Doctoral Studies in the Context of Global Trends: Problems and Key Factors of Development

The article focuses on the analysis of the current state, problems and key factors in the development of Russian doctoral education in connection with its transition from 2022/2023 academic year to the implementation of a new model in the context of global trends. As a result of analyzing and evaluating statistical data for 2010-2021 and summarizing numerous publications of researchers, the authors conclude that the trend of steady decline in the efficiency of doctoral education over the past decade is a systemic problem. It is proved that the transition to a new model of implementation of doctoral training programs for scientific and scientific-pedagogical staff aimed at improving its effectiveness, strengthening the scientific component and the quality of PhD dissertations is an important and necessary condition, but not sufficient to solve the existing problem. This study is an attempt to systematize the factors affecting the development of doctoral education in Russia, which determine the possibility of creating necessary and sufficient conditions for the effective functioning of the system of training highly qualified personnel. The authors identify three groups of key factors: dynamic changes in the development of the state policy aimed at improving management in the field of training scientific and scientific-pedagogical personnel; developed ecosystem of educational and scientific organizations that provide doctoral education, including infrastructure, information, financial, organizational resources and scientific potential; doctoral students with interest and abilities in research activities, possessing a set of competencies necessary for the development of doctoral education. At the same time, such prospective tasks are considered as increasing reputational responsibility of organizations, which offer programs for training scientific and scientific-pedagogical personnel; forming effective system of targeted training in doctoral education; developing mechanisms for integration of science, higher education and industry by means of creating consortiums, the incentives for which are laid down in the “Priority 2030” university state support program

The first combined russian experience of using perampanel in children and adolescents with epilepsy in everyday clinical practice

Background. Real world data help to provide more information on the effects and tolerability of therapy. However, data on the use of perampanel in Russian population of children remain limited. aim. To conduct a retrospective analysis of perampanel efficacy and tolerability in children and adolescents with epilepsy in real clinical practice. Materials and methods. A total of 106 children aged 4–18 years receiving perampanel as part of combination therapy for epilepsy were observed at 18 centers. Seizure frequency at 1–3, after 6 and 12 months of treatment, presence and type of adverse events (AEs) were analyzed. The main assessed efficacy parameters were seizure control, significant (≥50 %) decrease in seizure frequency. All other outcomes (<50 % decrease, no change or increased seizure frequency) were considered to be no effect. The assessed safety parameters were the percentage of patients with or without AEs and the percentage of perampanel withdrawals due to AEs. results. We defined 3 age groups for comparison: children 4–6, 7–11 and 12–17 years old. Perampanel efficacy was 69 % (seizure control – 23.6 %, ≥50 % decrease in seizure frequency – 45.3 %). The mean duration of the effect was 7.3 ± 4.1 months. No significant difference in efficacy between age groups was found. However, some greater efficacy of perampanel was noted in adolescents: absence of effect in the form of remission or significant decrease in seizures frequency was noted only in 25.5 %, with 40 % in children 4–11 years old. Among those with inefficacy, 3.8 % reported seizure aggravation. AEs occurred in only 23 % of patients, with the least frequent occurrence in adolescents (11.8 %) and the most frequent in children aged 7–11 years (40 %). The most frequent AEs was sluggishness and/or drowsiness. Discontinuation of perampanel due to AEs was required in 7.6 %. Conclusion. Perampanel has demonstrated high efficacy and good tolerability in real clinical practice among children from 4 years of age and adolescents with partial (focal) and secondary generalized seizures. The AEs that developed were not serious and very rarely led to withdrawal of the therapy. The results are comparable to those of phase III studies and previous real-world data. The usage of perampanel in children with primary generalized seizures should be further investigated. © 2022 ABV-Press Publishing House. All rights reserved.EisaiО.А. Рахманина / O.A. Rakhmanina: https://orcid.org/0000-0001-9218-2531 И.В. Волков / I.V. Volkov: https://orcid.org/0000-0002-7816-7535 О.К. Волкова / O.K. Volkova: https://orcid.org/0000-0003-3314-3895 Ю.А. Александров / Yu.A. Aleksandrov: https://orcid.org/0000-0003-3887-5219 М.В. Бархатов / M.V. Barkhatov: https://orcid.org/0000-0002-6372-4677 И.С. Бахтин / I.S. Bakhtin: https://orcid.org/0000-0003-3600-687X Г.М. Бережная / G.M. Berezhnaya: https://orcid.org/0000-0003-3917-422X А.Ю. Карась / A.Yu. Karas: https://orcid.org/0000-0001-9089-9627 Д.В. Морозов / D.V. Morozov: https://orcid.org/0000-0003-4389-9143 И.С. Бахтин / I.S. Bakhtin: https://orcid.org/0000-0003-3600-687X Т.Р. Томенко / T.R. Tomenko: https://orcid.org/0000-0002-0652-1996 Ж.М. Цоцонава / Zh.M. Tsotsonava: https://orcid.org/0000-0003-3275-5099 Конфликт интересов и финансирование. Публикация подготовлена при финансовой поддержке компании «Эйсай». Авторы несут полную ответственность за содержание статьи и редакционные решения. Conflict of interest and funding. This publication was funded by Eisai. The authors are fully responsible for the content of the article and editorial decisions

Functional disorders of the biliary tract. What a pediatrician needs to know

According to the frequency of contact with a doctor, abdominal pain in children is second only to respiratory diseases. Since the pain syndrome is a nonspecific manifestation of various pathologies, the doctor faces a serious diagnostic task, which is especially difficult in pediatric practice. One of the frequent causes of abdominal pain in children is a disruption of the function of the digestive tract, in particular, the dysfunction of the billiard tract. The article considers etiopathogenetic mechanisms of development of functional disorders of the biliary tract in children, classification in the light of the Rome IV consensus, modern low-invasive methods for diagnosing dysfunctions of the biliary tract. The ultrasound of the hepatobiliary zone was assessed. Questions are given for self-control

Abernethy Malformation in Combination with Gilbert’s Syndrome

Aim. To present a clinical case of the Abernethy syndrome.Key points. Abernethy syndrome is a rare vascular anomaly associated with a congenital absence of the portal vein, as a result of which portal blood from the intestines and spleen drains directly into the systemic circulation bypassing the liver though a complete or partial shunt. In the vast majority of cases, Abernethy syndrome is manifested during the newborn period by jaundice syndrome, hypergalactosemia and encephalopathy. In rare cases, this vascular malformation is diagnosed in older patients during ultrasound screening. A 31 year-old patient sought medical attention with the complaints of sleep disturbance and fatigue. The conducted instrumental observation revealed echo-signs of malformation (agenesia) of the portal vein, which was further confirmed by both X-ray-contrast computed tomography and the pathohistological analysis of liver biopsy slides. The genotype UGT1A1•28 confirmed Gilbert's syndrome. Neutropenia (0.8 × 109/L) with a drop in the level of segmented neutrophils up to 27% was regarded as shunt neutropenia. Number connection test confirmed shunt encephalopathy. Conservative therapy for correcting hepatic encephalopathy was prescribed, followed by a dynamic monitoring of the patient’s condition.Conclusion. Diagnosis of Abernethy malformation is important for choosing the right treatment for the timely correction of complications of the disease and early detection of adenoma or hepatocellular carcinoma