Current issues in pharmacy and medicine: science and practice

Prospects for the creation of new phytochemical medicinal products based on Myrtus communis L. (a review)

O. Ye. Matsehorova, V. M. Odyntsova — Fri, 23 Feb 2024 00:00:00 +0200

The number of medicinal products based on biologically active substances (BAS) of plant origin is increasing every year. Scientists are exploring non-official plant raw materials used in non-traditional medicine to expand the raw material base for creating new phytopreparations. Among numerous plants, common myrtle (Myrtus communis L.), which is a fairly common indoor plant, is recognized as a valuable source of BAS.

The aim of the work is to analyze and summarize new literature data on the botanical characteristics, chemical composition, pharmacological and toxicological properties of Myrtus communis L.

Materials and methods. Data were collected from several legitimate databases and services such as PubMed, Medline, Scopus, Google Scholar, ResearchGate using the key terms “Myrtus communis L.”, “botanical characteristics”, “pharmacological studies”, “phytochemical studies” in each database data Relevant and related data were filtered as appropriate if deemed relevant to the topic of interest. Time frames have also been adjusted to provide up-to-date information.

Results. Myrtus communis L., commonly known as common myrtle, is a widely recognized medicinal plant in the Mediterranean region. Various parts of this plant, including the leaves, fruits, and flowers, have been used in traditional medicine for treating a wide range of ailments. The pharmacological properties of common myrtle are attributed to the presence of essential oils and phenolic compounds, and these properties include antimicrobial, antiviral, antidiabetic, antispasmodic, vasodilator, antiulcer, antioxidant, antitumor, and anti-inflammatory effects. This article offers an overview of the botanical characteristics and chemical composition of different parts of common myrtle, and it presents a literature review of pharmacological studies that provide evidence for the plant’s medicinal properties.

Conclusions. Common myrtle is a promising plant for further pharmacognostic research with the aim of expanding the raw material base, using the method of clonal micropropagation and creating new phytopreparations based on it.

Valeriana officinalis (Valerian) – review

V. O. Kokitko, V. M. Odyntsova — Fri, 23 Feb 2024 00:00:00 +0200

Valeriana officinalis L. s.l. is a perennial herbaceous plant belonging to the Valerianaceae family. It is widely distributed in Ukraine and around the world. The official medicinal raw material derived from Valeriana officinalis consists of the dried, whole, or fragmented underground parts of the plant, including the rhizome along with the roots and stolons. To meet the standards outlined in the European Pharmacopoeia, this raw material must be standardized based on its essential oil content (a minimum of 4 ml/kg in dried preparations) and sesquiterpenic acids (a minimum of 0.17 percent by weight, calculated as valeric acid, in dried preparations).

The aim of the work was searching, systematizing, and generalizing information from the specialized literature on the chemical composition, biological activity and therapeutic use of Valeriana officinalis.

Valeriana officinalis has sedative, mild analgesic, hypnotic, antispasmodic, carminative, and hypotensive effects. Historically, it was used for hysterical conditions, hyperexcitability, insomnia, hypochondria, migraine, spasms, intestinal colic, rheumatic pains, dysmenorrhea, and especially for conditions accompanied by nervous excitability. The main classes of biological substances identified in Valeriana officinalis are valepotriates, iridolactones, alkaloids, phenolic acids, sesquiterpenes, flavonoids, terpene coumarins, lignans, terpene and flavonol glycosides. It has not yet been established which components of Valeriana officinalis are responsible for its pharmacological effects. Current opinion is that the overall effect of valerian is due to several different groups of components and their different mechanisms of action. Therefore, the activity of different preparations of valerian will depend on their content and concentration of several types of components.

Conclusions. Summarized and systematized original works related to pharmacognostic study, phytochemical analysis, and medicinal use of underground and aerial parts of various species of Valeriana genus. The analysis of the material shows that in recent years, scientists from all over the world have paid attention to the above-ground part of valerian and have chosen it as an object of in-depth study. This approach opens new possibilities for the use of the herb Valeriana officinalis in medicine.

