Development of human capital in the system of economic categories of work

Today, human capital is one of the main factors in the formation of the knowledge economy, which is the highest stage in the development of an innovative, post-industrial economy. The development of intellectual and spiritual capabilities of a person, as well as the accumulation of human capital, which has a strong influence on the productivity and quality of labor, becomes one of the priorities for the future development of the state. This article discusses the development of human capital in the system of economic categories of labor.peer-reviewe

Comparative Reproducibility Analysis of Thoracic Aorta Morphometric Parameters According to Computed Tomography and Magnetic Resonance Angiography

Objective: to compare intra- and inter-operator reproducibility of thoracic aorta (ThAo) morphometric parameters, calculated by multislice computed tomography (MSCT) and magnetic resonance imaging (MRI).Material and methods. The prospective study included 20 patients with ascending aorta (AAo) dilatation (≥45 mm). All patients underwent MSCT- and MRI-angiography in electrocardiogram-gated mode. Mean diameter (Dmean) and cross-sectional area (CSA) were measured at different ThAo levels in the systole and diastole along the inner contour of the vessel. All measurements were performed by two radiologists. Each of them took measurements twice at an interval of at least 1 month. The reproducibility of repeated measurements was studied using intraclass correlation coefficient. Results. The analysis of the systolic frame revealed significant differences between the methodsfor measuring Dmean (MRI: 42.5 (41.0–47.8) mm; MSCT: 37.7 (34.7–40.3) mm; p = 0.003) and CSA at the level of the sinotubular junction (MRI: 14.8 (12.7–17.9) cm2; MSCT: 11.4 (10.3–13.3) cm2; p = 0.009), AAo CSA(MRI: 17.6 (14.6–20.8) cm2; MSCT: 19.6 (16.7–21.5) cm2; p = 0.035) and Dmean at the level proximal to left subclavian artery (LSA) (MRI: 31.5 (31.0–34.0) mm; MSCT: 31.7 (27.3–32.9) mm; p = 0.041). For the diastolic frame, significant differences between the methods were observed when measuring AAo CSA (MRI: 17.0 (14.5–19.7) cm2; MSCT: 19.7 (15.3–21.8) cm2; p = 0.025), Dmean (MRI: 30.5 (29.3–32.8) mm; MSCT: 29.8 (27.1–31.3) mm; p = 0.05) and CSA at the level proximal to LSA (MRI: 7.5 (6.9–7.9) cm2; MSCT: 7.4 (5.9–7.8) cm2; p = 0.007), as well as CSA at the left atrium level (MRI: 4.9 (4.2–5.0) cm2; MSCT: 5.1 (4.67–5.5) cm2; p = 0.042). For MSCT-angiography, good intra- and inter-operator reproducibility of measurements at all ThAo levels was obtained. For MRI-angiography, there was a strong intra- and interoperator variability in determining Dmean and CSA at the levels of aortic arch and descending aorta.Conclusion. Aortic cross-sectional area showed the best intra- and inter-operator reproducibility and comparability of measurements between MSCT- and MRI-angiograph

The use of {99m}Tc-Al[2]O[3] for detection of sentinel lymph nodes in cervical cancer patients

The purpose of the study was to evaluate the feasibility of using {99m}Tc-Al[2]O[3]- based radiopharmaceutical, a novel molecular imaging agent for sentinel lymph node detection in patients with invasive cervical cancer. The study included 23 cervical cancer patients (TlaNxMx- T[2]bNxMx) treated at the Tomsk Cancer Research Institute. At 18 hours before surgery, 80 MBq of the {99m}Tc-Al[2]O[3] were injected peritumorally, followed by single-photon emission computed tomography (SPECT) of the pelvis and intraoperative SLN identification. Twenty-seven SLNs were detected by SPECT, and 34 SLNs were identified by intraoperative gamma probe. The total number of identified SLNs per patient ranged from 1 to 3(the mean number of SLNs was 1.4 per patient). The most common site for SLN detection was the external iliac region (57.2%), followed by the internal iliac, obturator, presacral and retrosacral regions (they amounted to 14%, respectively),and the parametrial region (1%). Sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 79% for SPECT image

Influence of characteristics of epicardial adipose tissue and myocardial sympathetic innervation on the development of late recurrence of atrial fibrillation after radiofrequency ablation

