The effect of degradation products of the implant magnesium based alloy on the rats (test group 14 animals, control groups – 6). The study was based on a study of the protein level indicators and nitrite in urine, and behavioral responses. As a result of the found no significant differences in terms of the test and control groups of laboratory animals. Materials and methods. We used white mongrel male rats weighing 220-270 g (n = 20). The animals of the experimental group (n = 14) in the femur muscle mass, of a modified retainer implanted magnesium alloy ML-10. The control group consisted of white mongrel male rats weighing 230-250 g (n = 6) were not subjected to surgery (intact group). Animal Watching, lasted for 6 months. In order to identify possible signs of intoxication conducted regular weighing animals (twice a month), followed their motor activity and research, followed by the nature of their use of water and food, the state of hair and mucous membranes. To detect violations of the urinary system conducted a study of pet urine on its content of protein and nitrite. In behavioral studies in terms of toxicology test was performed "open field." Both groups of animals had free access to food and water, and received a standard diet. Results and Discussion. Dynamics showed that during the first two weeks after surgery, the rats of the experimental group there was a slight decrease in this indicator (7%), which, in our opinion, has been associated with post-operative trauma and pain at the site of intervention, rather than toxic effects of degradation products of implants . Further observation of rat study group showed a significant improvement in appetite in rats and a significant increase in weight. In addition, the systematic monitoring of the scalp and mucous membranes did not reveal any abnormalities. In the urine collected from the metabolic chambers were found only traces of protein and the amount of nitrites were not significantly different from those of intact rats. Revealed no increase in proteinuria. The study of orientation and exploratory behavior in the "open field" found that on the second day after surgery with implants in rats decreased the total index of motor activity and exploratory behavior by 60.6%. On the 14th day after the operation of the activity of the animals of the experimental group rose slightly, but was significantly lower (35.3%) than in the group of intact rats. This phenomenon can be attributed to post-operative trauma. Further indicators of physical activity research and intact groups were not significantly different. The lack of neurotoxicity of degradation products of implants confirmed the general neurological status of animals (high level of emotional and behavioral reactivity, the absence of symptoms of neurological deficits, high locomotor and exploratory activity, locomotor stereotypies and emotional state). Conslusions Conducted registration of specific and non-specific symptoms of intoxication on the study of the biological safety of biodegradable magnesium implants showed: 1) no adverse impact on the overall physical condition (no pathological changes the eye, hair, mucous membranes, body weight) 2) no change in behavior - high motor and Research activity is detected neurological deficits and abnormalities in emotional state.

Introduction. Miscarriage is one of the important problems in modern obstetrics and pediatrics, which is responsible for its negative impact on women's health, a direct connection to a high perinatal mortality [1, 6, 7]. Pregnancy loss rate changes from 10 up 25% of all pregnancies and is not marked tendency to it’s decrease [2, 6]. Therefore particularly important to the develop new methods of treatment and rehabilitation of pregnant women, especially health resort treatment. This allows to get a set of extremely valuable, long-lasting effects of adaptive-compensatory and protective changes and to reduce the adverse effects on the body of the pregnant woman and the fetus. The aim of the work was to evaluate the effectiveness of rehabilitation of women with miscarriage in clinical sanatorium «Velikij Lug». Materials and methods. We observed 93 women. Thirty women with threatened miscarriage, who received sanatorium treatment, composed the main group. The comparison group included 28 women with threatened miscarriage, who did not receive rehabilitation sanatorium during pregnancy. The control group consisted of 35 women without risk of early termination of pregnancy and physical illness and who didn’t receive sanatorium rehabilitation. The research was conducted on the basis of clinical sanatorium «Velikij Lug» and the birth house number 9. The results of research. The average age of pregnant women was 27,3 ± 0,65 years. Significant differences between the groups were not founded. The threat of miscarriage in the main group was in the first trimester - 58.3% versus 60.7% in the comparison group, in the second trimester - 35.7% vs. 61.6%, while in the third trimester - 8.94% vs. 33.3 %. The threat of preterm birth in the main group was met with the frequency of 14.3%, while in the comparison group - 41.7%. Gestational age of all women ranged from 19 to 33 weeks. Among the most frequent extragenital pathology should be noted anemia during pregnancy, chronic gastro, and chronic pyelonephritis. One woman in the main group had preterm delivery (3.85%). In the second group five women (16.7%) had premature births. In the control group preterm labor was not observed. Deliveries in the first group of women were complicated by premature rupture of membranes in 18.3%, while in the second group, only in 12.5% of cases. In the control group, this figure was 20%. Births by caesarean section have been observed in two pregnant women in the main group (6.7%) and in five (17.9%) women in the comparison group. Average evaluation results by Apgar scores at 1st minute of the newborns in the first group was 7,8 ± 0,1, and at 5th minute - 8,3 ± 0,1, in the second group - 6,8 ± 0,5 and 7,2 ± 0 5 points respectively. There are established significant differences between the indices of the main group and the comparison group, as well as the main group and the control group. Conclusions. In women with threatened miscarriage during pregnancy and childbirth observed such complications as anemia during pregnancy, premature rupture of membranes, fetal distress, and premature delivery. There are marked positive effects of sanatorium rehabilitation in women with threatened miscarriage, which reduced the frequency of gestational complications and improve the outcome of delivery for the mother and fetus.

Introduction. Arterial hypertension is one of the most important causes of mortality in the world. Vascular endothelial growth factor-1 (VEGF-1) pathways are the most frequently involved in hypertension development, especially related cardiovascular remodelling. On the other hand, many retrospective studies have suggested a relationship between cardiovascular risk in antihypertensive patients and VEGF-1. However, an impact of VEGF-1 in hypertensive subjects after ischemic stroke is still uncertain. High sensitive C-reactive protein (hs-CRP) is considered as a sensitive indicator of systemic inflammation and direct mediator of atherogenesis that has been shown to be a powerful predictor of future recurrent coronary and cerebral ischemic events in subjects after stroke. However, the pathogenic and clinical significance of these associations is controversial. Objective. To evaluate the relationship between circulating vascular endothelial growth factor-1 level and high sensitive C-reactive protein (hs-CRP) in III stage arterial hypertension patients. Methods. 102 mild-to-moderate arterial hypertension patients were enrolled to the study in 3 weeks after ischemic stroke. Circulating vascular endothelial growth factor-1 level and hs CRP were determined at study entry only. Results. Analysis of obtained outcomes have been showed that circulating VEGF-1 is independently associated with the hsC-RP (R = 0.478; P = 0.001), type 2 diabetes (R = 0.422; P = 0.001) and hyperlipidemia (R = 0.413; P = 0.002), male gender (R = 0.407; P = 0.001), BMI (R = -0.422; P = 0.001), statins using (R = -0.411; P = 0.001), treatment of ACE inhibitor (R = -0.403; P = 0.001), triglycerides concentration (R = -0.356; P = 0.002). In this case, the circulating VEGF-1 increases non-linearly proportional to the quartiles of the hs CRP quartile level in the blood. In conclusion, we found that concentration of high-sensitivity C-reactive protein above 10.57 mg/l might be an indicator of vascular endothelial growth factor-1 elevation in hypertensive patients irrespective of traditional cardiovascular risk factors.

