Socio-economic burden of atrial fibrillation in the Russian Federation: dynamics over 12 years

Relevance. Diseases of the cardiovascular system remain one of the main causes of death worldwide. The incidence of cardiovascular and circulatory diseases increased by one third between 1990 and 2010. The prevalence of atrial fibrillation (AF) ranges from 2.5–3.5% in the general population of patients to 9–17% in individuals aged 80 years and older.The aim of the study is to analyze the costs of the Russian healthcare system for various types of treatment of atrial fibrillation.Materials and methods. The assessment of the present economic burden of AF included an assessment of such direct costs as inpatient treatment, outpatient visits, treatment in a day hospital, medical support, treatment of complications of AF.Results. The socio-economic burden of AF in the Russian Federation for 2022 without surgical treatment amounted to 196.44 billion rubles per year, compared to 2010 and 2018, costs increased by 77% and 73%, respectively

Luminescence and vacuum ultraviolet excitation spectroscopy of cerium doped Gd3Ga3Al2O12 single crystalline scintillators under synchrotron radiation excitations

Authors gratefully acknowledge the financial support from the Latvian Science Council grant LZP-2018/2-0358 . The research leading to this result has been supported by the project CALIPSO plus under the Grant Agreement 730872 from the EU Framework Programme for Research and Innovation HORIZON2020 . The work of A.P.K. was supported by the Ministry of Science and Higher Education of the Russian Federation , state contracts No. 11.6181.2017/ITR .Cerium doped Gd3Ga3Al2O12 (GGAG) single crystals as well as GGAG:Ce single crystals co-doped by divalent (Mg2+, Ca2+), trivalent (Sc3+) or tetravalent (Zr4+, Ti4+) ions have been studied by means of the excitation luminescence spectroscopy in vacuum ultraviolet spectral range. Synchrotron radiation from the undulator beam was utilized for the luminescence excitation in the energy range from 4.5 to 800 eV. The influence of the co-dopant ions on the excitonic transitions as well as on the intrinsic defects in GGAG was revealed examining the luminescence emission and excitation spectra of both Gd3+ and Ce3+ ions in all single crystals studied. Special attention was paid to the analysis of Ce3+ excitation spectra in VUV spectral range (4.5–45 eV) where multiplication of electronic excitation (MEE) processes occur. It was obtained that GGAG:Ce single crystals having different co-dopant ions reveal distinguished efficiency of MEE. The role of intrinsic defects in MEE processes in the co-doped GGAG:Ce single crystals was elucidated.Latvian Science Council LZP-2018/2-0358,730872; Ministry of Science and Higher Education of the Russian Federation 11.6181.2017/ITR; Institute of Solid State Physics, University of Latvia as the Center of Excellence has received funding from the European Union’s Horizon 2020 Framework Programme H2020-WIDESPREAD-01-2016-2017-TeamingPhase2 under grant agreement No. 739508, project CAMART²https://www.sciencedirect.com/science/article/pii/S2211379719334527?via%3Dihu

INFLUENCE OF ERBIUM QUANTITY ON LUMINESCENCE PROPERTIES OF ER-DOPED GADOLINIUM OXIDE

The study focuses on the characterization of the gadolinium oxide and Er - doped gadolinium oxide powders prepared by coprecipitation of hydroxides. The specific surface of gadolinium oxide, the average size and oxides phase were determined. It was found that Er – doping improves luminescence

Влияние солегирования Ca2+ и Zr4+ на оптические характеристики монокристаллов Gd3Al2Ga3O12 : Ce

