Multistage Treatment Research Articles

Клинический случай увеита грибковой этиологии у пациента, перенесшего COVID-19

Purpose. To analyze a clinical case of fungal uveitis in a patient who has undergone COVID-19. Material and methods. A patient born in 1962 was admitted to the Kaluga branch of the MNTK with complains of blurred vision. From the anamnesis: in the first half of 2020, he was treated at the Kaluga branch of the MNTK with a diagnosis of complicated cataract, highly complicated myopia, PCRD, CCRD, pigmentary glaucoma; in the autumn of 2020, he suffered a coronavirus infection complicated by severe bilateral interstitial pneumonia, he was in the intensive care unit for 2 weeks. Results. During examination of the patient, the clinical picture and data of objective methods indicated the development of bilateral uveitis in the patient. A course of anti-inflammatory therapy was prescribed, and positive dynamics were achieved. But there was a sharp deterioration on the 10th day. Concilium was held: a fungal etiology of uveitis was suspected. The anterior chamber was washed, material from the anterior chamber was taken for bacterial culture. At the 3rd day the results of bacterial culture showed the growth of Candida albicans fungi. A multistage complex medical and surgical treatment was carried out. The outcome is encouraged however, the observation time is insufficient to draw final conclusions. Conclusion. The incidence of COVID-19 remains high, so ophthalmologists should remain vigilant, collect a careful anamnesis and expect an increase of the number of patients with intraocular fungal infection. Key words: uveitis; fungal infection; COVID-19.

Оптимизированная технология YAG-лазерного витреолизиса помутнений стекловидного тела

Introduction. Vitreous opacities are quite common, occurring in 76% of cases and significantly reducing quality of life in 33% of them. YAG-laser vitreolysis is considered as an alternative treatment option for patients with floating vitreous opacities. Purpose. To develop an optimized YAG-laser vitreolysis technology based on the assessment of the acoustic density of the vitreous opacities. Material and methods. The results of YAG-laser vitreolysis of vitreous opacities in 318 patients (318 eyes) were analyzed. A photo-optical method has been developed for visualizing opacities of the vitreous body, registering the area of opacities and the dimming intensity index. A method has been developed for the personalized selection of laser energy taking into account the acoustic density of the vitreous opacities. Results. After performing multi-stage laser treatment, a significant decrease in the area of opacities and the dimming intensity index, an increase in the threshold of retinal photosensitivity according to microperimetry data and a decrease in the acoustic density of opacities were noted. Conclusions. Application of optimized YAG-laser vitreolysis technology for vitreous opacities allows to achieve the best values of clinical and functional parameters (p<0.05). Key words: vitreous body opacities, photo-optical method, efficiency of YAG-laser vitreolysis

Knee joint instability in conditions of congenital malformations of the lower extremities

It is impossible to find out the number of patients with knee joint instability (KJI) in case of congenital malformations of the lower extremities (CMLE). Children, adolescents and young people usually adapt well to this abnormality, so they rarely present with symptoms of instability, even with positive tests. The main reasons for the manifestation of KJI in CMLE are inadequate loading, injuries of the lower extremity and surgical correction. Objective. Based on the assessment of the scientific literature to define the KJI terminology, to identify the main causes of its development and clinical manifestations in conditions of CMLE, to identify trends in the treatment tactics. Methods. More than 500 articles from international libraries PubMed, NCBI, Google Scholar, Medscape, MedlinePlus were searched and analyzed. Taken into account the rarity of the abnormality and the small amount of research in recent years, the depth of the search was 25 years. Results. KJI in children with CMLE may be a consequence of congenital structural features of the lower extremity (isolated malformation in the form of agenesis of the cruciate ligaments or inferiority of the ligament of the knee joint in complex abnormality) and complication of surgical correction of longitudinal defects of the extremities. As the abnormality is not well studied, the tactics for such patients still remain the topic of discussion. The expediency of surgical stabilization of the knee joint has not been conclusively proven due to the fact that in the case of its anomalies certain adaptive mechanisms are formed, which on the one hand are not appropriate to violate, and on the other hand, the current level of medicine allows to promote patients’ functional capabilities, inducing KJI progressing. Conclusions. Children with CMLE adapt well to the concomitant KJI, so in everyday life and prior to surgical correction of CMLE, it does not bother patients. Particular attention should be paid to the stability of the knee joint both before and during prolongation and correction of deformity. The variability and severity of CMLE determines the implementation of multi-stage surgical treatment and surgical stabilization of the knee joint to improve extremity function may be one of them. Key words. Children, knee joint instability, congenital malformations, lower extremities, surgical treatment.