The morphology of stomach structural components in rats was studied in normal conditions and after intrauterinal introduction of Vaxigrippe vaccine. Intrauterinal antigen stimulation resulted in increase of the thickness of stomach’s mucosa in all age groups.

Introduction. Diabetic macular edema (DME) is a common manifestation of diabetic retinopathy and an important cause of visual impairment in people with diabetes. DME is the most common cause of decreased vision in patients with diabetes. It can accompany any stage of the disease and occurs on average 10% of patients with diabetes. In this case, due to structural changes in the endothelium of retinal vessels violation of the retinal barrier increased permeability of blood vessels wall and fluid accumulation in the intercellular space retinal optical coherence tomography (OCT) is a method of diagnostic morphological structure of the retina and allows high precision of the DME diagnose, assess the severity and observe the dynamics. Materials and methods. During the work general ophthalmic examination, OCT, PAH and immunological studies were performed in all patients. Total 64 patients (128 eyes), including 28 women (43.8%) and 36 men (56.3%), whose average age was '58 (SD 10), 24 to 78 years with diabetes type II diabetic macular edema of various kinds took part in the study. Diffuse (occlusal and unocclusal kind ) and complicated (occlusal and unocclusal ) DME were studied. Diffuse occlusal DME was diagnosed in 33 cases, diffuse unocclusal DME – in 35 cases, complicated occlusal DME - in 28 cases, complicated unocclusal DME - in 32. Statistical analysis was performed in the program MedCalc 9.0. Results and Discussion: In this clinical study there is a clear pattern between the type and the presence of DME. Conclusions: We can talk about the use of the criterion of the presence or absence of RPE detachment to differentiate species (occlusion or unocclusual) diffuse and complicated DME in patients with diabetes type II.

Purpose. Nowadays information about significance of different types of vascular remodeling and their interrelation with hypertensive heart development is scarce. Aim. To assess separate changes in carotid intima and media thickness and their interrelations with heart remodeling in women with arterial hypertension. Materials and methods. 95 female (to avoid sex difference) patients with AH I – II degree without any additional risk factors ( disease duration 2 – 16 yrs ) with the average age 47,6 ± 7,4 yrs have been examined. 36 apparently healthy women ( the average age 44,0 ± 8,3 yrs ) have formed the control group. The carotid IMT has been measured by LOGIC P5 PRO, GE (B-regime) using ZOOM function (at the level 1 cm aside from the bifurcation area following the standard procedure); simultaneously the intima thickness (as hyperechogenic stripe and according to its echogenicity which corresponds to surrounding tissues of the vessel) and the media thickness (as hypoechogenic stripe which is located under intima and its echogenicity corresponds to the vessel lumen) have been measured separately. Simultaneously all significant heart indexes: posterior wall thickness (PWT), interventricular septum thickness (IVST) in diastole, left atrial dimension (LA), end-systolic (ESD), end-diastolic dimensions (EDD), end-diastolic (EDV) and end-systolic volume (ESV), left ventricular mass index (LVMI) and ejection fraction (EF) were measured and estimated. Statistical methods included Spearman's rank correlation, statistically significant at p value < 0.05. Results and discussion. Between media of the carotid arteries and PWT (R = 0,295, p <0.003), as well as with LVMI (R = 0,322, p <0.001) was fixed direct correlation, which is characterized by greater power and the level of statistical significance, than with the intimal layer. Also a direct correlation between the media and performance EDD (R = 0,289, p = 0.004), EDV (R = 0,289, p = 0.004), ESD (R = 0,339, p = 0.0008), ESV (R = 0,339 , p = 0.0008) and IVST (R = 0,258, p = 0.003), which may indicate the role of LV systolic function in the formation of hypertensive heart. Direct correlation between inner diameter of the carotid arteries and ESD, EDD, PWT, IVST, EDV, ESV, LVMI (R от 0,250 до 0,458, р < 0,05) and inverse relationship with EF (r = -0,467; р = 0,001) has been established. Conclusions: Cardio - vascular remodeling in AH is associated not only with traditional common intima – media thickness but more tightly with separate media thickness and inner vessel diameter of large arteries enlargement. Significant and reliable negative relationship between media thickening, inner diameter of carotid arteries index and left ventricle EF has been established; it may indicate new peculiarities of the initial impact of vascular remodeling onLV systolic dysfunction development.