Scintillation materials that can convert absorbed high-energy particles into photons of visible radiation find many applications, in particular in modern methods of medical imaging. Gd3Al2Ga3O12 : Ce is promising single crystal for use as a detecting crystal element of the positron emission tomographs due to its unique properties: high density, high light output, radiation hardness, etc. However, its scintillation kinetics currently limit the use of this crystal. Changing of these kinetics by codoping becomes a priority task, which is considered in many papers. The literature data analysis showed that the optical characteristics of such codoped crystals were not well enough studied or were not investigated at all. In this regard, the spectral dependences of transmission, absorption and reflection are measured using optical spectroscopy for Gd3Al2Ga3O12:Ce, Gd3Al2Ga3O12 : Ce,Ca and Gd3Al2Ga3O12 : Ce,Zr. Dispersion dependences of refractive in dices are obtained by approximating the refractive indices measured using the Brewster method. The approximation was carried out using the Cauchy equation. The material constants of this equation are estimated.Сцинтилляционные материалы, способные преобразовывать поглощенные высокоэнергетические частицы в фотоны видимого излучения, находят множество областей применения, в частности в современных методах медицинской визуализации. Среди кислородсодержащих сцинтилляторов перспективным для использования в качестве детектирующего кристаллического элемента позитронно-эмиссионного томографа является Gd3Al2Ga3O12 : Ce за счет своих уникальных свойств: высокой плотности, высокого значения световыхода, радиационной стойкости и т. д. Однако его кинетические характеристики в настоящее время ограничивают использование кристалла для этих целей. Попытки изменения временных характеристик нарастания и спада люминесценции путем введения дополнительных примесей стали приоритетной задачей, которая рассматривается во многих работах. Анализ литературных данных показал, что оптические характеристики таких солегированных кристаллов исследованы недостаточно хорошо или вовсе не исследованы. В работе методами оптической спектроскопии в диапазоне длин волн 200—2200 нм исследованы кристаллы Gd3Al2Ga3O12 : Ce, солегированные Ca2+ и Zr4+. Измерены спектральные зависимости пропускания, поглощения и отражения, а также показатели преломления. Дисперсионные зависимости получены путем аппроксимации экспериментально измеренных показателей преломления методом Брюстера. Аппроксимацию проводили с использованием уравнения Коши. Оценены материальные константы этих уравнений для каждого из солегированных кристаллов

КЛИНИЧЕСКАЯ И ФАРМАКОЭКОНОМИЧЕСКАЯ ЦЕЛЕСООБРАЗНОСТЬ ИСПОЛЬЗОВАНИЯ ПРОБИОТИЧЕСКОГО ШТАММА ЭНТЕРОКОККА В КОМПЛЕКСНОЙ ПРОГРАММЕ ВЫХАЖИВАНИЯ НЕДОНОШЕННЫХ ДЕТЕЙ

Introduction. Possibilities of using probiotic enterococci in premature neonates undergoing inpatient antibacterial therapy remains understudied. The article is aimed at analyzing clinical and pharmacoeconomic reasonability of using probiotic Enterococcus faecium L3 strain in premature infants with very low body weight in the framework of complex inpatient developmental care. Patients and methods. 55 children randomized into 2 groups were observed: the control group (n = 26) was undergoing standard developmental care program, the primary group (n = 29) was introduced liquid probiotic Enterococcus faecium L3 strain (titer — 108 CFU/ml or more) (0.5 ml TID for 14 days) after attaining the enteral feeding volume of 5.0 ml. Results. Analysis of the clinical symptoms characteristic of non-smooth course of developmental care over premature infants helped to reveal higher frequency of infectious complications in the control group children than in the primary group (14 [53.8%] vs. 6 [20.7%]; p < 0.05). Acute food intolerance was observed less frequently in the primary group than in the control group (6 [20.7%] vs. 10 [38.5%], p > 0.05). The primary group's children featured significant decrease in the frequency of monocytosis, positive changes of intestinal microbiotic composition (increase in the amount of bifidum bacteria, lactobacilli, enterococci, decrease in the amount of Clostridium difficile and antibiotic-resistant clinical Klebsiella pneumoniae strains). Conclusion. Favorable outcome of developmental care over premature infants (absence of infectious complications) was less expensive in the primary group's children.Введение. Возможности использования пробиотических энтерококков у недоношенных новорожденных детей, получающих антибактериальную терапию в стационаре, остаются малоизученными. Цель — исследование клинической и фармакоэкономической целесообразности использования пробиотического штамма Enterococcus faecium L3 у недоношенных детей с очень низкой массой тела в комплексной программе стационарного этапа выхаживания. Пациенты и методы. Наблюдали 55 детей, которые были рандомизированы на 2 группы: группа сравнения (n = 26) получала стандартную программу выхаживания, основная группа (n = 29) при достижении объема энтерального питания 5,0 мл получала внутрь пробиотический штамм E. faecium L3 в жидкой форме (с титром не менее 108 КОЕ/мл) по 0,5 мл 3 раза в день в течение 14 дней. Результаты. Изучение клинических признаков, характерных для негладкого течения при выхаживании недоношенных детей, выявило более высокую частоту инфекционных осложнений у детей группы сравнения, чем у детей основной группы — 14 (53,8%) против 6 (20,7%); p < 0,05. Ситуации острой пищевой непереносимости с меньшей частотой отмечались в основной группе (6; 20,7%), чем в группе сравнения (10; 38,5%; p > 0,05). У детей основной группы наблюдались достоверное снижение частоты моноцитоза, положительные изменения состава микробиоты кишечника (нарастание количества бифидобактерий, лактобацилл, энтерококков, снижение количества Clostridium difficile и клинических штаммов Klebsiella pneumoniae, устойчивых к антибиотикам). Заключение. Достижение благоприятного исхода выхаживания недоношенных детей (отсутствие инфекционных осложнений) было наименее затратным у детей основной группы.

