Background. 5-fluorouracil (5-FU) is a basic chemotherapeutic agent, but its clinical use is limited by rapid metabolism and high toxicity. The development of controlled release systems based on polymethacrylic acid (PMAA) allows for an improved pharmacokinetic profile of the drug, which requires validation of analytical methods for the resulting compound to ensure the quality requirements of such polymer systems.

Objective. Development and validation of a method for the quantitative determination of 5-FU in a PMAA based polymer complex using UV spectroscopy in various media simulating biological conditions.

Materials and methods. The object of the study was a lyophilized polymer complex of 5-FU and PMAA, obtained by liquid phase synthesis. The analysis was performed by UV spectroscopy on a Shimadzu UV-1800 instrument at a wavelength of 265–267 nm. The method was validated in accordance with the State Pharmacopoeia XV for the following parameters: specificity, linearity, accuracy, repeatability, and intralaboratory precision (with the participation of two operators). The studies were conducted in three media: purified water, phosphate buffer (pH 7.4 blood) and citrate buffer (pH 5.1 intracellular medium).

Results. Complex formation via hydrogen bonds between 5-FU and the carboxyl groups of PMAA was confirmed. The method was deemed specific, as the polymer carrier does not absorb in the analytical range (265 nm). A linear relationship was established (R[2] > 0.999). The recovery rate (accuracy) ranged from 98.48 % for a citrate buffer solution to 99.23 % for a phosphate buffer solution. The coefficient of variation (RSD) during precision testing did not exceed 2 %, confirming that the proposed method has satisfactory repeatability (convergence) and ensures reproducible results with multiple sample analyses under identical conditions. Calculated Student's and Fisher's t-tests confirmed the absence of systematic errors between operators. The study revealed that in an acidic environment (pH 5.1), the release of 5-FU was 15.92 % higher than at pH 7.4, confirming the pH sensitivity of the system.

Conclusions. The developed spectrophotometric method fully meets validity requirements and can be used for quality control of PMAA based polymeric 5-FU delivery systems. The demonstrated selectivity of 5-FU release in an acidic environment confirms the potential of using polymeric complexes for targeted delivery to tumor tissue.

Background. The problem of antimicrobial resistance is one of the main challenges of modern medicine. Bacteriophages represent a promising approach in the treatment of infectious diseases, particularly in the treatment of wound infections. However, the use of bacteriophages in clinical practice is associated with a number of technological problems, the key ones being the methods of their delivery to the site of infection and maintaining their therapeutic concentration in the area of clinical interest. To achieve this goal, the use of polymeric materials as bacteriophage carriers holds promise. Polyurethane foam is a potential material for the creation of wound dressings due to its porous structure, elasticity, and biocompatibility.

Objective. The aim of this study was to develop a prototype wound dressing based on modified polyurethane foam for the immobilization of bacteriophages and their controlled release in the wound.

Materials and methods. Technical polyurethane foam (OOO Sintez OKA, Dzerzhinsk, Nizhny Novgorod Region) was used in the study. The modification of polyurethane foam plates was carried out by oxidative polymerization of catecholamine derivatives. Physicochemical properties were determined by comparing the absorption capacity by mass and volume, porosity, and droplet imbibition time. To assess the potential of the material as a platform for delivering bacteriophages to the clinical site of interest and ensuring uniform release, Kruvchinsky dialysis through a semipermeable membrane was used. Bacteriophage titer was determined using the Appelman method.

Results. A comparative assessment of the physicochemical properties of standard and modified polyurethane foam, including porosity, absorption capacity, and hydrophilicity, was conducted. The viability of immobilized bacteriophages and their release kinetics were studied using Kruvchinsky dialysis. The results showed that the modification significantly improves the hydrophilic properties of the material (droplet imbibition time is reduced from 53 minutes to 4.3 seconds) and ensures the preservation of bacteriophage lytic activity for 8 hours. Appelman titration demonstrated that the modified polyurethane foam maintains the viability of bacteriophages at dilutions up to 10⁻⁵, compared to 10⁻³ for conventional polyurethane foam. The developed coating can be used to treat infected wounds, providing controlled release of bacteriophages and maintaining therapeutic concentrations in the area of clinical interest.

Conclusions. The modified polyurethane foam represents a promising platform for creating biomimetic wound dressings capable of effectively delivering bacteriophages to the site of infection and maintaining their therapeutic concentrations. The developed material may find application in the treatment of infected wounds, particularly those caused by antibiotic-resistant staphylococcal strains.

Relevance. Trust significantly determines consumers' choice of pharmacy products and increases the frequency of purchases: 46–76 % of customers are loyal to chains thanks to it. Trust factors include emotional, rational and social aspects. In a competitive environment, studying the phenomenon of trust is relevant for the formation of loyalty and competitive advantages of a pharmacy organization.

