ОПЫТ ЛИМФАДЕНОЭКТОМИИ СТОРОЖЕВЫХ ЛИМФАТИЧЕСКИХ УЗЛОВ, ОБНАРУЖЕННЫХ МЕТОДАМИ РАДИОИЗОТОПНОЙ ДИАГНОСТИКИ ПРИ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЯХ РОТОГЛОТКИ

The excision of sentinel lymph nodes has a growing relevance in the diagnostics of oral and oropharyngeal cancer in case of N0. The validity of sentinel node biopsy (SNB) was examined as single surgical staging tool. Within the framework of a multi-modality treatment scheme, SNB without elective neck dissection performed during surgery of the primary tumor in 70 previously untreated patients. Control of accuracy took place by observation of manifestation of neck node metastases in 45 patients who had not been postoperatively irradiated. 94% of sentinel nodes could be excised; nine patients (13%) had positive nodes and were undergone radical neck lymph nodes dissection. There were 2 neck lymph node metastases in the context of second primaries, all other patients remained regionally unconspicious (median observation time: 26 months). As staging tool assessing T1-3 N0 tumors, SNB could lead to a considerable reduction of the number of elective neck dissections. it could be integrated well into a multi-modality treatment scheme.Определение сторожевого лимфатического узла (СЛУ) с использованием коллоидных радиофармпрепаратов, меченных99mТс (Nanocol®), с последующей лимфосцинтиграфией и интраоперационной детекцией гамма-зондом - перспективное направление в современной ядерной медицине и клинической практике. Особо важную роль играет вышеназванная методика в сочетании с последующим прицельным иссечением сторожевого (сентинельного) узла (СЛУ) при лечении злокачественных новообразований в области ротоглотки. Биопсия таких узлов позволяет четко верифицировать распространение и стадию опухолевого заболевания. В данном исследовании в рамках междисциплинарного ведения больных со злокачественной опухолевой патологией ротоглотки, совмещающего как диагностические, так и лечебные процедуры, проводились удаление и биопсия выявленных с помощью гамма-зонда СЛУ, без обязательной в таких случаях расширенной лимфаденэктомии шеи у 70 пациентов. Контроль точности поставленного диагноза по данным биопсии был проведен в группе из 45 пациентов. В 94% случаев СЛУ были выявлены и удалены и пациенты находились в состоянии полной ремиссии (катамнез наблюдения составил в среднем 26 мес); у 9 пациентов (13%) имело место метастатическое поражение в области детектированных СЛУ, и им была проведена полная лимфаденэктомия. У 2 пациентов были выявлены метастазы в лимфатические узлы при наличии сочетанной карциномы другой локализации. Итак, новый комплексный подход к ведению таких пациентов является одним из эффективных способов стадирования злокачественных опухолей, что значительно сокращает число необоснованных радикальных вмешательств и может быть внедрено в современный интеграционный процесс лечения

Modern approaches to improving the quality of medical care for premature children in Moscow health care

This article is devoted to the issue of nursing and further monitoring of children born with very low and extremely low body weight. The article presents the data of international statistics and seven-year experience of the Rehabilitation Center for children born with very low and extremely low body weight, based on a large multidisciplinary children’s hospital. The authors pay particular attention to improvement of medical care of children born with very low and extremely low body weight

New COVID-19 coronavirus infection in the practice of a neonatologist and pediatrician

The article analyses the data published from January 2020 to April 25, 2020 in the print media or available on the official websites of peer-reviewed medical sources (pre print), international and national medical professional communities, and state regulatory authorities dedicated to the epidemiological and clinical laboratory features of the new coronavirus infection in newborns, infants and older children. The authors have concluded that currently there are no convincing data on vertical transmission of infection. At the same time, they have found that there is a risk of horizontal infection of a newborn child; therefore, there is the need for strict adherence to the recommended algorithms for monitoring children in the neonatal period born by the women with positive or presumably positive COVID-19 (Coronavirus disease 2019) status. The authors note that due to the limited quantity of observation cases, all existing recommendations are temporary and may be revised. The newborns from mothers with COVID-19 demonstrate the variability of clinical picture from asymptomatic course to severe respiratory failure. In the post-neonatal period children have asymptomatic or mild course of a new coronavirus infection. The authors note that some children with an asymptomatic course of the disease have pneumonia detectable during X-ray examination. Children with the manifest forms of COVID-19 do not have specific clinical symptoms; both children and adults have fever, cough and other catarrhal symptoms; tachypia, tachycardia and gastrointestinal symptoms are much less common. It has been found that children with COVID-19, unlike adults, are unlikely to develop severe pneumonia, as well as conditions requiring intensive care and mechanical ventilation. Changes in laboratory parameters in children also do not have a consistent pattern and they are less pronounced than in adults. The epidemiological data indicate that children are one of the main sources of the ongoing spread of infection in the human population. The authors present the first-ever data on the cases of 45 infants born from the mothers with positive COVID-19 status in Moscow

ОПЫТ ЛИМФАДЕНОЭКТОМИИ СТОРОЖЕВЫХ ЛИМФАТИЧЕСКИХ УЗЛОВ, ОБНАРУЖЕННЫХ МЕТОДАМИ РАДИОИЗОТОПНОЙ ДИАГНОСТИКИ ПРИ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЯХ РОТОГЛОТКИ

