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1.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 28(Special Issue): 1118-1122, 2020 Oct.
Artículo en Ruso | MEDLINE | ID: mdl-33219768

RESUMEN

The article presents a review of the historical facts related to the discovery and introduction of chloroquine and hydroxychloroquine. The history of studying aminoquinoline preparations is associated with the discovery of the antimalarial action of the bark of the quinine tree, the isolation of quinine from other active substances - alkaloids and the determination of their structure. The structural similarity of quinine and one of the first chemically synthesized dyes - methylene blue-was an important factor at the beginning of the synthesis of molecules with antimalarial activity in the 1930s in Germany. Pamaquin (plasmoquin, plasmoсid), quinacrine (quinacrine, Atebrin, Mepacrine), sontoquine (sontochin), chloroquine, primaquine, hydroxychloroquine, and mefloquine (Lariam) were consistently introduced in medical practice. Many of these medications are no longer widely used. However, chloroquine and hydroxychloroquine have not lost their relevance. The scope of their use has been expanded.


Asunto(s)
Antimaláricos , Cinchona , Cloroquina , Corteza de la Planta , Quinina
2.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 28(Special Issue): 1154-1161, 2020 Oct.
Artículo en Ruso | MEDLINE | ID: mdl-33219773

RESUMEN

Evaluate the cost-effectiveness of various options for the supply of direct antiviral agents for patients with chronic viral hepatitis C. An analysis of the data of Moscow Department of Health on the drug supply of patients with chronic hepatitis C antiviral drugs at the expense of budgetary funds in Moscow was carried out. The direct medical costs of the urban healthcare system for the use of direct antiviral action drugs for the period from 2017 to 2019 were calculated. For the period from 2017 to 2019, 6,936 patients with chronic hepatitis C received medication with antiviral drugs at the expense of budget funds in Moscow. An increase in the number of patients compared to the base (2017) year was noted by 76%, as well as an increase in the volume of interferon-free antiviral therapy sets against the background of an increase in budget expenditures by 212%. The average level of cost for all sets with direct antiviral drugs amounted to 689,844 rub. The most commonly used set is Dac + Asu. The average cost of this set per patient treated as part of the first-line antiviral therapy was 58,899 rub. cheaper than a set of 3D, and 58,861 rub. more expensive than the Grz/Elb set, while the need for retreatment for the Dac + Asu set was 8.4%, and for the 3D, Grz/Elb and Gle/Pib sets, 0.58%, 0% and 0%, respectively. An even greater excess of the average was recorded for the Sof + Dac, Sof + Sim sets: which naturally entailed the excess of the costs of treating one patient with this distribution of treatment sets and financial resources by 253,236 rub. and 189,173 rub., respectively, which is 1.36 and 1, 27 times the average cost of all prices for antiviral treatment sets. Most often, re-medication was provided to patients who were initially provided with Sof set (33%), followed by Sim + Dac set (18.6%), 8.4% of re-medication cases were registered in patients who received Dac + Asu set as the first line of therapy. Budget costs for the second and subsequent sets of therapy increased by 92,739,115.30 rub.


Asunto(s)
Antivirales , Hepatitis C Crónica , Hepatitis C , Quimioterapia Combinada , Hepacivirus , Hepatitis C/tratamiento farmacológico , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C Crónica/epidemiología , Humanos , Moscú
3.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 28(Special Issue): 1168-1175, 2020 Oct.
Artículo en Ruso | MEDLINE | ID: mdl-33219775

RESUMEN

This article presents the results obtained during the analysis of different types of health technology assessment (HTA). In the world HTA agencies can be organized at the national (federal), regional or local levels; they can have various levels of dependence on public authorities (independent, public, dependent), various sources of financing (state, mixed). The nature of the tasks and the range of powers of the institutions for HTA differ: regulatory, organizational or advisory. They themselves can initiate HTA (proactive), or they can conduct HTA at the suggestion of the applicants and analyze the quality of the HTA reports provided (reactively). HTA can be focused on economic assessment, comparative clinical assessment, as well as balanced, both on economic and comparative clinical assessments. HTA may be conducted on drugs, medical devices, and other medical technologies. The methods for conducting HTA significantly depend on its subject. In terms of the scope of the assessment, it is possible to single out full OMT, mini-OMT and express-OMT, as well as fast-track-OMT, proposed by the HTA agency in the UK. The final users of HTA (administration, suppliers, patients) and its perceptions (instrumental, conceptual, or formal) are specified. The impact of HTA on decision-making is progressively increasing, as the number of medical technologies that should be assessed to maintain budget discipline is increasing. The versatility of HTA indicates its universality and can contribute to the further expansion of its application at various levels of medical care around the world.


Asunto(s)
Evaluación de la Tecnología Biomédica , Análisis Costo-Beneficio , Humanos
4.
Mol Biol (Mosk) ; 51(4): 622-628, 2017.
Artículo en Ruso | MEDLINE | ID: mdl-28900080

RESUMEN

Malignant cell transformation is accompanied with abnormal DNA methylation, such as the hypermethylation of certain gene promoters and hypomethylation of retrotransposons. In particular, the hypomethylation of the human-specific family of LINE-1 retrotransposons was observed in lung cancer tissues. It is also known that the circulating DNA (cirDNA) of blood plasma and cell-surface-bound circulating DNA (csb-cirDNA) of cancer patients accumulate tumor-specific aberrantly methylated DNA fragments, which are currently considered to be valuable cancer markers. This work compares LINE-1 retrotransposon methylation patterns in cirDNA of 16 lung cancer patients before and after treatment. CirDNA was isolated from blood plasma, and csb-cirDNA fractions were obtained by successive elution with EDTA-containing phosphate buffered saline and trypsin. Concentrations of methylated LINE-1 region 1 copies (LINE-1-met) were assayed by real-time methylation-specific PCR. LINE-1 methylation levels were normalized to the concentration of LINE-1 region 2, which was independent of the methylation status (LINE-1-Ind). The concentrations of LINE-1-met and LINE-1-Ind in csb-cirDNA of lung cancer patients exhibited correlations before treatment (r = 0.54), after chemotherapy (r = 0.72), and after surgery (r = 0.83) (P < 0.05, Spearman rank test). In the total group of patients, the level of LINE-1 methylation (determined as the LINE-1-met/LINE-1-Ind ratio) was shown to increase significantly during the follow-up after chemotherapy (P < 0.05, paired t test) and after surgery compared to the level of methylation before treatment (P < 0.05, paired t test). The revealed association between the level of LINE-1 methylation and the effect of antitumor therapy was more pronounced in squamous cell lung cancer than in adenocarcinoma (P < 0.05 and P > 0.05, respectively). These results suggest a need for the further investigation of dynamic changes in levels of LINE-1 methylation depending on the antitumor therapy.


Asunto(s)
Adenocarcinoma/genética , Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/genética , Metilación de ADN , Regulación Neoplásica de la Expresión Génica , Elementos de Nucleótido Esparcido Largo , Neoplasias Pulmonares/genética , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Adenocarcinoma del Pulmón , Anciano , Antineoplásicos/uso terapéutico , Biomarcadores de Tumor/sangre , Carboplatino/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/cirugía , Transformación Celular Neoplásica/genética , Transformación Celular Neoplásica/metabolismo , Transformación Celular Neoplásica/patología , ADN de Neoplasias/sangre , ADN de Neoplasias/genética , Femenino , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Paclitaxel/uso terapéutico , Análisis de Supervivencia , Resultado del Tratamiento
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