INTRODUCTION:Patients with chronic obstructive pulmonary disease (COPD) usually have a decreased quality of life (QOL). Specialized questionnaires on QOL may be more sensitive when studying individual issues of COPD therapy than general (universal) questionnaires. GOAL:Conducting a review of specific tools for assessing the quality of life of patients with COPD. MATERIALS AND METHODS:The study was carried out based on the results of a search of scientific literature presented in the bibliographic databases PubMed (USA) and ELIBRARY.RU (Russia, Russian-language sources). Keywords were used to search for relevant sources: «quality of life», «COPD», «chronic obstructive pulmonary disease» etc. In order to search for information on individual questionnaires, queries containing the names of the questionnaires were used. Additional references were obtained using the search engines Google and Yandex. RESULTS:Based on the results of a study of the scientific literature and a search in the PubMed / Medline information base, 22 specific tests used to assess the quality of life of patients with COPD were considered. These tests demonstrate different relevance and scientific applicability in recent years. Five tests were most often used in foreign and domestic studies: St. George respiratory questionnaire (SGRQ), the COPD assessment test (CAT), the modified Medical Research Council dyspnea scale (mMRC), the chronic respiratory questionnaire (CRQ), the clinical COPD questionnaire (CCQ). CONCLUSION:Further study as well as local adaptation (if so required) of some questionnaires will open up new opportunities for their wider implementation into the routine daily practice of providing medical care to patients with COPD in the regions.

INTRODUCTION:Chronic obstructive pulmonary disease (COPD), usually in advanced stages, is associated with high mortality, being the third leading cause of death worldwide. In the Netherlands, care delivery to patients with COPD has become a focus of the regional medical community, since the COPD death rates in this country are higher than the European Union average. However, between 2011 and 2021, the number of people with COPD (under follow-u by general practitioners) decreased. The experience of this country is interesting, as a large set of measures to improve the situation has been developed and implemented in this region. The purpose of the study was to analyze the experience of the Netherlands in organizing medical care for COPD in primary care settings.MATERIAL AND METHODS:The search for scientific literature sources was carried out using the PubMed database and Google system. The search time horizon equaled to 5 years.RESULTS:In the Netherlands, in the system of care delivery to patients with COPD, primary care settings are heavily burdened. The article summarizes approaches to identify COPD risk factors, summarizes current clinical recommendations as of December 2022, and highlights findings of the study on medical digital platforms with the potential to organize continuous monitoring of patients. The paper exemplifies criteria for assessing the treatment quality in specialized care settings, including primary care.DISCUSSION:It is assumed that the most effective measure to further improve efficacy of COPD treatment is the introduction of remote digital medical devices. A possible integration of the updated standards and quality indicators into digital services will further strengthen the concept of continuous automated remote monitoring of COPD patients. Evidence-based selection and introduction of effective digital solutions into current practice will improve quality of care delivery to patients.

Aim: to analyze the safety and effectiveness of the method of cold snaring resection with preliminary hydropreparation when removing superficially colorectal epithelial neoplasms with a diameter of 5 to 25 mm.Material and methods. The number of complications and disease recurrence after endoscopic excisions by “cold” snaring resection with preliminary hydropreparation of superficially neoplasms with a diameter of 5 to 25 mm was assessed.Results. Neoplasms were removed in a single block in 89/122 (72.95 %) cases. Neoplasms with a diameter of 5 to 9 mm were excisions in a single block in 100 % of cases, with a diameter of 9 to 14 mm in 28/30 (93.33 %) cases, with a diameter of 15 to 19 mm in 12/38 (31.57 %) cases. According to the results of a lifetime pathoanatomic examination of the removed material, serrated dysplasia (serrated dysplasia, low grade) was detected in 76 cases; micro vesicular hyperplastic polyps (Hyperplastic polyp, micro vesicular type MVHP) were established in 9 cases; hyperplastic polyps containing goblet cells (Hyperplastic polyp, goblet cell GCHP) were in 5 cases; tubular adenoma with dysplasia (Tubular adenoma, low grade) was in 32 cases. Delayed bleeding and perforation of the intestinal wall, both at the time of resection, and in the delayed period was not observed. No local recurrence was detected in the groups of patients with neoplasms diameters of 5-9 and 10-14 mm. One case of local recurrence was detected in a group of patients with a neoplasms diameter from 15 to 19 mm (1/38 = 2.63 %) and one case in a group with a neoplasms diameter of 20-25 mm (1/5 = 20 %).Conclusions. Cold endoscopic snaring resection of colorectal epithelial neoplasms with preliminary hydropreparation in the submucosa is a safe and effective method of excisions superficially epithelial neoplasms of the colon with a diameter of 5 to 19 mm.

