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Given the high value of the biochemical composition of soybean seeds and the versatility of using this crop, the need for it will continue to grow, which makes it necessary to improve existing and develop new technologies for its cultivation, considering local agroclimatic resources. Therefore, this study, aiming to investigate the agroecological foundations of the use of chemical and biological techniques in modern technologies for growing soybeans, is relevant. The purpose of the study was to identify the features of the formation of symbiotic productivity of soybeans under the influence of bacterial and mineral fertiliser in the conditions of the Right-Bank Forest-Steppe of Ukraine. A field method was laid down according to the developed scheme to achieve this goal. The positive effect of mineral fertiliser and inoculation on the formation of the symbiotic apparatus of soy and its productivity was established. The smallest increase in the number of root nodules was noted for the introduction of N45P60K60 – 24.7-27.3%, depending on the variety. Small initial doses of nitrogen were more effective – within the limits of N15–30 – they provided an increase in the number of active bulbs by 51.2-106.9%. Bacterisation of seeds with the complex bacterial preparation Phosphonitragine increased the number of active nodules on soybean roots by 106.8-138.6%, depending on the variety. The interaction of technological methods of mineral fertilisation and inoculation contributed to an increase in both the number of nodules with leghemoglobin – by 128.5-198.6%, and their mass – by 111.1-147.6%. The soy symbiotic apparatus was maximally developed by interacting seed inoculation factors with a bacterial preparation containing Br. japonicum and B. Mucilaginosus strains and applying N30P60K60 +N15 in the budding phase. This technological model of crop cultivation provided the highest productivity of legume-rhizobial symbiosis of soybean plants in terms of the volume of accumulation of symbiotically fixed nitrogen – in the early-ripening soybean variety Vilshanka – 124.2 kg/ha, in the medium-ripening variety Suziriia – 130.3 kg/ha. The practical importance of the obtained results is in the improvement of varietal technologies for growing soybeans based on the complex application of seed inoculation with a bacterial preparation and the introduction of nitrogen fertilisers in retail against the background of phosphorus-potassium fertiliser

Стаття 64 Конституції України визначає перелік прав і свобод людини, які можуть бути обмежені в умовах воєнного стану задля захисту національної безпеки та територіальної цілісності України, до переліку яких відноситься і право на доступ до інформації. Це положення кореспондується з частиною 3 статті 34 Конституції України, частиною 1 статті 8 Закону України «Про правовий режим воєнного стану». Через військову агресію російської федерації проти України поширення інформації щодо діяльності органів державної влади, їхніх працівників, в тому числі щодо судів та органів системи правосуддя, може становити загрозу їх життю та здоров'ю, спричиняти скоєння злочини та бути загрозою національній безпеці, а тому може підлягати обмеженню в силу закону. В статті досліджуються підстави, умови обмеження права на доступ до публічної інформації в умовах воєнного стану, особлива увага приділена питанню обмеження доступу до публічної інформації, що знаходиться в розпорядженні судів, Державної судової адміністрації України. Авторами проаналізовані статистичні дані щодо кількості поданих запитів на отримання публічної інформації, випадки подання скарг на неправомірні дії розпорядників публічної інформації при розгляді запитів з моменту запровадження на території України воєнного стану. В статті доводиться, що оскільки Законом України «Про правовий режим воєнного стану» не передбачено прямої можливості встановлювати будь-які заборони чи обмеження щодо виконання обов’язків розпорядників з розгляду запитів чи оприлюднення публічної інформації, при вирішенні питання щодо обмеження чи надання доступу до тієї чи іншої інформації в умовах воєнного стану зберігається необхідність дотримання відповідного балансу між захищеним інтересом конкретної особи та суспільними інтересами, застосування так званого «трискладового тесту». В статті досліджується також можливість обмеження в період воєнного стану поширення інформації з обмеженим доступом, яка є суспільно необхідною, коли право громадськості знати цю інформацію переважає потенційну шкоду від її поширення.

73Ge(n,γ) cross sections were measured at the neutron time-of-flight facility n_TOF at CERN up to neutron energies of 300 keV, providing for the first time experimental data above 8 keV. Results indicate that the stellar cross section at kT=30 keV is 1.5 to 1.7 times higher than most theoretical predictions. The new cross sections result in a substantial decrease of 73Ge produced in stars, which would explain the low isotopic abundance of 73Ge in the solar system. Keywords: Nucleosynthesis, Neutron capture, s process, Germanium, n_TOF

The neutron capture cross section of 154Gd was measured from 1 eV to 300 keV in the experimental area located 185 m from the CERN n_TOF neutron spallation source, using a metallic sample of gadolinium, enriched to 67% in 154Gd. The capture measurement, performed with four C6D6 scintillation detectors, has been complemented by a transmission measurement performed at the GELINA time-of-flight facility (JRC-Geel), thus minimising the uncertainty related to sample composition. An accurate Maxwellian averaged capture cross section (MACS) was deduced over the temperature range of interest for s process nucleosynthesis modelling. We report a value of 880(50) mb for the MACS at kT=30 keV, significantly lower compared to values available in literature. The new adopted 154Gd(n,γ) cross section reduces the discrepancy between observed and calculated solar s-only isotopic abundances predicted by s-process nucleosynthesis models. Keywords: s process, 154Gd, Neutron time of flight, n_TOF

The article contains theoretical provisions for understanding of the phenomenon of emotional intelligence as metacompetence of personality. It is examined the content of the concept of “emotional intelligence” and its structure. The article scientifically confirms the need to develop emotional intelligence as the basis for a successful personality self-identity. Analysis of the current research shows that great attention to the problem of emotional intelligence emerged in the last decade. The driving force is the employers, large companies that require versatile professionals and investe in the development of empathy in the staff that focus on intellectual capital personality. Emotional intelligence is the main component in achieving maximum successful fulfillment. It is an essential factor motivating mental activity as recognition of the feelings and manage them in a constructive way to increase the intellectual power of personality. To raise the level of emotional intelligence is completely possible due to the training, personal motivation, a desire to change himself, to get out of the comfort zone of personality — it is an important step to increase the level of emotional intelligence which leads to self-improvement.

Aim. To evaluate the real practice of thrombolytic therapy of patients with ST-elevation myocardial infarction (STEMI) at cardiological departments of Saratov and Saratov region hospitals.Material and methods. Retrospective pharmacoepidemiologic study was carried out. Case histories of STEMI patients discharged from cardiologic departments of several central district hospitals (CDH) of Saratov region, cardiologic department of one of Saratov general municipal hospitals (MH) and urgent cardiology department of Saratov clinical hospital (CH) in 2006 were analyzed.Results. In CH all patients received thrombolytic therapy given they did not have contraindications and were admitted to the hospital timely. Few patients received thrombolytic therapy in MH and CDH in 2006.Conclusion. Correlation between hospital type and quality of STEMI management has been revealed.

