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The article presents an overview of customer relationship management approaches. These approaches are associated with CRM and CMR systems. The key aspects in them are personalization and individualization in working with consumers, which provides certain advantages for catering companies, including those in hotels. As such an approach, a direction in the assortment policy is considered - a special menu «AntiJetlag», which is most relevant for the catering service of accommodation facilities. This direction of the assortment policy is analyzed on the basis of the restaurant practice of the leading hotels in Krasnodar. The purpose of the study is to identify ways to form a loyalty system through keeping records of features and consumer wishes, based on innovative solutions related to the guest relationship management system based on the special AntiJetlag menu, based on new forms of service and technological ideas. Research methods: analysis, synthesis, generalization, observation and forecasting. Results and discussion: the article focuses on the fact that it is not enough to sell an assortment position or service to guests. They must be sold correctly, based on the tastes and capabilities of the guests. This is due to the trend of personalization and individualization of the guest, which is fundamental when developing a special menu «AntiJetlag». This is how all guest preferences are clarified, including arrival from which city, time spent in flight, whether there are any contraindications in order to choose a personal diet from the AntiJetlag menu using ingredients that help alleviate jetlag symptoms. Conclusions: in order to provide the guest with the best customer service, individualization is necessary in working with him, which is the basis of a proactive service that contributes to the growth of consumer loyalty and increases the likelihood of him returning to this hotel and restaurant complex again.

Introduction. surgical treatment of patients with pelvic bone tumors, in particular periacetabular tumors, remains challenging. There are many different reconstruction options after resection of these tumors. These include allo- and autografts, megaprosthesis, saddle endoprosthesis, custom-made endoprosthesis, 3D printing endoprosthesis, and femur transposition with the formation of neo-arthrosis. However, all of them are characterized by technical complexity and high risk of postoperative complications. There is still no standard procedure for reconstruction after resection of malignant periacetabular tumors. To date, modular endoprosthesis is a well-established reconstructive device in orthopaedic oncology to manage wide bone resections. Modular systems provide patient-specific endoprostheses that could be modified during surgery. In this article, we present the results of modular acetabular endoprostheses in the treatment of patients with periacetabular tumors.Material and Methods. From 2011 to 2018, 30 patients underwent modular endoprosthetic reconstruction after periacetabular resection. There were 13 (43 %) male and 17 (57 %) female patients aged from 23 to 63 years (median age 45 years). Primary malignant bone tumors were detected in 19 (63 %) patients, giant cell tumor in 5 (17 %), local soft tissue sarcoma in 1 (3 %), solitary metastases of kidney cancer in 2 (7 %) and recurrent sarcoma after previous surgical treatment in 3 (10 %) patients.Results. The average duration of surgery was 310 minutes (range: 145-520 minutes), blood loss was 5520 ml (range: 600-20000 ml). The median follow-up time was 36 months. Histological examination revealed a positive resection margin in 3 (10 %) patients. At a follow-up from 6 to 40 months, disease progression was detected in 10 (33 %) patients. Eight (27 %) patients died on disease progression. Complications of various types were diagnosed in 11 (37 %) patients. Infectious complications were the most common (30 % of patients). The average value of the functional assessment by the MSTS scale was 59 % (15-82%).Conclusion. Modular endoprosthetic replacement for tumors of the acetabulum and hip joint is a promising surgical technique allowing adequate functional results to be achieved.

