Medical Research Center Research Articles

A Study on Prescription Pattern of Drugs in Orthopaedics Inpatient Department of Navodaya Medical College Hospital and Research Centre in Raichur

A Study on Prescription Pattern of Drugs in Orthopaedics Inpatient Department of Navodaya Medical College Hospital and Research Centre in Raichur

Clinical and history features of patients with recurrent deep endometriosis: A retrospective study

Aim. To identify clinical and history features of patients with recurrent deep endometriosis (RDE). Materials and methods. A retrospective study of clinical and history data of 200 patients with DE undergoing surgical treatment at the Department of General Surgery of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology in 2020–2021. Group 1 included 80 patients with RDE, group 2 included 120 patients with newly diagnosed DE. All patients underwent surgical treatment followed by immunohistochemical examination and DE confirmation. Results. An association was found between the young age of the patient at the time of the first surgery and the type of endometriosis. It was found that women with a history of endometriosis surgery in early reproductive years (29.22±5.3 years) are at risk of recurrent endometriosis. Two or more surgeries were reported in 33.7% of RDE patients. In 90.2% of patients, endometriosis recurred with clinical manifestations; in 9.8%, it was asymptomatic and diagnosed on pelvic ultrasound. The group of RDE patients showed a longer period of infertility (5.432±3.53 years) than the group with newly diagnosed DE (2.953±1.29 years). It was found that the surgeries performed in RDE patients were longer, more complex, and associated with more blood loss. Intestinal resection, ureterolysis, adhesiolysis, and salpingectomy were significantly more common in the RDE group than in patients without a history of endometriosis surgery. Conclusion. In most cases, RDE is clinically manifested, rarely asymptomatic and diagnosed by visualization methods. Patients with a history of surgery at a younger age are at risk of RDE, and their surgical interventions are more complicated with more blood loss. Currently, surgical treatment of DE is the optimal method; however, it has serious disadvantages with severe and even life-threatening postoperative complications.

Primary data of the local register of hip periprosthetic infection in the Ilizarov Center

Aim: demonstrate of primary analysis of the data of local registry which contains all cases of hip periprosthetic infection from 01.01.2010 to 31.12.2020. Methods: We retrospectively have entered into the database information about patients with hip periprosthetic infection who have been treated in the clinic from 2010. Data was collected by researching medical cards and medical information system, examination of patients in the outpatient clinic, phone communication and e-mail. Results and discussion: We have treated 449 patients with hip periprosthetic infection. The average age of patients was 55,6±12,6 years(Ме -57, CI 54,4; 56,8) and turned out to be significantly younger than the mean age in well-noun national registers and 66%(n=277) were male. In more than 90% (n=407) of cases, infection was classificated as cronic (more than 3 weeks after manifestation), 76,8% (n=345) of patients had open sinus tract to the prosthesis. Our results have a significant difference from Australian register, as only 21 % of patients in Australia have a sinus or time after manifestation of symptoms for more than 30 days. Among the patients of «Ilizarov Centre» gram-positive flora was 55.7%(n=288). This result correspond with publications analyzing the National Registers of Denmark, Sweden and Australia. We were able to evaluate the results of treatment in 84% (n=377) of the patients and we couldn’t connect with patients in 16% (72/449) of cases. The average follow-up time 5,92 ± 2,55 years; Me-6; CI 2,39; 2,73. The percentage of patients who died of uncontrolled infection was 1,7% (n=8/449); reinfection of periprosthetic infection were in 6,2% (n=28/ 449) of cases, death from other diseases after treating in our clinic without any sights of infection was identified in 9,1% (n=41/ 449) of cases. Infection control has been achieved in 67% (300/449) of cases. Conclusion : The object of the local register of the National Ilizarov Medical Research Centre for Traumatology and Ortopaedics" were only patients with periprosthetic infection. The main goal of our work is analysis of factors related to the patient and surgical technique that directly affect the outcomes of treatment.

