Synthesis Strategy of Tetrapyrrolic Photosensitizers for Their Practical Application in Photodynamic Therapy

This review presents a wide range of tetrapyrrole photosensitizers used for photodynamic therapy (PDT), antimicrobial photodynamic therapy, photoinactivation of pathogens. Methods of synthesis and design of new photosensitizers with greater selectivity of accumulation in tumor tissue and increased photoinduced antitumor activity are considered. The issues of studying the properties of new photosensitizers, their photoactivity, the ability to generate singlet oxygen, and the possibility of using targeted photodynamic therapy in clinical practice are discussed. The review examines the work on PDT by national and foreign researchers.

The effectiveness of secondary prevention of malignant neoplasms during the COVID-19 pandemic.

Objective. To evaluate the effectiveness of the detection of malignant neoplasms (MNPs) when implementing secondary preventive measures against cancer in municipal healthcare facilities during the COVID-19 pandemic. Material and methods. The model of the Volga Federal District (VFD) of Russia was used to conduct analytical and statistical studies of the rates of active detection of MNPs in the municipal healthcare facilities in 2019-2020. The demographic indicators and state statistics data, which were publicly available on the Internet, on the official websites of the territorial health authorities, oncology dispensaries of the VFD subjects, were comparatively analyzed. A database (State Registration Certificate of the Russian Federation under No. 2021621834/01.09.21) was used to evaluate the effectiveness of secondary preventive measures against cancer during the COVID-19 pandemic in 2020. Results. Compared to 2019, the COVID-19 pandemic caused a 2.1% expansion in the network of patients' examination rooms mainly due to an increase in the number of male rooms by 5.6% and mixed-type rooms by 6.3%. The number of mid-level healthcare workers that provided the functioning of patients' examination rooms rose by 5.2%;the proportion of specialists trained in the area of oncology decreased by 20% (85% in 2019 and 68.1% in 2020). The introduction of restrictive measures determined a statistically significant (p<0.05) decline in the proportion of people who had undergone a primary medical examination in the male (32.9%), female (35.6%), and general (34.7%) populations. The mean frequency of detected MNPs in 2019 and 2020 was 0.91 and 0.76, respectively (a 16.5% decrease). There was an increase in the incidence of lung cancer (LC) (a 4.2% increase) and a reduction in that of breast cancer (BC) (a 56.6% decrease). A comparative assessment of changes in the rate of active detection of MNPs in healthcare facilities at all health levels revealed a negative increase in its mean value in 2020 versus 2019 for colorectal cancer (CRC) (-25.6%), LC (-25.0% ), BC (-11.6%), cervical cancer (CC) (-12.4%), and prostate cancer (PC) (-2.1%). The prognosis of the number of actively detected MNP cases during the pandemic shows that, provided that the effectiveness of MNP detection rates remains the same as in 2019;there were no CRC (n = about 1100 cases), LC (n=1050), BC (n=1470), CC (n=300), and PC (n=300) cases in the VFD in 2020. An analysis of the effectiveness of secondary preventive measures against LC and BC in the VFD showed that among the number of newly diagnosed cases of a disease in 2019, there were LC (92.3%) and BC (75.1%) cases in the municipal healthcare facilities;there were LC (100%) and BC (60.9%) cases during the COVID-19 pandemic. Conclusion. The COVID-19 pandemic led to a decline in the number of participants in preventive activities. Considering the uneven territorial spread of COVID-19, the development of a methodology for the preventive measures adapted to a pandemic, mainly in the municipal healthcare facilities, is an extremely important area of preventive healthcare activities.Copyright © 2022, Media Sphera Publishing Group. All rights reserved.

The impact of the COVID-19 pandemic on the diagnosis of malignant neoplasms during preventive medical examinations.