Methodology. During the research, sociological research methods were used in the form of questionnaires. The content analysis method was used to analyze the literature. When developing the concept, we used the theory of trust, a systems approach, and methods of logical, comparative, and structural analysis. When processing the research results, mathematical and statistical research methods were used.

Results. The factors and conditions that shape consumer confidence in pharmaceutical products have been identified, and a concept for building consumer confidence in pharmaceutical products has been developed, ensuring the effective provision of medicinal care.

Conclusion. The study conducted a comprehensive assessment of the phenomenon of trust, its significance and role in shaping consumer attitudes towards pharmaceutical products. Particular attention is paid to the analysis of conditions influencing the formation of consumer trust factors, including both external conditions (product quality, pricing policy, packaging, assortment) and internal ones emotional and social conditions of interaction.

Background. Drug-induced weight gain (DIWG) is a common and often overlooked adverse effect of many widely prescribed medications, representing a significant interdisciplinary challenge. Despite its high prevalence, DIWG remains underrecognized in clinical practice, contributing to poor treatment adherence, worsening of cardiometabolic risk factors, and diminished quality of life. 

Objective. This review provides a comprehensive analysis of the pathophysiological mechanisms underlying medication-associated weight gain, including modulation of central neurotransmitter systems (serotonin, histamine, dopamine), endocrine alterations (hyperinsulinemia, leptin resistance), changes in energy expenditure, as well as the emerging roles of gut microbiota and genetic susceptibility. 

Key drug classes. The article details the major drug classes implicated in weight gain: antipsychotics (particularly atypical agents), antidepressants, antihypertensives, corticosteroids, and antihyperglycemic drugs (insulin, sulfonylureas). For each class, the magnitude of weight change, underlying mechanisms, and metabolic consequences are discussed. 

Management strategies. Current approaches to the prevention and treatment of DIWG are presented, emphasizing the selection of medications with a favorable metabolic profile (e. g., metformin, topiramate, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors), the use of adjunctive therapies, and non-pharmacological interventions. The importance of early screening (body mass index, waist circumference, glucose, lipids) and a multidisciplinary approach involving psychiatrists, endocrinologists, and cardiologists is underscored. 

Conclusion. A personalized strategy that balances therapeutic efficacy with metabolic safety is essential to minimize iatrogenic risks and improve long-term patient outcomes. 

Background. Chronic pruritus (CP) is one of the most frequent complaints in the practice of a general physician, associated with a significant reduction in quality of life, sleep disturbance, anxiety and depression. The prevalence of CP in the general population reaches 13.5–22.0 %, and in persons over 65 years of age — up to 60 %, making the problem clinically and socially significant.

Objective. Based on the analysis of current guidelines and clinical studies, to summarize data on the epidemiology, pathogenesis, differential diagnosis and treatment of CP from a patient‑centered perspective.

Data sources. An analysis of key sources was conducted: clinical guidelines, original studies and meta-analyses indexed in PubMed and the Cochrane Library, published on chronic itching.

Key findings. Non‑histaminergic mechanisms dominate in the pathogenesis of CP: IL‑31, TSLP, μ/κ‑opioid receptor imbalance, activation of TRPV1/TRPA1 channels and JAK/STAT signaling. A three‑step diagnostic algorithm is proposed, including mandatory laboratory screening (complete blood count, ferritin, TSH, creatinine, liver function tests) and additional methods (ultrasound, skin biopsy, spinal MRI). Treatment includes correction of the underlying disease, the use of emollients, and stepwise prescription of systemic agents: naltrexone (for cholestasis), gabapentin (for neuropathic pruritus), antidepressants (paroxetine, mirtazapine), biologic therapy (dupilumab), and JAK inhibitors. Special attention is paid to shared decision‑making, consideration of patient preferences, and assessment of quality of life using the ItchyQOL and DLQI questionnaires.

Conclusion. The narrative review is intended for general physicians, dermatologists, neurologists, and general practitioners. Timely etiological diagnosis and stepwise pathogenetic therapy allow control of CP and prevention of psychosocial maladaptation of patients.

Relevance. Long-term combination chemotherapy for tuberculosis using multiple groups of antituberculosis drugs to enhance antimicrobial efficacy inevitably potentiates their toxic effects on the liver, kidneys, and pancreas. A promising strategy for protecting these organs is to employ the insufficiently explored organ-protective activity of relatively safe peptide agents.

Objective. To perform a comparative experimental evaluation of the hepato-, nephroand pancreatoprotective activity of three peptide drugs (glutoxim, dalargin, and human chorionic gonadotropin) on a modified model of multiorgan pathology induced by a combination of first-line antituberculosis agents.

