Distance learning: opportunities and challenges in quarantine.

The urgent introduction of distance education into the learning process due to the COVID-19 pandemic has become a spontaneous experiment, requiring urgent decisions, effective mechanisms to implement into the educational process and analysis of ongoing educational process. The possibilities of modern digital technologies made it possible to quickly set up the information component of education and to controle student’s knowledge. A detailed analysis of the communication between the faculty members of the department among themselves and analysis of the features of teaching and self-education of students in the field of medical radiology and oncology based on answers and comments with using Google classroom, Socrative, Messenger Telegram, etc. was made. Issues of communicative interaction between faculty members and students, psychological aspects of distance communication, language of instruction, logistics of distance education and methodological problems are described in details. It has been suggested that distance education may be equally effective for theoretical subjects in full-time study form, but when studying clinical disciplines, the priority should be given to traditional methods of teaching, involving student's bedside training. Taking into account technical possibilities and high risk of development of extreme and emergency situations, it is suggested to introduce permanent readiness for distance education, to create all – Ukrainian distance imitation service of patients’ follow-up. The importance of using the state language in training as the basis for mastering the professional Ukrainian and English language as the basis for mastering international medical experience is indicated

Herbal and nutritional supplement use among college students in Qatar

There is increasing demand for herbal and nutritional supplements in the Middle East. This study aimed to examine the use of supplements by college students in Qatar and to elucidate users' views about them. A total of 419 college students completed a self-administered questionnaire. Almost half of the respondents (49.6%) had used supplements (ever users), with 32.7% reporting using them in the previous 6 months (current users). Of the latter, 27.7% had used herbal supplements, 56.2% vitamins and minerals and 56.9% non-vitamin, non-mineral, non-herbal supplements. Many participants considered supplements to be safer and more effective than conventional medicines. Supplements were preferred over conventional medicines for the treatment of digestive conditions and common respiratory ailments and for weight management. Educating health-care providers about the benefits and risks of supplements is imperative and will enable health-care practitioners to guide patients in making informed decisions about supplement use.Scopu

Прогностична цінність клінічних, лабораторних та молекулярних предикторів у формуванні персонифікованих підходів до лікування раку молочної залози.

Background. The death rate from breast cancer in the past 10 years has increased steadily and has won first place in frequency among women. Despite advances in modern oncofarmakology, there is a heterogeneous tumor response to treatment between different patients. The objectives of our study were to evaluate the relationship between tumor response to systemic therapy and general and histological characteristics of patient’s tumors, including molecular subtypes of breast cancer, identify patterns between antropometric parameters of patients, comorbidities, and tumor response to the treatment; to study the effect of hematological, blood biochemical parameters on the results of the treatment of breast cancer. Methods. Molecular subtypes of breast cancer were established among 7521 patients, their changebility or stability in 67. Overall survival data was available for 491 patients with metastatic disease, peculiarities of development of metastases based on RECIST 1.1. criteria - 306. Retrospectively reviewed medical records of 110 patients with inoperable breast cancer (breast cancer) who received systemic therapy for the standard scheme. In the course of treatment were studied indicators such as: medical history of patients, life history, hematology, blood biochemistry, the results of primary and repeated histological and immunohistochemical studies of tumors, determination of molecular subtypes of breast cancer. Results. The distribution of the molecular subtypes of patients were as follows: A luminal - 69% luminal B - 9%, HER-2 / neu-positive - 7%, triple negative - 15%. Accounting factor Ki-67 (≥14%) led to an increase in the frequency of luminal B subtype from 9% to 19% by reducing the luminal A. In 44.8% of patients it was noted a change of molecular subtypes. Targeted therapy (Herceptin) in these patients allowed to overcome unfavorable prognostic background - results in median survival from them (41,3±4,5 months) were higher than in the group without Herceptin (27,4±3,4 months) and higher than the HER-2 / neu-negative patients (38,1±3,0 months). The value of coefficient Spearman rank correlation to tumor response and the factor of menopause, age, general condition of the patient were - 0.174; -0.222; -0.250 (P <0.05), in accordance. The status of regional nodes N and tumor response have the correlation coefficient: - 0,265; (P <0.05), the status of the primary tumor T and metastases M - 0.107; and -0.071 (p> 0.05), in accordance. In the presence of neutropenia at 1 week after treatment it has been revealed significantly better tumor response to treatment - the correlation coefficient: 0.204 (p <0.05). Conclusion. Molecular subtypes detection had shown that HER-2/neu-positive and tripple negative breast cancer demonstrated the most aggresive course of disease. It was found that a more pronounced tumor response to combination chemotherapy can be expected in young patients, pre-menopausal, high ECOG status. The presence of neutropenia has a significantly positive impact on the results of treatment of patients with metastatic breast cancer.Несмотря на достижения современной онкофармакологии, в клинической практике отмечается гетерогенный ответ опухоли на лечение у различных пациентов, что диктует необходимость персонифицированного лечения. В данном исследовании было изучено влияние стадии, анамнеза болезни, гистологических характеристик опухолевого процесса, молекулярных подтипов опухоли, антропометрических показателей пациентов, гематологических, биохимических показателей крови на результаты полихимиотерапии неоперабельного рака молочной железы, что является практически значимым при подборе оптимальных схем системного лечения.Незважаючи на досягнення сучасної онкофармакологіі, в клінічній практиці відзначається гетерогенна відповідь пухлини на лікування у різних пацієнтів. В даному дослідженні було вивчено вплив стадії, анамнезу хвороби, гістологічних характеристик пухлинного процесу, молекулярних підтипів пухлини, антропометричних показників пацієнтів, гематологічних, біохімічних показників крові на результати поліхіміотерапії неоперабельного раку молочної залози, що має важливе практичне значення при підборі оптимальних схем системного лікування

Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment.

Background. The death rate from breast cancer in the past 10 years has increased steadily and has won first place in frequency among women. Despite advances in modern oncofarmakology, there is a heterogeneous tumor response to treatment between different patients. The objectives of our study were to evaluate the relationship between tumor response to systemic therapy and general and histological characteristics of patient’s tumors, including molecular subtypes of breast cancer, identify patterns between antropometric parameters of patients, comorbidities, and tumor response to the treatment; to study the effect of hematological, blood biochemical parameters on the results of the treatment of breast cancer. Methods. Molecular subtypes of breast cancer were established among 7521 patients, their changebility or stability in 67. Overall survival data was available for 491 patients with metastatic disease, peculiarities of development of metastases based on RECIST 1.1. criteria - 306. Retrospectively reviewed medical records of 110 patients with inoperable breast cancer (breast cancer) who received systemic therapy for the standard scheme. In the course of treatment were studied indicators such as: medical history of patients, life history, hematology, blood biochemistry, the results of primary and repeated histological and immunohistochemical studies of tumors, determination of molecular subtypes of breast cancer. Results. The distribution of the molecular subtypes of patients were as follows: A luminal - 69% luminal B - 9%, HER-2 / neu-positive - 7%, triple negative - 15%. Accounting factor Ki-67 (≥14%) led to an increase in the frequency of luminal B subtype from 9% to 19% by reducing the luminal A. In 44.8% of patients it was noted a change of molecular subtypes. Targeted therapy (Herceptin) in these patients allowed to overcome unfavorable prognostic background - results in median survival from them (41,3±4,5 months) were higher than in the group without Herceptin (27,4±3,4 months) and higher than the HER-2 / neu-negative patients (38,1±3,0 months). The value of coefficient Spearman rank correlation to tumor response and the factor of menopause, age, general condition of the patient were - 0.174; -0.222; -0.250 (P 0.05), in accordance. In the presence of neutropenia at 1 week after treatment it has been revealed significantly better tumor response to treatment - the correlation coefficient: 0.204 (p <0.05). Conclusion. Molecular subtypes detection had shown that HER-2/neu-positive and tripple negative breast cancer demonstrated the most aggresive course of disease. It was found that a more pronounced tumor response to combination chemotherapy can be expected in young patients, pre-menopausal, high ECOG status. The presence of neutropenia has a significantly positive impact on the results of treatment of patients with metastatic breast cancer

The Role of Tumor Molecular Subtypes in Formation of Personalized Approach to the Theatment of Breast Cancer.

Extreme heterogeneity of breast cancer (BC) is considered to be one of the reasons that affects the success of treatment. According to current classifications, there are 4 molecular subtypes (MS). The basis forsubtypes division is immunohistochemical testing of tumor cell receptors - estrogen (ER), progesterone (PR), HER2-neu and Ki-67. The doctrine of the tumor MS was the basis for the individualization of therapeutic tactics in patients with breast cancer. It was studied that luminal A subtype is the most common and the most favorable, with hormone therapy being a highly effective treatment method. Luminal B subtype, HER2 - positive and triple negative MSis characterized by a high ag­gressiveness, worse survival rate of patients and better prognostic effect of chemotherapy. The importance of determining the level of Ki-67 for assessment of tumor aggressiveness was revealed. Significant differences in receptor status of the primary tumor and metastases were proven. Data on the impact of changes in receptor status of the tumor prognosis are ambiguous and need further study. The use of targeted agents in the treatment of HER2 + patients can significantly improve treatment outcomes, turning this MS from historically aggressive subgroup to quite favorable