Modern Therapy Research Articles

Animal tissue-derived biomaterials for promoting wound healing.

The skin serves as the primary barrier between the human body and external environment, and is therefore susceptible to damage from various factors. In response to this challenge, animal tissue-derived biomaterials have emerged as promising candidates for wound healing due to their abundant sources, low side-effect profiles, exceptional bioactivity, biocompatibility, and unique extracellular matrix (ECM) mimicry. The evolution of modern engineering technology and therapies has allowed these animal tissue-derived biomaterials to be transformed into various forms and modified to possess the necessary properties for wound repair. This review provides an overview of the wound healing process and the factors that influence it. We then describe the extraction methods, important properties, and recent practical applications of various animal tissue-derived biomaterials. Our focus then shifts to the critical properties of these biomaterials in skin wound healing and their latest research developments. Finally, we critically examine the limitations and future prospects of biomaterials generated from animal tissues in this field.

Cвітові тенденції терапії пацієнтів з бронхіальною астмою — персоніфікований підхід до лікування

Abstract. Bronchial asthma (BA) refers to those diseases that significantly disrupt the adaptation of patients in society and the family, lead to temporary and permanent loss of working capacity, significant economic costs in many countries of the world. The goals of treating people with ВA in recent years have traditionally remained unchanged and consist in achieving effective symptom control and maintaining a normal level of activity. Despite the availability and accessibility of modern asthma control therapy, lack of control or partial control of ВА is, unfortunately, a common phenomenon among patients with BA. The m ain reason for this phenomenon is the low adherence of people with BA to anti-inflammatory therapy of the disease. Patients with BA often rely on drugs to relieve symptoms, but low adherence to basic therapy and the lack of timely increase in its volume at the initial signs of loss of asthma control sometimes lead to irreversible consequences. The m odern approach to the treatment of BA in adults and adolescents over 12 years of age according to the recommendations of GINA 2022 and NAEPP 2020 is to use a fixed combination of an inhaled corticosteroid with formoterol both for basic therapy and as needed, since it has a rapid and simultaneous anti-inflammatory effect and is effective by alleviating symptoms and reducing the risk of exacerbation. Global climate change is one of the most acute environmental problems facing humanity. The m ain cause of climate change is greenhouse gases produced by human activity. The use of large numbers of short-acting β2-agonist inhalers for the relief of asthma symptoms is one important component of total carbon emissions to the atmosphere, which can be reduced by patients using a fixed combination of inhaled corticosteroid and formoterol as a means of basic and symptomatic therapy.

РЕДКИЕ ЗАБОЛЕВАНИЯ СИСТЕМЫ КРОВИ: БОЛЕЗНЬ ГОШЕ. ОПИСАНИЕ КЛИНИЧЕСКОГО СЛУЧАЯ

Gaucher disease is the most common form of hereditary enzymopathies included in the group of lysosomal storage diseases. The disease is based on a hereditary deficiency in the activity of the enzyme glucocerebrosidase (also called glucosylceramidase or acid β-glucosidase) which is involved in the degradation of cellular metabolic products. Gaucher disease is a systemic disease characterized by the same type of clinical manifestations (hepatosplenomegaly, cytopenias, lesions of the skeletal system) but an extremely heterogeneous clinical course. In the article, the authors describe their own clinical case of Gaucher disease in a teenage girl. A long past history of he¬terogeneous clinical symptoms, the complexity of differential diagnosis and interpretation of existing deviations within the course of the single systemic process were noted. The high effectiveness of modern enzyme replacement therapy has been demonstrated.