Why do we age? The main signs of aging

Ugіs Kletnieks, Audrius Butkevichius, V. V. Hladyshev, S. S. Sоkolovskyi — Fri, 23 Feb 2024 00:00:00 +0200

Aging is a gradual and irreversible pathophysiological process. This is manifested in the decline of tissue and cell functions and a significant variety of pathologies associated with aging, including neurodegenerative diseases, cardiovascular diseases, metabolic disorders, increased risk of diseases of the skeleton and the immune system. Although modern medical advances have made a certain contribution to human health and greatly extended life expectancy, along with the aging of society, various chronic diseases are gradually emerging, which are the most important causes of disability and death of the elderly.

Aim. The aim of the work is to analyze modern ideas in the field of causes and manifestations of aging processes for the possibility of developing a strategy to slow down its course. At the molecular and cellular level, aging is a complex biological process involving the gradual deterioration of various cellular and molecular processes in the body over time.

The length of a person’s life is closely related to the decrease in the possibilities of repair and regeneration of tissues and organs. In response to stress at the molecular, cellular, and systemic levels, genetic, epigenetic, and environmental regulatory factors cause a decrease in the body’s physiological capabilities. They use complex molecular mechanisms that together contribute to aging. Molecular mechanisms (such as telomere shortening, accumulation of DNA damage, metabolic changes, and excessive free radical generation) strongly link various factors to the rate of aging. Collectively, these mechanisms inhibit cell proliferation, alter metabolism and gene expression, and induce high levels of free radicals, maintaining a senescent cell phenotype. Although the number of early senescent cells is low, they can limit the regenerative capacity of tissue stem cells and lead to the accumulation of cellular damage, thereby contributing to age-related diseases.

Conclusions. Current advances in high-throughput genomics, transcriptomics, proteomics, and metabolomics enable the characterization and quantification of thousands of epigenetic markers, transcripts, proteins, metabolites, and can reveal general changes that occur with age in complex organisms at the molecular level. Thus, the integration of these molecular markers and related molecular mechanisms into a comprehensive assessment of biological age to prevent age-related functional decline and morbidity is becoming an increasingly pressing issue in medical science and should be implemented in practice as soon as possible.

Search for molecular descriptors and computer prediction of biological activity in a series of S-derivatives (1,2,4-triazole-3(2H)-yl)methyl)thiopyrimidines

Yu. V. Karpenko, O. I. Panasenko, A. P. Litun — Fri, 23 Feb 2024 00:00:00 +0200

Most pharmaceutical compounds interact with various molecular compositions in the body, leading to complex biological effects. Furthermore, during biotransformation, they may generate one or more metabolites with potent bioactive properties. Therefore, the development and careful use of new medications require thorough examination of their biological impact profiles, including considerations of human metabolic processes. In silico techniques are currently widely used to evaluate the interactions of emerging drug candidates with pharmacological conditions and predict their metabolic conversions. To investigate the bioactivity of compounds based on the structure of 1,2,4-triazole-3(2H)-thione with pyrimidine-2-thiol, we generated a combinatorial library of bioregulators using the computer programs SuperPred and SwissADME. The relevance of this research is underscored by the ongoing quest for novel biomolecular compounds that are highly effective yet low in toxicity, spanning both natural and synthetic sources. Much attention is directed towards nitrogen-containing heterocycles, particularly derivatives of 1,2,4-triazole, due to their substantial medical and biological potential.

The aim of the work is to create a combinatorial library of bioregulators, which contains the structures of 1,2,4-triazole and pyrimidine, and to carry out in silico screening of heterocycle derivatives using the SuperPred web server to determine promising directions for the study of their bioactivity.

