ПРИМЕНЕНИЕ МЕТОДОВ ЭКОНОМИКИ КАЧЕСТВА ПРИ УПРАВЛЕНИИ РАЗВИТИЕМ ИННОВАЦИОННОГО ПОТЕНЦИАЛА

Purpose: to reveal the possibilities of applying the methods of the quality economy to improve the management efficiency of the development of the region's innovative potential.Results: in the article topical questions of development of innovative potential of the region are considered - one of the important factors providing improvement of quality of life of the population and sustainable development of the territory. The content of the concept of "innovation potential of the region" is disclosed and its components are described. The purposes of development of innovative potential are considered. A comparative analysis of the methods of managing the development of potential in the market and planned economy is carried out. Particular attention is paid to the application of quality management methods to improve management effectiveness. In conclusion, the advantages and disadvantages of the economy of the macro-region "North-West" from the point of view of transition to an innovative development path, as well as scenarios for the development of the economy, are discussed.Conclusions and relevance: the use of quality economy tools to manage the development of innovative capacity will help to avoid mistakes and choose the right directions for development. In the era of globalization, improving quality is a prerequisite for successful competition in world markets. Therefore, the issues of innovation capacity assessment should be taken into account in the development of regional plans and programs, as well as socio-economic policy.Цель: Цель исследования – раскрыть возможности применения методов экономики качества для повышения эффективности управления развитием инновационного потенциала региона.Результаты работы: В статье рассматриваются актуальные вопросы развития инновационного потенциала региона – одного из важных факторов, обеспечивающих повышение качества жизни населения и устойчивое развитие территории. Раскрывается содержание понятия «инновационный потенциал региона» и описываются его составляющие. Рассматриваются цели развития инновационного потенциала. Проводится сравнительный анализ методов управления развитием потенциала в рыночной и плановой экономике. Особое внимание уделяется применению методов управления качеством для повышения эффективности управления. В заключение рассматриваются преимущества и недостатки экономики макрорегиона «Северо-Запад» с точки зрения перехода на инновационный путь развития, а также сценарии развития экономики.Выводы: Применение инструментов экономики качества в целях управления развитием инновационного потенциала поможет избежать ошибок и выбрать правильные направления развития. В эпоху глобализации повышение качества является необходимым условием для успешной конкуренции на мировых рынках. Поэтому вопросы оценки инновационного потенциала должны учитываться при разработке региональных планов и программ, а также проведении социально-экономической политики

Short- and long-term outcomes from the upfront high-dose chemotherapy, followed by autologous hematopoietic stem cell transplantation in diffuse large B-cell lymphoma

Introduction. Diffuse large B-cell lymphoma (DLBCL) is the most common (30-35%) type of B-cell lymphomas. Only about 60% of all newly diagnosed advanced-stage DLBCL can be completely treated by x6 CHOP-R only. High dose chemotherapy (HDCT) followed by autologous hematopoietic stem cell transplantation in the first remission (upfront auto-HSCT) can serve an option to improve prognosis in these patients (pts).Aim. To improve prognosis in DLBCL IV stage, IPI ≥2 pts by upfront auto-HSCT.Materials and methods. Included 105 pts: DLBCL NOS, age 18-65, stage IV, IPI ≥2, CR/PR after x6 CHOP/EPOCH + R from 2010 to 2019 at NMRC of Oncology named after N.N. Petrov of MoH of Russia were retrospectively analyzed. HSCT group includes pts with upfront HDCT followed by auto-HSCT (n = 35). The control group includes pts with non-invasive follow-up after induction only (n = 70). Primary endpoints were overall (OS) and progression-free survival (PFS). Secondary endpoints were response rate, relapse rate and treatment toxicity.Results and discussion. The 3-yr OS (p = 0.01) and 3-yr PFS (p = 0.018) were significantly higher in HSCT group. The complete response rate was significantly increased after upfront auto-HSCT (p < 0.001). Early relapse served as an independent negative prognostic factor in OS (p < 0.001) and experienced statistically less in HDCT group (p = 0.027). Early (ER) and late relapse (LR) rate were higher in pts with DEL (ER - p < 0.001, LR - p < 0.001 in control group and ER - p < 0.001, LR -p = 0.013 in all pts). The overall relapse rate was higher if pts had >1 extranodal site with lung involvement (p < 0.004 in the control group and p = 0.021 in all pts). Prognostic models suggested DEL and presence of >1 extranodal site with lung involvement as an independent negative prognostic factors for increasing the relapse probability in two years after treatment.Conclusion. Upfront HSCT can serve as a clinical option to consolidate the first remission in IV stage DLBCL pts with DEL and/or >1 extranodal sites with lung involvement

