REMEDIUM

Many studies conducted in the field of cardiology have recently shown that elderly patients (≥ 65 years old) who undergo emergency non-cardiac surgery have a significantly higher mortality rate (12.5%) compared to patients who undergo elective surgery (2.6%). In this regard, many doctors are wondering whether it is possible to reliably predict myocardial injury after non-cardiac surgery (MINS) at the preoperative stage. The search was conducted in January–September 2025 using the PubMed, Scopus, and Web of Science databases. Publications from 2005 to 2025 were considered. The review included original articles, meta-analyses, and systematic analyses relevant to the selected topic.

Introduction. Direct UV detection of amino acids without a derivatization step is of interest for pharmaceutical analysis, as it simplifies sample preparation and eliminates an additional reaction step. This study involved the development and evaluation of an ion-pair HPLC method with direct UV detection for the determination of five amino acids in a multicomponent drug product with the INN "Ketoanalogues of Amino Acids." The aim of the study was to develop and evaluate the applicability of an HPLC method with direct UV detection for determining five amino acids (histidine, threonine, tyrosine, tryptophan, and lysine) in a multicomponent drug product with the INN "Ketoanalogues of Amino Acids." Materials and methods. Chromatography was performed using an Agilent 1260 Infinity II chromatograph equipped with a UV-spectrophotometric detector. A YMC-Triart C18 column (250 × 4.6 mm, 5 μm, 120 Å) was used. The flow rate was 1.0 mL/min, the column oven temperature was 25 °C, the injection volume was 10 μL, and the total analysis time was 40 min. During method development, the detection wavelength was varied; initially, detection was performed at 200 nm. Results. The selected conditions ensured the separation of the target amino acids in the standard solution. However, when analyzing the test solution, method specificity was not achieved due to the co-elution of matrix components in the lysine elution region, a finding confirmed by peak spectral purity assessment. Conclusion. HPLC with direct UV detection demonstrated analytical potential for the separation of amino acids; however, the method proved to have limited applicability for the multicomponent drug product under investigation due to insufficient specificity. The results confirm the need for more selective approaches, specifically methods involving derivatization.

The article considers the production of medical organizations as a specific area of marketing and communication activities focused on the formation of public expertise, strengthening patient confidence and developing the media image of a medical organization. It is proved that producing in healthcare cannot be reduced to advertising, PR, SMM or personal branding of a doctor, since medical communication is associated with special legal, ethical and professional restrictions. It is concluded that there is a need for institutional regulation of the production of medical organizations based on evidence, ethics, legal correctness and priority of the patient's interests.

This study proposes a conceptual periodization scheme with characteristics of the stages of legal regulation. A retrospective systematic analysis of legislative and other regulatory sources was conducted to identify and evaluate restrictive and stimulating legal norms that have a regulatory impact on the development of Russian pharmaceutical market entities and the availability of pharmaceutical care for the population. Regulatory directions and problematic trends of the pharmaceutical market at the current stage are formulated; measures of legal regulation are proposed to improve the sustainability of pharmaceutical market entities and the level of availability of medicines.

Introduction. Digitalization in the pharmaceutical sector involves the implementation and use of Internet of Things (IoT) technologies to improve production processes, distribution and circulation of medical and pharmaceutical goods. The aim of the study was to analyze the opinion and readiness of pharmacists to apply IoT technologies in their professional activities. Methods. The opinions of 101 pharmacists were studied using a sociological survey (anonymous questionnaire). 80.2% of respondents have higher pharmaceutical education, 19.8% — secondary pharmaceutical education. 89.1% work in pharmaceutical organizations, 10.9% — in other organizations in the field of pharmacy. 26.7% of respondents work as pharmacist's assistants, 42.6% — as pharmacists; 24.8% hold senior positions. Statistical processing was carried out using descriptive statistics (calculation of relative values) and nonparametric statistics (Pearson criterion) using Microsoft Office Excel 2016 and BioStat. Results. The majority of pharmacists have a positive attitude towards any innovation in their professional activities (75.2%) and the use of IoT technologies in their work (65.3%). Possible reasons for the positive attitude are simplification of the work (51.5%), strengthening the competitive position of the organization in the pharmaceutical market (24.8%), professional interest (17.8%). There are differences of opinion about the possibility of using IoT in the workflow, depending on the length of service. Pharmaceutical workers are willing to use IoT technologies if it significantly simplifies their professional duties (83.2%), increases their salaries (58.4%), facilitates career advancement (43.6%), or is a mandatory requirement (29.7%). 91.1% have no experience using IoT technologies in their professional activities, 95.0% would like to receive additional information on the use of IoT technologies in pharmacy, Issues of management, economics, law, and digitalization and 89.1% wish to improve their skills in this area. Conclusion. Pharmacists are interested in the possibility of using IoT technologies in pharmacy and demonstrate their willingness to use IoT in their professional activities, however, specialists do not have a clear understanding of the "IoT" category and do not have sufficient information about the possibilities of their use.