Hypokinesia can reduce physical performance and impair human health, which is evident by significant morphofunctional changes in the body. To correct these abnormalities and prevent their occurrence actoprotectors are used in hospitals. In previous studies [Stepanyuk G.I, 2012] we found that 5-R-thio-tetrazol [1,5-c] quinasoline derivatives quite clearly improved physical performance of rats according to swimming test. In terms of actoprotective activity compound-leader КВ-28 (sodium 2-( tetrazol [1,5-с] quinazolin -5- ylthio)acetate) for certain predominated over reference compound bemityl. WORK OBJECTIVE. To describe the influence of course administration of sodium 2-( tetrazol [1,5-с] quinazolin -5- ylthio) acetate in comparison with bemityl on the behavioral reactions of rats under 18-day hypokinesia. RESEARCH MATERIALS AND METHODS. Chronic stress immobilization was modeled by keeping rats in small wooden cases for 16 hours / day for 18 days. Animals were divided into 4 groups of 6 animals in each: I - intact animals, II - rats stressed with hypokinesia without correction (control), III and IV - hypokinetic rats who one-time within 18 days take daily intraperitoneally КВ -28 (1,7 mg/kg) and bemityl (32 mg/kg) at doses equal to their ED50 according to swimming test. Orientative-searching and emotional activity were assessed by neuroethological "open field" test [Buresh, 1991] on the 4th, 12th and 18th day of experiment, that accordingly characterize the stage of anxiety, resistance and exhaustion of general adaptation syndrome [Stefanov, 2001]. To analyze the behavior the following neurophysiological indices were used: horizontal motor activity (number of the crossed squares), vertical activity (number of racks), number of examined holes and autonomic balance: number of washings (grooming) and defecation acts (number of boluses and urinations). Duration of observation was 3 min. RESULTS AND THEIR DISCUSSION. In the course of the experiment a negative correlation of orientative-exploratory activity and autonomic balance indices were revealed in rats of the control group, indicating the inhibition of searching activity and high level of animals’ anxiety as a result of the negative effect of stress factors on them. Daily administration of compound КВ-28, as well as bemityl to rats with chronic hypokinesia contributed to the increased locomotor and searching activity and normalization of autonomic balance indices in animals compared with the control group. Received data can show indications of psycho-emotional stress reduction in animals that was most clearly evident on the 4th and 12th day of the experiment when administering КВ-28 and on the 4th day - when applying bemityl. Thus, the results of the study give reason to expect that antistress action is inherent to sodium 2 - (tetrazol [1,5-c] quinazolin-5-ylthio) acetate (1,7 mg / kg / intraperitoneally) as well as to bemityl (32 mg / kg / intraperitoneally). CONCLUSIONS. Chronic stress immobilization causes reduction of motor activity and exploratory behavior of rats in the “open field” test. Course administration of sodium 2-(tetrazol [1,5-с] quinazolin -5- ylthio) acetate (1,7 mg / kg / intraperitoneally), as well as bemityl (32 mg / kg / intraperitoneally) to rats with chronic hypokinesia, contributes to the restoration of indices of emotional and behavioral reactions of animals in the given experimental conditions. The highest antistress effect of compound КВ-28 occurred on the 4th and 12th day of the experiment.

Nowadays diseases of digestive organs in children are significant medico-social problem. It is known that adaptive reactions in many respects determine morbidity, severity of disease, effectiveness of medical treatment. The aim was to study organism nonspecific adaptative reactions (ONAR) in children with chronic pathology of digestive tract (DT): chronic gastritis (CG) in stages of acute and remission stages, and biliary dyskinesia (BD). Мethods. 40 children with CG, age 9-17 years, and 41 children with BD, age 7-12 years were examined. Control group was formed by 38 healthy children, age 7-12 years. Clinical methods and evaluation of hematologic criteria of ONAR were used. Results. In children with chronic pathology of DT significantly frequently unfavorable stress reaction (8,6±3,1% against 0% in control group, р<0,01) and training reaction were detected (22,2±4,6 against 7,9±4,4% in control group, р<0,05). In CG in stage of clinical implications significantly rarely than in stage of remission (28,6±9,9% against 55,3±8,1%, р<0,05) reaction of increased activation were detected, and significantly frequently – unfavorable ONAR. Conclusion. In boys with CG in stage of clinical implications and BD significantly frequently unfavorable reaction of adaptation were found.

The study of the activity of infl ammation in children with asthma by determining the levels of total IgE, eosinophilic cationic protein, ICAM-1, leukotrienes (C4/D4/E4) is described.

The problem of choose of the safe anticonvulsant for the treatment of epilepsy is quite relevant. When choosing a drug, the physician should strive to balance the frequency of attacks and the severity of side effects in each individual patient. Rational antiepileptic therapy should improve the quality of life of the patient and his social adaptation. Purpose of the work : a comparative study of the effect of anticonvulsants on behavioral and emotional reactions and physical performance under the experimental conditions. MATERIALS AND METHODS. Study was conducted on 30 white nonlinear rats weighing 180 - 220 g and 30 white nonlinear mice weighing 17-25 g, which were kept on a standard diet of the vivarium. Drugs: sodium valproate, at a dose of 80 mg / kg and carbamazepine - a dose of 125 mg / kg. All animals were randomly divided into 6 groups of 10 rats and mice. Determination of physical performance of mice was done in a "stretched wire" (or "muscle relaxation") test, in accordance with the methodology . The "open field" test allows us to determine the type of effect of the drug on the central nervous system as well as to clarify the nature of its influence on orientational-research activity and emotional sphere of experimental animals. The data were analyzed by statistic method using statistical analysis programs such as StatPlus, AnalystSoft. Results: It should be noted that anticonvulsants had a sedative effect on orientational and exploratory activity in rats. The most pronounced difference in data of the behavior of experimental rats was observed when carbamazepine was administered. Horizontal motor activity that was determined by the number of peripheral squares that were crossed by the tested animals under carbamazepine decreased to 88,4% (p <0,05) compared to controls. And vertical motor activity was 89,7% (p <0,05). A similar situation was observed in the study of sodium valproate but the rate of horizontal locomotor activity was 67.3% (p <0,05) compared to controls, which was less than with carbamazepine. With the introduction of sodium valproate uprights decreased by 54,0% (p <0,05). In antiepileptic drugs administered to animals inhibited “hole reflex”: the number of holes decreased compared with control when using carbamazepine - by 76,9% (p <0,05), sodium valproate to 69.2% (p <0,05). The effect of drugs on physical performance of the animals was also studied. According to the results of our study, the duration of the retention on the wire in the control group was 34 ± 4,5 sec. (M ± SD). With the introduction of anticonvulsants the average time was moderately reduced compared with the control: on the sodium valproate to 38.2% (p <0.05) and was 21,0 ± 2,7 sec., on the carbamazepine to 43.2% (p <0.05) and was 19,3 ± 3,7 sec. More relaxing effect on the muscles provided carbamazepine. Conclusions: Carbamazepine and valproate sodium show a sedative effect on the central nervous system, resulting in disturbance of emotional and behavioral sectors as well as impairing the performance of the animals.