Efficacy of traditional Chinese medicine on shortening the negative conversion time of SARS-CoV-2 ribonucleic acid in patients with mild COVID-19: a retrospective cohort study

BackgroundThe holistic view of the ‘The unity of man and nature’ promotes the development and application of traditional Chinese medicine (TCM). Despite the absence of modern pharmacological therapies with robust efficacy against coronavirus disease 2019 (COVID-19), TCM has exhibited potential utility for treating the disease in clinical practice. MethodsA retrospective cohort study was conducted to investigate the therapeutic effect of TCM treatment intensity (TCMTI) in patients with mild COVID-19. A total of 6120 laboratory-confirmed patients with mild COVID-19 were recruited from temporary isolation facilities. The primary outcome measure was severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid conversion time. In addition, restricted cubic spline models were employed to elucidate nonlinear relationships. ResultsThe median age (range) of the study participants was 43.0 (2.0–75.0) years, with a median hospitalization duration of 9.7 (4.1–22.5) days. The median time for achieving SARS-CoV-2 ribonucleic acid negativity was 6.67 days. The restricted cubic spline models revealed a remarkable nonlinear association between TCMTI and the time-to-ribonucleic acid negativity. After adjusting for potential confounders, the high TCMTI group exhibited a markedly shorter median time to SARS-CoV-2 ribonucleic acid negativity and reduced hospitalization duration (P < 0.001) than the low TCMTI group. Moreover, the mean time to achieve SARS-CoV-2 ribonucleic acid negativity was shortened by 1.909 days (P < 0.001) in the high-TCMTI group compared to the low-TCMTI group. ConclusionThis study suggests that early initiation and intensified use of TCM may accelerate the time required to achieve SARS-CoV-2 ribonucleic acid negativity in patients with COVID-19, bearing considerable implications for public health.

Radiation Oncology-Future Vision for the Modern Radiation Oncologist

Radiation oncology has evolved as a discipline and the physicians who practice radiation oncology are adapting to the changing landscape of oncology management. The skill set for the modern radiation oncologist has matured as the requirements for modern patient care have become increasingly complex both in patient evaluation and treatment execution. Radiation oncology interacts with all medical and surgical subspecialties and advanced radiation therapy treatment plans require nimble use of volumetric anatomic and metabolic image sets and applied pathology to contour targets for successful treatment. Although multidisciplinary care management can serve to confirm and validate a treatment plan among providers, the number of providers involved with an individual patient management plan can also generate confusion and mixed messaging for the patient and their family. Because radiation oncologists work with every discipline and see patients weekly on treatment, often the relationship between the radiation oncologist and the patient can serve as a bridge between disciplines and radiation oncologists can serve to align the disciplines with the patient to re-affirm the care plan, limit confusion, and generate confidence for the patient with the plan and the providers. In this chapter, we will review the changing role of the radiation oncologist as we continually move directly into the mainstream of patient care, in equal partnership to medical oncology with highly advanced tools for modern therapy. Survivorships models of care will mature as radiation oncologists become more integrated into primary and follow up management of each cancer patient.

Деквалиния хлорид в терапии вагинальных инфекций

The most common inflammatory and infectious diseases of the lower genital tract include bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), aerobic vaginitis, and mixed infections. Standard modern therapies show acceptable but short-term efficacy in most cases, and high recurrence rates and increased antimicrobial resistance remain an unresolved issue. Moreover, vaginal infections are associated with different adverse outcomes both in terms of higher incidence of infertility among couples and gestational complications, having a serious impact on patients’ quality of life. The determination of appropriate management tactics for these women, especially in mixed infections, is quite a challenge for clinicians. This metaanalysis evaluates the efficacy of topical therapy with antimicrobial antiseptics containing dequalinium chloride for various types of vaginal infections. Objective. To analyze the clinical and microbiological efficacy and safety of dequalinium chloride in the treatment of vaginal infections of different etiologies. Materials and methods. A review of selected scientific publications over the past 40 years on the use of dequalinium chloride in the treatment of vaginal infections with assessing the efficacy and safety of its topical use in women was conducted. A total of 4,783 patients (from 26 studies) were included. Results. Dequalinium chloride is an antimicrobial antiseptic agent with broad bactericidal and fungicidal activity and low systemic absorption after vaginal administration. At the same time, dequalinium chloride has similar clinical efficacy to clindamycin when used topically in the treatment of bacterial vaginosis, and its broad antimicrobial activity appears to be most suitable for the treatment of mixed vaginal infections. In addition, the development of microbial resistance to this drug is unlikely due to its pluripotent mechanism of action and local application. Conclusion. The analysis showed that the current formulation of dequalinium chloride (10 mg vaginal tablets) as 6-day therapy with its broad spectrum of antimicrobial activity and good tolerability offers a safe and effective option for empiric therapy of various vaginal infections in daily practice. Key words: vaginal infections, bacterial vaginosis, vulvovaginal candidiasis, anaerobic vaginitis, dequalinium chloride