Aim. To estimate the prevalence of atherothrombotic complications depending on platelet sensitivity to acetylsalicylic acids (ASA) in patients with stable angina.Material and methods. 96 patients with stable angina of II-III functional classes received basic therapy included ASA (125 mg daily) to prevent atherothrombotic complications. Platelet ability to aggregation was assessed with laser aggregometer. Resistance to ASA was determined, if cumulative index of platelet aggregation (after stimulation with ADF, 5 µmol\l) remain on the level of 50-70% in spite of ASA. Atherothrombotic complications (cardiovascular death, myocardial infarction, unstable angina, cerebral stroke) were registered during 24-36 months.Results. Resistance to ASA was detected in 24% of patients. Atherothrombotic complications were registered in 66% of patients with ASA resistance (myocardial infarction or unstable angina were observed in 14 patients of 21 ones) and in 27% of patients with sensitivity to ASA (myocardial infarction or unstable angina were observed in 19 of 70 ones). Besides, resistance to ASA was associated with high rate of thrombosis of installed stents or coronary artery bypasses.Conclusion. In patients with unstable angina insufficient inhibition of platelet aggregation with ASA is associated with 2, 45 times increase in risk of atherothrombotic complications and higher rate of thrombosis of installed stents or coronary artery bypasses.

Aim. To compare direct medical costs of dabigatran and warfarin therapy in patients with non-valvular atrial fibrillation (NVAF) during preparation for elective cardioversion. Material and methods. An open non-randomized study was conducted to evaluate direct medical costs (cost of drug, cost of the international normalized ratio (INR) adjust- ment in outpatient clinic, cost of visits to cardiologist). Patients (n=62) with persistent NVAF (AF paroxysm duration > 48 hours) were enrolled. All of them requested medical as- sistance and were decided to perform an elective cardioversion. The patients received warfarin (n=32) or dabigatran (n=30). The patients of the both groups were similar in the main clinical characteristics and thromboembolic risk levels according to CHA2DS2-VASc scale.Results. Treatment duration before elective cardioversion was 21±2 and 30.5±4.5 days for dabigatran and warfarin groups, respectively (p

Interval QT prolongation is a predictor of the life-threatening cardiac arrhythmias — polymorphic ventricular tachycardia (torsade de pointes). Long QT syndrome may be congenital or acquired. It is known that a wide range of both antiarrhythmic and non-cardiac medications might lead to QT interval prolongation. List of drugs that cause QT prolongation is constantly growing and being updated. The review contains current data on the clinical significance of the control of QT interval duration within drug therapy. Clinical conditions associated with an increased risk of QT interval prolongation are described. Drugs that can induce QT prolongation are also discussed.

Comparative experimental studies of fuel sprays evolution dynamics in a constant volume chamber were carried out with a view to reduce the uneven distribution of diesel fuel in the combustion chamber when the Common Rail injector is inclined. The fuel sprays was captured by a high-speed camera with simultaneous recording of control pulses of camera and injector on an oscilloscope. Two eight-hole diesel injectors were investigated: One injector with identical orifice diameter (nozzle 1) and another injector with four orifices of the same diameter as orifices of nozzle 1 and four orifices of enlarged diameters (nozzle 2). Both injectors were tested at rail pressure from 100 to 165 MPa and injector control pulse width of 1.5 ms. The dynamics of changes in the spray penetration length and spray cone angle were determined. It was found that sprays develop differently in nozzle 1 fuel. The difference in the length of fuel sprays is 10−15 mm. As for nozzle 2, the fuel sprays develop more evenly: The difference in length is no more than 3−5 mm. The difference of the measured fuel spray cone angles for nozzle 1 is 0.5°−1.5°, and for nozzle 2 is 3.0°−4.0°. It is concluded that the differential increase in the diameters of nozzle orifices, the axes of which are maximally deviated from the injector axis, makes it possible to reduce the uneven distribution of fuel in the combustion chamber and improve the combustion process and the diesel performance as a whole.

Aim. To illustrate feasibility of successful correction of chronic long-standing right-side inferioatrial tachycardia (RIT). Material and methods. A case report of examination and effective treatment of long-standing RIT. The diagnosis was made after ECG, Holter ECG monitoring, Doppler echocardiography, endocardial electrophysiological examination, analysis of the disease history. Results. Conservative treatment proved low effective. Imaging diagnostic methods and x-ray surgery (radiofrequency ablation of the ectopic activity zone) were leading techniques. Conclusion. If a patient is operated (radiofrequency ablation) early, he will not have to take long-term treatment with antiarrhythmic drugs and will be able to live without limitations deteriorating his quality of life.

Meat cattle breeding should develop in Ukraine as a priority and independent industry to meet beef needs. The meat industry has enormous potential and, as the most promising and attractive, will take a dominant place in the structure of the domestic food industry in the coming years. Beef is one of the most essential elements of the human diet. It contains complete proteins and animal fats, biologically active substances, mineral elements, and vitamins. The most important feature of food products is their quality and safety indicators, that is, the absence of substances harmful to the consumer's health and pathogens of infectious and invasive diseases. In this regard, veterinary and sanitary expertise and product safety control are of particular importance, as they are necessary to ensure the health of the population of Ukraine. Improving the quality of meat and meat products is a primary task in modern conditions. The implementation of this task depends not only on agricultural but also on processing enterprises. The article presents materials on the study of critical indicators of the safety and quality of beef. The study was carried out as part of the research work of the Department of Normal and Pathological Morphology, hygiene, and Expertise: “Monitoring the content of toxic substances in drinking water, feed and their impact on the body of cattle and the quality and safety of products”, state registration number – 0120U101318. The material for the research was the slaughter products of domestic animals, such as cattle, which were supplied to enterprises in the city of Zhytomyr. Pre-slaughter inspection and veterinary-sanitary examination of carcasses and their slaughter products of cattle was carried out following the “Rules of pre-slaughter veterinary examination of animals and veterinary-sanitary examination of meat and meat products”. The study aims to determine the safety and quality indicators of beef obtained in the conditions of meat processing enterprises of the Zhytomyr region. To achieve this goal, a comprehensive survey of beef safety and quality indicators was conducted. As a result of the tests, it was established that the pH level of the meat was 5.7–6.1. Carrying out the reaction with a 5 % solution of CuSO4 in the broth showed that the broth was transparent. A positive response to peroxidase was also detected. The safety parameters corresponded to regulatory documents. Careful control of the safety and quality of beef at every stage of production, starting from the rearing of animals and up to the sale of the product, guarantees a high degree of consumer protection.

New carriers for protein immobilization are objects of interest in various fields of biomedicine. Immobilization is a technique used to stabilize and provide physical support for biological micro- and macromolecules and whole cells. Special efforts have been made to develop new materials for protein immobilization that are non-toxic to both the body and the environment, inexpensive, readily available, and easy to modify. Currently, biodegradable and non-toxic polymers, including cellulose, are widely used for protein immobilization. Bacterial cellulose (BC) is a natural polymer with excellent biocompatibility, purity, high porosity, high water uptake capacity, non-immunogenicity, and ease of production and modification. BC is composed of glucose units and does not contain lignin or hemicellulose, which is an advantage allowing the avoidance of the chemical purification step before use. Recently, BC–protein composites have been developed as wound dressings, tissue engineering scaffolds, three-dimensional (3D) cell culture systems, drug delivery systems, and enzyme immobilization matrices. Proteins or peptides are often added to polymeric scaffolds to improve their biocompatibility and biological, physical–chemical, and mechanical properties. To broaden BC applications, various ex situ and in situ modifications of native BC are used to improve its properties for a specific application. In vivo studies showed that several BC–protein composites exhibited excellent biocompatibility, demonstrated prolonged treatment time, and increased the survival of animals. Today, there are several patents and commercial BC-based composites for wounds and vascular grafts. Therefore, further research on BC–protein composites has great prospects. This review focuses on the major advances in protein immobilization on BC for biomedical applications.

