Objective. Cost-effectiveness analysis of triptorelin and other luteinizing hormone releasing hormone (LHRH) agonists in the treatment of adults with prostate cancer. Material and methods. Cost-effectiveness analysis included costs of drugs and treatment of adverse events, budget impact analysis (BIA) and sensitivity analysis. Three LHRH agonists were selected (goserelin, leuprorelin, triptorelin). Results. The most efficient is triptorelin (35.870.01 rubles for a 9-month course of drug therapy). The highest cost is associated with leuprorelin therapy (54.945.51 rubles). Analysis of costs for AE relief showed that the lowest costs were associated with triptorelin (RUB 971.21), the highest — with goserelin (RUB 3.448.24). Thus, the highest total costs were associated with leuprorelin (RUB 57.857.15), the lowest — with triptorelin (RUB 36.841.22). The ratio of costs to probability of achieving serum testosterone<10 ng/dL after 9-month therapy was RUB 41.163.38 for triptorelin, RUB 69.456.36 for leuprorelin, and RUB 132.810.02 for goserelin. Triptorelin turned out to be strictly preferable compared to leuprorelin and goserelin due to higher efficiency and lower costs. According to BIA data, widespread triptorelin and leuprorelin therapy will decrease burden on healthcare system in the Russian Federation. Savings amount to 1 256 927.88 rubles for population of 1000 patients. Sensitivity analysis revealed that triptorelin retains its advantages even in deviations of baseline clinically significant parameters by ±10%. Conclusion. Compared to other LHRH agonists, triptorelin is cost-effective strategy for care in patients with prostate cancer in the Russian Federation.
Actually the screening of all the known genes allows identifying mutations only in 60– 65% patients with arrhythmogenic right ventricular dysplasia. This review analyses domestic and foreign studies on this issue on a basis of long-term observation. The materials presented demonstrate problems of the genotype-specific diagnostics and prompt treatment of the patients with this disease
The paper presents a literature review on the arrhythmogenic dysplasia of the right ventricle – a family disease with variable clinical manifestations up to the sudden cardiac death. For the time being screening of all the known genes allows to detect mutations only in 60–65% patients with arrhythmogenic dysplasia of the right ventricle. Domestic and foreign literature on this issue has been studied. Specific features of pathogenesis and clinical presentation of this category of patients are described, genotypespecific approach to the study of the disease is considered
The article presents features and possibilities of rehabilitation of the patients with combat injuries in outpatient facilities. It evaluates the role of primary health care in ensuring accessibility and continuity of rehabilitation and describes specific objectives and resources of the outpatient facilities necessary to meet the needs of this category of patients. The importance of integrating the outpatient stage into the overall rehabilitation system is emphasized.
The article provides information on the specifics of organizational support for the activities of forensic medical experts as part of mobile medical units of the Disaster Medicine Service of the Ministry of Health of the Russian Federation. The issues of organizational, methodological and personnel support, formation and coordination of the work of mobile medical teams of the Federal Center for Disaster Medicine in the context of the organization of the activities of forensic medical experts are considered. The authors analyzed the interaction of federal executive authorities, the Federal Center for Disaster Medicine, heads of state expert institutions of the subjects of the Russian Federation, analyzed the related problematic issues and proposed ways to solve them.