Abstract PO1-02-09: Efficacy of breast conserving treatment of minimal residual tumors after neoadjuvant therapy for breast cancer

Abstract Background. Determining the most effective drug therapy regimens is one of the top priorities in the individualization of the treatment of patients with breast cancer (BC). Achievement of pathological complete response (pCR) is important prognostic factor, and used as the surrogate primary end point in many clinical trials. According to the literature, the achievement of pCR after neoadjuvant systemic treatment (NST) in breast cancer varies from 30 to 70%. Patients who do not achieve pCR require post-neoadjuvant treatment, even when reaching minimal size of residual tumors. Initially, primary minimal tumors are characterized by high survival rates, which are proved by international and domestic studies. It is required to clarify the survival rates in the presence of a minimal residual tumor (ypT < 10mm) after neoadjuvant systemic therapy and to compare with primary minimal forms of breast cancer (pT1a-b N0M0), characterized by the most favorable prognosis. Objective. Improvement of the effectiveness of treatment of residual minimal forms (ypT1a-b) of BC after NST. Determination of the correlation between the schemes of NST and the rates of tumor response based on the results of postoperative pathological reports including RCB scale. Methods. The study included 602 patients aged 18–65 years with early and locally advanced I–IIIC stage T1-3N1-3M0 breast cancer,who underwent complex or combined treatment. This study included patients treated at the N.N. Petrov National Medical Research Center of Oncology from 2015 to 2021 Conclusion. After reaching a complete pathomorphological response of the tumor to NST (RCB 0), the 5-year disease-free (DFS) and overall (OS) survival rates (DFS – 78.5%; OS 90.4%) were inferior to the survival rates of patients with primary minimal breast cancer (pT1ab N0M0) [DFS – 86.4%; OS – 98.6%]. Neoadjuvant chemotherapy regimens that allow achieving a pathological complete response in triple-negative and HER2- positive breast cancer have been defined. An assessment of adverse factors that affect the effectiveness of breast conserving treatment and correlate with a deterioration in overall survival was performed. Results. Our data analysis revealed that the survival rates (DFS and OS) of patients with minimal residual tumor after neojuvant systemic therapy were not comparable with those in the group of patients with primary minimal breast cancer. Data analysis revealed the most effective combinations of drugs expressed in the rates of pathomorphological response according to the RCB scale. An assessment of adverse factors that affect the effectiveness of organ-preserving treatment and correlate with a deterioration in overall survival was performed. Citation Format: Roman Pesotsky, Vladimir Semiglazov, Petr Krivorotko, Tengiz Tabagua, Konstantin Zernov, Alexander Emelyanov, Viktoria Mortada, Nikolay Amirov, Daria Ulrikh, Valerii Levchenko, Yana Bondarchuk, Diana Enaldieva, Nestan Bekkeldieva, Konsantin Zirov, Sergey Yerechshenko, Vladislav Evseev, Kirill Rychagov, Sergey Novikov, Maria Kazantseva, Larisa Gigolaeva, Elena Zhiltsova, Denis Nesterov, Olga Ivanova, Tatiana Semiglazova. Efficacy of breast conserving treatment of minimal residual tumors after neoadjuvant therapy for breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-02-09.

Pregnancy outcomes and complications after renal transplantation

Introduction. Chronic kidney disease (CKD) in pregnancy poses certain risks of both gestational complications and adverse perinatal outcomes, which increase with the decline of renal function.Aim to access pregnancy outcomes in patients who underwent nephrotransplantation.Materials and methods. Retrospective study of pregnant women who gave birth at Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology in the period from 2005 to 2021: 102 pregnancies in 97 patients were analyzed: five recipients had two successful pregnancies.Results. The average age of pregnant women was 31 ± 4.03 years. In equal proportions, patients underwent related or cadaveric kidney transplantation – 52% (n = 53) and 48% (n = 49) of cases, respectively. The average delivery time was 35.5 ± 2.7 weeks. The average weight of newborns was 2545 ± 655 grams. Premature birth (PB) occurred in 47.1%, the average period of birth was 33.4 ± 2.87 weeks, of which early birth (<32 weeks) was 22.5%. The average period of pregnancy after transplantation was 5 ± 3.31 (1–18) years, this period was not associated with obstetric complications or deterioration of graft function. A significant increase in the following parameters was noted during pregnancy: serum creatinine level (p = 0.006), proteinuria (p = 0.003). The glomerular filtration rate also decreased significantly by the end of pregnancy (p = 0.011). Preeclampsia was the leading cause of decreased graft function during pregnancy (32.4%).Conclusions. In general, pregnancy outcomes after nephrotransplantation are favorable, but there is an increased risk of preeclampsia, preterm birth, including operative delivery, urinary tract infection and anemia.