Materials and methods. The subject of our research is S-derivatives of (1,2,4-triazole-3(2H)-yl)methyl)thiopyrimidines. Virtual screening of compounds was carried out using the SuperPred computer program. The ADME study was performed using the free service SwissADME, which is used to evaluate the pharmacokinetics, bioavailability, and interaction of small molecules with enzymes in medicinal chemistry.

Results. Predicting the likelihood of a substance demonstrating a particular biological activity enables the selection of the most appropriate tests for studying the activity of a given chemical compound, as well as identifying which substances available to the researcher are most likely to enhance the effectiveness of the effects. This principle is grounded in the concept that “the biological activity of a substance is a function of its chemical structure”. Such predictions are generated based on the structural formula of a chemical compound and can be made during the planning stage of synthesis.

Conclusions. A combinatorial library of bioregulators was created by combining the structure of 1,2,4-triazole-3(2H)-thione with pyrimidine-2-thiol. The conducted virtual screening of the 1,2,4-triazole-3(2H)-thione heterocycle with pyrimidine-2-thiol shows promise for obtaining non-toxic compounds with antineoplastic biological activity. Screening of derivatives, particularly S-derivatives of (1,2,4-triazole-3(2H)-yl)methyl)thiopyrimidines, indicates the potential for discovering biologically active substances with antineoplastic, antibacterial, analgesic, antidiabetic, antihypertensive, and other types of biological activities within this compound series.

In silico study of properties in the series of 1-alkyl-4-(((5-nitrofuran-2-yl)methylene)amino)- 1,2,4-triazole halides

L. I. Kucherenko, T. S. Brytanova, A. S. Hotsulia — Fri, 23 Feb 2024 00:00:00 +0200

1,2,4-Triazole derivatives open up wide horizons for modern medicinal chemists to develop innovative drugs. The use of 1,2,4-triazole derivatives in pharmacological research is based on their ability to produce an effective effect on biological systems and interact with molecular targets. These azoles can be used to regulate various physiological processes, which opens up the possibility of their effective use in the treatment of various diseases.

Targeted modification of the structure of 1,2,4-triazole derivatives opens up wide opportunities for the creation of biologically active compounds with improved properties, which contributes to further advances in pharmaceutical research and the development of new, effective drugs.

The aim of this work is to predictively assess the pharmacological potential of 1-alkyl-4-(((5-nitrofuran-2-yl)methylene)amino)-1,2,4-triazole halides by in silico studies.

Materials and methods. ADME-analysis is a method of studying the physical-chemical and pharmacokinetic parameters of the studied substances using the online resource SwissADME. Molecular docking is a method of predicting and evaluating the interaction between a ligand molecule and the three-dimensional structure of the target protein. The ligands have been prepared with the software MarvinSketch 6.3.0, Hyper Chem 8, and AutoDockTools-1.5.6, whereas the software packages Discovery Studio 4.0 and AutoDockTools-1.5.6 have been used for the preparation of enzymes. The Vina program was used for direct molecular docking.

Results. A prescreening analysis was conducted on a virtual series of 1-alkyl-4-(((5-nitrofuran-2-yl)methylene)amino)-1,2,4-triazole halides, recognized as potential sources of biologically active substances. The study involved determining the main physicochemical characteristics and unveiling general pharmacokinetic parameters of the molecules. The Vina program was employed to identify the nature and number of amino acid residues in the active sites of model enzymes interacting with the proposed ligands. Results indicate the highest affinity for lanosterol 14α-demethylase. However, the analysis of ligand complexes with cyclooxygenase-2 and anaplastic lymphoma kinase suggests a low probability of a significant effect on these enzymes.

Conclusions. The overall prognosis for bioavailability in the case of oral administration of dosage forms with the investigated substances is favorable. Pharmacodynamics in silico studies allow us to identify 1-heptyl- and 1-octyl-4-(((5-nitrofuran-2-yl)methylene)amino)-1,2,4-triazolium bromides as potential antifungal agents that can reasonably be involved in further in-depth studies of this type of activity.