Оптические характеристики монокристаллического материала Gd3Al2Ga3O12 : Ce

Nowadays new high-energy emission detection technologies with use of materials doped with rare-earth activators appear. There is still a great need for the development of new inorganic scintillators for medical application in particular detection of X-rays and -grays. In this case, the scintillation materials must meet basic requirements: high optical quality, high light output, fast response time and et al. One of these materials is the scintillation crystal Gd3Al2Ga3O12 : Ce (GAGG : Ce) investigated in this work. Analysis of the literature data showed that the optical characteristics of Gd3Al2Ga3O12 : Ce have not been studied enough. Hence the GAGG : Ce optical parameters (spectral transmission and reflection) were measured by optical spectroscopy in the wavelength range 200—750 nm. We calculated values of the absorption and extinction coefficients, refractive indices and the optical band gap of the Gd3Al2Ga3O12 : Ce. We used two spectrophotometric methods to determine the values of the refractive index: Brewster angles (jB) and the reflection coefficients at a small incidence angle of light close to normal (R0). The obtained results were used to build dispersion dependences graphs of the refractive indices.В настоящее время появляются новые технологии детектирования высокоэнергетических излучений, для которых применяются материалы, легированные ионами редкоземельных элементов. Существует большая потребность в разработке новых неорганических сцинтилляторов для медицинского применения, в частности для детектирования рентгеновского и гамма-излучений. В этом случае сцинтилляционные материалы должны отвечать основным требованиям: высокое оптическое качество, высокое значение световыхода, быстрое время реагирования и др. К таким материалам относится сцинтилляционный кристалл Gd3Al2Ga3O12 : Ce (GAGG : Ce). На сегодняшний день оптические характеристики GAGG : Ce исследованы недостаточно. В связи с этим методом оптической спектроскопии в диапазоне длин волн 200—750 нм измерены спектральные зависимости пропускания и отражения таких кристаллов. Для кристаллов GAGG : Ce определены значения показателей поглощения и преломления, коэффициенты экстинкции, проведена оценка значения оптической ширины запрещенной зоны. Для определения значений показателей преломления использованы два спектрофотометрических метода: по измеренным углам Брюстера и по коэффициенту отражения при малом угле падения света, близком к нормальному. На основании полученных результатов построены дисперсионные зависимости показателей преломления.