The important role of honey bees has been known for a long time, as the successful work of Apis mellifera helps to maintain natural biogeocenoses and provides humanity with food and medicinal production. The massive loss of honeybee colonies in the southern and eastern border regions of Ukraine is putting a strain on beekeeping production in the north-western regions of Ukraine. To intensify apiaries, there is a need for systematic and regular monitoring research. Epizootic monitoring provides data on the health of honey bees in a specific geographical region that can be scientifically substantiated. To analyse the epizootic situation with contagious bee diseases in the Rivne region in 2017–2022, we used official data from the State Service of Ukraine on Food Safety and Consumer Protection in the Rivne region. In addition to epizootic monitoring, the aim of our study was to identify the most common bee diseases in this region. The analysis of the results shows that diagnostic tests for varroosis and nosema, acarapidosis, American and European foulbroods, and amoebiasis are planned and carried out systematically. From 2017 to 2021, the number of diagnostic tests for bacterial diseases of bees was increased. At the same time, in 2022, the activity of such research decreased by 6.4% in comparison to 2021. A different pattern was registered for parasitic diseases of bees. For example, there was an increase in the number of such studies from 2019 (1678 studies) to 2022 (3184 studies). It was found that the Rivne region has been safe from American and European foulbroods, acarapidosis, braulosis and amoebiasis for the last 6 years. Varoosis and nosema are registered annually in 2017–2022, with the infection rate for these diseases set at 11.06 % (2020) – 14.82 % (2022), respectively. This data is likely to indicate a change in the economic situation of beekeepers, which makes it impossible to prevent hives from being treated for certain diseases in a timely manner. Thus, the analysis of laboratory tests for contagious diseases of bees helps to detail the epizootic state of a particular region, which allows to determine the direction for veterinary and sanitary measures for a specific apiary.

Beekeeping is one of the essential branches of agriculture in Ukraine, the main activity of which is aimed at breeding bees and obtaining honey and other products beneficial for human health. Maintaining the physiological state of bee colonies at the proper level is one of the essential tasks of veterinary medicine doctors and beekeepers. Compliance with veterinary and sanitary requirements at bee farms is the basis of preventing infectious pathologies in bee colonies. Since the body of insects has a fast metabolism, any infectious pathology quickly acquires a massive manifestation. One indicative symptom of infectious damage to the “gut” of bees is dyspepsia. Diarrhea, anorexia, and loss of productivity are observed in bees in this condition. The market of means to prevent such pathological manifestations in beekeeping is relatively narrow. The healing and favorable properties of honey, manifested in pain-relieving, antimicrobial and anti-inflammatory effects, have been known since ancient times. Sunflower honey differs from other types in a wide range of components, particularly phytoncides, which inhibit the growth of pathogenic microorganisms. Therefore, the main goal of the experiment was a laboratory study of the effect of different concentrations of sunflower honey sieve on the mixed microbial association isolated from bees with signs of dyspepsia. The activity of sunflower honey in laboratory conditions was studied by the disco-diffusion method in Petri dishes on MPA medium (meat-peptone agar). To obtain syrup from sunflower honey, sunflower honey was diluted with distilled water in a ratio of 1:1, working solutions were prepared from sunflower honey syrup in dilutions of 1:2, 1:4, 1:10, 1:100. The data analysis indicates the bacteriostatic activity of the syrup from sunflower honey in all studied concentrations concerning the mixed microbial association. Moreover, the largest diameter of the growth inhibition zone of the studied microorganisms was noted when the syrup from sunflower honey was diluted in a ratio of 1:10 (19.2 ± 0.42 mm). In turn, the antagonistic effect of the syrup from sunflower honey was observed in all dilutions concerning the mixed microbial association, where the largest diameter of the antagonism was 19.6 ± 0.27 mm when the disc was impregnated with the native working solution. Thus, it is promising to accumulate and identify a pure culture antagonist concerning a mixed culture of bacteria isolated during bee diarrhea to further create a pharmacological agent for preventing infectious pathologies of bees in unhealthy apiaries.

First experimental modeling of decarbonation reactions resulting in the formation of CO2-fluid and Mg, Fe, Ca, and Mn garnets, with composition corresponding to the garnets of carbonated eclogites of types I and II (ECI and ECII), was carried out at a wide range of lithospheric mantle pressures and temperatures. Experimental studies were performed on a multi-anvil high-pressure apparatus of a “split sphere” type (BARS), in (Mg, Fe, Ca, Mn)CO3-Al2O3-SiO2 systems (with compositional variations according to those in ECI and ECII), in the pressure interval of 3.0–7.5 GPa and temperatures of 1050–1450 °C (t = 10–60 h). A specially designed high-pressure cell with a hematite buffering container—preventing the diffusion of hydrogen into the platinum capsule—was used, in order to control the fluid composition. Using the mass spectrometry method, it was proven that in all experiments, the fluid composition was pure CO2. The resulting ECI garnet compositions were Prp48Alm35Grs15Sps02–Prp44Alm40Grs14Sps02, and compositions of the ECII garnet were Prp57Alm34Grs08Sps01–Prp68Alm23Grs08Sps01. We established that the composition of the synthesized garnets corresponds strongly to natural garnets of carbonated eclogites of types I and II, as well as to garnets from xenoliths of diamondiferous eclogites from the Robert Victor kimberlite pipe; according to the Raman characteristics, the best match was found with garnets from inclusions in diamonds of eclogitic paragenesis. In this study, we demonstrated that the lower temperature boundary of the stability of natural garnets from carbonated eclogites in the presence of a CO2 fluid is 1000 (±20) °C at depths of ~90 km, 1150–1250 (±20) °C at 190 km, and 1400 (±20) °C at depths of about 225 km. The results make a significant contribution to the reconstruction of the fluid regime and processes of CO2/carbonate-related mantle metasomatism in the lithospheric mantle.

The seasonal blood pressure variability (BPV) is known to demonstrate a typical winter peak. Recently, more attention is paid to the opposite situation: the summer BP levels being higher than those in winter. This phenomenon is called inverse BPV. The present article summarizes recent data on this topic. The data of the HOMED-BP project, as well as the results of the original prospective study in 770 hypertensive patients from two Russian Federation regions (mean follow-up duration 6.4 years), were used. According to the preliminary knowledge, the prevalence of inverse BPV in hypertensive patients is relatively high (15-25%). This phenomenon is more typical for treated patients, particularly for those on combination therapy, and is associated with beta-blocker intake. Higher duration of hypertension and higher levels of some risk factors (smoking) characterize the patients with inverse BPV. According to the HOMED-BP data, patients with inverse BPV had the highest overall cardiovascular risk (hazard ratio in comparison with the reference group of “minimal” “normal” BPV was 3.07; p=0.004). In summary, inverse BPV is a potentially unfavorable BP phenotype. However, its reproducibility and prospective value deserve further investigation. The absolute magnitude of seasonal BPV in these patients, calculated using different BP measurement methods, warrants special attention.