Rheumatoid arthritis (RA) leads not only to a rapid development of disability, but can influence the life of these patients. One-third of patients with rheumatoid arthritis may have signs of disability during the first 3 years of the onset of the disease, while mortality in patients with RA almost two times higher in comparison with the general population. Analysis of recent prospective studies on the progression of the pathological process and predicting of the long-term outcomes in RA clearly indicate the need for clinical evaluation and a comprehensive laboratory and instrumental diagnosis of the disease in the initial manifestations of the most followed by early adequate pathogenetic therapy. The purpose of this survey was to determine modern clinical aspects of diagnosis, the possibility of standard and specialized instrumental examinations in patients with eRA, followed by predicting long-term results. We studied 52 specialized publications on clinical classification and a modern laboratory and diagnostic tests for eRA. This review presents the data of the importance of differentiation of several stages of RA in relation to the time factor. The data on the sensitivity and specificity of the diagnostic classification and clinical criteria of eRA and an algorithm for the identification of the disease were presented. It was shown prognostic value of the main serological markers of RA, and the predictive value for early detection of antibodies to the circulating peptide as a marker of the severity of bone-destructive changes in patients with certain clinical manifestations. Antibodies to the circulating peptide (ACPA) can be detected many years before the onset of RA. Study of anti-citrulline mutated vimentin (anti-MCV) in patients with eRA can be applied as a marker of activity of the process and the subsequent possibility of use for predicting long-term results. This review presents the major diagnostic errors using standard instrumental methods of diagnosis of RA. Describes the diagnostic capabilities of the periarticular soft tissue changes at different stages. Provides information about using US of joints as a methodology for monitoring patients with eRA. The data presents the diagnostic capabilities of magnetic resonance imaging (MRI) in patients with eRA by using different modes of MRI and radiopaque substance with a strong tropism to the synovial membrane. Conclusion: For the purpose of early diagnosis and prognosis of joint erosions appropriate set of laboratory monitoring indicators (ESR, CRP, RF and ACPA anti-MCV) characterize the pathological changes of the articular structure in patients with eRA. The introduction into the routine clinical practice US of joints allows to reach high accuracy of the diagnosis of eRA (before the erosive and destructive changes of bone tissue), which significantly improvement prognosis of the patients. Instrumental examination using MRI (especially in the study of small joints and muscles function T1 fs-fat) is essential for the study of the pathophysiology of objectification of patients with eRA. When conducting MRI in patients with very eRA - is diagnostic and prognostic factor in the rapid progression to erosive and destructive arthritis.

Introduction. Peripheral blood lymphocytes (PBL) express neurotransmitter and neuropeptide receptors. The dopamine receptors in PBL may reflect the status of homologous brain receptors. Therefore, PBL were proposed as a model for investigating possible systemic derangement in various psychiatric disorders. Expression of PBL dopamine D2 receptors was not investigated in subcortical vascular dementia (SCVaD) as opposed to Alzheimer`s disease and range of neuropsychiatric patients. Objective. To assess the expression of dopamine D2 receptors on PBL in different stages of SCVaD formation. Patients and methods. The expression of dopamine D2 receptors was assessed on PBL in 18 patients with subcortical vascular mild cognitive impairment (SVMCI) and 10 early stages SCVaD patients by indirect immunoperoxidase method. Results. It was shown that expression of dopamine D2 receptors on PBL was reduced in concordance with severity of subcortical vascular cognitive deficit. This parameter was 19,5 (19-20) in SVMCI group and 18,5 (18-19) in SCVaD patients (Р = 0,016). It had a significant (P < 0,05) modest correlation with cognitive deficit severity according to MMSE (rs = 0,50), severity of kinetic apraxia (rs = -0,44) and attention impairments (rs = 0,40). The conclusion. The density of dopamine D2 receptors on PBL reduction could be the marker of transformation of SVMCI into SCVaD and could reflect the reduction of postsynaptic dopamine D2 receptors expression in frontal-subcortical brain regions. dopamine D2 receptors, lymphocytes, subcortical vascular dementia.

Reactive chlamydia arthritis is accompanied by the increase of parameters of volume viscidity, elastic of viscidity and static (equilibrium) surface-tension and phase corner of tensiogramm serum of blood, on background of the reduction of relaxation time, that is related with duration of illness, activity of pathological process, tendovaginities. Major role in the development of oculopathy (uveitis, scleritis, keratitis, conjunctivitis, cataract, glaucoma) take part disorders of the adsorption-rheological properties of the blood.

There are the data on the features of the treatment of patients with nonalcoholic steatohepatitis on the background of the 2nd stage of hypertension and metabolic syndrome are given in the article. Comparative characteristic of dynamic quality indexes of the treatment with the traditional medicines and with the use of Gepadif, Ezetrol and Fosinopril was done.

Introduction. In patients with extensive deep burns the most severe of all infectious and inflammatory complications is sepsis which causes high death rate. The purpose of our work was to develop the algorithm of bacterial sepsis diagnosis in patients with severe burn disease. Materials and methods. The study involved 140 burned patients divided into two groups: Group 1 – 78 patients who underwent necrectomy within 3-7 days after the burn, Group 2 (control) – 62 patients with necrectomy performed in later period. In 78 patients of the main group the average meaning of the total area of the burn was 45.47 ± 1.91% of the body surface (bs); of the deep burn area - 21.76 ± 1.85% bs, while in 62 patients of the control group it was respectively 40.03 ± 2.29% and 23.74 ± 1.81%. Results of the research. In the main group, after early necrectomy, the number of symptoms of the systemic inflammatory response syndrome (SIRS) measured at an average from 1.79 to 2.03 of the 4 possible symptoms, which is 20-22% less compared to the control group of patients in whom surgical treatment was carried out at later terms. Death rate in patients with early necrectomy was 11.54 ± 3.62% (9 patients), while in the control group it was 32.26 ± 5.94% (20 patients). The causes of mortality were burn sepsis and pneumonia. In those patients who recovered the severity of SIRS was 1.4 times less in comparison with those who died. Out of 46 samples of blood serum procalcitonin (PCT), in 31 cases PCT level was <0.5 ng/ml, in 10 cases it ranged 0.5-2.0 ng/ml, and in 5 studies it was 2.0-10.0 ng/ml. Increased levels of PCT were found in burned patients with the developing sepsis. PCT level <0.5 ng/ml confirms the absence of bacterial sepsis, while the value of PCT grown to 0.5-2.0 ng/ml shows the necessity of dynamic monitoring of this index changes, and ≥2,0 ng/ml value of PCT confirms the presence of bacterial sepsis, which requires timely administration of adequate methods of treatment. While using SAPS modified prognostic scale (SAPS MPS) it was found out that in burned patients having the level of PCT >0.5 ng/ml, general condition severity measured >18 points. Conclusions. Burn sepsis diagnosis algorithm incorporated SIRS level assessment, evaluation of the severity of patients’ condition using SAPS MPS (with SIRS >2 signs), determination of blood serum PCT level (with SAPS MPS ≥18 points). The use of this algorithm has allowed to significantly reduce the number of severe sepsis cases by 56 % and mortality rate by 64%.

