scholarly journals Pegvisomant and current approaches to the medical treatment of acromegaly (literature review and case report)

2020 ◽  
Vol 16 (4) ◽  
pp. 73-79
Author(s):  
Larisa K. Dzeranova ◽  
Alexandra A. Povaliaeva ◽  
Anastasia A. Romanova ◽  
Elena G. Przhiyalkovskaya ◽  
Ekaterina A. Pigarova ◽  
...  
Keyword(s):  
Adverse Events ◽  
Growth Hormone Receptor ◽  
Clinical Observation ◽  
Practical Experience ◽  
Somatostatin Analogues ◽  
Minimal Amount ◽  
Good Prospect ◽  
The Russian Federation ◽  
Biochemical Remission

This review provides the main results of clinical trials and the literature on the experience of using pegvisomant, the first drug from the class of growth hormone receptor antagonists. The mechanism of action of the drug, its effectiveness with respect to disease control and its effect on complications, information on adverse events, and brief information on the experience of use during pregnancy are discussed in detail. In conclusion, a clinical observation of successful use of pegvisomant in resistant to standart treatment acromegaly is given. A discussion of the available literature data, the results of clinical studies and practical experience allows us to conclude that the drug is highly effective in terms of achieving biochemical remission of acromegaly, and also has a number of additional valuable properties: it is capable of improvement of patients glucose metabolism and quality of life and has a minimal amount of adverse events. Pegvisomant is currently registered in the Russian Federation only for use in monotherapy; the possibility of combination therapy with somatostatin analogues will additionally allow to reliably control the growth of the pituitary adenoma and significantly cut treatment costs by reducing the dose of pegvisomant. These features of the drug make it very relevant when discussing issues related to drug therapy of acromegaly, and suggest a good prospect for use in clinical practice.

scholarly journals Resistance to drug treatment of acromegaly and ways to overcome it

2021 ◽  
Vol 18 (2) ◽  
pp. 150-162
Author(s):  
O. O. Golounina ◽  
L. K. Dzeranova ◽  
E. A. Pigarova ◽  
Zh. E. Belaya
Keyword(s):  
Growth Hormone ◽  
Drug Treatment ◽  
Growth Hormone Receptor ◽  
First Generation ◽  
Treatment Method ◽  
Somatostatin Analogues ◽  
Biochemical Remission ◽  
High Doses ◽  
Personalized Approach ◽  
Selection Of

Acromegaly is a severe disabling neuroendocrine disease caused by hypersecretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). The problem of resistance to drug therapy in patients with acromegaly is quite common in clinical practice and requires a personalized approach, considering various predictors of sensitivity to the choice of the treatment method. To date, first-generation somatostatin analogues are first-line drugs in the medical treatment of acromegaly, but up to 50% of patients do not achieve biochemical remission of the disease. The prognosis of sensitivity to somatostatin analogues is of great importance and the selection of patients in whom this therapy will be not successful provides invaluable assistance in choosing the optimal treatment approach. This review summarizes potential predictors of sensitivity and resistance to existing drug treatment of acromegaly, discusses possible ways to overcome the resulting resistance to therapy, suggests options for a personalized approach to choosing a treatment strategy in the absence of disease control against the background of monotherapy with somatostatin analogues, including «off-label» combinations. Timely addition of growth hormone receptor antagonist (pegvisomant) avoids repeated neurosurgical intervention, radiation therapy or prescribing excessively high doses of somatostatin analogues. Optimal use of mono- or combination therapy contributes to the achievement of biochemical remission in most resistant patients.