Investigation of antioxidant interaction between ascorbic acid and rutin in medicine “Ascorutin”

O. Yu. Maslov, M. A. Komisarenko, S. V. Kolisnyk, M. Yu. Golik — Fri, 23 Feb 2024 00:00:00 +0200

Phytomedicines are combined pharmaceuticals containing various groups of phenolic compounds. It is known that phenolic compounds are powerful antioxidants, but their level of antioxidant activity during interactions has not been previously studied.

The aim of the work was to investigate interaction between ascorbic acid and rutin in medicine “Ascorutin”.

Materials and methods. The objects of the study were one series of tablets “Ascorutin,” rutin, and ascorbic acid. The level of antioxidant activity was measured by the potentiometric method.

Results. The level of antioxidant activity of model solutions of rutin was 265.51 ± 1.00 mmol-eq./L, ascorbic acid – 99.00 ± 1.00 mmol-eq./L, a combination of rutin and ascorbic acid – 255.60 ± 1.00 mmol-eq./L, and medicine “Ascorutin” – 256.52 ± 1.00 mmol-eq./L. An experimental value of the level of antioxidant activity of “Ascorutin”, the combination of rutin and ascorbic acid was 30 % less than theoretical values.

Conclusions. The antioxidant interaction of ascorbic acid and rutin in “Ascorutin” medicine has been studied. It has been established that the combination of rutin and ascorbic acid has an antagonistic effect. The findings of this research will serve as a stimulus for exploring the interaction of bioactive substances and selecting their optimal combinations for the development of pharmaceuticals, special food products, food, and cosmetic products.

Coupling thin layer chromatography with mass spectrometry for detection and identification of sertraline and its metabolite in the urine

Fri, 23 Feb 2024 00:00:00 +0200

The aim of the study was to detect sertraline and its metabolites in urine under standardized thin layer chromatography (TLC) screening conditions and identify the metabolites using the mass spectrometry method.

Materials and methods. Urine samples, collected within 30 hours in portions of 20–50 mL, commenced from the seventh hour after the administration of a single therapeutic dose of the drug. The sample preparation process involved dilute acid hydrolysis, followed by the extraction of the native compound and metabolites with chloroform at a pH of 8–9. Thin layer chromatography studies of the extracts were conducted using four unified TLC systems recommended by The International Association of Forensic Toxicologists for general drug screening. Chromatograms were subjected to color reactions with a variety of chromogenic reagents. For the analysis of eluates from chromatograms, a Varian 1200 L mass spectrometer (Netherlands) equipped with a dual quadrupole mass analyzer was employed. Identification was performed through direct sample introduction into the ion chamber, electron-impact ionization (70 eV), and full ion scanning mode.

Results. The spot of the native drug on the chromatogram was identified by the R_f, value. Metabolite of sertraline was identified as N-desmethyltrihydroxysertraline by the molecular ion peak in the mass spectrum.

Conclusions. The study demonstrated the ability of TLC to detect sertraline and its metabolite, N-desmethyltrihydroxysertraline, in urine after the administration of a single therapeutic dose of the drug. The chromatographic mobility of the native compound and N-desmethyltrihydroxysertraline in the unified TLC screening systems, along with the results of their visualization using chromogenic reagents for toxicological drug screening, was determined. Furthermore, the potential of coupling TLC with mass spectrometry for the separation, detection, and confirmatory identification of sertraline and its metabolic products in urine was established.

Chromatographic determination of volatile compounds of Achillea micranthoides Klok. et Krytzka

I. F. Duyun, S. V. Panchenko — Fri, 23 Feb 2024 00:00:00 +0200

The processes of free radical oxidation are known to play a crucial role in the pathogenesis of many diseases. Therefore, the use of antioxidants is considered both pathogenetically justified and rational. Plants belonging to the genus Achillea L. are noted for their diverse content of biologically active substances, which contributes to their antioxidant activity. Given the availability of raw materials and the high biological activity of volatile compounds, it is particularly advisable to explore promising species within the genus Achillea L., such as yarrow (Achillea micrantoides Klok. et Krytzka). Yarrow is widespread in Ukraine, characterized by a long vegetation period, and holds promise for further pharmacognostic study.

