Modified Porro’s Operation in Ovarian Cancer: a Clinical Case

Background. Ovarian cancer in pregnancy is quite rare having a top 5th incidence among other pregnancy-associated tumours [1]. Due to a low population rate in pregnant women, the lack of standardised management of such patients and the paucity of relevant randomised and cohort studies, analyses of individual clinical cases acquire particular importance.Materials and methods. This article presents a clinical case of de novo diagnosed ovarian cancer in pregnancy tackled with a modified Porro’s operation of peritonectomy, para-aortic and parametric lymphadenectomy and greater omentum resection at a gynaecology unit of the Kuvatov Republican Clinical Hospital of Ufa.Results and discussion. This clinical case is special in terms of a rare occurrence of ovarian cancer in pregnancy. The choice of this radical surgical technique is considered optimal for inspecting most plausible metastatic foci and ensuring a life-preserving prognosis.Conclusion. In the absence of standardised management protocols in pregnancy-associated ovarian cancer, further analyses and discussions of routine clinical case evidence are imperative

Perforated Peptic Ulcer Combined with Posttraumatic Diaphragmatic Hernia in Third Gestation Trimester: a Clinical Case

Background. Gastric and duodenal ulcers are extremely rare in pregnancy, according to published literature. Peptic ulcer is found in 1 per 4,000 pregnant women, a figure probably underestimated due to its hampered diagnosis in pregnancy. Pregnancy peptic ulcer is considered less expected. Perforated gastric and duodenal ulcers comprise about 1.5 % of total acute abdominal diseases, and the perforation rate in ulcer patients ranges within 5–15 %. This complication afflicts the ages of 20–40 years in men much more frequently than in women. Three perforation types occur: free into abdominal cavity (87 %), contained (9 %), into lesser omentum and retroperitoneal tissue (4 %).Materials and methods. The clinical case describes surgical management of posttraumatic diaphragmatic hernia-comorbid perforated gastric ulcer in a pregnant woman in third trimester. Surgery with postoperative patient management enabled for a favourable outcome.Results and discussion. Perforation-entailing gastric and duodenal ulcers in pregnant women have received negligible attention due to rarity in clinical practice. Paul et al. described 14 cases of duodenal perforation in pregnancy, all fatal.Conclusion. Early diagnosis of surgical pathology during gestation is still difficult contributing to the development of severe complications associated with high mortality. The patient’s admission to a level III interspecialty hospital was key to enable a timely consilium-driven decision of caesarean intervention for saving the child, diagnosing intraoperatively life-threatening complicated surgical diseases and opting for radical surgery that ended in a favourable outcome

Biomarkers of oxidative stress and smoking in cancer patients

Context: Increased oxidative stress is a significant part of pathogenesis of smoking-related cancer. Aim: The study aims to investigate changes in antioxidant status induced by chronic cigarette smoking in cancer patients and healthy subjects. Setting and Design: We examined the venous blood samples of 54 healthy subjects, both smokers (25) and non-smokers and of 50 patients with smoking-related cancer, both smokers (34) and non-smokers. Materials and Methods: We measured the activities of five antioxidant (AO) enzymes: glutathione peroxidase, glutathione transferase (GST), glutathione reductase, superoxide dismutase and catalase in the blood of 50 cancer patients and 54 healthy persons. Damage to cellular structures (level of malonic dialdehyde, micro viscosity of erythrocyte membranes, number of leukocyte DNA breaks) was determined. Statistical analysis of results obtained was performed using conventional and multi-factorial statistical methods. Results: Statistically significant increase in GST activity and DNA breaks, but decrease of membranes micro viscosity in cancer patients, compared with healthy subjects were obtained. In the cancer patients, no influence of smoking on studied parameters was found. Correlations of parameters within cancer patients and healthy subjects group did not coincide with each other. Conclusions: Changes of AO status parameters and oxidative damages in cell structures are related to tumor processes indicating the augmentation of oxidative stress in human blood. This study demonstrated potential applicability of a statistical model based on the evaluated biomarkers of oxidative stress to determine a smoking-induced harm of cancer incidence in healthy subjects

