Assessment results professional development of medical specialists of an average link

In article the substantiation of the method of formalized individual assessment of results of professional development of medical specialists of an average link was given. Systematic multi-factor data analysis of the test survey, characterizing the level of development of additional professional programs, educational activity of specialist was conducted. The values of integral indicators, of influence coefficient, determining the most significant factors for the development of continuing medical education and a particular specialist in particular were obtained.В статье приведено обоснование формализованного метода индивидуальной оценки результатов профессионального развития медицинских специалистов среднего звена. Выполнен системный многофакторный анализ данных тест-опроса, характеризующего уровень освоения дополнительных профессиональных программ, образовательной активности специалиста. Получены значения интегральных показателей, коэффициентов влияния, определяющих наиболее значимые факторы развития системы непрерывного медицинского образования и конкретного специалиста в частности

Данные Эко-эффективность

Данные по экологической нагрузке и ВРП для расчета эко-эффективности регионов

Osteoporosis in women in menopause/postmenopause: what to do?

An analytical review of domestic and foreign literature on the problem of osteoporosis was performed, and the principles of the approach to diagnosis and treatment of this disease are described.The probability of vertebral fracture should be assumed if there is a history of growth loss of 4 cm or more, the appearance of kyphosis in patients who received long-term therapy with glucocorticoids, with bone mineral density (BMD) less than 2.5 points In the treatment of patients with osteoporosis at the initial stage there is a tendency to limit oneself to non-drug measures, advising to change lifestyle and diet, to increase intake of vitamin D and calcium with food, to optimize physical activity. However, the main place in the prevention and treatment of osteoporosis in postmenopausal women is occupied by medication therapy, which can reduce the risk of fractures by 70%: bisphosphonates, drugs derived from parathyroid hormone, denosumab and selective estrogen receptor modulators. It is advisable to start therapy with oral bisphosphonates in most cases. They are powerful inhibitors of bone resorption and act by reducing the activity of osteoclasts and increasing their apoptosis. In 2020, the patent protection period of the main original bisphosphonates expired and generics of Russian production appeared: Rezoviva (ibandronic acid 3 mg for intravenous injection once every 3 months) and Osteostatix (zoledronic acid 5 mg 100 ml solution for intravenous drip once a year). After 3–5 years of bisphosphonate treatment, treatment should be reconsidered. The risk of recurrent fractures should be reassessed after the injury occurs. The risk of new fractures increases in patients who stop treatment. Study results have recommended ibandronate as a first-line drug in women with postmenopausal osteoporosis. Studies comparing intermittent intravenous ibandronate administration with daily oral treatment in women with postmenopausal osteoporosis allowed to recommend intravenous ibandronate at a dose of 3 mg every 3 months as the preferred therapy

Cardiovascular risk profiles and stress echocardiography results in patients with hypertensive response to exercise

Aim. To compare markers of high cardiovascular risk and stress echocardiography results depending on the type of blood pressure (BP) response to exercise in patients without obstructive coronary artery disease.Material and methods. Our single-center cross-sectional study included 96 patients without hemodynamically significant coronary artery stenosis according to coronary angiography or multislice computed tomography angiography. All patients underwent physical examination, cardiovascular risk stratification, electrocardiography, extracranial cerebrovascular ultrasound, echocardiography, treadmill exercise stress echocardiography.Results. According to the test results, the patients were divided into groups with a hypertensive response (n=41) and a normal response to exercise (n=55). Patients with hypertensive response to exercise had significantly higher values of left ventricular mass index (100,0 (90,0; 107,0) g/m2 vs 76,0 (68,0; 91,0) g/m2, p<0,0000001) and left atrial volume index (36,7 (32,0; 46,0) ml/m2 vs 29,7 (26,3; 32,0) ml/m2, p=0,000003). There was also a higher level of cardiovascular SCORE risk (5,0 (2,0; 6,0) vs 2,0 (1,0; 3,0), p=0,004); patients more often had associated clinical conditions (36,6% vs 12,7%, χ2=7,57, p=0,006) and left ventricular diastolic dysfunction (39,02% vs 78,18%, χ2=15,21, p=0,0001). Pathological BP increase during stress echocardiography was associated with worse exercise tolerance (7,4 (5,6; 10,0) METs vs 10,2 (8,4; 11,95) METs, p=0,000041) and more frequent transient regional contractility impairment (46,34% vs 1,8%, p<0,00001), mainly of the lateral and inferior left ventricular walls.Conclusion. Despite the absence of coronary artery stenosis, patients with hypertensive response to exercise are significantly more likely to have markers of high cardiovascular risk and require more careful monitoring of risk factors. Also, the hypertensive response to exercise is associated with more frequent regional contractility impairment even without coronary artery stenosis

Composites on the basis of Y₂O₃ submicron spheres functionalized with nanosize titania: preparation and characterization

Composites anatase/Y2O3, η-TiO2/Y2O3, Degussa P25/Y2O3 and Hombifine/Y2O3 were prepared by simultaneous dispersion of Y2O3 and TiO2 powders in weakly alkaline aqueous media or dispersion of Y2O3 powders in acidic titania-containing hydrosols followed by special treatment. Initial reagents and composites were characterized by X-ray diffraction, IR spectroscopy, transmission and scanning electronic microscopy with X-ray spectral microanalysis