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OBJECTIVE: Clinical and economic evaluation of using the dapagliflozin in addition to standard therapy for patients with CHF (Chronic Heart Failure) and concomitant type 2 DM (Diabetes mellitus).MATERIALS AND METHODS: All adult Russian patients with confirmed diagnosis of CVD and concomitant type 2 DM were considered as the target population. We evaluated the use of dapagliflozin in addition to standard therapy in comorbid patients with CHF and DM type 2 on the indicators of CC death, death from any cause of hospitalization due to CHF, emergency treatment due to CHF, as well as calculated the cost per life year saved and quality-adjusted life year (QALY) saved both when using standard therapy alone and in combination with dapagliflozin.RESULTS: The use of dapagliflozin in addition to standard therapy for the treatment of comorbid patients with CHF and DM 2 per cohort of 1,000 people will prevent an additional 1,3 and 10 years:CHD-related hospitalizations: 40, 99, 195, respectively;Emergency admissions due to CVD: 15, 38, 73 respectively;CC deaths: 9, 19, 25 respectively;Deaths from any cause: 10, 21, 19At the same time, the costs per one year of quality-adjusted life saved were 1,923,509 rubles during the first year, 1,102,680 rubles during the first 3 years, and 560,841 rubles for 10 years, which did not exceed the calculated value of the willingness-to-pay threshold — 3.14 million rubles, and allowed us to conclude that dapagliflozin is clinico-economically feasible in the studied patient population.CONCLUSION: The use of dapagliflozin in addition to standard therapy for the treatment of comorbid patients with CHF and type 2 diabetes is clinically and economically feasible, considering the cost per year of life saved, adjusted for quality of life.

Aim. To assess the outcomes of combination therapy with rivaroxaban and acetylsalicylic acid (ASA) in patients with stable coronary artery disease (CAD) and a high risk of thrombotic events on the set targets of Ministry of Health for reduction of cardiovascular mortality in Russia.Material and methods. The development of the model for analysis in MS Excel included the following stages: calculation of the population of patients with stable CAD who can be treated with combination therapy (rivaroxaban and ASA); calculation of the number of deaths due to cardiovascular disease (CVD), number of strokes and myocardial infarction (MI) in the current scenario (patients receive monotherapy with ASA) and simulated scenario (some patients switch from monotherapy to combination therapy); estimation the impact of the number of avoided cases of deaths due to combination therapy on set target for reducing CVD mortality in 2024 year; sensitivity analysis to assess the sustainability of outcomes.Results. Total number of eligible patients for combination therapy was estimated as 1.08 million patients. Based on the simulation results, it was determined that with the reallocation of patients from monotherapy with ASA to combination therapy with rivaroxaban and ASA, the number of avoided deaths in 2022 will be 973 cases, in 2023 – 1,622 cases, in 2024 – 3,245 cases, which will make it possible to reach 6.7%, 7.4% and 11.1% of the set target for reduction of mortality from CVD in the respective years. In addition, the gradual reallocation of patients from monotherapy to combination therapy might decrease the cases of stroke and MI in 973 and 649 cases by 2022, 1,622 and 1,082 cases by 2023, and 3 245 and 2 163 cases by 2024 year, respectively. Sensitivity analysis showed that outcomes are sustainable.Conclusion. The use of combination therapy of rivaroxaban and ASA in patients with stable CAD and high thrombotic risk will allow to achieve up to 11.1% of the set target for reduction of mortality from CVD by 2024 in Russia and can also potentially impact on another set target for reduction mortality from cerebrovascular diseases by reducing the number of strokes. Thereby, this therapy can be considered for drug provision programmes for patients with stable CAD and high thrombotic risk to fulfill the goals to reduce mortality from CVD.

Clinical guidelines have long been one of the working tools of the modern doctor, helping him quickly navigate the most effective proven methods of treatment and prevention of various diseases, and also to adapt these methods to the specific tasks of their patients and to achieve maximum personalization of treatment. Clinical practice guidelines are drawn up by professional non-profit associations and are approved by the Scientific Council of the Ministry of Health of the Russian Federation, while often one recommendation is prepared by two or even three associations. The peculiarity of the recommendations offered to your attention is that not only endocrinologists, but also therapists, cardiologists, gynecologists, gastroenterologists, and experts of many other specialties are involved in the prevention and treatment of obesity. The Multidisciplinary Working Group presents this a project in a multidisciplinary journal to bring together the efforts of several professional associations that associated with the need to pay attention not only to obesity itself but also to comorbid conditions. We are looking forward to constructive criticism and a comprehensive discussion of the problem on the pages of our journal.

The development of globalization processes requires the provision of scientific and technological leadership of economies. In solving this goal, universities are called upon to play a special role, which can ensure the competitiveness of engineering education. Among the main indicators of academic leadership are ensuring the world level of training content, increasing academic mobility, growing demand and efficiency of master's and postgraduate studies, increase in the number of online educational programs, increase in the number of competitive courses and programs taught online, development of a targeted training system. The key condition for increasing the competitiveness of engineering education is the strengthening of its integration with science and the industrial sector. This is due to the possibility of solving a set of tasks for the development of content, organization and management of the educational process. The effectiveness of their solution is determined by the composition of partners involved in joint activities. The analysis shows that there are trends in the expansion of partnerships and the intensification of international cooperation. This facilitates the development of various formats of interaction to improve the training of engineers. Among the most developing integrated forms of training are networked educational programs. A distinctive feature of their implementation is the growth in the number of participants in network partnerships, among them are universities (as a rule more than one), industry institutes, enterprises (more than one). The network format is being implemented and remains promising in the organization of student practices. The basic departments created at enterprises are the main instrument of targeted training. With the development of the system of professional standards, the role of integration of universities with enterprises in organizing and conducting procedures for assessing the qualifications of personnel has increased. The need to solve the problem of increasing the global competitiveness of education reinforces the requirement to develop the integration of universities with academic science in the form of scientific and educational centers, with foreign universities, enterprises and high-tech businesses.