This article analyzes the relationship between migration and demographic processes in contemporary Russia amid persistent natural population decline and changing age structure. It demonstrates that net migration is becoming a key component of demographic dynamics, partially offsetting natural decline and maintaining the working-age population. The theoretical framework is based on the concept of replacement migration, ideas about the demographic transition, and approaches that view migration as an independent instrument of demographic policy. The empirical base consists of official Rosstat data, demographic forecasts, and analytics from Russian and international centers, enabling comparisons of migration flow dynamics with natural population movements and regional differences. Particular attention is paid to the role of external and internal migration in maintaining population size and adjusting the age and sex structure, as well as their impact on the territorial redistribution of demographic potential. The scientific novelty lies in the comprehensive assessment of migration as a factor in demographic development and an element of state policy, which allows us to clarify the boundaries of its compensatory potential and outline directions for improving the migration policy of the Russian Federation.

This article presents the experience of implementing the interdepartmental project "Mom in Resource" in the Dmitrov Municipal District of the Moscow Region. The project aims to improve the quality of medical and social care for women during the perinatal period by developing a systemic algorithm for interaction between local governments, healthcare organizations, and civil society institutions. It focuses on women's assessments of the quality of medical care in maternity hospitals as a management indicator, as well as changes in their subjective perceptions of their first motherhood experience. The empirical basis is data from a survey of participants in the information chat "Maternity Hospital and Women's Consultation. Dmitrov" (n = 151). The article argues that managing the quality of the maternal experience can be considered a tool for increasing family trust in the region; however, a direct link to fertility requires separate research and is not confirmed in this study.

The article presents an overview of Russian studies on professional burnout of pharmaceutical workers. It analyzes the methodological tools, and also shows and summarizes results of empirical studies of respondents that demonstrate regional features at the level of this syndrome. It has been established that the highest and average levels of professional burnout are most characteristic for the specialists of the pharmacy sector. The narrow focus of existing research papers that do not cover the full range of specialties in the pharmaceutical industry has been identified.

The article examines the role of parents in the formation of dental literacy in primary school children. It is shown that during the period of the beginning of school education, the child gradually learns independent oral care skills, however, the organization of preventive behavior, the choice of hygiene products, diet and time to visit the dentist remain largely the responsibility of the family. A child's dental literacy is interpreted as a set of knowledge, practical skills, motivation, and the ability to apply information to maintain oral health. A model of parental influence on dental literacy of a younger student is proposed and the directions of improving the effectiveness of family dental education are identified.

The article presents an analytical review of the monograph by Nagornykh O. S., Pivovarova N. Yu., Tikhonov V. V., Shok N. P. "The History of medicine in Russia: ethics and politics" (Moscow, 2025), devoted to the historical development of medical ethics, deontology and bioethics in the context of public policy, social transformations and international relations. Special attention is paid to the interdisciplinary nature of the research, its source base, scientific novelty and significance for understanding the Russian medical tradition. The main advantages of the work, controversial provisions and promising areas for further historical and medical research are highlighted.

The article is dedicated to V. K. Anrep, a Russian physiologist, pharmacologist, forensic physician, and state and political figure. Anrep was the first in the world to identify and experimentally substantiate the local anesthetic properties of cocaine. His scholarly legacy encompasses original scientific research, pedagogical contributions, and extensive public service. He played a key role in the establishment of the St. Petersburg Women's Medical Institute and served as a deputy in the Third State Duma of the Russian Empire, where he advocated for progressive healthcare reforms.

