Impact of Intangible Factors on Business Value

The global financial and economic crisis of 2008-2009 has caused a significant drop in business efficiency. Today’s management model of the overwhelming majority of companies is oriented towards satisfying the interests of owners and business groups, while the interests of clients, creditors, state and society are not sufficiently taken into account. This creates barriers to the growth of business value, which today has become a generally recognized indicator of the success, sustainability and investment attractiveness of companies. It is the reason for the introduction of the policy of value-oriented management of a company aimed at preserving and increasing the value of business, harmonizing the economic interests of all its stakeholder

Dental implantation in secondary adentia: X-ray diagnostics

Пациентам выполняли конусно-лучевую томографию зубочелюстной системы и панорамную зонографию (ортопантомограмма, снимок височно-нижнечелюстных суставов). Обследования выполнены на конусно-лучевом томографе PaxZenith 3D фирмы “Vatech”. Использовались основные методики конусно-лучевой томографии: двух челюстей в окклюзии, средней зоны лица, придаточных пазух носа, височной кости. Исследования проводились на этапе планирования, послеоперационного контроля дентальной имплантации в течение реабилитационного периода. Важными анатомическими образованиями при планировании дентальной имплантации являются нижнечелюстной канал, полость носа и полость гайморовой пазухи. Описаны результаты использования конусно-лучевой томографии и панорамной зонографии при планировании и послеоперационном контроле результатов дентальной имплантации. Показаны преимущества каждого рентгенологического метода. Обоснована перспективность комбинации конусно-лучевой томографии и панорамной зонографии в практике дентальной имплантации.Patients were performed cone-beam tomography and panoramic dental systems. Surveys were carried out on cone beam tomography PaxZenith 3D firm “Vatech”. Main methods used cone-beam tomography: two jaws in occlusion of the midface, sinuses, temporal bone. The studies were conducted at the planning stage, postoperative monitoring of dental implantation, during the rehabilitation period. The important anatomical structures in the planning of dental implants are the mandibular canal, nasal cavity and the maxillary sinus cavity. There were examined 80 patients and divided into three groups. The first group (25 patients were carried out planning of surgical interventions and post-operative monitoring only on the basis of panoramic zonography data. In the second group (25 patients) there the data were evaluated using 3D cone-beam computed tomography and panoramic zonography. The third group (30 patients) — planning and monitoring of dental implant surgery was carried out using only the cone-beam tomography. The first group of patients had incorrect placement of implants (5 persons). The main causes of which was distortion of the subject (upper and lower jaw) in size and shape, which led to the wrong choice of size and diameter of the implant to the perforation of the maxillary sinus and the upper wall of the mandibular canal. The second and third groups had not such complications, but the third group patients had complications as osteointegrations disorder between implant and osseous tissue. When performing the panoramic X-ray it was possible comprehensive assessment of dental system as a whole, taking account of the temporomandibular joint, the adjacent parts of the maxillary sinuses. The use of cone-beam tomography in all phases of dental implantation to avoid errors due to incorrect installation of the implant helps to reveal the full dentition comorbidities and upper respiratory tract, but is not sufficiently informative to monitor osseointegration before installing the abutment. These cone-beam CT scanner, complemented by panoramic X-ray give an objective evaluation of information in the planning stages and the stages of post-operative monitoring, avoid complications

Human Platelet-Rich Plasma- and Extracellular Matrix-Derived Peptides Promote Impaired Cutaneous Wound Healing In Vivo

Previous work in our laboratory has described several pro-angiogenic short peptides derived from endothelial extracellular matrices degraded by bacterial collagenase. Here we tested whether these peptides could stimulate wound healing in vivo. Our experiments demonstrated that a peptide created as combination of fragments of tenascin X and fibrillin 1 (comb1) applied into cranial dermal wounds created in mice treated with cyclophosphamide to impair wound healing, can improve the rate of wound closure. Furthermore, we identify and characterize a novel peptide (UN3) created and modified from two naturally-occurring peptides, which are present in human platelet-rich plasma. In vitro testing of UN3 demonstrates that it causes a 50% increase in endothelial proliferation, 250% increase in angiogenic response and a tripling of epithelial cell migration in response to injury. Results of in vivo experiments where comb1 and UN3 peptides were added together to cranial wounds in cyclophosphamide-treated mice leads to improvement of wound vascularization as shown by an increase of the number of blood vessels present in the wound beds. Application of the peptides markedly promotes cellular responses to injury and essentially restores wound healing dynamics to those of normal, acute wounds in the absence of cyclophosphamide impairment. Our current work is aimed at understanding the mechanisms underlying the stimulatory effects of these peptides as well as identification of the cellular receptors mediating these effects.National Institutes of Health (U.S.) (Grant EY15125)National Institutes of Health (U.S.) (Grant EY19533)Wound Care Partners, LL

Диагностика и коррекция нарушений гемостаза в периоперационном периоде в хирургии печени