Full recycling of high-value resources from cabbage waste by multi-stage utilization

Cabbage waste (CW) was recycled for generating some potential high-value products by a multi-stage treatment technology. A novel multi-stage utilization process was successfully proposed which consisted of low-temperature extraction, medium-temperature thermolysis, and high-temperature activation. Plant extracts that contain fatty acids, alcohol, furan, and esters were first extracted from raw cabbage waste by ethanol at 70 °C. Pyrolytic oil was obtained by cabbage waste pyrolysis at different medium temperature conditions. The produced carbon residue was further activated at high temperature for environmental purification such as VOCs removal. The performance of this process was characterized by N2 isothermal adsorption, Fourier transform infrared spectrometer (FTIR), thermogravimetric analysis (TG) and gas chromatography–mass spectrometry (GC–MS). Experimental results showed that the optimum temperatures for extraction, pyrolysis, and activation were 70 °C, 520 °C and 700 °C, respectively. Phenolic-rich pyrolysis solution with 50% phenolic contents could be obtained with the potential application of botanical pesticide. The produced biochar had a BET surface area of as high as 891.12 m2/g. The yields of biochar, pyrolytic liquid, and pyrolytic gas were 43.86%, 17.47%, 38.67%, respectively, and the process energy efficiency was over 42.7%. Applicability and feasibility of this process were also discussed in the aspects of energy quality balance, economy, and environment. The proposed multi-stage thermal-chemical process could be used as a full recycling method for biomass waste.

Особливості проведення фізичної реабілітації при часто рецидивуючому типу перебігу виразкової хвороби

The article deals with the results of single-stage and multi-stage rehabilitation treatment of patients with often recurrent peptic ulcer disease. The aim of the investigation: to study and improve a comprehensive physical rehabilitation program for people who are actively involved in sports with recurrent peptic ulcer disease of the stomach and duodenum. Material and methods. The study involved 42 patients with peptic ulcer of the stomach and duodenum with often recurrent type (age 18–28). The results of the study: The first experimental group was recommended treatment at all stages of rehabilitation (inpatient, outpatient and sanatorium). During 9 months, each patient received treatment in a hospital (day hospital), clinic and sanatorium. The second control group underwent rehabilitation measures only at the inpatient or outpatient stage. Diet therapy, phytotherapy, medical physical training, physiotherapy were used at all stages of rehabilitation treatment.The effectiveness of treatment and rehabilitation was assessed by the following indicators: the dynamics of subjective and objective manifestations of the disease, the condition of the mucous membrane of the stomach and duodenum and the frequency of recurrences during the year. In the period between treatments, treatment methods were recommended to perform them at home (diet therapy, kinesitherapy, etc.). After rehabilitation and staged treatment, observation of patients lasted 12 months. Analysis of the disease course indicates that the prolonged treatment of peptic ulcer disease with the use of various rehabilitation measures in the inpatient, outpatient and sanatorium, reduced the number of exacerbations during the year and the number of hospitalizations compared to cases where patients underwent only one stage of rehabilitation.The greater efficiency of multi-stage treatment indicates the data obtained during the examination of the state of acid formation in the stomach. Conclusion: Rehabilitation should be carried out continuously, including all stages of rehabilitation and continue until maximum recovery is achieved.

