67 research outputs found
The state and prospects of development of problem-based learning in higher education
Β© 2016 Ibragimov, Ibragimova and Bakulina.Relevance of the work due to the need to resolve the contradiction between the new requirements for future professionals associated with the presence of experts formed by the ability to see, to identify and find solutions to problems that arise in their professional activity and the lack of readiness of teachers to implement the learning process of these requirements. The purpose of the article is to substantiate the thesis that the problem-based learning in a modern high school is objectively demanded as a basic foundation training. The methodological basis of the study was a systematic, competence and problem approaches. We used methods of study, analysis and synthesis of innovative experience of high school, the requirements of employers to the graduates, the latest scientific and educational literature in the field of didactics of vocational schools. The main results are that: The basic requirements for a modern model of learning in higher education; It justified the conclusion that in today's higher education Problem-based learning should be seen as a basic type of training that allows you to integrate educational opportunities and other learning technologies; revealed three major trends in the development of problem-based learning: the formation of an active problem-interactive learning technology, which is based on the interaction of at least three core technologies-the problem, and an interactive computer-based training; extension of the core of didactic teaching aids the creation of problematic situations in order to create all sorts of competencies; active development of integrative forms of realization of problem-based learning (problem-situational, problem-activity, problem-modular, task-design, problem-targeted, problem-playing, etc.). Materials may be useful to those skilled in the field of didactics of general and higher education, post-graduate students, university professors and secondary education system
ΠΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠΈΠ»Π° ΠΠ Π’-ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ° Ρ ΠΠΠ§-ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° ΠΏΡΠΈΠΌΠ΅ΡΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΡΠ΅ΡΠ°ΡΡΠΈΡ Π΄Π΅ΡΠ΅Π²ΡΠ΅Π² ΠΈ ROC-Π°Π½Π°Π»ΠΈΠ·
Introduction. Immune reconstitution inflammatory syndrome involving the central nervous system (CNS-IRIS) is a dangerous complication in HIV-infected patients on antiretroviral therapy (ART). The radiologic features of this syndrome have been little studied and are presented in isolated works. The diagnosis is difficult because there are no generally accepted criteria for IRIS. Our study is devoted to radiology of IRIS. Based on the results of brain MRI, together with clinical and laboratory data, MRI criteria for IRIS were formulated.Purpose and goals. To determine the prognostic value of MRI signs of CNS-IRIS using in a cohort of HIV-positive patients with neurological symptoms.Materials and methods. The analysis includes data from 68 HIV-infected patients who underwent brain MRI. In 14 of them were diagnosed IRIS with involvement of the central nervous system. To determine the diagnostic efficiency of the formulated MRI criteria, the STATISTICA program was used, decision trees were built, and a ROC analysis