Aim. The purpose of the work is to study the volatile compounds of the yarrow extract (Achillea micrantoides Klok. et Krytzka) and to establish their component composition.

Materials and methods. The Thin-Layer Chromatography (TLC) method and Gas Chromatography-Mass Spectrometry (GC/MS) on an Agilent Technology 7890 B chromatograph were employed to determine the component composition of volatile compounds in Achillea micranthoides Klok. et Krytzka. The NIST14 mass spectral library was utilized for identifying the components of the samples.

Results. Identification of volatile compound components was carried out by chromatography of ethyl acetate extracts from the leaves and inflorescences of the subject TLC in the mobile phase ethyl acetate – toluene (5:95). By the gas method Chromatography-mass spectrometry determined the presence of 30 volatile compounds of grass A. micranthoides Klok. et Krytzka, 26 of the compounds were identified, which accounted for 86.76 % of the total number of compounds.

Determination of the isotonicity 1 % solution of sodium 2-((4-amino-5-thiophen-2-ylmethyl)-4H-1,2,4-triazole-3-yl)thio)acetate

D. L. Usenko, A. H. Kaplaushenko, B. O. Varynskyi — Fri, 23 Feb 2024 00:00:00 +0200

The aim of the work is to justify the composition of a 1 % aqueous solution of sodium 2-((4-amino-5-(thiophen-2-ylmethyl)-4H-1,2,4-triazole-3-yl)thio)acetate for parenteral use.

Materials and methods. The osmolality study of a 1 % solution of sodium 2-((4-amino-5-(thiophen-2-ylmethyl)-4H-1,2,4-triazole-3-yl)thio)acetate was conducted using the cryoscopic method according to the State Pharmacopoeia of Ukraine (2.2.35). The calculations were based on measuring the depression of the crystallization temperature of the 1 % solution of sodium 2-((4-amino-5-(thiophen-2-ylmethyl)-4H-1,2,4-triazole-3-yl)thio)acetate, 0.9 % NaCl solution, and high-purity water (Q₃). The measurements of crystallization temperature were performed using a Beckman TL-1 thermometer, which allows for research with high precision up to ± 0.005 °C, making it valuable and most effective for studying isotonic concentration.

Results. Temperature measurements of the crystallization of a 1 % solution under investigation, a 0.9 % NaCl solution, and high-quality purified water were conducted. Calculations of isotonic concentration were performed based on the measurement results.

Conclusions. Based on the obtained experimental data on the depression of the crystallization temperature and the calculations, the amount of sodium chloride necessary for the preparation of an isotonic 1 % aqueous solution of AFI sodium 2-((4-amino-5-thiophen-2-ylmethyl)-4H-1,2,4-triazole-3-yl)thio)acetate for parenteral use was established.

Study of factors influencing the occurrence of conflicts in pharmacies

Т. P. Zarichna, N. M. Chervonenko, N. O. Brahar — Fri, 23 Feb 2024 00:00:00 +0200

The aim of the study was to investigate the factors influencing the occurrence of conflicts in pharmacies during the provision of pharmaceutical care, with the subsequent goal of optimizing the social and psychological climate within the team and improving the quality of service to the population.

Materials and methods. Systematic-analytical, mathematical statistical, comparative, and sociological research methods were employed in the study. Descriptive statistics were utilized to present the obtained data. To assess the significance of individual factors, the questionnaire results were converted into corresponding component weights (Wij).