Boric acid removal with polyol-functionalized polyether membranes

Poor selectivity of conventional desalination membranes for boron often necessitates multi-stage treatment trains to achieve desired boron removal for end uses such as irrigation. One approach to membrane design for improved single-pass boric acid removal is via incorporation of chelating ligands that selectively sorb boron. In this study, membranes based on epoxy-amine cross-linked poly(glycidyl glycidyl ether) (PGGE) were synthesized and functionalized with N-methyl-d-glucamine (NMDG), a polyol known to interact selectively with boron. PGGE and PGGE-NMDG membranes exhibited boron sorption isotherms that were well-described by dual mode isotherms. PGGE-NMDG sorbed 2.5 mmol B/g dry polymer from a neutral aqueous solution containing 100 mmol B/L, which was almost three times the adsorption density of a commercial boron selective resin, Amberlite IRA743. The membranes were regenerated in acid without a significant loss of boron sorption capacity over four cycles. Interactions between boron and NMDG and PGGE sites (e.g., epoxides) impacted boron diffusion in both membranes. The use of ligand functionalized membranes to capture target solutes such as boron requires high loading of interacting sites to maximize uptake capacity. Establishing fundamental structure/property rules for boron selectivity could lead to new material designs with improved boron separation properties for water purification.

The Effect of Water and Sewage Treatment on Reducing Residues of Selected Organochlorine Pesticides in Szczecin (Poland)

Water is principally intended for direct consumption and for the production of food and beverages. It is also a valuable raw material in the industry. Despite the use of multi-stage treatment processes, the quality of drinking water may still be a concern in some countries due to the presence of toxic pollutants, often challenging to remove through the conventional treatment process. The presence of even trace amounts of organochlorine pesticides in drinking water is dangerous due to their ability to accumulate in the human body and their effects, especially their capacity for endocrine disruption. The present study aimed to assess the effect of water and sewage treatment on the efficiency of reducing residues of selected organochlorine pesticides in drinking water and treated sewage. It was found that the water treatment process reduced concentrations of these compounds by an average of 80% (46–100%) and that the levels of organochlorine pesticides in the drinking water were no higher than 0.55% the maximum residue limit (MRL). The sewage treatment process led to a reduction in organochlorine pesticide concentration of 37–100%, averaging 85%, and the sums of organochlorine pesticide residues in treated sewage ranged between 0.02 and 14.97 ng/L in annual terms.

The Role of Deep Hypothermia in Cardiac Surgery.

Hypothermia is defined as a decrease in body core temperature to below 35 °C. In cardiac surgery, four stages of hypothermia are distinguished: mild, moderate, deep, and profound. The organ protection offered by deep hypothermia (DH) enables safe circulatory arrest as a prerequisite to carrying out cardiac surgical intervention. In adult cardiac surgery, DH is mainly used in aortic arch surgery, surgical treatment of pulmonary embolism, and acute type-A aortic dissection interventions. In surgery treating congenital defects, DH is used to assist aortic arch reconstructions, hypoplastic left heart syndrome interventions, and for multi-stage treatment of infants with a single heart ventricle during the neonatal period. However, it should be noted that a safe duration of circulatory arrest in DH for the central nervous system is 30 to 40 min at most and should not be exceeded to prevent severe neurological adverse events. Personalized therapy for the patient and adequate blood temperature monitoring, glycemia, hematocrit, pH, and cerebral oxygenation is a prerequisite and indispensable part of DH.

SURGICAL TACTICS FOR PURULENT-SEPTIC COMPLICATIONS OF COMBAT BELLY INJURIES

Summary. Combat injury of the abdomen, according to the ATO / OOS is from 6.7 to 9 %. The specificity of gunshot wounds to the abdomen causes the development of functional disorders and complications (51–81 %) and, as a consequence, a high mortality rate (12–31 %).
 Objective: To improve the effectiveness of surgical treatment of purulent-septic complications in the wounded with combat trauma to the abdomen (BTC).
 Materials and methods. The Military Medical Clinical Center of the Southern Region (VMKC PR) analyzed the treatment of 86 wounded who were hospitalized with purulent-septic complications of BTZ from 2014 to 2020, taking into account the location, clinical manifestations and severity of injury, used modern treatment methods , namely: puncture and drainage interventions under the control of ultrasonography and installation of NPWT systems. Comprehensive treatment was supplemented with antibacterial therapy and oxygen barotherapy.
 First of all, the wounded underwent puncture and drainage interventions under ultrasonic navigation and gradual rehabilitation for diagnostic and therapeutic purposes. NPWT therapy was used in 11 patients with extensive wounds and purulent-septic complications of the soft tissues of the anterior abdominal wall.
 Thus, the use of interventional sonography, as the primary diagnostic and treatment method for the treatment of purulent-inflammatory complications of combat trauma to the abdomen, has improved the quality of diagnosis and reduced traumatic interventions, which has reduced postoperative complications and inpatient treatment.
 Results and discussion. Eleven (14.2 %) cases of puncture and drainage interventions were ineffective, in connection with which we had to resort to traditional methods of treatment — opening and drainage of purulent-inflammatory foci and the use of NPWT-therapy. Vacuum therapy is an effective method of treatment of purulent-septic complications of gunshot wounds of the soft tissues of the abdomen, which in combination with puncture-drainage interventions, can reduce by 2.5 times the number of repeated operations (mainly multi-stage surgical treatments), thereby reducing 1.8 times the length of stay of patients in the hospital.
 Conclusions. Thanks to the use of modern methods it was possible to improve the results of surgical treatment of purulent-septic complications in the wounded with purulent-septic complications of combat trauma to the abdomen.
 The use of the latest techniques has helped reduce the number of invasive treatments, accelerate recovery, reduce bed rest, reduce intoxication, and increase the rate of return of servicemen.