Background. As of 2019, prostate cancer (PCa) is the second most common malignancy in men living in Russia (15.7 % of all cancer cases detected in 2019). Cardiovascular diseases, in particular atherosclerosis, are believed to be the second most frequent cause of death in PCa patients.Aim. To evaluate cardiovascular safety of hormone therapy for PCa on the example of gonadotropin releasing hormone (GnRH) agonists and antagonists (leuprolide and degarelix), second-generation antiandrogens (enzalutamide), and steroidogenesis inhibitors (abiraterone).Materials and methods. We analyzed the results of original studies assessing cardiovascular safety of hormone therapy in PCa patients published in 2020–2021 and indexed in PubMed. The results of other meta-analyses and systematic reviews were not included.The search for publications was performed using the PubMed database and the Google system. The following key words were used for searching: prostate cancer, cardiovascular risks, cardiovascular safety, outcomes, atherosclerosis, etc. We analyzed studies published between January 2020 and January 2022. Articles in English and Russian were selected manually; no filters were applied.Results. We examined the results of the latest and most relevant original studies assessing cardiovascular safety of key innovative hormone therapies for PCa. The majority of recent studies were based on routine clinical practice; they were registered in highly specialized cancer registers.Hormone therapy is associated with cardiotoxicity, which increases the risk of non-cancer related death in PCa patients. New, sometimes conflicting evidence is being constantly accumulated. This evidence suggests that the GnRH antagonist (degarelix) has a better cardiovascular safety profile than the GnRH agonist (leuprolide); enzalutamide is safer than abiraterone. Further search for prognostic biomarkers in PCa patients is needed.Conclusion. More high-quality studies analyzing adverse cardiovascular events in PCa patients conducted in routine clinical practice and registered in the online databases are the next stage to identify benefits of one antitumor drug over another. This will help to choose optimal hormone therapy algorithms for PCa patients and, therefore, increase their overall survival.

Common surgical treatment options for colorectal cancer (CRC) are high-risk interventions. The accumulation of various digital health data is critical to improving the quality of cancer care. The article analyzes cases of using the composite unified quality criteria (QC) in CRC surgery and highlights the directions of further development of specific quality indicators and an evaluation system for CRC treatment outcomes. Integrative multiparametric approaches to quality analysis have the potential to improve the quality of surgical oncology. They can be implemented along with other approaches after approval for use in real-world clinical practice.

Background. Further improvement of the internal quality assurance of clinical practice is critical to achieve the goals and objectives of the Federal project entitled “Battle with cancer”, which aimed at reduction in cancer mortality by 2024 to 185 cases per 100,000 population. Prostate cancer (PCa) is the third leading cause of cancer mortality among men in Russia. For the selection of quality indicators (QIs) for the assessment of oncological care, including the treatment of PCa, the modified Delphi method is widely used. Aim. Identification of examples of actively used modifications of the Delphi technique and the most relevant QIs designed to control the quality of active surveillance of patients with low-risk PCa and the quality of cancer care for patients with metastatic PCa. Materials and methods. The literature search was performed using the following thematic queries in PubMed: “Delphi method/technique”, “quality indicators”, “cancer care”, “prostate cancer”, “tumors”, etc. The search time horizon extended to 2021–2022. The most modern publications devoted to applications of the Delphi methodology in the selection of QIs for treatment of men with PCa were identified. Results. The scientific literature describes in detail how to adapt the Delphi technique to choose the QIs for PCa. 20 QIs for active surveillance of patients with low-risk PCa (the draft version) and 23 QIs for treatment of patients with metastatic PCa were identified. The use of the modified Delphi technique resulted to certain consensus among experts leading to better understanding of QIs for PCa care. Conclusion. The Delphi method is a valid tool for analyzing the points of view of specialists and reaching a consensus on the considered options for solving complex problems. With the consistent improvement of oncourological practice, updating of clinical guidelines for PCa, it is feasible to revise and improve the list of the key QIs for PCa care.

