Introduction. Employees of the main occupations of metalworking production are exposed to a complex of harmful production and non-production factors contributing to the formation of bronchopulmonary pathology. The identification of priority factors leading to the development of diseases of the respiratory system is important in order to develop methods of effective prevention of bronchopulmonary diseases in employees of the metalworking industry. Materials and methods. As part of the cross-sectional study, the medical and social aspects and the health status of three hundred metalworking employees were studied. A hygienic assessment of the factors of the working environment and the labour process was carried out. The results of the study were statistically processed using the Statistica 10 software. Results. There was a discrepancy in the number of workers with an established diagnosis of bronchopulmonary disease and the number of workers complaining from the respiratory system and having physical and spirometric disorders. Workers were established to be exposed to a complex of harmful chemicals of hazard classes 1–4, having an irritating, carcinogenic, sharply directed mechanism of action on the human body (classes 2–3.2) and aerosols of predominantly fibrogenic action (class 2). The harmful chemical factor affecting metalworking employees did not have a significant effect on the formation of functional disorders of the respiratory system. The priority risk factor for the development of bronchopulmonary pathology in metalworking employees is the use of tobacco smoking products. Limitations. The study has regional (Saratov region) and occupational (metalworking employees) limitations. Conclusion. The priority risk factor for the development of bronchopulmonary pathology is the use of smoking tobacco products, and the impact of a harmful chemical factor that had an insignificant effect on the formation of functional disorders of the respiratory system of metalworking employees.

Objective: to study the level of inflammatory biomarkers and growth factors in the peripheral blood of patients with chronic cerebrovascular disease (CCVD) and anamnesis of coronavirus infection COVID-19.Material and methods. The study included patients with CCVD (n=41), 26 of them had a documented anamnesis of coronavirus infection within 4 months before inclusion in the study, 15 people did not have COVID-19. The control group consisted of 20 apparently healthy individuals of the same age. Neuroimaging was performed using a Philips Achieva 1.5 T device. Pro-inflammatory cytokines were determined in blood serum – tumor necrosis factor α (TNF α ), interleukin 6 (IL6), IL18, interferon γ (IFN γ ); chemokines – monocytic chemoattractant protein 1 (MCP-1), IL8; growth factors – vascular endothelial growth factor type A (VEGF-A), transforming growth factor β 1 (TGF β 1).Results. In patients with CCVD, compared with the control group, an increase in the level of proinflammatory cytokines (TNF α , IL6, IL18), chemokines (MCP1 and IL8), a decrease in the concentration of IFN γ , and divergent changes in the content of growth factors (VEGF-A and TGF β 1) were noted. Patients who recovered from COVID-19 showed an increase in the level of IL6 and a decrease in the level of IFN γ compared with those who had not been ill, which indicates a persistently high activity of immunoinflammatory processes and an insufficient humoral immune response.Conclusion. Postponed coronavirus infection COVID-19 aggravates the existing endothelial dysfunction and intravascular inflammation in patients with CCVD, which may probably require changes in their treatment and prevention strategies in the future.