Efficacy of total neoadjuvant chemotherapy in the FLOT regimen in patients with locally advanced gastric and gastroesophageal junction: results of a phase II study

Background. The established approach notably improving the therapeutic outcomes for locally advanced gastric cancer and gastroesophageal junction cancer, presently entails the amalgamation of perioperative chemotherapy aligned with the FLOT protocol and surgical intervention. However, this approach harbors limitations, as only half of the patient cohort successfully completes the entire prescribed course of drug therapy. The potential solution to this problem lies in the complete transfer of the chemotherapy volume to the preoperative period and the execution of total neoadjuvant chemotherapy with FLOT regimen.Aim. Aim is to conduct a comparative assessment of the efficacy and safety between total neoadjuvant and perioperative chemotherapy with FLOT regimen for patients with locally advanced gastric cancer and gastroesophageal junction cancer.Materials and methods. In a retrospective study we enrolled patients with histologically confirmed locally advanced gastric cancer and gastroesophageal junction cancer meeting clinical stage criteria T2–4 and N0–3, without of distant metastases, treated between 2014 and 2020 at Federal State Budgetary Institution “N. N. Blokhin National Medical Research Center of Oncology” оf the Ministry of Health of the Russian Federation and Moscow City Oncologic Hospital No. 62 Department of Healthcare of Moscow. Participants in the control group underwent 8 courses of perioperative chemotherapy (4 preoperatively and 4 postoperatively), while those in the experimental group received 8 courses of total neoadjuvant chemotherapy. Both groups received drug therapy according to the FLOT protocol: 5-fluorouracil 2600 mg/m2 , intravenous drip, over 24 hours, leucovorin 200 mg/m2 , intravenous drip, oxaliplatin 85 mg/m2 , intravenous drip, docetaxel 50 mg/m2 , intravenous drip, on day 1, with a 14-day intercourse interval. The primary endpoint was one-year progression-free survival.Results. In the study included 187 patients. Participants were divided into two groups: 95 in the total neoadjuvant chemotherapy group and 92 in the perioperative chemotherapy group. The one-year progression-free survival was higher in the total neoadjuvant chemotherapy group at 79 %, compared to 68 % in the perioperative chemotherapy group (HR 0.54, 95 % confidence interval 0.32–0.9, p = 0.02). Median disease-free survival was 27.2 and 19.5 months in the neoadjuvant and perioperative chemotherapy groups, respectively. The tolerability of the entire planned drug treatment regimen was superior in the total neoadjuvant chemotherapy group, reaching 88.4 %, as opposed to 57.6 % in the perioperative chemotherapy group (p = 0.0001).Conclusion. Among patients with locally advanced gastric cancer and gastroesophageal junction cancer, the application of total neoadjuvant chemotherapy according to the FLOT protocol, administered over 8 courses, demonstrated enhanced one-year progression-free survival and improved tolerability of the entire planned treatment regimen.

Metal-(Acyclic Diaminocarbene) Complexes Demonstrate Nanomolar Antiproliferative Activity against Triple-Negative Breast Cancer.

Invited for the cover of this issue are Tatiyana Serebryanskaya, Mikhail Kinzhalov and co-workers at St. Petersburg State University, the Research Institute for Physical Chemical Problems, Belarusian State University, Togliatti State University and Blokhin National Medical Research Center of Oncology. The image depicts the shield of Pallas Athena with the structure of a palladium carbene complex that protects against triple-negative breast cancer. Read the full text of the article at 10.1002/chem.202400101.

