ЛЬГОТНОЕ КРЕДИТОВАНИЕ КАК АКТУАЛЬНЫЙ ИНСТРУМЕНТ ГОСУДАРСТВЕННОЙ ФИНАНСОВОЙ ПОДДЕРЖКИ АПК

Subject. From all set of forms and methods of impact of the state on the agrarian sector of economy the most significant — financial and credit tools. The necessity of a specific mode of crediting of the agrarian sector of economy is caused by the numerous internal and external factors influencing its rather low profitability and the increased risk of production. Owing to the submitted review of economic indicators of the agrarian sector of economy of Russia in 2015–2017 the analysis of indicators of investments into fixed capital under the article “Agriculture” for the 10-year period (2006–2015), expenses of the federal budget and budgets of territorial subjects of the Russian Federation for 2016 which source of financial security is the subsidy is carried out. An assessment is given to indicators of subsidizing and crediting of the agrarian and industrial complex enterprises in 2006–2015. The structure of the modern mechanism of crediting of agrarian and industrial complex of the Russian Federation is given, common features and differences of preferential crediting in a se ction of the shor t-term and investment credit are revealed. Purposes. A complex author’s research of system of subsidizing and crediting of the agrarian and industrial complex enterprises of Russia, detection of advantages of new forms of crediting of the agrarian sector and also the existing concepts and approaches to a solution of the problem of financial support of agrarian and industrial complex. Justification of essentially new approaches of access for agricultural producers to credit resources and providing to an opportunity development of the new equipment and technologies in production of competitive production in the conditions of new “wave” of sanctions of the USA and the European Union countries. Methodology. The research is based on dialectic approach. When carrying out a research system, institutional approaches and statistical methods hav e been used. Results. On the basis of the analysis of dynamics of crediting of agrarian and industrial complex of JSC Rosselkhozbank in 2006–2015 on indicators of volume, structure, quantity of the credits, terms and subjects of crediting offers on change of system of crediting of the agricultural organizations, individual forms of managing and agricultural consumer cooperatives are provided. The bit-by-bit structure of the modern mechanism of crediting of agrarian and industrial complex within market system and state regulation is disclosed and also common features and distinctive features of conditions of preferential crediting of agrarian and industrial complex on the shor t-term and investment credits are revealed. Conclusions. Considering the fact that in Russia generally two banks with the state participation are engaged in crediting of agriculture now: Rosselkhozbank and Sberbank of the Russian Federation while in the middle of the 2000th years, over 200 Russian commercial banks participated in the system of crediting of agricultural producers with subsidizing of an interest rate, need to be expanded both the list of the credit institutions, and the range offered by them credit products, considering the interests of all forms of managing in the village. Further development of components of the mechanism of crediting of agrarian and industrial complex and also development and deployment of new forms of crediting in the form of the soft short-term and investment loans have to be focused on ensuring high rates of production and consumption of domestic agricultural production per capita and an impor t substitution course.Предмет. Дана оценка показателям субсидирования и кредитования предприятий АПК в 2006–2015 гг. Приведена структура современного механизма кредитования АПК РФ, выявлены общие черты и отличия льготного кредитования в разрезе краткосрочного и инвестиционного кредита. Цели. Комплексное авторское исследование системы субсидирования и кредитования предприятий АПК России, выявление преимуществ новых форм кредитования аграрного сектора, а также существующих концепций и подходов к решению проблемы финансовой поддержки АПК. Обоснование принципиально новых подходов доступа сельхозпроизводителей к кредитным ресурсам и предоставление возможности освоения новой техники и технологий в производстве конкурентоспособной продукции в условиях новой «волны» санкций США и стран Евросоюза. Методология. Исследование базируется на диалектическом подходе. При проведении исследования были использованы системный, институциональный подходы и статистические методы. Результаты. На основе анализа динамики кредитования АПК ОАО «Россельхозбанком» в 2006–2015 гг. по показателям объема, структуры, количеству кредитов, срокам и субъектам кредитования приведены предложения по изменению системы кредитования сельскохозяйственных организаций, индивидуальных форм хозяйствования и сельскохозяйственных потребительских кооперативов. Раскрыта поэлементная структура современного механизма кредитования АПК в рамках рыночной системы и государственного регулирования, а также выявлены общие черты и отличительные особенности условий льготного кредитования АПК по краткосрочному и инвестиционному кредитам. Выводы. Учитывая тот факт, что кредитованием сельского хозяйства в России в настоящее время занимаются в основном два банка с государственным участием: Россельхозбанк и Сбербанк РФ, в то время как в середине 2000-х гг. в системе кредитования сельхозпроизводителей с субсидированием процентной ставки участвовали свыше 200 российских коммерческих банков, необходимо расширить как перечень кредитных учреждений, так и ассортимент предлагаемых ими кредитных продуктов, учитывающих интересы всех форм хозяйствования на селе

Habitual miscarriage in women with a combination of autoimmune diseases of the thyroid gland and AFS