There are still many complex issues in the management of autoimmune pathologies in gynecology and reproductology, endometriosis in particular. Naltrexone, a competitive antagonist of opiate receptors in the central and peripheral nervous systems, reveals new qualities such as effects on autoimmune processes. Naltrexone in low doses of 1.7–5 mg (Low Dose Naltrexone, LDN) revealed the opposite effect on opiate receptors in the form of a rebound effect and, as a consequence, a strong increase in endogenous endorphins and enkephalins. Studies of elevated levels of these neurotransmitters have provided evidence of a multidisciplinary beneficial effect on the immune system of people with endorphin and enkephalin deficiency, an association between the endogenous opiate system and cells and tissue growth in general and healthy immune function was confirmed. The most explored effects of them are such as blocking the synthesis of pro inflammatory cytokines IL-6, IL-12, tumor necrosis factor, the effect on neuroglia through toll-like receptors, the effect on the cycle cells growth, especially malignant tumor cells, through interaction with opiate growth factor, modulation synthesis of T- and B-lymphocytes. Growing evidence of LDN efficacy is becoming a potentially effective clinical practice in autoimmune pathologies, but still off-label used. Some data of clinical trials is presented. Four studies with Crohn's disease with results of relief of symptoms and remission, including experience in pediatrics. Three clinical trials with LDN results in multiple sclerosis with improved quality of life and improved symptoms. The scientific hypothesis suggests the success of LDN due to the reduction of induced nitric oxide synthase activity. The success of management of patients with malignant tumors is also presented. The article contains the latest data from clinical trials on reported serious and non-serious side effects of naltrexone at various doses, including data confirming the safety of taking mid-therapeutic naltrexone doses throughout pregnancy. These effects of LDN may prove to be effective in management patients with endometriosis.

Aim. To study the changes that have occurred in the pharmacotherapy of atrial fibrillation (AF) in the Saratov Region for 5 years by analyzing the antithrombotic therapy of patients who were admitted in a specialized department of the multidisciplinary hospital in Saratov in 2011-2012 and in 2016-2017.Material and methods. A pharmacoepidemiological retrospective study was conducted. The object of the study was the medical records of inpatients (Form 003/y) with the diagnosis “Atrial fibrillation” (ICD-X code I48), that consecutively admitted to the cardiology department of the multidisciplinary hospital in Saratov from January 1, 2011 to December, 31, 2012 (n=211) and from January 1, 2016 to December, 31, 2017 (n=227). Criteria for inclusion in the study: patients over 18 years of age, established diagnosis of non-valvular AF of ischemic genesis. Exclusion criteria from the study: non-ischemic cardiomyopathy, thyrotoxicosis, congenital heart defects, rheumatic heart damage, acute coronary syndrome, endocarditis, myocarditis, pericarditis, pulmonary thromboembolism, the presence of prosthetic heart valve. Pharmacoepidemiological analysis was carried out for the drugs prescribed during hospitalization and given by doctors at discharge of patients from the hospital. The risk of ischemic stroke was assessed using the CHA2DS2-VASc score, and the risk of bleeding – according to the HAS-BLED score.Results. When analyzing the risk of ischemic stroke, it was found that 100% of patients in 2011-2012 years and 98.2% in 2016-2017 years had indications for the prescription of oral anticoagulants (OAСs). In 2011-2012 there were no patients with a low risk of stroke (CHA2DS2-VASc=0). High risk of bleeding (HAS-BLED≥3) occurred in 4.7% of patients in 2011-2012 and in 10.6% in 2016-2017, however, due to the high risk of stroke, the refusal to prescribe OAC in these patients was inappropriate in accordance with the recommendations for the treatment of AF. In the group of patients with CHA2DS2-VASc=0 in 2016-2017 antiplatelet therapy was prescribed in 100% at the hospital stage and at discharge, which contradicts the guidelines, according to which antithrombotic therapy is not recommended to patients with CHA2DS2-VASc=0. In patients with CHA2DS2-VASc=1, a low percentage of anticoagulants prescription was noted. In 2016-2017 OACs were prescribed only in 12.5% of patients at all stages of observation. In 2011-2012 OAC alone was prescribed only to 1 person (20%) at the hospital stage, which does not comply with modern guidelines for the treatment of patients with AF, according to which patients with a risk score CHA2DS2-VASc=1 are recommended to receive OACs in the absence of contraindications. OACs prescription in group CHA2DS2-VASc≥2 occurred only in 15% of patients in 2011-2012 and in a third of patients in 2016-2017 (p

Background. Early diagnostics of masked hypertension (MH) is one of the key problems in modern cardiology due to the association of this blood pressure (BP) phenotype with doubled cardiovascular risk in comparison with normotension (NT). The current hypertension guidelines list numerous conditions, when the ambulatory BP monitoring (ABPM) is desirable in patients with normal office BP. However this list does not represent clearly defined, agreed and approved indications for ABPM as a diagnostic tool for MH.Aim. To develop a method of MH diagnostics for the use in routine clinical practice based on the comparing characteristics of patients with reproducible MH vs NT.Material and methods. The patients were selected from two trials that used ABPM (n=1778). The selection criteria included age 40-79 years, office BP

The purpose of this research work was the creation of a safe and effective wound healing drug, in the multicomponent polysaccharide base of which the fibroblast growth factor is integrated in the optimal concentration. Materials and Methods: The present work was carried out in three stages. In Stage 1, the essential formula of a wound healing drug was created. In order to optimize the composition of the base formula, studies were conducted with various concentrations of structure-forming polysaccharides. In Stage 2, we performed technical tests of the gel composition of the medical product on hMSCs culture, and determined the optimal concentration of the growth factor, which was added to the base formula developed at Stage 1 in different concentrations. In Stage 3, an experimental safety study of the developed gel composition, including growth factors, was performed on laboratory animals. In an experimental safety study (subchronic toxicity) on a wound model, sexually mature male rats and Wistar females of the same age (8–9 months) were used. In all animals, 2 wounds of standard size were modeled on the back. Taking into account the weight and gender, rats were distributed evenly into two experimental groups. Group 1 included rats we treated with a polysaccharide gel based on polymers. This polysaccharide gel included rhFGF-b. Group 2 was used as control (without treatment). Results: The laboratory, histological and gravimetric studies of the internal organs and wounds of the animals in the experimental and control groups did not reveal any regular pathomorphological changes indicating the presence of the general toxicological properties of the studied products. This indicates the safety in vivo of the product being developed. Conclusion: The studies conducted in vitro and in vivo allow us to proceed with studies determining the effectiveness of the developed wound healing medical product on laboratory animals.

