A MODERN VIEW ON THE PROBLEM OF TREATMENT OF UROTHELIAL CANCER

Urothelial cancer (UC) is one of the leading onco-urological diseases. The lack of clinical manifestations of the disease at earlier stages does not allow assigning an adequate therapy in good time. Currently they extensively use conventional methods of treatment, which are constantly improving. Nevertheless, such methods are not always sufficiently effective: they neither always avert recurring, nor ensure sufficient remission and longevity of a patient. Identification of new trends in the early diagnostics of not only cancers but also pre-cancers plays an important role in forming conceptually new approaches to medical treatments. Molecular genetic features of UC have shown a significant chromosomal mutational variability, the dependence of genetic variations on the tumor invasion level, as well as its high level of immunizing power. Successes achieved in understanding the processes taking place not only in the tumor microenvironment but also in tumors have enabled creating fundamentally new anticancer drugs and achieving a significant progress in treating UC. This article presents a new classification of UCs based on immune histochemical data and molecular genetic characteristics of tumors, presents a cluster analysis of various types of UCs, recites present-day data on the disease incidence, analyses up-to-date conventional and innovative methods of UC treatment including non-specific and specific immunotherapy, describes the underlying mechanisms preventing tumors to evade immune surveillance, shows the role of immune checkpoints and their inhibitors, target and cytokine therapies, tumor vaccines, cell-based therapies, combined and integral methods of noninvasive and metastatic UC, as well as describes the results of clinical trials when using various methods of tumor treatments

Interdisciplinary approach in the management of asthma in the elderly

Asthma (BA) in the elderly people (BAE) is an important cause of their morbidity and mortality. The elderly people (EP) have several chronic comorbidities that significantly reduce the quality of their lives and there are consequences for the control of BA. Psychological characteristics of patients suffering from BA, affect such as emotional reactions. Primary care clinicians treating BA should be aware of the possibility of psychological dysfunction in BAE, especially those with poor control. For the prevention of boundary psychological disorders in BAE important are: to make the dynamic monitoring of the psychologist/psychiatrist together with the allergist/pulmonologist, individual psychological consultations and educational programs. An interdisciplinary approach is essential in the management of BAE. Screening of mental disorders and early diagnosis of neurovegetative status of BAE, based on the integration of different specialists (physicians: allergists, pulmonologists, internists, cardiologists, neurologists, psychiatrists, psychologists, social workers etc.) will provide comprehensive psychological and medical care for patients with psychosomatic disorders and their comorbidity, as well as will enhance their quality of life

Atopic Dermatitis in Children: Differential Approach to the Choice of Treatment Strategy

The study considers advantages of differential approach to the treatment of children (Ch) with different immunopathogenetic phenotypes (IPGF) of atopic dermatitis (AD). It has been found that patients with non-IgE-mediated type of AtD was not sensitization to IgE to house dust mite allergens (HDMA) and was observed a decline in macrophage-phagocytic component of immune system (MPCIS). It was shown, that the IgE-mediated phenotype includes 3 forms of AtD: allergic form; mixed form (in combination with allergic rhinitis, asthma); immunocompromised form (ICF). Allergic and mixed have a proven sensitivity to non-eliminated HDMA, which promoted allergization and provoked the development of symptoms in the course of AtD, and in Ch with ICF of AtD a decrease in parameters of MPCIS (such as phagocytic number, phagocytic index). On the basis of immune system disorders (ISD), has been developed a different complex of immunotherapy (CIT). The developed algorithm of examination and diagnosis of patients with AtD allows the choice of an adequate CIT in accordance with IPGF based on detected of immune system disorders (ISD). Implementation of individual treatment allowed to reduce the risk of developing severe and chronic AD and to improve the quality of life of patients

Atopic Dermatitis in Children: Differential Approach to the Choice of Treatment Strategy

The study considers advantages of differential approach to the treatment of children (Ch) with different immunopathogenetic phenotypes (IPGF) of atopic dermatitis (AD). It has been found that patients with non-IgE-mediated type of AtD was not sensitization to IgE to house dust mite allergens (HDMA) and was observed a decline in macrophage-phagocytic component of immune system (MPCIS). It was shown, that the IgE-mediated phenotype includes 3 forms of AtD: allergic form; mixed form (in combination with allergic rhinitis, asthma); immunocompromised form (ICF). Allergic and mixed have a proven sensitivity to non-eliminated HDMA, which promoted allergization and provoked the development of symptoms in the course of AtD, and in Ch with ICF of AtD a decrease in parameters of MPCIS (such as phagocytic number, phagocytic index). On the basis of immune system disorders (ISD), has been developed a different complex of immunotherapy (CIT). The developed algorithm of examination and diagnosis of patients with AtD allows the choice of an adequate CIT in accordance with IPGF based on detected of immune system disorders (ISD). Implementation of individual treatment allowed to reduce the risk of developing severe and chronic AD and to improve the quality of life of patients

Interdisciplinary approach in the management of asthma in the elderly

Asthma (BA) in the elderly people (BAE) is an important cause of their morbidity and mortality. The elderly people (EP) have several chronic comorbidities that significantly reduce the quality of their lives and there are consequences for the control of BA. Psychological characteristics of patients suffering from BA, affect such as emotional reactions. Primary care clinicians treating BA should be aware of the possibility of psychological dysfunction in BAE, especially those with poor control. For the prevention of boundary psychological disorders in BAE important are: to make the dynamic monitoring of the psychologist/psychiatrist together with the allergist/pulmonologist, individual psychological consultations and educational programs. An interdisciplinary approach is essential in the management of BAE. Screening of mental disorders and early diagnosis of neurovegetative status of BAE, based on the integration of different specialists (physicians: allergists, pulmonologists, internists, cardiologists, neurologists, psychiatrists, psychologists, social workers etc.) will provide comprehensive psychological and medical care for patients with psychosomatic disorders and their comorbidity, as well as will enhance their quality of life

Prevalence, Triggers and Clinical Features of Atopic Dermatitis in Children

Atopic dermatitis (AtD) - chronic inflammatory allergic dermal disease (ADs) of multifactorial pathogenesis. Most authors point out critical pathogenetic role of IgE-mediated mechanisms of hypersensitivity in relation to many food-borne, domestic and/or environmental allergens. The aim of the study was to study the cause-significant allergenic and non-allergenic triggers, prevalence and clinical features of AtD in Primorye Territory of Russia among young children (Ch) and teenagers (Tn). Researchers conducted showed wide prevalence of AtD among children in Vladivostok and Primorye Territory with high incidence rate in the last decade. The true picture of prevalence of ADs in Primorye Territory of Russia among Ch and Tn was established, clinical features and the main allergenic and non-allergenic triggers that contribute to the early development of the disease were determined. The revealed peculiarities will be promoting the timely conduct of therapeutic and preventive measures among Ch

THE MAIN STAGES OF THE PREPARATION OF VIABLE TUMOR CELLS OF BLADDER CANCER: FROM ISOLATION OF THE TUMOR MATERIAL TILL CRYOPRESERVATION OF CELL LINES

The development of personalized autologous dendritic cell anti-tumor vaccines (PDPW) against bladder cancer (BC) is a relevant issue that covers many aspects required for its standardization. The article presents personal experimental studies related to development of optimal conditions of transportation of biological material; temperature and temporary modes for the storage of the samples; the materials about the optimal method of disaggregation of the biomaterial; there has been shown a comparative analysis of different methods of tumor disaggregation; the selection of nutritious growth mediums and growth factors for urothelial carcinoma cells (UCC), the conditions of cryopreservation of tumor cells for maximum UCC viability, potentially suitable for creating PDPW against BC