Materials and methods. The study was conducted on 100 male white rats divided into five groups of 20 animals. In the experimental groups, multiorgan pathology was modelled over 21 days by combined administration of isoniazid and rifampicin together with chronic alcohol intoxication as a factor potentiating organ toxicity. Glutoxim, dalargin, and human chorionic gonadotropin were used as experimental pharmacotherapy. Efficacy was assessed by survival rate, general and biochemical blood parameters, and histological examination of the liver, kidneys, and pancreas.

Results. All tested drugs exhibited a pronounced organ-protective effect. For liver protection the ranking was: human chorionic gonadotropin = glutoxim > dalargin; for kidney protection: human chorionic gonadotropin > glutoxim > dalargin; for pancreatic protection: dalargin > human chorionic gonadotropin > glutoxim.

Conclusion. The results support the feasibility of including glutoxim and dalargin in combined antituberculosis therapy to prevent drug-induced organ toxicity and highlight the promise of repurposing human chorionic gonadotropin as a universal organ-protective agent during treatment with first-line antituberculosis drugs.

We present a clinical case of a 34-year-old male patient with a long-standing history of arterial hypertension dating back to adolescence, accompanied by persistent hypokalemia and poor response to standard antihypertensive therapy. Despite combination treatment with amlodipine, telmisartan, and indapamide, target blood pressure levels were not achieved, and hypokalemia (2.7–3.3 mmol/L) persisted over several years. Laboratory evaluation revealed suppressed plasma renin activity (0.5–0.8 µIU/mL) and elevated aldosterone levels (up to 29 ng/dL), with a markedly increased aldosterone-to-renin ratio (ARR > 50). A captopril suppression test confirmed autonomous aldosterone secretion, and abdominal CT identified a 20×14 mm adrenal adenoma in the left adrenal gland. The patient underwent unilateral adrenalectomy, which resulted in normalization of blood pressure without antihypertensive medications, correction of serum potassium levels, and improvement in renal parameters, including a reduction in the albumin-to-creatinine ratio. This case underscores the importance of early screening for primary aldosteronism in young hypertensive patients with resistant hypertension and hypokalemia, and highlights the potential for complete cure through timely surgical intervention.

Relevance. At the time of admission to the hospital of a patient with acute pancreatitis (AP), the severity of his condition, as well as the results of instrumental and laboratory examination methods do not allow us to unambiguously conclude about the prospect of the disease. At the same time, it was proved that the immediately started adequate intensive therapy in the intensive care unit significantly reduces the percentage of complications and mortality in this category of patients.

Objective. To objectify the risk of an aggressive course of the disease based on the use of laser Doppler flowmetry (LDF), which can help in predicting destructive complications of AP. 

Materials and methods. Blood microcirculation parameters were analyzed in 55 healthy volunteers (control group) and 118 patients of the surgical department of the N. A. Semashko Clinical Hospital of Yaroslavl with AP. According to Atlanta criteria, 58 people had a mild course of the disease, 60 had a severe form. The age of patients averaged 54±16.6 years. The blood microcirculation index (MI), its standard deviation and coefficient of variation (σ and Kv, respectively), the level of nutritional blood flow (M nutr), the amplitude of the endothelial (Ae), neurogenic (An), myogenic (Am), respiratory (Ar), cardiac (Ac) oscillation ranges were measured. Predictive power of indicators was assessed using ROC analysis, calculating the area under the curve (AUC).

Results. With both forms of AP, a decrease in PM, Ae, An and Am was noted upon admission. Pronounced predictive possibilities regarding the complicated course of AP were identified for An and As. The AUC for An was 0.857, σ = 0.112, 95 % confidence interval (CI) = 0.558–0.984, p = 0.0015. AUC = 0.889 was obtained for Ac; σ = 0.115, 95 % CI = 0.6230.990, p = 0.0007. For clinical testing of the prognostic system, the results of treatment of patients with pancreatic necrosis were analyzed. 40 patients were hospitalized in the intensive care unit (ICU), the comparison group consisted of 20 patients who, despite the alarming dynamics of LDF indicators due to stable hemodynamics, were initially hospitalized in the general ward. Mortality in group 1 was 5 %, in group 2–35 % (χ² = 25.93, df = 1, p = 0.00001).

Conclusions. Taking into account the results of LDF when deciding on admission of patients in ICU can reduce the overall and postoperative mortality in destructive pancreatitis and improve treatment outcomes.

Background. Emotional burnout in parents of children with chronic diseases (CD) is a growing medical and social problem exacerbated by chronic caregiving stress, frequent hospitalizations, and lack of external support. The prevalence reaches 40–60 %, adversely affecting the child's treatment quality and family functioning, highlighting the need for preventive interventions.

Objective. To study the burnout syndrome in parents of children with chronic diseases and to develop practical recommendations for its prevention and correction.

