Author as a corporal subject of a. Huxley’s works

The relevance of the problem studied in the article is conditioned by the fact that A. Huxley’s works are regarded in the context of the modern theory of mimesis for the first time. The aim of the article is to analyze the author’s problem as a corporal subject of Huxley’s works in the context of the modern theory of mimesis. The leading method for studying this problem is the analytical anthropology of literature which allows describing mimetic features and the author’s image as a corporal subject of Huxley’s works. The main attention in the article is paid to the artistically embodied forms of the author’s corporality. The article may be useful for philologists, philosophers, for developing courses and seminars on the history of the English literature, and also within courses on the anthropology of literature. © 2016 Falaleeva et al

Видеоконтролируемое лечение – инновационный метод мониторинга терапии туберкулеза в условиях ограниченных ресурсов системы здравоохранения

The objective of the study: to analyze the potential use of video observed therapy (VOT) as one of the fields of mobile health care for treatment of patients with tuberculosis, to substantiate prospects of using VOT as an alternative to directly observed therapy including settings with limited health care resources.Subjects and Methods. The relevant studies were searched for in the following bibliographic databases: MEDLINE/PubMed, EMBASE, LILACS, IMEMR and IMSEAR, and clinicaltrials.gov. 40 publications devoted to video observed treatment of tuberculosis abroad and in Russia were selected. The recommendations of the World Health Organization on the use of digital technology in tuberculosis treatment, in particular video observed treatment have been studied.Results. The article highlights the advantages of video observed treatment of tuberculosis, the possibility of implementing this approach in different groups of patients taking into account the inclusion and exclusion criteria, assessing effectiveness of its use (improved treatment adherence, higher number of completed observations, better responsibility of patients for the disease and therapy, economic benefits for the health system and the patient). The study speculates on the potential implementation of video observed therapy of tuberculosis in the Russian Federation.Цель исследования: анализ возможностей видеоконтролируемой терапии (ВКТ) как одного из направлений мобильного здравоохранения для мониторинга процесса лечения больных туберкулезом, обоснование перспектив применения ВКТ как альтернативы непосредственно контролируемой терапии, в том числе в условиях ограниченных ресурсов здравоохранения.Материалы и методы. Проведен поиск исследований из библиографических баз данных: MEDLINE/PubMed, EMBASE, LILACS, IMEMR и IMSEAR, а также clinicaltrials.gov. Отобрано 40 публикаций по применению видеоконтролируемой терапии туберкулеза за рубежом и в РФ. Изучены рекомендации Всемирной организации здравоохранения по применению цифровых технологий в терапии туберкулеза, в частности видеоконтролируемого лечения.Результаты. Определены преимущества видеоконтролируемой терапии туберкулеза, возможности реализации данного подхода в различных группах пациентов с учетом критериев включения и исключения с оценкой эффективности его применения (повышение приверженности к терапии, увеличение числа завершенных наблюдений, повышение ответственности пациента за заболевание и терапию, экономическая выгода для системы здравоохранения и пациента). Исследование предопределяет возможности реализации видеоконтролируемой терапии туберкулеза в Российской Федерации

Лекарственная устойчивость M. tuberculosis (исторические аспекты, современный уровень знаний)

The review presents data on the frequency of detection of drug resistant (DR) tuberculosis mycobacteria (MTB) as well as on the change in DR patterns in Russia and abroad from the mid-50s of the 20th century till the present. Along with the well-known mechanisms for DR MTB development, it tells about new research describing mutations associated with drug resistance.В обзоре приведены данные о частоте выявления микобактерий туберкулеза (МБТ) с лекарственной устойчивостью (ЛУ), а также об изменении спектра ЛУ в России и за рубежом с середины 50-х годов XX в. до настоящего времени. Наряду с известными механизмами формирования ЛУ МБТ, представлены новые исследования с описанием мутаций, сопряженных с наличием ЛУ

СПЕКТР ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТИ ВОЗБУДИТЕЛЯ С ЧУВСТВИТЕЛЬНОСТЬЮ К РИФАМПИЦИНУ И РЕЗИСТЕНТНОСТЬЮ К ИЗОНИАЗИДУ У БОЛЬНЫХ ТУБЕРКУЛЕЗОМ ЛЕГКИХ

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Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms

Is it necessary to apply the Tyumen experience of intracoronary interventions in the Chelyabinsk region

Aim: to evaluate the prevalence and characteristics of percutaneous coronary interventions (PCI) performed in the Ural federal district (in particular in Tyumen and Chelyabinsk regions) in 2010 and to assess the efficiency of PCI in CAD in the real clinical practice by the data of Tyumen Cardiology Center (TCC). In the Chelyabinsk region insufficient usage of PCI was noticed (124.8 PCI in 1 million inhabitants compared to 720.4 PCI in the Tyumen region). The efficacy of PCI in patients with CAD was proven by the improvement of long-term results and patients quality of life especially if regular medical check-ups are performed. Our data show that PCI should be used more frequently in the real clinical practice in all Russian regions, and in the Chelyabinsk region as well.Целью работы явился анализ частоты и особенностей выполнения чрескожных коронарных вмешательств (ЧКВ) в Уральском федеральном округе, в частности в Тюменской и Челябинской областях в 2010 г., а также оценка эффективности ЧКВ при ИБС в реальной клинической практике по данным Филиала НИИ кардиологии СО РАМН «Тюменский кардиологический центр» (ТКЦ). В Челябинской области отмечается недостаточная обеспеченность населения ЧКВ (124,8 операций на 1 млн. жителей, что значительно уступает количеству вмешательств в Тюменской области - 720,4 ЧКВ на 1 млн. населения). Эффективность операций ЧКВ в лечении ИБС, доказанная улучшением отдаленного прогноза и качества жизни пациентов, особенно при активной диспансеризации, диктует необходимость их более широкого внедрения в практику как во всех регионах России в целом, так и в Челябинской области в частности