Organizational and management mechanism for reforming agricultural organizations based on cooperation and integration of economic systems

In the agricultural sector of Russia, a high proportion of insolvent organizations is currently maintained. Ensuring food independence of the country, the availability of high-quality and affordable food for the population are the main objectives of the development of the domestic agricultural sector. In agriculture, there is growing interest in the formation of universal approaches to the procedure for managing economic entities. The reform of insolvent agricultural producers based on the development of cooperation and integration processes by absorbing economically weak farms by successful agribusiness organizations is one of the methods to achieve these goals. The subject of the research is the methodology and management practice of reforming domestic agricultural organizations based on cooperation and integration of economic systems. Theoretical research and practical material is based on the results of economic activity and the experience of reforming in economic entities. Systemic and process approaches, statistical and economic methods were used mainly in obtaining research results.The purpose and objective of the study is the introduction of progressive methodological approaches to assess the effectiveness of reforming economic entities. The paper presents the conditions and factors, the organizational and managerial mechanism, methods and practical experience in implementing the reform process of insolvent agricultural organizations, as well as an assessment of the production and economic efficiency of reforming on the materials of the agricultural organization. The results of the study confirm the need to replicate the methodology and experience of reforming agricultural organizations through cooperation and integration of economic entities with the provision of state support in all its existing forms for this process. In particular, we propose the formation and legislative consolidation of a system of competitive reform of insolvent agricultural organizations

Drug-Induced Liver Injuries (Clinical Guidelines for Physicians)

Aim. Clinical guidelines for the management of adult patients suffering from drug-induced liver injuries (DILI) are intended for all medical specialists, who treat such patients in their clinical practice.Key findings. The presented recommendations contain information about the epidemiological data, terminology, diagnostic principles, classification, prognosis and management of patients with DILI. The recommendations list pharmacological agents that most commonly cause DILI, including its fatal cases. Dose-dependent and predictable (hepatotoxic), as well as dose-independent and unpredictable (idiosyncratic) DILI forms are described in detail, which information has a particular practical significance. The criteria and types of DILI are described in detail, with the most reliable diagnostic and prognostic scales and indices being provided. The pathogenesis and risk factors for the development of DILI are considered. The clinical and morphological forms (phenotypes) of DILI are described. The diseases that are included into the differential diagnosis of DILI, as well as the principles of its implementation, are given. The role and significance of various diagnostic methods for examining a patient with suspected DILI is described, with the liver biopsy role being discussed. Clinical situations, in which DILI can acquire a chronic course, are described. A section on the assessment of causal relationships in the diagnosis of DILI is presented; the practical value of using the CIOMS-RUCAM scale is shown. All possible therapeutic measures and pharmacological approaches to the treatment of patients with various DILI phenotypes are investigated in detail. A particular attention is paid to the use of glucocorticosteroids in the treatment of DILI.Conclusion. The presented clinical recommendations are important for improving the quality of medical care in the field of hepatology

Drug-Induced Liver Injuries (Clinical Guidelines for Physicians)

Aim. Clinical guidelines for the management of adult patients suffering from drug-induced liver injuries (DILI) are intended for all medical specialists, who treat such patients in their clinical practice.Key findings. The presented recommendations contain information about the epidemiological data, terminology, diagnostic principles, classification, prognosis and management of patients with DILI. The recommendations list pharmacological agents that most commonly cause DILI, including its fatal cases. Dose-dependent and predictable (hepatotoxic), as well as dose-independent and unpredictable (idiosyncratic) DILI forms are described in detail, which information has a particular practical significance. The criteria and types of DILI are described in detail, with the most reliable diagnostic and prognostic scales and indices being provided. The pathogenesis and risk factors for the development of DILI are considered. The clinical and morphological forms (phenotypes) of DILI are described. The diseases that are included into the differential diagnosis of DILI, as well as the principles of its implementation, are given. The role and significance of various diagnostic methods for examining a patient with suspected DILI is described, with the liver biopsy role being discussed. Clinical situations, in which DILI can acquire a chronic course, are described. A section on the assessment of causal relationships in the diagnosis of DILI is presented; the practical value of using the CIOMS-RUCAM scale is shown. All possible therapeutic measures and pharmacological approaches to the treatment of patients with various DILI phenotypes are investigated in detail. A particular attention is paid to the use of glucocorticosteroids in the treatment of DILI.Conclusion. The presented clinical recommendations are important for improving the quality of medical care in the field of hepatology