Treatment of large osteosarcoma in children: new approach

Aim - to improve the treatment results of patients with locally advanced osteosarcoma with large volume using neoadjuvant chemotherapy (NACT) (ifosfamide at a dose of 18 g/ml) and planning of organ-conserving surgery by evaluating the state of tumor pseudocapsule. A study group included 46 children aged from 7 to 18 years, mean age - 12 years. In 68 % of the patients tumor volume was larger or significantly larger than 200 ml (from 27 to 2400 ml), mean tumor volume was 342 ml. All patients have been examined by X-ray radiography, CT, Doppler ultrasound. Convenient chemotherapy consisted of methotrexate at a dose of 12 g/ml, cisplatin (120 mg/ml) in combination with doxorubicin (75 mg/ml). If such chemotherapy was considered ineffective with the use of an algorithm for determination of chemotherapy efficacy, 2 cycles of chemotherapy with ifosfamide at a dose of 18 g/ml per course have been applied. At the stage of planning of organ-conserving surgery, the state of tumor pseudocapsule was analyzed. In 6 months post-operative chemotherapy was carried out with the use of methotrexate, cisplatin with doxorubicin, ifosfamide at the same doses. Myelotoxicity of ifosfamide treatment at a dose of 18 g/ml is comparable to that of to a course of doxorubicin + cisplatin: the depth of leucopenia was significantly higher (p << 0,05), the duration of agranulocytosis is similar after such therapies. In the study group, 69,6 % patients have reached grade 3 - 4 pathomorphosis. Organ-conserving surgery was performed in 86,9 % of the patients. Local tumor recurrence was registered in 15,2 % patients of the study group. 5-year relapse-free survival was achieved in 62 +- 10 % (p = 0,02), the overall 5-year survival - 76,5 +- 9 % (p = 0,02). Conclusions: introduction of ifosfamide at a dose of 18 g/ml in the treatment scheme of pediatric patients with locally advanced osteosarcoma along with individualization of pre-oper- g/ml in the treatment scheme of pediatric patients with locally advanced osteosarcoma along with individualization of pre-oper- g/ml in the treatment scheme of pediatric patients with locally advanced osteosarcoma along with individualization of pre-oper- ml in the treatment scheme of pediatric patients with locally advanced osteosarcoma along with individualization of pre-oper- in the treatment scheme of pediatric patients with locally advanced osteosarcoma along with individualization of pre-oper- in the treatment scheme of pediatric patients with locally advanced osteosarcoma along with individualization of pre-oper- in the treatment scheme of pediatric patients with locally advanced osteosarcoma along with individualization of pre-oper- osteosarcoma along with individualization of pre-oper along with individualization of pre-operative chemotherapy, pre-oper ative analysis of NACT efficacy and the state of tumor pseudocapsule during planning stage of organconserving surgery significantly improves efficacy of the therapy in patients with large tumor volume. Key Words: osteosarcoma, children, pseudocapsule tumors, tumor volume, chemotherapy

Modelled Ceramics of Ancient Towns of the North Black Sea Region

В статье рассмотрены публикации ряда археологов, посвящённые изучению лепной керамики древних городов Северного Причерноморья. Особое внимание уделяется различным подходам к проблеме её этнической атрибуции

THE SYSTEMATIC APPROACH TO MODERN POLITICAL AND LEGAL SYSTEMS OF STATES ON COUNTERING INTERNATIONAL (TRANSNATIONAL) EXTREMISM

