RISK FACTORS AFFECTING THE SURVIVAL OF PATIENTS WITH BLADDER CANCER

Bladder cancer (BC) is consistently among the ten most common malignant neoplasms worldwide. Patients with BC are describe by a high level of postoperative complications and comorbidity. The aim of the study: analysis of risk factors affecting the duration and quality of life of patients with BC

Analysis of the Survival Rate of Cancer Dispensary Patients after Radical Cystectomy

One of the most commonly used surgical operations among patients with bladder cancer is radical cystectomy. An important stage of the operation is the choice of the method urine derivation. The aim of the study: to analyze the survival of patients with three different meth-ods of urine derivation

Adiponectin circulating levels and 10-year (2002–2012) cardiovascular disease incidence:the ATTICA Study

Purpose: Adiponectin is an adipokine with anti-inflammatory and cardiovascular-protective properties. Existing epidemiological evidence is conflicting on the exact relationship between adiponectin and long-term cardiovascular disease (CVD) risk. Our aim was to prospectively assess whether circulating adiponectin is associated with long-term incident CVD. Methods: A population-based, prospective study in adults (>18 years) without previous CVD history (ATTICA study). Circulating total adiponectin levels were measured at baseline (2001–2002) in a sub-sample (n = 531; women/men: 222/309; age: 40 ± 11 years) of the ATTICA cohort and complete 10-year follow-up data were available in 366 of these participants (women/men: 154/212; age: 40 ± 12 years). Results: After adjusting for multiple factors, including age, sex, body mass index, waist circumference, smoking, physical activity, Mediterranean diet adherence, hypertension, diabetes, and hypercholesterolemia, our logistic regression analysis indicates that an increase in circulating total adiponectin levels by 1 unit was associated with 36% lower CVD risk (relative risk [RR]: 0.64, 95% confidence interval [CI] 0.42–0.96; p = 0.03). Further adjusting for interleukin-6 plasma levels had no significant impact (RR: 0.60, 95% CI 0.38–0.94; p = 0.03), while additional adjustment for circulating C-reactive protein (CRP) modestly attenuated this association (RR: 0.63, 95% CI 0.40–0.99; p = 0.046). Conclusions: In our study, elevated circulating total adiponectin levels were associated with lower 10-year CVD risk in adults without previous CVD, independently of other established CVD risk factors. This association appeared to be modestly attenuated by CRP, yet was not mediated by interleukin-6 which is the main endocrine/circulating pro-inflammatory cytokine

Прогнозирование продолжительности сроков заболевания и возраста пациентов с разными стадиями первичной открытоугольной глаукомы

PURPOSE: To find out the expected duration of the disease and age of patients with different primary open-angle glaucoma changes. METHODS: The study protocol included data from 120 patients (50 males (41.7%), 70 females (58.3%)); 189 eyes; 102 right eyes; 87 left eyes). The first study group (28 patients, 44 eyes) comprised patients with suspected glaucoma. The second group (53 patients, 84 eyes) consisted of patients with early glaucoma changes. The third group (21 patients, 33 eyes) included patients with advanced glaucoma changes. The forth group (18 patients, 28 eyes) comprised patients with terminal glaucoma. The mean age of the patients was 61.6 (58.4; 66.9) years at the time of diagnosis and 66.9 (63.4; 72.8) years at the endpoint visit in 2013. In all cases the diagnosis was made according to the differential diagnosis system and was proved by special diagnostic techniques. The database included data from 3 qualified examinations as well as tonometry and static automatic perimetry results. RESULTS: The expected mean age of the patients at the moment of total vision loss was 75.1 years. The period, during which patients developed blindness, was limited to 6.1 years. Mean age of the patients at the time of possible glaucoma development was 59.58 (56.14; 64.36) years. The disease itself could have developed within -3.24 (-5.38; -1.2) years prior to the diagnosis. CONCLUSION: Glaucoma diagnostic research should be focused on the age group of 55-60 years. The degree of IOP-lowering in patients with advanced glaucoma changes does not correspond with the Russian glaucoma society recommendations, which determines further progression of the disease.ЦЕЛЬ. Определить предполагаемую продолжительность сроков течения заболевания и возраст пациентов с разными стадиями первичной открытоугольной глаукомы. методы. в протокол исследования были включены данные 120 человек (50 (41,7%) мужчин, 70 (58,3%) женщин; всего 189 глаз, из них 102 правых и 87 левых). В 1-ю группу (28 человек, 44 глаза) вошли пациенты с диагнозом подозрение на глаукому. Пациенты с начальной стадией глаукомы составили 2-ю группу (53 человека, 84 глаза), с развитой стадией заболевания - 3-ю (21 пациент, 33 глаза), с далекозашедшей стадией болезни - 4-ю группу (18 пациентов, 28 глаз). Средний возраст всех пациентов на момент проведения первичной диагностики составил 61,6 (58,4; 66,9) года и 66,9 (63,4; 72,8) года на момент проведения финального исследования в 2013 г. Во всех случаях диагноз был установлен в соответствии с системой дифференциальной диагностики заболеваний и подтвержден специальными методами исследования. В базу данных были включены результаты трех квалифицированных заключений, с результатами тонометрии и статической периметрии. РЕЗУЛЬТАТЫ. Средний предполагаемый возраст пациентов на момент наступления слепоты составил 75,1 года, а период, когда такие изменения наступят, был ограничен сроком в 6,1 года. Возраст пациента при вероятном возникновении глаукомы составил 59,58 (56,14; 64,36) года, а само заболевание могло начаться за 3,24 (-5,38; -1,2) года до момента постановки диагноза на практике. ЗАКЛЮЧЕНИЕ. Профилактические осмотры населения с целью выявления глаукомы должны быть в первую очередь ориентированы на возрастную группу от 55 до 60 лет. Степень понижения уровня внутриглазного давления у пациентов с продвинутыми стадиями заболевания не соответствует рекомендациям Российского глаукомного общества для этих категорий пациентов, что определяет дальнейшее прогрессирование заболевания