Integrated and intelligently controlled unit for suspension freeze concentration: design and experimental verification

Suspension freeze concentration (SFC) can avoid denaturation while concentrating thermal-sensitive aqueous solutions. However, the complex treatment process and high capital cost severely limit its application in large-scale production. In this paper, a compact and integrated unit is devised to overcome these shortcomings and improve the operability of SFC. The unit is in a vertical layout and supports multistage treatment to successively condense the solution. Several innovative designs are made for the key components, including the helical blades in the scraped surface heat exchanger and a dual-use column for recrystallization and washing. The former helps to establish the circulation of solution and impose forces to compress the ice column, while the latter enables seamless switch between different processes. As the whole process of SFC is well known to be time-consuming and labor-intensive, an intelligent controlling system is installed on the unit to realize on-site and/or remote monitoring and adjustment of the treatment. A concentration experiment using apple juice was conducted to verify the design and demonstrate the advantages. The results show that high-quality solutions were obtained with this unit. The recovery yields of the soluble solids and nutrients components are over 98.5% and 80.0%, respectively. Based on the work principles of the freezing and washing process in this design, the mechanism behind the superior recovery yields is analyzed. This study opens up a potential route for scaling up SFC and is expected to stimulate further work to achieve industrial application.

Multi-stage treatment of non-specific spondylodiscitis of the cervical spine

The objective is to present a clinical case of successful treatment of a patient with recurrent spondylitis at the cervical level.Clinical case. A 65-year-old patient was diagnosed with purulent spondylodiscitis at the level of C6-C7 vertebrae with the epidural and paravertebral abscesses and spinal cord compression. Emergency left colotomy, paravertebral abscess dissection, corporectomy of the C6 vertebra, abscess removal, anterior spondylodesis with bone autograft and titanium plate were performed. Massive antibacterial therapy was prescribed. After the operation, the volume of movement in the left limbs was restored, and on the 15th day after the operation, the patient was discharged. On the 36th day after discharge, she was hospitalized again with hematuria. A recurrence of suppuration in the area of the operation and phlegmon of both feet was revealed. Revision of the surgical wound and rehabilitation of the purulent focus on the neck, surgical intervention for phlegmon were performed. In purulent foci, Staphylococcus aureus was verified, which is sensitive to the main antibacterial drugs. Antibacterial therapy was continued, then, after changing the microflora in the wound, other antibiotics were prescribed. There was a pain in the area of the left spinal root C5. The connection of the fistula course with the titanium plate, the increase of pathological kyphosis at the level of the overlying vertebrae was found. The wound was examined, the titanium plate was removed, and the halo device was applied to correct the pathological kyphosis. After the operation, the radicular pain syndrome regressed, and the axis of the cervical spine was restored. After 1 month, the posterior combined fixation of the cervical spine at the C3-Th7 level was performed, and the halo device was dismantled. After 6 months, the patient was stopped wearing the Philadelphia neck collar, no recurrence of suppuration was observed, and a complete regression of neurological disorders was noted. After 1 year, a complete bone block is preserved between the C4-C7 vertebrae.Conclusion. The presented clinical case clearly illustrates the complexity of managing patients with inflammatory diseases of the cervical spine. Currently, there is no single treatment strategy for patients with spondylitis.