The purpose of the article is to study the political and legal systems of states on countering international extremism with the use of a systematic approach in the context of certain characteristics of Eastern and Western (European) countries, as well as the United States and Great Britain. The methodological base includes the use of comparative analysis (identifications and differences) and methods for constructing certain typologies of Western and Eastern states, which are grouped according to both qualitative and quantitative characteristics. Findings. In modern conditions, a systematic approach in scientific research has been used since the mid-50s of the 20th century. The article discusses this approach in the political and legal sphere on international issues; Eastern and Western (European) types of states in the context of countering extremism are analyzed as examples. The processes of globalization influenced the 21st century led to the emergence of "transnational extremism." In modern conditions, in order to counter international (transnational) extremism, it is necessary to develop new mechanisms and approaches, taking into account the realities of modern society. The world community has encountered the use of Internet space by extremist organizations, which threatens the security of modern society and individual countries. Countering extremism on an international scale is proposed to be carried out in the following areas: first, the development of an international legal and information base; second, the creation of a favorable social and economic environment in states and regions; third, the development of mechanisms to prevent the financing of extremist activities; fourth, the creation of an international analytical structure involving scientific personnel from different countries to identify the causes of extremism in different regions of the world community and develop forecasts at certain stages in different regions, and develop modern mechanisms to counter transnational extremism

Critical Thinking Assessment in Adults: Methodology and Development Experience

Critical thinking (next CT) is one of the key competencies in the modern world. Despite the variety of assessment systems for secondary and higher education, there is a lack of tests for assessing this competence for adults. The importance of adult assessment is emphasized primarily by the need for employers to have employees with developed CT in various work contexts. The article describes the procedure for creating a measurement test for students of the training course &laquo;Critical Thinking&raquo; of the &laquo;Yandex.Practice&raquo; platform and the results of assessing its psychometric quality. When creating this test, we relied on the Evidence Centered Design (ECD) approach. The test is performed in computer form and consists of tasks aimed at identifying the relevant observed behavior of the subject. The validity of the developed test, including its compliance with theoretical expectations about the factor structure, is confirmed by evidence of constructive, criterion, convergent and content validity. The limitations of this study and possible directions for future developments are considered. The result of the work is a validated test for measuring critical thinking for adults, the quality of the tasks of which is confirmed by psychometric analysis in modern mental test theory (IRT &mdash; Item Response Theory).</p

Prednisolone and pentoxifylline combination in patients with severe acute alcoholic hepatitis

Clinical manifestation of alcoholic hepatitis is a serious and adverse sign of progression of alcoholic liver disease. Therapy of acute alcoholic hepatitis is currently limited to symptomatic therapy and prednisolone. The aim of our study was to analyze pentoxifylline and prednisolone combination in patients with severe acute alcoholic hepatitis. 136 patients with severe acute alcoholic hepatitis (Maddrey discriminant function > 32) were included. Patients in the control group (73 patients) received symptomatic therapy, the patients in the first study group (41 patients) additionally received 400-600 mg pentoxifylline intravenously. The second study group (22 patients) additionally treated by combination of pentoxifylline and prednisolone. In the group of patients treated with pentoxifylline significant reduction in creatinine was determined (p <0.05). Short-term mortality in pentoxifylline group of was lower (15 %) than in the control group (25%). In prednisolone and pentoxifylline combination groups was the maximum mortality rate - 45%. Pentoxifylline improves short-term survival in patients with severe acute alcoholic hepatitis, significantly reduces the incidence and mortality from hepatorenal syndrome. The combined use of prednisolone and pentoxifylline probably negates the positive effect of pentoxifylline against hepatorenal syndrome

Mitochondrial calcium uniporter structure and function in different types of muscle tissues in health and disease

Calcium ions (Ca2+) influx to mitochondrial matrix is crucial for the life of a cell. Mitochondrial calcium uniporter (mtCU) is a protein complex which consists of the pore-forming subunit (MCU) and several regulatory subunits. MtCU is the main contributor to inward Ca2+ currents through the inner mitochondrial membrane. Extensive investigations of mtCU involvement into normal and pathological molecular pathways started from the moment of discovery of its molecular components. A crucial role of mtCU in the control of these pathways is now recognized in both health and disease. In particular, impairments of mtCU function have been demonstrated for cardiovascular and skeletal muscle-associated pathologies. This review summarizes the current state of knowledge on mtCU structure, regulation, and function in different types of muscle tissues in health and disease. © 2019 by the authors. Licensee MDPI, Basel, Switzerland

Eradication of HCV infection in patients with liver cirrhosis: Factor of cancer prevention or carcinogenesis? [ЭРАДИКАЦИЯ HCV-ИНФЕКЦИИ НА СТАДИИ ЦИРРОЗА ПЕЧЕНИ: ФАКТОР КАНЦЕРОПРЕВЕНЦИИ ИЛИ КАНЦЕРОГЕНЕЗА?]

