DIAGNOSTIC AND TACTICAL IMPORTANCE OF STUDYING SHORT CHAIN FATTY ACIDS IN DIFFERENT BIOLOGICAL SUBSTRATES TOOK PLACE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE, LUNG CANCER AND COMMUNITY-ACQUIRED PNEUMONIA DEVELOPED AFTER ANTICANCER THERAPY.

The main aim of the study is to examine microbiocenosis of lower respiratory tract and intestine in patients with chronic obstructive pulmonary disease (COPD), lung cancer (LC), lung cancer with community-acquired pneumonia (CAP) and to determine their role in the etiological diagnosis of lower respiratory tract infections (LRTi), including those that develop during cancer chemotherapy (CC), to discuss the possibility of optimizing the treatment tactics. MATERIALS AND METHODS: To solve this task were examined 147 patients and 30 healthy individuals were divided into 4 groups, according to nosology. The number of patients in the COPD group was 38 people, m / f-35/3, median age 63 (57; 69) years, in the LC group -60 people, m / f - 56/4, with a median age of 65 (58; 71) year; LC groupwith CAP -21 persons m / f - 17/4, with a median age of 73(69; 75) years, in the LC group with CAP developed in the period up to 30 days after the end of chemotherapy (LC with CAP / CC) -28 persons m / f - 22/6, with a median age of 70 (67; 73) years, the norm group -30 healthy persons m / f- 26/4, median age 48(40,691 years. The spectrum of short-chain fatty acids (SCFA) sputum (in bronchoalveolar lavage standards group) and test groups of feces were studied by gas-liquid chromatographic analysis (GLC analysis). Results of the study. In the norm group: total absolute content of SCFA (X) in sputum was 0.032 mg / g, the relative content of acetic acid (pC2) 0906 u, propionic acid (pC3) 0.085 u, butyric acid (pC4) 0.009 u, anaerobic index (Al) -0.104 units. According to the analysis the total absolute content of SCFA in the sputum may be expressed as follows: ∑ SCPA (C2-C4) norm (0,032) <∑ SCFA (C2-C4) COPD (0,201) <∑ SCFA (C2-C4) RL (0,463) < ∑ SCFA (C2-C4) LC with CAP (0.510) < RCMP ∑ (C2-C4) LC with CAP / CC (0.612) (mg / g), the differences are statistically significant when compared with the norm. The findings of the relative content of C2-C4 show a statistically significant increase of the relative content of propionic and butyric acids: PC3 (0,085) pC4 (0.009) norm pC2 (0.846) COPD> pC2 (0.792) LC> pC2 (0.765) LC with CAP> pC2 (0.719) LC with CAP / CC (u) in patients of all study groups compared to the norm, and between groups. And the more pronounced changes in the content of SCFA in the sputum are ascertained in lung cancer with CAP during chemotherapy. *The values of Al in the studied groups are displaced to more negative values: Al (- 0.104) rate> Al (- 0.190) COPD> Al (- 0.257) RL> Al (- 0.307) LC with CAP> Al (- 0.391) LC with CAP / CC (sing.) compared with the norm and between groups. The findings of SCPA in feces in the group norm: ~1 SCFA 10.51 mg / g, 0.634 units pC2, pC3 0,189 units, 0,176 units pC4, -0.576 Al units. The total absolute content of SCFA in feces can be expressed as follows: ∑ SCFA (C2-C4) LC (4,11) <∑ SCFA (C2-C4) COPD (4,81) <∑ SCFA (C2-C4) norm (10 51) (mg / g), the differences were statistically significant when compared with the norm; depending on the chemotherapy, preceding the development of the CAP: ∑ SCFA (C2-C4) norm (10,51)> ∑ SCFA (C2-C4) LC with CAP / che- motherapy (5,54)> ∑ SCFA (C2-C4) LC CAP (4,96)> ∑ SCFA (C2-C4) LC (4.11) (mg / g). Results of the study of the relative content of C4-C2 also demonstrate a statistically significant increase of the relative content of propionic and butyric acids: pC3 (0.189), pC4 (0.176) norm pC2 (0.590) COPD> pC2 (0,560) LC> pC2 (0.529) LC with CAP> pC2 (0.503) LC with CAP! chemotherapy (u) in patients of all study groups in comparison with the norm. And the more pronounced changes in the content of SCFA in feces are ascertained at LC with CAP during chemotherapy. The values of Al intestinal ecological community of all groups are displaced to more negative values when compared with the norm: Al (- 0.576) norm> Al (- 0.695) COPD> Al (- 0.786) LC> Al ('0.890) LC with CAP> Al (- 0.988) LC with CAP / chemotherapy (u), with the most significant changes were observedin the group of LC with CAP during chemotherapy. Conclusion, Increased absolute SCFA concentration in patients with CQPD, lung cancer, lung cancer with CAP, LC with CAP! CC in comparison with the norm indicates increased number and activity of anaerobic flora, the most significant changes observed in patients with lung cancer with CAP, developed in the period up to 30 days after the end of chemotherapy. The unidirectional changes in SCFA parameters in the sputum and stool demonstrate the dependence of microorganism biocenosis. The resulting information can be used in the etiological diagnosis of LRTI, as well as the development of therapeutic and preventive measures flAw Af infprtiniis rnmnlications and treatment of these patients.

[The multifocal breast cancer].

Survival data of patients with multifocal breast cancer in dependence on surgical resection volume were analyzed. Two types of surgery were performed: the modified radical mastectomy by Madden and radical resection of the mammary gland. It was stated, that organ-preserving operation in combination with complex adjuvant therapy of the multifocal breast cancer stage I-II did not lead to the decrease of the overall and recurrence-free 5 and 10-year survival rate.