There are various methods of restoring the integrity of the pelvic ring, after surgery in patients with tumor lesions of the pelvic bones, allowing to keep the limb with good oncological and functional results. A new stage in the development of organ conservation treatment in this group of patients is the use of modular endoprostheses based on the conical leg. The development of postoperative complications leads to an unsatisfactory result of treatment, despite the radical surgery and technically correct endoprosthesis. This, in turn, leads to repeated surgical interventions, namely to remove metal structures, or to perform a crippling operation.Purpose. To analyze postoperative complications and methods of their treatment in patients after modular endoprosthesis replacement of the acetabulum.Patients and methods. From 2011 to 2018, surgical treatment of endoprosthesis using modular metal structures based on a conical leg was performed in 30 patients. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary malignant tumors of pelvic bones were in 19 (63%) patients, 5 (17%) had a giant cell tumor. Two (7%) patients had solitary metastases of kidney cancer and one (3%) with synovial sarcoma, and 3 (7%) had relapses after previous surgical treatment.Results. The average follow-up period was 36 months. Progression of the disease in terms of 6 to 40 months was revealed in 10 patients (33%), 8 (27%) of which died, the remaining 22 (67%) are alive with no signs of progression. In the postoperative period, 11 (37%) patients developed complications with predominance (up to 30%) of infectious. The average functional result on the MSTS scale was 59%.Conclusion. The use of modular prostheses on the basis of a conical leg in patients with tumors of the pelvic bones allow to perform safe operations with a satisfactory functional and oncological result. The result obtained in our study is comparable with the data of world literature.

Surgical treatment of patients with tumoral defeat of pelvic bones, of preacetabular region, in particular, is one of the most challenging topics of modern oncorthopedics. Currently, one of the most modern methods of reconstruction of the pelvic bones is the use of modular endoprostheses based on the conical leg, the advantage of which is the ability to intraoperatively simulate an endoprosthesis that best meets the specific clinical situation. Purpose of research. To assess the benefits of modular endoprosthesis of the acetabulum in patients with tumoral defeat periacetabular region.Patients and methods. Within the period of 2011–2018 30 patients underwent surgical treatment in form of periacetabular resection with a modular endoprosthesis reconstruction in P.Hertsen Moscow Oncology Research Institute – Branch of National Medical Research Radiological Centre of Ministry of Health of Russian Federation. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary bone cancers were in 19 (63%) patients, giant cell tumors in 5 (17%), locally advanced soft tissue sarcoma in 1 (3%), solitary metastases of kidney cancer in 2 (7%), and recurrent sarcomas after previous surgical treatment in 3 (10%) patients.Results. The average duration of the operation was 310 min (145–520 min), the volume of intraoperative blood loss was 5520 ml (600–20 000 ml). The positive edge of resection according to the results of the planned morphological study was revealed in 3 (10%) patients. The average follow-up period was 36 months (4-73 months). Disease progression in terms of 6 to 40 months was revealed in 10 (33%) patients. 8 (27%) patients from disease progression. Complications of different types were diagnosed in 11 (37%) patients, among whom infectious complications prevailed 9 (30%). The average value of the functional results on a scale MSTS accounted for 59% (15 to 82%). Conclusion. The use of modular systems of endoprosthesis replacement of the acetabulum and hip joint in tumor lesions is a promising surgical technique that allows to achieve adequate functional results with a comparable number of postoperative complications.

Purpose of the study. Evaluation of the results of surgical treatment of desmoid fibroids (DF) using reconstructive plastic surgery and determination of possible prognostic factors of relapses.Patients and methods. The results of surgical treatment of 40 patients with desmoid fibroids of extra abdominal local­ization were analyzed. In 45% of patients, the tumor was located in soft tissues of the shoulder girdle and upper limb, in 35% — on the trunk, in 20% — in soft tissues of the lower limb and in 7% of patients on the neck. The tumor size varied from 2 to 20 cm, the median was 8 ± 4.38 cm. Surgical treatment for newly diagnosed DF was performed in 22 (55%) patients, and for recurrent tumors — in 18 (45%) patients.Results. According to the planned histological study, negative resection boundaries were established in 24/40 patients (63%). In the remaining 16 cases (37%) positive resection margins were obtained: R1 in 14 patients and R2 in 2 patients. Adjuvant treatment is recommended for 14 patients with resection R1/R2. The duration of follow — up after treatment ranged from 6 to 107 months, median‑16.5 months. During follow-up, relapses were diagnosed in 14 patients (35%). No deaths have been reported.Conclusion. Surgical treatment of DF of extraabdominal localization is accompanied by a sufficiently high frequency of relapses. According to the results of the study, an unfavorable factor in the development of relapses is the location of the tumor in soft tissues of the shoulder girdle and upper limb.

