Репозиторий Университета

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To analyze the data available in the modern scientific medical literature on contemporary aspects of the diagnosis, staging and differential treatment tactics in patients with epithelial ovarian cancer. Materials and methods: Research method used in this article is the systematic analysis of the medical literature, including Pubmed and ClinicalTrials.gov. Results: This article attempts to summarize the worldwide experience of modern medicine in management of epithelial ovarian cancer. The current version of the ovarian cancer classification is described. The possibilities of imaging techniques and their place in the staging are determined. The accurate criteria for tumor resectability assessment and the main treatment tactics are given in details. The possibilities of imaging methods in treatment control and monitoring treatment response are provided. The leading imaging modalities for recurrent disease evaluation are delineated. Conclusion: Ovarian cancer is a serious diagnostic challenge in terms of differential diagnosis, staging and selection of optimal treatment strategy. Proper use of visualization modalities allows better management of primary and recurrent ovarian cancer. Moreover, it is necessary to conduct further investigations aimed at developing well-defined diagnostic protocols in monitoring during treatment in order to obtain response evaluation with minimal time delay.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Demonstration of various radiological methods possibilities in diagnosis, evaluation of the lung resection volume, planning of thoracoplasty and efficacy monitoring of the surgical treatment of destructive pulmonary multi-drug resistant (MDR) tuberculosis (TB). Results: Plain chest film revealed a widespread pulmonary tuberculosis inflammation. With CT application, the nature and prevalence of pulmonary parenchymal involvement was clarified, indications and volume of complex surgical intervention were determined, and surgical treatment efficacy was controlled. Digital tomosynthesis application determined the state of the lung tissue after resection and the volume of the planned postponed thoracoplasty. Discussion: Taking into account the incidence of pulmonary tuberculosis in our country, the similarity of its clinical and radiological picture with a number of other pathological processes, as well as the polymorphism of alterations, it is necessary to know the pathomorphological, clinical and radiological manifestations of this disorder. A reliable assessment of the respiratory organs state according to the radiography data has objective limits due to the presence of a cumulative effect and other factors. So, CT is the priority method in diagnosis, evaluation of lung resection volume, planning of thoracoplasty, and monitoring of surgical treatment efficacy. Due to layer-by-layer visualization, the method of digital tomosynthesis makes it possible to obtain additional information, in comparison with radiographic data, in pulmonary parenchyma state assessment at pre- and postoperative stages, which indicates the prospects of its application in solving this tasks. Conclusion: Due to modern radiological methods in the study of respiratory organs TB, the question of the expediency of surgical treatment or refusal in favor of conservative therapy is solved, which is of particular relevance in patients with MDR TB. Accurate determination of lung resection and thoracoplasty volume significantly reduces the risk of postoperative complications, which contributes to improving the quality of life of the patient. A correct control of respiratory TB surgical treatment efficacy with CT application allows estimating the state of the zone of interest, and timely reveal the relapse of a specific process.

Carboxytherapy (the treatment based on carbon dioxide injections) is a multipurpose and widely used medical technology. The use of CO2 injections (intracutaneous, subcutaneous, and pneumopuncture) have substantially supplemented and increased the practical relevance of carboxytherapy as a method for the treatment of many diseases. Thanks to it physiological properties, CO2 has antihypoxic, antioxidant, vasodilatory, anti-inflammatory, analgesic, and spasmolytic activities; moreover, it improves blood viscosity, stimulates neoangiogenesis, and regenerative processes. Carbon dioxide is a sort of biochemical 'peacemaker' in tissue oxygenation: when blood cells are exposed to high CO2 concentrations (Bohr effect), the rate of gas exchange (CO2 and O2) increases. The human organism interprets carboxytherapy (local hypercapnia) as oxygen deficiency and responses to it by boosting not only the blood flow, but also the vascular endothelial growth factor which stimulates neoangiogenesis and in the long run improves blood supply and tissue trophism. The multiple mechanisms of action, polymodal efficacy, a tool kit with a wide range of detectors and various modes of treatment make carboxytherapy a popular medical technology all over the world, namely in cosmetology, dermatology, aesthetic medicine, angiology, orthopaedics, cardiology, neurology, pulmonology, gynaecology, urology, proctology, plastic and general surgery, and other areas. Carboxytherapy provides a perfect example of the off-label usage in medicine that made it one of the most extensively applied medical technology for the treatment of various diseases despite the lack of the preclinical data and scarce relevant information available in textbooks, reference books and booklets.

