Vol 24, No 1 (2022)

The use of drugs in pediatrics has a number of features and is associated with a number of applied problems. Medical workers are often faced with the prescription of drugs «off-label», lack of drugs in appropriate doses for children and, accordingly, with the need to develop appropriate dosage forms. The article discusses the issues of the safety of the use of drugs in children and the principles of drug provision in pediatrics. The issues of drug provision in pediatrics are considered. It was shown that the largest number of children’s dosage forms was registered in the group of drugs acting on the central nervous system, mainly in the subgroup of analgesics. In the groups of drugs that act on the cardiovascular system, regulate metabolic processes, for the treatment of infectious diseases, children’s dosage forms are presented in an extremely limited number, and in the groups of drugs for the treatment of malignant neoplasms and diagnostic drugs, there are simply no special pediatric dosage forms. The topic is a continuation of an article published in the journal «Medizinskaya Sestra» /Nurse (Rus) in 2020 (Grigoriev K.I. and Vykhristyuk O.F, «Medicines and children. Problems of the XXI century»: vol. 22, №1: 5-14).

The problem of infections associated with the provision of medical care or nosocomial infections does not lose its relevance. The formation of hospital strains of microorganisms has their own characteristics, namely, the adaptation of pathogens to hospital conditions, the struggle for nutritional niches, homogenization, clonal distribution, and the formation of an artificial ecological system. A stable trend towards a decrease in species diversity and the displacement of unstable bacterial strains under the influence of disinfectants and the unjustified use of antimicrobial drugs leads to multidrug resistance of microorganisms, which increases the hospitalization period of patients, complicates the treatment of the underlying disease, and increases the risk of mortality among persons with immunodeficiency. This article discusses the ways of spreading infection associated with the provision of medical care in a surgical hospital, risk factors and a modern strategy for the prevention of nosocomial infections. This article discusses the routes of infection associated with the provision of medical care in a surgical hospital, risk factors, and the current strategy for the prevention of nosocomial infections.

Mortality from viper bites among the adult population ranges from 2–12%, in children it is even higher – about 25%. According to the I.I. Janelidze Research Institute of Emergency Medicine, an average of 7 to 12 people annually seek help, while snake venom poisoning with a fatal outcome is noted. Mortality after the bite of the common viper is about 1% of the total number of victims.

According to the mechanism of action, the poisons of all snakes are divided into three groups, and this is due to their composition. Snake venoms have a complex composition, in addition to exotoxins, proteins with specific properties (neurotoxic, hemolytic, cardiotoxic), they contain enzymes that determine the species specificity of snake venom. The venom contains proteases, hyaluronidase, trypsin and thrombin activator enzymes with kallikrein-like action.

To date, the mechanisms of action of many snake venom toxins have been established (crotoxin; caudoxin; viperotoxin; crotamine; serine proteases; thermolabile proteins; beta-bungarotoxin; mojavetoxin; textilotoxin; typoxin; notexin); they have been shown to alter the activity of enzymes, receptors or ion channels, thus disrupting the normal functioning of the central or peripheral nervous system, cardiovascular system, muscular system, coagulation system and hemostasis.

Many species of snakes contain toxins of various types of exposure in one venom. The main toxic effect of the venom of the common viper is due to the presence of hyaluronidase, phospholipase-A2 and proteolytic enzymes in it. When such a poison enters the tissues, extensive hemorrhagic edema develops, due to both vascular and tissue permeability, and a violation in the coagulation potential of the blood. The body’s reaction to the bite is accompanied by the release of histamine, bradykinin, prostaglandins and serotonin. The release of biologically active substances leads to a violation of vascular permeability and a drop in BCC, with a decrease in systemic blood pressure. One of the severe coagulopathies against the background of snake bites of these families is the development of disseminated intravascular coagulation with typical multiple organ lesions. Possible development of cortical or tubular necrosis of the kidneys. And if medical care is not provided in time, a person may die.

From practical activity in medicine, it is customary to determine the danger of a snake not from the degree of toxicity of the poison, but in accordance with the categories of danger. And the combined experience of professional herpetologists and physicians allowed us to develop very simple first aid rules.

Arterial Hypertension is the leading risk factor for the development of cardiovascular diseases. AH is commonly understood as a chronically occurring disease in which an increase in blood pressure is not associated with the identification of obvious causes leading to the development of secondary forms of hypertension. AH prevails among all forms of hypertension; its prevalence is over 90%. Сardiovascular diseases and cerebrovascular disease, presented in official statistics as diseases of the circulatory system, are the leading causes of mortality in the Russian Federation, their share of the total number of deaths from all causes accounts for 48% of deaths. In the Russian population, the prevalence of hypertension among men is slightly higher, in some regions it reaches 47%, among women the prevalence of hypertension is about 40% [1]. According to experts, by 2025 the number of people with hypertension will increase by 15-20%, reaching about 1.5 billion people. This article is devoted to the etiology, pathogenesis, classification, diagnosis, approaches to the treatment of hypertension.

The article is devoted to the results of the study of the problem of prevention of diseases of the musculoskeletal system in nurses. The study examined the working conditions of nurses, conducted a self-assessment of the health status of the musculoskeletal system in nurses, preventive measures and self-assessment of knowledge of the rules of biomechanics and ergonomics of nurses in medical organizations in Moscow. The paper reveals the diseases of the musculoskeletal system, the reasons for which they appear, as well as the types of prevention.