Hepatocellular carcinoma (HCC) is one of the most common causes of death from cancer and is the final stage of chronic liver disease, usually occurring in patients with cirrhosis (CP). Chronic infection with hepatitis C virus (HCV) leads to progressive liver inflammation and cirrhosis because this virus specifically affects liver tissue. Previously used interferon therapy had a relatively low efficiency and very high risks of side effects. during the period of administration of interferon (iFn) schemes it was proved that elimination of the virus significantly reduced risk of liver cancer development. discovery of direct-acting antiviral (daa) drugs have revolutionized HCV therapy with virus elimination rate of more than 95 % and an excellent safety profile. However, the risk of transformation of liver cirrhosis into hepatocellular carcinoma is still high even after complete eradication of the virus. numerous studies have shown conflicting results on the possible relationship between the use of new antiviral drugs and the increase in the frequency of newly diagnosed or recurrent hepatocellular carcinoma. thus, the long-term prognosis in terms of risk for HCC development among patients with sustained virological response (sVR) remains unclear. The purpose of the study was to analyze the literature on the effect of antiviral therapy of chronic hepatitis C with interferon-containing regimens and drugs of direct antiviral action on the risk of developing or recurring hepatocellular carcinoma. Material and Methods: We analyzed publications available from PubMed, scopus, e-library, Web of science using the key words “hepatocellular carcinoma”, “chronic hepatitis C”, “direct-acting antiviral drugs”, “liver cirrhosis”, “interferons”, and “sustained virological response”. Of the 99 studies found, 21 were used to write a systematic review. Results: Eradication of the virus reduces the risks of HCC. despite reports on high risk of occurrence or recurrence of hepatocellular carcinoma in patients with cirrhosis after treatment with daas compared with interferon-containing regimens, there is not enough data confirming the direct link between the use of daas and the development of hepatocellular carcinoma. no statistically significant difference in the frequency of HCC between patients treated with interferon or daas was detected. Conclusion: Eradication of the virus is the most significant factor in the prevention of HCC; therefore, treatment of CHC should not be delayed due to the risk of HCC. Patients with liver cirrhosis require a long period of follow-up, even after successful treatment of chronic hepatitis C with daa drugs. stratification of HCC risk requires further research. © 2019 Tomsk National Research Medical Center of the Russian Academy of Sciences. All rights reserved

Prednisolone and pentoxifylline combination in patients with severe acute alcoholic hepatitis

Clinical manifestation of alcoholic hepatitis is a serious and adverse sign of progression of alcoholic liver disease. Therapy of acute alcoholic hepatitis is currently limited to symptomatic therapy and prednisolone. The aim of our study was to analyze pentoxifylline and prednisolone combination in patients with severe acute alcoholic hepatitis. 136 patients with severe acute alcoholic hepatitis (Maddrey discriminant function > 32) were included. Patients in the control group (73 patients) received symptomatic therapy, the patients in the first study group (41 patients) additionally received 400-600 mg pentoxifylline intravenously. The second study group (22 patients) additionally treated by combination of pentoxifylline and prednisolone. In the group of patients treated with pentoxifylline significant reduction in creatinine was determined (p &#60;0.05). Short-term mortality in pentoxifylline group of was lower (15 %) than in the control group (25%). In prednisolone and pentoxifylline combination groups was the maximum mortality rate - 45%. Pentoxifylline improves short-term survival in patients with severe acute alcoholic hepatitis, significantly reduces the incidence and mortality from hepatorenal syndrome. The combined use of prednisolone and pentoxifylline probably negates the positive effect of pentoxifylline against hepatorenal syndrome