INFORMATION ANALYSIS DECISION SUPPORT SYSTEM FOR STRATEGIC PLANNING OF REGIONAL AND URBAN DEVELOPMENT

2020 ◽  
Vol 1 (11) ◽  
pp. 67-76
Author(s):  
Mikhail N. Ivanov ◽  
Keyword(s):  
Decision Support ◽  
Online Courses ◽  
Practical Experience ◽  
Educational Process ◽  
Fund Management ◽  
Information Analysis ◽  
The Russian Federation ◽  
The Government ◽  
Financial Fund

This article discusses the ways to improve the quality of the educational process with using virtual simulators. The main trends in the use of simulators in education are presented. The practical experience of the Financial University under the Government of the Russian Federation on the development of the Open Online Academy online.fa.ru is presented. Specific examples of the developed virtual simulators «Financial Fund Management», «Russian as Foreign» and «Financial Director» for online courses of the Open Online Academy of the Financial University are considered. The description of the structure of a virtual simulator is given on the example of a simulator «Blockchain and Cryptocurrencies»

scholarly journals To solve the problem of driving a car in epilepsy: by liberalization or by tightening the license?

2020 ◽  
Vol 48 (1) ◽  
pp. 65-72
Author(s):  
I. V. Ponomareva ◽  
A. P. Gerzen ◽  
M. N. Lapina ◽  
M. A. Sherman
Keyword(s):  
Russian Federation ◽  
Road Safety ◽  
Practical Experience ◽  
Road Accidents ◽  
The Road ◽  
The Russian Federation ◽  
Liberal Approach ◽  
The Right ◽  
Patients With Epilepsy

In the modern mobile world, there is no single solution to the problem of issuing a driving license for patients with epilepsy. Most countries do have liberalized laws that allow driving a car to persons with controlled epilepsy. As far as individuals with regular seizures are concerned, there is a temporary prohibition to drive with potential restoration of the driving right if there is no relapse. The existing experience has shown that such strategy can lead not only to higher quality of life of the patients (more than 70% patients with epilepsy has the right to drive a car), but also to ensure the road safety. Even with this quite liberal approach, about 20% of the drivers with epilepsy do not have their epilepsy fully controlled. In the countries with absolute prohibition of the driving in epilepsy, such as the Russian Federation and China, there is no official statistics on the issue. Based on our practical experience, we concluded on a high (at least 35%) prevalence of drivers among patients with epilepsy; this cannot but increase the risk of road accidents, including fatal. Based on a clinical observation, we illustrate the failure of the mechanisms to prevent road accidents related to epilepsy that are currently in force in the Russian Federation. In our opinion, the problem under discussion does not have an exclusively medical solution. Taking into consideration the accumulated world experience, ensuring of the road safety requires that the state law regulations should be in effect that include a differentiated approached to issuing of permissions to drive a car for persons with epilepsy, from one side, and a serious legal treatment of persons with epilepsy who ignore their adequate therapy and become a cause for road accidents inflicting an injury, from the other.

scholarly journals Problems of Defining the Taking Up of the Highest Position in the Prison Hierarchy

2021 ◽  
Vol 3 (13) ◽  
pp. 81-85
Author(s):  
A. A. SHIKOV ◽  
Keyword(s):  
Social Organization ◽  
Russian Federation ◽  
Practical Experience ◽  
Criminal Code ◽  
Theoretical Understanding ◽  
The Social ◽  
Important Quality ◽  
The Russian Federation

In the conditions of insufficient practical experience related to the application of Article 210.1 of the Criminal Code of the Russian Federation, introduced into legislation in April 2019, the theoretical understanding of the issues of occupying the highest position in the prison hierarchy seems relevant and significant. The article puts forward the hypothesis that the prison hierarchy forms the basis of the criminal hierarchy. These phenomena are not identical: the prison hierarchy includes a much larger number of subcategories than the criminal one. An important quality of the prison hierarchy is the variability of the names of its castes, with almost complete rigidity of the general principles of the social organization of prisoners, which determine the existence of a well-established system of informal subordination in penitentiary institutions. We conclude that when determining an individual’s belonging to those who occupy the highest position in the prison hierarchy, one should be guided not so much by their subcultural name (for example, «vor v zakone [code-bound thief]», «smotryashchii [alpha dog]», «polozhenets [mafia enforcer])», as by an assessment of the nature of the actions they commit, the degree of influence on other convicts, the presence of stable connections in the criminal environment and other distinctive criminological signs specified in Article 210.1 of the Criminal Code of the Russian Federation.

