7 research outputs found
Clinical case the management of a patient with endometriosis of the diaphragm
Extragenital endometriosis β a rare pathology in which tissue similar morphologically to the endometrium is located outside the reproductive system. One of the main problems in the diagnosis and treatment of EGE is the erased course of different forms, so doctors of different profiles have difficulties with making an accurate diagnosis. The clinical case described in this article is a rare manifestation of EGE. Errors in diagnosis, management tactics, as well as in the treatment of the underlying disease were the reason for the provision of inappropriate specialized medical care.ΠΠΊΡΡΡΠ°Π³Π΅Π½ΠΈΡΠ°Π»ΡΠ½ΡΠΉ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ· (ΠΠΠ) β ΡΠ΅Π΄ΠΊΠ°Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ, ΠΏΡΠΈ ΠΊΠΎΡΠΎΡΠΎΠΉ ΡΠΊΠ°Π½Ρ, ΡΡ
ΠΎΠ΄Π½Π°Ρ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΈ, Π»ΠΎΡΠΈΡΡΠ΅ΡΡΡ Π·Π° ΠΏΡΠ΅Π΄Π΅Π»Π°ΠΌΠΈ ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ. ΠΠ΄Π½ΠΎΠΉ ΠΈΠ· Π³Π»Π°Π²Π½ΡΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΠΠ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΠ΅ΡΡΠΎΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΡΠ°Π·Π½ΡΡ
ΡΠΎΡΠΌ, ΠΏΠΎΡΡΠΎΠΌΡ Ρ Π²ΡΠ°ΡΠ΅ΠΉ ΡΠ°Π·Π½ΡΡ
ΠΏΡΠΎΡΠΈΠ»Π΅ΠΉ Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡ ΡΡΡΠ΄Π½ΠΎΡΡΠΈ Ρ ΠΏΠΎΡΡΠ°Π½ΠΎΠ²ΠΊΠΎΠΉ ΡΠΎΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°. ΠΠΏΠΈΡΠ°Π½Π½ΡΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ Π² Π΄Π°Π½Π½ΠΎΠΉ ΡΡΠ°ΡΡΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ΅Π΄ΠΊΠΈΠΌ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΠΠ. ΠΡΠΈΠ±ΠΊΠΈ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅, ΡΠ°ΠΊΡΠΈΠΊΠ΅ Π²Π΅Π΄Π΅Π½ΠΈΡΡ
, Π° ΡΠ°ΠΊΠΆΠ΅ Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΡΠ²Π»ΡΠ»ΠΈΡΡ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ Π½Π΅ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΡΡΠ΅ΠΉ ΠΏΡΠΎΡΠΈΠ»ΡΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ
Analysis of risk factors for the development of external genital endometriosis
A comparative assessment of two groups of patients - with initially detected external genital endometriosis (n = 20) and relapse (n = 20), undergoing treatment in the hospital of the Department of Emergency Gynecology of Clinical Hospital No. 40, allowed us to rank the significance of various risk factors for the development of relapse of the disease. Clinical characteristics were derived from their medical records. Patients were interviewed, complaints and anamnesis were collected, and WHOQOL-BREF quality of life questionnaire was completed. The analysis of the obtained data was performed using the statistical package SPSS 20.0. and Πxcel.Π‘ΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° Π΄Π²ΡΡ
Π³ΡΡΠΏΠΏ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ - Ρ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎ Π²ΡΡΠ²Π»Π΅Π½Π½ΡΠΌ Π½Π°ΡΡΠΆΠ½ΡΠΌ Π³Π΅Π½ΠΈΡΠ°Π»ΡΠ½ΡΠΌ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·ΠΎΠΌ (ΠΠΠ) (n=20) ΠΈ Ρ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΎΠΌ (n=20), ΠΏΡΠΎΡ
ΠΎΠ΄ΡΡΠΈΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡ Π½Π΅ΠΎΡΠ»ΠΎΠΆΠ½ΠΎΠΉ Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΠΠ β 40, ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»Π° ΡΠ°Π½ΠΆΠΈΡΠΎΠ²Π°ΡΡ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° Π΄Π»Ρ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ Π±ΡΠ»ΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ ΠΈΠ· ΠΈΡ
ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΠΎΠΏΡΠΎΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠ±ΠΎΡ ΠΆΠ°Π»ΠΎΠ± ΠΈ Π°Π½Π°ΠΌΠ½Π΅Π·Π°, Π·Π°ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ WHOQOL-BREF. ΠΠ½Π°Π»ΠΈΠ· ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠ°ΠΊΠ΅ΡΠ° SPSS 20.0. ΠΈ Excel
Formation of the competitive potential of the agricultural territories