Materials and methods. A standardized anonymous survey was conducted among 78 parents (82 % mothers) of children aged 1–18 years with confirmed chronic diseases (chronic adenoiditis, bronchial asthma, type 1 diabetes mellitus, and others) followed up in medical institutions of Yaroslavl from January to April 2026. Validated instruments were used: Maslach Burnout Inventory (MBI), Hospital Anxiety and Depression Scale (HADS), and COPE inventory. Statistical analysis was performed using Excel and SPSS 26.0, including Spearman's correlation, chi-square test, and regression analysis; significance level was set at p < 0.05.

Results. High-level burnout on the MBI scale was found in 45 % of parents: emotional exhaustion 52 %, depersonalization 41 %, and reduced personal accomplishment 28 %. The dominant risk factors were: lack of social support (62 %, OR=4.2), frequent hospitalizations (> 3/year, 50 %, r = 0.48), financial difficulties (44 %), and disease duration > 5 years (40 %, r = 0.62; p < 0.001). Significant differences across nosological groups were observed (χ², p=0.03): parents of children with asthma and adenoiditis showed higher burnout rates (52 %) compared to diabetes (32 %). Active coping strategies (COPE, 58 %) were associated with low burnout (67 %; p < 0.05); clinically significant anxiety/depression (HADS > 11) was noted in 52 % (r = 0.53). Qualitative analysis revealed predominant complaints: fatigue (67 %), guilt (54 %), and social isolation (49 %).

Conclusions. The prevalence of emotional burnout among parents of children with CD in Yaroslavl was 45 %, with emotional exhaustion dominating. Key predictors include disease duration, lack of support, and frequent hospitalizations. To reduce risks, implementation of MBI screening in outpatient clinics (every 6 months), training in active coping strategies, and establishment of specialized parent support groups are recommended, which may reduce burnout by 30–40 % and improve treatment adherence in children.

Objective. To study the epidemiological patterns and clinical features of purulent complications in patients with lower limb injuries who were treated in medical organizations in the city of Yaroslavl and the Yaroslavl Region .

Materials and methods. A comprehensive epidemiological analysis was conducted of data on the prevalence of purulent complications associated with lower extremity injuries among patients receiving inpatient treatment in traumatology, orthopedics, and surgical departments of medical organizations in Yaroslavl Oblast from 2016 to 2025.

Results. The average annual number of complications was 627.8, with a coefficient of variation was 38.4 %, indicating high instability in the indicators. Trend analysis revealed a general downward tendency in recent years, where the linear regression coefficient points to a decrease of 62.4 cases per year (R²=0.42), thereby evidencing a moderately positive dynamic. Particularly noteworthy is the sharp drop in 2025 to a historical minimum, which constitutes only 20.9 % of the 2016 level and 19.0 % of the 2021 peak. The opposite situation is observed in the accounting of trauma consequences, which can also serve as initial manifestations of subsequent infectious complications, with an extreme increase from 0.07 % (2016) to 4.78 % in 2023, and sustained growth maintained over the last three years.

Conclusion. In Yaroslavl and the region, high traumatization of the lower extremities persists, with a predominance of ankle joint and foot injuries, where the frequency of complications reaches 5.39 % with a relative upward trend in complications associated with surgical consequences. The most dynamic increase is observed in the group of trauma sequelae, necessitating enhanced rehabilitation, while low and stable rates of infectious complications confirm the effectiveness of their prevention. At the same time, there is a lack of reliable data on the prevalence of all infectious complications and recurrences after treatment of lower extremity injuries, including abscesses, suppuration in the osteosynthesis zone, ligature fistulas, wound necrosis, and migration of metal constructs. Some complications are lost in statistics or altered during registration, which requires multicenter research and patient follow-up from the moment of injury to the resolution of complications or recurrence within a one-year observation period.

Introduction. Depressive disorders are a significant medical and social issue, particularly among young people, including medical students, due to high academic loads and stressful factors.

Objective. To determine the prevalence and structure of depressive symptoms among students of the International Medical Institute of Kursk State Medical University (IMI KSMU).

Materials and methods. A cross-sectional study was conducted from September to October 2025 involving 60 students aged 18–25 years. The Beck Depression Inventory was used to assess the level of depression, and the data were processed using descriptive statistics.

Results. Mild depression (5–9 points) was found in 40 % of respondents, moderate (10–14 points) in 23 %, and severe or very severe forms (15–27 points) in 22 %, while only 15 % of participants had no significant symptoms (0–4 points). The most common symptoms were low mood, fatigue, difficulty concentrating, and sleep disturbances. Suicidal thoughts were reported by 6.7 % of the respondents.

Conclusion. The findings indicate a high level of emotional distress among students and highlight the need for implementing psychological support programs, resilience training, and prevention of depressive states in academic settings.