Experience of extracorporeal membrane oxygenation in a laboring woman with severe preeclampsia

The aim of the work is to demonstrate the possibility of using extracorporeal membrane oxygenation in the complex therapy of severe lung damage in a patient with multiple organ failure caused by severe preeclampsia.Цель работы – демонстрация возможности применения экстракорпоральной мембранной оксигенации в комплексной терапии тяжелого поражения легких у пациентки с полиорганной недостаточностью, вызванной тяжелой преэклампсией

Модифицированная операция Порро при злокачественной опухоли яичника: клинический случай

Background. Ovarian cancer in pregnancy is quite rare having a top 5th incidence among other pregnancy-associated tumours [1]. Due to a low population rate in pregnant women, the lack of standardised management of such patients and the paucity of relevant randomised and cohort studies, analyses of individual clinical cases acquire particular importance.Materials and methods. This article presents a clinical case of de novo diagnosed ovarian cancer in pregnancy tackled with a modified Porro’s operation of peritonectomy, para-aortic and parametric lymphadenectomy and greater omentum resection at a gynaecology unit of the Kuvatov Republican Clinical Hospital of Ufa.Results and discussion. This clinical case is special in terms of a rare occurrence of ovarian cancer in pregnancy. The choice of this radical surgical technique is considered optimal for inspecting most plausible metastatic foci and ensuring a life-preserving prognosis.Conclusion. In the absence of standardised management protocols in pregnancy-associated ovarian cancer, further analyses and discussions of routine clinical case evidence are imperative.Введение. Рак яичников при беременности является достаточно редкой патологией. Данный вид опухоли занимает 5-е место среди всех выявленных во время беременности опухолевых процессов Из-за небольшой частоты распространения данной патологии в популяции беременных женщин, отсутствия стандартизированных рекомендаций по ведению данной группы пациенток, а также недостаточного количества рандомизированных и когортных исследований по данной проблеме особую актуальность приобретает разбор отдельных клинических случаев.Материалы и методы. В данной статье проводится разбор клинического случая de novo выявленного рака яичника во время беременности, проведения модифицированной операции Порро с перитонэктомией, парааортальной и параметральной лимфоаденодиссекцией, резекцией большого сальника в условиях гинекологического отделения РКБ им. Г.Г. Куватова г. Уфы.Результаты и обсуждение. Уникальность данного клинического случая состоит в редкой встречаемости развития рака яичников во время беременности, а также в выборе оперативной тактики с перитонэктомией в области расположения данной опухоли. Выбор данной радикальной техники оперативного вмешательства является наиболее рациональным для возможности эффективно исследовать вероятные очаги метастазирования и благоприятного исхода для жизни пациентки.Заключение. Ввиду отсутствия стандартизированных протоколов ведения пациенток с раком яичников во время беременности необходимо продолжать анализ и обсуждение данных клинических случаев в повседневной практике

Biomarkers of oxidative stress and smoking in cancer patients

Context: Increased oxidative stress is a significant part of pathogenesis of smoking-related cancer. Aim: The study aims to investigate changes in antioxidant status induced by chronic cigarette smoking in cancer patients and healthy subjects. Setting and Design: We examined the venous blood samples of 54 healthy subjects, both smokers (25) and non-smokers and of 50 patients with smoking-related cancer, both smokers (34) and non-smokers. Materials and Methods: We measured the activities of five antioxidant (AO) enzymes: glutathione peroxidase, glutathione transferase (GST), glutathione reductase, superoxide dismutase and catalase in the blood of 50 cancer patients and 54 healthy persons. Damage to cellular structures (level of malonic dialdehyde, micro viscosity of erythrocyte membranes, number of leukocyte DNA breaks) was determined. Statistical analysis of results obtained was performed using conventional and multi-factorial statistical methods. Results: Statistically significant increase in GST activity and DNA breaks, but decrease of membranes micro viscosity in cancer patients, compared with healthy subjects were obtained. In the cancer patients, no influence of smoking on studied parameters was found. Correlations of parameters within cancer patients and healthy subjects group did not coincide with each other. Conclusions: Changes of AO status parameters and oxidative damages in cell structures are related to tumor processes indicating the augmentation of oxidative stress in human blood. This study demonstrated potential applicability of a statistical model based on the evaluated biomarkers of oxidative stress to determine a smoking-induced harm of cancer incidence in healthy subjects