Aim. To investigate the relationship between radiological characteristics of epicardial adipose tissue (EAT) and myocardial sympathetic activity, as well as to study their association with late recurrence of atrial fibrillation (AF) after radiofrequency ablation (RFA).Material and methods. This prospective study included 26 people with persistent and long-standing persistent AF scheduled for interventional AF treatment. Before the RFA procedure, all patients underwent cardiac 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy to assess the myocardial sympathetic innervation and contrast-enhanced cardiac multislice computed tomography to assess pulmonary vein anatomy, left atrial volume, and EAT volume. Clinical follow-up, including 12-lead electrocardiography (ECG) and 24-hour ECG monitoring, was carried out 3, 6 and 12 months after RFA.Results. After the end of follow-up, the patients were divided into two groups: with AF recurrence (group 1, n=8) and without AF recurrence (group 2, n=18). Multivariate logistic analysis found that only the 123I-MIBG washout rate (odds ratio, 1,0943; 95% confidence interval, 1,0138-1,1812) proved to be an independent predictor of late AF recurrence after RFA. ROC analysis revealed that a 123I-MIBG washout rate >21% with a sensitivity of 75% and a specificity of 83,3% (AUC=0,844; p<0,001) predicts late AF recurrence after RFA.Conclusion. Parameters of myocardial sympathetic activity, assessed by 123I-MIBG myocardial scintigraphy, are associated with late AF recurrence after RFA in patients with persistent and long-standing persistent AF. There were no reliable data confirming associations between myocardial sympathetic innervation and radiological EAT indicators, as well as the effect of the latter on the risk of AF recurrence after RFA

ОТЕЧЕСТВЕННЫЙ ОПЫТ ПРОФИЛАКТИКИ И ЛЕЧЕНИЯ ПРОЯВЛЕНИЙ КОЖНОЙ ТОКСИЧНОСТИ У ПАЦИЕНТОВ МКРР, ПОЛУЧАЮЩИХ ИНГИБИТОРЫ EGFR, НА ПРИМЕРЕ ПРЕПАРАТА ПАНИТУМУМАБ

The results of the first national experience of skin toxicity correction in patients with metastatic colorectal cancer (mCRC) receiving EGRF-inhibitors shown on the example of using of Panitumumab. The collection and evaluation of the data were produced in the framework of the project of the working group on maintenance therapy of Russian society of clinical oncologists and chemotherapeutists (RUSSCO) to develop recommendations for the prevention and treatment of dermatological toxicity in patients receiving EGFR-inhibitors. The project involved 10 centers in Russia.  In 58 patients receiving Panitumumab, the efficacy of prophylactic medication and symptomatic treatment of clinical manifestations of dermatological toxicity using available remedies was evaluated. The results confirm the effectiveness of preventive therapy. Optimal correction schemes of various manifestations of dermal toxicity were developed depending on the clinical manifestations and severity.Освещены результаты первого отечественного опыта коррекции кожной токсичности у пациентов мКРР, получающих ингибиторы EGRF, на примере препарата Панитумумаб. Сбор и оценка данных произведены в рамках проекта рабочей группы по поддерживающей терапии Профессионального Общества онкологов-химиотерапевтов (RUSSCO) по разработке рекомендаций для профилактики и лечения дерматологической токсичности у пациентов, получающих ингибиторы EGFR. В проекте принимали участие 10 центров РФ. У 58 пациентов, получавших Панитумумаб, оценивалась эффективность профилактической медикаментозной и симптоматической терапии клинических проявлений дерматологической токсичности доступными средствами. Полученные результаты подтверждают эффективность профилактической терапии. Разработаны оптимальные схемы коррекции различных проявлений кожной токсичности в зависимости от клинических проявлений и степени тяжести

Особенности эластических свойств дилатированной и аневризматически расширенной грудной аорты по данным ЭКГ-синхронизированной КТ-ангиографии