Introduction. Effective algological therapy is a key aspect of the treatment of patients with pain syndromes. Modern approaches involve the active use of a large arsenal of drugs to form personalized treatment regimens. However, there is a serious problem of insufficient anesthesia patients may not receive adequate anesthesia due to the lack of awareness of doctors about the legal aspects of prescribing potent and narcotic drugs. Aim. Collection and structuring of data on prescribing non-narcotic opioid-like opioid analgesics to patients with chronic pain syndrome. Materials and methods. In study with a convenient sample 36 medical histories and outpatient records of patients receiving medical algological care in different types of 5 medical organizations were analyzed. Statistical processing was carried out in the Jupyter Notebook environment in the Python programming language. Non-parametric criteria χ2, Mann–Whitney, Wilcoxon were used to evaluate the effectiveness of drugs. Independent Ethics Committee of Irkutsk State Medical Academy of Postgraduate Education (protocol No. 9 dated 11/24/2023). Results. The following distribution by MKB-10 classes was recorded: II. New formations — 25 (69.5%); XIII. Musculoskeletal diseases — 8 (22.2%); XIX. Musculoskeletal injuries — 3 (8.3%). In order to correctly compare the efficacy of drugs between two independent groups of patients, the balance was checked by signs (gender, age, type of disease). χ2 criteria for binary and Mann–Whitney for numerical data were used. No statistically significant differences were found, the groups were comparable. A significantly greater reduction in pain was observed in the tramadol group. The assessment of tolerability of drug exposure was at an acceptable level. Specialists, without distinguishing the difference between the prescription of narcotic and psychotropic drugs and potent drugs subject to quantitative accounting, are often reinsured and prescribed tramadol according to the rules for the use of narcotic drugs. Conclusions. Data indicate the presence of barriers in the availability of effective drugs for the correction of chronic pain syndrome, providing a faster and more pronounced reduction in pain intensity: incorrect prescriptions, incorrect assessment of the status of tramadol as a narcotic analgesic, lack of unification of pain assessment in the cards.

Introduction. The Iraqi pharmaceutical market is of significant interest to international manufacturers; however, the potential for Russian exports to the region remains understudied. An analysis of the official register of manufacturers identifies key market niches and strategic opportunities, while "support for the export of Russian pharmaceutical products, including the harmonization of regulations with evolving best practices" offers prospects for development in the Iraqi pharmaceutical market. Objective: to conduct a comprehensive analysis of the range of medicinal products (MPs), dietary supplements (DS), and medical devices (MDs) registered for supply to the Iraqi pharmaceutical market, in order to identify niche opportunities and develop recommendations for Russian exporters. Materials and methods. The study is based on an analysis of the official register of manufacturers (Site Master File) approved for supply to the Republic of Iraq as of June 2025 (n=383). Statistical, comparative, and structural analysis methods were used to assess the geographic distribution of manufacturers and their specializations, as well as pharmacotherapeutic groups and dosage forms. Results. The Iraqi market was found to be characterized by a high degree of international competition, with Indian (17.5%) and Turkish (11.5%) manufacturers dominating the market. Russian companies account for only 0.5% (two manufacturers). The market structure was determined to include pharmaceuticals (62%), medical devices (26%), and dietary supplements and herbal remedies (12%). Promising high-tech niches for Russian exports were identified, including biosimilar drugs, biotech and oncology products, complex sterile dosage forms, and high-tech medical devices. Conclusion. The study demonstrated the untapped export potential of Russian pharmaceutical companies in the Iraqi market. Successful marketing penetration requires a strategic focus on high-tech segments, active government support, partnerships with local distributors, and strict compliance with regulatory requirements.

The article examines the problem of territorial and economic accessibility of medical care for the rural population of Russia, which makes up about a quarter of the country's inhabitants. It has been revealed that federal innovations — the sale of medicines through district hospitals, simplification of licensing of medical organizations, and an experiment with mobile pharmacy facilities for the period 2026—2029 — open up the possibility of integrating the pharmacy circuit into the state program for integrated rural development. An organizational and economic model based on the “hub — dispensing channels” principle is proposed, combining an inpatient pharmacy, a point at a paramedic—obstetric station, a pick-up point and a mobile format, with a system of controlled indicators of territorial, temporary, assortment and price accessibility; the illustrative calculation shows that the annual maintenance of accessibility is estimated at about 922 rubles per rural resident. It is concluded that the transfer of pharmaceutical accessibility from an optional health function to a mandatory infrastructure standard in rural areas is a reasonable institutional measure that requires pilot testing in the constituent entities of the Russian Federation.