Клинический случай прободной язвы желудка в сочетании с посттравматической диафрагмальной грыжей у беременной в третьем триместре гестации

Background. Gastric and duodenal ulcers are extremely rare in pregnancy, according to published literature. Peptic ulcer is found in 1 per 4,000 pregnant women, a figure probably underestimated due to its hampered diagnosis in pregnancy. Pregnancy peptic ulcer is considered less expected. Perforated gastric and duodenal ulcers comprise about 1.5 % of total acute abdominal diseases, and the perforation rate in ulcer patients ranges within 5–15 %. This complication afflicts the ages of 20–40 years in men much more frequently than in women. Three perforation types occur: free into abdominal cavity (87 %), contained (9 %), into lesser omentum and retroperitoneal tissue (4 %).Materials and methods. The clinical case describes surgical management of posttraumatic diaphragmatic hernia-comorbid perforated gastric ulcer in a pregnant woman in third trimester. Surgery with postoperative patient management enabled for a favourable outcome.Results and discussion. Perforation-entailing gastric and duodenal ulcers in pregnant women have received negligible attention due to rarity in clinical practice. Paul et al. described 14 cases of duodenal perforation in pregnancy, all fatal.Conclusion. Early diagnosis of surgical pathology during gestation is still difficult contributing to the development of severe complications associated with high mortality. The patient’s admission to a level III interspecialty hospital was key to enable a timely consilium-driven decision of caesarean intervention for saving the child, diagnosing intraoperatively life-threatening complicated surgical diseases and opting for radical surgery that ended in a favourable outcome.Введение. Язвенная болезнь желудка и двенадцатиперстной кишки крайне редко встречается у беременных, что подтверждено доступными литературными данными. Язвенную болезнь выявляют у 1 из 4000 беременных. Эти данные могут быть занижены, поскольку диагностика язвенной болезни во время беременности затруднена. Считается, что риск язвенной болезни во время беременности снижается. Прободение язв желудка и двенадцатиперстной кишки среди острых заболеваний брюшной полости составляет около 1,5 %, а частота перфорации у язвенных больных колеблется в пределах 5–15 %. Это осложнение значительно чаще возникает у мужчин, чем у женщин, в возрасте 20–40 лет. Различают три вида перфорации: в свободную брюшную полость (87 %), прикрытые перфорации (9 %), перфорации в малый сальник и забрюшинную клетчатку (4 %).Материалы и методы. В публикации представлен клинический случай, описывающий хирургическую тактику при выявлении прободной язвы желудка в сочетании с посттравматической диафрагмальной грыжей у беременной в 3-м триместре гестации. Выполненное оперативное вмешательство с последующим послеоперационным ведением пациентки привело к благоприятному исходу.Результаты и обсуждение. Случаи язвенной болезни желудка и двенадцатиперстной кишки, связанные с прободением у беременных, почти никто не изучал в связи с редкой встречаемостью в клинической практике. Paul et al. описали 14 случаев прободной язвы двенадцатиперстной кишки во время беременности, и все 14 случаев закончились летальным исходом.Заключение. Ранняя диагностика хирургической патологии во время беременности до сих пор остается непростой задачей, которая способствует развитию тяжелых осложнений и сопровождается высокой летальностью. Очень важным явилось то, что пациентка оказалась в многопрофильном стационаре III уровня, где удалось вовремя принять коллегиальное решение о проведении кесарева сечения, что позволило спасти ребенка, а также интраоперационно выявить серьезные хирургические заболевания с их грозными осложнениями и выбрать правильное тактическое решение в пользу радикального оперативного вмешательства с благоприятным исходом