results may be linked to cultural and historical reasons. This study provides useful information for possible medical and allied health curriculum and education purposes.

“Pirogov's Legacy: Past, Present, Future” – Ten Years After the Anniversary International Conference (to the 210th Anniversary of the Birth of N.I. Pirogov)

The article is dedicated to the anniversary date, the 210th anniversary of the birth of the genius of Russian medicine, doctor and surgeon, anatomist and teacher, an outstanding citizen and ardent patriot of Russia – Nikolai Ivanovich Pirogov. On November 25, 2010, on the day of the 200th anniversary of the scientist, a memorial plaque was installed at the Department of Operative Surgery of the Academy, made in the Urals at the expense of cadets and being the only material monument in our country that reminds of this event. The article describes thelife path and stages of scientific activity of N.I. Pirogov, his contribution to science and the unconditional significance of his work for the development of clinical medicine and morphology. The international scientific conference “Pirogov's Legacy: Past, Present, Future”, held in November 2010, was a major event in the scientific life of many department teams of the Military Medical Academy and became a memorable part of the anniversary scientific events of St. Petersburg dedicated to the great scientist and organized by the Pirogov Surgical Society and the medical community of the city. This article presents the scientific works of N.I. Pirogov, which can rightfully be considered fundamental in the formation of modern morphology and medicine.

Analysis of Public Procurement of Medicines in Russia

One of the main components of the drug supply of the country's population with medicines is public procurement, which at the legislative level implements the principle of universal access to medical care and guarantees the quality of medical services provided. The authors analyzed the system of public procurement of medicines in Russia: the main sources of financing, customers and suppliers, territorial distribution, structure of methods of placing state orders are determined.

ПРОФЕССИОНАЛЬНЫЕ КОМПЕТЕНЦИИ ВРАЧА В ТЕЛЕМЕДИЦИНЕ

Objective: To analyse the professional skills forming the professional competence of a doctor providing medical care in the field of telemedicine. Methods: The following research methods were used: secondary analysis of sociological research data from Russian analytical agencies and the author's medico-sociological research on the topic "Telemedicine in the daily professional activity of a doctor." The analysis was carried out by the method of questionnaires and semi-structured interviews. The total sample size was 100 respondents; the study period is October 2021. Results: The study results showed a relatively high level of medical specialists' preparedness to use telecommunication technologies in their professional activities. Telehealth skills are necessary for a more accurate diagnosis, correct use of medical equipment, etc. According to the respondents, the primary way of telemedicine skills mastering is training from medical equipment suppliers, self-education and refresher courses initiated by the employer. In addition, a modern doctor needs to master "soft skills", which include operational thinking, multitasking and multiskilfulness, autonomy, communication skills, multilingualism and multiculturalism, creativity. Conclusion: Telemedicine and personalised medicine in Russia and globally are opening up a new frontier for the medical industry development. Therefore, a teledoctor, in addition to essential universal and general professional skills, should have new eHealth technology competencies. Keywords: Professional competence, medical care, telemedicine, information technology, online consultations, professional activity, skills.

Об отечественной гастроэнтерологии как самостоятельной клинической дисциплине и академике АМН СССР Владимире Харитоновиче Василенко

The process of differentiation of clinical medicine and the formation of multiple new clinical disciplines substituting former therapy and surgery is an important stage of the historical development of clinical internal medicine in Russia, stretching over the third quarter of the 20th century. The author illustrates this process by the example of gastroenterology, showing the constitutive role of academician V.Kh.Vasilenko. Addressing a wide range of sources (literature, archives, including family records; memoirs and personal memories), he creates a faithful portrait of V.Kh.Vasilenko – a physician, scientist, citizen, and a human being. The author holds the opinion that V.Kh.Vasilenko, along with I.A.Kassirskiy and A.L.Myasnikov, who were part of the outstanding leadership team of the therapeutic elite of their time – radiated especially bright light, had an amazingly brilliant talent and unique personality. Key words: V.Kh.Vasilenko, physician, scientist, citizen, human

