Sustainable territorial development based on the effective use of resource potential
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01.09.2019 |
Voronkova O.
Yankovskaya V.
Kovaleva I.
Epishkin I.
Iusupova I.
Berdova Y.
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Entrepreneurship and Sustainability Issues |
10.9770/jesi.2019.7.1(47) |
9 |
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© 2019 by author(s) and VsI Entrepreneurship and Sustainability Center. The effective use of resource potential is a prerequisite for implementing all the functions of the territory and thus, can be considered fundamental for sustainable territorial development. Within the context of the current crisis in the economic sphere, regional affiliation generally occupies a special place in the structure of socio-economic development. Therefore, finding ways to ensure the effective use of resource potential is a crucial task, combining territorial specifics with the interests of the state. Modern approaches to the organization and management of the resource potential of the territory in the direction of its sustainable strategic development are analyzed. The authors substantiate the conditions and factors of formation of the resource potential of the region. On the basis of a detailed study of the problem, the mechanism developed by the authors to implement the strategy of effective use of resource potential at the regional level is presented. The proposed mechanism can be implemented in the socio-economic management of the territory focused on sustainable development.
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Uterine leiomyoma: An everlasting problem. treatment perspectives
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01.01.2018 |
Davydov A.
Belotserkovtseva L.
Shakhlamova M.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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1 |
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© 2018, Dynasty Publishing House. All rights resvered. The work specifies the indications and conditions for surgical treatment of patients with uterine leiomyoma. The role and clinical significance of ulipristal acetate (UPA, Esmya) in a complex treatment of patients with uterine leiomyoma of varied localisation of nodules according to the FIGO classification have been determined. Special attention is paid to the problem of drug-induced liver injury (DILI) against the background of intake of Esmya. As has been shown, there no reasons to associate UPA with DILI, since (1) UPA does not pertain to the group of drugs associated with a risk for DILI; (2) no cases of DILI have been recorded in patients receiving UPA in a therapeutic dose (5 mg). Treatment with UPA should be administered with control of transaminases. If ALT or AST activity exceeds 2×upper limit of normal (ULN) either isolatedly or in combination with bilirubin >2 × ULN, the intake of Esmya is contraindicated.
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Results of one-year treat-to-target strategy in early psoriatic arthritis: Data of an open-label REMARCA study
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01.01.2018 |
Korotaeva T.
Loginova E.
Getiya T.
Nasonov E.
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Terapevticheskii Arkhiv |
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1 |
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© 2018 Media Sphera Publishing Group. All rights reserved. Objectives: To study efficacy of treat-to-target (T2T) strategy in early peripheral psoriatic arthritis (EPsA) after one year of treatment. Methods: 44 (M/F - 18/26) DMARD-na?ve patients (pts) with active EPsA, according to the CASPAR criteria, mean age 37.5±11.3 years, PsA duration 7 [4; 24] months, psoriasis duration 36 [12; 84] months, disease activity index (DAS) 3.78 [3.18; 4.67], DAS28 4.33 [3.67; 4.8] study were included. At the baseline and every other 3 months for total 12 months of therapy all pts underwent standard clinical examination, tender joint count (TJC), swollen joint count (SJC), patient pain VAS, patient/physiciańs global disease activity VAS, enthesitis by Leeds Enthesial Index (LEI)+Plantar Fascia (PF), dactylitis, Psoriasis Area Severity Index (PASI), body surface area (BSA), Health Assessment Questionnaire (HAQ), DAS, DAS28-C-RP, C-RP (mg/l). The dose of MTX s/c was escalated by 5 mg every 2 weeks from 10 mg/wk to appropriate dose 20-25 mg/wk according to the drug intolerance. If pts does not achieve the lower disease activity (LDA), MDA or remission after 3 months of MTX subcutaneous (s/c) mono-therapy, then combination therapy of MTX+Adalimumab (ADA) by standard regime was continued up to one year. At 12 months of therapy the proportion of pts who attained LDA by DAS/DAS28 or remission by DAS<1.6/DAS28-C-RP<2.6 or MDA, ACR20/50/70, PASI75 and dynamics of HAQ, LEI+PF, dactylitis were calculated. Mean±SD, Me [Q25; Q75], %, Friedman (Fr.) ANOVA, U-test, Wilcoxon test were performed. All p<0.05 were considered to indicate statistical significance. Results: At one year of treatment according to T2T strategy significant improvements disease activity and physical health function related to quality of life was seen. By 12 months of therapy remission by DAS and MDA was reached 61.4%/65.9% of pts accordingly. By 12 months of therapy ACR20/50/70 was seen in 88%/77%/59% of pts. In pts with BSA≥3% (n=16) at baseline psoriasis improvements by PASI75 was seen in 88% of pts. In 55% of active EPsA pts MTX (s/c) mono-therapy was an effective treatment. Conclusions: One-year treatment according to T2T strategy significantly improves all PsA clinical domains - Arthritis, dactylitis, enthesitis, skin psoriasis and quality of life despite of type of treatment. It seems that T2T is a useful strategy in EPsA but additional research concerning its implementation in real practice are needed.
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Psoriatic arthritis: Pathogenetic features and innovative therapies
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01.01.2018 |
Lila A.
Nasonov E.
Korotaeva T.
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Nauchno-Prakticheskaya Revmatologiya |
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1 |
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© 2018 Ima-Press Publishing House. All rights reserved. The paper considers the modern concepts of the etiology and pathogenesis of psoriatic arthritis (PsA). The latter is currently indicated as a T-cell-mediated disease that is based on the activation of cellular immunity, followed by the hyperproduction and imbalance of key pro- A nd anti-inflammatory cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-1â (IL-1â), IL-6, IL-12/23, and IL-17. The paper presents the basic principles of diagnosis and clinical manifestations of the disease and notes the importance of screening questionnaires, the use of which allows specialists to diagnose PsA early, by actively identifying articular complaints, the characteristic clinical and radiological signs of damage to the joint, spine, and entheses. It is pointed out that the key target of pharmacotherapy for PsA is to achieve remission or minimal activity of the main clinical manifestations of the disease, to slow down or prevent its radiographic progression, to increase the length and quality of life in patients, and to reduce the risk of comorbidities. The authors characterize the major groups of used drugs: Nonsteroidal anti-inflammatory drugs, conventional and targeted synthetic disease-modifying antirheumatic drugs, and biological drugs (inhibitors of TNF-α, IL-12/23, and IL-17). The key Treat-to-target principles of patient management are considered; it is noted that strict control over disease activity and treatment results provides suppression of all major clinical manifestations of PsA. The paper also shows the basic principles of the creation and further development of the All-Russian Registry of PsA patients, which makes it possible to optimize management decision-making on the provision of high-tech medical care and drugs for this cohort of patients.
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