[The social health of citizen of the Eurasian Economic Union in conditions of COVID-19 pandemic].

The article considers, on the basis of results of sociological research, consequences of pandemic impact on social health of citizens of the Eurasian Economic Union states. The comparative analysis was applied to two groups of labor migrants from the EAEU states in Moscow and Russian citizens of the same age. The measures taken by the EАEU to maintain population social health in conditions of COVID-19 pandemic are considered.

[Social health of the citizens of the States of the Eurasian Economic Union in the context of the COVID-19 pandemic].

Based on the results of sociological research, the article considers the consequences of the pandemic on the social health of citizens of the Eurasian Economic Union (EAEU) states. A comparative analysis is carried out between groups of labor migrants from the EAEU states in Moscow and Russian citizens of the same age. The paper discusses the measures taken by the EАEU, for the maintenance of social health in terms of the COVID-19 pandemic crisis.

[Results of a prospective randomized investigation [Russia (St.Petersburg)/WHO] to evaluate the significance of self-examination for the early detection of breast cancer]. / Rezul'taty prospektivnogo randomizirovannogo isledovaniia [Rossiia (Sankt-Peterburg)/VOZ] znacheniia samoobsledovaniia v rannem vyiavlenii raka molochnoi zhelezy.

Indications for puncture or excision biopsy were significantly higher in the study group (7.5%) as compared with control (3.5%) (p < 0.01) in a randomized prospective controlled trial of a comprehensive breast cancer screening (123,748) carried out in the framework of a self-examination education program. In the self-examination group, detection rates were higher both for benign (1.1%) and malignant (0.85%) tumors than in control (0.5% and 0.69%, respectively) (p < 0.05). Early stage (T1NOMO, Tis) distribution difference in the study group and controls was insignificant--23 and 17.6%, respectively. Compliance with the program requirements including monthly or bimonthly self-examination was followed by higher 15-year survival rates (53.2%) in 70-75% as compared with controls(45.8%) (p = 0.05105): yet it did not affect mortality.

DELSY project: status and development.

The DELSY (Dubna Electron Synchrotron) project is under development at the Joint Institute for Nuclear Research [Arkhipov et al. (2001). Nucl. Instrum. Methods, A467, 57-62; Arkhipov et al. (2001). Nucl. Instrum. Methods, A470, 1-6; Titkova et al. (2000). Proceedings of the Seventh European Particle Accelerator Conference, pp. 702-704]. It is based on an acceleration facility donated to the Joint Institute for Nuclear Research by the Institute for Nuclear and High Energy Physics (NIKHEF, Amsterdam). The NIKHEF accelerator facility consists of the linear electron accelerator MEA, which has an electron energy of 700 MeV, and the electron storage ring AmPS, with a maximum energy of 900 MeV and a beam current of 200 mA. There are three phases to the construction of the DELSY facility. Phase I will be accomplished with the construction of a complex of free-electron lasers covering continuously the spectrum from the far infrared down to the ultraviolet ( approximately 150 nm). Phase II will be accomplished with the commissioning of the storage ring DELSY. Complete commissioning of the DELSY project will take place after finishing Phase III, the construction of an X-ray free-electron laser. This phase is considered as the ultimate goal of the project; it is currently under development and is not described in this paper.

[Adjuvant chemotherapy with anthracyclines in comparison with the standard combination of CMF in breast cancer with high risk of relapse]. / Antratsiklin-soderzhashchaia ad''iuvantnaia khimioterapiia v sravnenii s klassicheskoi skhemoi CMF u bol'nykh rakom molochnoi zhelezy s vysokim riskom retsidiva.

The effectiveness of adjuvant therapy with adriablastin and doxorubicin for breast cancer has been compared to that of standard CMF. During 1985-1990, the study included 349 patients with T1-2N2M0 and T3N0-2M0 tumors; mean age--46 yrs; mean follow-up--96.7 months. Overall survival rate in the doxorubicin group was 73%, CMF--62%; relapse-free survival--62.1 and 55%, respectively. The absolute difference in overall survival rates (11%) proved barely significant (p = 0.056). However, the difference in overall survival (p < 0.05) after anthracyclines and CMF in patients with tumors T1-2N2M0 and T3N1M0 was significant and in favor of the former. As far as frequency and degree of side-effects is concerned, their patterns were practically identical in both groups, except for the significantly higher frequency of cardiotoxity and complete alopecia in doxorubicin therapy. Cardiotoxic complication rate was significantly reduced from 13.8 to 3.9% by cardioxane treatment.