Introduction: recently in Ukraine prostate diseases have taken one of the leading places among male urological pathologies. Prostate gland hyperplasia is one of the most common ones. Causes of hyperplasia have not been reliably established so far, however, it has been proved that the poor state of androgen production in men is an integral condition for the development of benign prostatic hyperplasia. One of the urgent tasks of modern pharmaceutical science is to create new high-performance drugs in such dosage forms that provide optimal therapeutic effect with minimal adverse complications. Among a large number of drugs for the treatment of prostate diseases a prominent place is occupied by alpha-adrenoblockers – drugs of the first-line treatments that affect the α1А-adrenergic receptors, reduce or completely eliminate the muscle tone of the prostatic urethra and bladder neck. Tamsulosin hydrochloride is a selective and competitive blocker of postsynaptic α1А-adrenergic receptors. The selectivity of tamsulosin to α1А-adrenergic receptors, which are located in the bladder, is 20 times greater than its ability to interact with α1В-adrenoceptors that are located in vascular smooth muscles. Objective: to study the pharmacokinetics of tamsulosin hydrochloride release into prostate gland after oral and rectal administration by a radioactive-tracer technique. Materials and methods of research: tamsulosin hydrochloride substance and suppositories with this substance labeled by 14С with a specific activity of 3.7× 107Bq/mg. Pharmacokinetic studies of tamsulosin hydrochloride in the prostate were performed after oral and rectal administration. The experiments were carried out on white mature male rats of Wistar line weighing 210 ± 10 g. Pharmacokinetic studies were performed using a radioactive-tracer technique (tracers) after oral and rectal administration of tamsulosin. Results and their discussion: after rectal administration the release of tamsulosin hydrochloride is more complete and intensive compared to oral route of administration. Thus, the results of the experiment prove that the preparation reaches the prostate much faster, releases more completely and has a higher bioavailability. Conclusions: the study of pharmacokinetics of tamsulosin hydrochloride accumulation in prostate gland after oral and rectal administration by a radioactive-tracer technique with the help of α-β-radiometer NRR-610 “Tesla” has been done. The research results proved the advantages of rectal route of drug administration compared with oral. The obtained results confirm the expediency of creation of the medicinal preparation with alpha-adrenoblocker tamsulosin hydrochloride in the form of suppositories for prostate diseases treatment.

Clinical computed electroencephalographic examination of 120 patients in acute period of ischemic supratentorial stroke was made with the aim of differential outcome prognosis optimization. The criteria of lethal and unfavorable nonlethal variant of clinical, social outcome prognosis of stroke’s acute period were developed by binary logistic regression method. Evaluation of prognostic models effectiveness was made using ROC-analysis. The practicability of model’s application for treatment measures optimization was justifi ed in patients with acute stroke.

Objective. The purpose of this research was to study the UV spectrum of Metronidazole in different polarity solvents (water, 95 % ethanol, 0,1 M sodium hydroxide, 0,1 M hydrochloric acid and 5 M sulfuric acid solution), to establish the relationship between chemical structure of the analyzed compounds and the nature of their electronic spectrum. In addition, a detailed study of the ultraviolet spectra of Metronidazole in different solutions enables to select the optimal wavelength and a thinner design for Metronidazole in substance and dosage forms. Materials and methods. Spectrophotometer SPECORD 200-222U214 has been used for study of the UV spectra of Metronidazole, the quantitative methods were used. Measuring of the absorption of Metronidazole solutions has been carried out in quartz cuvettes with a layer thickness of 10 mm. Due to the fact that the test material shows selective absorption in the ultraviolet spectra, model compounds were studied at a concentration of 1 mg%. Study of electronic spectra was performed in the range of 200 to 400 nm, and the curve has been constructed in coordinates A = f (λ). It has been used water, 95% ethanol, 0,1 M NaOH, 0,1 M HCl and 5 M H2SO4 as solvents. The content of Metronidazole in substance and dosage forms calculated with the equations according to SPU. The results. Study of the UV spectra of Metronidazole and its model compounds showed that in short-wave part of spectrum due to absorption and excitation electrons of imidazole ring were transferred, and in long-wave – conjugation chromophore imidazole cycle and nitro group as electron acceptor occurred. Analysis of the UV spectra of Metronidazole enables to determine a maximum of the analytical quantification of the medicine. Conclusions. Metronidazole UV spectra in water, 95% ethanol, 0,1 M solution of NaOH, 0,1 M solution of HCl and 5 M solution of H2SO4 have been studied. Metronidazole UV spectra are characterized by two absorption bands in the range 228-230 nm and 276-332 nm in specifying solvents. Quantitative determination methods of Metronidazole in the substance (water and 95% ethanol at 230 nm), 0,5% solution for infusion (water at 230 nm) and vaginal suppositories of 0,1 g (water at 230 nm) have been developed and proposed. The error in the determination of metronidazole in the substance did not exceed ± 0,03, and in dosage forms - ± 0,05.

According to many authors birth in breech presentation is pathological for the fetus. Correction of breech presentation to the head during pregnancy is worth close attention. Experience in performing prophylactic fetus rotation to the head in breech presentation has been analyzed.