Нейротоксические осложнения химиотерапии у детей при остром лимфобластном лейкозе

Modern therapy of acute lymphoblastic leukemia in children shows high efficiency. However, the outcome of the disease is often determined by the toxicity of chemotherapy drugs. In particular, neurotoxicity, which is characteristic of most anticancer drugs, can lead to severe neurological disorders, which significantly aggravates the course of the underlying disease and determines the formation of disability. The article presents two clinical cases that demonstrate severe chemoinduced neurological disorders in children. In the first case, damage to the central nervous system due to intraventricular administration of methotrexate is described. The second case demonstrates a severe degree of chemoinduced polyneuropathy with vincristine. Both children received the status of a patient in need of palliative care because of the complications received. The presence of such cases in practice dictates the need to develop new diagnostic methods aimed at early detection of neurotoxic complications, as well as to identify groups with high risk of the formation of chemoinduced neurological disorders.

Контроль качества планов с модуляцией интенсивности (volumetric modulated arc therapy - vmat) в лучевой терапии на линейном ускорителе vitalbeam

The importance of medical physics methods in modern radiation therapy is shown. The types of irradiation used in radiation therapy are considered. At each stage, it is necessary to maintain high accuracy of all procedures. One of the significant stages is the treatment planning, where the quality control of the plan is carried out to ensure the accuracy of the treatment of the patient. The process of quality control of radiation plans in radiation therapy with intensity modulation (Volumetric Modulated Arc Therapy - VMAT) on the VitalBeam linear accelerator is presented. The widely used method of quality control on the portal detector (Electronic Portal Imaging Device, EPID) of the radiation therapy plan with intensity modulation (Volumetric Modulated Arc Therapy - VMAT) is considered. Comparison of dose distribution that is the overlapping of dose distribution contours. Isodose lines and a dose-volume histogram for a plan with intensity modulation are presented and the main dimensional geometries used in clinical practice for dosimetric examination of treatment plans are described. Intensity modulated plan gamma analysis (VMAT) and gamma analysis criteria are defined. As well as the coverage of the physical volume of exposure. Quality control of dosimetric distributions of the intensity modulated treatment plan (VMAT) on the VitalBeam linear accelerator was assessed.

Survival and quality of life analysis in glioblastoma multiforme with adjuvant chemoradiotherapy: a retrospective study.

Glioblastoma multiforme (GBM) is the most common and aggressive primary intracranial tumor. Despite modern therapies, it is still fatal with tremendously poor prognosis with a median survival of 14 months. Even though mean survival and progression-free survival (PFS) are considered as primary response measure, it is important to assess the effects of therapies on disease burden and health-related quality of life (HRQoL). Changes in quality of life (QoL) indicates the impact of cytotoxic therapy and may aid in defining response in the absence of quantifiable endpoints like tumor regression. The objective was to assess 2-year survival and quality of life in GBM patients who underwent primary surgery followed by chemo-radiotherapy and 6-month adjuvant chemotherapy with temozolomide. Single-institution retrospective study of 60 patients of GBM from 2015 to 2017. Data regarding patient factors, disease factors, and treatment factors were collected and survival was calculated. 60 patients with GBM were analyzed, male to female ratio was 1.6:1. Patients most commonly presented with headache. Most common tumour site is the frontal lobe. The median overall survival (OS) was 10 months. The 1-year and 2-year survival rates were 30% and 6.7%, respectively. Compared to before surgery patients have showed improved emotional, social and role functioning in Post radiotherapy period. There was a decrease in symptoms like pain, headache and seizures. OS and QoL in GBM patients remains poor despite constant research and studies. Maximum safe resection followed by adjuvant temozolomide has shown improvement in OS. Post-surgery and adjuvant radiotherapy patients have shown a decrease in symptoms and better QoL.