Single- and multistage surgical treatment of patients with degenerative sagittal imbalance

Objective. To analyze the nearest clinical and radiological results of simultaneous and staged surgical treatment of patients with degenerative sagittal imbalance.Material and Methods. Retrospective monocentric cohort study included analysis of data from 54 patients who underwent simultaneous combination of surgical methods with obligatory corrective anterior fusion at the L4–L5 or at L4–L5 and L5–S1 levels (Group I, n = 27) or similar surgical intervention though divided into stages with an interval of 5 days or more (Group II, n = 27). A comparison of clinical, radiological, and operational data during inpatient treatment was carried out.Results. The duration of surgery was 410.93 ± 76.34 minutes in Group I and 594.63 ± 102.61 minutes in Group II (p = 0.000001); the blood loss was 926.67 ± 378.63 ml versus 1345.19 ± 522.97 ml, respectively (p = 0.001575). Postoperative clinical and radiological parameters did not differ between groups: VAS back (p = 0.248647), VAS leg (p = 0.196140), PT (p = 0.115965), SVA (p = 0.208449), LL (p = 0.023654), LDI (p = 0.931646), PI-LL (p = 0.693045), GAP (p = 0.823504), and restoration of the ideal Russoly type (p = 0.111476). The incidence of perioperative complications in groups was comparable: 17 (62.96 %) in Group I and 15 (55.56 %) in Group II (p = 0.583171). Patients with a high Charlson comorbidity index had a significantly higher incidence of complications (p = 0.023471). The index of surgical invasiveness in Group I had a significant correlation with the total number of complications (r = 0.421332).Conclusion. Clinical and radiological results and the incidence of complications are comparable between single- and multistage approaches to correct sagittal balance disorders. In staged treatment, the total duration of surgery and the volume of blood loss are significantly higher. With a high Charlson comorbidity index and Mirza surgical invasiveness index, a multistage approach to the treatment of patients with sagittal imbalance is preferred.

Incorporation of ozone-driven processes in a treatment line for a leachate from a hazardous industrial waste landfill: Impact on the bio-refractory character and dissolved organic matter distribution

The current work aimed to evaluate the feasibility of including ozone (O3)-based advanced oxidation processes (AOPs), as an intermediate step, in a multistage treatment system for non-biodegradable sulphur-rich leachate from a hazardous industrial solid waste landfill (HISWL), combining chemical and biological oxidation technologies. O3-based AOPs covered perozonation (O3/H2O2), photo-assisted ozonation (O3/UVC), and photo-assisted perozonation (O3/H2O2/UVC). All O3-driven processes were applied to HISWL leachate directly after sulphur compounds removal via catalytic oxidation and chemical precipitation. Moreover, ozonation was also tested after a sequential coagulation step using ferric or aluminium salts (O3/Fe2+ or O3/Al3+), and O3/H2O2/UVC system was likewise tried after Fe-mediated coagulation targeting photo-Fenton-assisted ozonation (O3/PF). The best-performing treatment train encompassed: (i) catalytic oxidation with H2O2 (stoichiometric amount) under free pH, to convert sulphite and sulphide ions into oxidised sulphur species, including sulphate; (ii) chemical precipitation of sulphate as barite mineral without pH correction; (iii) O3/H2O2 process for ca. 2.1-h (natural pH; room temperature; 3.5 kg O3 and 1.1 kg H2O2 per m3 leachate), to degrade refractory organic matter and improve biodegradability; and (iv) biological oxidation to remove the remaining bioavailable organics fraction. This four-stage approach allowed shifting from a highly recalcitrant wastewater to an effluent in full agreement with the regulation for industrial wastewater discharge into the municipal sewer network. Furthermore, the effectiveness of the O3/H2O2 process over the dissolved organic matter transformation was corroborated by fluorescence excitation-emission matrix and size exclusion chromatography analysis.