© Ima-Press Publishing House. All rights reserved. Objective: to investigate the effect of indapamide/perindopril fixed-dose combination (FC) on 24-hour blood pressure (BP) and cognitive functions in antihypertensive treatment-naive middle-aged patients with uncomplicated grade 1-2 essential arterial hypertension (EAH). Patients and methods. The open prospective study enrolled 25 patients (9 men and 16 women) aged 40-59 years with a diastolic BP of 90-109 mm Hg and/or a systolic BP of 140-179 mm Hg, as evidenced by routine measurements. As starting antihypertensive therapy, the patients received indapamide 1.25/perindopril 5 mg FC once daily in the morning; if necessary, after 2 weeks (if the routine blood pressure was ≥140/90 mm Hg) they took indapamide 2.5/perindopril 10 mg once daily in the morning. The follow-up period was 14-16 weeks. Before and at the end of the follow-up, the patients underwent 24-hour ambulatory BP monitoring (ABPM) and evaluation of cognitive functions using the Montreal Cognitive Assessment (MoCA), ten-words test (immediate and delayed word recall), verbal association test (literal and categorical associations), number connecting test (Trail making test (TMT), part A and numbers and letters connecting test (TMT) part B), and Stroop test. Results. At the end of the follow-up period, treatment with indapamide/perindopril fixed-dose combination showed a statistically significant reduction in BPs, as evidenced by routine measurements and ABPM (during 24-hour, and awake and sleep periods); a statistically significant cognitive improvement: an increase in the number of the so-called words in the ten-words test during both immediate (from 5.5±1.6 6.5±1.5 words; p=0.02 vs baseline) and delayed (from 6.2±1.7 to 7.4±1.4 words; p=vs baseline) recalls, a decrease in the performance time of TMT-B (from 112.6±42.5 to 90.4±28.4 sec; p=0.02) and Stroop test Part 3 (from 135.5±50.1 to 112.6±19.6 sec; p=0.02), and a larger number of called words in the categorical associations test (from 6.5±2.4 to 8.1±2.9 words; p=0.02). Conclusion. The results obtained indicate that in treatment-naive middle-aged patients with EAH, indapamide/perindopril fixed-dose combination assures an effective reduction in BPs, as evidenced by routine measurements and ABPM, also improves cognitive functions, particularly attention, information processing speed, semantic memory, cognitive flexibility, and short-term and long-term memory.

© 2018, Silicea-Poligraf. All rights reserved. Aim. To classify established clinical types of the right ventricle arrhythmogenic dysplasia (RVAD) taken a variety of genetic and inflammatory mechanisms, and to analyze the specifics of differential diagnostics and management of the respective types. Material and methods. Main group consisted of 50 patients with evident (n=26), probable (n=13) and possible (n=11) RVAD diagnosis, mean age 38,1±14,6 y. o., males — 20 (40%), follow up time 13,5 [4; 34] months. Comparison group consisted of 58 patients with some of the RVAD criteria insufficient for evident diagnosis. All patients underwent ECG, Holter ECG 24 hours, EchoCG; in the main group additionally — DNA-diagnostics (n=46), cardiac MRI (n=44), high definition ECG (n=16), endomyocardial biopsy of the RV (n=2), autopsy (n=2). In comparison group, MRI was done in 32 patients, biopsy to 7, and in 1 case — autopsy. Results. Based upon the clinical data and specifics of the disease course, 4 types of established clinical RVAD were selected, that do not tend to overlap: latent arrhythmic (50% patients), manifest arrhythmic (20%), RVAD with predominant biventricular chronic heart failure (CHF, 16%), and RVAD with non-compaction left ventricle myocardium (14%). The development of one or another type is based on genetic factors, as on comorbid myocarditis (in percent in the following, respectively). In diagnostics of the latent arrhythmic type (frequent right ventricle extrasystoly, VE and/or non-sustained right ventricular tachicardia, VT) the key role played female sex, syncopes in anamnesis (16%), family history of sudden death (12%), ECG-criteria and positive results of DNA diagnostics (24%). For manifest arrhythmic type (sustained VT) — sudden death family anamnesis (in 20%), MRI-criteria (enlarged RV with lower EF), ECG-criteria and positive DNA tests (50%). For RVAD with progressing CHF — sustained VT (50%), syncopes (37,5%), predominance of RV failure with its severely reduced EF (25,7±15,0%), major MRI-and ECG-criteria, decreased QRS-voltage and positive DNA test (38%). Comorbidity of RVAD and non-compaction myocardium differ by frequent VE, aggressive VT (57,1%), syncope (42,9%) and CHF with significantly lower than in DCMP EF LV. Mortality rate in I-IV types was, respectively, 0%, 10%, 25%, 14,3%, and relevant shocks in 8 of 13 (61,5%) patients with ICD. Conclusion. It is worthy to use the proposed RVAD classification in clinical practice to define the spectrum of diagnostical and management events and assess the individual patient prognosis.