Current guidelines for the management of patients with dyslipidemia define low-density lipoprotein cholesterol (LDL-C) as the primary target in addressing lipid-lowering therapy. The target level of LDL-C in real clinical practice is achieved in no more than a third of patients who have undergone a coronary event and receive high-intensity lipid-lowering therapy. Achieving the goals of lipid-lowering therapy in a significant proportion of patients with atherosclerotic cardiovascular diseases (ACVD) is impossible with the use of even high doses of statins, which requires its enhancement by other drugs. The article considers the place of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in the prevention of cardiovascular diseases in patients with ACVD in accordance with the latest Russian and international guidelines. A modern decision-making algorithm for the initiation of PCSK9 inhibitors therapy in patients with ACVD is presented. The authors provide a clear understanding about the patient populations that will benefit most from the taking of PCSK9 inhibitors. Particular attention is paid to Guidelines for the management of dyslipidemias developed by European Society of Cardiology and European Atherosclerosis Society in 2019. The issues of patients provision with PCSK9 inhibitors with reference to Russian conditions are described in details in accordance with the requirements for territorial programs of state guarantees. Further improvement in the provision of PCSK9 inhibitors to patients with indications for this therapy is necessary, considering the potential of these drugs in reducing cardiovascular morbidity and mortality in patients with ACVD.

Modern tactics of treatment of arterial hypertension (AH) involves the use of both monotherapy and combination therapy. Monotherapy is recommended primarily for low-risk patients with systolic blood pressure (BP)< 150 mm Hg. Monotherapy should also be preferred in very high risk patients with high normal BP and frail elderly patients. However, combination therapy is recommended for most hypertensive patients as initial therapy. Starting combination therapy is more effective in lowering BP than monotherapy. Even at low doses, it is usually more effective than maximum dose monotherapy. The most commonly prescribed combinations today contain a renin-angiotensin system blocker (angiotensin converting enzyme inhibitors or angiotensin II receptor blocker) with a calcium antagonist or diuretic. The combination of lisinopril with amlodipine not only proved its high efficiency in various international and Russian studies, but also turned out to be pharmacoeconomically more profitable. Fixed combinations of lisinopril and amlodipine are the optimal choice in the treatment of hypertensive patients, due to all the advantages of both components: higher efficacy and safety rates compared to monotherapy and better patient adherence to treatment.

The article deals with the problem of the reader and reading among the urban population, which is little studied in Russian history. Based on the analysis of the materials of the state archive of the Irkutsk region, the author characterizes the readership and the reader’s interests of certain social and professional groups of the Irkutsk population in the late XIX–early XX centuries. A distinctive feature of the Irkutsk readership is shown: the social composition of active readers of the city is revealed, the circle of the most popular domestic and foreign authors is designated, the most popular all-Russian, regional and local periodicals are marked. The obtained data can help to characterize the mechanism of influence of reading on the formation of socio-political views, moral education and artistic tastes of Irkutsk residents

Modern world integration processes lead to an increase in demand for engineers with international level competences. This requires the improvement of continuous training. Pre-university engineering training is considered as a stage of applicants’ orientation to engineering education and their adaptation to the complex educational process at university. This can be achieved by improving the content of education and including the technological, applied research and special linguistic components. The main directions of the content of the pre-university training are variable and have to be determined according to the tendencies of high-tech industries’ integration into the international technological space. An important factor is the implementation of training in an international multi-partner scientific and educational environment, which involves the international production companies, international profile network associations and the international academic community in the educational process. This allows implementing effective forms of training, including the work in real research teams, networked educational programs, the use of virtual platforms and simulators. The Tatarstan Republic has innovative practical experience of pre-university engineering education of schoolchildren oriented to the needs of the regional oil and gas chemical complex. In this regard, Kazan National Research Technological University (KNRTU) implements pre-university training on the basis of the lyceum with advanced curriculum in Chemistry. Such training is organ-ized with the participation of regional partners of the Danish Corporation “Haldor Topsoe” and the European Chemistry Thematic Network Association (ECTNA). Pre-university engineering training develops shoolchildren’s motivation for engineering education, has a professionally specified character of training and also comprises the changes in the content of the engineers’ future professional activity.

Aim. To evaluate the therapeutic equivalence between generic perindopril (Parnavel, LLC Ozone, Russia) and the original perindopril (Prestarium A, Laboratories Servier, France). Material and methods. Patients with arterial hypertension, grade 1-2 (n=40, aged 35-75 years) were included into the open randomized cross-over trial. The previous anti- hypertensive therapy was discontinued before study for 14 days in all patients. Each of the patients was randomized for alternate 8-week treatment with the original (Prestarium A) and generic (Parnavel) perindopril. Treatment efficacy was assessed by the achievement of target blood pressure (BP) Results. A significant reduction in systolic (SBP) and diastolic BP (DBP) was found in patients of Parnavel group by 28 mm Hg (19%) and 17 mm Hg (19%), respectively. In the patients of Prestarium A group SBP and DBP reduction was 27 mm Hg (18.5%) and 16 mm Hg (18.7%), respectively. After 2 months of therapy the target BP level (Conclusion. Efficacy and tolerability data demonstrated therapeutic equivalence of generic perindopril (Parnavel) to the original perindopril.