Introduction. A significant part of scientific publications on ensuring the availability of medicines in Ukrainian scientific and specialized publications is devoted, in particular, to the following issues: selection and optimization of methods for calculating prices for medicines and reference pricing, monitoring of prices for medicines, assessment of the availability of medicines, assessment of health technologies (medical technology assessment). The publications also address the issues of pricing for personalized medicines (extemporaneous manufacturing) and accounting for the release of medicines of different groups. However, the aspects of informatization of medicines price regulation from the point of view of pharmaceutical informatics have not been specifically considered. Therefore, the purpose of the study was to analyze the presented structures of information on nomenclature items of medicinal products in the regulatory legal acts on the regulation of prices for medicinal products in Ukraine. Based on the data obtained: to substantiate the feasibility of using a single identifier of the nomenclature position of a medicinal product in regulatory legal acts, to determine and systematize the format, scope and level of its application; to identify possible ways to reduce the number of regulatory legal acts regulating the prices of medicinal products in Ukraine. Material & methods. The objects of the study were information sources on the state regulation of pricing for medicines: regulatory acts, analytical documents, official websites of government agencies and specialized publications, scientific works of domestic scientists. The following methods were used in the study: descriptive statistics, systematization, grouping and generalization of the results. Results & discussion. The article analyzes the state of information on nomenclature items of medicinal products in the regulatory legal acts of the Ministry of Health of Ukraine on pricing: international nonproprietary names / common names of active pharmaceutical ingredients, names of manufacturers of medicinal products and codes of anatomical, therapeutic and chemical classification. The results of the work are presented as statistical data and examples of nonstandardized names of the above objects. Based on the data obtained, the problems caused by the state of submission of non-standardized information are described and ways to solve them are proposed. Conclusion. The basic method of information structure for recording information about medicinal products in the relevant registers and regulatory acts with regard to unique identifiers of nomenclature items is proposed. The author substantiates the need to create and use unified registers to ensure the possibility of automated generation of information on nomenclature items of medicinal products for regulatory legal acts. The lack of unified standards for the presentation of information on medicinal products in regulatory acts and medicinal product identifiers makes it impossible to use automated methods of information analysis, especially in the time dynamics. This, in turn, makes it impossible to use the results of the analyzes when making forecasts. The current structure of regulation and information provision may lead to cases where information in some regulations contradicts each other. The constant change in the validity of regulatory legal acts makes it impossible to create an up-to-date permanent reference to the latest information, and creates additional difficulties for practicing pharmacists who must comply with the standards and data specified in these legal acts in their daily work. The author substantiates the expediency of creating a single regulatory legal act on the regulation of prices for medicinal products for each of the regulatory authorities/structures. The author proposes to create a single legally approved URL with only relevant information on pricing aspects and the availability of an online chat and a public web forum where experts will provide quick responses to requests from practitioners.
Keywords: information, identification, standardization, regulations, registers, wholesale prices
The aim. To study the biocomplex of surfactants based on rhamnolipids Pseudomonas sp. PS-17 (biocomplex PS) as an emulsifier and co-emulsifier by using the method of modelling the composition of emulsions for use in dermatology.
Materials and methods. The biocomplex PS is a biogenic surface-active complex synthesized by bacteria of the genus Pseudomonas, which is a viscous mass that includes rhamnolipids, which make up to 80 % of the biocomplex, as well as alginate and water. The methods of computer simulation of semi-automated selection of the composition of the oil phase and emulsifiers of medicinal or cosmetic emulsions developed in the MO Excel program were used. In modelling processes, the biocomplex PS was studied as an independent emulsifier in o/w type emulsions, as well as a co-emulsifier of this type of emulsions in combination with type II emulsifiers.