Introduction. Anxiety-depressive disorders are among the most common psychiatric disorders in the group of borderline conditions, and antidepressants are widely used for their treatment. Around the world, there is an active development of new drugs with thymoanaleptic activity, as well as in-depth study and comparison of the efficacy and safety of existing drugs. Due to this, the approach to psychopharmacotherapy of anxiety-depressive disorders and the very structure of prescribing antidepressants are constantly changing. Thus, the analysis of the structure of prescribing antidepressants, as well as the identification and justification of the changes that this structure inevitably undergoes over time, becomes extremely relevant. Purpose of the study. Conduct a pharmacoepidemiological analysis of the structure of prescribing antidepressants to patients with anxiety-depressive disorders of the neurotic register (F 06.41 — Organic anxiety disorder due to cerebrovascular disease, F 41.0 — Panic disorder (episodic paroxysmal anxiety), F 41.2 — Mixed anxiety and depressive disorder and F 45 — Somatoform disorders according to ICD-10) in two comparable groups of patients treated in the Department of Crisis States of the Clinic of Hematology and Occupational Pathology of the SSMU in 2010–2012 and 2019–2021 respectively. Materials and methods. The volume of antidepressant prescriptions was assessed, taking into account dosages and treatment regimens, using the «Defined Daily Doses» technique in each of the study groups. Differences in the structure of prescribing antidepressants in the study groups were identified and analyzed, as well as the causes and prerequisites for their occurrence were investigated. Results. The conducted comparative pharmacoepidemiological study revealed discrepancies in the structure of antidepressant prescriptions in the 2010–2012 groups. and 2019–2021 Maprotiline was in second place in terms of prevalence in the 2010–2012 group, while in the 2019–2020 group never been appointed. By the end of the decade, the frequency of prescribing clomipramine significantly decreased, which in the 2010–2012 group ranked third in terms of appointments. When comparing groups of 2010–2012 and 2019–2021 it was found that in the first case, the volume of clomipramine prescriptions was almost 6 times higher. There is a trend towards an increase in the volume of prescriptions for almost all drugs of the SSRI group, both individually and for this group as a whole. The structure of prescriptions is significantly influenced by such factors as an in-depth study of the main and side effects of drugs, accessibility for patients and the volume of supplies of individual drugs to the territory of the Russian Federation. Conclusion. Modern pharmacoepidemiological studies make it possible to study in depth the advantages and disadvantages of each specific antidepressant, so that in each clinical case it is possible to choose the most suitable drug or combination thereof. It is necessary to continue and increase the scale of such studies, maintaining their independence from the financing of pharmaceutical companies, as well as to expand the local market for psychopharmacotherapeutic agents so that its limitations do not reduce the effectiveness of the therapy on a large scale.

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Introduction. The problem of choosing antidepressants in the pharmacotherapy of depression remains relevant over the past decades, not only due to the annual steady increase in the number of depressive disorders around the world, but also with the appearance of new drugs of this group on the pharmaceutical market. In addition, the costs of diagnosing and treating anxiety-depressive states are increasing, as is the financial loss associated with the disability of patients due to depression. Thus, it is extremely important to analyze the structure of prescribing antidepressants in anxiety-depressive disorders and the structure of financial costs. Purpose of the study: To conduct a pharmacoepidemiological and pharmacoeconomic analysis of the prescription of antidepressants to patients with neurotic disorders of an anxiety and anxiety-depressive nature (F 41.0 – Panic disorder (episodic paroxysmal anxiety), F 41.2 – Mixed anxiety and depressive disorder, F 45 – Somatoform disorders, F 06.41 – Organic anxiety disorder in connection with cerebral vascular disease (according to ICD-10)) on the basis of the Department of Crisis Conditions of the Clinic of Hematology and Occupational Pathology of the SSMU in 2019-2021 and to reveal the correlation between the structure of costs and the structure of prescribing antidepressants. Materials and methods. The volume of antidepressant prescriptions, taking into account dosages, treatment regimens and treatment outcomes using the method of “Defined daily doses”, was assessed. The structure of financial costs for prescribed drugs was investigated, and an analysis of the demographic data of patients (gender and age), as well as their history of life and illness, was carried out. Results. The carried out pharmacoepidemiological and pharmacoeconomic studies made it possible to determine that there are discrepancies between the structure of prescribing antidepressants and the structure of financial costs. The most commonly prescribed antidepressant was amitriptyline, while it accounted for a very small proportion of the cost. Trazodone incurred the maximum financial costs, and therefore its high cost seriously limited the possibilities of its prescription. Pipofezin, which has great potential for expanding use, ranks second in both the cost structure and the structure of prescriptions. In the course of the study, the features of the drugs that determined the prevalence of their prescription were identified and their advantages and disadvantages were assessed. It was noted that some antidepressants, which could potentially be more effective, turned out to be unavailable to patients due to the high price or absence in the city pharmacies. Conclusion. Based on the study, it can be concluded that it is advisable to conduct a full-scale clinical study in order to determine the pharmacoeconomic effect of pipofezin in comparison with other antidepressants.