The excision of sentinel lymph nodes has a growing relevance in the diagnostics of oral and oropharyngeal cancer in case of N0. The validity of sentinel node biopsy (SNB) was examined as single surgical staging tool. Within the framework of a multi-modality treatment scheme, SNB without elective neck dissection performed during surgery of the primary tumor in 70 previously untreated patients. Control of accuracy took place by observation of manifestation of neck node metastases in 45 patients who had not been postoperatively irradiated. 94% of sentinel nodes could be excised; nine patients (13%) had positive nodes and were undergone radical neck lymph nodes dissection. There were 2 neck lymph node metastases in the context of second primaries, all other patients remained regionally unconspicious (median observation time: 26 months). As staging tool assessing T1-3 N0 tumors, SNB could lead to a considerable reduction of the number of elective neck dissections. it could be integrated well into a multi-modality treatment scheme.Определение сторожевого лимфатического узла (СЛУ) с использованием коллоидных радиофармпрепаратов, меченных99mТс (Nanocol®), с последующей лимфосцинтиграфией и интраоперационной детекцией гамма-зондом - перспективное направление в современной ядерной медицине и клинической практике. Особо важную роль играет вышеназванная методика в сочетании с последующим прицельным иссечением сторожевого (сентинельного) узла (СЛУ) при лечении злокачественных новообразований в области ротоглотки. Биопсия таких узлов позволяет четко верифицировать распространение и стадию опухолевого заболевания. В данном исследовании в рамках междисциплинарного ведения больных со злокачественной опухолевой патологией ротоглотки, совмещающего как диагностические, так и лечебные процедуры, проводились удаление и биопсия выявленных с помощью гамма-зонда СЛУ, без обязательной в таких случаях расширенной лимфаденэктомии шеи у 70 пациентов. Контроль точности поставленного диагноза по данным биопсии был проведен в группе из 45 пациентов. В 94% случаев СЛУ были выявлены и удалены и пациенты находились в состоянии полной ремиссии (катамнез наблюдения составил в среднем 26 мес); у 9 пациентов (13%) имело место метастатическое поражение в области детектированных СЛУ, и им была проведена полная лимфаденэктомия. У 2 пациентов были выявлены метастазы в лимфатические узлы при наличии сочетанной карциномы другой локализации. Итак, новый комплексный подход к ведению таких пациентов является одним из эффективных способов стадирования злокачественных опухолей, что значительно сокращает число необоснованных радикальных вмешательств и может быть внедрено в современный интеграционный процесс лечения

Vitamin D and defensins production in infants

Relevance: immunotropic effects of cholecalciferol are caused by vitamin-D-induced synthesis of antimicrobial peptides (AMP), in particular р-defensins. There are very few studies in pediatric clinical practice confirming the effect of vitamin D availability on AMP synthesis.Aim: analysis of the correlation between vitamin D availability and AMP production and assessment of the effect of cholecalciferol medication intake on defensin synthesis in young children.Materials and methods: 108 healthy children aged 1 month to 3 years were examined, of which 34 (31.5%) were adequately provided with vitamin D (calcidiol level over 30 ng/ml), 40 (37.0%) with insufficiency (20 to 30 ng/ml), 27 (25.0%) with vitamin D deficiency (10 to 20 ng/ml) and 7 (6.5%) with severe deficit (less than 10 ng/ml). In the presence of hypovitaminose of vitamin D the monthly course of cholecalciferol in doses of 2000-4000 lU/day was prescribed for correction, and in normal provision -prophylactic administration of 1000 IU/day. The indices of 25(ON)D, β1- and β2-defensins were determined three times.Results. On natural feeding, the rates of β1-defensin are 2.3 times (p<0.05) and β2-defensin 7.5 times (p<0.001) higher than those of children on artificial feeding.Against the background of the correction course, the level of β1-dephensin increased from 3.3 [2.24-5.85] pg/ml to 3.7 [2.25-6.32] pg/ml (p = 0.05), and β2-dephensin from 240.7 [86.77-686.64] pg/ml to 514.2 [468.19-1104.98] pg/ml (р<0.001). The treatment doses of cholecalciferol contributed to a more significant increase of β1- and β2-defensin; a direct correlation relationship (r = 0.34, p<0.05) was found between the daily dose of vitamin D and the increase of β2-defensin.Reception of the prophylactic dose of cholecalcipherol of 1000 lU/day during 6 months was accompanied by further increase of AMP production - the level of β1-defensin increased 2.4 times (р<0,001), and the level of β2-defensin - 2.5 times (р<0,001) in comparison with the initial values.Conclusions. Administration of cholecalcipherol preparations in children of early age is accompanied by an increase in the level of в-defensins - the most important factors of congenital immunity

EANM 2012 guidelines for radionuclide imaging of phaeochromocytoma and paraganglioma

Item does not contain fulltextPURPOSE: Radionuclide imaging of phaeochromocytomas (PCCs) and paragangliomas (PGLs) involves various functional imaging techniques and approaches for accurate diagnosis, staging and tumour characterization. The purpose of the present guidelines is to assist nuclear medicine practitioners in performing, interpreting and reporting the results of the currently available SPECT and PET imaging approaches. These guidelines are intended to present information specifically adapted to European practice. METHODS: Guidelines from related fields, issued by the European Association of Nuclear Medicine and the Society of Nuclear Medicine, were taken into consideration and are partially integrated within this text. The same was applied to the relevant literature, and the final result was discussed with leading experts involved in the management of patients with PCC/PGL. The information provided should be viewed in the context of local conditions, laws and regulations. CONCLUSION: Although several radionuclide imaging modalities are considered herein, considerable focus is given to PET imaging which offers high sensitivity targeted molecular imaging approaches