The restrictive social distancing strategy during the COVID-19 pandemic in the healthcare system has led to a reduction in measures for the active detection of malignant neoplasms (MNs). Objective. To evaluate the impact of a temporary stop the measures for the secondary prevention of MNs on the frequency of detected cases of the disease during preventive medical examinations (PMEs). Materials and methods. The efficiency of active MN detectability in 2020 versus the pre-COVID-19 period (2018-2019) was com-paratively analyzed in 17 regions of the Central Federal District (CFD) of Russia. Information on the coverage of the population with PMEs and on the frequency of detected cancer cases when using fluorographic, mammographic, and cytological studies was obtained from the study of the data contained in the information project <<Passport of an Oncology Dispensary>> of the P.A. Herzen Moscow Oncology Research Institute, as well as those available in the public domain on the Internet and on the official websites of regional health authorities. Results. The comparative analysis of the results of PMEs did not reveal significant differences in their efficiency in the studied regions of the Central Federal District of Russia in 2018 and 2019. Compared to the pre-COVID-19 period in 2020, there was a sta-tistically significant decline in the population coverage with primary care, which was 33.2+/-2.3% among both sexes (p<0.01), 25.8+/-2.3 for males (p<0.05) and 39.7+/-3.0% females (p<0.01). The frequency of detected cancer cases was 1.0 in the general population, 0.6 for males and 1.2 for females. There was an increase in the number of detected cases during fluorographic (+27.1%) and mammographic (+22.9%) studies and a decrease in the proportion of cytologically detected MNs (-33.2%). At the same time, due to a decline in the number of the surveyed population in 2020, there was a decrease in the number of detected cancer cases of the lung (-34.8%), breast (-37.1%), as well as tumors diagnosed cytologically (-65.9%). Conclusion. This investigation may suggest that at least 1.065 lung cancer cases and 1.875 breast ones were not diagnosed due to the temporary reduction in PMEs in the regions studied.Copyright © 2021, Media Sphera Publishing Group. All rights reserved.

The impact of the COVID-19 pandemic on the diagnosis of malignant neoplasms during preventive medical examinations

The restrictive social distancing strategy during the COVID-19 pandemic in the healthcare system has led to a reduction in measures for the active detection of malignant neoplasms (MNs). Objective. To evaluate the impact of a temporary stop the measures for the secondary prevention of MNs on the frequency of detected cases of the disease during preventive medical examinations (PMEs). Materials and methods. The efficiency of active MN detectability in 2020 versus the pre-COVID-19 period (2018—2019) was com-paratively analyzed in 17 regions of the Central Federal District (CFD) of Russia. Information on the coverage of the population with PMEs and on the frequency of detected cancer cases when using fluorographic, mammographic, and cytological studies was obtained from the study of the data contained in the information project «Passport of an Oncology Dispensary» of the P.A. Herzen Moscow Oncology Research Institute, as well as those available in the public domain on the Internet and on the official websites of regional health authorities. Results. The comparative analysis of the results of PMEs did not reveal significant differences in their efficiency in the studied regions of the Central Federal District of Russia in 2018 and 2019. Compared to the pre-COVID-19 period in 2020, there was a sta-tistically significant decline in the population coverage with primary care, which was 33.2±2.3% among both sexes (p<0.01), 25.8±2.3 for males (p<0.05) and 39.7±3.0% females (p<0.01). The frequency of detected cancer cases was 1.0 ‰ in the general population, 0.6‰ for males and 1.2‰ for females. There was an increase in the number of detected cases during fluorographic (+27.1%) and mammographic (+22.9%) studies and a decrease in the proportion of cytologically detected MNs (–33.2%). At the same time, due to a decline in the number of the surveyed population in 2020, there was a decrease in the number of detected cancer cases of the lung (–34.8%), breast (–37.1%), as well as tumors diagnosed cytologically (–65.9%). Conclusion. This investigation may suggest that at least 1.065 lung cancer cases and 1.875 breast ones were not diagnosed due to the temporary reduction in PMEs in the regions studied. © 2021, Media Sphera Publishing Group. All rights reserved.

Oncology during the New Coronavirus Infection Pandemic.

The COVID-19 pandemic has served as a catalyst for a whole layer of scientific research, including in Russia, where, since 2020, international multicenter studies have been conducted on the impact of the coronavirus infection on the course of oncological diseases, as well as on the development and application of new clinical methods in oncology. In the years 2020-2022, new methods of nuclear medicine based on the targeted effect of ionizing radiation of radiopharmaceuticals began to be actively developed, in particular, new domestic radiopharmaceuticals (RPs) for diagnostics and therapy and methods of intra-arterial radioembolization developed by RPs with 90Y and 188Re of primary and metastatic tumors of various localization. New methods of radiation therapy have been introduced into clinical practice, including remote radiation therapy with "fast" neutrons, which makes it possible to overcome the resistance of a tumor to radiation and drug treatment. In addition, the search for and introduction into clinical practice of new approaches in the field of gene therapy and the use of oncolytic viruses continues. Platforms for complex pharmacogenomic analysis based on global knowledge and deep machine learning are being used in Russia, allowing for the precise selection of the most effective therapy. New multidisciplinary technologies are being developed.

