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To Develop classification of legal acts regulating the activities of hospital pharmacies and identify significant problems in them for drug provision enhancement in health facilities. Methods The main regulatory framework governing the hospital pharmacies activities was carried out using the computer help system "Con- sultant Plus" and Internet search engines Google and Yandex. The first group (group No. 1) includes terms that affect the actual subject of the study – hospital pharmacy and synonyms. The second group of words used (group No. 2) is common terms of hospital pharmacy activities and drug supply in the health facilities. Results We developed classification of regulatory legal acts that regulate the work of hospital pharmacies by the method of regulation (regulating directly and indirectly) and by content (regulating general aspects and applied aspects of drug provision in the health facility. Regulations governing general aspects, the definition of the hospital pharmacy as a pharmacy organization, the classifi- cation of pharmacy organizations, the status of a hospital pharmacy, the list of goods provided by a hospital pharmacy, as well as pharmaceutical works performed. Legal acts regulating applied aspects include groups of documents regulating the main process- es (drug supply) and regulating the supporting processes (personnel policy, provision of material and technical resources). Conclusion We identified non-regulated stages of drug supply specific for health facilities. In connection with the abolition of Soviet period legal acts important issues, personal and material and technical resources, were excluded from the legal framework, which was not compensated by the emergence of relevant legal acts. To date, a systematic approach has not been developed in the legal regula- tion of the hospital pharmacy, there is no continuity of legal acts and uniformity of terminology.

Epidermolysis bullosa is a severe hereditary disease caused by mutations in genes encoding cutaneous basement membrane proteins. These mutations lead to dermal-epidermal junction failure and, as a result, to disturbances in the morphological integrity of the skin. Clinically, it manifests in the formation of blisters on the skin or mucosa that in some cases can turn into non-healing chronic wounds, which not only impairs patient’s quality of life, but also is a live-threatening condition. Now, the main approaches in the treatment of epidermolysis bullosa are symptomatic therapy and palliative care, though they are little effective and are aimed at reducing the pain, but not to complete recovery. In light of this, the development of new treatment approaches aimed at correction of genetic defects is in progress. Various methods based on genetic engineering technologies, transplantation of autologous skin cells, progenitor skin cells, as well as hematopoietic and mesenchymal stem cells are studied. This review analyzes the pathogenetic methods developed for epidermolysis bullosa treatment based on the latest achievements of molecular genetics and cellular technologies, and discusses the prospects for the use of these technologies for the therapy of epidermolysis bullosa.

The physical development of newborns and infants is the most important parameter in assessing their health. However, the standards of anthropometric parameters, and most importantly their growth in premature babies, especially those born with low and extremely low body weight, are still controversial.Objective: to apply the methodology for measuring and assessing the main anthropometric indicators of newborns using the international standards of postnatal growth of premature babies INTERGROWTH-21st to resolve the issue of the feasibility of its adaptation and widespread introduction into neonatological and pediatric practice in the Russian Federation. 4876 children were born at Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology (participant of the international project for the implementation of INTERGROWTH-21st standards in neonatological and pediatric practice) from 15.05.2018 to 26.11.2018. 439 (9%) of them were born premature, of which 376 children (89,3%) with gestational age confirmed by ultrasound were included in the study. There was a detailed file for each child to assess the environment and health of the mother, the course of pregnancy, childbirth, the state of health of the child from birth to discharge from the hospital. 2.1% of children classified by INTERGROWTH-21st as children with intrauterine growth retardation, according to Fenton charts, had normal intrauterine growth. When comparing the postnatal growth at discharge from hospital on the Fenton scale, more children were classified as children with impaired postnatal growth; the discrepancy between INTERGROWTH-21st and Fenton diagrams was 8%. At discharge, 52% of premature babies were exclusively breastfed, 28.8% of premature babies were at mixed feeding.Conclusion.On the one hand, the use of INTERGROWTH-21st scales helps to correct nutrition in case of delay in physical development, and, on the other hand, it reduces the risk of metabolic disorders associated with an aggressive desire to achieve rapid growth of a premature baby.

Рассматривается интеллектуализация управления транспортно-логистической системой, путем создания информационных моделей для сбора, обработки, анализа, ранжирования, накопления, хранения необходимой информации и обеспечения благоприятной среды для поиска, просмотра, визуализации данных, сравнения возможных вариантов решений проблемных вопросов и выборе наилучшего на основе накопленных знаний, опыте и имеющихся ресурсных возможностей. Представлена концептуальная модель управления транспортнологистической системой, а также предложена методика формирования онтологий.