INTRODUCTION In the last decade, there has been a «breakthrough» development of scientific approaches to the assay of genomic and immune factors underlying anti-cancer treatment efficiency. The choice of antitumor therapy in practice is increasingly determined by molecular signatures, and not only by the specificity of organ tumor originated from (or by the histological properties of the tumor). An urgent and important scientific and practical task is to study the successful experience of organizing Centers for Personalized Cancer Treatment (CPCT). AIM analysis of the 10-year experience of the Clinical Center for Personalized Cancer Treatment in the Netherlands. MATERIALS AND METHODS Data were extracted from the internet databases using keywords: personalized cancer therapy / treatment, cancer, targeted therapy etc.Results. The Center's research project collects data on patients with metastatic cancer who are eligible for anticancer treatment as part of standard practice. The system accumulates various information about tumor DNA, mutations and abnormalities in DNA, treatment results (outcomes), as well as other important clinical characteristics, including individual tumor process. Registered parameters are stored in a digital database and are available for scientific research. DISCUSSION AND CONCLUSIONS CPCT consider the possibilities for the more in-depth genomic analysis of patient DNA (including non-tumor DNA) in the future in order to improve the medical decision making regarding early diagnosis and personalized choice of anticancer therapies. Rapid progress will lead to the emergence of more advanced methods for re-evaluating biological samples accumulated in biobanks, that will facilitate the understanding the pillars of personalized anti-cancer treatment approaches as well as create an additional bases for the new drug development.

Background. The growing number of patients with prostate cancer (PCa) imposes additional requirements on the quality control system in healthcare, including ensuring the widespread availability of innovative algorithms for early diagnosis and treatment. One illustrative example of quality management initiatives is national PCa audit in the UK. Objective. Highlighting the approaches to quality assessments within audit of PCa care in the UK. Materials and methods . The relevant scientific data have been retrieved from Google and PubMed. The search horizon covered the last 10 years. The queries included such wording as: "prostate cancer" AND "audit" OR/AND "Great Britain" AND "quality assurance", etc. Results. At least four basic parameters were used as signal indicators to check the consistency and overall quality of the collected data on PCa patients in England and Wales. The fundamental arrangement of clinical quality indicators for PCa care comprised not less than fourteen measures. The outliers for some indicators were allocated into two groups using such criteria as: 1) more than three standard deviations from the national average (definition of an alarm); 2) more than two but below three standard deviations from the national average (definition of an alert). The outlier policy is usually applied for three treatment outcome performance indicators. Conclusion. The multidisciplinary teams must actively collaborate to provide the best standards of cancer care to the community. The introduction of multicriterial assessments to monitor the performance of highly specialized professional groups would bring a great benefit for cancer patients, particularly, through increasing the affordability of state-of-the-art medical algorithms across the counties.

INTRODUCTION:The radiation therapy (RT) plays a tremendous role in the consistent treatment of prostate cancer (PCa). The research ideas underpinning the wide implementation of innovative digitalized continuous (nonstop) dynamic auditing are coming true. Simultaneously, there are increasing challenges in selection of RT quality indicators.OBJECTIVE:to study the pivotal indicators for RT quality assurance in treatment of PCa and to highlight the breaking through developments securing the delivery of top-quality cancer care in radiation oncology units.MATERIALS AND METHODS:The literature search was performed in the PubMed database and the Google system. The inquiries included such terms as: "quality of care", "quality assessment criteria", "indicators", "prostate cancer" and "radiation therapy". A logical and semantic approaches were applicated to select the relevant scientific resources.RESULTS:In most relevant studies, the variations of the Delphi technique are used to choose the quality assessment criteria. The targeted research papers describe the development of QIs for assessing the quality of radiation therapy in patients with locally advanced PCa; a hierarchical list of QIs has been generated. The adequate registration of information has huge impact on quality assessment to draw the definitive thorough conclusions.DISCUSSION:The further improvement of Delphi technique may form one of pillars for the development of valuable RT quality measures. Considering the math aspects and the physical nature of RT, it seems being important to include the key opinion leaders in the field of clinical oncoinformatics, radiation informatics, and specialists from technical industries in the expert committees for the selection of RT QIs.