Purpose: to compare the indicators of elasticity of the thoracic aorta, determined by ECG-Gated-CT angiography, in patients with ascending aortic aneurysm and dilatation.Materials and methods. The study included 20 patients with dilatation of the ascending aorta (40 mm ≤ maximum aortic diameter (Dmax) < 50 mm) (group 1a), 30 patients with non-syndromic aneurysms of the ascending aorta (n = 30, Dmax ≥ 50 mm) (group 1b), as well as 19 patients with normal aortic sizes (Dmax < 40 mm) as controls (group 2). All patients underwent multispiral computed tomography angiography of the aorta in ECG-Gated mode (ECG-Gated -CT). Maximum systolic and diastolic aortic diameters (Dmax) were measured at different levels of the thoracic aorta, followed by calculation of the difference between them and calculation of the circular deformation (CS), compliance, stiffness (Stiff), wall distensibility, longitudinal deformation (LS).Results. Moderate negative correlation between the age of the patients and CS at all levels of the thoracic aorta (rmaximum = –0.33, rminimum = –0.41) was revealed. Groups 1a and 1b did not differ significantly in all parameters. Group 1a differed from the control group (p < 0.05) in Stiff at the level of the aortic annulus (AA) (0.07 [–0.14; 0.15] vs –0.04 [–0.1; 0.06]), as well as CS at the level of AA and sinuses of Valsalva (SV ) (0.49 [–2.94; 3.36] vs –1.18 [–4.51; 3.87]), and group 1b – in CS at the level of SV (3.73 [0.24; 6.56] vs 0.13 [–1.42; 3.04]) and proximal part of the descending aorta (distal to the left subclavian artery) (5.48 [1.27; 8.40] vs 1.97 [–0.32; 6.08]), also in LS (5.96 [–8.98; 9.25] vs –2.58 [–7.75; 1.89]) at the level of the aortic arch.Conclusion. According to ECG-Gated-CT angiography, the indicators of elasticity of the thoracic aorta in patients with ascending aortic aneurysm and dilatation did not differ. Compared with the control group, patients with aneurysm of the ascending aorta showed an increased pulse deformity of the non-dilated aortic arch.Цель исследования: сопоставить показатели эластичности грудной аорты, определенные по данным ЭКГ-синхронизированной КТ-ангиографии, у пациентов с аневризмой и дилатацией восходящего отдела.Материал и методы. В исследование было включено 20 пациентов c дилатацией восходящей аорты (40 мм ≤ максимальный диаметр аорты (Dmax) < 50 мм) (подгруппа 1а), 30 больных с несиндромными аневризмами восходящей аорты (n = 30, Dmax ≥ 50 мм) (подгруппа 1б), а также 19 больных с нормальными размерами сосуда (Dmax < 40 мм) в качестве контроля (группа 2). Всем пациентам была выполнена мультиспиральная компьютерно-томографическая ангиография аорты в ЭКГ-синхронизированном режиме (ЭКГсинхр.-КТ). На различных уровнях грудной аорты измеряли максимальный систолический и диастолический диаметр сосуда (Dmax) с последующим расчетом разницы между ними и индексов циркулярной деформации (CS), комплаенса, жесткости (Stiff), растяжимости стенки (для всех уровней), продольной деформации (LS).Результаты. По результатам анализа была выявлена умеренная отрицательная корреляционная взаимосвязь между возрастом пациентов и CS на всех уровнях грудной аорты (rmax = –0,33, rmin = –0,41). Подгруппы 1а и 1б по всем показателям значимо не различались. От группы контроля подгруппа 1а отличалась (p < 0,05) по Stiff на уровне фиброзного кольца (ФК) аортального клапана (0,07 [–0,14; 0,15] vs –0,04 [–0,1; 0,06]), а также CS на уровне ФК и синусов Вальсальвы (СВ) (0,49 [–2,94; 3,36] vs –1,18 [–4,51; 3,87]), а подгруппа 1б – по CS на уровне СВ (3,73 [0,24; 6,56] vs 0,13 [–1,42; 3,04]) и проксималного отдела нисходящей аорты (дистальнее устья левой подключичной артерии) (5,48 [1,27; 8,40] vs 1,97 [–0,32; 6,08]), также по LS (5,96 [–8,98; 9,25] vs –2,58 [–7,75; 1,89]) на уровне дуги аорты.Заключение. По данным ЭКГсинхр. КТ-ангиографии показатели эластичности грудной аорты у пациентов с аневризмой и дилатацией восходящего отдела не различаются. По сравнению с группой контроля у больных с аневризмой восходящего отдела аорты отмечается увеличение пульсовой деформации в недилатированной зоне (дуге аорты)

Current status of nuclear cardiology in the Russian Federation

The article is devoted to the analysis of the current status of nuclear cardiology in the Russian Federation. The data on the number of facilities performing radionuclide investigations for the diagnosis and monitoring of the treatment of cardiovascular diseases, their staffing and equipment are given. The statistics of the conducted nuclear cardiology tests for 2018-2020 are given, as well as their methods, features and diagnostic significance are described