The effectiveness of secondary prevention of malignant neoplasms during the COVID-19 pandemic

Objective. To evaluate the effectiveness of the detection of malignant neoplasms (MNPs) when implementing secondary preventive measures against cancer in municipal healthcare facilities during the COVID-19 pandemic. Material and methods. The model of the Volga Federal District (VFD) of Russia was used to conduct analytical and statistical studies of the rates of active detection of MNPs in the municipal healthcare facilities in 2019-2020. The demographic indicators and state statistics data, which were publicly available on the Internet, on the official websites of the territorial health authorities, oncology dispensaries of the VFD subjects, were comparatively analyzed. A database (State Registration Certificate of the Russian Federation under No. 2021621834/01.09.21) was used to evaluate the effectiveness of secondary preventive measures against cancer during the COVID-19 pandemic in 2020. Results. Compared to 2019, the COVID-19 pandemic caused a 2.1% expansion in the network of patients’ examination rooms mainly due to an increase in the number of male rooms by 5.6% and mixed-type rooms by 6.3%. The number of mid-level healthcare workers that provided the functioning of patients’ examination rooms rose by 5.2%;the proportion of specialists trained in the area of oncology decreased by 20% (85% in 2019 and 68.1% in 2020). The introduction of restrictive measures determined a statistically significant (p<0.05) decline in the proportion of people who had undergone a primary medical examination in the male (32.9%), female (35.6%), and general (34.7%) populations. The mean frequency of detected MNPs in 2019 and 2020 was 0.91‰ and 0.76‰, respectively (a 16.5% decrease). There was an increase in the incidence of lung cancer (LC) (a 4.2% increase) and a reduction in that of breast cancer (BC) (a 56.6% decrease). A comparative assessment of changes in the rate of active detection of MNPs in healthcare facilities at all health levels revealed a negative increase in its mean value in 2020 versus 2019 for colorectal cancer (CRC) (–25.6%), LC (–25.0% ), BC (–11.6%), cervical cancer (CC) (–12.4%), and prostate cancer (PC) (–2.1%). The prognosis of the number of actively detected MNP cases during the pandemic shows that, provided that the effectiveness of MNP detection rates remains the same as in 2019;there were no CRC (n = about 1100 cases), LC (n=1050), BC (n=1470), CC (n=300), and PC (n=300) cases in the VFD in 2020. An analysis of the effectiveness of secondary preventive measures against LC and BC in the VFD showed that among the number of newly diagnosed cases of a disease in 2019, there were LC (92.3%) and BC (75.1%) cases in the municipal healthcare facilities;there were LC (100%) and BC (60.9%) cases during the COVID-19 pandemic. Conclusion. The COVID-19 pandemic led to a decline in the number of participants in preventive activities. Considering the uneven territorial spread of COVID-19, the development of a methodology for the preventive measures adapted to a pandemic, mainly in the municipal healthcare facilities, is an extremely important area of preventive healthcare activities. © 2022, Media Sphera Publishing Group. All rights reserved.

COMBINATION TREATMNET OF BREAST CANCER PATIENTS DURING THE COVID-19 PANDEMIC

The aim of the study was to analyze the most significant studies representing the basic principles of diagnosis and treatment of patients with breast cancer (BC) during the CO VID -19 pandemic. Material and Methods. The search for relevant sources was carried out in PubMed, Cochrane Library, Web of Science systems, publications for 2019-2020 were studied, 48 of which were used to write this review. Results. During the CO VID -19 pandemic, it is necessary to suspend screening examinations for a certain period of time;patients with early and metastatic breast cancer should be transferred to outpatient treatment in the LU s located in their place of residence. Examinations and consultations of patients undergoing hormone therapy should be postponed or carried out using telemedicine technologies. Treatment of breast cancer patients during a pandemic should be carried out according to clinical guidelines and protocols, but minimizing the number of visits to the hospitals. Conclusion. The pandemic of the novel coronavirus infection (CO VID -19) is a serious problem for healthcare and professionals around the world. All treatment decisions must be based on risks and benefits in the context of each stage of the pandemic, on an individual basis and taking into account the preferences of patients.