Aim. To assess the P2Y12 inhibitors switch in patients ST segment elevation myocardial infarction (STEMI) in real-life’ clinical practice, evaluate the functional activity of thrombocytes and thrombocytopoiesis and determine the clinical and prognostic value of P2Y12 inhibitors switch in the framework of dual antiplatelet therapy in patients with STEMI.Material and methods. We conducted local, stratified, prospective study in which were involved 101 patients, hospitalized no later than 12hours after the STEMI manifestation. The antiplatelet therapy (APT), prescribed by the physicians at the pre-hospital and inpatient phases of treatment, was analyzed. Functional activity of thrombocytes, levels of thrombopoietin (THPO), stromal cell-derived factor 1 (SDF1) and thrombopoietic receptor (MPL) were investigated. The minimum observation period was 2 years. Death and repeated hospitalizations due to cardiovascular causes were monitored.Results. P2Y12 inhibitors were switched in 32,7% of patients with STEMI. In the hospital, clopidogrel, which was prescribed at the prehospital phase, was replaced with ticagrelor (early APT escalation) — 22,8%. Patients with early APT escalation by the seventh day had significantly greater inhibition of platelet aggregation activity parameters (slope of the aggregation curve, latent aggregation time and area under the aggregation curve). Activation of the collagen-induced platelet aggregation was detected. With the early escalation of APT, the THPO level was statistically significantly higher, both on the second and on the 7th day measurements: 256,2 (209,0; 396,8) pg/ml vs 137,5 (105,7; 179,1) pg/ml (p=0,000) and 283,4 (228,9; 334,3) pg/ml vs 226,5 (163,2; 287,3) pg/ml (p=0,045), respectively. The frequency of reaching the combined endpoint (death + re-hospitalization) was 7,9% in patients who had a P2Y12 switch, and 28,1% in patients who did not change the P2Y12 blocker.Conclusion. In actual clinical practice, patients with STEMI had the most frequent early APT escalation, which was characterized by a more significant suppression of adenosine diphosphate-induced platelet aggregation and secretion than in patients without P2Y12 inhibitors switch, but with activation of collagen-induced aggregation. An increase in thrombocytogenesis was revealed in early replacement of clopidogrel by ticagrelor. Intrahospital replacement of the P2Y12 inhibitor in patients with STEMI was accompanied by a decrease in the two-year death risk and repeated hospitalizations.

In the article the features of the organization of international and Russian registers of patients with atrial fibrillation (AF), the clinical and demographic characteristics of patients included in the registers, as well as the features of antithrombotic therapy of AF and its compliance with current clinical guidelines were observed. In a number of large randomized controlled trials (RCTs), not less effectiveness, and in some cases, the superiority of direct oral anticoagulants (DOACs) over warfarin, were proved in the prevention of ischemic insulin stroke patients with non-valvular AF with better safety profile and ease of use. However, the problem of the use of data obtained during RCTs in real clinical practice, for the solution of which medical registers are gaining much popularity, remains relevant. The article provides an analysis of 16 prospective multicenter international and Russian registers of patients with AF. For convenience of comparison, registers were divided into three groups in accordance with the features of the organization and inclusion criteria. Unambiguous conclusions were drawn about the incompatibility of the real clinical practice of antithrombotic therapy of AF with current clinical recommendations. Differences in the population of patients with AF in Russia compared with European countries were found, which led to the conclusion that insufficient detection of AF at the outpatient stage of diagnosis and the resulting inappropriate anticoagulant therapy aiming the prevention of stroke and ischemic complications take place, which may be due to the differences in the socioeconomic status of the regions and the characteristics of the organization of medical treatment and preventive care to the population.

Aim. To compare features of pharmacotherapy of patients with chronic heart failure (CHF) with a reduced ejection fraction of the left ventricle (LV EF) who were admitted in a specialized department of the multidisciplinary hospital in Saratov before and after the publication of the Russian National Recommendations (4 revision) on the diagnosis and treatment of CHF (2012). Material and methods. A pharmacoepidemiological retrospective study was conducted. The object of the study was the medical records of inpatients (form 003/y) with the diagnosis "Heart failure" (ICD-I50), that consecutively admitted to the cardiology department of the multidisciplinary hospital in Saratov from April 28, 2009 to January 19, 2010 (n=52) and from February 19, 2014 to May 20, 2015 (n=95). Patients over 18 years of age with diagnosis of CHF (NYHA II-IV) and LV EF

Experimental modeling of ankerite–pyrite interaction was carried out on a multi-anvil high-pressure apparatus of a “split sphere” type (6.3 GPa, 1050–1550 °C, 20–60 h). At T ≤ 1250 °C, the formation of pyrrhotite, dolomite, magnesite, and metastable graphite was established. At higher temperatures, the generation of two immiscible melts (carbonate and sulfide ones), as well as graphite crystallization and diamond growth on seeds, occurred. It was established that the decrease in iron concentration in ankerite occurs by extraction of iron by sulfide and leads to the formation of pyrrhotite or sulfide melt, with corresponding ankerite breakdown into dolomite and magnesite. Further redox interaction of Ca,Mg,Fe carbonates with pyrrhotite (or between carbonate and sulfide melts) results in the carbonate reduction to C0 and metastable graphite formation (±diamond growth on seeds). It was established that the ankerite–pyrite interaction, which can occur in a downgoing slab, involves ankerite sulfidation that triggers further graphite-forming redox reactions and can be one of the scenarios of the elemental carbon formation under subduction settings.

Monitoring of the effectiveness of drug therapy is one of the most debated issues in everyday clinical practice. The emergence of new drugs, methods of analysis, standards, management protocols, and clinical guidelines increases the information load on practitioners and requires a significant investment of time and efforts for self-education. The purpose of the review is to help practitioners in summary form to obtain the necessary information on the issue of control of antiplatelet therapy. The review brings together data from current clinical recommendations on antiplatelet therapy in patients with ischemic heart disease, gives information of existing approaches to control of antiplatelet therapy specified in the guidelines and the consensuses of experts. It presents information on the most common modern methods of monitoring of the antiplatelet therapy effectiveness.

Aim. To evaluate the dynamics of thrombocyte functional activity (TFA) under antiplatelet treatment conditions which include the branded, and generic compounds as well, in ST elevation acute coronary syndrome patients (STEACS) in routine clinical practice.Material and methods. The open-label prospective study was done, including STEACS patients stratified according to the kind of antiplatelet in-patient treatment (original and/or generics). As an endpoint, we used the surrogate — functional activity of thrombocytes (TFA), measured by impedance and luminescent aggregatometry at 1 and 7 day from STEACS onset.Results. By the inclusion, baseline point all patients were comparable by TFA. On double antiplatelet therapy (DAT) by the 7th day of STEACS there was statistically significant difference of all ADP-induced thrombocyte aggregation. There was difference in ADP-induced platelet aggregation depending on the DAT variant, which included the original drug and generic.Conclusion. In STEACS patients the level of aggregation activity of platelets does significantly differ from the kind of antiplatelet treatment. Usage of the branded and generic compounds of the came antiplatelet agent by the same regimen does differ by different grade and dynamics of platelets activeness suppression.

Aim. To estimate an efficiency of influenza vaccination in patients with circulatory system diseases diseases (CSD) under 3-year follow-up in outpatient clinics.Methods. The efficiency of influenza vaccination was investigated in CSD patients followed up at 2Ivanovo outpatient clinics and 2Saratov ones. The investigation enrolled 817 people, including 367 patients who consented to Grippol Plus influenza vaccination and 450 who refused.Results. During 36-month follow-up after being included in the study the vaccinated group showed a significantly fewer influenza and acute respiratory viral infections than the non-vaccinated group (28 and 442; р