was performed.Results. Five decision tree models were built with different predictive values. The models took into account the categorical predictors (MRI criteria) in different order and quantity. The best performance has model #5, which can be considered a clinically useful predictive model.Conclusion. Brain MRI is an essential diagnostic step in HIV-infected patients on ART. It is necessary to expand the indications and conditions for radiological studies of the brain in patients with suspected immune reconstitution inflammatory syndrome.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π‘ΠΈΠ½Π΄ΡΠΎΠΌ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ° Ρ Π²ΠΎΠ²Π»Π΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ΅Π½ΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ (Π¦ΠΠ‘-Π‘ΠΠ) ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠΏΠ°ΡΠ½ΡΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠ΅ΠΌ Ρ ΠΠΠ§-ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΡΠΈΠ½ΠΈΠΌΠ°ΡΡΠΈΡ
Π°Π½ΡΠΈΡΠ΅ΡΡΠΎΠ²ΠΈΡΡΡΠ½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ (ΠΠ Π’). ΠΡΡΠ΅Π²Π°Ρ ΡΠ΅ΠΌΠΈΠΎΡΠΈΠΊΠ° Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΌΠ°Π»ΠΎ ΠΈΠ·ΡΡΠ΅Π½Π° ΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° Π² Π΅Π΄ΠΈΠ½ΠΈΡΠ½ΡΡ
ΡΠ°Π±ΠΎΡΠ°Ρ
. ΠΡΡΡΡΡΡΠ²ΡΡΡ ΠΎΠ±ΡΠ΅ΠΏΡΠΈΠ½ΡΡΡΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ Π‘ΠΠ, ΡΡΠΎ Π·Π°ΡΡΡΠ΄Π½ΡΠ΅Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ. ΠΠ°ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎΡΠ²ΡΡΠ΅Π½ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Π»ΡΡΠ΅Π²ΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½Ρ Π‘ΠΠ. ΠΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΠΠ Π’ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° Π² ΡΠΎΠ²ΠΎΠΊΡΠΏΠ½ΠΎΡΡΠΈ Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΈ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΠΌΠΈ Π΄Π°Π½Π½ΡΠΌΠΈ Π±ΡΠ»ΠΈ ΡΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°Π½Ρ ΠΠ Π’-ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° Π‘ΠΠ.Π¦Π΅Π»ΠΈ ΠΈ Π·Π°Π΄Π°ΡΠΈ. ΠΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΡΡ ΡΠΈΠ»Ρ ΡΠΎΠ²ΠΎΠΊΡΠΏΠ½ΠΎΡΡΠΈ Π»ΡΡΠ΅Π²ΡΡ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ², Π²ΡΡΠ²Π»ΡΠ΅ΠΌΡΡ
ΠΏΡΠΈ Π¦ΠΠ‘-Π‘ΠΠ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΠ Π’ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° Π² ΠΊΠΎΠ³ΠΎΡΡΠ΅ ΠΠΠ§-ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠΎΠΉ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Π°Π½Π°Π»ΠΈΠ· Π²ΠΊΠ»ΡΡΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ 68 ΠΠΠ§-ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠΌ Π±ΡΠ»Π° Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° ΠΠ Π’ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°. Π£ 14 ΠΈΠ· Π½ΠΈΡ
Π±ΡΠ» Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½ Π‘ΠΠ Ρ Π²ΠΎΠ²Π»Π΅ΡΠ΅Π½ΠΈΠ΅ΠΌ Π¦ΠΠ‘. ΠΠ»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΠ Π’-ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π±ΡΠ»Π° ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½Π° ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ° STATISTICA, ΠΏΠΎΡΡΡΠΎΠ΅Π½Ρ Π΄Π΅ΡΠ΅Π²ΡΡ ΡΠ΅ΡΠ΅Π½ΠΈΠΉ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ROC-Π°Π½Π°Π»ΠΈΠ·.