Alternatives and reduced need for sentinel lymph node biopsy (SLNB) staging for melanoma

Sentinel lymph node biopsy (SLNB) has been introduced in the 1990s to identify patients who might benefit from completion lymph node dissection. Neither SLNB nor CLND improved survival, but SLNB staging did provide the best staging, above Breslow thickness and ulceration. The SLN status and SLN tumour burden were used in all trials until date looking at modern adjuvant systemic therapy with immune checkpoint inhibition (ICI) or targeted therapies (TT). Adjuvant ICI and TT are shifting towards stage II melanoma. The question is whether there is still role for SLNB in melanoma, in this day and age, and if so, how does the future look for SLNB staging? The SLN status and SLN tumour burden might be useful for a consultation to discuss the number needed to treat in a risk/benefit discussion. For stage IIB/C patients, it seems likely, however, that patients will forego a nuclear scan followed by the risk of surgical intervention and morbidity associated with SLNB if they opt to receive adjuvant therapy regardless of the SLNB result. For stage I/IIA, it is still required to detect high-risk patients who might benefit from adjuvant therapy. However, biomarkers are emerging, such as gene expression profilers (GEP), immunohistological signatures and liquid biopsies with ctDNA. There still is a role for SLNB staging in melanoma today, but we expect that the availability of therapeutic option independent of SLNB status as well as emergence of validated biomarkers to predict risk will reduce the need for SLNB staging in the upcoming decade to the point it will no longer be used.

Место арГПП-1 и иНГЛТ-2 в современной терапии сахарного диабета 2 типа

Место арГПП-1 и иНГЛТ-2 в современной терапии сахарного диабета 2 типа

Influence of Green Synthesized Zinc Oxide Nanoparticles on Molecular Interaction and Comparative Binding of Azure Dye with Chymotrypsin: Novel Nano-Conjugate for Cancer Phototherapy.

Till date, different types of conventional drugs have been used to fight tumors. However, they have significant flaws, including their usage being constrained because of their low bioavailability, poor supply, and serious side effects. The modern combination therapy has been viewed as a potent strategy for treating serious illnesses, including cancer-type feared diseases. The nanoparticles are a promising choice for cancer therapeutic and diagnostic applications because of their fascinating optoelectronic and physicochemical features. Among the metallic nanoparticles, Zinc oxide nanoparticles possess interesting physicochemical and anti-cancer characteristics, such as ROS generation, high retention, enhanced permeability etc., making them attractive candidates for the treatment and diagnosis of cancer. Zinc oxide nanoparticles showed anti-cancer property via excessive reactive oxygen species (ROS) production, and by the destruction of mitochondrial membrane. Here, we have synthesized organic/inorganic hybrid nanosystem composed of chymotrypsin protein (Chymo) with AzureC (AzC) conjugated with Zinc oxide nanoparticles (ZnONPs). The conjugation of AzureC with ZnONPs was confirmed by transmission electron microscopy (TEM), zeta potential, and dynamic light scattering (DLS) experiment. The interaction of Chymo with AzC alone and AzC-ZnONPs was investigated, and it was observed that the interaction was enhanced in the presence of ZnONPs, which was concluded by the results obtained from different spectroscopic techniques such as UV-Visible spectroscopy, fluorescence spectroscopy and circular dichroism in combination with molecular docking. UV-Visible spectroscopic studies and the corresponding binding parameters showed that the binding of AzC-ZnONPs complex with Chymo is much higher than that of AzC alone. Moreover, the fluorescence measurement showed enhancement in static quenching during titration of Chymo with AzC-ZnONPs as compared to dye alone. In addition to this, circular dichroism results show that the dye and dye-NPs conjugate do not cause much structural change in α-Chymo. The molecular docking and thermodynamic studies showed the predominance of hydrogen bonding, Van der Waal force, and hydrophobic forces during the interactions. After correlation of all the data, interaction of Chymo with AzC-ZnONPs complex showed strong interaction as compared to dye alone. The moderate binding with chymo without any alteration in the structure makes it desirable for the distribution and pharmacokinetics. In addition, the in vitro cytotoxicity of the AzC-ZnONPs was demonstrated on A-549 adenocarcinoma cell line. Our findings from physiochemical investigations suggested that the chymotrypsin coated AzC conjugated ZnONPs could be used as the novel nanoconjugates for various cancer phototherapies.