Hepatic surgical interventions are highly traumatic and time-consuming and during these operations the hemostatic system is exposed to compound actions that lead to impaired organ and tissue microcirculation, thromboses, and coagulopathic hemorrhages.Objective: to enhance the efficiency of instrumental diagnosis and correction of perioperative hemostatic disorders during major hepatic surgical interventions.Subjects and methods: 80 patients divided into 3 groups were examined. A control group comprised apparently healthy individuals (donors) the values of whose hemostatic parameters were taken as normal ones. A study group consisted of patients who received conventional preoperative intensive care. Thirty patients were given complex perioperative hemostatic correction.Results. During major hepatic surgical interventions, impairments of the basic links of the hemostatic system are characterized by the development of prethrombosis: the enhanced vascular thrombocytic and hypercoagulant state of enzymatic hemostatic links, and pronounced fibrinolytic suppression. Rapid hemoviscosimetric parameters correlate with classical biochemical parameters and have rather high sensitivity and specificity. The pathogenetically grounded use of a combination of low molecular-weight heparin and the antioxidant mexidole enhances the efficiency of correction of perioperative impairments of the basic hemostatic links during major hepatic operations. Оперативные вмешательства в хирургии печени характеризуются высокой травматичностью и большой продолжительностью, а система гемостаза во время подобных операций подвержена сложным воздействиям, которые приводят к нарушениям микроциркуляции в органах и тканях, тромбозам и коагулопатическим кровотечениям.Цель исследования . Повысить эффективность инструментальной диагностики и коррекции периоперационных нарушений истемы гемостаза при обширных оперативных вмешательствах в хирургии печени.Материалы и методы. Обследовано 80 человек, которые были разделены на 3 группы. Контрольную группу составили практически здоровые лица (доноры), значения показателей системы гемостаза которых были приняты за норму. Основную группу составили больные, которым проводилась стандартная периоперационная интенсивная терапия. 30 больным применили комплекс периоперационной коррекции системы гемостаза.Результаты. Нарушения основных звеньев системы гемостаза при обширных оперативных вмешательствах в хирургии печени характеризуются развитием предтромботического состояния: усилением сосудисто-тромбоцитарного и гиперкоагуляционным состоянием ферментативного звеньев гемостаза, выраженным угнетением фибринолиза. Показатели экспресс-гемовискозиметрии коррелируют с классическими биохимическими показателями, обладают достаточно высокой чувствительностью и специфичностью. Патогенетически обоснованное применение комплекса низкомолекулярного гепарина и антиоксиданта мексидола позволяет повысить эффективность коррекции периоперационных нарушений основных звеньев системы гемостаза при обширных операциях в хирургии печени.

Mesoglycan connects Syndecan-4 and VEGFR2 through Annexin A1 and formyl peptide receptors to promote angiogenesis in vitro.

Mesoglycan is a mixture of glycosaminoglycans (GAG) with fibrinolytic effects and the potential to enhance skin wound repair. Here, we have used endothelial cells isolated from Wild Type (WT) and Syndecan-4 null (Sdc4-/-) C57BL/6 mice to demonstrate that mesoglycan promotes cell motility and in vitro angiogenesis acting on the co-receptor Syndecan-4 (SDC4). This latter is known to participate in the formation and release of extracellular vesicles (EVs). We characterized EVs released by HUVECs and assessed their effect on angiogenesis. Particularly, we focused on Annexin A1 (ANXA1) containing EVs, since they may contribute to tube formation via interactions with Formyl peptide receptors (FPRs). In our model, the bond ANXA1-FPRs stimulates the release of vascular endothelial growth factor (VEGF-A) that interacts with vascular endothelial receptor-2 (VEGFR2) and activates the pathway enhancing cell motility in an autocrine manner, as shown by Wound-Healing/invasion assays, and the induction of Endothelial to Mesenchymal Transition (EndMT). Thus, we have shown for the first time that mesoglycan exerts its pro-angiogenic effects in the healing process triggering the activation of the three interconnected molecular axis: mesoglycan-SDC4, EVs-ANXA1-FPRs and VEGF-A-VEGFR2

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Diagnosis and Correction of Perioperative Hemostatic Disorders at Hepatic Surgery

Hepatic surgical interventions are highly traumatic and time-consuming and during these operations the hemostatic system is exposed to compound actions that lead to impaired organ and tissue microcirculation, thromboses, and coagulopathic hemorrhages.Objective: to enhance the efficiency of instrumental diagnosis and correction of perioperative hemostatic disorders during major hepatic surgical interventions.Subjects and methods: 80 patients divided into 3 groups were examined. A control group comprised apparently healthy individuals (donors) the values of whose hemostatic parameters were taken as normal ones. A study group consisted of patients who received conventional preoperative intensive care. Thirty patients were given complex perioperative hemostatic correction.Results. During major hepatic surgical interventions, impairments of the basic links of the hemostatic system are characterized by the development of prethrombosis: the enhanced vascular thrombocytic and hypercoagulant state of enzymatic hemostatic links, and pronounced fibrinolytic suppression. Rapid hemoviscosimetric parameters correlate with classical biochemical parameters and have rather high sensitivity and specificity. The pathogenetically grounded use of a combination of low molecular-weight heparin and the antioxidant mexidole enhances the efficiency of correction of perioperative impairments of the basic hemostatic links during major hepatic operations