© 2018, Bionika Media Ltd. All rights reserved. Aim. To investigate the clinical features of the course and outcomes of pregnancy and placental morphology in HIV-infected pregnant women. Material and methods. This study is a retrospective analysis of 29 pregnant women. The study group comprised 14 pregnant women with antenatal human immunodeficiency virus infection. Fifteen women with a physiological course of pregnancy made up a control group. The mean age of patients in the study and control group was 28.0 ± 2.6 and 21.1±2.3 years, respectively. The analysis included gynecological history, the course of pregnancy and childbirth, and perinatal outcomes of newborns. The morphological study of placenta included macroscopic and histological examinations, and immunohistochemical studies using antibodies targeting CCR5 receptors. Results. Pregnant women in the study group had a gynecological history of sexually transmitted infections. The most frequent complications of the second and third trimesters of pregnancy were anemia (78.6%), the threatened preterm birth (35.7%), and preeclampsia (28.6%). Complications of labor were premature rupture of membranes (35.7%) and uncoordinated uterine activity (14.3%). Placental morphology showed signs of inflammation and hypoxia. Immunohistochemical studies identified a higher expression of CCR5 in chorionic villi. Conclusion. The findings indicate increased levels of CCR5 expression and the development of chronic placental insufficiency in HIV-infected pregnant women, which indicates the need for dynamic monitoring of this group of patients.