Study of Antioxidant Activity and Quantum-chemical Calculations of 2-aminopyrroles

Introduction. Modern therapy defines oxidative stress as one of the key links in the pathogenesis of different diseases, which makes the search for new low molecular weight antioxidants actual [1]. The widely used methods are imperfect, since they reflects reactivity of the sample under artificial conditions [2–4]. The proposed technique of using the "Ecolum" biosensor makes it possible to preserve the advantages of in vitro methods and improve the accuracy of determination through the use of biological reactions of cells [5, 6].Aim. Studying of the antiradical and antioxidant activity of 2-aminopyrroles, using in vitro methods and quantum-chemical calculations. Materials and methods. Earlier, derivatives of 2-aminopyrroles were obtained. Antiradical activity of the compounds was studied using the DPPH test (2,2-diphenyl-1-picrylhydrazyl). Antioxidant activity was evaluated on the model of oxidative stress using the «Ecolum» biosensor. The calculation data of the indices of reactivity in the approximation of the gas phase were obtained using quantum-chemical methods.Results and discussion. The antioxidant activity test indicated a higher antioxidant potential of 2a, compared to 2b. Antiradical activity test revealed a greater antiradical potential of 2b. Quantum-chemical calculations showed that 2b is characterized by a higher ionization potential, which may indicate its greater resistance to oxidation compared to 2a.Conclusion. The study of the antiradical and antioxidant activity of 2-aminopyrroles showed the importance of developing a methodology for the search for new antioxidants, because of antiradical activity test deviations, compared to living cell reactions.

Prawne aspekty badań genomicznych i biobankowania w regionie Azji Wschodniej

Legal aspects of genomics research and biobanking in the East Asia region The contemporary development of science and technology in the field of biomedicine has influenced the development of innovative research tools in modern diagnostics and therapies. Many Asian countries are currently interested in genetic research and biobanks, in response to increasing competitiveness on the global biotechnology market. Establishing of a modern research infrastructure in China, Japan, and South Korea is essential for future research on the etiology of genetic diseases and the development of effective methods of their treatment. Undertaking concerted legislative work is a response to numerous challenges related to the collection, processing, and sharing of biological material and related genetic information. The main problems in the field of genetic research and biobanks are the concept of informed consent, the protection of genetic data, and the commercialization of genetic material. Bio-law in China, Japan, and South Korea is the result of the search for consensus between protecting the fundamental rights of individuals and the freedom of research.

Advanced 3D Magnetic Scaffolds for Tumor-Related Bone Defects.

The need for bone substitutes is a major challenge as the incidence of serious bone disorders is massively increasing, mainly attributed to modern world problems, such as obesity, aging of the global population, and cancer incidence. Bone cancer represents one of the most significant causes of bone defects, with reserved prognosis regarding the effectiveness of treatments and survival rate. Modern therapies, such as hyperthermia, immunotherapy, targeted therapy, and magnetic therapy, seem to bring hope for cancer treatment in general, and bone cancer in particular. Mimicking the composition of bone to create advanced scaffolds, such as bone substitutes, proved to be insufficient for successful bone regeneration, and a special attention should be given to control the changes in the bone tissue micro-environment. The magnetic manipulation by an external field can be a promising technique to control this micro-environment, and to sustain the proliferation and differentiation of osteoblasts, promoting the expression of some growth factors, and, finally, accelerating new bone formation. By incorporating stimuli responsive nanocarriers in the scaffold's architecture, such as magnetic nanoparticles functionalized with bioactive molecules, their behavior can be rigorously controlled under external magnetic driving, and stimulates the bone tissue formation.

Synthesis and Biological Evaluation of Amphotericin B Formulations Based on Organic Salts and Ionic Liquids against Leishmania infantum.

