[PSYCHOLOGICAL CARE FOR SCHOOL-AGE PATIENTS WITH CORONAVIRUS INFECTION IN THE HOSPITAL].

For the first time in pediatric practice, the psychological state of 100 children (7-17 years old) with COVID-19 in the state of hospitalization was studied on the basis of the Scientific Medical Research Center of Children's Health of the Russian Ministry of Health Care and the directions of psychological and pedagogical assistance were determined. Analysis of medical and psychological-pedagogical documentation, conversation, observation, screening diagnostics were conducted. It was established that according to the totality of physical and psychological factors (the main psychological difficulty) patients can be grouped into the following groups: children in a severe physical state, with unstable manifestations of mental activity (n = 4; 4%); children in a predominantly moderately severe state with significant distress related to the disease (n = 48; 48%); children in a satisfactory physical state, with mild and mostly situational difficulties in adapting to the situation of hospitalization (n = 46; 46%); children in a satisfactory physical state, in a relatively stable positive psychological state (n = 2; 2%). Consideration of the severity of their physical and psychological condition and their basic psychological difficulties allows differentiated psychological aid to be rendered to children and teenagers in special conditions of the «red zone¼.

[The Study of Psychological Characteristics of Children and Adolescents with Digestive Diseases].

OBJECTIVE: The present study was aimed at the psychological characteristics of children with different chronic diseases of the digestive system and the identification of key factors influencing the formation of their personality. METHODS: The continuous prospective study of psychological peculiarities of 125 patients (7-17 y.o.) with diseases of the digestive system who have been monitored at Scientific Centre of Children's Health (Moscow) was performed. As research methods were used: analysis of medical and pedagogical documentation, participant observation, educational experiment, interview, questionnaires and projective methods. RESULTS: The study involved 125 patients aged 7-17 years (12.4 averagely) with diseases of the digestive system including teens--68 (54%), primary school pupil--57 (46%). The number of boys significantly prevailed over the number of girls (2:1). The study confirmed the existence of a close relationship and mutual influence of three factors: the physical condition, social situation of development, and individual psychological characteristics of children. According to the psychological characteristics the children can be combined in three groups: Group I (47 of 125 people; 37.6%) - children with bad psychological status. This is most typicalfor children with active form of chronic diseases requiring intensive medical assistance (37 of 47people; 78.7%). Group II (59 of 125 people; 47.2%)--children with instable psychological condition, with risk of neurotization. This group mainly comprises patients with chronic diseases at the stage of unstable clinical remission with preserved or compensated functions of organism bodies and systems or with incomplete compensation of functions requiring long term supportive treatment (45 of 59 people; 76.3%). Group III--patients with rather stable psychological condition (19 of 125 people; 15.2%). It comprises patients with rather stable psychological condition, anyway, with expressed psychological vulnerability in stress situation. Most children suffer from chronic diseases of different etiology at the stage of clinical remission with rare aggravations, with preserved or compensated functions, provided there are no aggravations of the basic disease (17of 19 people; 89.5%). CONCLUSION: Most children with diseases of the digestive system have the psychological difficulties, while their identity is often formed in the distorted social conditions. Therefore, these children need psychological and pedagogical support, as well the special psychological and pedagogical conditions for the realization of their mental and cognitive capacities. To put together a program of psychological and educational assistance we should take into account the child's age at the moment of occurrence of the disease, etiology, duration and severity of the illness, the nature and degree of non-compliance of social environmental.

[Changes in prostate-specific antigen in casodex (bicalutamide) monotherapy in a dose 150 mg/day given to patients with locally advanced and/or advanced prostatic cancer]. / Dinamika prostatspetsificheskogo antigena pri monoterapii kasodeksom (bikalutamidom) v doze 150 mg v den' u bol'nykh mestno-rasprostranennym i (ili) rasprostranennym rakom predstatel'noi zhelezy.

Three-month treatment with casodex (150 mg/day) of untreated patients with locally advanced and/or advanced cancer of the prostate is well tolerated. The only side effect encountered in 9(60%) patients was temporary breast painfulness and swelling. Subjective effects consisted of higher activity (in 40% of patients), pain relief (in 33.3%), improved urination (in 80%). Objective effects comprise: reduction of prostate-specific antigen in 14(93.3%) patients by 150.4 ng/ml at the average; a rise in testosterone concentration in 12(80%) patients; regression of the tumor by more than 50% in 5(33.3%) patients; stabilization and partial regression of regional metastases (1 case); stabilization of distant metastases (3 of 4 cases). One patient showed progression of bone metastasizing in partial local regression of the tumor.

Zinc in the human prostate gland: normal, hyperplastic and cancerous.

Zinc concentration in a prostate gland is much higher than in other human tissues. Data for zinc changes in different prostate diseases are limited and greatly contradictory. To analyze transrectal puncture tissue biopsy and resected materials, zinc content was estimated in benign prostatic hyperplasia (BPH) and cancer. There were 109 patients studied (50 BPH and 59 cancer). The control group consisted of 37 intact glands of men who died an unexpected death (accident, murder, acute cardiac insufficiency, etc.). All materials studied were divided into two parts. One of them was morphologically examined, while the zinc content of another one was estimated. The radionuclide induced energy dispersive X-ray fluorescent analysis was used for zinc determination. Zinc content (M +/- SE) of normal prostate, BPH and cancer was 1018 +/- 124, 1142 +/- 77, and 146 +/- 10 micrograms/g dry tissue, respectively. It was shown that zinc assessment in the material of transrectal puncture biopsy of prostate indurated site can be used as an additional test for differential diagnosis of BPH and cancer. Accuracy, sensitivity and specificity of the test are 98 +/- 2%.