Concept Of Increasing The Level Of Projects Of Work Production

2020 ◽  
pp. 59-63
Keyword(s):  
Practical Experience ◽  
Production Plan ◽  
The Real ◽  
Master Plans ◽  
General Contractor ◽  
Work Production ◽  
Construction Organization ◽  
Production Plans

The author analyzes the reasons that objectively reduce the importance and quality of the organizational and technological solutions of work production plans and the content of their main documents. Based on a generalization of practical experience, one of the real ways of increasing the level of work production plans is proposed as a result of the development of "The Unified Rules for Work Production on the Site" as part of the construction organization project, in the form of fundamental requirements, followed by the inclusion of this document in the work production plan as an input document. The structure and content of the Unified Rules are described with the disclosure of the main documents - calendar plans of work, construction master plans, technological schemes of works. The first section of the document contains requirements for the content of tasks for the development of the project of work execution, the order of its approval, and requirements for the quality of solutions. The second section presents principal solutions, methods of work execution and their technological schemes. The organizational and technological solutions adopted in the proposed document are specified and detailed by the General Contractor Construction Organization with due regard for the resource capabilities and the actual conditions of construction or reconstruction.

Risks and economic security of the life support system of citizens in the field of housing and communal services

2020 ◽  
Vol 19 (3) ◽  
pp. 175-191
Author(s):  
Vladimir M. Yakovlev
Keyword(s):  
Quality Of Life ◽  
Russian Federation ◽  
Support System ◽  
Internal Control ◽  
Life Support ◽  
Economic Security ◽  
Security System ◽  
Life Support System ◽  
The Russian Federation

The article analyzes the problems of the manifestation of risks of shadow and criminal activity in the life support system of citizens of the Russian Federation, the dissemination of which requires the development of effective measures to prevent and eliminate them. The most important issue is the formation of an effective economic security system with an emphasis on the new quality of life support for citizens of the Russian Federation in an adequate combination with the high growth rate of NTP in the Russian economy. The new technological structure emerging from the new achievements of scientific and technological progress involves the harmonization of the pace of scientific and technological development, combined with an adequate improvement in the quality of life support for citizens performing such achievements. Owing to this fact formation of new quality of the housing and communal services (HCS) as bases of life support of citizens becomes a prerequisite of increase in performance and intellectualization of human work. With this in mind, early recognition, prevention and elimination of risks of shadow and criminal activities in the housing and communal services system (housing and communal services) is considered as a significant mechanism to increase the effectiveness of the system of comfortable life support for citizens of the Russian Federation. The existing lag in the development of a high-quality and comfortable system for providing citizens of Russia on the basis of housing and communal services, the subject of which is the provision of quality and comfortable services, influenced by numerous risks of shadow and criminal influence, becomes a condition for intensifying economic development and increasing labor productivity on this basis. The need to develop and use modern scientific and technical achievements, especially in the field of digitalization, is emphasized in order to increase the efficiency of the economic security system of housing and communal services organizations based on innovative control mechanisms - internal control, audit, compliance control, taking into account financial investigations in order to prevent and eliminate the risks of shadow and criminal activities in the housing and communal services system.

Assessing the quality of public health in the Russian Federation and Israel: Main problems and solutions

2020 ◽  
Vol 19 (4) ◽  
pp. 618-632
Author(s):  
A.S. Panchenko
Keyword(s):  
Public Health ◽  
Russian Federation ◽  
Population Based ◽  
The Public ◽  
Disability Adjusted Life ◽  
Problems And Solutions ◽  
The Russian Federation ◽  
Disability Adjusted Life Year ◽  
Practical Recommendations

Subject. The article addresses the public health in the Russian Federation and Israel. Objectives. The focus is on researching the state of public health in Russia and Israel, using the Global Burden of Disease (GBD) project methodology, identifying problem areas and searching for possible ways to improve the quality of health of the Russian population based on the experience of Israel. Methods. The study draws on the ideology of the GBD project, which is based on the Disability-Adjusted Life-Year (DALY) metric. Results. The paper reveals the main causes of DALY losses and important risk factors for cancer for Russia and Israel. The findings show that the total DALY losses for Russia exceed Israeli values. The same is true for cancer diseases. Conclusions. Activities in Israel aimed at improving the quality of public health, the effectiveness of which has been proven, can serve as practical recommendations for Russia. The method of analysis, using the ideology of the GBD project, can be used as a tool for quantitative and comparative assessment of the public health.

