ABSTRACT
Introduction & Objectives: The incidence of prostate cancer, both in the world and in the Russian Federation, tends to increase. In the Republic of Bashkortostan in 2021, 699 patients with this diagnosis were registered. 19.6% of patients had stage IV disease at the time of diagnosis. 5818 patients were registered, of which 361 died within a year. The effectiveness of hormonal treatment of common prostate cancer has time limitations, after which there is a development of resistance to castration and progression of the disease. To date, drugs such as kabazitaxel, sipuleucel-T vaccine, abiraterone, enzalutamide and radium-223 have been approved for use in metastatic CRPC. The purpose of the work: analysis of the experience of systemic radiotherapyand Radium - 223 patients with mCRPC in the Republic of Bashkortostan in 2021. Material(s) and Method(s): Analysis of patients who received systemic radiotherapy Radium - 223 in the Republic of Bashkortostan according to medical documentation and research data. In 2021, Radiy-223 radiotherapy was performed on 7 patients diagnosed with mCRPC. Median age 63.14 years. All patients met the criteria for treatment, i.e. had castration-resistant prostate cancer with bone metastases, without visceral metastases. All patients had concomitant pathology from the cardiovascular system, respiratory tract, endocrine system. According to the previous surgical treatment, patients were distributed as follows: orchidectomy - 4, prostatectomy - 1 and 2 patients underwent tumor biopsy. By morphology: Glisson 6 - 2 patients, Glisson 7 - 1, Glisson 8 - 3, Glisson 10 - 1. 4 patients were referred to Xofigo for radiologically confirmed progression, 3 patients were progressingin height at PSA levels. Result(s): 1 patient previously received 1 line of systemic therapy, 5 patients received 2 lines, 1 patient received 3 lines of therapy. 6 patients received all 6 courses of radiotherapy, 1 patient did not complete treatment due to COVID 19. He is expected to complete therapy. All patients are currently alive with no signs of disease progression. Serious side effects were not registered. Conclusion(s): The "therapeutic window" for the prescription of radium-223 is the period before the appearance of visceral metastases and decline of the somatic status. To achieve the maximum benefit from the appointment of radium-223, it is necessary to conduct >=5 cycles of therapy, which is possible in 1-2 treatment lines. It is necessary to select patients carefully for radiotherapy - Radium 223.Copyright © 2022 European Association of Urology. Published by Elsevier B.V.
ABSTRACT
Based on statistics for 2012-2021, the article provides a comparative analysis of some migration indicators in the republics of Bashkortostan, Tatarstan and Tuva. The selection was informed by different levels of human development. In Tatarstan, the level of human development act as a migration attractor and contribute to stable population grown due to migrants. In Tuva, they have become a repulsive force and have led to a permanent population decline. While these two republics demonstrate two opposite types of migration processes, Bashkortostan occupies an intermediate position between them and can be linked to both Tuva (for example, by the nature of interregional exchange) and Tatarstan (by some indicators of international migration). Bashkortostan occupies the same intermediate position in terms of human development. The higher the level of human development in the region, the more stable and «calmer» the migration situation gets. Firstly, along with the positive values of migration growth, there is a relatively low intensity of intraregional and interregional exchange and high levels of the international;secondly, migration indicators do not feature strong fluctuations when external conditions change, such as during the COVID-19 pandemic. And, vice versa, the lower the level of development of the region, the more pronounced the migration decline of the population gets, and the more intensive the exchange takes place within the republic and between it and other regions, while that with other countries gets progressively weaker. When external conditions change in an underdeveloped region, migration suffers huge fluctuations. The former trend is more evident in such regions as Tatarstan;while Tuva is an example of the latter. The direction and intensity of migration processes are also influenced by the settlement system within a region. This can be seen in the center-periphery features of migration: the population is drawn into large cities and settlements adjacent to them. This trend, although common to all of republics in Russia, is most pronounced in Bashkortostan, which has a relatively high intensity of intraregional migration. In addition, the absence of large cities and the low level of their socio-economic development contribute to a vigorous outflow of population from the republic, as it happens in Tuva. © 2022 New Research of Tuva. All rights reserved.
ABSTRACT
Introduction: The past decade in rheumatology has seen tremendous innovation in digital health technologies. With a limited number and distribution of pediatric rheumatologists, telemedicine has been proposed as one way to meet this mission, yet the adoption of this modality has been slower than expected. The current global COVID 19 pandemic has triggered a paradigm shift in many centers to use telemedicine more widely Objectives: We report on the implementation of a telemedicine program in Russian Federation for the evaluation and treatment of patients with rheumatic diseases. Provide an overview of the use of telemedicine consultations in rheumatology department at the Federal Center. Methods: The telemedicine consultations department was established on the basis of the Federal Center on 7th of September in 2018. It is equipped with all the necessary equipment for organizing telemedicine consultations in real time, as well as holding deferred consultations on documents and selecting for hospitalization. Results: In 2020 433 requests were received (122 - emergency, 81 - urgent, 230 - planned), rheumatic disease were excluded in 48 patients, 196 patients were received the recommendations of investigations and correction of therapy, 189 patients were admitted (18 of them in the ICU). In 2021 (4 months) - 199 applications (52- emergency, 46 - urgent, 101- planned), rheumatic disease were excluded in 10 patients, 86 patients were admitted in the rheumatology department (5 of them in the ICU). In 2021 (from January to April) the number of applications increased 3 times in comparison with 2020. From April 2020 to April 2021, 44 initial applications and 19 repeated applications were received with a referral diagnosis of COVID 19, multisystem inflammatory syndrome. COVID 19 were confirmed in 10 patients. Other diagnoses were exposed: 6 - sepsis, 2 - PID, 1 - thrombophilia, 1 - relapse of leukemia, 5 - infection and 2 - deaths. 17 patients were admitted: sJIA were diagnosed in 8 patients, SLE -2, large B-cell lymphoma-1, colitis-1, Kawasaki-4, polyarthritis-1. There were patients from the remote regions: 30 were from Sakhalin Republic, 25 - Republic of Bashkortostan, 25- KhMAO, 28 -Orenburg Region, 14- Amur Region. Conclusion: Telemedicine is becoming more widespread, and the number of applications is increasing every year. We report the successful use of this service to assess the solution to the issue of hospitalization of children with rheumatic diseases for the initiation of DMARD in a region with limited access to rheumatological care.