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠ»ΠΈ ΠΏΠΎΡΡΡΠΎΠ΅Π½Ρ 5 ΠΌΠΎΠ΄Π΅Π»Π΅ΠΉ Π΄Π΅ΡΠ΅Π²ΡΠ΅Π² ΡΠ΅ΡΠ΅Π½ΠΈΠΉ, ΠΎΠ±Π»Π°Π΄Π°ΡΡΠΈΠ΅ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΡΡΡΠ΅ΠΉ ΡΠ΅Π½Π½ΠΎΡΡΡΡ. ΠΠΎΠ΄Π΅Π»ΠΈ ΡΡΠΈΡΡΠ²Π°Π»ΠΈ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠ°Π»ΡΠ½ΡΠ΅ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΡ (ΠΠ Π’-ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ) Π² ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΌ ΠΏΠΎΡΡΠ΄ΠΊΠ΅ ΠΈ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅. ΠΠ°ΠΈΠ»ΡΡΡΠΈΠΌΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ°ΠΌΠΈ ΠΎΠ±Π»Π°Π΄Π°Π»Π° ΠΌΠΎΠ΄Π΅Π»Ρ β 5, ΠΊΠΎΡΠΎΡΡΡ ΠΌΠΎΠΆΠ½ΠΎ ΡΡΠΈΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ ΠΏΠΎΠ»Π΅Π·Π½ΠΎΠΉ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΡΡ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΠ Π’ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° Ρ ΠΠΠ§-ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΡΠΈΠ½ΠΈΠΌΠ°ΡΡΠΈΡ
ΠΠ Π’, ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π΅ΠΎΡΡΠ΅ΠΌΠ»Π΅ΠΌΡΠΌ ΡΡΠ°ΠΏΠΎΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ. ΠΠ΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΡΠ°ΡΡΠΈΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ ΠΈ ΡΡΠ»ΠΎΠ²ΠΈΠΉ Π΄Π»Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° ΠΏΡΠΈ ΠΏΠΎΠ΄ΠΎΠ·ΡΠ΅Π½ΠΈΠΈ Π½Π° ΡΠΈΠ½Π΄ΡΠΎΠΌ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ°
The Black Sea Region Energy Cooperation: Current Trends and Prospects
The Black Sea region is one of the most complex regions in terms of energy development. It hosts several major powers and some developing countries that need to cut energy costs. In general, the region is controversial. It is influenced by external actors, and therefore regional stability is very difficult to achieve. In addition, institutional players such as the EU, the Belt and Road Initiative, the Black Sea Trade and Development Bank, etc., have their own vision of the future of the Black Sea region. The article is aimed at assessing the regional balance of power and estimating the interests of the countries of the region. Based on this assessment, the authors have classified the countries in the region, predicted potential alliances, and provided recommendations on how the countries should behave in the region. The key findings comprise the rejection of the two hypotheses: the countries of the region cooperate mainly through similar institutions; and the countries of the region can efficiently cooperate within the framework of a single strategy. The novelty of the article is in a new look on the regional distribution of power and new strategies for cooperation between countries in the region.Keywords: The Black Sea region, energy sector, strategy, institutions, balance of powerJEL Classifications: F59, Q48DOI: https://doi.org/10.32479/ijeep.11247</p
ΠΠ΅ΠΉΡΠΎΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ° ΠΏΡΠΈ ΠΠΠ§-ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ
The introduction of antiretroviral therapy has changed the human immunodeficiency virus pandemic. Some patients with HIV infection after starting or resuming ART develop a paradoxical worsening of clinical status, called Immune ReΡΠΎnstitution Inflammatory Syndrome (IRIS). However, if clinical and laboratory criteria for the diagnosis of this syndrome have been formulated, IRIS neuroradiological criteria do not exist yet. The present study presents neuroradiological features and diagnostic algorithm for identification of IRIS involving central nervous system.