Inter-ileal abdominal dissection (IIAD) is one of the most traumatic maiming operations, which implies removal of the lower limb with a single block with an adjacent half of the pelvic ring. Taking into account the low overall incidence of locally advanced bony and soft tissue sarcomas localized in the projection of the pelvic bone and hip joints, and a small number of clinics with sufficient experience in performing such operations, modern specialized literature has a limited number of publications on the IIAD.Purpose. Presentation of the experience in the implementation of the IIAD in patients with locally advanced sarcomas of bones and soft tissues.Patients and methods. The analysis of results of treatment of 26 patients with locally advanced sarcomas of bones and soft tissues is presented. There were 14 men (54%), women 12 (46%). Patients with primary malignant tumors of bones 23 (88%) prevailed among patients. Depending on the morphological structure, 16 (61%) had chondrosarcoma, 4 (15%) had osteosarcoma and 3 (11%) had a malignant fibrous histiocytoma. Three (11%) patients had locally advanced softtissue sarcomas. In 2 (7.5%) synovial sarcoma and in one (3.5%) malignant tumor from the shells of peripheral nerves. The primary tumor process was in 21 (81%) patients. The clinical stage was established as IIb in 14 (54%), Ib in 3 (11%), IVa 1 (3.5%) and IVb in 3 (11%) patients, respectively.Results. The average duration of the operation was 4.1 hours (2.7–6 hours). The volume of intraoperative blood loss is 3400 ml (500–9000 ml). The margin of resection was evaluated as positive in 4 (15%) patients. The recurrence of the tumor after the IIAD performed by us was in 4 (15%) patients with a negative edge of R0 resection.Conclusions. Postoperative complications were noted in 5 (19%) patients. Four (80%) had wound purulent-septic com-plications: partial flap necrosis — 2, total necrosis of the flap — 1, edge necrosis of the wound — 1 patient. The overall 5-year survival rate of patients treated in the clinic by the treatment was 40%. The results of the functional status of patients after the operation were 45% on the MSTS scale, which correlates with the data of other authors.

The incidence of primary malignant tumors of the skeleton is an average of 1.5 for men, for women – 0.9 per 100 000 population. Morphologically most common are: osteosarcoma (55-63%), chondrosarcoma (17–25%) and Ewing’s sarcoma family of tumors (8–15%). Metastatic lesions of long bones occurs 2-4 times more common than primary tumors and often are diagnosed with breast cancer in 65–73%, of prostate cancer in 56–68% and lung cancer in 30–36% of patients. World Data standard treatment for patients is a combined approach, one of the stages is a surgical treatment. In modern oncoorthopedics the standard of surgical treatment of patients with tumor lesions of bone is the conduction of segmental bone resection and oncological arthroplasty. However, just as with other surgical interventions, in arthroplasty with large joints that is associated with the introduction of foreign material into the body, there are complications which usually are infectious by nature. Complications associated with the continuous use of immunosuppressive therapy include bacterial and viral infections. It must be emphasized that in the context of immunosuppression bacterial infection is much greater and is accompanied by greater mortality than in patients without immunosuppression. The frequency of complications in patients who undergo total joint replacement after organ transplantation can be significantly reduced by the correction of metabolic disorders, the purpose of broad-spectrum antibiotics in the perioperative period and careful rehabilitation. It is necessary to work closely with the transplantologists. Also the method of using a local antibiotic administered directly to the site of surgery can be used. This method has significant advantages because of the high local concentrations with minimal risk of systemic toxicity. In this paper we present a clinical case of performing resection of the proximal humerus to the shoulder joint arthroplasty in patient on immunosuppressive therapy.