© 2018 Informing Science Institute. All rights reserved. Aim/Purpose The present quantitative, cross-sectional study aimed to investigate objective and subjective factors in the self-determination of doctoral students in their educational activities. Objective determinants included major discipline and forms of academic and scholarly activity (that is, attending classes and writing papers), and subjective determinants included personal characteristics of the doctoral students, including dispositional autonomy and perceptions of environmental supports for students' basic psychological needs. Background The quality of students' motivation for learning has been linked with many different outcomes. Specifically, students who are more internally motivated (that is, who engage in learning activities for reasons that are personally important and freely chosen) demonstrate better performance outcomes and are more likely to choose and to persist in challenging tasks, to enjoy learning, to exhibit greater creativity, and in general to experience greater psychological well-being. Important questions remain, however, regarding the sources that affect student motivation, in particular at the level of graduate school. The present study expands on existing research by exploring contributions to students' motivation both from the students, themselves, and from supports stemming from two interpersonal contexts: close relationships and the university environment. Methodology Participating in the study were 112 doctoral students from various natural sci-ences departments of a major university in the Volga region of Russia. Self-report measures included dispositional autonomy, motivation for various types of academic and scholarly activity, and satisfaction of basic needs for autonomy, competence, and relatedness in various interpersonal contexts. Analyses includ-ed descriptive statistics, comparison of mean differences, correlation, and struc-tural equation modeling. Contribution The present study goes beyond existing research by considering both disposi-tional and situational factors that influence the motivation of doctoral students for their scholarly and academic activities, and by comparing the impact on mo-tivation of close personal relationships with that of various interpersonal con-texts in the university setting. Findings Doctoral students reported greater supports for their basic needs (for compe-tence, autonomy, and relatedness) from their close personal relationships than in their university contexts. Students felt less support for their autonomy and competence with their research supervisor than in other university settings. The early stages of a scholarly activity, such as gathering sources and analyzing mate-rials, were more likely to be characterized by external motivation, whereas the later stages, like the actual writing of a manuscript, were more likely to be inter-nally motivated. When competing for variance, need supports from university-based but not from close personal relationships were significant contributors to students internal motivation for scholarly and academic activity; this effect, however, was fully mediated through students own dispositional autonomy. Recommendations for Practitioners The present study underscores the importance of creating an environment in the university that supports doctoral students needs for autonomy, competence, and relatedness. Educators, and in particular research supervisors, should attend to the ways in which their policies and practices support versus undermine these needs, which are shown to play an important role in promoting doctoral stu-dents own internal motivation for their scholarly and academic activities. Recommendations for Researchers Although in this sample need supports from university-based interpersonal con-texts outweighed the role of need supports from close personal relationships, in terms of doctoral students scholarly and academic motivation, it seems im-portant to keep both contexts in mind, given the general importance of close relationships for motivation and other educational and well-being outcomes. As well, accounting for students own dispositional attributes, such as their own personal tendency toward autonomy, seems a critical counterpoint to looking at environmental contributions. Future Research Future research should examine whether the mediational model tested in the present study applies to other samples of doctoral students, for example, to those from other disciplines, such as the humanities, and those in other cultural or geographic locations, where it is possible that close personal relationships may contribute more substantially to students motivation than was the case in the present sample. As well, future studies would do well to include other rele-vant outcomes, such as academic grades, successful degree completion, and measures of well-being, in order to confirm previous findings of the link be-tween internal motivation and various educational outcomes.

© 2018, Media Sphera Publishing Group. All rights reserved. Hereditary thrombophilias (HT) and undifferentiated connective tissue dysplasia (uCTD) are important causes of female infertility. Moreover, there are signs of their common pathogenesis: a number of proteins, such as PAI-1, play an important role in the pathogenesis of both conditions, as well as in the development of infertility in patients with HT and uCTD Objective — to determine the morphological substrate and molecular mechanisms of impaired pregnancy outcomes in women with uCTD and HT. Subject and methods. A study group included 130 reproductive-aged female patients with primary infertility and a control group consisted of 11 patients (surrogate mothers). An endometrial pipelle biopsy sample was taken from each patient on days 6—8 after ovulation according to the ultrasound findings. The study group patients were divided into subgroups: 1A) infertility and HT (n=91); 1B) infertility, NT, and uCTD (n=19); 1C) infertility and uCTD (n=20). The investigators examined obstetric/gynecological history data, determined the levels of PAI-1 and homocysteine in the blood samples of patients in the subgroups with HT (1A and 1B); assessed the results of the methionine test, and identified the polymorphism or mutations of the following genes: FII, FV (Leiden), FVII, FXII, FXIII, GpIa, GpIb (-5), GpIb (T145M), GpIIIa, PAI-1, FBGb, MTHFR, MTRR, MTR, SLC19A1, angiotensin gene (M235T and T145M), angiotensin-converting enzyme, and their homo-or heterozygosity. Endometrial morphological and immunohistochemical examinations were carried out using primary antibodies to sex hormone receptors, LIF, PAI-1, and osteopontin. Results. The number of pregnancies in the study group was comparable to the number of patients in each subgroup. Childbirth was considered to be a favorable pregnancy outcome; missed miscarriage was an unfavorable one. There were the most favorable outcomes in Subgroup 1C with uCTD and the least one in Subgroup 1B. Comparison of hemostatic system indicators revealed statistically significant differences only in the incidence of disaggregated thrombopathy (88% in Group 1B and 55% in Group 1A). In the endometrium of the study group, there was delayed maturation; sclerotic foci and dyscirculatory disorders were more frequent in the stroma. Conclusion. In HT, uCTD, and, to a greater extent, its concurrence, a genetically determined predisposition to impaired implantation develops due to genetically determined endometrial remodeling that leads to infertility and impaired pregnancy outcomes.

