NEOADJUVANT CHEMOTHERAPY FOR EPITHELIAL OVARIAN CANCER. MODERN METHODS AND PATIENTS SELECTION CRITERIA

Ovarian cancer is the 3rd most common cancer among women with gynecological neoplasms in Russia, at the same time, it have the highest mortality rate among malignant tumors of the female reproductive system. Because ofvague clinical picture and the lack of effective methods for early detection and screening, more than 60% of cases are diagnosed at stage III-IV, after the spread of tumor beyond the pelvis. Standard treatment for this category of patients includes debulking surgery on the first stage, followed by adjuvant chemotherapy. The main predictor of the prognosis is the residualvolume of disease after debulking surgery. Nowadays, complete resection of all macroscopic disease is considered as optimal cytoreduction. Trying to perform surgical treatment in the optimal volume dictates the need for complex, multi-component operations, accompanied by significant postoperative morbidity and mortality. In addition, in many cases, resection of all macroscopic foci of the disease is technically impossible.The use of neoadjuvant chemotherapy is designed to reduce the incidence of postoperative complications and to achieve optimal cytoreduction in the maximum number of patients.After an analysis of literature the authors could make up aconclusion that the place of neoadjuvant chemotherapy in the treatment of advanced forms of ovarian cancer is still arguable. Based on data from clinical trials, the primary debulking surgery after the diagnosis is the best treatment for this category of patients. However, among patients with markers of unresectability according to the radiologic methods, as well as patients with poor performance status, that significantly increases the risk of surgery, use of neoadjuvant chemotherapy is a reasonable method of choice

The Need for the Retina’s Surface “Drying” during Macular Hole Surgery

Purpose: to determine the relevance of retina’s surface “drying” during vitrectomy at the stage of exchange of infusion solution for air based on an experimental study and calculation of the geometric dimensions of a drop of moisture formed in the macular region.Patients and Methods. There were 10 patients (10 eyes), who had a vitrectomy for a macular tear with air injection in one eye. Their age was from 50 to 78 (64.0 ± 3.1), the size of the macular tear 250–631 (431.6 ± 44.3) mkm. After 27G subtotal vitrectomy intake of fluid formed after fluid-air exchange was performed and its volume was measured in equal time intervals 3 times. The next step is to determine the shape of a drop of intraocular fluid (IOF) that forms on the surface of the retina during BSS exchange. For example, in the cadaveric eye, the wetting of the retinal surface was studied with the volume of liquid that was obtained during the operation, and its edge wetting angle was measured. Given the fact that INFLOW during surgery formed from two sources: the result of the production of the ciliary body (CB) (2,5–4,0 μl/min) and dehydration of the vitreous body (VB) due to the pressure of the air supplied in the vitreal cavity was calculated drop diameter INFLOW first, when the product of TST and dehydration VB (CB + VB); second, only if the production CT. This made it possible to understand how a drop of HGH formed during the operation will be projected onto the surface of the macula. Results. Volume of intraocular fluid taken during surgery was 60–80 microliters (68.1 ± 2.8) for 3 minutes, or 22.7 microliters per minute. Rate of fluid formation decreased by 18–25 % for 9 minutes. Contact angle of wetting made 14.5°. Drop diameter calculated for ciliary body secretion and vitreous remnants dehydration equals 17.98 mm. Drop diameter calculated for ciliary body secretion alone equals 2.6 mm. Conclusions. “Drying” of the retina during macular hole surgery is impractical as intraocular fluid is constantly formed on the retina surface. Its volume is sufficient to cause opening of the hole. Refusal from this manipulation would not influence anatomic efficacy of the operation and would reduce surgical trauma

СОВРЕМЕННЫЕ МЕТОДЫ БИОМОНИТОРИНГА СТОЙКИХ ТОКСИЧНЫХ СОЕДИНЕНИЙ В АРКТИЧЕСКОЙ ЗОНЕ РОССИЙСКОЙ ФЕДЕРАЦИИ

The article is addressed to topical issues of organizing and conducting monitoring of the concentration of persistent toxic substances in human blood with a view to controlling their level and avoiding negative health effects of the population exposed to them in the Arctic zone of the Russian Federation. The purpose of the study was the scientific substantiation of evaluation criteria and methods for biomonitoring of chemicals that can be used in programs of state social and hygienic monitoring. The objectives of the study included: analysis of persistent toxic substances in the blood of the population; Development of recommendations on justifying the priorities of the state program of social and hygienic monitoring for Arctic. The results of the research showed insufficient effectiveness of existing programs, allowed to develop proposals for improving monitoring systems, including a list of new indicators and changing the structure, forming a single information space in general for all regions of the Russian Arctic.Статья посвящена актуальным вопросам организации и проведения наблюдения за содержанием стойких токсичных веществ в биологических средах с целью контроля их уровня и недопущения негативных последствий для здоровья населения, подвергающегося их воздействию в Арктической зоне Российской Федерации. Цель исследования — научное обоснование критериев оценки и методов биомониторинга химических веществ, которые могут быть использованы в программах государственного социально-гигиенического мониторинга. Задачи исследования включали: анализ содержания стойких токсичных веществ в крови населения; разработку рекомендаций по обоснованию приоритетов государственной программы социально-гигиенического мониторинга для Арктической зоны Российской Федерации. Полученные результаты исследования показали недостаточную эффективность существующих программ, позволили разработать предложения по совершенствованию систем мониторинга, включению в нее перечня новых показателей и изменению структуры, формированию в ней единого информационного пространства в целом для всех субъектов, географически входящих в состав Арктической зоны Российской Федерации (АЗРФ)