[The use of sodium hyaluronate to treat upper limb disease: A review].

The most common diseases of the upper limb are osteoarthritis (OA) of the joints of the hands, lateral epiconlitis, tendinitis of the shoulder muscles, adhesive capsulitis. OA of the shoulder and acromioclavicular joints is less common. The development of acute and subacute pain in the elbow and shoulder joints in the vast majority of cases is determined by the pathology of soft tissues: muscles, ligamentous apparatus and related synovial bags, making it difficult to diagnose. A clinical and radiological heterogeneity of OA of the joints of the hands is a very complex pathology for the study, and also to create a unified algorithms for therapy. Therapy nonsteroidal anti-inflammatory drugs are effective in the short term, but it has several side effects. Despite a variety of attempts at therapy with successful and unsuccessful outcome, the attention of researchers for several decades converted to the injection therapy with hyaluronic acid. The article presents the data of studies demonstrating the anti-inflammatory effect of hyaluronic acid in the treatment of OA, as well as the results of clinical trials and data system of meta-analysis demonstrating the effectiveness of intra-articular and extra-articular therapy tendinopathy of the upper limb. Most of the cited studies demonstrated the efficacy and good tolerance of 1% sodium hyaluronate. In the domestic market it is presented in the drug Flexotron Forte. The authors provide the results of the study results, demonstrating the efficacy and safety of using Flexotron Forte to clinical practice.

[The state and actual vectors of development of cardiologic care in conditions of region with low density of population].

The study was carried out to assess the state of cardiologic care and to determine current vectors of its development in the region with low population density. The health care system of the Kostroma Oblast was determined as research base. The information and methodological foundation of the study was compiled according results of special studies of patients aged from 8 to 80 years (n=1,400). The combination of research methods was implemented. The main vectors of the modern development of the cardiology service are identified: regional automated monitoring of quality of cardiologic care with operational analysis of its potential by 25 conjugated factors; implementation of continuous quality management technology according proposed algorithm; implementation of the decision-making scheme with allocation of 10 alternatives of achieving effectiveness of medical care according 4 criteria (standard performance, clinical result achievement, patient satisfaction, resources saving);, implementation of personalized approach to patient management.

[Pharmacoeconomic and pharmacogenetic aspects of the implementation of a personalized approach in the treatment of cardiac patients].

PURPOSE: To investigate the possibilities of pharmacoeconomic and pharmacogenetic factors monitoring to assess the effectiveness of treatment of a cardiological profile patients as a part of the implementation of a personalized approach. MATERIAL AND METHODS: 200 patients with arterial hypertension and CHD were examined. Pharmacotherapy was analyzed. ABC/VEN and DDD analysis, pharmacoeconomic analysis were applied. Genetic analysis of the polymorphism of the genes CYP2D6*4 and CYP2D6*10 encoding the subfamily of the cytochrome isoenzyme Р-450 was carried out. An original monitoring method was used to assess the effect of pharmacoeconomic and pharmacogenetic factors on the performance of cardiac care. RESULTS: When conducting a pharmacoeconomic analysis of cases of cardiac care, it was found that the costs of drug therapy are significant and take over 10% of the total costs. However, its effectiveness is insufficient in 58% of cases in inpatient and 37% in outpatient care. The analysis showed that there is an inverse mean correlation between gene polymorphism and clinical performance of cardiac care (r = -0.62) and a direct strong correlation between polypharmacy in pharmacotherapy, not accounting for interdrug interaction and clinical performance (r = 0.89).

[Empagliflozin and heart failure: position paper of the experts on the results of the online meeting and discussion of the EMPEROR-Preserved Trial].

At an international online expert meeting held on September 16, 2021, the results of the empagliflozin research program EMPA-REG Outcome, EMPEROR-Reduced and EMPEROR-Preserved were reviewed. We analyzed cardiovascular and renal outcomes during the treatment with empagliflozin in patients with chronic heart failure, regardless of the presence of type 2 diabetes mellitus. The positive results of the EMPEROR-Preserved study are updated and their significance for clinical practice is discussed. Several proposals have been adopted that will accelerate the introduction of empagliflozin therapy into practice in patients with heart failure and overcome clinical inertia.

Additivity of retention of diastereoisomeric and enantiomeric arylphthalides, aryl(arylene)phthalides and aryldiphthalides of dyadic and triadic composition.