The outpatient medical care in patients with chronic diseases under dispensary supervision in the conditions of the COVID19 pandemic. Temporary guidelines. Version 2

The aim of these guidelines is to provide primary care physicians with scientifically based algorithms for the implementation of dispensary monitoring in patients with chronic noncommunicable diseases in the conditions of the new coronavirus infection (COVID19) pandemic, including the use of telemedicine technologies. The organization and conduct of highquality medical followup are the most important tasks aimed at both reducing the risks of developing complications of chronic noncommunicable diseases and reducing overall mortality, especially in the current conditions of the COVID19 pandemic. The guidelines contain clinical aspects of dispensary followup, general principles of tactics for managing patients with various chronic noncommunicable diseases in COVID19 conditions, in addition, brief checklists with options for interviewing patients with various chronic noncommunicable diseases are presented, topical aspects of the interaction of drugs used in the treatment of chronic noncommunicable diseases with antiviral drugs are considered. The guidelines are intended for general practitioners, district therapists, general practitioners (family doctors), as well as doctors of other specialties providing primary health care. © 2022 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved.

Adiponectin: a pleiotropic hormone with multifaceted roles.

Adipose tissue mostly composed of different types of fat is one of the largest endocrine organs in the body playing multiple intricate roles including but not limited to energy storage, metabolic homeostasis, generation of heat, participation in immune functions and secretion of a number of biologically active factors known as adipokines. The most abundant of them is adiponectin. This adipocite-derived hormone exerts pleiotropic actions and exhibits insulin-sensitizing, antidiabetic, anti-obesogenic, anti-inflammatory, antiatherogenic, cardio- and neuroprotective properties. Contrariwise to its protective effects against various pathological events in different cell types, adiponectin may have links to several systemic diseases and malignances. Reduction in adiponectin levels has an implication in COVID-19-associated respiratory failure, which is attributed mainly to a phenomenon called 'adiponectin paradox'. Ample evidence about multiple functions of adiponectin in the body was obtained from animal, mostly rodent studies. Our succinct review is entirely about multifaceted roles of adiponectin and mechanisms of its action in different physiological and pathological states.

Treatment of cancer patients during COVID-19 pandemic

Background. Cancer patients comprise one of the most vulnerable subpopulations under COVID-19 pandemic, since the incidence of COVID-19 among cancer patients exceeds this value in general population. Risk of severe COVID-19 infection and mortality is higher in patients with cancer. Objective. Searching and retrospective analysis of risk factors of mortality in cancer patients with COVID-19 infection. Material and methods. A retrospective analysis included 31 cancer patients who underwent surgery at the Herzen Moscow Oncology Research Institute. COVID-19 was detected in postoperative period in each patient. We have compared survivors and non-sur-vivors and assessed the risk factors of mortality. Results. COVID-19 in postoperative period occurred in 31 (4.74%) out of 722 patients. Hypertension (74.2%, n=23) and car-diac diseases including coronary artery disease and chronic heart failure (19.35%, n=6) were the most common comorbidi-ties. Incidence of coronavirus infection was the highest among patients with colorectal cancer (16.13%, n=5), kidney cancer (16.13%, n=5) and lung cancer (12.9%, n=4). We found the following risk factors of mortality in cancer patients with COVID-19: CHD (OR 7.0, 95% CI 1.014-48.313, p<0.05), COPD (OR 15.000, 95% CI 1.397-161.052, p<0.05), lung cancer (OR 12.000, 95% CI 1.074-134.116, p<0.05), and mechanical ventilation (OR 135.000, 95% CI 7.485-2435.007, p<0.05). © 2021, Media Sphera. All rights reserved.

[Surgical management of cancer patients within the COVID-19 pandemic]. / Strategiya khirurgicheskogo lecheniya onkologicheskikh bol'nykh v usloviyakh pandemii COVID-19.

