High adherence to blood pressure (BP) medical correction determines clinical and socioeconomic efficacy of antihypertensive treatment. Separate components of adherence are to be studied, including regularity of drugs intake and reasons for non-compliance with medical recommendations in different categories of patients. Aim. Evaluation of antihypertensive drugs (AHD) intake regularity (as a component of treatment adherence) and factors it is influenced by in hypertensive patients who had for the first time visited a specialized cardiology center during the 6-month follow-up after the primary consultation. Material and methods. First, a number of hypertensive patients who had visited a cardiologist of one of Moscow's district cardiology clinics for the first time in 2010 (n=1766) had formed a sample of the study participants. The expert cards were filled out in accordance with the primary medical documentation data. The second step was conducted 6 months after the first visit by a phone survey with the completion of questionnaires (n=1419). Results. Majority of respondents (74.9%) had been taking AHD regularly 6 months after the primary consultation and 16.2% of the patients had been using them occasionally. 8.9% of the respondents completely refused to control hypertension with drugs. Respondents of male sex (OR=1.4), with poor BP self-control in home settings (OR=2.5), unable to get drugs under the medicine assistance scheme (OR=1.8), those without coronary heart disease (OR=1.9), with hypertension duration less than 5 years (OR=1.9), with changes in antihypertensive therapy regimen as compared to the one recommended by a cardiologist (OR=1.5), those who had 1-2 drugs in the treatment regimen at the moment of the survey (OR=2.4) and patients who had no fixed drug combinations in the treatment scheme (OR=1.4) were shown to have significantly higher probability of irregular AHD intake or complete treatment refusal. Conclusion. Outpatients of the specialized cardiology center are characterized by rather high treatment adherence by AHD intake regularity. We have revealed a number of factors that significantly correlate with reduced antihypertensive treatment adherence. These factors must be taken into account at treatment regimen selection and patients' follow-up.

Arterial hypertension is a disease which leads to severe negative social and economic consequences. Pharmacoepidemiologic studies allow assessment of present situation on high blood pressure (BP) treatment and search of ways of its efficacy improvement. Aim. To study treatment of hypertensive patients who had visited the cardiology referral clinic for the first time and to assess treatment dynamics over the following 6 months with the estimation of its efficacy. Material and methods. The study included two steps. At the first step a primary sample of the study participants was formed out of hypertensive patients who had visited for the first time a cardiologist in one of the Moscow district cardiologic dispensary in 2010 with the further completion of expert cards in accordance with the primary medical documentation (n=1766). At the second step the phone survey was conducted 6 months after the first visit with the completion of special questionnaires (n=1419). Results. Recommendations for antihypertensive treatment given to the cardiologic dispensary patients are in line with the current guidelines, and 6 months after the first visit 91% of the patients had continued antihypertensive treatment. However, the efficacy of BP control turned out to be low: target BP level was only detected in 28.8% of the patients, and 36.7% of the respondents developed hypertensive crises during the 6 months. Conclusion. Despite the follow-up in the referral clinic and the intake of the prescribed drugs the patients revealed low efficacy of BP control. The reasons for this fact require further investigation. Probably, the improvement of BP control requires implementation of special education and motivational techniques as short-term contact with specialists does not lead to high efficacy of antihypertensive treatment.

The features of performing and the main directions of research on objects of forensic fine art examination, namely works of painting. It is noted that according to the performance technique, the painting is divided into oil, tempera, watercolor and encaustic painting (wax as a binder of paints). Proved the need to know the expert of the painting technology. It is important to distinguish the materials that served as the basis, since each of them has its own composition, structure and features, which tells on their properties, and this, in turn, affects the character and condition of all components of painting and, in particular, the colorful layer as the most defining feature. Different types of craquelure and its origin are considered. It is indicated that craquelure is formed under the action of various factors, and therefore it differs both in form, location-oriented disposition, and formation method.The criteria for determining the composition creation time and its authenticity are defined. It is noted that craquelure is one of painting authenticity features, therefore, on non-authentic composition, in order to pass them off as genuine, craquelure is formed by means of mechanical action that is fairly easy to recognize, or by means of painting technology violating. Considered the need for comprehensive research. It is proved that correspondence of an handwriting to the author handwriting in the signature is one of the most important features of composition authenticity which is determined according to the methods of forensic handwriting researches by the relevant specialists and it is performed as a comprehensive fine art and handwriting examination. Another of the most important authenticity features is the correspondence of the chemical composition of coloring pigments and their origin to the time of applicability and time of composition creation which is determined with the involvement of the appropriate specialists in while performing a comprehensive forensic fine art and chemical examination.

No abstract

Objective: To estimate the economic benefits of using a fixed combination of bisoprolol/amlodipine in patients with arterial hypertension (AH).Design and method: the study included 61 patients with uncontrolled hypertension who were randomized in 2 groups. Patients of the 1st group (n = 30) received the ACE inhibitor ramipril 10 mg/day (Hartil, Egis), a fixed combination of bisoprolol and amlodipine (Concor AM, Takeda) in various doses for 12 weeks. Patients of group 2 (n = 31) recommended treatment at the discretion of the physician, be sure to include a free combination of ACE inhibitor, generic beta-blocker and dihydropyridine calcium antagonist (amlodipine). To assess the economic efficiency was calculated indicators cost/effectiveness (CER), where the cost takes into account only the direct costs for the purchase of medicines, as efficiency -changes in blood pressure (BP), the dynamics of pulse wave velocity in the aorta (PWVao) and augmentation index (Aix).