Оптимизация лечебно-диагностического процесса у пациентов с первичной открытоугольной глаукомой

PURPOSE: To create an optimal scientifically based system of management of diagnosis and treatment process (diagnosis, follow-up, rational medication treatment, surgical treatment) in patients with primary open-angle glaucoma. METHODS: The final protocol of combined analytical research and clinical multicenter study conducted from July to November 2015 included data from 591 patients (824 eyes). Age, disease duration, disease stage, IOP level and visual field parameters during treatment and treatment regimens were analyzed. Regimen included various combinations of medical, laser and surgical treatment used in the disease management. RESULTS: Average patients' age at the time of diagnosis establishment was 64.3 (57.5; 70.4). Mean disease duration was 4.1 years (2.0; 7.1). The administered regimen was considered to be effective when IOP level was below 20 mm Hg. The IOP level between 21 and 25 mm Hg was considered to be a sign of reduced treatment effectiveness and need for change of the regimen. 8 regimen changes were analyzed in total, though 90% of cases had 1-5 regimen changes. The first three regimens were used for 1.2 (0.4; 2.6), 1.3 (0.5; 2.5) and 1.1 years (0.5; 2.4) respectively. B-blockers and prostaglandin analogues monotherapy was used as a first-line therapy in 40.1% and 20.8% of cases respectively. Treatment was started with combination therapy in 27.82% of cases. Proportion of surgical treatment was 9.9% in regimen 2 and achieved 73% in regimen 5. Laser treatment was started from regimen 3 though the frequency of administration did not exceed 20%. Combination treatment using 3 and more components was found starting from regimen 5 (57.3%). CONCLUSION: First line therapy choice is still not rational in many cases. Laser and surgical treatment are used ineffectively after 3-4 years from the diagnosis.ЦЕЛЬ. Создать оптимальную научно обоснованную систему управления (диагностика, динамическое наблюдение, рациональная фармакотерапия, хирургическое лечение) лечебно-диагностическим процессом у пациентов с первичной открытоугольной глаукомой. МЕТОДЫ. В итоговый протокол комбинированного аналитического научно-клинического многоцентрового исследования, проведенного в июле-ноябре 2015 года, были включены данные 591 человека (женщин - 352 (59,6%), мужчин - 239 (40,4%); 824 глаза). Были проанализированы: возраст, анамнез, стадии заболевания, уровни офтальмотонуса и характеристики поля зрения на фоне лечения и лечебная тактика (режимы назначений от момента обнаружения заболевания). Под понятием «режим» понимались различные варианты медикаментозного, лазерного и хирургического лечения, использованные в тактике лечебно-диагностического процесса. РЕЗУЛЬТАТЫ. Средний возраст пациентов на момент диагностирования глаукомы (все стадии, без деления на гендерные группы) составил 64,30 (57,50; 70,40) года, а на момент включения в исследование - 68,80 (64,10; 75,60) года. Средний анамнез заболевания составил 4,10 (2,00; 7,10) года. Назначенный режим лечения оценивался исследователями как эффективный при показателях офтальмотонуса не выше 20 мм рт.ст., при этом за понижение эффективности лечения и необходимость перевода на другой режим принимались показатели ВГД в диапазоне от 21 до 25 мм рт.ст. Всего было проанализировано 8 смен схем режимов, при этом в режимах 1-5 были проанализированы более 90% всех назначений. Продолжительность использования первых последовательных трех режимов составила: первого - 1,20 (0,40; 2,60) года, второго - 1,30 (0,50; 2,50) года, третьего - 1,10 (0,50; 2,40) года. Доля бета-адреноблокаторов в монотерапии в первом режиме составила 40,1%, значительно снизившись ко второму - до 3,16%, и полностью отсутствовала в последующих назначениях. Доля аналогов простагландинов в монотерапии также уменьшается от режима к режиму: на старте их применяют в 20,8% случаев, а при режиме № 3 - в 6,7% (снижение в три раза). В лечебной тактике второго режима начинает использоваться хирургический компонент (9,9%). Наиболее наглядно выглядят компоненты, использованные в режиме № 5. Действительно, активное применение схем комбинированной терапии, включая применение трех и более компонентов, было установлено начиная с режима № 5 (57,3%). В это же время в 9,6% случаев становится актуальным повторное хирургическое лечение. ЗАКЛЮЧЕНИЕ. Учитывая, что продвинутые стадии заболевания превалируют при обнаружении глаукомы, следует обратить внимание на нерациональную тактику выбора терапии первой линии у таких лиц. Недостаточно эффективно применяется лазерное и хирургическое лечение, которое становится актуальным только в режимах №№ 3-4, т. е. после 3-4 лет от обнаружения болезни