© 2018 Ima-Press Publishing House. All right reserved. The response rate to therapy for rheumatoid arthritis (RA) rarely exceeds 60%. Mental disorders (MDs) of the anxiety-depressive spectrum (ADS) and cognitive impairment (CI) substantially affect the evaluation of the efficiency of RA therapy. Adequate psychopharmacotherapy is one of the possible approaches to optimizing the treatment of RA. The factors influencing the efficiency of RA therapy with standard disease-modifying antirheumatic drugs (DMARDs) and biological agents (BAs) in combination with adequate psychopharmacotherapy have not been previously identified. Objective: to determine the predictors of response to therapy in patients with RA receiving DMARDs and BAs with or without adequate psychopharmacotherapy for ADS disorders. Subjects and methods. The investigation included 128 patients (13% men and 87% women) with a reliable diagnosis of RA. At baseline, 75.1% of patients received DMARDs; 7.8% - BAs. ADS disorders were detected in 123 (96.1%) patients. Psychopharmacotherapy was offered to all the patients with MDs; 52 patients agreed to treatment and 71 refused. The following therapeutic groups were identified according to the performed therapy: 1) DMARDs (n = 39); 2) DMARDs + psychopharmacotherapy (n = 43); 3) DMARDs + BAs (n = 32); 4) DMARDs + BAs + psychopharmacotherapy (n = 9). The changes of MDs symptoms and the outcomes of RA were assessed in 83 (67.5%) patients at five-year follow-up. The efficiency of RA therapy was evaluated with DAS28 (EULAR criteria). Predictors of response to therapy were determined using linear regression modeling. Results and discussion. At 5 years, 22 (26.5%) and 37 (44.6%) patients were recorded to show good and moderate responses to therapy, respectively; 24 (28.9%) patients were non-respondents. The linear regression model included 14 factors (p<0.001). The high values of DAS28 (β=0.258) at the inclusion; belonging to therapeutic groups 2 (β=0.267), 3 (β=0.235), and 4 (β=0.210), the absence of diabetes mellitus (β=-0.230), and experience in using glucocorticoids (β=-0.230) were associated with a high likelihood of response to therapy; high body mass index (β=-0.200) and long RA duration (β=-0,181), a high level of rheumatoid factor (β=-0.176), a history of myocardial infarction (β=-0.153), schizotypic disorder (β=-0.132), and extra-articular manifestations of RA (β=-0.106), and older age (β=-0.102) were related to a low probability of response. The area under the ROC curve for the model was 0.99 (p<0.001). Conclusion. BA therapy and psychopharmacotherapy, along with younger age, shorter duration and high activity of RA, a low level of rheumatoid factor, lower body mass index, the absence of diabetes mellitus, myocardial infarction, and extra-articular manifestations of RA in the history, schizotypic disorder, and experience in using glucocorticoids are associated with a greater likelihood of a good and moderate treatment response.

© 2018 Trans Tech Publications, Switzerland  This paper presents the results of experimental studies of arrays of Ag 0.52 Au 0.48 alloy nanoparticles. Arrays were formed by vacuum-thermal evaporation on an unheated substrate and subsequent low-temperature vacuum annealing. The TEM images of the obtained nanoparticle arrays and corresponding histograms of particle size distribution are shown. The transmission spectra of these arrays showing the displacement of the plasma frequency as a function of the mean particle size are obtained. Spectra of Raman scattering from a thin film of amorphous carbon in presence of AgAu particles are obtained, and a comparative analysis of Raman scattering amplification factors for pure Ag, pure Au and Ag 0.52 Au 0.48 alloy nanoparticles is presented.

