SCORE performance in Central and Eastern Europe and former Soviet Union: MONICA and HAPIEE results

Aims: The Systematic COronary Risk Evaluation (SCORE) scale assesses 10 year risk of fatal atherosclerotic cardiovascular disease (CVD), based on conventional risk factors. The high-risk SCORE version is recommended for Central and Eastern Europe and former Soviet Union (CEE/FSU), but its performance has never been systematically assessed in the region. We evaluated SCORE performance in two sets of population-based CEE/FSU cohorts. Methods and results: The cohorts based on the World Health Organization MONitoring of trends and determinants in CArdiovascular disease (MONICA) surveys in the Czech Republic, Poland (Warsaw and Tarnobrzeg), Lithuania (Kaunas), and Russia (Novosibirsk) were followed from the mid-1980s. The Health, Alcohol, and Psychosocial factors in Eastern Europe (HAPIEE) study follows Czech, Polish (Krakow), and Russian (Novosibirsk) cohorts from 2002–05. In Cox regression analyses, the high-risk SCORE ≥5% at baseline significantly predicted CVD mortality in both MONICA [n = 15 027; hazard ratios (HR), 1.7–6.3] and HAPIEE (n = 20 517; HR, 2.6–10.5) samples. While SCORE calibration was good in most MONICA samples (predicted and observed mortality were close), the risk was underestimated in Russia. In HAPIEE, the high-risk SCORE overpredicted the estimated 10 year mortality for Czech and Polish samples and adequately predicted it for Russia. SCORE discrimination was satisfactory in both MONICA and HAPIEE. Conclusion: The high-risk SCORE underestimated the fatal CVD risk in Russian MONICA but performed well in most MONICA samples and Russian HAPIEE. This SCORE version might overestimate the risk in contemporary Czech and Polish populations

Additional Education for Children with Special Needs and Disabilities in the Russian Federation: National Monitoring Concept

The development of inclusive education progresses at different speeds across the world. In the Russian Federation inclusive education is developing primarily at the school level but one of the most crucial aspects of socialization is additional education, and in this regard the needs of children with special needs and disabilities remain an outstanding issue. A concept of the national monitoring of additional education for children with special needs and disabilities is proposed. The article presents the project of the toolkit for the national monitoring of entities engaged in additional educational activities for children with special needs and disabilities, which includes eight blocks: organizational structure of entities engaged in implementing additional educational programs for children in each constituent territory of the Russian Federation; implementation of additional educational programs for children with special needs and disabilities in entities with various subordination and organizational structures; material and technical support; staffing and professional training for specialists engaged in implementing additional educational programs for children with special needs and disabilities; information on ongoing additional educational programs for children with special needs and disabilities; typical obstacles which arise in the course of activities organized by entities engaged in implementing additional educational programs for children with special needs and disabilities; information resources and the system of inter-agency interaction in the course of the implementation of additional educational programs for children, including those with special needs and disabilities; financing of entities engaged in implementing additional educational programs for children. The presence/absence of a regional centre of additional education for children is going to be identified, as well as its official name, and the number of subordinate entities which implement additional educational programs in the corresponding Russian region in various areas: arts, sports, science, sociology and pedagogy, technical sciences, tourism and local history, intellectual games. The article could be of assistance for experts who study inclusion problems

Biophysical and electrochemical studies of protein-nucleic acid interactions

This review is devoted to biophysical and electrochemical methods used for studying protein-nucleic acid (NA) interactions. The importance of NA structure and protein-NA recognition for essential cellular processes, such as replication or transcription, is discussed to provide background for description of a range of biophysical chemistry methods that are applied to study a wide scope of protein-DNA and protein-RNA complexes. These techniques employ different detection principles with specific advantages and limitations and are often combined as mutually complementary approaches to provide a complete description of the interactions. Electrochemical methods have proven to be of great utility in such studies because they provide sensitive measurements and can be combined with other approaches that facilitate the protein-NA interactions. Recent applications of electrochemical methods in studies of protein-NA interactions are discussed in detail

Effect of prior treatments on selinexor, bortezomib, and dexamethasone in previously treated multiple myeloma