Nowadays, organic salts and ionic liquids (OSILs) containing active pharmaceutical ingredients (APIs) are being explored as drug delivery systems in modern therapies (OSILs-API). In that sense, this work is focused on the development of novel OSILs-API based on amphotericin B through an innovative procedure and the evaluation of the respective biological activity against Leishmania infantum. Several ammonium, methylimidazolium, pyridinium and phosphonium organic cations combined with amphotericin B as anion were synthesized in moderate to high yields and high purities by the water-reduced buffer neutralization method. All prepared compounds were characterized to confirm the desired chemical structure and the specific optical rotation ([α]D25) was also determined. The biological assays performed on L. infantum promastigotes showed increased activity against this parasitic disease when compared with the starting chloride forms and amphotericin B alone, highlighting [P6,6,6,14][AmB] as the most promising formulation. Possible synergism in the antiprotozoal activity was also evaluated for [P6,6,6,14][AmB], since it was proven to be the compound with the highest toxicity. This work reported a simple synthetic method, which can be applied to prepare other organic salts based on molecules containing fragile chemical groups, demonstrating the potential of these OSILs-AmB as possible agents against leishmaniasis.

Randomized Trials Fit for the 21st Century: A Joint Opinion From the European Society of Cardiology, American Heart Association, American College of Cardiology, and the World Heart Federation.

Randomized Trials Fit for the 21st Century: A Joint Opinion From the European Society of Cardiology, American Heart Association, American College of Cardiology, and the World Heart Federation.

441. Association between Incident HIV-Associated Wasting/Low Weight and All-Cause Mortality in the OPERA® Cohort

Abstract Background HIV-associated wasting (i.e., progressive, involuntary weight loss with both fat and lean tissue loss; HIVAW) is an under-appreciated AIDS-defining illness; the 2012-2018 period prevalence was reported as 18% in a recent claims study in the United States. We aimed to assess the association between incident HIVAW/low weight and all-cause mortality in the era of modern combination antiretroviral therapy (ART). Methods In the Observational Pharmaco-Epidemiology Research &amp; Analysis (OPERA®) cohort, PWH without (a) any prior HIVAW/low weight, (b) malignancy within 3 years, and (c) opportunistic infection within 1 year who were active in care between 2016 and 2020 were followed through death, loss to follow-up, or study end (31OCT2021). HIVAW/low weight included a wasting or low BMI/underweight diagnosis (ICD codes, title search) or BMI &amp;lt; 20 kg/m2. Hazard ratios (HR) and 95% confidence intervals (CI) for the association between time-dependent incident HIVAW/low weight (exposure) and all-cause mortality (outcome) were estimated with extended Cox regression models. The adjusted model included age at baseline, race, ethnicity, and time-dependent covariates (log10 viral load, Veterans Aging Cohort Study [VACS] Mortality Index score). Viral load and VACS score were included as surrogate markers for ART use and comorbidities, respectively. Linear and quadratic terms of continuous variables were included. Results Of 67,119 PWH without prior HIVAW/low weight in OPERA®, 62,314 (93%) PWH had non-missing covariate data and were included in the models; baseline characteristics did not differ between the full and model study populations (Table 1). Over a median follow-up of 45 months (interquartile range: 27, 65), there were 4,755 (8%) cases of incident HIVAW/low weight and 1,354 (2%) deaths. In the adjusted model, PWH who experienced incident HIVAW/low weight had a significantly increased risk of death over follow-up than those who did not experience HIVAW/low weight (HR: 1.96; 95% CI: 1.68, 2.27) (Table 2). Conclusion In this analysis of 62,314 PWH in care, incident HIVAW/low weight was associated with twice the risk for all-cause mortality in the modern ART era. Particular attention needs to be paid to HIVAW/low weight among PWH to restore health and potentially reduce the risk of death. Disclosures Rachel P. Weber, PhD, AIDS Healthcare Foundation: Client of my employer|EMD Serono: Client of my employer|Gilead Sciences: Client of my employer|Janssen: Client of my employer|Merck &amp; Co.: Client of my employer|TheraTechnologies: Client of my employer|ViiV Healthcare: Client of my employer Laurence Brunet, PhD, AIDS Healthcare Foundation: Client of my employer|EMD Serono: Client of my employer|Gilead Sciences: Client of my employer|Janssen: Client of my employer|Merck &amp; Co: Client of my employer|TheraTechnologies: Client of my employer|ViiV Healthcare: Client of my employer Javeed Siddiqui, MD, MPH, Abbvie: Advisor/Consultant|Abbvie: Honoraria|Cumberland pharmaceuticals: Advisor/Consultant|Cumberland pharmaceuticals: Honoraria|EMD serono: Advisor/Consultant|EMD serono: Honoraria|Merck: Advisor/Consultant|Merck: Honoraria Javeed Siddiqui, MD, MPH, Abbvie: Advisor/Consultant|Abbvie: Honoraria|Cumberland pharmaceuticals: Advisor/Consultant|Cumberland pharmaceuticals: Honoraria|EMD serono: Advisor/Consultant|EMD serono: Honoraria|Merck: Advisor/Consultant|Merck: Honoraria Michael Harbour, MD, MPH, FACP, EMD Serono: Employee Amy L. Phillips, PharmD, EMD Serono, Inc.: Employment Brooke Hayward, SM, MBA, EMD Serono, Inc.: Employee Jennifer S. Fusco, BS, AIDS Healthcare Foundation: Client of my employer|EMD Serono: Client of my employer|Gilead Sciences: Client of my employer|Janssen: Client of my employer|Merck &amp; Co.: Client of my employer|TheraTechnologies: Client of my employer|ViiV Healthcare: Client of my employer Ricky K. Hsu, MD, Gilead: Honoraria|Merck: Honoraria|ViiV: Advisor/Consultant|ViiV: Grant/Research Support|ViiV: Honoraria Gregory P. Fusco, MD, MPH, AIDS Healthcare Foundation: Client of employer|EMD: Grant/Research Support|Gilead Sciences: Client of employer|Janssen: Client of employer|Merck &amp; Co.: Client of employer|Theratechnologies: Client of employer|ViiV Healthcare: Client of employer.

