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The concept of a student scientific circle as a form of tutor training is presented. The history of the circle movement in Russian universities of imperial Russia is analyzed, starting with the circle organized by Professor Schwartz in 1781 and continued in the Soviet Union. The data on the state support of students research work in the post-war period, including state documents of title and measures of financial support, are presented. The traditional student scientific circle is a circle of those wishing to educate themselves in addition to the planned curriculum, by conducting their own research and publishing the results. As a result, an activity-level specialist is formed from a graduate of the circle. In contrast to the traditional one, the tutor-type training circle forms the circle member as a future specialist not only at the activity level, but also at the project and, preferably, conceptual levels. Methodologically, the task of a tutor-type training circle is not only to teach the circle members the practical skills of conducting scientific research, but, first of all, in personalized work to achieve anthropological goals, to create a reasonable, creative, effective personality who can create, plan and design. In the conditions of the rapid development of modern science, the construction of the future is proceeding at a rapid pace and is associated with the active implementation of the results of scientific experiments in all aspects of human life, which requires active suppression of everyday consciousness. At the same time, due to the risk of a landslide dehumanization, the circle member, as a scientist, needs to lay down humanitarian values that define the individual as a person who shares the ideals of goodness and justice. Thus, the student scientific circle is a system in which a new generation of honest and effective scientists and high class specialists is formed under the guidance of a tutor.

A447Objectives: Acromegaly is a rare, chronic, hormonal disorder caused by excessive growth hormone (GH) and insulin-like growth factor 1 (IGF-1) production resulting predominantly from pituitary adenoma. The objective was to test endocrinologist acceptability of the newly developed SAGIT tool in clinical practice. MethOds: SAGIT (Signs and symptoms -Associated comorbidities -GH concentration level -IGF-1 -Tumour) is a Clinician-Reported Outcomes (ClinROs) tool developed with international experts in acromegaly; it allows patient classification and description in a standardised manner. The tool was pre-tested for acceptability, understanding and ease of use with practicing endocrinologists in France, Germany, UK, Spain, Italy and Brazil (n= 2 per country) using the PRAgmatic Content and face validity Test (PRAC-Test). The endocrinologists completed the SAGIT tool prior to and following an intervention (therapeutics or surgery) for three patients each (n= 36). Once completed, a one-hour phone interview was conducted with each endocrinologist to collect their feedback on the tool. Results: The tool was well accepted and deemed concise (n= 11) and informative (n= 10) by the endocrinologists. Several points were raised that illustrate its usefulness in clinical practice, including the removal of the subjectivity when assessing the disease severity, the possibility of rapid evaluation of the control/progression of acromegaly or of a treatment response, and the possibility for standardisation across countries. Key recommendations for improvements were the need to include: 1) instructions to facilitate the understanding and the use of the tool; 2) definitions of rules and recommendations for patient management; and 3) addition of other signs and symptoms and further details about tumour size to better reflect their clinical cases. cOnclusiOns: SAGIT is a useful tool for endocrinologists to accurately stage and classify acromegaly patients in clinical practice. It is currently being piloted in a cross-sectional study. Validation of scoring rules will confirm the utility of the tool to improve patient management.

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Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes (POEMS) syndrome is a rare paraneoplastic syndrome associated with Castleman disease, monoclonal gammopathy of undetermined significance, symptomatic hemoblastosis or systemic autoimmune diseases. Slow development, nonspecifity of most clinical manifestations and lack of awareness of physicians are the main reasons for the late access to medical care and a long, sometimes many years, diagnostic search. Even after diagnosis, the use of modern methods of immunosuppressive, immunomodulating or antitumor therapy is significantly limited by the difficulties of taxonomic classification of the diagnosis, the lack of unified therapeutic approaches, and related unresolved issues of profiling and drug provision of patients. The article provides an overview of the basic information about the pathogenesis and clinical manifestations of POEMS syndrome. Using the example of a patient with Castleman’s disease, the difficulties of primary diagnosis of POEMS syndrome and the problems of interdisciplinary interaction of doctors of various specialties are demonstrated. The significance of endocrine disorders in the diagnosis and treatment planning is analyzed.

The results of evaluating the effectiveness of the use of an angiotensin receptor-neprilysin inhibitor (valsartan / sacubitrile) in addition to standard therapy in comorbid patients suffering from chronic heart failure and chronic obstructive pulmonary disease are presented. It was revealed that the combination of valsartan / sacubitrile has a more pronounced therapeutic effect than the separate use of valsartan. At the same time, the level of the N-terminal cerebral natriuretic peptide decreases, especially in patients with a left ventricular ejection fraction of less than 40%, which indicates the effect on the pathogenetic mechanisms associated with the formation and progression of chronic heart failure. The effectiveness of the recommended combination of valsartan / sakubitrile is confirmed by a significant increase in the ejection fraction of the left ventricle of patients suffering from chronic heart failure, which significantly affects the increase in exercise tolerance and improving the quality of life. Improving the quality of life is confirmed by the positive dynamics of the «symptoms», «activity» blocks of the questionnaire for patients suffering from respiratory diseases, St. George’s hospital and «mobility», «usual daily activities» of the quality of life questionnaire, which also shows the advantage of using valsartan / sakubitril and increases patient commitment to prescribed therapy. A decrease in the cavity of the left atrium and a decrease in pressure in the pulmonary artery indicates not only an improvement in the function of the left chambers of the heart, but also of the right ventricle.

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