Discovery of potential ovarian cancer biomarkers using low molecular weight blood plasma proteome profiling by mass spectrometry

At present, there is no screening test for the early detecting and monitoring of ovarian cancer, one of the most lethal form of gynaecological malig- nancy in the worldwide. In this study, the new methodology for the search of tumor markers of ovarian cancer, involving profiling the low-molec- ular blood plasma proteomes, is developed, unified and approved. The given approach included three basic components: pre-preparation of samples, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and bioinformatics software for mass spectral data process- ing. Opportunities and prospects of the developed approach for the detection of potential ovarian cancer markers were shown. For search of po- tential tumor markers, screening of 40 blood plasma samples from ovarian cancer patients and 48 control samples were carried out. As a result of the present research, peptides/polypeptides which can be used in future for detecting this pathology were found out

COMPETENCY ASSESSMENT OF A SECONDARY VOCATIONAL EDUCATION GRADUATE ACCORDING TO WORLDSKILLS STANDARDS

Introduction. The relevance of the research topic presented in this article is due to the need to spread the practice of assessing competencies formed during the training of graduates of secondary vocational education. The implementation of the comprehensive assessment tasks of the students’ competencies of secondary vocational education is carried out by conducting intermediate and final certification in the form of a demonstration exam according to WorldSkills standards. Aim. The aim of this article was to summarise the results of scaling up the practice of conducting a demonstration exam according to WorldSkills standards in the regional and competency-based sections, to identify factors that contribute to the expansion of the use of the demonstration exam procedure when conducting attestation procedures. Methodology and research methods. The theoretical level of the study included a generalisation of the provisions of the competency-based approach to the training of students in secondary vocational education. The empirical level of the study included an analysis of statistical materials reflecting the results of demonstration exams according to the WorldSkills standards by regions and competencies (skills). The results obtained were verified based on a survey of certified WorldSkills experts. The following general scientific methods were used: analytical review of scientific literature and the content of regulatory documents, generalisation, comparison, synthesis. Results. Only 30.86% of students confirmed the compliance of the acquired knowledge with WorldSkills standards. Among the main reasons for the low preparedness of students, there is a shortage of equipment, consumables, methodological developments, and inconsistency with the content of educational programmes. The low interest of employers is due to the discrepancy between the specifics of the competencies for which demonstration exams are held and the sectoral structure of the regional economy. This situation requires a revision of the processes of training students and the introduction of elements of a competency-based approach. Thus, the formed system for conducting intermediate and final certification in the form of a demonstration exam according to WorldSkills standards needs to be harmonised, the result of which should be the interconnection of the employer’s needs in the competencies of secondary vocational education students. The solution to this problem can be based on a number of regional programmes for staffing the regional economy. Scientific novelty. The novelty of the proposed assessment methodology of the competency-based approach consists in the use of a new integrative property formed in the learning process – competency, taking into account the system of behavioural indicators describing professional activity in terms of observed behaviour. Practical significance. The results obtained will help to develop the elements of a new educational infrastructure of innovative self-development in the regions of the Russian Federation, e.g. centres for advanced training, centres for conducting demonstration exams. Moreover, research results will help eliminate barriers to the spread of the spectrum of competencies and increase in the effectiveness of the formation and development of human capital on the principles of project management in order to increase the participation of employers in the process of training and certification of secondary vocational education graduates. © 2022 Russian State Vocational Pedagogical University. All rights reserved

EVALUATION OF SAFETY OF DOUBLE TAMPONADE OF VITREOUS CAVITY IN SURGICAL TREATMENT OF RETINAL DETACHMENT

Purpose. To assess the safety of retinal detachment surgery employing double endotamponade with PFCL and silicone oil for 30 days. Material and methods. Inclusion criteria: retinal detachment with retinal breaks located in both upper and lower retina and/or with residual severe proliferative vitreoretinopathy. In the study group (26 eyes) the surgery was finished with double tamponade with PFCL and silicone oil. In the control group (20 eyes) the surgery was finished with silicone oil tamponade. Tamponade agents were removed 1 month later. Examinations included optical coherence tomography (OCT) and microperimetry along with standard eye examination. Results. Retinal reattachment by means of one surgical procedure was achieved in 81% in the study group and in 65% in the control group. There was no significant difference in BCVA between the two groups. OCT data analysis showed no significant differences between the groups in the thickness of outer and inner nuclear layers. Microperimetry detected no significant differences in light sensitivity between the groups. Conclusion. Double endotamponade with PFCL and silicone oil seems to be a safe method for the treatment of complicated retinal detachments