ORGANIZATION OF INTEGRATIVE CARE FOR PATIENTS WITH ONCOPATHOLOGY

Clinical testing (providing of integrative care) was conducted to determine the methodology for the treatment and rehabilitation of patients who were previously denied in other hospitals. Defined the methodological approaches to the choice of the treatment, causing minimal harm to patients in other health care organizations were offered only symptomatic or palliative therapy.The purpose of the study:– improvement the quality of life;– increasing the terms of survival;– reduction of depressive state with confirmation of the diagnosis;– reducing the negative effects of the treatment.Patients and methods. In clinical trials 47 patients with stage IV of disease were involved, including in the integrative treatment group was 25 patients (16 women and 9 men), the group standard of treatment, 22 patients (15 women and 7 men). The group consisted of the patients with recurrences of the tumours, and patients after primary treatment at a late stage of the disease. The combination of all possible types of treatment (standard methods of treatment, immune therapy with drug “Helixor®  M”, psychological assistance) was performed depending on the disease defined by the overall clinical picture and psychological readiness of patients to one or another form of therapy. The choice of the injection scheme in order to quickly transition to a maximally tolerated doses was carried out using the control functional state.Results. The use of this method in comparison with the control group showed improvement in the quality of life of patients and increase in terms of survival.Conclusion. The results that are obtained during clinical testing confirmed the positive effect of integrative treatment of patients with oncologic pathology when choosing the best course and combination of treatments, depending on the needs and course of the disease. Also the immunotherapy with drug “Helixor®  M” showed efficacy in the treatment of viral infections for patients with tumors and without them

Analysis of industrial areas of Ekaterinburg

The article views the relationship between the change in the purpose of the industrial area and the planning structure of the city. Moreover it includes the proposed gradation of enterprises depending on the area of their industrial sites. Also the text point out the uniqueness of the industrial site of PJSC "Uralmashzavod"among other enterprises of the heavy industry of the city of Ekaterinburg. © Published under licence by IOP Publishing Ltd

Analyticity, Crossing Symmetry and the Limits of Chiral Perturbation Theory

The chiral Lagrangian for Goldstone boson scattering is a power series expansion in numbers of derivatives. Each successive term is suppressed by powers of a scale, $\Lambda_\chi$, which must be less than of order $4\pi f/\sqrt{N}$ where $f$ is the Goldstone boson decay constant and $N$ is the number of flavors. The chiral expansion therefore breaks down at or below $4 \pi f/\sqrt{N}$. We argue that the breakdown of the chiral expansion is associated with the appearance of physical states other than Goldstone bosons. Because of crossing symmetry, some ``isospin'' channels will deviate from their low energy behavior well before they approach the scale at which their low energy amplitudes would violate unitarity. We argue that the estimates of ``oblique'' corrections from technicolor obtained by scaling from QCD are untrustworthy.Comment: harvmac, 18 pages (3 figures), HUTP-92/A025, BUHEP-92-18, new version fixes a TeX problem in little mod

Хондроитина сульфат: механизмы действия, эффективность и безопасность при терапии остеоартроза

The ideas on the pathogenesis of osteoarthrosis are constantly expanding; there are new approaches to treating this disease. Chondroitin sulfate (CS) has a long history of use, but not all mechanisms of its action have been fully revealed to date. The results of laboratory and clinical studies suggest that CS has symptomatic properties and that the main point is that the drug may have a structure-modifying effect. This one of the most interesting properties of CS calls for further largescale studies. There are currently injectable CS formulations. Our country is manufacturing CS-containing Arthradol®; it is to be tested in some leading rheumatology centers of Russia.Представления о патогенезе остеоартроза постоянно расширяются, появляются новые подходы к лечению этого заболевания. Хондроитина сульфат (ХС) имеет длительную историю применения, но до настоящего времени не все механизмы его действия полностью раскрыты. Результаты лабораторных и клинических исследований свидетельствуют о наличии у ХС симптоматических свойств, и главное, о возможном структурно-модифицирующем эффекте препарата. Это одно из наиболее интересных свойств ХС требует дальнейших крупномасштабных исследований. В настоящее время появились инъекционные формы ХС. В нашей стране выпускается препарат Артрадол®, содержащий ХС, его исследование планируется в нескольких ведущих ревматологических центрах России