ΠΠ½Π΅Π΄ΡΠ΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΡΠ΅ΡΡΠΎΠ²ΠΈΡΡΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈΠ·ΠΌΠ΅Π½ΠΈΠ»ΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ Π²ΠΈΡΡΡΠ° ΠΈΠΌΠΌΡΠ½ΠΎΠ΄Π΅ΡΠΈΡΠΈΡΠ° ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°. Π£ Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ§-ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ ΠΏΠΎΡΠ»Π΅ Π½Π°ΡΠ°Π»Π° ΠΈΠ»ΠΈ Π²ΠΎΠ·ΠΎΠ±Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΠ ΠΠ’ ΡΠ°Π·Π²ΠΈΠ²Π°Π΅ΡΡΡ ΠΏΠ°ΡΠ°Π΄ΠΎΠΊΡΠ°Π»ΡΠ½ΠΎΠ΅ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ°, Π½Π°Π·Π²Π°Π½Π½ΠΎΠ΅ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ°. ΠΠ΄Π½Π°ΠΊΠΎ Π΅ΡΠ»ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ- Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΡΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°Π½Ρ, ΡΠΎ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π½Π΅ ΡΡΡΠ΅ΡΡΠ²ΡΠ΅Ρ. Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΡΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°Π½ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π»Π³ΠΎΡΠΈΡΠΌ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ° Ρ Π²ΠΎΠ²Π»Π΅ΡΠ΅Π½ΠΈΠ΅ΠΌ Π¦ΠΠ‘, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ Π΅Π³ΠΎ Π½Π΅ΠΉΡΠΎΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ
Biochemical and technological properties of moose (<i>Alces alces</i>) recombinant chymosin
Recombinant chymosins (rΠ‘hns) of the cow and the camel are currently considered as standard milk coagulants for cheese-making. The search for a new type of milk-clotting enzymes that may exist in nature and can surpass the existing βcheese-makingβ standards is an urgent biotechnological task. Within this study, we for the first time constructed an expression vector allowing production of a recombinant analog of moose chymosin in the expression system of Escherichia coli (strain SHuffle express). We built a model of the spatial structure of moose chymosin and compared the topography of positive and negative surface charges with the correspondent structures of cow and camel chymosins. We found that the distribution of charges on the surface of moose chymosin has common features with that of cow and camel chymosins. However, the moose enzyme carries a unique positively charged patch, which is likely to affect its interaction with the substrate. Biochemical and technological properties of the moose rChn were studied. Commercial rΠ‘hns of cow and camel were used as comparison enzymes. In some technological parameters, the moose rChn proved to be superior to the reference enzymes. Π‘ompared with the cow and camel rΠ‘hns, the moose chymosin specific activity is less dependent on the changes in CaCl2 concentration in the range of 1β5 mM and pH in the range of 6β7, which is an attractive technological property. The total proteolytic activity of the moose rΠ‘hn occupies an intermediate position between the rΠ‘hns of cow and camel. The combination of biochemical and technological properties of the moose rΠ‘hn argues for further study of this enzyme
ΠΠΠΠΠΠ‘Π¦ΠΠΠΠΠΠΠ ΠΠ«Π ΠΠΠ Π‘ΠΠΠΠΠΠΠΠ ΠΠΠΠΠΠ«Π ΠΠΠΠ₯ΠΠ Π Π’ΠΠ₯ΠΠΠΠΠΠΠ ΠΠΠ£Π§ΠΠΠΠ― ΠΠΠΠΠΠΠΠΠ ΠΠΠΠΠ ΠΠ Π ΠΠΠ§ΠΠΠ€ΠΠΠ¦ΠΠ