Results. The study of conflicts between visitors and pharmacy employees, from the point of view of visitors, revealed several key findings. Most customers expressed dissatisfaction with the prices of medicines and medical devices (Wij = 1.00). Additionally, there were concerns about the perceived quality of the products (Wi j= 0.67), and some customers reported feeling distressed due to the unavailability of necessary medicines (Wij = 0.57). The study, conducted from the point of view of employees, focused on conflicts between employees and visitors. The findings revealed that conflicts most often arise due to dissatisfaction with the prices of medicines and medical devices (Wij = 1.00). Additionally, issues such as requests to dispense over-the-counter medicines from the list of prescription drugs (Wij = 0.70) and returning medicines to the pharmacy after purchase (Wij = 0.67) were identified as contributing factors. The analysis of factors that provoke conflicts in the pharmacy team revealed several key contributors. The most significant include the inadequate behavior of employees (Wij = 1.00), inconsistency in words, assessments, and actions of some team members with the expectations and requirements of others (Wij = 0.89), and psychological incompatibility between employees (Wij = 0.88). The study of conflicts between the administration and subordinates in the pharmacy revealed frequent occurrences linked to several factors. Most notably, conflicts were associated with an imperfect bonus system (Wij = 1.00), high workload (Wij = 0.92), and a perceived lack of career development opportunities (Wij = 0.76).

Conclusions. The factors that contribute to the emergence of conflict situations in pharmacies have been identified and studied. Approaches to preventing and resolving conflicts by pharmacy employees are proposed.

Identification and analysis of the expression of genes, involved in insulin signals transmission in the development of experimental type 2 diabetes mellitus

T. V. Ivanenko, А. V. Vynokurova — Fri, 23 Feb 2024 00:00:00 +0200

Type 2 diabetes mellitus is a significant concern due to its high prevalence and impact on global health. Ongoing scientific research aims to enhance our understanding of the mechanisms involved in the development and progression of diabetes and devise effective strategies for its treatment. This involves the development of new pharmacological treatments, including novel antidiabetic drugs, and the exploration of individualized approaches to therapy.

The mechanisms underlying type 2 diabetes are intricate, involving various aspects of physiology and biochemistry. Gaining insight into the development and progression of type 2 diabetes mellitus through modern laboratory diagnostic methods is crucial for the development of effective treatment and prevention strategies for diabetes.

The aim of the study is to identify and analyze a panel of genes, involved in insulin signals transmission in the development of experimental type 2 diabetes mellitus.

Materials and methods. The analysis of gene expression involved in insulin signal transmission was conducted using real-time reverse transcription-polymerase chain reaction (RT-qPCR) on the CFX-96 Touch™ system (Bio-Rad, USA). The RT2Profiler™ PCR Array Rat Diabetes kit (QIAGEN, Germany) was employed for this purpose.

Results. Based on the study results, the activity of the genes involved in insulin signal transmission can be categorized as follows: genes with low expression compared to the control group of animals, where ∆∆Ct <30 (Akt2, Mapk14, Pik3r1); genes in which no significant changes were detected in the samples compared to the control group (Irs1, Irs2, Pik3cd); no genes with high expression were observed compared to the control group.

Conclusions. In the development of experimental type 2 diabetes mellitus, genes involved in insulin signal transmission (Akt2, Mapk14, Pik3r1) exhibited significantly low expression levels (Akt2 – 2.9, Mapk14 – 5.01, Pik3r1 – 8.87) where ∆∆Ct <30, compared to the control group of animals. Conversely, no significant changes were observed in the expression of genes Irs1, Irs2, Pik3cd, also involved in insulin signal transmission, during the development of experimental type 2 diabetes mellitus, compared to the control group of experimental animals.

Prognostic value of activin A level in patients with advanced lung cancer and sarcopenia

V. V. Kechedzhyiev — Fri, 23 Feb 2024 00:00:00 +0200

The aim of this work is to determine the prognostic role of activin A in patients with advanced lung cancer and sarcopenia.