Improving evaluations and management of the appropriate application of modern anticancer drug therapy

Introduction. Evaluation and further improvement of the use of resources of the oncological service (including drug therapy) can lead to a subsequent qualitative gain in the availability of new types of effective antitumor technologies for a larger number of patients with severe oncological pathology. The experience of the Netherlands in managing the cancer care is useful for the local regional health services. Purpose of the study. Study of approaches to economically and clinically feasible use of anticancer therapy in real hospital practice. Material and methods. The scientific study was performed on the base of the search results in the databases of the Dutch digital educational platform, in the PubMed/Medline database and the Google search engine. The queries used the words: doelmatigheid, kanker, doelgerichte therapie, rationality, cancer, targeted therapy, etc. We analyzed the results published in 2021-2022. Results. There hаve bеen studied methods for increasing the expediency of clinical application of therapeutic regimens in oncology including a) rationalization of chemotherapy regimens; b) ensuring the mobility of patients receiving chemotherapy: chemotherapy on the principle of “connect and go” technology, self-administration of anticancer drugs; c) lean use of immunotherapy: drug therapy shelf life extension, vial count rounding and immunotherapy hybrid dosing; justified reduction in the duration of the course of immunotherapy. Limitations. In general, initiatives being put forward to improve the appropriateness of anticancer therapy should be previously tested in pilot projects. Conclusions. If positive opinions are received from expert institutions and regulatory authorities based on the results of pilot projects, innovative schemes for the appropriate use of drugs can be included in the list of services and programs reimbursed by the health insurer on an ongoing basis.

Lung transplantation in a patient with α&lt;sub&gt;1&lt;/sub&gt;-antitrypsin deficiency emphysema

The condition of patients with chronic lung diseases is gradually deteriorating despite modern drug therapy and often progresses to severe respiratory failure. Thus, it is important to consider other options, including surgical methods, to help such patients. The aim of the study is to demonstrate potential additional pharmacological and surgical treatment algorithms for chronic obstructive pulmonary disease (COPD) associated with α1-anti-trypsin (A1AT) deficiency. Results. The analysis of long-term medical history (from the onset to the terminal stage of the respiratory failure) of a patient with A1AT deficiency was performed. Conclusion. Patients with COPD associated with A1AT deficiency require combination inhaled controller therapy and augmentation therapy with a1-proteinase inhibitor. Patients with terminal stage of the disease need lung transplantation unless they have any contraindications.