ЛУЧЕВАЯ ДИАГНОСТИКА ИНФЕКЦИОННЫХ ПОРАЖЕНИЙ ЛЕГКИХ У ПАЦИЕНТОВ С ОНКОГЕМАТОЛОГИЧЕСКИМИ ЗАБОЛЕВАНИЯМИ

Radiological imaging is the main diagnostic technique of infectious pulmonary complications in patients with hematological malignancy. Disturbance of the immune system in this group of patients causes uncommon epidemiology, nonspecific clinical manifestation and rapidly progressive development of the infectious process. Modern diagnostic methods allow to reveal inflammatory changes in the lungs with high efficiency. In the current clinical practice, the most actual problem is rapid identification of pathogens using the wide-spread method. This possibility results in faster and more accurate patient treatment. The article reviews different imaging techniques and focuses on the preferable method for diagnosing pneumonia in immunocompromised patients and presents a recent view of russian and foreign researchers on the advantages and limitations of computed tomography in the differential diagnosis of lower respiratory tract infections.Лучевые методы визуализации являются основными инструментами в диагностике инфекционных поражений легких, которые часто развиваются у  онкогематологических пациентов и  ассоциированы с  высокой летальностью. Глубокое нарушение иммунного ответа у данной группы больных обусловливает необычную эпидемиологию, стертую клиническую картину и быстрое, зачастую молниеносное, развитие инфекционного процесса. Современные методы диагностики позволяют выявить воспалительные изменения в легких с высокой эффективностью. В настоящий момент в клинической практике наиболее актуальной задачей является возможность предположить этиологию инфекционного осложнения и своевременно скорректировать этиотропную терапию, используя быстрый и доступный способ. В данной статье обоснован наиболее предпочтительный метод диагностики пневмоний у  иммунокомпрометированных пациентов и  представлен современный взгляд российских и  зарубежных исследователей на  потенциал и  ограничения компьютерной томографии в  дифференциальной диагностике инфекционных поражений нижних дыхательных путей

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. 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 — 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

APPLICATION OF QUALITY ECONOMY METHODS IN MANAGING INNOVATION CAPACITY DEVELOPMENT

Purpose: to reveal the possibilities of applying the methods of the quality economy to improve the management efficiency of the development of the region's innovative potential.Results: in the article topical questions of development of innovative potential of the region are considered - one of the important factors providing improvement of quality of life of the population and sustainable development of the territory. The content of the concept of "innovation potential of the region" is disclosed and its components are described. The purposes of development of innovative potential are considered. A comparative analysis of the methods of managing the development of potential in the market and planned economy is carried out. Particular attention is paid to the application of quality management methods to improve management effectiveness. In conclusion, the advantages and disadvantages of the economy of the macro-region "North-West" from the point of view of transition to an innovative development path, as well as scenarios for the development of the economy, are discussed.Conclusions and relevance: the use of quality economy tools to manage the development of innovative capacity will help to avoid mistakes and choose the right directions for development. In the era of globalization, improving quality is a prerequisite for successful competition in world markets. Therefore, the issues of innovation capacity assessment should be taken into account in the development of regional plans and programs, as well as socio-economic policy

Prognostic impact of immunohistochemical and molecular genetic markers in Diffuse Large B-cell lymphoma

Aim. To evaluate impact of different clinical features on prognosis in Diffuse Large B-cell lymphoma (DLBCL) patients and to determine potential correlation between IHC markers (double-expression of c-myc, bcl-2 and p53) on unfavorable clinical characteristics in DLBCL patients.Methods. We analyzed 215 patients with DLBCL who received treatment from 2008 to 2016. We assess impact of different clinical features, such as B-symptoms, extranodal involvement, advanced stages and refractory course on PFS. In this study we also access potentially unfavorable impact of double expression of c-myc and bcl-2 and p 53 by immunohistochemical analysis.Results. In both uni- and multivariant analysis B-symptoms, advanced stages and primary-refractory course were identified as negative prognostic factors for PFS rates. We found tendency to correlation between double expression of c-myc and bcl-2 and high International prognostic index as well as expression of p53 and advanced stages (87,5% vs 56,4% respectively, р = 0,095). Сonclusion. Patients with DLBCL aggressive course of the disease (B-symptoms, advanced stages and primary-refractory disease) have lower rates of PFS. Double-expression of c-myc and bcl-2 and p53 can be potentially associated with aggressive course of the disease