Prescription Pattern of Cholelithiasis at Surgery Ward in Tertiary Care Hospital

Background: Cholelithiasis is a chronic recurrent disease of the hepatobiliary system. The impaired metabolism of cholesterol, bile acids and bilirubin are characterized by gallstone formation.The number of surgical procedures for cholelithiasis has risen markedly in developed countries since 1950. An estimated 90% of cholecystectomies are now performed by the laparoscopic approach worldwide. Objectives: The aim of the study was to study prescription pattern of Cholelithiasis at surgery ward in B&C medical college teaching hospital and research Centre Pvt. Ltd. Materials and Methods: A Retrospective study was conducted and data of Cholelithiasis cases admitted at Surgery ward from 2077/01/01 BS to 2077/12/31 BS were collected. Coding of data , result and interpretation of data were drawn using SPSS version 16 and MS Excel 2016 . Result: The present study included 137 patients.Among them,80.3% were females and 19.7% were males. The high incidence of cholelithiasis was found in the age group 30-39 years (27%). 98.5% of total hospitalized patient were prescribed with antibiotics followed by Proton Pump inhibitors (93.4%) and NSAIDS(92%) .Among antibiotics, Ceftriaxone (65.7%) were the most prescribed one. During discharge , antibiotics (98.5%) were the most prescribed group of medicine followed by Proton Pump Inhibitors (88.3%) and NSAIDS(67.9%). And among antibiotics, Cefixime (52.6%) were mostly prescribed. While analyzing prescription pattern of discharge medication it was found that percentage of drugs prescribed by generic name was 13.86% and percentage of drugs prescribed from essential drug list was 43.36%. Conclusion: The present study revealed that there was greater incidence of Cholelithiasis in females (80.3%) than in males and in the age group 30-39 years (27%) .The results obtained from this study showed that most commonly prescribed medicines were antibiotics. Prescription through generic name and essential drug list was low. Therefore, prioritization on prescribing drugs by generic name and from essential drug list needs to be encouraged.

Efficiency of the use of coordination training in the program of medical rehabilitation of patients after reverse shoulder endoprosthesis

The goal of this study. The goal is to evaluate the effectiveness of using upper limb coordination training after reverse shoulder arthroplasty.Material and methods. 30 patients were examined in Federal State Budgetary Institution «National Medical Research Center for Rehabilitation and Balneology» of the Ministry of Health of the Russian Federation. They were examined in a long-term period after reverse shoulder arthroplasty (in 3–4 months) and were divided into two groups: the main and the comparison groups. All patients were similar in terms of gender and age. Their clinical and functional parameters of the shoulder joint were also comparable. The patients in the comparison group were treated with laser therapy, electrotherapy, massage, group exercises to train the upper limb and mechanotherapy. The patients in the main group additionally underwent coordination training with biological feedback to the shoulder joint.The results of the study were evaluated according to the pain syndrome, functional activity of the shoulder joint, shoulder joint flexion angle and values of dynamic strength of the shoulder muscles. After the course of medical rehabilitation, the patients in both groups showed improvement of all clinical and functional parameters of the shoulder joint. There was a statistically significant improvement in the dynamic strength of the shoulder joint and reduction of pain syndrome in the patients in the main group.Conclusions. The inclusion of shoulder coordination training allows to improve the rehabilitation results for the patients who undergo reverse shoulder joint arthroplasty.

Surgical treatment of secondary glaucoma in comorbid pathology with subsequent penetrating keratoplasty (case study)

PURPOSE. To evaluate the effect of surgical treatment of secondary glaucoma with subsequent end-to-end keratoplasty in a patient with aphakia, operated retinal detachment and condition after intrastromal keratoplasty.METHODS. A patient with secondary refractory glaucoma against the background of aphakia, a biopolymer implant in the corneal stroma, an inflammatory reaction to multiple surgical interventions (formation of anterior synechiae), operated retinal detachment was examined in the S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery" in Moscow. The following treatment was performed: implantation of Ahmed valve drainage and pene-trating keratoplasty with implant removal.RESULTS. On the second day after implantation of Ahmed valve drainage on the right eye, intraocular pressure was normal in palpatory examination, the drainage tube in the anterior chamber was in the correct position. Three months after the operation, there were no complaints, intraocular pressure was normal in palpatory examination, there was a decrease in corneal edema. Penetrating keratoplasty was performed four months after the implantation of Ahmed valve drainage. On the second day after the operation, hypotension was noted with palpatory measurement of intraocular pressure, which persisted for five days. At patient discharge, the graft was adapted, the sutures were consistent, normal pressure with palpatory examination. During the observation period of up to three months, visual acuity increased to 0.1.CONCLUSION. To prolong the hypotensive effect and minimize intra- and postoperative complications in order to achieve the highest possible visual functions before performing optical reconstructive surgery, it is advisable to perform an anti-glaucoma intervention. In secondary refractory glaucoma caused by various factors, the choice of surgical treatment is always individual and depends on the severity of anatomical changes, the experience and capabilities of the surgeon, and often requires multi-stage treatment with continuous observation.