[The effectiveness of adjuvant chemotherapy with anthracyclines (adriablastin, doxorubicin) for stage-IIb-IIIa breast cancer]. / Effektivnost' ad''iuvantnoi khimioterapii antratsiklinami (adriablastinom, doksorubitsinom) u bol'nykh rakom molochnoi zhelezy IIb-IIIa stadii.

The effectiveness of adjuvant treatment with anthracyclins (adriablastin, doxorubicin) and standard CMF regimens for breast tumors has been compared. The study included 349 patients with stage IIB-IIIA tumors (T1-2N2M0, T3N0-2M0) (mean age-46 years) during 1985-1990 follow-up-60.38 months. In the doxorubicin group, overall 5-year survival was 73 +/- 8%, in the CMF group-62 +/- 8%. Recurrence-free 5-year survival was 62 +/- 8 and 55 +/- 8%, respectively. The differences are not significant. A stage-related analysis established a significant difference in overall survival in patients with T1-2N2M0 tumors (c-sqare 9.92, p < 0.01). However, due to a small number of cases, the phenomenon requires further study. Although adriablastin treatment involved a significantly higher frequency of carciotoxic symptoms, complete alopecia and dyspeptic complication, a systemic administration of cardioxan and effective antiemetic drugs was lacking.

[Breast-preserving (conservative) therapy of breast cancer]. / Organosokhraniaiushchee (konservativnoe) lechenie raka molochnoi zhelezy.

Conservative surgery (sectoral or segmental + axillary dissection) was performed in 278 patients with breast cancer (T1-2N0M0) at the Institute Clinic in 1990-1995. Following thorough morphological examination. 148 patients (53.2%) were selected to form a clinical study group for an investigation of the role of postoperative radiotherapy in the conservative treatment of breast cancer. Two groups-irradiation of the remaining breast tissue and controls-were formed on the basis of randomized data. Follow-up continued 3-60 months (average duration-37.7 months). Local recurrence was detected in 3 out of 73 (4.2%) patients of group I. A similar relapse was detected in 6 out of 75 (8.0%) patients of group II. No significant difference in total survival rates in the two groups was observed (97.3 and 96.0%; p > 0.05).

[Postoperative hormone therapy of breast cancer (analysis of overall survival)]. / Posleoperatsionnaia gormonoterapiia raka molochnoi zhelezy (analiz obshchei vyzhivaemosti)

A third series of randomized evaluation of postoperative (adjuvant) hormone therapy (tamoxifen, sinestrol and orimeten) was carried out in breast cancer patients. The study group involved 1.332 reproductive and postmenopausal females with stage I-III tumors. The investigation established quite a range of 10-year survival evidence versus stage and reproductive status; however, no significant differences were recorded in either of the groups. Untoward side-effects were more frequent when treating with diethyl-stilbestrol (over 30%) than with tamoxifen (3.5%). No significant differences were registered in five-year total and recurrence-free survival in the treatment with orimeten or tamoxifen.

[Preliminary results of the Russia (St.Petersburg)/WHO program for the evaluation of the effectiveness of breast self-examination]. / Promezhutochnye rezul'taty programmy Rocciia (Sankt-Peterburg)/VOZ po otsenke éffektivnosti samoobsledovaniia molochnykh zhelez.

Although an absolute difference of 10% (65,4 vs. 54,9%) in 5- and 9-year survival in breast cancer patients was recorded between the self-examination and control groups a large-scale randomized population-controlled study of 122,471 females has failed to provide significant differences (Log-rank - 0,774, p > 0.05). No significant decrease in mortality was observed in the self-examination group as compared with the untrained controls. As a result of providing more information to the population on risk factors. twice as many of the trained females consulted oncologists. Also, the number of early detection of breast tumor (T1-2NOMO) in both groups was 1,5-2,5 times that recorded elsewhere. Since 3,55 per 1,000 patients with breast tumors per year, aged 50-59, died of cardio-vascular disease, i.e. 3,1 times the expected 1,16 per 1,000, more attention should be focused on timely diagnosis and treatment of concomitant cardio-vascular pathology.