Limited joint mobility syndrome as a predictor of the diabetic foot syndrome

Diabetes mellitus (DM) can lead to the development of late complications. In addition to the traditional late complications, a high prevalence of damage to the musculoskeletal system in diabetes was noted. The most appropriate term that reflects the defeat of the musculoskeletal system in diabetes is limited joints mobility syndrome (LJM). Damage to the hands in the presence of open painless stiffness of the joints, fixed flexion contractures, impaired fine motor skills of the hands and grip forces. Subsequently, it became clear that, over time, the restriction of joint mobility develops not only in the small joints of the hands, but also in other large and small joints of the limbs. Traditionally, LJM syndrome pays low attention on the part of practitioners in comparison with other micro- and macrovascular complications of diabetes, even though LJM can significantly impair functional activity, self-care, and impair the quality of life. It is assumed that damage to the periarticular tissues and joints in DM is caused by the accumulation of end glycation products. A decisive place in the diagnosis of LJM is the clinical examination. In the presence of LJM syndrome, the osteoarticular structures of the feet can be affected, timely diagnosis can lead to the development of diabetic foot syndrome

Sociological Research of the Adherence of Medical Students to Employment by Specialty Received at a University

Background. A significant number of medical students refuse to work on a specialty obtained in medical universities after its completion or during the first years of professional activity.Purpose of the study: to conduct a sociological study of the adherence of students of a medical university to employment in a specialty received at a university, as well as factors of its motivation.Methods. A sociological survey of graduate students of ISMU was conducted using specially designed questionnaires.Results. It was revealed that more than 5 % of students do not plan to work on the received specialty after graduating from a medical university. Only every fourth respondent after graduation is going to return to his place of permanent residence, one of four intends not to return, and half have not yet decided on the choice of a further place of work and residence. Work with undergraduates about bringing them to the territory of the initial residence is organized by the administration of municipal entities and medical organizations poorly. Meanwhile, the requirements of graduates presented to a potential employer in terms of the level of wages and the creation of conditions for residence and professional activity are not overstated.Conclusion. Working with graduates and taking specific steps to implement their requirements is the most logical option for joint activities of medical universities, health authorities, administrations of medical organizations and local self-government bodies to create favorable conditions for securing young professionals in their chosen field of activity

ANALYSIS OF VACANCIES AND JOB OFFERS FOR DOCTORS IN STATE MEDICAL ORGANIZATIONS OF THE IRKUTSK REGION

The analysis of vacancies and job offers for doctors, especially information on the declared amount of wages and benefits, allows  not only to study the need for personnel, but also to study the level  of motivation of candidates for medical posts. The aim of the study  was to analyze vacancies and job offers for doctors from state  medical organizations of the Irkutsk region. The study was  conducted using the method of continuous statistical analysis of job  offers for physicians posted on the official website of the Ministry of  Health of the Irkutsk region. The public sector of the healthcare  system in the Irkutsk region provides a large number of vacancies  for unemployed doctors and young professionals. Declared in job  advertisements, the salary level of doctors is below the level  reflected in regional state reports on the health of the population and  the organization of health care. There is a lag in the salaries of  medical workers from the average for the region, as well as the  backlog of the Irkutsk region in this indicator from the Russian  Federation. When comparing the municipalities of the region to the  maximum and minimum declared wage levels, it is revealed that the  difference between them is almost fourfold. Although the most  demanded are doctors who provide primary health care, the need for these specialists does not correlate with the level of wages offered to them in vacancy announcements. Fourfold excess of the maximum  declared wage level over the minimum in the municipal formations of the region is not a consequence of taking into account difficult  working conditions in hard-to-reach areas, but is due exclusively to factors of economic nature

Взаимосвязь лабораторных биомаркеров и ультразвуковых признаков воспаления у пациентов с ревматоидным артритом на фоне терапии биоаналогом ритуксимаба