МЕТОДОЛОГИЯ РАСЧЕТА ПЛОЩАДИ ЛОКАЛЬНОГО ОТЕКА КОЖИ ПРИ РАКЕ МОЛОЧНОЙ ЖЕЛЕЗЫ

Breast cancer with skin involvement is one of the least studied and at the same time difficult to treat forms of cancer. Despite the achievements of modern diagnostics, many issues related to skin edema severity evaluation and quantitative assessment of changes associated with neoadjuvant drug therapy often cause a number of difficulties. In turn, this can lead to both incorrect staging and «overtreatment» of patients, as well as subjectivity in assessing the response to the treatment. Various approaches have been proposed to calculate the severity of edema, but they have not been widely accepted. This article presents our method developed for determining the area of skin edema, which in the future will allow individualizing approaches to treatment.Рак молочной железы с вовлечением кожи — одна из наименее изученных и, в то же время, сложно поддающихся лечению форм. Несмотря на достижения современной диагностики, многие вопросы, касающиеся определения степени выраженности отека кожи и количественной оценки динамики на фоне неоадъювантной лекарственной терапии, зачастую вызывают ряд сложностей. В свою очередь, это может привести как к неправильному стадированию и «перелечиванию» пациентов, так и к субъективности в оценке ответа на проводимое лечение. Ранее были предложены различные подходы для расчета степени выраженности отека, однако широкого распространения они не получили. В данной статье представлен разработанный нами метод, позволяющий определить площадь отека кожи, который в дальнейшем позволит индивидуализировать подходы к лечению

Comparative Economic Evaluation of Haemophilus influenzae Type b Vaccination in Belarus and Uzbekistan

BACKGROUND: Hib vaccine has gradually been introduced into more and more countries during the past two decades, partly due to GAVI Alliance support to low-income countries. However, since Hib disease burden is difficult to establish in settings with limited diagnostic capacities and since the vaccine continues to be relatively expensive, some Governments remain doubtful about its value leading to concerns about financial sustainability. Similarly, several middle-income countries have not introduced the vaccine. The aim of this study is to estimate and compare the cost-effectiveness of Hib vaccination in a country relying on self-financing (Belarus) and a country eligible for GAVI Alliance support (Uzbekistan). METHODS AND FINDINGS: A decision analytic model was used to estimate morbidity and mortality from Hib meningitis, Hib pneumonia and other types of Hib disease with and without the vaccine. Treatment costs were attached to each disease event. Data on disease incidence, case fatality ratios and costs were primarily determined from national sources. For the Belarus 2009 birth cohort, Hib vaccine is estimated to prevent 467 invasive disease cases, 4 cases of meningitis sequelae, and 3 deaths, while in Uzbekistan 3,069 invasive cases, 34 sequelae cases and 341 deaths are prevented. Estimated costs per discounted DALY averted are US$9,323 in Belarus and US$ 267 in Uzbekistan. CONCLUSION: The primary reason why the cost-effectiveness values are more favourable in Uzbekistan than in Belarus is that relatively more deaths are averted in Uzbekistan due to higher baseline mortality burden. Two other explanations are that the vaccine price is lower in Uzbekistan and that Uzbekistan uses a three dose schedule compared to four doses in Belarus. However, when seen in the context of the relative ability to pay for public health, the vaccine can be considered cost-effective in both countries

CLINICAL AND PHARMACOECONOMIC REASONABILITY OF USING PROBIOTIC ENTEROCOCCUS STRAIN FOR THE COMPLEX DEVELOPMENTAL CARE PROGRAM FOR PREMATURE INFANTS

Introduction. Possibilities of using probiotic enterococci in premature neonates undergoing inpatient antibacterial therapy remains understudied. The article is aimed at analyzing clinical and pharmacoeconomic reasonability of using probiotic Enterococcus faecium L3 strain in premature infants with very low body weight in the framework of complex inpatient developmental care. Patients and methods. 55 children randomized into 2 groups were observed: the control group (n = 26) was undergoing standard developmental care program, the primary group (n = 29) was introduced liquid probiotic Enterococcus faecium L3 strain (titer — 108 CFU/ml or more) (0.5 ml TID for 14 days) after attaining the enteral feeding volume of 5.0 ml. Results. Analysis of the clinical symptoms characteristic of non-smooth course of developmental care over premature infants helped to reveal higher frequency of infectious complications in the control group children than in the primary group (14 [53.8%] vs. 6 [20.7%]; p < 0.05). Acute food intolerance was observed less frequently in the primary group than in the control group (6 [20.7%] vs. 10 [38.5%], p > 0.05). The primary group's children featured significant decrease in the frequency of monocytosis, positive changes of intestinal microbiotic composition (increase in the amount of bifidum bacteria, lactobacilli, enterococci, decrease in the amount of Clostridium difficile and antibiotic-resistant clinical Klebsiella pneumoniae strains). Conclusion. Favorable outcome of developmental care over premature infants (absence of infectious complications) was less expensive in the primary group's children