Epidemiology of alcohol use and alcohol use disorder among female sex workers in Mbeya City, Tanzania.

Alcohol misuse is a global concern, contributing to 5.3% of total deaths and 132.6 million disability-adjusted life years worldwide. In Sub-Saharan African countries, the prevalence of Alcohol Use Disorder (AUD) has risen, especially among female sex workers, due to increased availability and advertising. However, there are limited studies on alcohol use and AUD among female sex workers in Tanzania. This study aimed to determine the prevalence, patterns, and factors associated with alcohol use and AUD among sex workers in Mbeya city, Tanzania. In this cross-sectional study, 212 female sex workers in Mbeya city, Tanzania, seeking enrolment in the National Institute for Medical Research Mbeya Medical Research Centre's registration cohort from July to November 2022. Structured interviews covered socio-demographics, alcohol screening (AUDIT-C and Timeline Follow Back Calendar), and sexual behaviours data. Data were analysed using Stata version 17. Descriptive analysis assessed alcohol consumption and AUD prevalence. Factors associated with alcohol use and AUD at bivariate analysis were identified using Chi-square/Fisher's exact tests. All variables with p-value ≤ 0.20 were entered into a multivariable logistic regression model to identify factors associated with alcohol use and AUD. Among 212 participants, 86.6% reported alcohol use in the past 12 months, 85% in the past 30 days, and 98.5% met AUD criteria. Factors linked to recent alcohol consumption included primary education or higher, income above the median, and more than 10 sexual partners. Education level, marital status, income, and having dependents were significantly associated with heavy drinking episodes. The prevalence of AUD, alcohol use, and heavy episodic drinking were high among female sex workers in Mbeya city. Socio-demographic factors and risky sexual behaviours were associated with alcohol use and heavy episodic drinking highlighting the need for targeted interventions to combat alcohol abuse among female sex workers within the HIV program.

The State of Oncology Care in Russia: Localization Structure Features, Quality of Recording, and Survival of Cancer Patients in the Major Age Groups of the Population (population study). Part 6

Malignant neoplasms are considered among the most serious and prevalent diseases in many countries worldwide. In the course of our research, we conducted a review where we synthesized findings from five scientific articles providing detailed descriptions of age-related patterns of prevalence, structure, and survival among oncology patients. The final population-based study presents a culmination of all identified characteristics of this process, particularly regarding the role of age in the characteristics of prevalence and survival of cancer patients, which holds significant importance. The study utilized data from the International Agency for Research on Cancer (IARC), handbooks from the P. A. Herzen MNIOI and the N. N. Petrov National Medical Research Center of Oncology, as well as data from population-based cancer registries databases from the Saint Petersburg and Northwestern Federal District of Russia. Data processing was conducted using licensed software MS Excel 2013–2016 and STATISTICA 6.1. Modified Eurocare software, alongside mathematical, bibliographic, and statistical methods, was employed for survival calculations. The population-based study allowed for a detailed examination of the dynamics of age-specific indicators of morbidity, mortality, quality of initial patient management for MN, and survival rates of MN patients, consolidating vast datasets from across Russia and the Northwestern Federal District of Russia. All gathered and analyzed data indicate an enhancement in the quality of initial patient management for MN, a reduction in mortality rates, and an increase in survival rates.

Incidence of the musculoskeletal system diseases in children and the organization of specialized care in Saint Petersburg

BACKGROUND: The high prevalence of musculoskeletal system and connective tissue diseases, effects on the quality of life of children, and disability level are among the main medical and social problems.
 AIM: To assess the morbidity rates and provision of medical care to St. Petersburg children with musculoskeletal diseases between 2017 and 2021.
 MATERIALS AND METHODS: Data on the incidence of musculoskeletal diseases in children of St. Petersburg were analyzed based on the Federal statistical observation forms submitted by the St. Petersburg State Budgetary Institution Medical Center for Information and Analysis, collections of N.N. Priorov National Medical Research Center for Traumatology and Orthopedics of the Ministry of Health of the Russian Federation “Trauma, orthopedic morbidity, the state of trauma and orthopedic care for the population,” edited by Acad. S.P. Mironov, RAS, and data from the Federal State Statistics Service.
 RESULTS: In Saint Petersburg, the morbidity rate of musculoskeletal and connective tissue diseases from 2017 to 2021 was 13%, excluding 2020, which was most likely due to the introduction of measures aimed at counteracting the spread of COVID-19 and the suspension of planned outpatient specialized care. The number of orthopedic beds for children decreased by 58, whereas the availability of beds for children remained at the same level and amounted to 4.3 beds per 10,000 children, which exceeded the indicator for the Russian Federation (1.0). The number of children with these disabilities increased 1.4-fold. Deaths of children due to musculoskeletal and connective tissue diseases were recorded in 2019 and 2020.
 CONCLUSIONS: The results of the 5-year observation period of musculoskeletal and connective tissue diseases in children in St. Petersburg revealed increasing incidence because of the increase in the number of children newly diagnosed with these diseases.