OBJECTIVE: A systematic review of the world literature data on surgical management and preoperative screening of cancer patients within the COVID-19 pandemic, as well as prevention of SARS-CoV-2 transmission and resumption of elective surgery. MATERIAL AND METHODS: Literature data searching included Pubmed, MedLine, Scopus, Web of Science, and RSCI databases. We enrolled literature data published for the period from March 2020 to June 2020. RESULTS: Retrospective and prospective clinical trials have been analyzed. The review ensures up-to-date data on surgical management of cancer patients under the pandemic, recommendations for resuming the elective surgery, preoperative screening and prevention of COVID-19. CONCLUSION: To date, the COVID-19 pandemic is still not resolved, and infection continues spreading around the world. Thus, there is an urgent need for more thorough research of the strategies for mitigating the effects of pandemic. To date, the recommendations for optimal surgical management of cancer patients within the pandemic are still actively developed considering the benefits of treatment and risks of SARS-CoV-2 infection. Resumption of elective surgery should be progressive and cautious, especially in pandemic areas. For safety reasons, all patients eligible for surgical treatment should be carefully selected according to stratification of risk factors. Thorough preoperative screening, monitoring of symptoms of infection, and use of appropriate adapted personal protective equipment are extremely important.

Genitourinary system and COVID-19: some aspects

Objective. The COVID-19 pandemic has become a test for the global healthcare system. Significant forces have been invested in the treatment of COVID-19, while the interaction of the virus with various organs and systems of the human body has been studied very poorly. Materials and methods. When writing the review, we used data from scientific papers published in PubMed databases and websites of professional medical associations. 39 publications were selected directly for citation in the review. When writing the review, we used data from scientific papers published in PubMed databases (https://www.ncbi.nlm.nih.gov/pubmed/) and the websites of professional medical associations. Databases were searched using the keywords «coronavirus disease», «COVID-19», «urogenital system», «renal failure», «kidney cancer», «bladder cancer», «prostate cancer». After that, based on the relevance of the data, the reliability of the sources, impact factors of the journals and the sequence of presentation of the material in the manuscript, 39publications were selected directly for citation in the review. Results. SARS-CоV-2 is a new virus, it is highly contagious, the main transmission routes are contact and airborne. The incubation period for SARS-CoV-2 is from 2 to 14 days. The effects of SARS-CoV-2 on the kidneys and urinary tract. There is evidence that the urinary system is at high risk for coronavirus invasion with the development of acute renal failure (ARF), which may also be the result of a «cytokine storm». ARF with COVID-19 occurs in 5-15% of cases and is associated with high mortality. Treatment regimens for patients after a kidney transplant can be either with partial cancellation of immunosuppressive therapy, or without modification of the standard regimen. Patients undergoing hemodialysis with COVID-19, the dosage and regimen of drugs should be carefully selected. Oncological aspects and COVID-19. In a pandemic, standard and well-established cancer protocols require correction, while patient survival remains the number one priority. COVID-19 and prostate cancer. Published date demonstrates atypically low incidence among patients with prostate cancer who undergo androgen deprivation. Bladder, urine, ejaculate. The virus is found in urine and ejaculate, which can be both diagnostic for the detection of COVID-19, and prognostic for assessing the risks of early and late urogenital complications. Conclusion. In this review, we tried to summarize the currently available data on the effects of SARS-V-2 on the urogenital system, the features of the urological manifestations of COVID-19, as well as the tactical issues of managing oncourological patients. Введение. Пандемия COVID-19 стала испытанием для мировой системы здравоохранения. На лечение COVID-19 брошены значительные силы, при этом взаимодействие вируса с различными органами и системами организма человека изучено пока весьма скудно. Материалы и методы. При написании обзора были использованы данные из научных работ, опубликованных в базах PubMed (https://www.ncbi.nlm.nih.gov/pubmed/), и сайтах профессиональных медицинских ассоциаций. Поиск в базах данных проводили по ключевым словам «сoronavirus disease», «COVID-19», «urogenital system», «renal failure», «kidney cancer», «bladder cancer», «prostate cancer». После чего, исходя из актуальности данных, достоверности источников, импакт-факторов журналов и последовательности изложения материала в рукописи, непосредственно для цитирования в обзоре были отобраны 39 печатных работ. Результаты. SARS-CoV-2 - новый высоко контагиозный вирус, основные пути передачи: контактный и воздушно-капельный. Инкубационный период для SARS-CoV-2 составляет 2-14 дней. Воздействие SARS-CoV-2 на почки и мочевыводящие пути. Представлены данные о том, что мочевыводящая система подвержена высокому риску коронавирусной инвазии с развитием острой почечной недостаточности (ОПН), которая так же может быть и результатом «цитокинового шторма». ОПН при COVID-19 встречается в 5-15% случаев и ассоциирована с высокой смертностью. Схемы лечения больных после пересадки почки могут быть как с частичной отменой иммуносупрессивной терапии, так и без модификации стандартной схемы. Пациентам, находящимся на программном гемодиализе при COVID-19, дозировка и режим применения лекарственных препаратов должны тщательно подбираться. Онкоурологические аспекты и COVID-19. В условиях пандемии стандартные и хорошо отработанные онкологические протоколы требуют коррекции, при этом выживаемость пациентов остается приоритетом номер один. COVID-19 и рак предстательной железы. Опубликованы данные о нетипично низкой заболеваемости среди пациентов с раком предстательной железы, которым проводится андрогенная депривация. Мочевой пузырь, моча, эякулят. Вирус обнаружен в моче и эякуляте, что может иметь как диагностическое значение для выявления COVID-19, так и прогностическое - для оценки рисков развития ранних и поздних урогенитальных осложнений. Заключение. В данном обзоре мы постарались обобщить имеющиеся на сегодняшний день данные по воздействию SARS-CoV-2 на урогенитальную систему, об особенностях урологических проявлений COVID-19, а также тактических вопросах ведения онкоурологических пациентов.