© 2018, Slovak Academy of Sciences. All rights reserved. The therapeutic use of cisplatin for the treatment of solid tumours is associated with organ toxicity. Amongst those, the cardiotoxicity is an occasional but very serious and severe side effect. To prevent or reduce these negative effects, many cisplatin analogues have been synthesized and evaluated in terms of being a less toxic and more effective agent. In present study, we examined the effects of cisplatin and its three analogues in the isolated rat heart to determine whether changes in the structure of the platinum complexes (changing of carrier ligands – ethylenediamine; 1,2-diaminocyclohexane; 2,2’:6’,2’’-terpyridine) can influence their cardiotoxic effects. The results of our research indicate that the introduction of aromatic rings in the structure of the platinum complexes has a negative influence on the heart function. Conversely, the other two examined complexes had less negative effects on heart function compared to cisplatin. Our findings may be of interest for a possible synthetic strategy of introducing a carrier ligand that will exert a less cardiotoxic effect.

© 2018, Canadian Science Publishing. All rights reserved. The aim of this study was to assess the impact of atorvastatin and simvastatin on myocardial contractility during the different degrees of hyperhomocysteinemia (HHcy) in rats. Study was conducted on adult male Wistar albino rats (n = 90; 4 weeks old; 100 ± 15 g body mass) in which HHcy was achieved by dietary manipulation. Animals were exposed to pharmacology treatment with atorvastatin in dose of 3 mg/kg per day i.p. or simvastatin in dose of 5 mg/kg per day i.p. at the same time every day, according to equivalent therapeutic doses of these statins (10 mg atorvastatin = 20 mg simvastatin). After the dietary manipulation and pharmacological treatment and confirmation of HHcy, all animals were sacrificed, hearts were isolated, and cardiac function was tested according to the Langendorff technique. Size of recovery of maximum rate of left ventricular development (dp/dtmax), minimum rate of left ventricular development (dp/dtmin), systolic left ventricular development, diastolic left ventricular development, heart rate, and coronary flow at the 40, 60, 80, 100, and 120 cmH2O coronary perfusion pressure were measured in state of physiological condition (homocysteine less than 15 μmol/L), mild HHcy, and moderate HHcy. Atorvastatin treatment significantly attenuated homocysteine-induced impairment of myocyte contractility and dominantly decreased dp/dtmax, dp/dtmin, and heart rate and induced greater changes in systolic left ventricular development compared with simvastatin. Treatment with atorvastatin seems able to revert systolic abnormalities and improve contractility during the different degrees of HHcy.

© 2018 Media Sphera Publishing Group. All rights reserved. This article presents an overview of data of Russian and foreign literature on possible associations between cognitive impairment and atrial fibrillation (AF). It includes modern classification of cognitive impairment, mechanisms of the effect of AF on cognitive functions and development of dementia, recommendations for the prevention of cognitive impairment in patients with AF. Special attention is paid to the assessment of cognitive status, and safe anticoagulant therapy, which is a priority in the prevention of cognitive impairment in patients with AF. Analysis of literature showed greater efficacy and safety of drugs from the group of Non-Vitamin K Antagonist Oral Anticoagulants (NOAC), rivaroxaban in particular, in comparison with warfarin. Drugs from the NOAC group can be recommended for prevention stroke, cognitive impairment and dementia in elderly patients with AF.

© Copyright 2018 Inderscience Enterprises Ltd. Sanguinarine is a plant alkaloid with relatively low toxicity and high antiangiogenic, antitumour and antiviral potential. In order to increase its bioavailability and effectiveness, sanguinarine liposomes were prepared by a reverse phase evaporation method and characterised. Dynamic light scattering showed mean liposome size of 65 ± 11 nm, zeta-potential equal to -54 ± 1.2 mV, and polydispersity index equal to 0.26. The encapsulation efficiency was 78.6 ± 5.1%. The study on experimental models showed a prolonged sanguinarine release from liposome preparations. Liposomal sanguinarine showed dose-dependent cytotoxic activity in vitro on B16 (murine melanoma) and HeLa (human cervical carcinoma) cell lines. The highest cytotoxicity was observed on B16 cell line (IC50 6.5 μM). HeLa cell line cytotoxicity was relatively lower, equal to 8.03 μM. Compared with free sanguinarine, liposomal sanguinarine may have advantages for in vivo anticancer therapy, due to its lower toxicity and 'passive targeting' as a result of enhanced permeability of tumour vessels.

