The article analyzes the domestic experience of using digital technologies in the practice of external and internal state financial control. The prospective developments planned for implementation in the activities of control bodies, and the key problems that this sphere may face during digital transformation, as well as ways to solve them, are considered.
The availability of modern high-precision diagnostic methods increased the detection rate of pancreatic neuroendocrine neoplasia (pNEN). There is no doubt concerning the necessity of surgical treatment for localized functioning tumors, whilecurrently there is no objective way to choose the tactic for non-functioning asymptomatic neuroendocrine tumors of the pancreas (pNET) with the exception of the tumor size.Treatment tactics for non-functioning asymptomatic T1 neuroendocrine tumors (less 2 cm in size) are debatable. According to literature surgical treatment for lesions less than 2 cm does not always increase survival. In the same time even in high-volume centers pancreatic surgery shows high morbidity and mortality rate. Prospective randomized trials comparing surveillance and operative treatment are not published yet, as far as authors concerned. International guidelines answer the question of treatment such neoplasms ambiguously, while national Russian recommendations do not cover the topic. Guidelines are based on heterogeneous retrospective studies; therefore, the aim of scientific research is to determine reliable criteria for patient selection for dynamic observation or surgical treatment.This article provides an overview of 60 scientific publications covering the problem.
Pancreatic fibrosis (PF) is a part of the pathogenesis in most pancreatic disorders and plays a crucial role in chronic pancreatitis development. The aim of our study was to investigate a relationship between PF grade and signs in resected pancreatic specimens, and the results of both multidetector computed tomography (MDCT) post-processing parameters and fibronectin (FN), hyaluronic acid (HA), matrix metalloproteinase (MMP)-1, and MMP-9 serum levels. The examination results of 74 patients were analyzed. The unenhanced pancreas density (UPD) value and contrast enhancement ratio (CER) showed statistically significant differences in groups with peri- and intralobular fibrosis grades, an integrative index of fibrosis, inflammation in pancreatic tissue, and pancreatic duct epithelium metaplasia, while the normalized contrast enhancement ratio in the venous phase (NCER VP) significantly differed with the perilobular fibrosis grade, integrative fibrosis index, and inflammation (p < 0.05). The blood FN level showed a weak positive correlation with the intralobular fibrosis grade (rho = 0.32, p = 0.008). The blood level of HA positively correlated with the presence of prominent and enlarged peripheral nerves (rho = 0.28, p = 0.02) and negatively correlated with the unenhanced pancreas density value (rho = −0.42, p = 0.0001). MMP-1 and MMP-9 values’ intergroup analysis and correlation did not show any statistical significance. The UPD value, NCER VP, and CER, as well as blood levels of FN and HA, could be used in non-invasive PF diagnosis.
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