Results. The substantiation of the concentration of emulsifiers in the composition of emulsion medicinal and cosmetic products is mainly carried out based on experimental studies; therefore, it requires a long time and is expensive. To reduce the number of technological experiments in the development of emulsion products stabilized by a biocomplex of surfactants based on biocomplex PS, a method of computer simulation of the composition of emulsions in the MO Excel program was developed and used. A method based on the application of the hydrophilic- lipophilic balance system. Two examples of solving specific problems of choosing a complex emulsifier and the composition of the oil phase components of the emulsion product are given.
Conclusions. The use of a semi-automated modelling system provides a reasoned choice of the composition of the oil phase of the emulsion when using the PS biocomplex as an independent emulsifier or the choice of the ratio between the PS biocomplex and the type II emulsifier when using a complex emulsifier and allows rational experimental study
Keywords: emulsions, emulsifiers, rhamnolipids Pseudomonas sp. PS-17, medicines, cosmetics, hydrophilic-lipophilic balance, emulsions, emulsifiers, rhamnolipids Pseudomonas sp. PS-17, medicines, cosmetics, hydrophilic-lipophilic balance
The aim of the study management of medical institutions in the context of providing medical and preventive care in conditions of COVID-19 is an urgent research problem because it provides detection of management’s effective mechanism in times of crisis. It was to identify the management’s peculiarities of medical institutions in the context of providing medical and preventive care in conditions of COVID-19. The article uses a qualitative content analysis method, a method of comparison, and a method of analysis of countries’ cases in the context of rendering medical and preventive care in Ukraine, Spain, Italy, Germany, and the Czech Republic. The article identifies the main elements of the health system management mechanism during the pandemic, which includes coordinated work by stakeholders to ensure a coordinated response to the emergency. The mechanism includes the organizational, legal, and financial components of cooperation between agencies and ministries of national, regional level, involvement international organizations in the process of development of policy and tactics, management crisis’ strategies. Strategic documents of the national level are one of the main elements of the management’s system.
Despite the war, or maybe because of it, progress was made in the European integration process: in June 2022, Ukraine entered the status of an applicant for the EU state. Along with this, the requirements remain the same as before, and improving the level of medicine and healthcare is among them. The purpose of writing an academic paper was to familiarize Ukraine’s citizens with equal access to quality medical services, as a result of changes to orient the system and to place the patient in its center. The research methods were analysis, synthesis, generalization, explanation and data qualification. The regional office of the World Health Organization for Europe (WHO / Europe) became the first and main source for the disclosure of the topic outlined (World Health Organization). The present scientific work will reveal the possible consequences of European integration for Ukrainian medicine. It is important to understand that the arguments of this research are not entirely academic, because it is impossible to know when the war will end and whether Ukraine will not remain a buffer zone for the EU countries. Nevertheless, regardless of the development of events, it is important to critically assess the role of the European Union and its interests in Ukraine.
HIGHLIGHTS
The reform of the health care system in accordance with the goals of sustainable development in the EU countries is analyzed.
The research reveals the possible consequences of European integration for Ukrainian medicine. The research reveals the possible consequences of European integration for Ukrainian medicine.
УДК 616.24-007.241-036.12:612.014.4]-036-092
Метою дослідження було визначити клініко-лабораторні особливості запальних фенотипів серед пацієнтів з хронічним обструктивним захворюванням легень, помірним порушенням функції зовнішнього дихання та анемією хронічного захворювання.
Об’єкт та методи. Обстежено 150 пацієнтів із загостренням хронічного обструктивного захворювання легень та анемією хронічного захворювання, в яких було визначено фенотипи запалення, серед яких найбільшу частку становив нейтрофільний (66/44,0±4,0%), меншу лімфоцитарний (35/23,3±3,4%) та еозинофільний (16/10,7±2,5%). У 33/22,0% хворих фенотип запалення був змішаним і пацієнти були виключені з дослідження.
Серед 117 пацієнтів, включених до дослідження, було 67,5% чоловіків та 32,5% жінок середнього (25,6%), похилого (42,7%) та старечого (24,8%) віку. Результати опрацьовано методами варіаційної статистики, поріг істотності р<0,05.