Materials and methods. Forty patients with advanced pulmonary adenocarcinoma who received treatment in the medical center “ONCOLIFE” from 2020 to 2022 were studied. Computed tomography (CT) was used to measure skeletal muscle index at the third lumbar vertebra level expressed in cm²/m². The criteria for sarcopenia using CT was <55 cm²/m² for men and <39 cm²/m² for women. Determination of activin A (DAC00B, RnD Systems) was carried out by the immunoenzymatic method based on using the “sandwich” variant of solid-phase immunoenzymatic analysis.

Results. Overall survival in patients with a high level of activin A was worse than in patients with a low level (22.7 % vs. 64.2 % respectively; p = 0.017 by the log-rank test).

Conclusions. A high level of activin A in the blood plasma can contribute to the worsening of the severity of sarcopenia, thereby affecting the survival of cancer patients. Understanding and finding new molecular targets underlying muscle atrophy will help identify new potential for treating patients with advanced cancer.

Study of the effect of bifonazole concentration on the antifungal activity of vaginal suppositories

T. V. Mielnyk, N. L. Kolycheva — Fri, 23 Feb 2024 00:00:00 +0200

The analysis of the current state of pharmacotherapy for vulvovaginal candidiasis reveals that there is a contemporary need for the development of soft dosage forms for the local treatment of infectious diseases affecting the vulva and vagina. This should be based on azole derivatives that, despite possessing a well-established wide spectrum of antifungal and antibacterial effects, have not been utilized for vaginal administration in domestic formulations. The successful realization of this project would enable the field of domestic dermatology to provide effective, compliant, and affordable drugs for gynecological practice to the general population of Ukraine. Additionally, it would establish a viable alternative to imported pharmacotherapeutic agents.

Aim. The purpose of this work is the scientific substantiation of the concentration of bifonazole in suppository compositions for vaginal use.

Materials and methods. Research was conducted to investigate the influence of bifonazole concentration ranging from 1 % to 15 % in soft dosage forms for vaginal use. Model compositions were formulated on a polyethylene oxide carrier, considering its solubility. The antifungal activity of the experimental suppository compositions was chosen as the optimization parameter and assessed using the diffusion method in agar against Candida albicans ATCC 885-653. Variance analysis of the results revealed a significant impact of bifonazole concentration on the antimycotic activity of the suppository compositions based on the model polyethylene oxide.

Results. The research results show that increasing the concentration of the active pharmaceutical ingredient in suppository masses above 10 % does not lead to a statistically significant increase in their antimycotic activity.

Conclusions. As a result of the conducted study on the antifungal effect of suppository masses with bifonazole on a model polyethylene oxide basis, it was found that the concentration of the active pharmaceutical ingredient has a statistically significant effect on the effectiveness of the soft dosage form. It was established that a ten percent concentration of bifonazole, equivalent to 0.3 g of the biologically active substance in vaginal suppositories, provides the optimal level of their antifungal effect.

Features of the clinical course of chronic pancreatitis in patients with chronic obstructive pulmonary disease

O. S. Khukhlina, I. V. Dudka, T. V. Dudka — Fri, 23 Feb 2024 00:00:00 +0200

Aim. The purpose of the study is to determine the intensity of the manifestation of clinical syndromes in the comorbid course of chronic pancreatitis (CP) in patients with chronic obstructive pulmonary disease (COPD) in comparison with the isolated course of CP and to assess the intensity of the mutual burden syndrome.

Material and methods. A prospective cohort study was conducted, analyzing the medical records of 212 inpatients. The first group comprised 96 individuals with an isolated course of chronic pancreatitis (CP), while the second group included 116 patients with CP and comorbid chronic obstructive pulmonary disease (COPD), categorized as Group E. The study focused on subjective manifestations of pain syndrome in CP, the extent of exocrine pancreatic insufficiency, clinical blood analysis, biochemical research regarding the content of markers indicating pancreatic enzyme deviation in the blood, and the level of elastase-1 in feces. Additionally, ultrasonographic examination of the organs in the abdominal cavity was performed.