The purpose of the study is to develop a mechanism for the formation of the competitive potential of the agricultural territories of Kazakhstan as the basis for ensuring the dynamic development of agricultural business in Kazakhstan. The research methodology is based on strategic alternative modeling for agricultural territories competitiveness management with the help of fuzzy cognitive logic. The study used a cognitive approach to decision making in the management of poorly structured systems proposed by V. Silov and actively developed in the works of modern scientists. Fifteen competent experts were invited to select the concepts and build a fuzzy cognitive map of the formation of the competitive potential of the agricultural territories of Kazakhstan. To carry out calculations and justify the content of the strategy, the authors used the software product βIntelligent generation of the best alternativesβ (βIGLAβ). The result of the study is the developed strategy for the management of agricultural territories competitiveness in Kazakhstan with a set of strategic goals and the best option for managerial impact, ensuring the formation of agricultural export potential of the region. The proposed version of the content of the strategy for managing the competitiveness of the agricultural territories of Kazakhstan can be used either as a system or as its separate elements in managing the development of agricultural business in the country and in developing strategic planning programs for the agro-industrial complex of the region. The novelty of the study in theoretical terms is justified by the approach to the formation of the country's agricultural export potential through ensuring the competitiveness of its agricultural territories. In methodological terms, the novelty of the study is expressed by the use of cognitive modeling technologies to develop a strategy for managing the competitiveness of Kazakhstan's agricultural territories, the implementation of which will allow achieving sustainable dynamics of agricultural production and increase the efficiency of the agricultural economy. Β© 2020 by author(s) and VsI Entrepreneurship and Sustainability Center
Analysis of risk factors for the development of external genital endometriosis
A comparative assessment of two groups of patients - with initially detected external genital endometriosis (n = 20) and relapse (n = 20), undergoing treatment in the hospital of the Department of Emergency Gynecology of Clinical Hospital No. 40, allowed us to rank the significance of various risk factors for the development of relapse of the disease. Clinical characteristics were derived from their medical records. Patients were interviewed, complaints and anamnesis were collected, and WHOQOL-BREF quality of life questionnaire was completed. The analysis of the obtained data was performed using the statistical package SPSS 20.0. and Πxcel.Π‘ΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° Π΄Π²ΡΡ
Π³ΡΡΠΏΠΏ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ - Ρ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎ Π²ΡΡΠ²Π»Π΅Π½Π½ΡΠΌ Π½Π°ΡΡΠΆΠ½ΡΠΌ Π³Π΅Π½ΠΈΡΠ°Π»ΡΠ½ΡΠΌ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΎΠ·ΠΎΠΌ (ΠΠΠ) (n=20) ΠΈ Ρ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΎΠΌ (n=20), ΠΏΡΠΎΡ
ΠΎΠ΄ΡΡΠΈΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΡ Π½Π΅ΠΎΡΠ»ΠΎΠΆΠ½ΠΎΠΉ Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΠΠ β 40, ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»Π° ΡΠ°Π½ΠΆΠΈΡΠΎΠ²Π°ΡΡ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° Π΄Π»Ρ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ Π±ΡΠ»ΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ ΠΈΠ· ΠΈΡ
ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΠΎΠΏΡΠΎΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠ±ΠΎΡ ΠΆΠ°Π»ΠΎΠ± ΠΈ Π°Π½Π°ΠΌΠ½Π΅Π·Π°, Π·Π°ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ WHOQOL-BREF. ΠΠ½Π°Π»ΠΈΠ· ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠ°ΠΊΠ΅ΡΠ° SPSS 20.0. ΠΈ Excel
Π’ransplantation of autologous stem cells, obtained from adipose tissue, in complex treatment of chronic ischemia of the lower extremities
Objective. To investigate the efficacy of application of autologous mesenchymal stem cells (AMSC) in treatment of patients, suffering critical ischemia of the lower extremities (CILE).