Currently, the state of the national health system (health) is characterized by a low level of funding for medical and pharmaceutical care and the lack of effective methods of free and preferential dispensing of medicines (drugs) and compensation of their value. Thus the most urgent problem arises is unregulated drugs prescription, which is one of the main negative factors behind the rapid spread of self-medication and polypragmasy. Thus, improving drugs prescription dispensing is one of the current challenges of medicine and pharmacy management which should be solved to provide a safe, rational and effective drug therapy. The results of the questionnaire survey of doctors and pharmaceutical workers identified and explored key factors that contribute to a violation of drugs prescription. The authors analyzed the literature on the current state of drugs prescription in Ukraine, which resulted in selected priority issues that need resolution as soon as possible. Established that the main disadvantages of the national health care system is unreasonable approach to state regulation of the relevant system and the low level of funding. This situation prevents rational regulation of free and preferential delivery of drugs, the introduction of obligatory medical insurance and the reimbursement cost of drugs and other modern approaches that are effective in developed countries. Тhe main motive of view of legislative acts to implement strict drugs prescription in Ukraine is a link to international experience, guided by the standards of European and international practices that do not comply with the Law of Ukraine issued on 18.03.2004 № 1629-IV «On the National Program for Adaptation of Ukraine to the European Union, "and points to the disparity modern domestic rule-making European practice. The fundamental problem here is the comparison of the legal, social, financial and economic status of the counter in Ukraine with the countries in which the system of local government regulation of the drugs cost. The results of the study identified the main directions of improvement of medicines prescription in Ukraine. The major factors of modern problems with drugs prescription include lack of prescription forms F-1. According to respondents thought one of the main directions of reforming the national health care system should be the implementation of local governmental and insurance recipes that will counter the financial status of the document and at the same time effectively solve the problem of drugs prescription. The investigation identified the main directions for improvement of drugs prescription: • Development and installation authority of Health Management Ukraine at all levels to ensure the prescription forms for hospitals in sufficient quantities; • continuous monitoring of the implementation of these powers in the regional offices of health care.

Introduction. In previous researches we grounded expedience of «Indotril» tablets development; formulation and technology of "Indotril" tablet cores were developed. Received tablet cores should be covered by protective polymeric film with the purpose of unpleasant taste elimination, increase of tablets expiration date. Objective. The aim of our investigation was to develop the film forming composition and technology of polymeric film coating on «Indotril» tablets in pseudo-fluidized layer. Materials and Methods. As “Indotril” tablets cores should be covered by protective polymeric film we performed research designed to select efficient film forming solution. Thus modern filming agents were studied, besides such factors were investigated: concentration of film forming suspension, increase of tablet coat in mass, air temperature under gas distribution grid. Obtained tablets were checked according to pharmacopeia methods. Results and discussion. First we studied tablet compression force influence on main parameters of «Indotril» cores tablets: on crushing strength, abrasion in pseudo-fluidized layer unit and disintegration. Then for further investigation we chose «Indotril» cores tablets with crushing strength near 70 H, abrasion - up to 0,5% and disintegration time - not more than 10 minutes. We performed research to select film forming solution for covering “Indotril” tablets in pseudo-fluidized layer unit. As filming agents we used different samples of hydroxypropyl methylcellulose (HPMC) by Japan company Shin-Etsu Chemical Co and English company Colorcon. Water HPMC solutions were prepared which contained plasticizer (propylene glycol), pigment (titanium IV dioxide) and dye (tartrazine). Coating process of “Indotril” tablets was performed in laboratory pseudo-fluidized layer unit with the air temperature 75ºC under gas distribution grid. Variance analysis of experimental data on quality of coat surface showed insignificance as for nature of studied filming agents. Homogeneity in bulk of coated “Indotril” tablets also did not differ significantly as for filming agents’ nature. Divergence in mass of coated tablets did not differ significantly from uncoated ones; it testifies identity of filming process over all tablets surface. Strength of coated “Indotril” tablets as compared with uncoated ones increases in average on 15-20 H. Variance analysis of experimental data concerning tablets disintegration resistance showed that there was no significant difference between studied filming agents. While defining disintegration time statistical significance of filming agents’ nature was determined. Ranking is the following: 6% solution of HPMC Pharmacoat 603 > 5% solution of Opadray II WHITE > 5% solution of HPMC Pharmacoat 606 > 4% solution of HPMC Pharmacoat 615. But the difference between filming agents’ nature is not more than 2 minutes. Opadray II WHITE has been chosen for further study; it comes to the enterprise (“Arterium” Corporation) where the results of investigation are planned to be introduced for the manufacture of other tablet dosage forms. On the next stage of our investigation we defined optimal values of quantitative factors, notably the influence of air temperature under gas distribution grid, concentration of film forming suspension and film thickness on the properties of coated “Indotril” tablets. Conclusion. Influence of filming agent nature on properties of coated tablets «Indotril» was studied, namely on appearance, homogeneity in bulk, mechanical strength, disintegration time. Opadray II WHITE was proposed for coating “Indotril” tablets by protective polymeric coat in pseudo-fluidized layer. Worked out formulation of filming agent solution and technology of its application were included into technological regulation of «Indotril» tablets production.

Priority direction of state policy concerning the development of higher education inUkraineis to prepare qualified and competitive staff in the labor market. The high level of competence and scientific competence along with pedagogical craftsmanship and psychological culture of teachers is condition for improving the efficiency of the educational process in higher education. Aim of research was theoretical justification importance of competence and competency of high school teacher for the establishment his innovation potential. In the article the analysis of interpretation of the terms competence and competency in various scientific sources and scientific works of individual authors were presented. Moreover important are ability to creativity, solving of problem’s tasks, ingenuity, flexibility and criticality mind, intuition, originality and self-confidence; ability to formulate and solve non-standard tasks; ability to analyse, synthesis and combination, to share experiences, predictions, etc.. Emotionally-shaped quality represented by the following components as spirituality, the emotional upsurge in creative situations; associativity, imagination, sense of novelty, sensitivity to contradictions, empathy; insight, ability to see the familiar in an unfamiliar; overcome the stereotypes; risk appetite, desire for freedom. The general regularities of formation of research competence have been detected. In particular, the formation carried out through the development of competencies invariant character and increasing of specialized skills. It is proved that scientific and research competence is determined primarily by the system of teacher's professional education and self-education. The most important objective characteristics that reflect the competence of teachers in the field R & D is the total number of publications, number of scientific articles, monographs, and also won grants, competitions, etc. Moreover the level of competence in the field of self-control increases with age and with experience of work in the high school.

The questions connected with fi nding-out of sense, and also the analysis of the points of view of different authors concerning definitions «pharmaceutical sphere» and «pharmaceutical branch», more accurate allocation of borders of this set of specifi c relations for more effective application of institute of administrative responsibility for infringements of the pharmaceutical legislation are considered.

Salmonella biofi lms’ resistance to the action of the disinfectants was studied. It was founded that Salmonella biofi lms, which were formed on the hard carriers during 24 hours of incubation, demanded 32-fold increase of the minimal bactericide concentration of the disinfectant with quaternary ammonium compound.

