Three lives of Norwegian consulate in Arkhangelsk

The article is devoted to the history of the Norwegian Consulate in Arkhangelsk, which began in 1815 and has continued to the present time. The history of the Consulate is analyzed from the standpoint of identifying the fundamental differences in the activities in each of the three periods (lives) of the Consulate. This, in particular, is the novelty of the research. Moreover, the first two lives (1815–1920 and 1924–1939) are presented as a background to a more detailed study of the prerequisites for creation, priorities in work, successes and some failures of the modern one — the third Consulate reopened in Arkhangelsk in 2010 and has the status of “Honorary”. The authors pay attention to the personal factor — the life path of the first and current honorary consul Andrei Alexandrovich Shalev. His activity was mainly discussed in regional mass media and was not subjected to research analysis. Even the actual material about the events held by the Honorary Consulate was not collected and not systematized, although it has relevance, as it concerns the interests of thousands of residents of the region. The authors believe that in this article they only outlined those directions in the study of consulates that deserve attention

Эффективность и безопасность использования различных режимов комбинированной терапии у пациентов с тяжелой неконтролируемой бронхиальной астмой

Comparative randomized opened study involved 50 patients with brittle phenotype of severe asthma. The purpose of study was to compare efficacy and safety of different combined therapeutic modes in patients with severe uncontrollable asthma. The research consisted of 2 stages: initial 10-week treatment (beclomethasone 1500 meg daily) and actually investigation of different modes of combined 20-week therapy (Seretid Multidisk 250/50 2 inhaled doses daily; Flixotide 2000 meg daily; Flixotide 1000 meg daily + long-acting theophylline; Flixotide 1000 meg daily + leucotrien antagonists; Seretide Multidisk 250/50 2 inhaled doses daily and minimal effective doses of prednisolone). The evaluation of the asthma control level was assessed with E.Bateman's criteria. The safety of the drugs was estimated by questions, electrocardiogram data, serum potassium and cortisol levels.The combined therapy with Seretid Multidisk demonstrated the high efficacy and safety when compared with other investigated therapeutic modes.В открытом рандомизированном исследовании по изучению сравнительной эффективности и безопасности режимов комбинированной терапии у пациентов с тяжелой неконтролируемой БА (фенотип brittle) принимали участие 50 пациентов (37 женщин и 13 мужчин). Исследование состояло из двух этапов. Первый этап — предшествующая терапия (беклометазона дипропионат 1500 мкг/сут) в течение 10 нед. Второй этап — собственно назначение различных режимов комбинированной терапии сроком на 20 нед (серетид мультидиск 250/50 мкг дважды в сутки; фликсотид 2000 мкг/сут; фликсотид 1000 мкг/сут + теопек; фликсотид 1000 мкг/сут + аколат; серетид мультидиск 250/50 дважды в сутки + минимально эффективная доза преднизолона). Конечными показателями эффективности терапии служили критерии, предложенные Е.Bateman и соавт. Безопасность фармакологических режимов оценивалась путем выявления неблагоприятных лекарственных реакций (НЛР) методом открытого стандартного вопроса, электрокардиографического обследования, определения уровня калия в сыворотке крови методом селективной ионометрии и базального уровня кортизола в сыворотке крови радиоиммунным методом.При сравнительном анализе эффективности и безопасности различных режимов комбинированной терапии у пациентов с тяжелой неконтролируемой БА (фенотип brittle) установлено, что применение серетида мультидиска превосходит другие терапевтические подходы по указанным параметрам. Комбинация серетид мультидиск и системные кортикостероиды не приводит к более выраженному клиническому эффекту, уступая изолированному использованию серетида мультидиска по параметрам безопасности

Pseudoprogression in patients on immunotherapy

Now the number of patients receiving immunotherapy with checkpoint inhibitors is growing. At the same time, clinicians increasingly encounter such a clinical phenomenon as pseudoprogression. Nowadays we have no radiological evidences of pseudoprogression. The every such case requires an individual decision

Immuno-related endocrinopathy in patients treated with immune checkpoint inhibitors

Recently immune checkpoint inhibitors amazingly changed the landscape of cancer therapy worldwide. The number of immune checkpoint molecules in clinical practice is constantly increasing. There are some monoclonal antibodies recently registered in the Russian Federation: anti-PD1 antibodies (nivolumab, pembrolizumab), anti-PD-L1 (atezolizumab, durvalumab), anti-CTLA-4 (ipilimumab). Immune-mediated endocrinopathies are some of the most common complications of immunotherapy. According to the results of clinical studies, the incidence of serious endocrine immuno-mediated adverse events with anti-PD1 monoclonal antibodies is low (3.5–8%). The use of anti-CTLA4 antibodies, combined regimens, and the use of immunotherapy after chemoradiotherapy significantly increase the incidence of serious adverse events to 30%. In clinical practice of N.N. Blokhin Cancer Research Center among 245 non-small cell lung cancer and hepatocellular carcinoma patients treated with immunotherapy, 22 (8,9%) developed an immune-mediated endocrinopathy. Most patients developed adverse events of 1–2 degrees, in two patients – 3 degrees, requiring discontinuation of treatment. The aim of this article was to provide useful information and recommendations regarding the management of common immuno-related endocrine adverse events (including hypothyroidism, hyperthyroidism, pituitary, adrenal insufficiency) for clinical oncologists

Implemented models and perspectives of managing lipid metabolism disorders. Concept of rare lipid disease centers

Despite the advances in lipidology over the past decade, the control of dyslipidemia at the population level in Russia, as in a number of European countries, remains unsatisfactory. The need for novel organizational approaches to solving the problem at the regional and federal levels is obvious. This publication provides an overview of the implemented projects and the successful practical experience of lipid centers in Russia, as well as the prospects for the development of novel models that will optimize the care provision for patients with lipid metabolism disorders at the population level