There was made an attempt to link interdisciplinary research methodically, from clinical diagnostic techniques, modern instrumental, laboratory and basic research to their implementation in practice. The experience of several partner groups studying the brainΒ in HIV infection was analyzed and summarized. It was based on an interdisciplinary approach, the goals and authorities of infectious disease specialists,Β psychiatrists, neurologists, radiologists, laboratory doctors, clinical examination algorithm, the role ofΒ history and interview, express-diagnostic of cognitive functions, specialized psychiatric, neurologicalΒ diagnosis, conclusion of clinical psychologists, indications for radiology methods. The choice and analysis of radiological and instrumental methods, the volumeΒ and structure of laboratory methods of central nervous system study were justified. The role of molecular genetic studies of HIV inΒ blood and cerebrospinal fluid, the identification of drug-resistant forms of the virus was determined when choosing the therapy.Π‘Π΄Π΅Π»Π°Π½Π° ΠΏΠΎΠΏΡΡΠΊΠ° ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈ ΡΠ²ΡΠ·Π°ΡΡ ΠΌΠ΅ΠΆΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, Π½Π°ΡΠΈΠ½Π°Ρ Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΠ΅ΠΌΠΎΠ²,Β ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
, Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΈ ΡΡΠ½Π΄Π°ΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π΄ΠΎ ΠΈΡ
ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ Π² ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Β ΠΈ ΠΎΠ±ΠΎΠ±ΡΠ΅Π½ ΠΎΠΏΡΡ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
ΠΏΠ°ΡΡΠ½Π΅ΡΡΠΊΠΈΡ
ΠΊΠΎΠ»Π»Π΅ΠΊΡΠΈΠ²ΠΎΠ² ΠΏΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° ΠΏΡΠΈ ΠΠΠ§-ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ. Π ΠΎΡΠ½ΠΎΠ²ΡΒ Π»Π΅Π³Π»ΠΈ ΠΌΠ΅ΠΆΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄, Π·Π°Π΄Π°ΡΠΈ ΠΈ ΠΏΠΎΠ»Π½ΠΎΠΌΠΎΡΠΈΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½ΠΈΡΡΠΎΠ², Π½Π°ΡΠΊΠΎΠ»ΠΎΠ³ΠΎΠ²-ΠΏΡΠΈΡ
ΠΈΠ°ΡΡΠΎΠ², Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΎΠ², ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ², Π²ΡΠ°ΡΠ΅ΠΉ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΡΠ»ΡΠΆΠ±Ρ, Π°Π»Π³ΠΎΡΠΈΡΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, ΡΠΎΠ»Ρ Π°Π½Π°ΠΌΠ½Π΅Π·Π° ΠΈ ΠΎΠΏΡΠΎΡΠ°, ΡΠΊΡΠΏΡΠ΅ΡΡ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Β ΡΡΠ½ΠΊΡΠΈΠΉ, ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΠ· ΠΏΡΠΈΡ
ΠΈΠ°ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ, Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ, Π·Π°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΎΠ², ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡ Π΄Π»ΡΒ ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ. ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½Ρ Π²ΡΠ±ΠΎΡ ΠΈ Π°Π½Π°Π»ΠΈΠ· ΡΠ°Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΎΡΠ΅Π½ΠΊΠΈ Π¦ΠΠ‘, ΠΎΠ±ΡΠ΅ΠΌΒ ΠΈ ΡΡΡΡΠΊΡΡΡΠ° Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ² Π² Π¦ΠΠ‘. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΡΠΎΠ»Ρ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΠΠ§Β Π² ΠΊΡΠΎΠ²ΠΈ ΠΈ ΡΠΏΠΈΠ½Π½ΠΎΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ, Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΡΡ
ΡΠΎΡΠΌ Π²ΠΈΡΡΡΠ°, ΡΡΠ΅Ρ ΠΏΡΠΈ Π²ΡΠ±ΠΎΡΠ΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
ΠΠΎΠ²Π°Ρ ΠΌΡΡΠ°ΡΠΈΡ Π² Π³Π΅Π½Π΅ TYMP: ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ Ρ Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ MNGIE