Summary: Article is devoted to the legislation review of the public-private partnership projects of the healthcare sector inUkraine. Authors focused attention on the basic problems of public-private partnership projects inUkraine. Objective: Analysis of the legal framework provides the possibility of public-private partnerships in health care ofUkraine and confirms the relevance of the scientific concept of development of public-private partnerships in health care ofUkraine. Methods: There were used periodic data of legal, economic and medical research publications inUkraine and CIS countries on regulatory support public-private partnerships. Results: The researches in many countries have proven the established of state regulatory bodies that carefully study various aspects of the business partnership in the services of provision of health care. Developed numerical models as simple infrastructure projects implement business participation in providing non-medical services (construction, hotels and utilities, technical re-equipment etc.) to complex integrated models that involve the transfer of important state functions to private partner (strategic planning, highly specialized medical care, research, medical education, etc.). Conclusion: The development of public-private partnerships in health care of Ukraine is possible only in condition of further improvement of legislation to the line with the norms and principles of international law, providing a clear and coordinated cooperation of all branches and friendly to business partnership administrative environment.

Market of parapharmaceutical products appeared on the pharmaceutical market of Ukraine not long ago, so it has not got a clear official status. This factor influenced on the formation of the contradictions in the legal framework, resulting in complications for manufacturers, distribution companies, retailers (pharmacies, pharmacy, Farmmarket) and consumers. Formation of the parapharmaceutical domestic market performed despite the inadequacies and contradictions of the legal framework, Surveys of consumers, producers and distributors can help to improve the development of scientific and teaching activities on the regulation of parapharmaceutical goods in Ukraine. A questionnaire survey among consumers, pharmacists in pharmacy segment and distributors on pharmaceutical market of Ukraine monitors the need for state regulation of parafarmacutical goods. The method of questionnaire survey of consumers, managers of pharmaceutical distribution companies and pharmacists need in the government regulation was studied. Consumers survey found that 80% of respondents who consume parapharmaceutical goods for hair were female. Most of the residents lived in the city − 90%. 80% had higher education. Within the consumers of the parapharmaceutical goods 45% were employees, 20% workers, 15% retired. Only 5% of them were pupils and students. The main consumers of age were − 21−45 years (21 to 35 years − 45%, from 36 to 45 years − 35%). The need for parapharmaceutical goods distribution in a pharmacy indicated 58% of respondents. 90% of specialists said that it is necessary to make adjustments in the legal documents regarding parapharmaceutical advertising by manufacturers and distributors. Most part of the respondents (50%) noted that the financial crisis has slowed down pharmaceutical companies work, by reducing consumer demand for parapharmaceutical and preference for medicines purchasing. 40% of managers pointed to the difficulties in work with parapharmaceutical goods because of the minimum amount of purchases from the manufacturer.

Introduction. Every year in Ukraine more than 160,000 new cases of cancer are registered, the number of deaths from the disease each year is more than 87,000. Over the last decade in Ukraine gastric cancer have took third place in the structure of cancer incidence among men and fourth in women. At the same time, since 2009, the main cause of adult deaths from malignant tumors in Ukraine is colorectal cancer. According to the forecasts of the Ministry of Health under the conditions, the situation in the Ukraine will be continued to 2020. So important is the issue of improving the existing pharmaceutical care for this group of patients. Thus, the aim of the work was a comprehensive expertise of anticancer drugs for the treatment of cancer patients with abdominal profile. As a method of research the method of expert evaluation was used (oncologists-chemotherapeutist). The authors had developed an algorithm for expert evaluation of anticancer drugs used in pathogenetic therapy of stomach cancer and colorectal (rectal) cancer. Questionnaire for oncologists was designed by researchers of Organization and economy of pharmacy department led by professor Nemchenko A.S. and successfully used in conducting of fundamental researches from 1998; questionnaire proposed to assess 48 anticancer drugs. The study was carried out in eight basic regions in which structure of morbidity corresponds to the general structure in the country. Previously the coefficient of competence of each expert have been calculated. For further research authors used questionnaires of the experts with very high, high and sufficient competence, accounting for nearly 65% of the questionnaires. Tothe high-level group of drugs experts allocated 24 anticancer medicines, corresponding to 8 INN, in group of middle- experts identified 16 anticancer medicines or 9 INN. Thus, 80% of the researched medicines were recommended by experts or inclused in the formulary lists for treatment stomach and rectal cancer. In conclusion, it should be noted that, in general, the recommended list of the drugs mainly corresponded to the current state protocols of treatment of patients with stomach and rectal cancer.

Introduction. Due to the necessity to obtain the reliable results of a clinical trial and to distribute it to the general population of patients the problem of recruiting the adequate number of individuals to participate in the study as objects of observation in the group receiving the investigational medicinal product or as a member of the control group should to be solved. Aim of study. The aim of our study was to research and to justify practically the methodological approaches to determining financial compensation for participation of volunteers in the clinical trials and the appropriate methods of its calculation. Material and methods. For the purpose of determining the baseline factors for calculating the hourly compensation the survey of healthy volunteers and of expert professionals as well as the analysis of its results have been done. Questioning healthy volunteers regarding their attitudes towards inconvenience and discomfort during participation in clinical trials was held at the Ukrainian clinical research centers. Survey participants number was 99, they were healthy volunteers who took part in the first phase clinical trial or bioequivalence studies. The expert survey included questioning of the 193 professionals from Ukrainian clinical research centers, CRO, pharmaceutical manufacturers – research sponsors and collaborators State Expert Center Ministry of Health of Ukraine, who were involved in the planning, organization, implementation and evaluation of clinical trials as well as their regulatory control. Results of study. Using the method of pairwise comparisons and iterative refinement procedures the collective estimate of experts questionnaire results has been performed, by the results of which the nine indicators have been identified and the importance of each of them as units of discomfort have been established. Motivational factors of voluntary participation in clinical trials have been studied. Motivation system for participation in clinical trials by patients and healthy volunteers has been rationalized, whereas methods of calculating monetary compensation for such participation have been suggested. The two methods of calculating of the financial compensation were proposed: first - hourly compensation for the time which was spent on clinical trials, the second - hourly-bonus compensation for the possible discomfort and inconvenience of participation in clinical trials in accordance with the ethical rules for research involving people as objects of observation. Conclusion. Achievement of the organizational and financial constituent ensuring participation of volunteers in a clinical trial on the one hand should assure the appropriate experimental foundation for reliable research conducting and on other hand should focus attention on the fulfillment of mental and ethical rules for investigations involving human as a studied object. Basing on the results of an analysis and the survey performed which involved qualified experts regarding aspects affecting volunteers enrollment in a clinical trial, the scientifically substantiated system of the volunteers discomfort and inconvenience assessment in a clinical trial has been proposed, which includes criteria: study duration, adverse events/adverse reactions possibility, blood sampling during study, discomfort caused by study design, inconvenience to participate in a clinical trial. Two techniques for calculation of the financial compensation for healthy volunteers participation in a clinical trial have been proposed: the first one is the payment by the hour spent for participation in a study, and the second one is the hourly pay with bonus for possible discomfort caused by involvement in a clinical trial. In the further study authors plan to research the aspects of risk assessment associated with volunteers participation in a clinical trial and its considering as an additional constituent in the process of the calculation of financial incentives to participate in a clinical trial.