© 2018, Silicea-Poligraf. All rights reserved. The review is focused on clinical significance of the left ventricle hypertrophy (LVH) — presentation of heart lesion as a target organ for systemic hypertension (SH). Various LVH development mechanisms are presented, and special attention is paid to sympathic nervous system and β-adrenoreceptors in pathogenesis. Fundamental methods of diagnostics are described for LVH, in comparison. The pathology is classified from the perspective of recent guidelines on echocardiographic diagnostics. Epidemiology provided. Taken current evidence, the prognostic role of LVH is described as a factor increasing the risk of fatal and non-fatal cardiovascular, cerebrovascular and renal complications in SH patients. Trials data presented that points on LVH regression with highly selective β1-blocker bisoprolol treatment. Pathophysiology of LVH regression is discussed for β1-blocker treatment.

© 2018 Carta, Mariani, Sambiagio, Chuchueva, Lecis, Gerosa and Puxeddu. The present study analyzed the results of the endoscopic approach to T1, T2 and selected T3 supraglottic carcinoma with the aim of reviewing functional and oncologic outcomes after different types of endoscopic supraglottic laryngectomies. This is a retrospective clinical study of 42 consecutive patients (mean age of 61.8 years, 33 males, 9 females) treated by the senior author for supraglottic squamous cell carcinoma with a transoral CO2 laser approach and reviewed from November 2010 to September 2017. Surgical procedures were classified according to the European Laryngological Society. In addition to the standardized transoral supraglottic laryngectomies, we introduced a modified type IVb by sparing the inferior third of the arytenoid if not directly involved in the tumor. Swallowing was evaluated with the Swallowing Performance Status Scale reported by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. Survival probabilities were estimated using Kaplan-Meier curves. Two type I, 2 type IIa, 2 type IIb, 3 type IIIa, 12 type IIIb, 13 type IVa, 3 type modified IVb, and 5 type IVb supraglottic laryngectomies were performed. Twenty-one patients (50%) underwent primary neck dissection. The pathologic TNM classification according to the 8th edition of the American Joint Committee on Cancer system was as follows: 9 pT1cN0, 2 pT1N0, 1 pT1N1, 7 pT2cN0, 1 rypT2cN0, 9 pT2N0, 4 pT2N1, 2 ypT2N1, 2 pT3cN0, 2 rypT3cN0, 1 pT3N1, and 2 pT3N2b. Mean follow-up was 3.4 years (range of 9 months to 6 years). According to the Kaplan-Meier analysis, 5-year disease-specific survival, local-relapse-free survival, nodal-relapse-free survival, overall laryngeal preservation and overall survival of patients without previous head and neck radiotherapy/open surgery were 100%, 95.2%, 87.8%, 100%, and 64.6%, respectively. Patients who underwent type I, IIa, and IIb resections (n = 6) started oral feeding the day after surgery, patients who underwent type III-IVb modified resections (n = 31) started oral feeding 3-4 days after surgery, and patients who underwent standard type 4b resections (n = 5) started oral feeding 7 days after surgery. Threemonths after surgery, patients without a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed significantly better swallowing compared to patients who underwent standard type IVb resection: grade 4-6 impairment of swallowing in 8 and 66.7% of cases, respectively (p = 0.006072); patients with a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed not statistically significant better swallowing compared to patients who underwent standard type IVb resection: grade 4-6 impairment of swallowing at 3 months in 16.7% and 50% of cases, respectively (p = 0.23568). Transoral CO2 laser supraglottic laryngectomy is an oncologic sound alternative to traditional open neck surgery and chemo-radiotherapy. Recovery of swallowing is significantly worsened after total resection of the arytenoid. Modified type IVb procedure leaving intact, when possible, the inferior third of the arytenoid and consequently the glottic competence, improves functional outcome.

