ЭФФЕКТИВНОСТЬ ОРГАНИЗАЦИОННО-ИНСТИТУЦИОНАЛЬНЫХ ПРЕОБРАЗОВАНИЙ В АПК

Unlike most post-Soviet countries, in Belarus predominantly large-scale agricultural production is observed, so the process of organizational and institutional transformation changes in the agro-industrial complex is aimed not only at developing small forms of management, but also at improving arrangement and management of existing large enterprises. This peculiarity is in many respects unique from the point of view of world practice, therefore the analysis of achievements and problems of the organizational arrangement of domestic agro-industrial complex is of considerable interest both for Belarusian and foreign scientists. The main aim of institutional transformation changes of agro-industrial complex was to increase the efficiency of production based on gradual creation of economic mechanism for arrangement of a multi-structured economy, competition between organizations of different incorporation and management forms, equivalent exchange between the industry and agriculture, arrangement of market infrastructure and efficient state social policy regarding the rural population. The article presents the results of analysis of efficiency of structural transformation changes in agro-industrial complex, estimation of efficiency is given for various organizations forms functioning in agrarian business in the Republic of Belarus for the period of 2000-2016. Three modern directions of organizational and institutional transformations in agro-industrial complex are distinguished: business organization based on private ownership of property, including sale, lease of enterprises, unused or inefficiently used state property or its gratuitous alienation into private ownership for development of small and medium-sized businesses; implementation organizations association based on reorganization via join, merger of enterprises, trust management of property, sale of enterprises as property complexes to large integrated entities (holding companies, agricultural plants); transformation of state and non-state property into economic companies with priority state participation; conducting public (IPO) privatization of state block of shares of companies at the stock market. В Беларуси в отличие от большинства постсоветских стран сохраняется преимущественно крупнотоварный характер сельскохозяйственного производства, соответственно, процесс организационно-институциональных преобразований в АПК направлен не только на развитие малых форм хозяйствования, но и на совершенствование организации и управления существующими крупными предприятиями. Данная особенность является во многом уникальной с точки зрения мировой практики, поэтому анализ достижений и проблем организационного устройства отечественного АПК представляет собой значительный интерес как для белорусских, так и зарубежных ученых. Основной целью институциональных преобразований агропромышленного комплекса является повышение эффективности производства на основе поэтапного создания экономического механизма формирования многоукладной экономики, конкуренции организаций разных форм собственности и хозяйствования, эквивалентного обмена между промышленностью и сельским хозяйством, формирования рыночной инфраструктуры и эффективной государственной социальной политики в отношении сельского населения. В статье представлены результаты анализа эффективности структурных преобразований в АПК, дана оценка эффективности функционирования различных форм организации аграрного бизнеса в Республике Беларусь за период 2000–2016 гг. Выделены три современных направления организационно-институциональных преобразований в АПК: организация бизнеса на основе частной собственности на имущество, в том числе путем продажи, аренды предприятий, неиспользуемого либо неэффективно используемого государственного имущества либо безвозмездного его отчуждения в частную собственность в целях развития малого и среднего предпринимательства; осуществление процессов объединения организаций на основе реорганизации путем присоединения, слияния предприятий, доверительного управления имуществом, продажи предприятий как имущественных комплексов в крупные интегрированные формирования (холдинговые компании, агрокомбинаты); преобразование объектов государственной и негосударственной собственности в хозяйственные общества с приоритетным участием государства; проведение публичной (IPO) приватизации государственного пакета акций хозяйственных обществ на фондовом рынке.

Carotid endarterectomy in Russia. What if current guidelines do not answer difficult questions?

This literature review covers the publications of Russian vascular surgeons in recent years and deals with debatable issues of carotid surgery, including: 1. What is the best technique for carotid endarterectomy (CEA)? 2. Why does restenosis of the internal carotid artery (ICA) develop and how to eliminate it? 3. How to operate on bilateral ICA stenosis? 4. Should carotid glomus be preserved? 5. Is CEA safe in the acute phase of cerebrovascular accident (CVA)? 6. Is CEA safe in elderly patients? 7. How to operate on patients with combined internal carotid and coronary artery involvement? The evidence presented in this publication makes it possible to draw the following conclusions: 1. When choosing a CEA technique, the classical technique with patch angioplasty should be avoided due to the high risk of ICA restenosis. 2. To eliminate ICA restenosis, carotid angioplasty with stenting (CAS) should be used. When performing primary CEA with ICA transposition over the hypoglossal nerve, reCEA can be used 3. In the absence of contraindications, bilateral ICA stenosis can be operated at the same time using CEA. 4. CEA with carotid glomus preservation is the operation of choice in the treatment of patients with hemodynamically significant ICA stenosis due to the elimination of the risks of postoperative hypertension and the formation of hemorrhagic transformation. 5. If there are indications for cerebral revascularization in the most acute period of stroke, CEA should be abandoned in favor of CAS. 6. In old age, CAS is the safest treatment strategy. 7. In the presence of a combined ICA and coronary involvement, the choice of treatment tactics should be carried out only by a multidisciplinary commission, taking into account the risk stratification of adverse cardiovascular events

Efficacy and safety of glycyrrhizic acid combined to essential phospholipids (Phosphogliv) at non-alcoholic fatty liver disease: results of multicenter double blind randomized placebo-controlled post-registration clinical study (IV phase) «Gepard» (PHG-M2/P02-12)

Aim of investigation. To estimate efficacy and safety of two pharmacological forms of «Phosphogliv» (lyophilizate for intravenous administration and capsules) for the treatment of fatty liver degeneration of non-alcoholic etiology. Material and methods. Original study included overall 180 patients with nonalcoholic fatty liver disease that were randomized to the basic and control groups in the ratio of 2:1. The basic group patients received Phosphogliv 5 mg/day as intravenous bolus injection for 2 weeks, followed by oral intake of 2 capsules t.i.d. for 10 weeks (the total treatment duration was 12 weeks), control group patients received placebo in the same mode. Serum levels of inflammatory marker adiponectin, NAFLD fibrosis score, treatment effect on quality of life and safety of patients were monitored. Results. In 12 wks in patients with more significant cytolysis (threefold and higher serum alanine transaminase activity) and the rate of adiponectin level improvement on the background of Phosphogliv was 57.9% versus only 10.0% (p=0.019) in the placebo group. The mean NAFLD fibrosis score in the basic group remained almost unchanged, while in the control group negative dynamics was revealed, that resulted in statistically significant differences between groups (2.5±1.2 units versus 2.0±1.3 units respectively; р=0.009). At Phosphogliv injection already during the first 2 wks more pronounced improvement of subjective perception of dyspeptic symptoms was observed (mean score was 5.6±1.3 versus 5.1±1.4; р=0.021). When the treatment course was completed the basic group patients had higher mean score by «level of energy» scale (5.9±1.0 versus 5.6±1.0; р=0.034). Only sporadic adverse effects were found to the background of treatment, no statistically significant differences in their rate in were recorded. Dynamics of the basic physical parameters and laboratory tests was comparable as well. Conclusions. Treatment of non-alcoholic fatty liver disease that includes Phosphogliv provides reduction of steatohepatitis activity, retardation of fibrosis progression, improvement of overall disease prognosis and high satisfaction of patients at a favorable safety profile