The purpose of the study: to evaluate the efficacy of surgical and combined modality treatment in patients with pelvic chondrosarcoma. Materials and methods. The study included 52 patients with pelvic chondrosarcoma. Forty-two (81 %) patients had well-differentiated and 10 (19 %) patients had poorly differentiated chondrosarcoma. Sixteen (30 %) patients underwent interiliac-abdominal resection of the pelvis and 36 (70 %) patients were treated with organ-preserving surgery. Of the patients treated with organpreserving surgery, 22 (61 %) patients underwent reconstructive surgery. The follow-up period was 45 months (range, 8 –18 months). Results. Positive resection margins were found in 8 (15 %) patients. Postoperative complications were observed in 13 (25 %) patients. The median MSTS score was 92 % (range, 62–100%) for 14 (27 %) patients, who underwent surgery without reconstruction and 67 % (range, 40–95 %) for 22 (61 %) patients, who underwent reconstructive surgery. For 16 (30 %) patients, who underwent interiliacabdominal resection of the pelvis, the median MSTS score was 45 % (range, 25–68 %). Disease progression was observed in 16 (31 %) patients. The overall 5-year survival rate was 75 % and the 5-yaer disease-free survival rate was 60 %. Conclusion. The oncology and functional outcomes are consistent with other recent studies, which indicate that organ-preserving surgery may be an appropriate approach in the treatment of patients with pelvic chondrosarcoma.

The paper presents the experience in surgical treatment of 10 patients with tumors of the sacroiliac joint. All patients underwent reconstruction of the pelvic ring with polyaxial screws and titanium rods. The mean age of the patients was 39 years (23 to 59). There were 6 (60%) patients with chondrosarcoma, 1 (10%) with fibrosarcoma, 1 (10%) with Ewing’s sarcoma, 1 (10%) with metastasis from kidney cancer and 1 (10%) with metastasis from osteosarcoma. The mean length of surgery was 4.2 hours (3 to 6). The average volume of intraoperative blood loss was 2 800 ml (1500 to 5000 ml). Microscopically positive resection margin (R1) was revealed in 2 (20 %) patients. The median follow-up was 8.5 months (2 to 40). All patients are alive with no evidence of disease progression. Postoperative complications were observed in 4 (40 %) patients. The mean Musculoskeletal Tumor Society score at last available follow-up was 70 % (62 to 92 %).

Introduction Currently the organ-preserving surgical treatment (oncological arthroplasty) may be provided in 90% of patients with malignant lesions of the long bones and large joints. Due to the development and improvement of surgical techniques, the application of new antibacterial drugs, the development of new systems of modular endoprosthesis managed to achieve a meaningful reduction of complications, such as infection, instability of the endoprosthesis, and receive good and excellent functional results after surgery, mainly in lesions of the bones of the lower extremities. The risk of complications in conducting oncoloicaly arthroplasty upper extremity is also low, but functional performance after these operations is significantly lower. Objective.To analyze and evaluate the results of applying the "Anatomical" and "Reverse" shoulder replacements in patients with neoplastic lesions of the proximal humerus.Materials and methods. Depending on the type of metal implants patients were divided into two groups. "Anatomical" implant was installed in 28 patients (13 men and 15 women) and "Reverse" prosthesis in 14 patients (6 men and 8 women). The average age was in the first group 32±4 years and the second 38±3 years, respectively. Primary bone tumors were diagnosed in 19 (68%) patients first and 12 (86%) patients of the second group.Results. The average follow-up period was 42 months. 4 patients with primary malignant bone tumors had the progression of the disease during the period from 6 to 14 months. In 2 of them they diagnosed the metastatic lung disease, in one case – the recurrence of tumor and also in one patient there was the relapse with metastases to the lungs. In the group of patients with "Anatomical" arthroplasty of the shoulder joint functional status after surgery was assessed according to the scale MSTS (Musculo-skeletal tumor standing System) in the range of 60-80 points - 3, 40-60 points - 6 and less than 40 points in 19 patients, respectively. Patients who selected "Reverse" prosthesis of functional status on a scale MSTS were in the range of from 80 to 100 points in 6 patients , 60-80 points - 6, 40-60 points - 2 patients, respectively. They marked the improvement in functional status with Reverse arthroplasty in 75% of cases.Conclusion. The use of modular "Return" implants in organ-preserving treatment of patients with neoplastic lesions of the proximal humerus, compared to the "Anatomical" arthroplasty, is a more promising technique, because it allows significantly improved functional outcome and social adaptation after surgery.

