Significance of basic clinical tests changing after the Hypec procedure in patients with gastric cancer and some other tumors

Hyperthermic intraperitoneal chemotherapy is a popular method of palliative treatment in patients with malignant abdominal tumors. This review is devoted to trace changes in general clinical tests in patients with carcinomatosis. The patients were operated on at the Clinic of Reconstructive and Plastic Medicine of the Odessa National Medical University. All patients satisfactorily tolerated this procedure. The object of the study was to track those changes with patients that took place in the immediate (prior to discharge) postoperative period. 25 patients have recruited to the study. In the group changes in 11 basic clinical and laboratory parameters among those included were monitored in the study. Hemoglobin, leukocytes, platelets, total protein, bilirubin, serum glucose concentration, liver enzymes alanine aminotransferase and aspartate aminotransferase levels, thymol test and coagulogram indices. Thus, the most significant indicators, such as the concentration of hemoglobin, leukocytes and platelets, have not undergone significant changes after HIPEC. Hemoglobin decreased by 6 units (g / l), the concentration of leukocytes, on the contrary, increased by 2 units (T/l), platelet levels dropped by 61 units (also G/l). The concentration of total protein decreased by 7 units. The concentration of total bilirubin practically did not change, decreasing by about 1 unit. Indicators of AST and ALT did not increase, decreasing by 8 and 3 units, respectively. The average concentration value of blood glucose level slightly increased by almost 1 unit. Thymol levels have not changed. The prothrombin index decreased by 3 units; the concentration of fibrinogen in serum remained at approximately the same level. HIPEC procedure does not significantly affect the clinical and laboratory parameters. However, the tendency of this category of patients to hypercoagulation, hypoproteinemia and hyperglucosemia was noted

Correction of a connective tissue dysplasia in the treatment of postoperative abdominal hernias

Проаналізовані результати лікування 112 хворих з приводу післяопераційної грижі черевної стінки (ПОГЧС), у яких виконана алопластика передньої черевної стінки, після операції проводили патогенетично обґрунтовану комплексну терапію, беручи до уваги наявність синдрому дисплазії сполучної тканини, та профілактику ранніх і віддалених післяопераційних ускладнень. Вивчені особливості перебігу післяопераційного періоду та віддалені результати. Фенотипні ознаки синдрому дисплазії сполучної тканини виявлені у 53 (47, 3 %) хворих, імунногістохімічні ознаки дисплазії сполучної тканини (порушення співвідношення колагену I та III типу з збільшенням кількості волокон колагену III типу в 3 рази і більше) виявлене у 78 (69, 6%) хворих, яким стимулювали процеси синтезу колагену та його надмолекулярних утворень шляхом призначення магнію оротату (Магнерот) по 1 г двічі на добу протягом 4–6 тиж. Застосування композитних сіток з великими порами в комплексі з патогенетично обґрунтованою терапією після операції справляло позитивний вплив на перебіг захворювання та віддаленні результати лікування.There were analyzed the results of treatment of 112 patients, suffering postoperative abdominal hernia, in whom the anterior abdominal wall alloplasty was performed as well as postoperative pathogenetically substantiated complex therapy, taking into account the presence of a connective tissue dysplasia syndrome (CTDS) and the early and late postoperative complications prophylaxis. The peculiarities of postoperative period course and late follow—up results were studied up. Phenotypic features of CTDS were revealed in 53 (47.3%) patients, immunohistochemical features of a connective tissue dysplasia (a failed collagen type I and III ratio, manifested by increase of a collagen type III fibers quantity in 3 or more times) were revealed in 78 (69.6%) patients, in whom the processes of a collagen and its supermolecular formations synthesis were stimulated, using a magnesium orotate (Ìàgnerot), which was prescribed in 1 g dose twice a day during 4 — 6 weeks. Application of composite nets, owing big pores, in a complex with a postoperative pathogenetically substantiated therapy conduction have positively influenced the disease course and the late follow—up results achieved

Impact of connective tissue dysplasia on quality of life of patients, suffering postoperative abdominal hernia