Aim. To study the prevalence of high residual platelet reactivity (HRPR) during the dual antiplatelet therapy (DAT) with acetylsalicylic acid (ASA) and clopidogrel by optical aggregometry in patients with ischemic heart disease (IHD) after percutaneous transluminal coronary angioplasty (PTCA) in clinical practice, as well as to determine its value for the prediction of clinical course and outcome of disease.Material and methods. Patients after PTCA and during DAT were included into the study. Evaluation of the functional activity of platelets by optical aggregometry was performed in all patients at baseline. Resistance to ASA, clopidogrel and DAT were detected. Endpoints included cases of repeated atherothrombotic events (sudden cardiac death, myocardial infarction, unstable angina, ischemic stroke, stent thrombosis). Adherence to therapy was evaluated by Morisky-Green test.Results. 97 patients were included into the final analysis. The risk of myocardial infarction or unstable angina pectoris in the ASA-resistant patients was significantly higher than this in the DAT-sensitive patients [relative risk (RR)=7.68; 95% confidence interval (CI) 2.8-20.54; p=0.045]. Maximum RR for stent thrombosis was in clopidogrel-resistant (RR=7.1; 95% CI 1.41-35.82; p=0.0485) and DAT-resistant patients (RR=12.8; 95% CI 4.5-36.38; p=0.0491), compared with patients with a sensitivity to antiplatelet therapy. DAT-resistance was associated with a higher RR of the combined endpoint, compared with the sensitivity to antiplatelet therapy (RR=10.24; 95% CI 3.96-26.5; p=0.046]), and have a tendency to association with increased risk of combined endpoint compared with isolated ASA-resistance (RR=1.3; 95% CI 0.68-2.6; p=0.081).Conclusion. HRPR during DAT is common in clinical practice in patients with ischemic heart disease after PTCA. Routine use of optical aggregometry in DAT may help to identify patients with an increased risk of thrombotic events in the postoperative period and to assign them an alternative antiplatelet therapy.

Aim. To evaluate risk of repeated atherothrombotic events in patients survived acute coronary syndrome (ACS) and having poorly reduced platelet aggregation (proven by optical aggregometry) in response to acetylsalicylic acid (ASA) therapy.Material and methods. 200 patients with ACS (aged 56,6±9,2 y.o.) were included in the study. Platelet functional activity during ASA therapy was evaluated with laser aggregometer. ASA resistance was defined if the summarizing index of platelet aggregation (induced with ADP, 5 mμml/l) was 50% or higher during ASA therapy. Observation period was 18±6 months. Atherothrombotic events (unstable angina, myocardial infarction, stroke, cardiovascular death) were considered.Results. Lack ASA response rate was about 12%. Totally 22 repeated atherothrombotic events were registered: 5,6% among ASA sensitive patients and 50% - among ASA resistant patients. Repeated atherothrombotic events were registered in ASA resistance patients during first 14 days. ASA sensitive patients showed repeated atherothrombotic events in some months after ACS. The relative risk of cardiovascular event in ASA resistance patients was 8,92 (CI 95% 4,39; 17,84 р=0,05).Conclusion. The high level of the induced platelet aggregation (proven by laser aggregometry) points to high risk of repeated atherothrombotic events in patients with ACS.

Aim. To evaluate the structure of drug prescriptions in acute coronary syndrome (acute myocardial infarction and unstable angina) on the first day of hospital therapy in Saratov city and Saratov region.Material and methods. Retrospective pharmacoepidemiology study was carried out in 1276 patients with acute coronary syndrome (ACS) without elevation ST during first 24 hours.Results. Prescription of drugs with proven efficacy in ACS was higher in Saratov city clinical hospital than this in Saratov municipal hospital or hospitals of Saratov region. There were no significant differences in drug prescriptions in Saratov municipal hospital and hospitals of Saratov region.Conclusion. The first day therapy of ACS depends on hospital type.

Aim. In patients after acute coronary syndrome (ACS) to study the effect of adherence to recommended therapy on the risk of cardiovascular events during a year after hospital admission, and to identify the main causes of low adherence to prescribed therapy. Material and methods. Patients with ACS (n=271), consistently admitting to the emergency cardiology department were included into the study. Complex therapy (acetylsalicylic acid (ASA), beta-blockers (BB), ACE inhibitors, statins) was prescribed to all patients. The drugs prescription rate was analyzed. The cardiovascular events (death, myocardial infarction, stroke, episodes of unstable angina, decompensated heart failure) were recorded for 12 months. The adherence of patients to recommended therapy was evaluated. Results. After hospital discharge ASA therapy was recommended to 98% of patients, BB — 95%, ACE inhibitors — 97%, statins — 63%. In 12 months only 73% of patients continued therapy with ASA, 66% — BB, 74% — ACE inhibitors, 44% — statins. The rate of hospital re-admission was significantly higher in patients with low adherence: 80% (n=32) vs 24% (n=55) among compliant patients. The main causes of hospital re-admission were decompensated heart failure (46%), recurrent episodes of angina (32%) or ACS (19%). Conclusion. A significant part of patients (about 1/3) terminates the recommended therapy within 12 months after ACS. Low adherence to therapy is often determined by subjective factors and associated with a 3-fold increased risk of cardiovascular events (RR 3.27; 95% CI 2.49-4.30; p=0.05).

Recent data and perspectives of antithrombotic therapy in patients with atrial fibrillation (AF) are highlighted. The main statements of current Russian and international guidelines about thromboembolic events prevention in AF patients are presented. Special attention paid to new agents for oral anticoagulation therapy , last information about their efficacy , safety and potential of application.

Aim. To evaluate pharmacotherapy of ST-elevation myocardial infarction (STEMI) in cardiology departments of Saratov hospitals of various types. Material and methods. The retrospective pharmacoepidemiological study was carried out with involved of 424 hospital charts of STEMI patients, discharged during the year from the cardiology department of Saratov municipal hospital (MH; n=216) and emergency cardiology department of Saratov clinical hospital (CH; n=208). Results. The real practice in the audited hospitals are not fully consistent with current guidelines for the STEMI patients management. The relationship between guidelines compliance and hospital type is clearly seen. Doctors in MH in comparison with them in CH more often prescribed respiratory analeptics (13.4% vs 5.3% , respectively), metabolic drugs (63.4% vs 37.5%, respectively) and rarer used beta-blockers (50% vs 88.9%, respectively) and thrombolytic therapy (3.7% vs 51%, respectively). In MH dipyridamole was used in 9.6% of patients as an alternative to the acetylsalicylic acid, and clopidogrel was not prescribed. At the same hospital clotting time was determined for monitoring of heparin therapy. Statins were rare used in both hospitals (26% in MH vs 40% in CH). Conclusion. The real clinical practice of STEMI patients management in Saratov hospitals are not completely consistent with current clinical guidelines. There are differences in STEMI patients therapy depending on hospital type.

Atherothrombosis is a complication of ischemic heart disease, and it leads to development of acute coronary syndrome. Atherothrombosis is characterized by sudden destruction of atherosclerotic plaque, which results into platelets activation and thrombus formation. Aspirin - one of the most widely used antiaggregate drugs, prevents development of the recurring myocardium infarction, stroke, sudden coronary death. But in number of patients aspirin is not efficient. Development of repeated thrombotic complications with aspirin therapy or resistance to aspirin is independent predictor of high coronary risk. There are controversial data about aspirin resistance incidence, which varies from 5 to 48%. Possible reasons for this are discussed: low compliance with treatment, peculiarities of functional condition of platelets, genetically given variability of platelet receptors etc. Different methods, based on estimation of platelets activity are proposed to assess the possibility of repeated thrombotic complications, caused by resistance to aspirin. Further researches including valid number of patients are needed to assess incidence of aspirin resistance and to reveal mechanisms of its development.

Estimation of cardiovascular risk is discussed. Serum lipoproteins, glucose, fibrinogen, von Willebrand factor, tissue-type plasminogen activator, C-reactive protein etc are offered for use as laboratory indicators. At the same time new markers of high cardiovascular risk are under development. D-dimer is a product of fibrin degradation and its plasma level reflects intensity of intravascular thrombosis and fibrinolysis. Plasma level of D-dimer as a tool for estimation of cardiovascular risk and pharmacotherapy efficacy is discussed.