In world literature, published many works, the main object of study are women of reproductive age, including healthy women, women with recurrent pregnancy loss and infertile women undergoing assisted reproductive technologies. Most of these studies showed a significant Association between the presence tireoidnykh autoantibodies, infertility and an increased risk of miscarriage. Adequate levels of circulating blood levels of thyroid hormones is the subject of “Essentials” for the normal functioning of the reproductive system. This article examines the relationship of miscarriage with autoimmune thyroid diseases and circulation of antiphospholipid antibodies. This Association is not accidental. A possible mechanism for this relationship is the fact that the presence of antithyroid antibodies reflects a generalized activation of the immune system and enhances autoimmune process directed against fetoplacental system.В мировой литературе опубликовано много работ, основным объектом изучения которых являются женщины репродуктивного возраста, включая здоровых женщин, женщин с привычным невынашиванием и бесплодных женщин, подвергающихся вспомогательным репродуктивным технологиям. Большинство зтих исследований показало достоверную связь между наличием тиреиодных аутоантител, бесплодием и повышенным риском невынашивания. Адекватный уровень циркулирующих в крови гормонов щитовидной железы является предметом “первой необходимости" для нормального функционирования репродуктивной системы. В данной статье рассматривается взаимосвязь невынашивания с аутоиммунными заболеваниями щитовидной железы и циркуляцией антифосфолипидных антител. Эта ассоциация возникла не случайно. Возможным механизмом такой взаимосвязи является тот факт, что наличие антитиреоидных антител отражает генерализованную активацию иммунной системы и усиливает аутоиммунный процесс, направленный против фетоплацентарной системы

Совершенствование диагностики и лечения острого аппендицита у беременных

Objective: to improve the diagnosis of acute appendicitis and the results of its treatment in pregnant women. Subjects and methods. Two hundred and forty-three pregnant women sent with the diagnosis of acute appendicitis were followed up. Clinical and laboratory methods were used to diagnose acute appendicitis. One hundred and thirty-nine pregnant women were operated on, of them 47 underwent laparotomy, two-step abdominal sanitation, and drainage for general purulent peritonitis. Results. The authors have elaborated and introduced into practice a diagnostic algorithm for acute appendicitis in pregnant women, a procedure to estimate an electrical cecal cupula potential that allows its location to be specified, improved laparo-scopic techniques, and introduced a procedure long-term autonomous intestinal motility stimulation, which fails to affect uterine tone in pregnant women. An antibiotic cocktail that has an effect on different types of the microflora has been proposed to sanitize the abdomen in pregnant women with complicated acute appendicitis. Conclusion. Examination of pregnant women with suspected appendicitis according to the proposed algorithm makes it possible to rule out diagnostic errors, to specify indications for appendectomy, to correctly choose an access, by estimating the electrical potential of the cecal cupula, to guard against the development of peritonitis, by administering the proposed antibiotic cocktail, to implement a package of measures for the detoxification and early recovery of intestinal motility, and to prevent antenatal fetal death. The mortality rates in pregnant women with acute appendicitis were 0.7%. Key words: acute appendicitis in pregnant women.Цель исследования : улучшение диагностики и результатов лечения острого аппендицита у беременных. Материал и методы. Осуществлялось наблюдение за 243 беременными, доставленными с диагнозом «острый аппендицит». Применялись клинические и лабораторные методы диагностики острого аппендицита. Оперировано 139 беременных, из них у 47 была выполнена лапаратомия, двухмоментная санация и дренирование брюшной полости по поводу разлитого гнойного перитонита. Результаты исследования. Разработан и внедрен в практику алгоритм диагностики острого аппендицита у беременных, способ определения электрического потенциала купола слепой кишки, позволяющий уточнить его локализацию, усовершенствована методика лапараскопии, внедрена методика длительной автономной стимуляции перистальтики кишечника, не влияющая на тонус матки у беременных. Для санации брюшной полости беременным с осложненным острым аппендицитом предложен коктейль, включающий антибиотики, действующий на различные виды микрофлоры. Заключение. Обследование беременных с подозрением на аппендицит по предложенному алгоритму позволяет исключить ошибки диагностики, уточнить показания к аппендэктомии, правильно выбрать доступ с помощью определения электрического потенциала купола слепой кишки, предупредить развитие перитонита введением в брюшную полость предложенного коктейля, содержащего антибиотики, осуществлять комплекс мер по дезинтоксикации и раннему восстановлению перистальтики кишечника, предотвратить антенатальную гибель плода. Летальность беременных с острым аппендицитом составила 0,7%. Ключевые слова: острый аппендицит беременных

КЛИНИЧЕСКАЯ ХАРАКТЕРИСТИКА ВИРУСНЫХ ГАСТРОЭНТЕРИТОВ СМЕШАННОЙ ЭТИОЛОГИИ У ДЕТЕЙ РАННЕГО ВОЗРАСТА В Г. БАКУ, АЗЕРБАЙДЖАН

The article presents the results of studying the etiological structure and clinical features of acute intestinal infections (AII) in young children in Baku, Azerbaijan. In most cases, the disease has a viral etiology and proceeds in the form of gastroenteritis. At the same time in the age groups 6—12 months and 1—3 years of life, viral intestinal infections in 72.72% of cases have a mixed etiology (usually viral-viral), with a predominance of rotavirus infection. Taking into account the obtained results, it is necessary for all children of early age with AII, in addition to routine diagnostics, to conduct research using modern methods for virus verification (Latex-test, PCR).В статье представлены результаты изучения этиологической структуры и клинических особенностей острых кишечных инфекций (ОКИ) у детей раннего возраста в г. Баку, Азербайджан. В большинстве случаев заболевание имеет вирусную этиологию и протекает в виде гастроэнтерита. При этом в возрастных группах 6—12 мес. и 1—3 лет жизни вирусные кишечные инфекции в 72,72 % случаях имеют смешанную этиологию (чаще вирусно-вирусную), с преобладанием ротавирусной инфекции. Учитывая полученные результаты, необходимо всем детям раннего возраста с ОКИ, помимо рутинной диагностики, проводить исследование с применением современных методов на верификацию вирусов (РЛА, ПЦР)

A chromosome conformation capture ordered sequence of the barley genome

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COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)

Background: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. Conclusions: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.EPICOVIDEHA has received funds from Optics COMMITTM (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223)

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p&lt;00001), age 70 years or older versus younger than 70 years (230 [165-322], p&lt;00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p&lt;00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research