[The immune homeostasis of patients with prostatic cancer on hormonal chemotherapy, radiation treatment and immunological action]. / Immunnyi gomeostaz bol'nykh rakom predstatel'noi zhelezy pri gormonokhimioterapii, luchevom lechenii i immunovozdeistvii.

The trial covered 58 patients with prostatic cancer aged 50-79. Before treatment these patients exhibited weak proliferative response of T-cells to PHA, increased number of T-suppressors/killers, enhanced suppressive influence of regulatory cells. Hormone chemotherapy produced immunodepressive and immunomodulating effects (normalization of the count of T-suppressors/killers and their function). Subsequent radiotherapy on the prostatic region (total dose 60 Gy) worsened immunodepression. Efficacy of placental suspension and levamisol depends on the treatment stage at which the latter were used: during hormone chemotherapy the addition of the suspension and levamisol corrects its immunodepressive effects, in subsequent radiotherapy immunodeficiency greatly increased.

[The late results of the combined hormonal chemoradiation treatment of prostatic cancer]. / Otdalennye rezul'taty kompleksnogo gormonokhimioluchevogo lecheniia raka predstatel'noi zhelezy.

Combined treatment of 111 patients with prostatic cancer stage IV including 3 components (hormones, drugs and radiation) proved superior by survival and tolerance over hormone therapy alone. Relevant dosages and regimens are detailed.

Zinc concentration in human prostatic fluid: normal, chronic prostatitis, adenoma and cancer.

Radionuclide induced energy dispersive X-ray fluorescence was used to estimate zinc content in prostatic fluid in normal, chronic prostatitis, adenoma and cancer cases, Groups of patients suffering from chronic prostatitis, adenoma and malignant tumours consisting of 28, 28 and 13 men, respectively, were examined. The control group included 22 healthy volunteers. Expressed prostatic fluid was obtained by digital rectal massage. The zinc concentration of intact prostatic fluid was 590 +/- 45 (SE) micrograms/ml. Almost no difference was found between the zinc concentration for chronic prostatitis and for adenoma, and those for normal levels being 455 +/- 60 (SE) and 540 +/- 50 (SE) micrograms/ml, respectively. Prostatic neoplasm resulted in a significant decrease of zinc secretion, with the concentration averaging 34.7 +/- 9.6 micrograms/ml, p < 0.000001.

[The role of lymphography in the choice and planning of treatment in patients with malignant tumors of the lesser pelvis]. / Znachenie limfografii v vybore i planirovanii lechebnykh meropriiatii pri zlokachestvennykh opukholiakh organov malogo taza.

Lymphographic studies were carried out in 1070 patients to identify patterns of lymphogenic dissemination of cancer of the cervix and corpus uteri, prostate, urinary, bladder and rectum. A direct correlation between the frequency and degree of metastatic spread and local extension of tumor process was established. The most frequent sites for metastasis were the external and common iliac lymph nodes. Whatever the site of primary tumor or the predominant direction of its growth, these lymph nodes on both sides of the pelvis and lumbar area were involved. The significance of lymphographic results for selecting and planning treatment modalities as well as indications for lymphography were identified.

[Lymphography in cancer of the prostate]. / Limfografiia pri rake predstatel'noi zhelezy.

The frequency and area of lymphogenic metastasis with relation to the histological structure, differentiation and degree of local dissemination of a primary tumor were determined at lymphography of 114 patients with prostatic cancer. Lymph node involvement was often observed in poorly differentiated and solid trabecular adenocarcinoma, scirrhous cancer and locally disseminated tumors extending beyond the prostatic capsule. Metastases were usually located in the external and common inguinal lymph nodes. Lymphography was shown to be indicated to patients with a local spread of prostatic cancer (T2, T3 and T4).

[Results of gamma teletherapy of prostate cancer patients]. / Rezul'taty distantsionnoi gamma-terapii bol'nykh rakom predstatel'noi zhelezy.

The paper is concerned with the results of clinical examination of 44 patients with prostatic cancer and their distribution according to disease stages. The authors provide morphological evaluation of the data (cytological and histological confirmation of the diagnosis). In the data analysed most of the patients had T3 and T4-34 (77.3%), i. e. patients with poorly differentiated tumor forms. All the patients were given a radical course of gamma-beam therapy of the prostate, 19 of them took estrogens prior to irradiation. Moving gamma-beam therapy of prostatic cancer is well tolerated by patients. It can be used in any stage of disease and in the progression of disease as well. Radiation reactions in the form of epitheliitis of various degree in the inguinal region were noted in 15% of the cases at a dosage of 32-44 Gy. Short-term results of the treatment were good: subjective signs of improvement were observed in 99.7% of the patients, objective signs of a positive therapeutic effect in 21 (48.1%). The 3-year survival rates were 44.3% for patients after a radical course of radiotherapy and 32.6% in radiotherapy for patients with tumor progression.

[Histological structure of the prostate and its zinc content at various ages]. / Gistologicheskoe stroenie predstatel'noi zhelezy i soderzhanie v nei tsinka v razlichnye vozrastnye periody.

As it has been demonstrated by a morphological investigation of the prostate from 85 corpses of various ages, each age period defined has certain specific objective morphometric indices, histological peculiar features of epithelium and changes in zinc content. The prostatic epithelium is the most monomorphous and the least active in the prepubertal group. In persons 14-40 years of age, the epithelium is characterized by morpho-functional features of high activity with preservation of its histological peculiarities. This corresponds to zinc content within the limits 48.10+/-9.10-64.10+/- +/-6.10 mg/kg in dry tissue of the gland. The most outstanding feature of the prostatic epithelium during transitional period of age is polymorphism of its structure, which corresponds to the greatest zinc content (115.10 +/- 13.10 mg/kg). In elderly and old persons this index is somewhat decreasing.