The content of soluble forms of galectins -1, -3, -4, -7, -9 in patients with renal cell cancer of various morphological types

Background: Galectins are a family of β-galactoside binding proteins that regulate the vast majority of cellular functions, including proliferation, migration, adhesion, and phagocytosis in both health and disease. More and more experimental and clinical evidence indicates that galectins are involved in many stages of carcinogenesis, including patients with renal cell carcinoma (RCC).
 Aim: To analyze the clinical significance of soluble forms of galectins -1, -3, -4, -7, -9 in patients with various histological RCC types.
 Materials and methods: We performed a retrospective analysis of the clinical significance of galectins -1, -3, -4, -7, -9 in the serum of 140 RCC patients (84 with clear cell RCC (ccRCC), 38 with papillary (papRCC), 18 with chromophobe (chrRCC)) and in 73 healthy donors (control group), who were examined and treated from 2019 to 2023 in the N. N. Blokhin National Medical Research Center of Oncology. Galectin levels were measured in serum (obtained according to standard methods before the initiation of specific treatment) with an enzyme-linked immunosorbent assay.
 Results: There was a significant increase in serum galectin -1, -3, -9 levels in the whole RCC patient group, compared to the healthy donor control group; no increase was found for galectins -4 and -7. Serum galectin-1 levels in the ccRCC and papRCC patients were significantly higher than those in the controls (p = 0.0003 and p = 0.0135, respectively). No association between the serum galectins -1 and -7 and the clinical and morphological characteristics of RCC was found; however, serum galectin-7 levels in the papRCC patients correlated with the grade of tumor differentiation (r = -0.592; p = 0.001). The area under the ROC curve (AUC) for galectin-1 in ccRCC was 0.721 (p 0.0001), in papRCC 0.673 (p = 0.0086), and in chrRCC 0.576 (p = 0.355). For galectin-7, the ROC AUC values were 0.527 (p = 0.634) in ccRCC, 0.513 (p = 0.845) in papRCC, and 0.566 (p = 0.425) in chrRCC. In all histological types of RCC, there was a significant increase in serum galectin-3 compared to the controls (ccRCC, p = 0.0208; papRCC, p = 0.0014; chrRCC, p = 0.0041). The ROC analysis for galectin-3 in patients with RCC of various histological types showed AUC = 0.721 (p 0.0001) for ccRCC, 0.673 (p = 0.0086) for papRCC, and 0.576 (p = 0.355) for chrRCC. Galectin-9 levels was directly and significantly associated with the tumor size, as well as with regional metastases (r = 0.251, p = 0.021; r = 0.239, p = 0.028, respectively). The AUC values for galectin-4 were 0.619 (p = 0.021) in ccRCC, 0.577 (p = 0.214) in papRCC, and 0.534 (p = 0.666) for chrRCC. For galectin-9, they were 0.649 (p = 0.0075), 0.613 (p = 0.087), and 0.539 (p = 0.637), respectively.
 Conclusion: The study has demonstrated a certain association between serum galectin -1, -3, -4, -7, and -9 in the patients with RCC of various histological types. Although the results of the ROC analysis indicated average quality of the model, which does not allow for the use of the obtained data for diagnostic purposes, it is necessary to continue the research for better understanding of the mechanisms of galectin functioning, before galectin-based therapeutic agents would be introduced into clinical practice for the treatment of RCC.