This article discusses negative effects of vitamin D deficiency on low birthweight preterm and full-term newborns. Results of the studies on vitamin D provision to pregnant women and their newborn children are addressed. Vitamin D deficiency is highly prevalent in pregnant women and newborns. It was demonstrated that inadequate antenatal provision of a fetus with vitamin D may result in congenital rickets and neonatal seizures due to hypocalcemia in newborns and also accounts for increased rates of necrotic enterocolitis, bronchopulmonary dys-plasia, and impaired growth and development as well as higher risk of lower respiratory tract infections (i.e., bronchiolitis, pneumonia) during the first year of a child’s life. In addition, it was shown that persistent vitamin D deficiency in future years may be associated with recurrent respiratory infections, allergic (e.g., atopic dermatitis, asthma, etc.), autoimmune, endocrine, and psycho-neurological disorders. Preventive and therapeutic strategies for vitamin D deficiency in low birthweight preterm and full-term newborns since neonatal period are discussed.Keywords: vitamin D, vitamin D deficiency, calcidiol, low birthweight newborn, preterm newborn, full-term newborn.For citation: Zakharova I.N., Mal’tsev S.V., Zubkov V.V. et al. Vitamin D, low birthweight preterm and full-term newborns: time for a paradigm shift. Russian Journal of Woman and Child Health. 2020;3(2):142–148. DOI: 10.32364/2618-8430-2020-3-2-142-148.

This paper reviews the effects of vitamin D deficiency on pregnant women and newborns. It was demonstrated that vitamin D deficiency in pregnant women is associated with higher risks of threatened preterm labor, placental insufficiency, preeclampsia, gestational diabetes, bacterial vaginosis, and impaired uterine contractility as well as higher rate of C-sections. Vitamin D insufficiency in newborns is associated with inadequate bone mineralization and also results in metabolic disorders, hypocalcemic seizures, bronchopulmonary dysplasia, necrotic enterocolitis, sepsis, mental and developmental disorders, and higher risks of various (infectious, allergic etc.) disorders. Optimal vitamin D dosing regimen in pregnant women and newborns is discussed.KEYWORDS: pregnancy, vitamin D, vitamin D insufficiency, newborn, complications of pregnancy, preeclampsia, gestational diabetes.FOR CITATION: Zakharova I.N., Mal’tsev S.V., Zubkov V.V. et al. Effect of vitamin D on the pregnancy and the health of newborns and infants: state-of-the-art. Russian Journal of Woman and Child Health. 2020;3(3):174–181. DOI: 10.32364/2618-8430-2020-3-3-174-181.

Рассматривается организация транспортного процесса потребителей и поставщиков энергоресурсов. Делается вывод о необходимости совершенствования производственного процесса и транспортного обслуживания в железнодорожном местном сообщении в сегменте грузовых перевозок. Предложен информационный ресурс в виде системы управления «Контроль завоза, наличия и остатков угля на складах жилищнокоммунального хозяйства». При создании системы использовались методы адаптивного управления и принципы модульного структурирования.

Introduction. Complex ultrasound diagnosis of the organ and, directly, cardiac function allows forming groups of prognostically significant risk factors for the development of complications in newborns with a congenital diaphragmatic hernia (CDH) and on their basis to select patients with the negative life expectancy. The determination of hemodynamic disorders as secondary ones will allow emphasizing the treatment on the elimination of the main pathology, which will lead to an improvement and/or normalization of cardiac activity. The aim of the work is to identify ultrasound markers of risk factors for complications in CDH newborns. Material and methods. In 32 left side CDH newborns at the age of 6-18 h of the 1st day of the life, there was performed an examination on the expanded echographic protocol. The indices studied included the end-diastolic volume (EDV) of the left ventricle (LV) indexed to the surface area of the body; the mass of the myocardium (MM) of the LV; index of the shape (IS) of the LV; the ratio of the pulmonary blood flow to the systemic (Qp/Qs); cardiac index (CI); the McGun index; the ratio of the systolic blood pressure (SBP) in the pulmonary artery (PA) to systemic arterial pressure (SAP); the ratio of the time of the systole to the time of the diastole of the right ventricle (RV); a marker of the total myocardial contractility; the presence of organs of the abdominal cavity in the pleural cavities on the affected side (the proportion of the liver, stomach, spleen). The results of the extended echocardiographic examination were correlated with the clinical data characterizing the severity of the patient’s condition in the perioperative period (duration of the artificial ventilation, the need for cardiotonic and inotropic therapy, the length of the stay in the hospital), the outcome of the disease after surgery. Results. The overall survival rate of CDH newborns was 78.2%. EDV, MM, IS, CI and the ratio of systolic pressure in the pulmonary artery to systemic blood pressure in the groups of deceased and surviving patients significantly differed on the 1st day of the life (p = 0.013, p = 0.037, p = 0.001 and p = 0.04, respectively ). Within the framework of binary logistic regression, only CI affects the outcome of the treatment of CDH newborns (OR = 43.8 at p = 0.029). CI less than 2 L/min/m2 is a predictor of death of CDH newborns. EDV (less than 26 ml/m2), MM (less than 37g/m2), the ratio of systolic pressure in the pulmonary artery to systemic blood pressure (more than 0.9) are additional markers affecting on the outcome of treatment for CDH newborns. Conclusion. CI is an independent index in predicting the outcome of the treatment of CDH newborns (OR = 43.8 at p = 0.029). EDV, MM, the ratio of systolic pressure in the pulmonary artery to systemic BP are additional markers in predicting the outcome of treatment of newborns with EDC. The presence of a portion of the liver, stomach, and spleen in the thoracic cavity has no statistical significance in predicting the outcome of treatment of such children.