Aim. To evaluate the structure of drug prescriptions in acute coronary syndrome (acute myocardial infarction and unstable angina) on the first day of hospital therapy in Saratov city and Saratov region.Material and methods. Retrospective pharmacoepidemiology study was carried out in 1276 patients with acute coronary syndrome (ACS) without elevation ST during first 24 hours.Results. Prescription of drugs with proven efficacy in ACS was higher in Saratov city clinical hospital than this in Saratov municipal hospital or hospitals of Saratov region. There were no significant differences in drug prescriptions in Saratov municipal hospital and hospitals of Saratov region.Conclusion. The first day therapy of ACS depends on hospital type.

Aim. To evaluate risk of repeated atherothrombotic events in patients survived acute coronary syndrome (ACS) and having poorly reduced platelet aggregation (proven by optical aggregometry) in response to acetylsalicylic acid (ASA) therapy.Material and methods. 200 patients with ACS (aged 56,6±9,2 y.o.) were included in the study. Platelet functional activity during ASA therapy was evaluated with laser aggregometer. ASA resistance was defined if the summarizing index of platelet aggregation (induced with ADP, 5 mμml/l) was 50% or higher during ASA therapy. Observation period was 18±6 months. Atherothrombotic events (unstable angina, myocardial infarction, stroke, cardiovascular death) were considered.Results. Lack ASA response rate was about 12%. Totally 22 repeated atherothrombotic events were registered: 5,6% among ASA sensitive patients and 50% - among ASA resistant patients. Repeated atherothrombotic events were registered in ASA resistance patients during first 14 days. ASA sensitive patients showed repeated atherothrombotic events in some months after ACS. The relative risk of cardiovascular event in ASA resistance patients was 8,92 (CI 95% 4,39; 17,84 р=0,05).Conclusion. The high level of the induced platelet aggregation (proven by laser aggregometry) points to high risk of repeated atherothrombotic events in patients with ACS.

Aim. To analyze current clinical practice in the treatment of atrial fibrillation (AF) in emergency care department of multidisciplinary hospital in 2008-2009. Material and methods. Retrospective continuous pharmacoepidemiology study was carried out. Hospital history sheets of the patients admitted to the emergency care department in the period from 01.01.2008 to 31.12.2009 were analyzed. Results. Physicians of emergency care department mainly chose strategy of sinus rhythm restoration and maintenance in patients with paroxysmal and persistent AF . To implement this strategy pharmacological cardioversion was performed in patients with stable hemodynamics. The most frequently used medicine for pharmacological cardioversion was procainamide (60% of all prescriptions). Its efficacy was about 50% as compared with this of 80% for amiodarone and propafenone. In order to maintain sinus rhythm monotherapy with beta-blockers or amiodarone was preferred. Conclusion. Overall, AF treatment corresponded to current guidelines. Physicians preferred strategy of sinus rhythm restoration and maintenance.

Aim. To evaluate the real practice of thrombolytic therapy of patients with ST-elevation myocardial infarction (STEMI) at cardiological departments of Saratov and Saratov region hospitals.Material and methods. Retrospective pharmacoepidemiologic study was carried out. Case histories of STEMI patients discharged from cardiologic departments of several central district hospitals (CDH) of Saratov region, cardiologic department of one of Saratov general municipal hospitals (MH) and urgent cardiology department of Saratov clinical hospital (CH) in 2006 were analyzed.Results. In CH all patients received thrombolytic therapy given they did not have contraindications and were admitted to the hospital timely. Few patients received thrombolytic therapy in MH and CDH in 2006.Conclusion. Correlation between hospital type and quality of STEMI management has been revealed.

Aim. To evaluate the pre-hospital treatment of patients with acute coronary syndromes (acute myocardial infarction and unstable angina) in 2001 and 2006.Material and methods. Retrospective pre-hospital treatment survey was performed in 1114 patients with acute coronary syndrome (acute myocardial infarction (AMI) or unstable angina (UA)) in 2001 and 2006.Results. For acute myocardial infarction use of aspirin, β-blockers, heparin was 0%, 0%, 81,5% in 2001 and 23,9%, 8%, 13,4% in 2006, respectively. Use of aspirin, β-blockers, heparin in unstable angina were 0%, 16,2%, 12,3% in 2001 and 3,4%, 1,6%, 0,5% in 2006, respectively. Fibrinolytic therapy was not provided. Polypragmasia reduced in 2006 in comparison with 2001.Conclusions. This survey demonstrates the discordance between existing current practice and guidelines for acute coronary syndrome.

Inhibitors of the renin-angiotensin-aldosterone system, statins, and possibly , ω-3 polyunsaturated fatty acids may influence the incidence of atrial fibrillation (AF), and can be used to prevent it. In recent medical literature, this approach is referred to as upstream treatment. The results of experiments and clinical studies show that the use of these drugs may be useful for AF primary prevention in certain categories of patients. Nevertheless, there are currently no sufficient evidences to justify these recommendations and apply them to a wider range of patients with AF risk factors. Thus, it is reasonable to continue studies on both primary and secondary AF prevention.

Aim. Тo evaluate compliance of ongoing antithrombotic therapy (ATT) in various forms of atrial fibrillation (AF) with the risk level of thromboembolic complications (TEC), calculated with the СHADS2 and CHA2DS2–VASc scales in real clinical practice. Material and methods. A retrospective study of hospital records of 308 in-patients admitted to the cardiology departments of two multidisciplinary hospitals during the year because of nonvalvular AF . Risk of thromboembolic complications was estimated with the CHADS2 and CHA2DS2–VASc scales and appointed ATT was analyzed. Results. Patients with high risk of TEC were predominated in the study population: 77.6% and 91.9% according to CHADS2 and CHA2DS2–VASc scales, respectively. Moderate risk was found in 17.6% and 6.1% of patients according to CHADS2 and CHA2DS2–VASc scales, respectively. Only 32.2% and 28.6% 28.6% of patients at high risk according to CHADS2 and CHA2DS2–VASc scales, respectively received warfarin in hospital. All patients with permanent AF in this sample had a high risk of TEC according to the both scales. In the group of paroxysmal/persistent AF the high, moderate and low risk of TEC was identified in 87%, 9.9%, and 3.1% of patients, respectively , according to CHA2DS2–VASc scale and in 64.25%, 28.5% and 7.5% of patients, respectively , according to CHADS2 scale. Difference in high-risk patient rate was not significant among patients with permanent AF . In high risk group contraindications for receiving indirect anticoagulants were more frequent in the group with permanent AF (OR 3.1; 95% CI 0.88–10.7; p>0,05). The probability of warfarin prescription in patients with permanent AF was higher than in patients with paroxysmal or persistent AF (OR 1.98, 95% CI 1,18-3,31), and probability of aspirin prescription was lower (OR 0.82; 95% CI 0,51-1,32; p>0,05). Conclusion. In real clinical practice oral anticoagulants are prescribed insufficiently in patients at high risk. Usage of CHA2DS2–VASc scale compared with usage of CHADS2 scale, leads to significant increase in the proportion of patients at high risk due to reduction in the proportion of patients with moderate risk in persistent or permanent AF . Usage of CHADS2 scale can lead to an underestimation of the TEC risk in patients with persistent or permanent AF .