Introduction. Nanotechnology is the science of manipulating atoms and molecules in the nanoscale. Applications of nanotechnology are widely used in electronics and medicine and now are founded in the field of cosmetics (nanocosmetics). Nowadays cosmetology became science. Progress in the study of the physiology of the skin, the mechanisms of aging and skin diseases pathogenesis, allowed developers to create cosmetic products consciously based on the needs of the skin and the mechanisms of action of active components. However, there are debates over their toxicity. The aim. The aim of our study was to analyze scientific literature about types of nanomaterials used in cosmetics and the potential risks of nanoparticles. Materials and methods. Informational search about: different types of nanomaterials in cosmetics including nanosomes, liposomes, fullerenes, solid lipid nanoparticles and also toxicity and safety; in scientific editions, medical and pharmaceutical databases, and other web-resources was carried out. Results. There are currently exist two main uses for nanotechnology in cosmetics. First of all - use of nanoparticles as UV filters. Titanium dioxide and zinc oxide are the main compounds used in these applications. The second use is nanotechnology for delivery. Liposomes and nanosomes are used in the cosmetic industry as delivery vehicles. Scientists currently believe that these nanomaterials are unlikely to have a toxic effect on humans or ecosystems that differ them from the effect of the larger particles of other substances. However, these carrier systems can change the bioavailability and the toxicological behaviour of the agents that they transport. For several years, many studies assess the health risks of the nanomaterials. Toxicologists’ thoughts about approach to the safety assessment of nanomaterials vary greatly: some scientists suggest that nanomaterials should be considered as new substances and therefore careful study of their safety should be done. It is necessary to take into account shape of the particles, and the degree of miniaturization (size of particles and their size distribution), the ratio of surface area and weight. Other toxicologists consider that nanomaterials may exhibit increased systemic toxicity and cytotoxicity and altered toxicokinetics. Conclusion. The number of applications of nanomaterials in cosmetics in Ukraine is still relatively small and the absolute safety is not proven. Therefore, market participants cosmetics is important to follow the information on the safety of nanomaterials and new laws in this area.

The study of the features of daily monitoring of blood pressure in patients with essential hypertension by obesity compared with patients with essential hypertension without excess weight was done. Combined therapy with amlodipine and olmesartan leads to a signifi cant decrease in mean integral indicators and improve the circadian blood pressure.

Traumatic cranial injury is one of the leading reasons in the statistics of mortality. Modern ideas about the pathogenesis of traumatic brain injury based on the allocation of primary and secondary factors of brain damage. One of the main causes of secondary brain injury is hypoxia – insufficient provision with oxygen. Changes in oxygen balance lead to activation of oxidative stress, disturbances of mitochondria membranes and their death, and progression of energy metabolism imbalance caused by trauma. Millions of people worldwide suffer from diabetes mellitus. One of the factors that influences the development of complications of diabetes, is an accumulation of highly toxic peroxide compounds that intensify the processes of destabilization of cell membranes. Further research of peculiarities of oxidative stress and energy metabolism imbalance in diabetes associated with trauma will provide the basis for therapeutic directions to increase treatment options and improve patient health and well-being. Therefore, the purpose of this work is to study the effect of traumatic cranial injury on the energy supplying processes in the liver and kidneys of rats with streptozotocin diabetes, as well as establishing a link between impaired mitochondrial oxidation and the intensity of oxidative stress. Hundred adult male Wistar rats, weighing 180-220 g, were used in this study. Rats were assigned to one of four groups: (1) control animals (n=10); (2) rats with diabetes (n=10); (3) rats with closed cranial trauma (n=40); (4) animals with cranial trauma on the diabetes background (n=40). To induce diabetes, streptozotocin (“Sigma-Aldrich”,USA) was dissolved in citrate buffer (pH 4.5) and a single intra-peritoneal injection (60 mg/kg) was given to each animal. The application of the cranial injury was done according to the method developed in our laboratory. The rats were sacrificed under thiopental sodium anesthesia by total bloodletting from the heart. The rats of groups 3 and 4 were euthanized 3 h, 24 h, 5, and 14 days after the onset of the injury. Blood of the experimental animals was analyzed for succinate dehydrogenase, cytochrome oxidase, proton adenosine triphosphatase activity, the concentration of adenosine triphosphate, diphosphate, and monophosphate. Additionally, we studied the products of protein and lipid peroxidation. Succinate dehydrogenase activity decreased 22,6% after 3 h, by 38,8% after 24 h, by 34,7% after 5 days, and by 22,2% after 14 days post-traumatically in diabetic rats. The most pronounced decrease in cytochrome oxidase activity in the liver was 26,3 and 40 % after 5 and 14 days after TBI, respectively. These changes were accompanied by an increase in the proton adenosine triphosphatase activity in the liver by 42,1, 53,5, 68,6, 63,3 % after 3 h, 1, 5 and 14 days after injury, compared to injured rats without diabetes. Statistically significant increase in the products of protein and lipid peroxidation after traumatic cranial injury in combination with diabetes mellitus towards non-diabetic injured rats was observed. It has been established that there are inhibition of the respiratory chain enzymes activity (succinate dehydrogenase and cytochrome oxidase), an increase in the proton adenosine triphosphatase activity and a decrease in the concentration of adenosine triphosphate in the liver and kidneys of experimental animals with cranial trauma and diabetes. The degree of mitochondrial oxidation impairment and adenosine triphosphate synthesis processes positively correlates with the intensity of oxidative stress in the liver and kidneys. In the event of traumatic cranial injury on the background of concomitant diabetes mellitus, indicators of the mitochondrial energy supplying oxidation, the level of macroergic compounds and the intensity of oxidative stress were significantly worse compared to analogical indicators in the normoglycemic injured animals.