The organizational aspects of security support of participants of clinical testing of vaccine "Gam-COVID-Vac"

The COVID-19 pandemic resulted in many aftermaths, economic crisis and extra charging of health care. The development of vaccine against SARS-nCoV-2 agent turned out as the priority task of world and Russian medicine and pharmaceutics. The investigation of efficiency and safety of vaccines can be prolonged for many years that can aggravate the observed crisis. Having regard to the global scope and speed of pandemic spreading, the vaccine "Gam-COVID-Vac" was registered with special procedure by the Decree of the Government of the Russian Federation No. 441 of 03.04.2020 for accelerated access to civic turn-over. To monitor safety of vaccine on the basis of international experience, the decision was made to organize the independent Committee of monitoring data concerning efficacy and safety of vaccines applied to prevent COVID-19. The article presents rationale for necessity to create independent committee and to implement such a practice.

Search for approaches to solving the problem of between-reagent-lot variation in the realities of Russian laboratory medicine. Opinion paper

Search for approaches to solving the problem of between-reagent-lot variation in the realities of Russian laboratory medicine. Opinion paper

Physical activity in medicine students during COVID-19 pandemic

The COVID-19 pandemic and caused restrictions have a negative impact on the regular physical activity of human population. Relevance: Scientists indicate that the detailed study of the COVID-19 pandemic impact on the regular physical activity and behaviour of medicine students are needed. Objective: Collecting data on the physical activity and behaviour of Russian medicine students during the COVID-19 pandemic. Materials and methods: Participants – medicine students (n=218) aged 19-23 years. The tool of the study is IPAQ-SF (modernized form). All participants provided complete data on their physical activity and behaviour during one week (pre-pandemic and during the COVID-19 pandemic). Data analysis using SPSS Statistics 17.0 and Mann-Whitney U-test was performed. Results: There were a significant (p ≤0,05) differences in the data of IPAQ-SF survey, in pre- and during the COVID-19 pandemic. There was a significant decrease in physical activity in sports and fitness, and a significant increase in overall physical activity and physical activity at work and educational training in the study participants during the pandemic. A significant increase in sedentary behaviour among medicine students during the COVID-19 pandemic was revealed. Conclusion: The obtained knowledge indicate that to take measures to increasing of physical activity in sports and fitness, and to reducing the overall time of sedentary behaviour among medicine students during the COVID-19 pandemic are needed.

Patronage and Social Sponsorship’s Role in the Development of Russian Medicine in the Second Half of the 18th and in the Beginning of 19th Century

This article analyzes different aspects of the patronage and social sponsorship’s role in the development of Russian medicine in the second half of the 18th and in the beginning of 19th century. The present study includes the scientific data concerning patrons and philanthropists’ aid for Russian medical education. This article also includes the overview on formation of Russian tradition of charity, patronage and social sponsorship during different periods of Russian history. The present study reveals the patronage’s influence on Russian hospital system from 1750s to 1820s. Authors of this article also explore the interaction between the patronage and the charity establishments founded by Russian monarchs in the second half of the 18th century and in the beginning of 19th century.

Russian doctors and world medicine

The article contains historical materials for the development of domestic obstetrics, anesthesiology, transfusiology, forensic medicine and pediatrics in the late 19th and early 20th centuries in comparison with world examples. The names of dissertation studies and monographs in the presented directions are presented.

Pokrovskiy Valentin Ivanovich

On October 29, 2020, the leader of Russian medicine, a great scientist and teacher, a truly great doctor, mentor of Russian infectious disease specialists and epidemiologists, the founder of a medical dynasty, advisor to the director for innovation of the Central Research Institute of Epidemiology of Rospotrebnadzor, professor, academician of the Russian Academy of Sciences Valentin Ivanovich Pokrovsky passed away.