Mitochondrial neurogastrointestinal encephalomyopathy is an extremely rare (1β9:1 000 000, Orphanet, 2021) multisystem genetic disease caused by mutations in the TYMP gene encoding the enzyme thymidine phosphorylase.The article presents the data of a thirteenβyear survey on 40βyearβold patient D. with clinical manifestations of mitochondrial neurogastrointestinal encephalomyopathy syndrome associated with the previously undescribed missense mutation c.1301G>T (p.Gly434Val) of the TYMP gene. Detailed clinical picture (gastrointestinal dysfunction, cachexia, blepharoptosis, ophthalmoparesis, peripheral polyneuropathy and leukoaraiosis), electroneuromyography data (demyelination with secondary axonopathy), high blood serum level of dihydrothymine together with normal levels of thymidine and deoxyuridine made it possible to verify the diagnosis. Histopathological examination revealed atrophy of the longitudinal (outer) muscle layer of the small and large intestines and a significant decrease in the number of CD117+ cells (telocytes), signs of damage to the striated skeletal muscles of a mixed nature with a predominance of the myogenic pattern, as well the destruction of the myelin sheaths of peripheral nerves. Histochemical examination did not reveal βragged red fibersβ characteristic of mitochondrial pathology. Transmission electron microscopy demonstrated the presence of megalomitochondria in the myocardium.Π‘ΠΈΠ½Π΄ΡΠΎΠΌ ΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΠ³Π°ΡΡΡΠΎΠΈΠ½ΡΠ΅ΡΡΠΈΠ½Π°Π»ΡΠ½ΠΎΠΉ ΡΠ½ΡΠ΅ΡΠ°Π»ΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ β ΡΠ΅Π΄ΠΊΠΎΠ΅ (1β9:1000000, Orphanet, 2021) Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΌΡΠ»ΡΡΠΈΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΠΎΠ΅ ΠΌΡΡΠ°ΡΠΈΡΠΌΠΈ Π² ΡΠ΄Π΅ΡΠ½ΠΎΠΌ Π³Π΅Π½Π΅ TYMP, ΠΊΠΎΠ΄ΠΈΡΡΡΡΠ΅ΠΌ ΡΠ΅ΡΠΌΠ΅Π½Ρ ΡΠΈΠΌΠΈΠ΄ΠΈΠ½ΡΠΎΡΡΠΎΡΠΈΠ»Π°Π·Ρ.ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ 13βΠ»Π΅ΡΠ½Π΅Π³ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ Π., 40 Π»Π΅Ρ, Ρ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ ΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΠ³Π°ΡΡΡΠΎΠΈΠ½ΡΠ΅ΡΡΠΈΠ½Π°Π»ΡΠ½ΠΎΠΉ ΡΠ½ΡΠ΅ΡΠ°Π»ΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ, ΡΠ²ΡΠ·Π°Π½Π½ΡΠΌ Ρ ΡΠ°Π½Π΅Π΅ Π½Π΅ ΠΎΠΏΠΈΡΠ°Π½Π½ΠΎΠΉ ΠΌΠΈΡΡΠ΅Π½ΡβΠ·Π°ΠΌΠ΅Π½ΠΎΠΉ c.1301G>T (p.Gly434Val) Π² Π³Π΅Π½Π΅ TYMP. ΠΠΈΠ°Π³Π½ΠΎΠ· ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π½Π΅ΠΉΡΠΎΠ³Π°ΡΡΡΠΎΠΈΠ½ΡΠ΅ΡΡΠΈΠ½Π°Π»ΡΠ½ΠΎΠΉ ΡΠ½ΡΠ΅ΡΠ°Π»ΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ Π±ΡΠ» ΠΏΠΎΡΡΠ°Π²Π»Π΅Π½ Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ (Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΡ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎβΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ°, ΠΊΠ°Ρ
Π΅ΠΊΡΠΈΡ, Π±Π»Π΅ΡΠ°ΡΠΎΠΏΡΠΎΠ·, ΠΎΡΡΠ°Π»ΡΠΌΠΎΠΏΠ°ΡΠ΅Π·, ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΏΠΎΠ»ΠΈΠ½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΡ ΠΈ Π»Π΅ΠΉΠΊΠΎΡΠ½ΡΠ΅ΡΠ°Π»ΠΎΠΏΠ°ΡΠΈΡ), ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ»Π΅ΠΊΡΡΠΎΠ½Π΅ΠΉΡΠΎΠΌΠΈΠΎΠ³ΡΠ°ΡΠΈΠΈ (Π΄Π΅ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΈΠ·Π°ΡΠΈΡ Ρ Π²ΡΠΎΡΠΈΡΠ½ΠΎΠΉ Π°ΠΊΡΠΎΠ½ΠΎΠΏΠ°ΡΠΈΠ΅ΠΉ), Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΡΠΎΠ²Π½Ρ Π΄ΠΈΠ³ΠΈΠ΄ΡΠΎΡΠΈΠΌΠΈΠ½Π° Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ ΠΏΡΠΈ Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΡΡ
ΡΡΠΎΠ²Π½ΡΡ
ΡΠΈΠΌΠΈΠ΄ΠΈΠ½Π° ΠΈ Π΄Π΅Π·ΠΎΠΊΡΠΈΡΡΠΈΠ΄ΠΈΠ½Π°. ΠΠ°ΡΠΎΠ³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΡΡΠ²ΠΈΠ»ΠΎ Π°ΡΡΠΎΡΠΈΡ ΠΏΡΠΎΠ΄ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ (Π½Π°ΡΡΠΆΠ½ΠΎΠ³ΠΎ) ΠΌΡΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΠ»ΠΎΡ ΡΠΎΠ½ΠΊΠΎΠΉ ΠΈ ΡΠΎΠ»ΡΡΠΎΠΉ ΠΊΠΈΡΠΎΠΊ ΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π° CD117+βΠΊΠ»Π΅ΡΠΎΠΊ (ΡΠ΅Π»ΠΎΡΠΈΡΠΎΠ²), ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ ΡΠΊΠ΅Π»Π΅ΡΠ½ΡΡ