ЭФФЕКТИВНОСТЬ СУПРАМОЛЕКУЛЯРНОГО КОМПЛЕКСА ФЕНБЕНДАЗОЛА ПРИ НЕМАТОДОЗАХ ОВЕЦ

 Objective of research: to study the anthelmintic efficacy of the supramolecular complex of Fenbendazole used against different nematode species in sheep Materials and methods: Experiments were carried out on young sheep spontaneously infected with gastrointestinal strongylates (48 head), Dictyocaulus filaria (42 head), Strongyloides papillosus (21 head) и Trichocephalus ovis (24 head). In each helminthiasis, the supramolecular complex of Fenbendazole was given once orally to sheep from various groups at the dose of 3,0; 2,0 and 1,0 mg a.i./kg in comparison with the base preparation Fenbendazole at the doses of 1,0 and 3,0 mg/kg. Sheep which didn’t receive the drug served as controls. The efficacy of drugs was evaluated before and 18 days after dehelmintization according to the results of coprolarvoscopic examination by flotation and G. Baermann methods. The registration of drug activity was performed using the «control test». Results and discussion: Anthelmintic efficacy was studied and a therapeutic dose for the supramolecular complex of Fenbendazole produced by chemical mechanical technology using the Drug Delivery System was determined. In gastrointestinal strongylatoses the supramolecular complex against D. filaria. at the doses of 3,0; 2,0 and 1,0 mg a.i./kg showed the efficacy of 100; 93,4 and 78% , respectively. The efficacy of supramolecular complex at the dose of 3,0 mg/kg against S. papillosus was 100 %, and against T. ovis - 98,3 % at 10–13% efficacy of the base preparation Fenbendazole at the dose of 1,0 mg/kg. The therapeutic dose for the supramolecular complex at main nematodiasis in sheep was 3,0 mg a.i./kg. Цель исследования – изучение антигельминтной эффективности супрамолекулярного комплекса фенбендазола против разных видов нематод у овец. Материалы и методы. Опыты проводили на молодняке овец, спонтанно инвазированном желудочно-кишечными стронгилятами (48 гол.), Dictyocaulus filaria (42 гол.), Strongyloides papillosus (21 гол.) и Trichocephalus ovis (24 гол.). При каждом гельминтозе овцам разных групп задавали однократно перорально супрамолекулярный комплекс фенбендазола в дозе 3,0; 2,0 и 1,0 мг/кг по ДВ в сравнении с базовым препаратом фенбендазолом в дозах 1,0 и 3,0 мг/кг. Контролем служила группа овец, не получавшая препарат. Эффективность препаратов учитывали по результатам копрооволарвоскопических исследований методом флотации и Бермана до и через 18 сут после дегельминтизации. Учет активности препаратов проводили по типу «контрольный тест». Результаты и обсуждение. Изучена антигельминтная эффективность и установлена терапевтическая доза супрамолекулярного комплекса фенбендазола, полученного по механохимической технологии с адресной доставкой Drug Delivery System. Комплекс в дозах 3,0; 2,0 и 1,0 мг/кг по ДВ показал соответственно 100; 93,4 и 78%-ную эффективность при  стронгилятозах пищеварительного тракта, 100; 92,4 и 76,0%-ную – против D. filaria. Эффективность комплекса в дозе 3,0 мг/кг составила против S. papillosus 100 % и против T. ovis 98,3 % при 10–13%-ной эффективности базового препарата – фенбендазола в дозе 1,0 мг/кг. Терапевтическая доза супрамолекулярного комплекса при основных нематодозах овец составила 3,0 мг/кг по ДВ

ЭФФЕКТИВНОСТЬ СУПРАМОЛЕКУЛЯРНЫХ КОМПЛЕКСОВ АНТИГЕЛЬМИНТИКОВ ПРИ ЖЕЛУДОЧНО-КИШЕЧНЫХ СТРОНГИЛЯТОЗАХ ОВЕЦ В ПРОИЗВОДСТВЕННЫХ УСЛОВИЯХ

Effectiveness of a supramolecular nanotech-based Albendazole – Fenbendazole complex has been tested using the Drug Delivery System. Tests for efficacy of new drugs Albendazole and Fenbendazole were conducted on 37 sheep spontaneously infected with Nematodirus sp. and other gastrointestinal strongylates in agricultural farm «Leninsky Put’» located in Pestravsky district of Samara region. The supra-molecular Albendazole – Arabinogalactan complex at a dose of 1,0 mg/kg of active ingredient and the base Albendazole at a dose of 10 mg/kg have shown a 100 % effectiveness. Albendazole – Chitosan complex has shown a 87,5 % extenseffectiveness and a 98,4 % reduction in number of nematode eggs in feces. The effectiveness of supramolecular Fenbendazole – polymer complex was lower. Испытана эффективность супрамолекулярных комплексов альбендазола и фенбендазола, приготовленных по нанотехнологии с использованием адресной доставки Drug Delivery System. Испытание новых лекарственных форм альбендазола и фенбендазола проводили в колхозе «Ленинский путь» Пестравского района Самарской области на 37 овцах, спонтанно инвазированных нематодирусами и другими видами желудочно-кишечных стронгилят. Супрамолекулярный комплекс альбендазола с арабиногалактаном в дозе 1,0 мг/кг по ДВ и базовый альбендазол в дозе 10 мг/кг показали 100%-ную эффективность. Комплекс альбендазола с хитозаном проявил 87,5%-ную экстенсэффективность и 98,4%-ное снижение числа яиц нематод в фекалиях. Эффективность супрамолекулярного комплекса фенбендазола с полимером была ниже

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