Objective: to assess the relationship between laboratory biomarkers and ultrasonographic signs of inflammation in patients with rheumatoid arthritis during therapy with a rituximab (RTM) biosimilar.Patients and methods. 20 patients with definite diagnosis of RA were examined. All patients received 2 infusions of RTM (Acellbia®), at a dose of 600 mg intravenously 2 weeks apart during therapy with methotrexate, non-steroidal anti-inflammatory drugs and glucocorticoids. Clinical and laboratory parameters were analyzed immediately before the start of therapy, and then 12 and 24 weeks after the first infusion of the drug.Results and discussion. By the 24th week of RTM therapy, a good/moderate effect according to the EULAR criteria was registered in 17 (85%) patients; remission according to DAS28 (<2.6) was achieved in 4 (20%) patients, SDAI (≤3.3) – in 2 (10%), CDAI (≤2.8) – in 1 (5%). Prior to the start of treatment, active synovitis was detected in 13 (65%) patients by power Doppler imaging (PD), and in 20 (100%) patients by gray scale scanning. During therapy with the RTM biosimilar, a significant decrease in inflammatory changes in the joints was observed, and by the 24th week after the start of treatment, the median PD was 0.5; active inflammation persisted in 7 (35%) patients. As shown by ROC analysis, the initial level of interleukin (IL) 6 >100.0 pg/ml is associated with the persistence of inflammatory activity according to PD by the 24th week of therapy with the RTM biosimilar, while the sensitivity was 85% and the specificity was 62% (AUC 0.78, 95% CI 0.57–0.99)Conclusion. An association was found between an increased level of pro-inflammatory cytokines, mainly IL6, and the activity of synovial inflammation according to ultrasound data. IL6 is the most promising marker for predicting persistent inflammatory activity based on the results of PD; other analyzed parameters have worse sensitivity and specificity parameters.Цель исследования – оценить взаимосвязь лабораторных биомаркеров и ультразвуковых признаков воспаления у пациентов с ревматоидным артритом на фоне терапии биоаналогом ритуксимаба (РТМ).Пациенты и методы. Обследовано 20 больных с достоверным диагнозом РА. Всем пациентам проведено по 2 инфузии РТМ (Ацеллбия®) в дозе 600 мг внутривенно с интервалом в 2 нед на фоне терапии метотрексатом, нестероидными противовоспалительными препаратами и глюкокортикоидами. Клинические и лабораторные показатели анализировались непосредственно перед началом терапии, а затем через 12 и 24 нед после первой инфузии препарата.Результаты и обсуждение. К 24-й неделе терапии РТМ хороший/умеренный эффект по критериям EULAR зарегистрирован у 17 (85%) пациентов; ремиссия по DAS28 (<2,6) достигнута у 4 (20%) больных, SDAI ( ≤3,3) – у 2 (10%), CDAI ( ≤2,8) – у 1 (5%). До начала лечения активный синовит по данным энергетического допплеровского картирования (ЭД) выявлен у 13 (65%) пациентов, а при сканировании в режиме серой шкалы – у 20 (100%). На фоне терапии биоаналогом РТМ наблюдалось значимое уменьшение воспалительных изменений в суставах, и к 24-й неделе после начала лечения медиана ЭД составила 0,5; активное воспаление сохранялось у 7 (35%) больных. Как показал ROC-анализ, исходный уровень интерлейкина (ИЛ) 6 >100,0 пг/мл ассоциируется с сохранением воспалительной активности по данным ЭД к 24-й неделе терапии биоаналогом РТМ, при этом чувствительность составила 85% и специфичность – 62% (AUC 0,78, 95% доверительный интервал 0,57–0,99)Заключение. Выявлена ассоциация между повышенным уровнем провоспалительных цитокинов, в основном ИЛ6, и активностью синовиального воспаления по данным УЗИ. Для прогнозирования сохраняющейся воспалительной активности по результатам ЭД наиболее перспективным маркером является ИЛ6, другие анализируемые показатели имеют худшие параметры чувствительности и специфичности

CASE OF LEFLUNOMIDE-INDUCED CLINICAL AND MORPHOLOGICAL REGRESSION OF AA-AMYLOIDOSIS AND REMISSION OF ADULT-ONSET STILL'S DISEASE

The paper describes a long-term observation and discusses the possible mechanism of leflunomide-induced clinical and morphological regression of AA-amyloidosis diagnosed at a nephrotic stage in the presence of adult-onset Still's disease

The use of leaves of different tree species as a sorption material for extraction of heavy metal ions from aqueous media

© 2016, International Journal of Pharmacy and Technology. All rights reserved.In a review article summarizes the literature data on the use of tree leaves as sorption materials for removal of heavy metal ions from aqueous media. It is shown that the sorption characteristics of the leaves of trees and the degree of removal of metal ions depends both on the conditions of adsorption (initial concentration of metal ion, temperature, pH, duration of contact), and from species trees. It is shown that the majority of publications devoted to removal from aqueous media toxic ions Cd(II), Cr(VI), Cu(II) and Pb(II). The greatest sorption performance removal of metal ions and the largest number of publications in the literature devoted to sorption using the leaves of the Neem tree (Azadirachta indica)