Inhibitors of the renin-angiotensin-aldosterone system, statins, and possibly , ω-3 polyunsaturated fatty acids may influence the incidence of atrial fibrillation (AF), and can be used to prevent it. In recent medical literature, this approach is referred to as upstream treatment. The results of experiments and clinical studies show that the use of these drugs may be useful for AF primary prevention in certain categories of patients. Nevertheless, there are currently no sufficient evidences to justify these recommendations and apply them to a wider range of patients with AF risk factors. Thus, it is reasonable to continue studies on both primary and secondary AF prevention.

Aim. To estimate the prevalence of atherothrombotic complications depending on platelet sensitivity to acetylsalicylic acids (ASA) in patients with stable angina.Material and methods. 96 patients with stable angina of II-III functional classes received basic therapy included ASA (125 mg daily) to prevent atherothrombotic complications. Platelet ability to aggregation was assessed with laser aggregometer. Resistance to ASA was determined, if cumulative index of platelet aggregation (after stimulation with ADF, 5 µmol\l) remain on the level of 50-70% in spite of ASA. Atherothrombotic complications (cardiovascular death, myocardial infarction, unstable angina, cerebral stroke) were registered during 24-36 months.Results. Resistance to ASA was detected in 24% of patients. Atherothrombotic complications were registered in 66% of patients with ASA resistance (myocardial infarction or unstable angina were observed in 14 patients of 21 ones) and in 27% of patients with sensitivity to ASA (myocardial infarction or unstable angina were observed in 19 of 70 ones). Besides, resistance to ASA was associated with high rate of thrombosis of installed stents or coronary artery bypasses.Conclusion. In patients with unstable angina insufficient inhibition of platelet aggregation with ASA is associated with 2, 45 times increase in risk of atherothrombotic complications and higher rate of thrombosis of installed stents or coronary artery bypasses.

Aim. Тo evaluate compliance of ongoing antithrombotic therapy (ATT) in various forms of atrial fibrillation (AF) with the risk level of thromboembolic complications (TEC), calculated with the СHADS2 and CHA2DS2–VASc scales in real clinical practice. Material and methods. A retrospective study of hospital records of 308 in-patients admitted to the cardiology departments of two multidisciplinary hospitals during the year because of nonvalvular AF . Risk of thromboembolic complications was estimated with the CHADS2 and CHA2DS2–VASc scales and appointed ATT was analyzed. Results. Patients with high risk of TEC were predominated in the study population: 77.6% and 91.9% according to CHADS2 and CHA2DS2–VASc scales, respectively. Moderate risk was found in 17.6% and 6.1% of patients according to CHADS2 and CHA2DS2–VASc scales, respectively. Only 32.2% and 28.6% 28.6% of patients at high risk according to CHADS2 and CHA2DS2–VASc scales, respectively received warfarin in hospital. All patients with permanent AF in this sample had a high risk of TEC according to the both scales. In the group of paroxysmal/persistent AF the high, moderate and low risk of TEC was identified in 87%, 9.9%, and 3.1% of patients, respectively , according to CHA2DS2–VASc scale and in 64.25%, 28.5% and 7.5% of patients, respectively , according to CHADS2 scale. Difference in high-risk patient rate was not significant among patients with permanent AF . In high risk group contraindications for receiving indirect anticoagulants were more frequent in the group with permanent AF (OR 3.1; 95% CI 0.88–10.7; p>0,05). The probability of warfarin prescription in patients with permanent AF was higher than in patients with paroxysmal or persistent AF (OR 1.98, 95% CI 1,18-3,31), and probability of aspirin prescription was lower (OR 0.82; 95% CI 0,51-1,32; p>0,05). Conclusion. In real clinical practice oral anticoagulants are prescribed insufficiently in patients at high risk. Usage of CHA2DS2–VASc scale compared with usage of CHADS2 scale, leads to significant increase in the proportion of patients at high risk due to reduction in the proportion of patients with moderate risk in persistent or permanent AF . Usage of CHADS2 scale can lead to an underestimation of the TEC risk in patients with persistent or permanent AF .

Aim. To evaluate the pre-hospital treatment of patients with acute coronary syndromes (acute myocardial infarction and unstable angina) in 2001 and 2006.Material and methods. Retrospective pre-hospital treatment survey was performed in 1114 patients with acute coronary syndrome (acute myocardial infarction (AMI) or unstable angina (UA)) in 2001 and 2006.Results. For acute myocardial infarction use of aspirin, β-blockers, heparin was 0%, 0%, 81,5% in 2001 and 23,9%, 8%, 13,4% in 2006, respectively. Use of aspirin, β-blockers, heparin in unstable angina were 0%, 16,2%, 12,3% in 2001 and 3,4%, 1,6%, 0,5% in 2006, respectively. Fibrinolytic therapy was not provided. Polypragmasia reduced in 2006 in comparison with 2001.Conclusions. This survey demonstrates the discordance between existing current practice and guidelines for acute coronary syndrome.

An experimental study aimed at the modeling of dolomite- and ankerite-involving decarbonation reactions, resulting in the CO2 fluid release and crystallization of Ca, Mg, Fe garnets, was carried out at a wide range of pressures and temperatures of the upper mantle. Experiments were performed using a multi-anvil high-pressure apparatus of a “split-sphere” type, in CaMg(CO3)2-Al2O3-SiO2 and Ca(Mg,Fe)(CO3)2-Al2O3-SiO2 systems (pressures of 3.0, 6.3 and 7.5 GPa, temperature range of 950–1550 °C, hematite buffered high-pressure cell). It was experimentally shown that decarbonation in the dolomite-bearing system occurred at 1100 ± 20 °C (3.0 GPa), 1320 ± 20 °C (6.3 GPa), and 1450 ± 20 °C (7.5 GPa). As demonstrated by mass spectrometry, the fluid composition was pure CO2. Composition of synthesized garnet was Prp83Grs17, with main Raman spectroscopic modes at 368–369, 559–562, and 912–920 cm−1. Decarbonation reactions in the ankerite-bearing system were realized at 1000 ± 20 °C (3.0 GPa), 1250 ± 20 °C (6.3 GPa), and 1400 ± 20 °C (7.5 GPa). As a result, the garnet of Grs25Alm40Prp35 composition with main Raman peaks at 349–350, 552, and 906–907 cm−1 was crystallized. It has been experimentally shown that, in the Earth’s mantle, dolomite and ankerite enter decarbonation reactions to form Ca, Mg, Fe garnet + CO2 assemblage at temperatures ~175–500 °C lower than CaCO3 does at constant pressures.

Aim. To analyze gender differences in pharmacotherapy and outcomes of ST-elevation myocardial infarction (STEMI) in patients of cardiology hospital in real clinical practice. Material and methods. A continuous pharmacoepidemiological analysis was performed on the base of 153 records of patients with STEMI (men 102, women 51), consecutively admitted to the emergency department of cardiology hospital in the period from October 2010 to April 2011.Results. Women were on average 10.6 years older than men, had significantly higher incidence of severe comorbid conditions and significantly fewer prescribed medications improving STEMI prognosis - thrombolytics (21% vs 50%; pConclusion. Older age, higher comorbidity rate, and lower treatment compliance with the current clinical recommendations in female STEMI patients in comparison with these in male STEMI patients contribute to higher hospital mortality and 12-month mortality after discharge in women with STEMI.