For the first time, four series of new phthalide-containing heteroaromatic compounds were separated by reverse phase HPLC: OYO, OYS, SYS; OYOYO, OYOYS, SYOYS; SYSYS, SYSYO, OYSYO; OYYO, OYYS, SYYS, (where O - diphenyloxide, S - diphenylsulfide, Y - phthalide group). A fundamental difference was established in the chromatographic behavior of diaryl(arylene)diphthalides, built on the principle of "head-to-tail", and diaryldiphthalides with a structure of "head-to-head". The meso and chiral diastereoisomers of the former were eluted by one peak, while the latter existed in solution in the forms of stable cis (racemic form) and trans (meso form) rotamers with different retention times. It was shown that to calculate the retention times of related diarylphthalides, diaryl(arylene)phthalides, diastereoisomeric and enantiomeric diaryldiphthalides of an asymmetric structure, the half-sum rule can be applied according to which: tR(A-X-B)≈[(tR(A-X-A)+tR(B-X-B)]/2. For diaryl(arylene)diphthalides of a triadic structure, a modified additive scheme for calculating retention times is proposed, including multiplication and division operations: tR(A-A-A) = tR(A-A-B) × tR(A-B-B)/tR(B-B-B).

Elucidation of retention mechanisms on hypercrosslinked polystyrene used as column packing material for high-performance liquid chromatography.

Establishing of basic retention mechanisms was considered the key target during the development of new column packing materials. To extract, from an appropriate retention data matrix on hypercrosslinked polystyrene Chromalite 5HGN, certain factors that can be brought in an obvious correspondence with known retention mechanisms, the principal component analysis (PCA) was applied. The approach was used to elucidate the adsorption properties of the above novel HPLC packing. Besides HPLC, knowledge of retention mechanisms helps to reveal perspective application area for the hypercrosslinked polystyrene-type materials in solid-phase extraction (SPE) and low-pressure preparative LC.

Hypercrosslinked polystyrene as a novel type of high-performance liquid chromatography column packing material. Mechanisms of retention.

An experimental material, Chromalite 5HGN (Purolite, UK), that represents hypercrosslinked polystyrene as a new type of neutral stationary phase for HPLC was examined. The material contains no functional groups, but is compatible with any kind of nonpolar and highly polar mobile phase, and even with water. It is chemically resistant and thermally stable. When using aqueous organic mobile phases, Chromalite 5HGN works similar to standard C18 reversed-phase packings, but is characterized by much greater hydrophobicity and, sometimes, unusual selectivity. When using nonpolar mobile phases, i.e. under "quasi normal-phase" conditions, the retention is mostly governed by the interactions between pi-electronic systems of the adsorbent and adsorbate. Adding highly polar, even hydrophilic solvents into the mobile phase, leads to a shift of retention times toward the "reversed-phase" kind of chromatography, which gives an additional possibility in fine tuning the column selectivity.

Hypercross-linked polystyrene and its potentials for liquid chromatography: a mini-review.

Hypercross-linked polymeric adsorbing materials are obtained under conditions that (i) their polymeric network is formed in the presence of large amounts of a thermodynamically good solvent (porogen) and (ii) the network is rigid. Hypercross-linked polystyrene is a transparent microporous low-density material with an apparent inner surface area of over 1,000 m2/g and an unprecedented adsorption capacity. To enhance the mass transfer, the adsorbent beads may be provided with large transport pores, in addition to the inherent micropores; these beads are opaque. Hypercross-linked polystyrene sorbents are widely used for large scale adsorption of organic compounds from aqueous and gaseous media and for solid-phase extraction of trace components. Novel perspective application areas of the materials are high-performance liquid chromatography column packings and blood purification. Present mini-review summarises basic principles of obtaining hypercross-linked materials, their structural peculiarities and distinguishing properties, as well as major application areas. Important new unpublished data are also included.

Mass-spectrometric analysis of N-acetylchitooligosaccharides prepared through enzymatic hydrolysis of chitosan.

A semipreparative scale chromatography of N-acetylchitooligosaccharides (GlcNac)2-7 on a reversed-phase C-16 HPLC column is reported. The initial material was obtained by enzymatic hydrolysis of chitosan with a complex of chitinases from Streptomyces kurssanovii, followed by a complete acetylation of amino groups. Isolated N-acetylchitooligosaccharides were characterized by the mass-spectrometric method. On interacting with the sample, the fragments of 252Cf caused desorption of quasi-molecular ions of the substance. All mass spectra of chitin oligomers contained intense quasi-molecular ions [M + Na]+ and a less intense [M + K]+ ion. Fragment ions, compared to the quasi-molecular ion [M + K]+, had a lower intensity and confirmed the structure of samples under study. Due to this phenomenon, an accurate analysis of both individual compounds and mixtures of N-acetylchitooligosaccharides (n = 2-7) may be performed.