Результати. Встановлено, що за аналізом периферійної крові та біохімічними параметрами, незалежно від патофізіологічного характеру запалення, у всіх групах спостерігались помірні порушення функції зовнішнього дихання, нормохромний нормоцитарний характер анемії хронічного захворювання легкого ступеня з активацією усіх компонентів зовнішнього механізму згортання та збільшеним протромбіновим часом та запалення (за підвищенням значень С-реактивного протеїну та серомукоїдів). Нейтрофільний фенотип запалення, у порівнянні з лімфоцитарним та еозинофільним, зустрічався найчастіше, та супроводжувався найбільш вираженим анемічним синдромом, найвищою активністю системного запалення та найбільш вираженим синдромом ендогенної інтоксикації з погіршенням функціонального стану печінки. Лімфоцитарний фенотип запалення виявився другим за частотою, та характеризувався найбільш вираженим нормохромним анемічним синдромом з найбільш вираженою схильністю до гіперкоагуляції та найвищим протромбіновим індексом серед усіх типів запалення, та з високою активністю синдрому запалення. Еозинофільний фенотип запалення зустрічався істотно рідше, ніж нейтрофільний та лімфоцитарний, з найбільш сприятливими характеристиками анемічного синдрому, з невисокою активністю запалення та найменшою вираженістю синдрому ендогенної інтоксикації, однак найвищим вмістом глюкози крові натще на рівні нормо-гіперглікемії.
Висновок. Клініко-патофізіологічне фенотипування хронічного обструктивного захворювання легень дає можливість визначати не лише активність запалення, але й вираженість анемічного синдрому, ендогенної інтоксикації, стану печінки та вуглеводного метаболізму, що має практичне значення як для лікарів, так і для науковц
The purpose of the study was to determine the clinical and laboratory features of inflammatory phenotypes among patients with chronic obstructive pulmonary disease, moderate respiratory failure and anemia of chronic disease.
Materials and methods. The study included 150 patients with exacerbation of chronic obstructive pulmonary disease and chronic anemia, in which inflammatory phenotypes were identified, among which the largest share was neutrophilic (66/44.0±4.0%), less lymphocytic (35/23.3±3.4%) and eosinophilic (16/10.7±2.5%). In 33/22.0% of patients, the inflammatory phenotype was mixed and patients were excluded from the study. Among 117 patients included in the study, 67.5% were men and 32.5% were middle-aged (25.6%), elderly (42.7%) and senile (24.8%). The results were processed by the methods of variation statistics, the materiality threshold p <0.05.
Results and discussion. It was established, that peripheral blood analysis and biochemical parameters, regardless of the pathophysiological nature of inflammation in all groups showed moderate dysfunction of external respiration, normochromic normocytic nature of mild chronic anemia with activation of all componentsof the external coagulation mechanism and increased prothrombin time and inflammation activation (by C-reactive protein and seromucoids). The neutrophilic phenotype of inflammation, in comparison with lymphocytic and eosinophilic, was the most common and was accompanied by the most pronounced anemic syndrome, the highest activity of systemic inflammation and the most pronounced syndrome of endogenous intoxication with deterioration of liver function. The lymphocytic phenotype of inflammation was the second widespread and was characterized by the most pronounced normochromic anemic syndrome with the most pronounced predisposition to hypercoagulation (the highest prothrombin index) with high activity of the inflammatory syndrome. The eosinophilic phenotype of inflammation was significantly less common than the neutrophilic and lymphocytic with the favorable characteristics of the anemic syndrome and with low inflammatory activity and the small activity of endogenous intoxication but the highest fasting blood glucose level as normo-hyperglycemia.
Conclusion. Clinical and pathophysiological phenotyping of chronic obstructive pulmonary disease makes it possible to determine not only the activity of inflammation, but also the severity of anemic syndrome, endogenous intoxication, liver status and carbohydrate metabolism, which is of practical importance for both physicians and scientists.