To 110th anniversary of cardiac surgeon and researcher Igor N. Meshalkin

Igor N. Meshalkin (1913–1996) was Soviet cardiac surgeon, Dr. Sci. (Medicine). He was a graduate of the 2nd Moscow State Medical Institute (2nd MSMI, now the N.I. Pirogov Russian National Research Medical University). He was a participant in the Great Patriotic War. Igor N. Meshalkin began his professional career as a medical resident and an assistant of the clinic of faculty surgery in the 2nd MSMI since 1947; then as a medical resident of the Main Military Hospital of the Armed Forces of the USSR since 1951 and an assistant of the general surgery department of the pediatric faculty in the 2nd MSMI since 1954. In 1958–1963, he headed the Department of Acquired Heart Diseases in the Institute of Experimental Biology and Medicine (now the E.N. Meshalkin National Medical Research Center). In 1963–1977, Igor N. Meshalkin was the head of the department in the Central Clinical Hospital of the 4th Main Directorate of the USSR Ministry of Health. His research interests were focused on urgent abdominal surgery, thoracic surgery, mitral stenosis surgery. Igor N. Meshalkin was the author of 55 scientific works including two monographs. Received 8 November 2023. Accepted 14 November 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article. Acknowledgment: The authors would like to thank Marina, daughter of Igor N. Meshalkin, for providing personal documents and photographs.

Surgical treatment of a massive soft tissue neurofibroma in neurofibromatosis type 1

Introduction. Neurofibromas developing in neurofibromatosis type 1 rarely grow to a large size. However, in cases of massive lesions, selection of optimal treatment tactics can be complicated. Clinicians usually resort to surgical treatment which currently serves as an effective instrument for improving patients’ quality of life and for achieving good cosmetic results.Aim. To describe a successful experience of surgical treatment in a patient with giant neurofibroma type 1 affecting a massive pool of soft tissues.Clinical case. Patient, 22 years, sought medical help at the N.N. Blokhin National Medical Research Center of Oncology with diagnosis of neurofibromatosis type 1 with massive lesions in the tissues of the lower third of the back, gluteal region, thighs. The disease has existed since birth, family medical history is fraught: father died of malignant manifestation of a neurogenic tumor. The younger sister is also diagnosed with neurofibromatosis affecting the brain and manifesting through cafe au lait spots on the body. Due to massive tumors significantly decreasing the patient’s quality  of life, cytoreductive surgical treatment was prescribed aimed at maximally radical resection of all available tumors to alleviate the patient’s condition.Conclusion. The presented clinical case demonstrates successful experience of surgical treatment of a patient with giant neurofibroma affecting a massive pool of soft tissues.

Validation of the Russian version of Spine Oncology Study Group Outcomes Questionnaire

Introduction. Surgical intervention is the only or main component of combination treatment of the majority of malignant tumors of the spine. Pronounced pain syndrome and neurological deficit caused by spinal tumors significantly worsen disease progression, decrease patients’ quality of life.Aim. To develop a Russian-language version of a specialized questionnaire to study the quality of life of patients suffering from tumor lesions of the spine Spine Oncology Study Group Outcomes Questionnaire (SOSG-OQ).Materials and methods. In 82 patients with tumors of various parts of the spine who are treated at the N.N. Blokhin National Medical Research Center of Oncology, psychometric evaluation of the SOSG-OQ questionnaire was performed confirming its convergent validity and reliability–consistency (Cronbach’s α = 0.899).Results. Exploratory factor analysis confirmed adequacy of the questionnaire’s structure and its conformity to the basic factor model. Instruments of the validated Russian version of the SOSG-OQ questionnaire (text and data analysis instructions) for its use in clinical practice are presented. Results obtained using the new SOSG-OQ questionnaire show a significant decrease in quality of life of patients with spinal tumors. Additionally, after surgery patients described their health-related quality of life significantly higher than prior to treatment.Conclusion. Validated Russian version of the SOSG-OQ questionnaire can be recommended for application in oncological clinic for more precise and differentiated evaluation of performance status, emotional condition, experience of patients, evaluation of life circumstances associated with the disease to promote more targeted and personalized psychological care.