Results. Patients in group 2 exhibited manifestations of abdominal pain syndrome 1.2 times more frequently than those in group 1 (p < 0.05). The frequency of pain in the pancreas radiating to the right subcostal region was 1.9 times higher in group 2 compared to group 1 (p < 0.05), along with a 2.1 times increase in the symptom of girdled pain radiating to the back (p < 0.05). Although the frequency of dyspeptic syndrome was slightly higher in group 2 (1.3 times, p > 0.05), astheno-vegetative syndrome was significantly more pronounced, exceeding the frequency in group 1 by 1.7 times (p < 0.05).

Ultrasonography parameters of the pancreas in both groups revealed characteristic signs of chronic pancreatitis (CP). The analysis of pancreatic functional state indicators during exacerbation indicated hyperenzymemia syndrome, with α-amylase activity significantly higher in patients of both groups compared to the control group – by 1.8 and 2.6 times, respectively (p < 0.05).

Conclusions. CP with chronic obstructive pulmonary disease (COPD) is characterized by a significantly lower frequency of paroxysmal abdominal pain syndrome but a higher frequency of constant aching pain in the pancreas area. Additionally, it is associated with the maximum intensity of inflammation, hyperfermentemia, a decrease in the activity of elastase-1 in feces, and a higher intensity of astheno-vegetative, painful, dyspepsia, intoxication syndromes. Moreover, there is a more pronounced exocrine dysfunction of the pancreas and more significant changes in the sonographic structure of the pancreas compared to cases with the isolated course of CP.

The influence of carotid plaque on carotid artery stiffness indicators in hypertensive patients with and without accompanying type 2 diabetes

V. V. Syvolap, A. O. Bohun — Fri, 23 Feb 2024 00:00:00 +0200

Aim. To compare the elastic properties of the common carotid arteries (CCA) in patients with stage II hypertension (HTN) depending on the presence of diabetes mellitus (DM) and atherosclerotic plaque (ASP) <50 % of carotid arteries (CA).

Materials and methods. The study included 80 patients with stage II HTN, 43 of them without type 2 DM, 37 with type 2 DM, average age – 57.7, 55.3 % men. Basic anthropometric data, laboratory indicators of lipid and carbohydrate metabolism, creatinine, data of daily blood pressure monitoring, echocardiography, intima-media thickness, local stiffness indicators: artery diameter, distensibility, the distensibility coefficient (DC), and compliance coefficient (CC), stiffness indices α, β, local pulse wave velocity (PWV), pressure and augmentation index (using radiofrequency-based technologies) were studied. Statistical analysis was performed; the probability of differences is at the level of p < 0.05.

Results. The prevalence of ASP in the carotid basin in the group of patients with HTN without DM was 51.1 %, with DM – 54.0 % (p = 0.79). While comparing the elastic properties of CCA of patients without ASP, no reliable similarities were found in the studied indicators. In patients with HTN, accompanying type 2 DM with ASP, the diameter of the CCA was significantly larger by 11.8 % (p = 0.03), and the CC was also higher by 23.6 % (p = 0.049) than in patients with HTN without DM. In patients with HTN with and without DM the limit levels for the intima-media thickness of the left CCA associated with the presence of atheroma were determined, however, the comparison of the areas under the ROC curves did not reveal a statistical difference in the cut-off values in the studied groups (р = 0.681).

Conclusions. A feature of CCA remodeling in HTN patients with DM at the stage of ASP presence should be considered a more substantial increase in the diameter of the CCA with preservation of the distensibility of the plaque-free vascular wall. The addition of a second factor (DM) to one risk factor (HTN) is not accompanied by a further statistically significant increase in IMT as a mandatory prerequisite for the appearance of ASP.