The emergence of new means of administering genetically-engineered biological drugs, such as an autoinjector (pen injector device), can positively affect the organizational aspects of treating patients with severe eosinophilic asthma (SA) who need biological therapy.The aim. To determine the place of a new delivery device for benralizumab (autoinjector, pen injector device) in the clinical practice of treating eosinophilic SA.Results. The expert council considered the results of the latest clinical studies and real practice data on the use of genetically-engineered biological drugs in the form of an autoinjector. The experts discussed the safety and efficacy of this delivery device and recommended considering the possibility of switching eosinophilic SA patients to self-administration of genetically-engineered biological drugs (autoinjector form) at home. This treatment tactic is especially relevant in the current epidemiological situation since it will reduce the risks of infection compared to planned medical care in inpatient or outpatient treatment settings and reduce the burden for healthcare workers.Conclusion. The practice of switching eosinophilic SA patients to self-administration of biologics in the form of an autoinjector (pen injector device) can improve the adherence to biological therapy and quality of life of this group of patients.

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Наиболее целесообразным методом ретроспективной оценки расходования ресурсов, выделяемых на лекар ственное обеспечение, является ABC/VEN анализ (оценка рационального использования денежных средств по 3 классам в соответствии с их фактическим потреблением за предыдущий период / сегментация ассортимента), который может быть использован и для расчета потребности в финансовых средствах. АВС/VEN анализ -методология оценки рациональ ности использования денежных средств на лекар ственное обеспечение, признанная эффективной в мировой практике лекарствоведения, рекомендо ванная Всемирной организацией здравоохранения (ВОЗ) к по всеместному применению и используемая во всем мире. Проведение ABC/VEN анализа обеспе чивает достаточную объективность при анализе рас ходов государства на лекарственное обеспечение и помогает свести к минимуму затраты в процессе за купок [1].АВC анализ (анализ Парето -ВОЗ) -метод оцен ки структуры расходов на лекарственное обеспечение, позволяющий определить наиболее дорогостоящие направления расходов посредством распределения ле карственных препаратов по 3 классам, в зависимости от объемов их потребления на протяжении определен ного периода (стоимость единицы препарата умножа ют на количество его упаковок). Деление на классы осуществляется следующим образом: класс А состав ляют лекарственные средства, на которые расходуется основной объем (80 %) лекарственного бюджета; класс В -лекарственные средства средней группы, затраты на которые составляют 15 % всех расходов; класс С -лекарственные средства оставшейся части ассортимента с низкой частотой использования (≤ 5 % общей суммы расходов) [2].Одним из важных параметров контроля финан совых и трудовых затрат, связанных с закупками ле карственных средств, является размер заказа. Целью при установлении объема заказов, естественно, должно быть снижение до минимума их числа за 1 год, позволяющее получить наиболее благоприят ные цены, а также, одновременно -сокращение за пасов лекарственных средств. Это кажущееся проти воречие задач может быть устранено посредством АВС анализа, иначе называемого стоимостным. При помощи АВС анализа лекарственные средства распределяются по 3 группам в соответствии с их го довым потреблением. Такое распределение позволяет The ABC/VEN analysis of drug provision in a pneumology department of a multi disciplinary hospital SummaryThe study of reasons for admission to a hospital and the ABC/VEN analysis of drug provision a pulmonology department of a multi disciplinary hospital in 2009-2011 has been carried out. Among reasons for admission to a hospital, airway obstructive disease and respiratory infections were the most often (69.8-70.5 %). Yearly, a deal of obstructive airway disease, mainly of asthma and chronic obstructive pulmonary disease, has been increasing. A list of medications for treatment of these patients according to the International Nonproprietary Names (INN) for pharmaceutical substances was extended from 141 in 2009 to 246 items in 2011. The ABC/VEN analysis has shown that the expenditure of financial resources...

Aim    To evaluate the incidence rate of major adverse cardiovascular events (MACVE) in the long-term following percutaneous coronary interventions (PCCI) in patients with acute and chronic ischemic heart disease (IHD) and the contribution of concurrent chronic obstructive pulmonary disease (COPD) to the long-term prediction.Material and methods    This prospective cohort study included 254 patients with IHD and concurrent COPD and 392 patients with IHD without COPD. PCCI was performed in all patients: for acute coronary syndrome in 295 patients and for chronic IHD in 351 patients. The follow-up period lasted for up to 36 months. The outcome was a composite endpoint, MACVE, that included cardiovascular death, myocardial infarction, stroke, repeated unscheduled myocardial revascularization (MR), and the time to the event.Results    The age-standardized incidence of MACVE in patients with IHD and COPD was 31.5 vs. 23.2 % in patients with IHD without concurrent COPD (p=0.025), primarily due to an increased frequency of repeated unscheduled MR (20.5 vs. 14.0 %, p=0.041), which was associated with earlier occurrence of adverse events (p<0.001). Repeated unscheduled MR was more frequently performed in patients with moderate COPD; the frequency of MR decreased with increasing severity of COPD, whereas the total incidence of cardiovascular death, myocardial infarction, and stroke was the highest in patients with severe and very severe COPD.Conclusion    The presence of concurrent COPD increases the relative risk of MACVE 1.36 times (95 % confidence interval: 1.05–1.75) and facilitates their earlier development. Repeated unscheduled MR makes the major contribution to the increase in the total risk (relative risk, 1.46; 95 % confidence interval: 1.03–2.06). The increase in severity of COPD is associated with the increase in total frequency of MACVE (p=0.005).

A 22-year-old pregnant woman (34.6 weeks of pregnancy) with A(H1N1) influenza-associated acute respiratory distress syndrome was admitted to the intensive care unit. Results. The patient was connected to femoral-jugular veno-venous extracorporeal membrane oxygenation (ECMO) 2 hours after admission. On the 2nd day of ECMO support, in connection with the beginning of labor activity and a threat to the life of the mother and fetus, the decision was made on the implementation of caesarean section (CS) without the termination of ECMO. CS was performed under general anesthesia, 2 hours after discontinuation of heparin infusion. Were extracted a premature baby girl, weighing 2380 g. Intraoperative period was complicated by atonic uterine bleeding, requiring a hysterectomy. On the 16th day the patient was successfully weaned from ECMO and was discharged after 11 days. The newborn was discharged from the clinic in a satisfactory condition after 24 days with a weight of 2860 g. Conclusion. This is the first case in Russia of successful use of ECMO and emergency cesarean section (CS) during ECMO in a pregnant woman with acute respiratory distress syndrome (ARDS) due to complications of influenza A(H1N1).