Поражение костей - одно из наиболее частых проявлений метастазирования злокачественных опухолей. Одним из патогенетических направлений борьбы с метастазами в костях является применение бисфосфонатов наряду с химио - и лучевой терапией. Это особый класс препаратов, которые ингибируют патологическую резорбцию костной ткани. Применение зометы в комплексе с противоопухолевой терапией позволяет стабилизировать состояние костной системы, в короткие сроки добиться уменьшения болевого синдрома, улучшения общего состояния, купировать гиперкальциемию и, как результат, обеспечить более высокий уровень качества жизни онкологических больных.Для достижения стойкого эффекта целесообразно проведение минимально 6 курсов лечения.

The crystal structure of mendeleevite-(Ce), (Cs,〈)6(〈,Cs)6(〈,K)6(REE,Ca,〈)30(Si70O175)(H2O,OH,F,〈)35, a new mineral from the moraine of the Darai-Pioz glacier, the Alai mountain ridge, Tien-Shan mountains, northern Tajikistan, was solved by direct methods and refined to R1= 4.15% based on 2274 observed [Fo> 4σ|F|] unique reflections measured with Mo-Kα radiationona Bruker P4 diffractometer equipped with a CCD detector. Mendeleevite-(Ce) is cubic, space group Pm3, a21.9148(4) Å, V10525(1) Å3, Z= 2, Dcalc= 3.066 g/cm3. The empirical formula (electron microprobe) is Cs5.94K2.22[(Ce11.35La5.86Nd3.23Pr1.54Sm0.32Gd0.20)Σ22.50(Ca4.68Sr1.00)Σ5.68]Σ28.18Si70.12O203.17H45.67F6.83, Z= 2, calculated onthe basis of 210 (O + F) a.p.f.u., with H2O and OH calculated from structure refinement (OH + F = 17 p.f.u.; H2O = 17.75 p.f.u.).The structural formula is (Cs4.65〈1.35)Σ6(〈4.71Cs1.29)Σ6(〈3.78K2.22)Σ6{[(Ce11.35La5.86Nd3.23Pr1.54Sm0.32Gd0.20)Σ22.50(Ca4.68Sr1.00)Σ5.68]Σ28.18〈1.82}Σ30(Si70O175)[(OH)10.17F6.83]Σ17(H2O)17.75. Simplified and endmember formulae are as follows: (Cs,〈)6(〈,Cs)6(〈,K)6(REE,Ca,〈)30(Si70O175) (H2O,OH,F,〈)35and Cs6(REE22Ca6)(Si70O175)(OH,F)14(H2O)21. The crystal structure of mendeleevite(Ce) is an intercalation of two independent Si–O radicals and an M framework of (REE, Ca) polyhedra. The Si–O radicals are an(Si104O260)104–framework and an (Si36O90)36–cluster which do not link directly. The M framework is located betweenthe Si–O framework and the Si–O clusters. Interstitial cations occupy two types of cages and channels. Cages I and II are 78 and 22% occupied by Cs. Channels along [100@] contain K atoms and H2O groups. Mendeleevite-(Ce) has no natural or synthetic structural analogues. Mendeleevite-(Ce) is a framework mineral with large cavities and it has the potential to be used as a model for the synthesis of microporous materials of industrial interest. [ABSTRACT FROM AUTHOR]