[Diagnostics of the primary multiple forms of the colorectal cancer].

The issue analyses the diagnostics of the repeated malignant lesions of the colorectal region. The study covers the two decades period (1992-2011 yy). Of the observed patients with primary colorectal tumors, 238 showed the repeated lesions of the region. The article focuses on the on-time diagnostics and differential approach to the repeated malignancies of the colorectal region.

[Clinical value of antracycline toxicity: modern approaches to diagnosis, prevention, and treatment].

In this literature review we present analysis of various aspects of the problem of cardiotoxicity of antracyclines used for the treatment of the breast cancer. We consider mechanisms of their cardiotoxic action, role of risk factors, clinical manifestations of acute and chronic cardiotoxicity, and dependence of their severity on treatment duration and drug dose. We give data on contemporary methods of diagnostics of early toxic cardiac effects of antracyclines from the side of cardiovascular system. We also conducted assessment of possibility of prevention of toxic action of antracyclines with the use of combination of different methods including dose sparing regimens and schemes of treatment, combinations of drugs, use of cardioprotectors as well as novel preparations from the antracycline group, possessing lesser cardiotoxicity. Clinical and experimental data on the treatment of manifestations of cardiotoxicity with consideration of pathogenetic mechanisms of their development are given.

[Polyneoplasia in the structure of urologic cancer morbidity].

A retrospective analysis of case histories made for cancer patients treated from 1980 to 2004 has established 2233 cases of urological cancer. Of them, 540 (24.2%) had polyneoplasia. Urogenital cancer most frequently runs in parallel with neoplasia of the colon, stomach, kidney, skin and prostate. These patients should be adequately examined and followed up to detect primary metachronic tumor early and to treat radically subsequent tumors.

Development of insulin resistance in experimental animals during long-term glucocorticoid treatment.

Long-term treatment with glucocorticoids led to the development of insulin resistance in experimental animals, which was confirmed by a progressive increase in blood insulin level and decrease in the glucose/insulin index. The comparative study showed that hydrocortisone produced more pronounced and rapid changes than dexamethasone. However, we found no differences in the glucose/insulin index by the 23rd day of treatment with these hormones.

[Renal carcinoma: active detection in regular check-ups]. / Rak pochki: vozmozhnosti aktivnogo vyiavleniia pri dispanserizatsii.

AIM: To improve early diagnosis of renal carcinoma (RC) in the course of check-ups. MATERIAL AND METHODS: Regular checkups performed in 1980-1999 detected 715 cases of renal carcinoma. Among the patients were 452 male (60.2%) and 263 female (39.8%) patients. Mean age was 66 years. Screening methods for healthy examinees and risk group examinees, RC incidence rate, 1 year lethality and survival were assessed. RESULTS: Mean RC incidence rate in men was 80.9, in women 34.9 per 100,000. Early diagnosis of RC stage I and II made up 58.4 in men and 59.4% in women. Significantly more patients with RC stage I and II were diagnosed at checkup than among those seeking medical advice. 5-year corrected survival in males was 80%, 10-year survival--74%, in females--84 and 80%, respectively. CONCLUSION: Check-up raised early diagnosis of RC stage I and II up to 82.3%. This, in its turn, improved survival of RC patients.

[The current status of the diagnosis of lung cancer under the conditions of the long-term dispensary care of a population group]. / Sovremennoe sostoianie diagnostiki raka legkogo v usloviiakh dlitel'noi dispanserizatsii gruppy naseleniia.

In 1980-1995 the authors observed 739 cases of lung cancer. A special screening program on early diagnosis of lung cancer has been developed. The centralized system of the information collection, storage and processing of all the cancer cases, follow-up of all the registered cases provided observed and corrected 5- and 10-year survival. Efficacy of screening and early treatment is shown.

[Functional state of the thyroid gland in rats receiving an increased quantity of iodine with drinking water]. / Funktsional'noe sostoianie shchitovidnoi zhelezy u krys, poluchavshikh povyshennye kolichestva ioda s pit'evoi vodoi.

Thyroid and adrenocortical function was examined in rats fed increasing quantities of iodine with drinking water. No noticeable deviations in thyroid hormone levels were found in the blood of experimental animals. Thyroid hormone levels in thyroid tissue were changing in the same direction in the animals kept on various iodine diets, these changes depending on experiment duration: an increase of thyroxine and more so, of triiodothyronine was observed in 50 days, and reduction thereof in 90 days. In rats fed the maximal iodine dose, 8000 micrograms daily, the level of thyroglobulin in thyroid tissue decreased. Increased iodine consumption reduced the glucocorticoid function of the adrenals in experimental animals, as manifested by reduction of corticosterone levels in the adrenals, blood plasma, and reduction of nonmetabolized hormone excretion with the urine.

[Diagnostic and treatment results in small-cell lung cancer detected during dispensary care]. / Rezul'taty diagnostiki i lecheniia melkokletochnogo raka legkogo, vyiavlennogo pri dispanserizatsii.

The study was concerned with evaluating diagnosis and treatment for small-cell cancer of the lung in 75 patients who had been followed up for long periods of time before tumor detection. Methods of monitoring healthy populations as well as those at risk for lung cancer are discussed. Small-cell carcinoma was identified in 18.1%. Prophylactic fluorography of the chest conducted once a year was shown to fail to assure timely identification of small-cell cancer of the lung in most patients. An extra yearly X-ray examination of those at risk was followed by a rise in the percentage of actively--identifiable small-cell lung tumors to 66.7 while tumors detected on presentation--to 25%. Survival in small-cell lung cancer patients was studied and its median was established at 22 months in stage I--II patients given specialized antitumor treatment, 16 months in stage III and 7 months in stage IV.