Therapeutic regimens for previously treated multiple myeloma (MM) may not provide prolonged disease control and are often complicated by significant adverse events, including peripheral neuropathy. In patients with previously treated MM in the Phase 3 BOSTON study, once weekly selinexor, once weekly bortezomib, and 40 mg dexamethasone (XVd) demonstrated a significantly longer median progression-free survival (PFS), higher response rates, deeper responses, a trend to improved survival, and reduced incidence and severity of bortezomib-induced peripheral neuropathy when compared with standard twice weekly bortezomib and 80 mg dexamethasone (Vd). The pre-specified analyses described here evaluated the influence of the number of prior lines of therapy, prior treatment with lenalidomide, prior proteasome inhibitor (PI) therapy, prior immunomodulatory drug therapy, and prior autologous stem cell transplant (ASCT) on the efficacy and safety of XVd compared with Vd. In this 1:1 randomized study, enrolled patients were assigned to receive once weekly oral selinexor (100 mg) with once weekly subcutaneous bortezomib (1.3 mg/m2) and 40 mg per week dexamethasone (XVd) versus standard twice weekly bortezomib and 80 mg per week dexamethasone (Vd). XVd significantly improved PFS, overall response rate, time-to-next-treatment, and showed reduced all grade and grade ≥ 2 peripheral neuropathy compared with Vd regardless of prior treatments, but the benefits of XVd over Vd were more pronounced in patients treated earlier in their disease course who had either received only one prior therapy, had never been treated with a PI, or had prior ASCT. Treatment with XVd improved outcomes as compared to Vd regardless of prior therapies as well as manageable and generally reversible adverse events. XVd was associated with clinical benefit and reduced peripheral neuropathy compared to standard Vd in previously treated MM. These results suggest that the once weekly XVd regimen may be optimally administered to patients earlier in their course of disease, as their first bortezomib-containing regimen, and in those relapsing after ASCT. Trial registration: ClinicalTrials.gov (NCT03110562). Registered 12 April 2017. https://clinicaltrials.gov/ct2/show/NCT03110562

Динамика выживаемости больных муковисцидозом в Москве и Московской области за периоды 1992–2001 и 2002–2011 гг.

Summary. The aim of this study was to evaluate changes in survival of patients with cystic fibrosis (CF) in Moscow and Moscow region and to determine factors influencing the survival. We analyzed outpatient medical records of patients followed-up in Moscow CF centers by the 1st of January, 2002, and by the 1st of January, 2012.Median survival for 2002–2012 was 37.2 years; this was significantly higher that the similar value for the previous decade (25.9 years). A total number of CF patients was more than doubled due to increased survival and improved diagnosis of the disease.Improved survival was due to improved work of CF centers and to implementation of effective medications, primarily dornase alfa (Pulmozyme) and some inhaled and systemic antibiotics and macrolides in subinhibitory concentrations, in routine clinical practice. Gram-negative infection, especially Burkholderia cepacia, was shown to decrease survival in CF patients in contrary to "mild" mutations that are better prognostic factors.Резюме. Целью работы явилось определение динамики числа и выживаемости больных муковисцидозом (МВ) в Москве и Московской области, а также определение факторов, влияющих на выживаемость. Были проанализированы амбулаторные карты больных, состоящих на учете в московских центрах муковисцидоза на 01.01.2002 и 01.01.2012.Медиана выживаемости больных за периоды 2002–2011 гг. составила 37,2 года, что достоверно выше, чем аналогичный показатель за предыдущее 10-летие – 25,9 года. Отмечено более чем 2-кратное увеличение общего количества больных, обусловленное ростом выживаемости и улучшением диагностики.Увеличение выживаемости обусловлено оптимизацией работы центров МВ и началом рутинного применения различных эффективных медикаментозных препаратов, прежде всего дорназы альфа (Пульмозим), а также некоторых ингаляционных и системных антибиотиков, макролидов в субингибирующих концентрациях. Показано, что инфицирование грамотрицательной инфекцией, особенно Burkholderia cepacia, снижает выживаемость пациентов с МВ, а наличие "мягкого" генотипа является более благоприятным прогностическим фактором

SPECIAL ASPECTS OF MEDICAL SUPPORT IN EDUCATIONAL ORGANIZATIONS FOR CHILDREN WITH HEALTH IMPACT ASSESSMENT (HIA) IN RUSSIA

Operating efficiency with children with Health Impact Assessment ( HIA) depends on a well-coordinated and comprehensive medical impact on the part of different medical professionals: paediatricians, psychiatrists, ophthalmologists, otolaryngologists, etc. Medical support for children with HIA in educational organizations has a set of particular qualities and difficulties. The study was conducted in spring 2017 to make known the main problems of medical support. 4234 headmasters throughout Russia participated in the survey. It should be noted that these were ordinary schools where children with HIA can study