ADEL FEDOROVNA HAMMERMANN (1888-1978)

Thanks to Nina Vladimirovna Bespalova for the active support of the present essay. She cherishes the memory of her grandmother Adele Fedorovna Hammermann all her life, a scientist who opened the way for women to the scientific community of Russian pharmacists. A.F. Hammermann became one of the leading specialists in pharmacognosy, the founder of the school for the study of Tibetan traditional medicine in Russia.
 For almost half a century, Adel Fedorovna's life was inextricably linked with the present Saint Petersburg State Chemical and Pharmaceutical University. Here she first studied, and then taught and headed the Department of Pharmacognosy.
 A.F. Hammermann has become one of those dedicated scientists that the Russian pharmaceutical school is proud of, and generations of university students have learned from her unique scientific heritage.
 In the essay, based on materials from the home archive and the memoirs of teachers who at different times worked at the Department of Pharmacognosy of the University, we managed to describe the main milestones in the life path and scientific achievements of Adele Fedorovna Hammermann.
 In the future, the authors of the essay hope to collect additional materials about this amazing woman and publish them in a separate edition.

Thoughts of N.I. Pirogov «About desirable transformations of the Medico-Surgical Academy»

The great doctor, anatomist, surgeon, teacher, professor Nikolai Ivanovich Pirogov (1810-1881) glorified not only Russian medicine, but also Russia as a whole. The vast majority of scientific results were achieved by him during his work at the Imperial Medical and Surgical Academy from December 1840 to July 1856. His discoveries and achievements relate primarily to anatomy and its topographic direction, surgery and its military field, the military medical «administration» - the organization of medical support for the army. Contemporaries N.I. Pirogov was noted for his high pedagogical abilities. 21 years after the death of N.I. Pirogov, his wife transferred part of the archive to Novorossiysk (now Odessa) University. Among the works was an article written in pencil, «On the desirable transformations of the Medical and Surgical Academy». Professor of Anatomy of the University N.A. Batuev published an article in the Russky Doktor newspaper in 1902, in which the idea that military doctors are educated in universities in European countries on the basis of medical faculties, which should be administratively independent of university leadership, was a common thread. Nikolai Ivanovich proposed at the initial stage of training to guide students through the general faculty of natural sciences. Further, his proposal was that the medical faculty should be divided into two departments: the first - for the training of civilian doctors, and the second - for those wishing to enlist in the military. Commonwealth with the University of N.I. Pirogov was seen as an opportunity to deepen and expand the knowledge acquired by students, especially natural sciences, in the initial period of study.

The science of eye diseases in Saint Petersburg in the XVIII century

A brief overview of the state of Russian medicine of the XVII century is presented firstly. The main attention is paid to the treatment of eye diseases during the XVIII century and the influence of famous foreign doctors and scientists on the origin and formation of Russian ophthalmology and its scientific basis. Special attention is paid to the role of the outstanding Dutch doctor and world-famous scientist G. Burhaave, who was called the teacher of the whole Europe, in the development of medicine and identification of ophthalmology as an independent section of medicine and as a special discipline. This contributed to the further development of ophthalmology not only in Europe but also in Russia. The important role of the Vienna ophthalmology school and its representatives, including G.Y. Beer, Y. Bart, J.Ya. Morenheim and others, is stated in relation to the formation of the Russian scientific school of ophthalmology, which was the successor of Vienna best traditions. Great attention is paid to scientific papers and textbooks on ophthalmology published in the XVIII century in Russian. We also studied the student book by G. Burhaave Public lectures on eye diseases that was the main textbook of the XVIII century for medical students throughout Europe and was published in Russia in 1798. We also analyzed the little-known in Russia handwritten document from the funds of the Russian State Historical Archive an essay by the Austrian doctor of medicine and surgery Professor J. Ya. Plenka Doctrina de morbisoculorum (Doctrine of Eye Diseases) translated into Russian by the doctor of medicine A. Maslovsky (1798). A. Maslovsky dedicated the translation of this recognized in Europe scientific work to the Chief Director of the Medical College Baron A. I. Vasiliev. On September 23, 1818, according to the Highest Order of Emperor Alexander the I the first department of optics in Russia was established at the Saint Petersburg branch of the Medical and Surgical Academy with the approval of doctor of medicine and surgery I. E. Grubi in the position of full professor.