Проаналізовані результати лікування 122 хворих, у яких з приводу грижі передньої черевної стінки (ГЧС) здійснено алопластику. У 76 хворих діагностовано дисплазію сполучної тканини (ДСТ), 32 з них – після операції здійснено медикаментозну корекцію ДСТ, 44 – проведено стандартну терапію. Аналіз показників якості життя з використанням опитувальника SF – 36 свідчив, що синдром ДСТ вірогідно погіршує суб'єктивне сприйняття якості життя як до операції, так і у віддаленому післяопераційному періоді. Встановлено, що призначення комплексної терапії ДСТ сприяло поліпшенню якості життя пацієнтів до рівня, середнього у дослідженні, проте, нижчого, ніж у контрольній групі. Медикаментозна корекція ДСТ та комплексна реабілітація хворих з післяопераційною ГЧС, що утворилася на тлі ДСТ, потребують подальшого вдосконалення для підвищення ефективності їх лікування.The results of treatment of 122 patients, in whom alloplasty was performed for anterior abdominal wall hernia (AAWH), were analyzed. In 76 patients the connective tissue dysplasia (CTD) was diagnosed, in 32 of them postoperative medicinal correction of CTD was done and in 44 — a standard therapy. Analysis of the quality of life indices, using SF—36 questionnaire, have witnessed, that a CTD syndrome degrades trustworthy a patient's subjective perception of quality of life before the operation and in far remote postoperative period as well. There was established, that the complex therapy of CTD prescription have promoted the patients quality of life improvement up to the level, of average value in the investigation, but lower, than in a control group. Medicinal correction of CTD and complex rehabilitation of patients, suffering postoperative AAWH, which have occurred on a CTD background, need further improvement for rising of their treatment efficacy

The impact of laparoscopic hernioplasty, using various types of allotransplants, on the quality of life in patients, suffering postoperative abdominal wall hernia

У 67 хворих, у яких з приводу післяопераційної грижі черевної стінки у строки до 6 міс після виконання лапароскопічної герніопластики (ЛГ) з застосуванням сітки Proseed та політетрафторетиленової (ПТФ) сітки/натягнутої на нітиноловий каркас (НК), вивчено в динаміці якість життя (ЯЖ). Хворі, розподілені на 2 групи за видом застосованого алотрансплантата, відповідали на запитання опитувальника SF-36 перед виписуванням зі стаціонара, а також через 1 і 6 міс після ЛГ. Встановлено, що ЛГ з інтраперитонеальним розташуванням алотрансплантата впливає на ЯЖ хворих, показники якої повністю відновлювалися у строки до 6 міс після операції. У хворих, яким встановлювали ПТВ сітку з НК, інтенсивність болю була енше перед виписуванням і через 1 міс; відновлення за цим критерієм у пацієнтів обох груп відзначено через 6 міс після операції. У разі застосування сіток ПТФ з ПК показники фізичного та психічного здоров'я нормалізувалися через 1 міс після операції, за застосування сіток Proseed через 6 міс після ЛГ відзначено відновлення лише компонентів фізичного здоров'я.The quality of life (QL) dynamics during 6 mo after laparoscopic hernioplasty (LH), using the Proseed and polytetrafluoroethylene (PTFE) net, pulled over nitinol carcase (NC), was studied in 67 patients, suffering postoperative abdominal hernias (POAH). These patients were divided into two groups in accordance to two kinds of allotransplants used. They have had answered the SF—36 questionnaire questions while discharging from stationary ànd also in 1 and 6 months after LH. The results obtained witness, that LH with intraperitoneal allotransplant placement certainly impacts QL in the patients, suffering POAH, but its indices completely restore up to 6 mo postoperatively. In the patients, for whom PTFE with NC was applied the pain intensity was lesser while discharge from stationary and in 1 mo after discharge from the hospital. Restoration for this criterion in both groups of patients was registered up to sixth postoperative month. In the patients with the PTFE and NC nets applied the indices of physical and psychiatric blocks of QL in 1 mo postoperatively have appeared normal. While in the patients with the Proseed nets applied in 6 mo after LH the restoration of components of physical health was only noted