ΠΌΡΡΡ ΡΠΌΠ΅ΡΠ°Π½Π½ΠΎΠ³ΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ° Ρ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°Π½ΠΈΠ΅ΠΌ ΠΌΠΈΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠ°ΡΡΠ΅ΡΠ½Π°, Π° ΡΠ°ΠΊΠΆΠ΅ Π΄Π΅ΡΡΡΡΠΊΡΠΈΡ ΠΌΠΈΠ΅Π»ΠΈΠ½ΠΎΠ²ΡΡ
ΠΎΠ±ΠΎΠ»ΠΎΡΠ΅ΠΊ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π½Π΅ΡΠ²ΠΎΠ². ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ S100βΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΡ
Π²Π΅Π³Π΅ΡΠ°ΡΠΈΠ²Π½ΡΡ
ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠΉ ΡΡΠ΅Π½ΠΊΠΈ Π½Π΅ Π²ΡΡΠ²ΠΈΠ»ΠΎ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ. ΠΡΠΈ Π³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π½Π΅ Π±ΡΠ»ΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ Β«ΡΠ²Π°Π½ΡΠ΅ ΠΊΡΠ°ΡΠ½ΡΠ΅ Π²ΠΎΠ»ΠΎΠΊΠ½Π°Β», Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΡΠ΅ Π΄Π»Ρ ΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠΎΠΏΠ°ΡΠΈΠΉ. Π’ΡΠ°Π½ΡΠΌΠΈΡΡΠΈΠΎΠ½Π½Π°Ρ ΡΠ»Π΅ΠΊΡΡΠΎΠ½Π½Π°Ρ ΠΌΠΈΠΊΡΠΎΡΠΊΠΎΠΏΠΈΡ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»Π° Π½Π°Π»ΠΈΡΠΈΠ΅ ΠΏΠΎΠ»ΠΈΠΌΠΎΡΡΠΈΠ·ΠΌΠ° ΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠΉ ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΡΠΈΡΠΎΠ² ΠΈ ΠΌΠ΅Π³Π°Π»ΠΎΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠΉ Π»Π΅ΠΉΠΎΠΌΠΈΠΎΡΠΈΡΠΎΠ² ΠΊΠΈΡΠ΅ΡΠ½ΠΈΠΊΠ°
Russian consensus on exoand endocrine pancreatic insufficiency after surgical treatment
The Russian consensus on exo - and endocrine pancreatic insufficiency after surgical treatment was prepared on the initiative of the Russian "Pancreatic Club" on the Delphi method. His goal was to clarify and consolidate the opinions of specialists on the most relevant issues of diagnosis and treatment of exo - and endocrine insufficiency after surgical interventions on the pancreas. An interdisciplinary approach is provided by the participation of leading gastroenterologists and surgeons
Rehabilitation after COVID-19. Resolution of the International Expert Council of the Eurasian Association of Therapists and the Russian Society of Cardiology
By the middle of 2021, the official global number of coronavirus disease 2019 (COVID-19) patients was close to 230 million, but the number accounting for asymptomatic patients was much higher. Consequences and rehabilitation after COVID-19 are of particular interest and raise many controversial and unresolved issues. On May 18, 2021, the Eurasian Association of Therapists organized an international panel of experts to analyze challenges associated with the post-COVID-19 period. This panel aimed to develop approaches to identify gaps in the discussed issues. This interdisciplinary team of leading experts reviewed the current literature and presented their data to formulate practical guidance on management of patients after COVID-19. The panel of experts also presented recommendations on how to implement the gained knowledge into health care practices
Clinical features of post-COVID-19 period. Results of the international register βDynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)β. Data from 6-month follow-up
Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 β 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period
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