Analysis of Concentration Dependent Interdiffusion Coefficient Under the Condition of Pre-Existing Non-uniform Solute Distribution

A numerical inverse method is used to calculate concentration dependency of interdiffusion coefficient under a condition of pre-existing non-uniform solute distribution, which is impossible to do by standard techniques including the Boltzmann–Matano, Sauer–Freise, Hall, and Wagner methods. The results show that in contrast to what has been implicitly assumed in the literature, “calculation-error-free” concentration-dependent interdiffusion coefficient can be significantly influenced by non-uniform solute distribution that pre-exists in a material prior to a diffusion process. In such cases, the use of concentration-dependent interdiffusion coefficient obtained by the standard techniques, such as, the Boltzmann–Matano, Sauer–Freise, Hall, and Wagner methods, to model, predict or analyze diffusion effects during multi-stage materials processing, such as, sintering, brazing, coating and heat treatments, can be considerably unreliable.

Injuries after Forklift Trucks Accidents - Injury Patterns, Therapy and Outcome in the Context of the Statutory Accident Insurance.

The use of forklift trucks during work has a high accident potential. The aim of this study is to describe injury patterns, treatment and outcome after forklift truck accidents in the context of the employers' liability insurance association. Retrospective data collection of all cases between 2004 and 2019. Excluded were patients < 18 years, without follow-up or with definitive external treatment. Trauma mechanism, injury patterns and distribution, treatment, complications, time of incapacity for work, return to work and impairment of earning capacity were recorded. Of 109 patients with 110 injuries, 52.7% showed isolated injuries and 47.3% combined injuries, which affected the lower extremity in 95 cases. There were fractures in 85.5%, including 32.7% in open form. The mean length of stay was 29.1 days (range 1 - 129); an indication for surgery was seen in 80.9%. Surgical treatment required an average of 3 interventions, with significantly more operations for soft tissue closure than for the fractures (p ≤ 0.023). Amputations were necessary in 8 cases; complications occurred in 29.1%. Return to work was possible in 90%, after a mean period of incapacity for work of 33.6 weeks. A total of 40% showed a pensionable impairment of earning capacity. Accidents with forklift trucks result in complex lower extremities injuries with the need of multi-stage treatment and show relatively high complication rates. A return to work is often possible after a long period of convalescence, and a pensionable impairment of earning capacity often persists.

A clinical case of staged endovascular treatment of a patient with coronary heart disease and multiple lesions of peripheral arteries

A clinical case of successful treatment of a patient with atherosclerotic peripheral artery disease and clinically significant lesion of the coronary and carotid arteries. Patients underwent multi-stage surgical treatment. The first stage performed endovascular treatment the left internal carotid artery, the second — myocardial revascularization, the third — endovascular treatment of the left iliac arteries, the fourth — rotational atherectomy with stenting of the right superficial femoral artery. There were no complications in the perioperative period. The technique of operations is described, explanations are given for the chosen treatment strategy. The conclusion is drawn about the advantage of endovascular techniques in the treatment of patients with multifocal atherosclerosis.

Addendum

Addendum

Comprehensive treatment of cervical intraepithelial neoplasia

Aim. To study the effectiveness of the use of Neovir (sodium oxodihydroacridinyl acetates) as immunomodulatory and antiviral drug in the comprehensive treatment of various grade cervical intraepithelial neoplasia (CIN). Study design: prospective comparative study.&#x0D; Materials and methods. The study included 60 patients (mean age 34.78.2 years) with morphologically verified various grade CIN, who were received comprehensive treatment, including the use of Neovir (sodium oxodihydroacridinyl acetate) as the drug with immunomodulatory and antiviral activity, 250 mg/2 ml intramuscularly every 48 hours, 10 injections before (group 1) or after (group 2) multi-stage radiosurgical diagnostic and treatment procedure or only a similar surgical intervention (group 3). All patients underwent complete clinical, morphological and laboratory examination with monitoring for the presence of high-risk human papillomavirus (HPV) in the cervical scraping and the dynamics of peripheral blood lymphocyte subpopulations.&#x0D; Results. Dynamic follow-up showed that in a month after surgery, patients who were treated with radiosurgical resection as monotherapy (group 3) had the lowest rate of complete epithelialization of the cervical stump 30.0% vs 55.0 and 65,0% in the group 1 and group 2 respectively. In this group, the proportion of patients with persistent viral infection was 1.52 times higher than in the groups where an antiviral drug was used in combination with radiosurgical intervention 35.7% vs 17.6 and 22.2% in the group 1 and group2, respectively. In 6 months, elimination of high-risk HPV in groups with comprehensive treatment reached 94.5 in the group 1 and 94.1% in the group 2 (p0.05) vs 78.6% in the group 3. The lowest number of TNK- and NK-cells was found in the group of patients who received radiosurgical treatment as monotherapy, which correlated with the highest incidence of high-risk HPV persistence after treatment in this group.&#x0D; Conclusions. In patients with various grade CIN, the use of an immunomodulatory drug with antiviral activity in combination with radiosurgical intervention promotes early epithelialization of the cervix and elimination of high-risk HPV, which is confirmed by significant changes in the lymphocyte subpopulations which provide antiviral immunity.