Background. Acne occurs in at least 85 % of male and female teenagers, often lasts a long time, with relapses in the 3rd and 4th decades of life. Since 2000, the technology of photodynamic therapy (PDT) has been actively used in many countries. Over the past two years, numerous important studies on the effectiveness of PDT for the treatment of acne have been conducted.Aim. To generalize most recent information on the effects of PDT and to show its applicability in clinicalpractice.Methods. The data search and analysis were carried out using the US National Library of Medicine (PubMed database) and E-library online resources. The study included original articles published over the past two years and devoted to or related to the use of PDT for the treatment of acne vulgaris.Results. A total of 55 articles were discovered. A total of 9 clinical trials or descriptions of clinical cases meeting the criteria for analysis were selected. The investigated clinical studies used various and ambiguous, non-standardized approaches in terms of photosensitizer incubation periods, cumulative doses of the light source energy and the number of treatment sessions. An analysis of the publications revealed a trend to use shorter incubation periods and less active photosensitizers in order to reduce the risk of such adverse events as erythema, edema, hyperpigmentation and blistering.Discussion and conclusions. PDT is an effective and promising medical technology for the treatment of acne. PDT can be used for mild and severe inflammatory and cystic acne in patients with various skin types and lesion localizations. This type of acne therapy is currently performed using various approaches. Further research is needed to develop optimal and standard procedures for implementing this relevant and clinically beneficial medical technology.

Background . To retain guarantees for the provision of quality medical services in oncology, optimal tools of the system for monitoring medical activities are required to be further introduced in real practice. Analysis of the results of the selection of the most valid criteria for assessing the quality of medical activity is of significant scientific interest and contributes to the improvement of the organization of medical care. The work aimed to review the international literature on the identification of control criteria for the quality of cancer care. Materials and methods . The international experience is analyzed based on reliable sources of information obtained through the application of queries on the topic under study in the PubMed (Medline) database and Google search engine. Additional key phrases were used as and when required. About 45 of the most relevant information sources were selected. Results . Various criteria for the quality and safety of medical activity in oncology are presented. Some general (universal) criteria for assessing the quality of medical activity, specific to individual nosologies, have been identified. The advanced international experience in the classification and identification of key quality criteria used in oncology in patients with the most frequently diagnosed cancer types in Russia has been generalized. The standardization and validation of new quality assessment criteria are priorities for subsequent scientific development. Discussion and conclusions . During standardization, there has been a tendency to determine comprehensive parametric criteria for assessing quality and covering the entire scope of interdisciplinary medical care. To further improve the scientific and methodological support of control, it is advisable to develop medical methodologies for conducting clinical audits for various types of malignant neoplasms (ICD10: S00–96), considering specific indicators and requirements of regional healthcare system. The selection of the optimal, most valid, and informative indicators of the quality of medical activity and the establishment of digital standards for the quality of services are becoming an integral aspect of the general processes of improving clinical audit tools in oncological institutions.

Lung cancer is leading cause of death across oncological diseases. Nowadays, the therapy of lung cancer remains most serious problem of oncology. Targeted therapy including tyrosine kinase inhibitors (TKIs) is widely used in current clinical practice to treat advanced or metastatic non-small cell lung cancer. This paper reviews the clinical aspects of TKIs application in practical medicine. The article summarizes the results and outcomes of key clinical trials focused on efficiency and safety of TKIs, describes the results of analysis for TKIs need within the Moscow City Department of Healthcare system providing preferential medicines. The perspectives of future clinical developments of targeted treatments for lung cancer are postulated and discussed as well. Our previously unpublished data clearly demonstrate that gefitinib, erlotinib and afatinib turned out to be the most used TKIs for treatment of non-small cell lung cancer in the system of preferential medicine supply for Moscow population in 2018. The choice of targeted drugs directly depends on the molecular genetic profile of the tumor. To further improve the use of financial resources of the Moscow City Department of Healthcare it is essential to define accurately the molecular profile of the tumor specimens and prescribe the most effective TKIs for each individual case of lung cancer.