Remodeling the cancer service in the context of the COVID-19 pandemic at the Federal research center of the 1st level

The article is devoted to the most relevant topic at present - the possibilities of providing full medical care to cancer patients in the context of the spread of the COVID-19 coronavirus pandemic. Cancer patients are the most vulnerable group, because they are at high risk from the position of immunosuppression, which is often combined with other risk factors for infection: old age, diabetes and cardiovascular diseases. Procrastination and delaying the start of antitumor therapy is unacceptable, since it inevitably leads to a deterioration of treatment results, an increase in one-year mortality and worsens the overall survival rate for malignant neoplasms. Thus, it is necessary to develop a set of measures that will allow all types of anti-cancer treatment to be carried out in parallel with anti-epidemic measures without losing the quality of treatment and preserving the safety of patients and medical personnel. Статья посвящена наиболее актуальной в настоящее время теме - возможностям оказания полноценной медицинской помощи онкологическим пациентам в условиях распространения пандемии коронавируса COVID-19. Онкологические пациенты являются наиболее уязвимым контингентом, поскольку находятся в зоне повышенного риска с позиции иммуносупрессии, которая зачастую сочетается с остальными факторами риска развития инфекции: пожилой возраст, наличие диабета и сердечно-сосудистых заболеваний. Промедление и затягивание сроков начала противоопухолевой терапии недопустимы, поскольку неизбежно ведут к ухудшению результатов лечения, повышению одногодичной летальности и ухудшают показатели общей выживаемости при злокачественных новообразованиях. Таким образом, необходимо разработать комплекс мер, которые позволят проводить все виды противоопухолевого лечения параллельно с противоэпидемическими мероприятиями без потери качества лечения и сохраняя безопасность для пациентов и медицинского персонала.

Impact of the covid-19 pandemic on the oncological practice

Detailed, systematic review of the world literature data, including all aspects that reflect the impact of the COVID-19 pandemic on the oncological practice was conducted. The information sources were taken from Pubmed, MedLine, Scopus, Web of Science, and RSCI systems. The data from retrospective and prospective clinical trials have been analyzed. This review presents current data on the impact of COVID-19 on cancer patients, mortality and prognosis of cancer patients infected with COVID-19, treatment options for COVID-19, as well as the case report of the cancer patient with rare atypical COVID-19 course of disease. To date, the groups of increased risk of being infected with a new coronavirus have been identified. These groups include cancer patients. Despite the pandemic, treatment of cancer patients must be continued, since the presence of a tumor process does not allow the therapy to be delayed. The world cancer community is actively continuing to develop recommendations for optimal management of cancer patients in the context of the pandemic. The most relevant of them are described in this article.