Comparative analysis of regional chemotherapy methods on an experimental rat model with peritoneal carcinomatosis

Peritoneal carcinomatosis is a variant of implantation metastasis of tumors sprouting the serous membrane of an organ. At the moment, the most effective treatment for this disease is regional chemotherapy. Systemic chemotherapy is not effective enough. The standard for the treatment of peritoneal carcinomatosis was cytoreductive interventions followed by open or closed hypertermic intraperitoneal chemoperfusion (HIPEC) or pressurized intraperitoneal aerosol chemotherapy (PIPAC).&#x0D; Purpose of the study: in an animal experiment to compare the efficacy and safety of regional chemotherapy methods HIPEC and PIPAC&#x0D; Materials and methods: the study was conducted on 44 rats of Wistar females. To simulate carcinomatosis, a strain of ascites ovarian tumor (OA) from the Russian Oncology Cancer Research Center N.N. Petrova. was used. The safety of the technique was evaluated clinically and based on laboratory blood tests. Efficiency - based on mass spectrometry, pathomorphological data and in assessing the life expectancy of animals.&#x0D; Results: the conducted methods HIPEC (open, closed) and PIPAC have shown their safety in experiments on laboratory animals. The closed HIPEC technique is most effective. The analysis of the incidence of postoperative complications demonstrated a greater aggressiveness of open and closed techniques compared to the more “sparing” PIPAC method.&#x0D; Conclusions: the experiment showed comparable safety of all animals tested. Due to the peculiarities of the technique, the PIPAC method can be used as an option for multi-stage treatment in cases where CPC and HIPEC are not possible due to a high index of peritoneal carcinomatosis, and as a neoadjuvant treatment to prevent peritoneal carcinomatosis. In any case, the prospects for using this method require further research.

Finding a suitable treatment solution for a leachate from a non-hazardous industrial solid waste landfill

The current study aimed at tackling the lack of effective treatment solutions for leachates from industrial solid waste landfills (ISWLs) through the development of a treatment train for a non-hazardous ISWL (NHISWL) leachate with low/moderate content of organics and salts and low biodegradability. The following technologies were tested: (i) coagulation using ferric chloride (FeCl3) or aluminium sulphate (Al2(SO4)3), (ii) biological oxidation, and (iii) chemical and electrochemical advanced oxidation processes (AOPs/EAOPs), including photo-Fenton oxidation using ultraviolet C (UVC) or ultraviolet A (UVA) radiation (PF-UVC or PF-UVA), anodic oxidation (AO), ozonation process and ozone (O3)-based processes. The best multistage treatment strategy included: (i) coagulation with FeCl3 for partial removal of organics (with direct impact on colour, odour and turbidity removal and biodegradability enhancement) and phosphorous, (ii) PF-UVC process for recalcitrant organics oxidation (with direct impact on colour and odour removal and biodegradability enhancement) coupled to a clarification step for removal of suspended solids, turbidity, iron and phosphorous, and (iii) biological process for removal of the generated biodegradable organics and of nitrogen compounds. Upon treatment, the NHISWL leachate fulfilled European and Portuguese requirements for discharge into aquatic systems, except for ammonium (and consequently for total nitrogen), pointing to the need to change the biological process conditions or add an air stripping step. The application of coagulation before the PF-UVC process has proved to be crucial for the fulfilment of the legislation requirements.