Cavernomas of cavernous sinus

Background. Cavernoma of cavernous sinus is a fairly rare benign neoplasm, accounting for less than 3 % of all neoplasms in this area. Due to the rarity of this pathology, a standardized protocol for diagnosis or treatment has not been developed. Surgical and radiosurgical methods are used for treatment.Aim. Analysis of the results of treatment of patients with cavernous sinus cavernomas operated at the N. N. Burdenko National Medical Research Center of Neurosurgery from 2000 to 2022 using endoscopic transnasal access.Materials and methods. We present our own experience in the treatment of 9 patients who underwent transnasal endoscopic removal of cavernous sinus cavernoma.Results. A total of about 300 cases of treatment of patients with cavernous sinus cavernomas have been described in the literature, and endoscopic removal has been described in only 12 cases.As a result, subtotal removal was achieved in 7 cases. In 2 cases, the removal was partial. The postoperative period proceeded in all patients without peculiarities and without complications.Conclusion. Endoscopic transnasal access allows partial or subtotal removal of the formation without risk of injury to cranial nerves and with minimal soft tissue injury, which has a positive effect on the postoperative period of patients. In combination with radiosurgical methods, it is possible to achieve satisfactory treatment results.

Objectification of the method for glomerular filtration rate assessing in patients with diffuse large B-cell lymphoma during induction immunochemotherapy

Aim. To study the glomerular filtration rate (GFR) dynamics calculated by creatinine and cystatin C during induction immunochemotherapy in patients with newly diagnosed diffuse large B-cell lymphoma in order to objectify the method for estimation.Materials and methods. The open longitudinal study included 39 patients with newly diagnosed diffuse large B-cell lymphoma who received specialized treatment at the Oncohematology Department of National Medical Research Centre for Oncology (Rostov-on-Don) in 2021. Patients received induction immunochemotherapy according to the R-CHOP regimen (rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisolone) in combination with accompanying therapy (allopurinol 300 mg/day). Blood sampling was carried out at 0, 24, 48, 72, 120 hours and on 21st day of the 1st therapy cycle. Patients were divided into 2 groups depending on the GFR level, calculated by creatinine, before treatment: group A – 27 (69 %) patients with GFR >90 ml/min/1.73 m2, group B – 12 (31 %) patients with GFR <90 ml/min/1.73 m2.Results. During the immunochemotherapy in patients with initially reduced GFR, a further decrease was observed with the restoration of the initial level by day 21 of therapy. When calculating GFR by cystatin C, in contrast to the calculation by creatinine, it revealed the dependence of GFR level on pathological process stage: GFR in group A patients with stages I–II is 20.4 % lower than in patients with stages III–IV, in group B – by 30.5 %. The use of the fisher test at GFR thresholds of 90 and 60 ml/min/1.73 m2 revealed a greater advantage in establishing absolute GFR levels, especially in the range of 60 to 90 ml/min/1.73 m2.Conclusion. The data obtained confirm that the determination of GFR by cystatin C in patients with diffuse large B-cell lymphoma is a more sensitive method that objectively reflects the functional state of the kidneys, especially when values are within the “gray area” – from 90 to 60 ml/min/1.73 m2.

IJCM_131A: Assessment of health related quality of life among type 2 Diabetics patients - A cross sectional study

Background: The impact of diabetes on a patient can be measured by traditional methods, like biochemical, morbidity and mortality although attention has recently been given to measuring health-related quality of life (HRQOL). HRQOL is important to assess the impact of the disease from the patient’s perspective. Hence, HRQOL can be defined as the subjective assessment of the impact of disease and its treatment across the physical, psychological and social domains of functioning and well-being. Objectives: 1. To assess the Health - related quality of life of patients with type- II diabetics.2. To study the associated factors affecting the quality of life of diabetic patients. Methodology: A cross sectional study was conducted in the rural field practice area of Sapthagiri Institute of medical sciences and research centre. Data was collected using a predesigned, pre-validated questionnaire. Data was collected by conducting house to house survey. Informed consent was taken. Data collected was entered in MS excel and analysis was done using SPSS. Frequency and percentages was used for categorized variables. Mean and standard deviation was used for continuous data. Results: A total of 100 diabetics were surveyed. Among them 56 were females and remaining were males. Overall patients with Type II diabetes have a negative impact on their quality of life with or without complications. It also shows that diabetes affects various domains such as physical functioning, emotional well-being, social functioning, economical status, and general health in a patient’s life, thereby affecting the QoL. Conclusion: It is recommended for patients to have an adequate and strict glycemic control enabling them to maintain their quality of life, preventing disease progression and diabetic complications.