© 2018 Media Sphera Publishing Group. All rights reserved. The article provides review of possible mechanisms of inhibitor coagulopathies, in particular of acquired hemophilia A. This pathology is an extremely rare disease occurring in 1-2 cases in 1 million per year. In the present study we provide data for two clinical cases of hemophilia A in women. These cases had different development mechanisms, although both women have a newly discovered missense mutation His2026Arg in the VIII factor gene. The matter of main interest is the description of the disease development in the patient with an acquired idiopathic hemophilia A with a possible disease occurrence due to an asymmetric X-chromosome inactivation (lyonization). In this particular case lyonization led to the late manifestation of the hemophilia A carrier's state and development of severe form of the inhibitor-associated acquired hemophilia A. We also discuss therapeutic approaches to these forms of the disease, considering there are no concise protocols for case management due to an extreme rarity of the pathology. Acquainting the clinical personnel working it the different areas of medicine with suchlike inhibitor coagulopathies has a major practical importance.

© 2018 Dynasty Publishing House. All rights reserved. Hepatocellular carcinoma (HCC) is rarely diagnosed during pregnancy, its fibrolamellar variant (FHCC) is a specific form that is more often diagnosed in young women and is rarely associated with cirrhosis or chronic infection with hepatitis B or C viruses. Making a diagnosis at early stages is complicated by the fact that the α-fetoprotein (AFP) level is usually not enhanced, and symptoms develop only at advanced stages of disease. A clinical case of FHCC in a 27-year-old woman is presented, diagnosed at the 30th week of pregnancy after persistent dragging and spastic pains in the epigastric region. US detected a tumour with sizes 110 × 81 × 89 mm and foci in the lungs. Variants of treating such patients depending on tumour characteristics, pregnancy period and family preferences are discussed.

© Bionika Media Ltd. Endometriosis affects up to 15% of reproductive-aged women. Consideration of this nosological entity in a new aspect is impelled by the evidence that 0.5–1% of cases develops endometriosis-associated ovarian neoplasms that are more represented by the endometrioid and clear-cell subtypes of tumors. This category also includes seromucinous ovarian tumors (SMOTs). Objective. To investigate the morphological and immunohistochemical (IHC) features of SMOTs in reproductiveaged women, including pregnant ones. Subjects and methods. Ovarian tumor samples from 15 patients who had been operated on in 2012-2016 were analyzed comprehensively at the National Medical Research Center of Obstetrics, Gynecology, and Perinatology: IHC examination was conducted using the biomarkers of estrogen and progesterone receptors and Ki-67. Results. Borderline SMOTs were characterized by papillary growths on the inner surface (in one case) and on the outer surface, with an adhesive process with the serous surface of the corpus uteri (FIGO Stage 1c), and mixed epithelial structures; leukocyte infiltration was observed in 4 cases. The epithelium of seromucinous carcinoma (n = 1) was similar to that of serous, endocervical, and endometrial types at the same time. All the samples exhibited a low Ki-67 expression and high positive receptor immunoreactivity. Endometriosis diagnosed in nine women was accompanied by benign seromucinous cystadenomas (n = 4), borderline tumors (n = 4), and carcinoma (n = 1). Conclusion. Most of the examined SMOTs showed the areas, covered with the endometrioid epithelium, with adjacent endometrial stroma, which indicated the development of carcinoma in the presence of endometrioid cyst. The revealed facts suggest that endometriosis plays an etiological role in developing SMOTs. When detected, most neoplasms are localized (limited to ovarian tissue, FIGO stage 1a) and characterized by a favorable prognosis as a whole.

© 2018 Bentham Science Publishers. The burden of cardiovascular and metabolic diseases is increasing with every year. Although the management of these conditions has improved greatly over the years, it is still far from perfect. With all of this in mind, there is a need for new methods of prophylaxis and treatment. Coenzyme Q10 (CoQ10) is an essential compound of the human body. There is growing evidence that CoQ10 is tightly linked to cardiometabolic disorders. Its supplementation can be useful in a variety of chronic and acute disorders. This review analyses the role of CoQ10 in hypertension, ischemic heart disease, myocardial infarction, heart failure, viral myocarditis, cardiomyopathies, cardiac toxicity, dyslipidemia, obesity, type 2 diabetes mellitus, metabolic syndrome, cardiac procedures and resuscitation.