ΠΠ°terials and methods. In 2012 - 2015 yrs there was conducted the treatment of 41 patients, suffering CILE: 22 (53.7%) - men, and 19 (46.3%) - women. In the Group I (the main) 21 (51.2%) patients have had obtained a standard course of treatment, using AMSC. In the Group II (the control one) 20 (49.8%) patients have obtained a standard course of conservative treatment, using prostaglandins of group Π1 (PGΠ1). The results were investigated, measuring ankle-brachial pressure index, and the indices of a laser duplex flowmetry and a walking distance.
Results. During a one-year follow-up a trustworthy enhancement of microcirculation index was registered in the patients, who were treated, using AMSC, comparing with the patients, who obtained a course of therapy of PGΠ1 (Ρ=0.037). Positive dynamics of the microcirculation index while a PGΠ1application was observed during (1.8 Β± 0.3) mo, Π°nd while application of AMSC the microcirculation index have been enhanced trustworthily in (2.7 Β± 0.4) mo and persisted during one-year of follow-up.
Conclusion. Development of therapeutic effect in groups of patients, who were treated with AMSC and PGΠ1, did not occur simultaneously, thus , a complex treatment with simultaneous application of both methods and conduction of a dosed physical training may be considered a rational option
Russian multicenter experience of using talazoparib in the treatment of patients with BRCA-associated metastatic breast cancer
Introduction. The presence of a germinal BRCA mutation occurs in 3β4% of all breast cancer (BC) patients with various biological subtypes, but significantly with a high frequency in patients with a triple negative biological subtype (in 10β20% of cases). For the treatment of patients with HER2-negative metastatic breast cancer associated with gBRCA mutation, the effectiveness of biologically targeted drugs from the group of PARP inhibitors (olaparib and talazoparib) has been proven.Purpose. Comparison of the results of our experience with the use of talazoparib in patients with HER2-gBRCA+ + mBC with the data of the EMBRACA registration study.Materials and methods. As part of the multicenter compassionate use program (CUP) with the support of Pfizer, 24 patients with HER2-negative metastatic gBRCA-associated mutation metastatic breast cancer (HER2-gBRCA+ breast cancer) received biologically targeted therapy with the PARP inhibitor talazoparib at a standard oral dose of 1 mg per day for vital indications . The average age of patients with HER2-gBRCAm+ breast cancer was 50 years (29β90 years).Results. Objective response (OR) was registered in 29% of cases, disease control (OR+stabilization) β in 71% of cases. The median progression-free survival (PFS) was 6.5 months (95% CI [3β10]). Objective response, disease control, and median PFS were evaluated depending on the biological subtype, the number of lines of previous therapy, and the presence of platinum-containing agents in the anamnesis.Objective response and disease control were evaluated depending on the biological subtype: in patients with ER+HER2-mBC versus patients with triple negative subtype, OR was 33% vs 22%, and disease control was 83% vs 61%, respectively. In the presence of < 3 vs β₯ 3 lines of therapy for metastatic disease in the anamnesis, OR was 31% vs 12.5%, disease control β 75% vs 50% of cases, respectively. In the presence or absence of platinum-containing agents in the anamnesis, OR was observed in 22% vs 33% of cases, and disease control β 67% vs 67%, respectively.In patients with the luminal subtype versus patients with the triple negative subtype, the PFS was 9 months vs 5 months, respectively (HR = 0.705; 95% CI [0.231β2.147]; p = 0.5208). Median PFS in the presence of <3 vs β₯3 lines of therapy for metastatic disease in the anamnesis was 9 months vs 4 months, respectively (HR = 4,216; 95% CI [1,334β13,327]; p = 0.0056). In the presence or absence of platinum-containing agents in previous lines of therapy 5 months vs 9.5 months, respectively (HR =1.484; 95% CI [0.48β4.582]; p = 0.4750).During the treatment with talazoparib adverse events of the 3rd-4th grades were observed in 5 patients (20,8%). These include moderate and severe anemia in 3 patients (12.5%), thrombocytopenia in 1 patient (4%), and neutropenia in 1 patient (4%). The majority of patients (79,5%), which received talazoparib, did not require dose adjustment. The need to reduce the dose to 0.75 mg was noted in 3 patients (12.5%), to 0.5 mg β in 2 patients (8%). Hemotransfusion was performed in 3 patients. For effective therapy safety management regular monitoring of blood parameters is necessary.Conclusion. Thus, targeted therapy with talazoparib is an effective treatment option for HER2-gBRCA+ mBC