THE VALUE OF LOVE IN THE SYSTEM OF FORMATION OF THE PROFESSIONAL MATURITY OF THE EDUCATOR

2020 ◽  
Vol 1 (10(79)) ◽  
pp. 12-18
Author(s):  
G. Bubyreva
Keyword(s):  
Russian Federation ◽  
The State ◽  
Educational Process ◽  
Wide Range ◽  
The Family ◽  
The Russian Federation ◽  
The Government ◽  
The Individual ◽  
The Right

The existing legislation determines the education as "an integral and focused process of teaching and upbringing, which represents a socially important value and shall be implemented so as to meet the interests of the individual, the family, the society and the state". However, even in this part, the meaning of the notion ‘socially significant benefit is not specified and allows for a wide range of interpretation [2]. Yet the more inconcrete is the answer to the question – "who and how should determine the interests of the individual, the family and even the state?" The national doctrine of education in the Russian Federation, which determined the goals of teaching and upbringing, the ways to attain them by means of the state policy regulating the field of education, the target achievements of the development of the educational system for the period up to 2025, approved by the Decree of the Government of the Russian Federation of October 4, 2000 #751, was abrogated by the Decree of the Government of the Russian Federation of March 29, 2014 #245 [7]. The new doctrine has not been developed so far. The RAE Academician A.B. Khutorsky believes that the absence of the national doctrine of education presents a threat to national security and a violation of the right of citizens to quality education. Accordingly, the teacher has to solve the problem of achieving the harmony of interests of the individual, the family, the society and the government on their own, which, however, judging by the officially published results, is the task that exceeds the abilities of the participants of the educational process.  The particular concern about the results of the patriotic upbringing served as a basis for the legislative initiative of the RF President V. V. Putin, who introduced the project of an amendment to the Law of RF "About Education of the Russian Federation" to the State Duma in 2020, regarding the quality of patriotic upbringing [3]. Patriotism, considered by the President of RF V. V. Putin as the only possible idea to unite the nation is "THE FEELING OF LOVE OF THE MOTHERLAND" and the readiness for every sacrifice and heroic deed for the sake of the interests of your Motherland. However, the practicing educators experience shortfalls in efficient methodologies of patriotic upbringing, which should let them bring up citizens, loving their Motherland more than themselves. The article is dedicated to solution to this problem based on the Value-sense paradigm of upbringing educational dynasty of the Kurbatovs [15].

Data analysis of social hygiene monitoring in russian regions determining environmental and hygienic safety for population

2020 ◽  
pp. 60-66
Author(s):  
O. Klepikov ◽  
S. Eprintsev ◽  
S. Shekoyan
Keyword(s):  
Environmental Safety ◽  
Environmental Risks ◽  
Priority Pollutants ◽  
Russian Regions ◽  
Social Hygiene ◽  
Atmospheric Air ◽  
The Social ◽  
The Russian Federation ◽  
Federal Center

Data of the Federal Information Fund for Social Hygiene Monitoring conducted on the basis of the Federal Center for Hygiene and Epidemiology of Rospotrebnadzor have been analyzed to assess environmental risks, as well as to develop environmental safety system as a factor for sustainable development of the territory in the regions of the Russian Federation. Atmospheric air pollution in Russian regions was evaluated by content of priority pollutants. Ranking of Russian regions according to the quality of drinking water supply was carried out. The possibility of using Federal Information Fund for Social Hygiene Monitoring as an integral part of the model for optimizing the social and environmental conditions of populated areas is estimated.

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