EPICARDIAL MONO- AND BIVENTRICULAR ELECTROCARDIOSTIMULATION IN TREATMENT OF CONDUCTION DISORDERS IN NORMAL SYSTOLIC FUNCTION

Aim. To reveal the specifics, and to evaluate the efficacy of implantation of epicardial (myocardial) electrodes under the conditions of artificial circulation and to define their influence on electromechanical parameters of the heart including pumping function.Material and methods. The results were analyzed of intraoperation and short-term (up to 24 months) results of implantation of epicardial electrodes under the conditions of AC in 32 patients, operated in 2007-2014 yy. For 32 patients the electrode was implanted (fixated) epicardially under the conditions of AC for conduction disorder correction after the main stage of cardiosurgical intervention. Including the fixation of epicardial electrode to both ventricles (group A, n=23) was done as biventricular ECS, and to one ventricle (group B, n=9) — monoventricular ECS. The following investigations were done: clinical examination, ECG, 6-minute walking test (6-WT), Echocardiography with dyssynchrony evaluation in M-, B-, doppler and tissue regimens, programming of ECS.Results. Mean follow-up period in both groups was 17±1,9 months. In 23 patients fixation of “-”-pole of epicardial electrode was done on the lateral surface of the left ventricle, and “+”-pole on posterior surface of the right ventricle, and in 8 patients epicardial electrode “+” and “-” was fixated in the area of lateral surface of the left ventricle and in one — area of the right ventricle if possible to the basal part. In 7 patients the atrial epicardial electrode was fixed to the base of the right atrium. So, we reached in 11 cases the 3-chamber ECS (CPT-ECS), in 12 — “biventricular” ECS (patients with permanent AF) and in 9 — monoventricular cardiostimulation.Conclusion. Epicardial (myocardial) biventricular stimulation of the heart is efficient method of rhythm disorder correction and the method of choice in those who need the replacement of endocardial ECS system, in heart defects patients, and if with CHF. While implanting epicardial systems there is a possibility to visually define the points and place of electrodes fixation. In biventricular ECS in dynamics there are significantly better results in the heart synchronicity parameters, that also was confirmed by the improvement of the LV systolic function and its remodeling in 12 months

Decreased SMG7 expression associates with lupus-risk variants and elevated antinuclear antibody production

OBJECTIVES: Following up the SLE GWAS identification of NMNAT2 at rs2022013, we fine-mapped its 150kb flanking regions containing NMNAT2 and SMG7 in a 15,292 case-control multi-ancestry population and tested functions of identified variants. METHODS: We performed genotyping using custom array, imputation by IMPUTE 2.1.2, and allele specific functions using qRT-PCR and luciferase reporter transfections. SLE PBMCs were cultured with siRNAs to measure antinuclear antibody (ANA) and cyto/chemokine levels in supernatants using ELISA. RESULTS: We confirmed association at NMNAT2 in European American (EA) and Amerindian/Hispanic ancestries, and identified independent signal at SMG7 tagged by rs2702178 in EA only (P=2.4×10(−8), OR=1.23 [95%CI=1.14–1.32]). In complete linkage disequilibrium with rs2702178, rs2275675 in the promoter region robustly associated with SMG7 mRNA levels in multiple expression quantitative trait locus datasets. Its risk allele was dose-dependently associated with decreased SMG7 mRNA levels in PBMCs of 86 SLE patients and 119 controls (P=1.1×10(−3) and 6.8×10(−8), respectively) and conferred reduced transcription activity in transfected HEK-293 and Raji cells (P=0.0035 and 0.0037, respectively). As a critical component in the nonsense-mediated mRNA decay pathway, SMG7 could regulate autoantigens including RNP and Sm. We showed SMG7 mRNA levels in PBMCs correlated inversely with ANA titers of SLE patients (r=−0.31, P=0.01), and SMG7 knockdown increased levels of ANA IgG and CCL19 in SLE PBMCs (P=2.0×10(−5) and 2.0×10(−4), respectively). CONCLUSIONS: We confirmed NMNAT2 and identified independent SMG7 association with SLE. The inverse relationship between levels of the risk-allele associated SMG7 mRNAs and ANA suggested the novel contribution of mRNA surveillance pathway to SLE pathogenesis