[The actual issues of improvement of organization of screening of skin neoplasms in out-patient conditions].

The skin malignant neoplasms constitute one of significant problems of public health. The increasing of morbidity and mortality of melanoma and other types of skin cancers is registered. The early detection of disease assures mortality decreasing and increases survival of patients. The purpose of the study is to develop optimal model of organizational and preventive measures of early diagnostic of malignant skin tumors. The comprehensive study was carried out, which included assessment of survey of patients using questionnaire "Melanoma Diagnosis Day". Also it included identification of level of awareness of physicians about screening, medical records of patients during COVID-19 pandemic, risk groups identification and effectiveness of selecting patient for screening. The total number of observations is 21 581. The selective and continuous observation method was applied and parametric and non-parametric methods as well. The study determined that during COVID-19 pandemic in 2020, there was significant reliable uncompensated decrease in the number of patients with diagnosis of ICD D23, L82, C44 and decrease in the number of detected diseases. The melanoma, basalioma and other skin malignant neoplasms are reliably more common in patients of medium-high risk group, aged 60 years and older and in persons sunburned at the age of 18 years. The assignation of separate specialist to diagnose skin neoplasms allows statistically reliably increase rate of morphological confirmation of malignant neoplasms as compared to common reception by dermatologist. The sociological survey of physicians revealed statistically reliable difference in knowledge between dermatovenereologists, oncologists and physicians of other specialties concerning screening issues. The results of the study permitted to develop complex of organizational measures to improve screening. The model of organizational and preventive measures for early diagnostic of skin malignant tumors in outpatient conditions was proposed.

[Association of polyunsaturated fatty acids treatment with coronary mortality. A meta-analysis].

AIM: A meta-analysis was undertaken to sum up data on long-chain polyunsaturated fatty acids treatment and coronary deaths. METHODS: Only studies with no less than 500 participants and length of follow-up no less than one year were included. Total number of studies was 13 with 127455 participants. RESULTS: Fixed factor (Peto) model demonstrated significant decrease in cardiac deaths in polyunsaturated fatty acids -treated group. (OR=0,89, 95%CI: 0,83-0,95, р=0,001). Random factor model confidence interval also does not included one (OR=0,88, 95%CI: 0,80-0,97, p=0.008). Subgroup analysis of studies that used therapy with 460 mg eicosapentaenoic acid and 380 docosahexaenoic acid per day demonstrated significant reduction in cardiac deaths (OR=0,84, 95%CI: 0,77-0,92) in both fixed factor and random factor models. CONCLUSION: Correspondingly supplementation with polyunsaturated fatty acids associated with lower coronary mortality.

[Use of Highly Concentrated Polyunsaturated Fatty Acids for Prevention of Complications After Myocardial Infarction. Cost-Utility Analysis].

Use of highly concentrated ethyl esters of polyunsaturated fatty acids after myocardial infarction (MI) and in patients with heart failure was associated with lower mortality. The goal of this analysis was to perform cost-utility analysis of the use of highly concentrated ethyl esters of polyunsaturated fatty acids after MI (with help of a Markov model) and to find whether its use in some group of patients led to decrease in budget costs. As a result, we have shown that use of highly concentrated ethyl esters of polyunsaturated fatty acids after MI leads to increase in quality-adjusted life expectancy on 0.5 QALY, with incremental cost-effectiveness ratio of 105 thousand rubles per QALY, and net monetary benefit of 780.5 thousand rubles. In the patient subpopulation that receives highly concentrated ethyl esters of polyunsaturated fatty acids for arrhythmia prevention after coronary artery bypass the estimated decrease of budget cost varies between 6 and 50% depending on denominator used.