Primary (neoadjuvant) chemotherapy and radiotherapy compared with primary radiotherapy alone in stage IIb-IIIa breast cancer.

BACKGROUND: A phase III randomized trial was activated to evaluate the efficacy of preoperative combined chemotherapy and radiotherapy as compared to preoperative radiation therapy alone, in patients with breast cancer presenting with a clinical stage of IIb-IIIa (TNM classification). PATIENTS AND METHODS: From 1985 to 1990, 271 patients, aged 27-55 years, with stage IIb-IIIa breast cancer were randomized to receive either one or two courses of thiotepa 20 mg (i.m. injection) on the days 1, 3, 5, 7, 9, 11 (total dose per course 120 mg), methotrexate 40 mg/m2, i.v. on days 1 and 8, and 5-fluorouracil 500 mg/m2, i.v. on days 1 and 8 (TMF regimen) plus radiotherapy (Group I, 137 patients), or preoperative radiation therapy only (Group II, 134 patients). After the preoperative treatment all patients underwent mastectomy and complete axillary clearance, and then received 4-6 courses of TMF. The trial was conducted in a single institution (N.N. Petrov Research Institute of Oncology, St. Petersburg). RESULTS: Histopathological assessment of the mastectomy specimens showed complete regression of the tumour in 29.1% of the patients in group I and in 19.4% of the patients e.c. in group II. The estimated 5-year overall survival percentages were 86.1% for group I, and 78.3% for group II (P > 0.05). 5-year disease-free survival percentages were 81.0% and 71.6%, respectively (p < 0.05). CONCLUSIONS: Despite the low number of the patients included in the trial, we were able to detect a significant improvement in treatment results with a combination of chemotherapy and radiation therapy given prior to mastectomy over those of local therapy alone with radiation therapy followed by mastectomy, for average- and high-risk patients with operable breast cancer.

[Neoadjuvant chemotherapy in combined treatment of breast cancer]. / Neoad''iuvantnaia khimioterapiia v kompleksnom lechenii raka molochnoi zelezy.

The paper deals with results of complex treatment of 387 patients with stage III breast cancer assigned to either neoadjuvant chemotherapy and preoperative radiotherapy or radiation alone. A study of immediate and end results showed combination of the two modalities to be more effective than each method alone in terms of degree of regression of primary tumor and, particularly, lymph node metastases and duration of recurrence-free period.

[Work experience of the WHO International Reference Center in assessing the effectiveness of self-examination for the early diagnosis of breast cancer (results of 2 years' research)]. / Opyt raboty Mezhdunarodnogo referativnogo tsentra VOZ po otsenke éffektivnosti samoobsledovaniia dlia rannei diagnostiki raka molochnoi zhelezy (rezul'taty dvukh let issledovaniia).

A prospective controlled study of the effectiveness of self-examination for early detection of breast cancer has been conducted in Leningrad since 1985. The study was carried out in a cohort of 90,000 females at 28 in- and outpatient clinics within 24 months. As a result, breast cancer was identified in 82 cases. Mean size of primary tumor proved 1.0 cm less and tumor detected 4.8 months earlier than those with standard diagnostic procedures. The cohort is planned to expand to 150,000 by the end of 1988. Data on correlation between application of self-examination and breast cancer mortality are expected by 1994.

[Evaluation of the effect of ovariectomy in patients with stage III breast cancer]. / Otsenka éffekta ovariéktomii u bol'nykh rakom molochnoi zhelezy III stadii.

The efficiency of prophylactic ovariectomy and hormone treatment with corticosteroids in patients with primary III degree breast carcinoma was studied. The indices of actuarial survival in the group of patients subjected to ovariectomy (n-115) during the follow-up period from 4 to 15 years proved to be reliably higher (p less than 0.05) as compared with controls (n-145). In determining the upper age limit of the susceptibility to ovariectomy it is expedient to take into consideration the menstrual status: in women it should be performed in premenopause or in the menopause not longer than 5 years.

Extended radical operations on breast cancer of medial or central location.

Two groups of patients with central or medical primary breast cancer (T1-2N0-1M0) were studied. One group of 478 patients had an extended radical mastectomy (Urban-Kholdin) that included removal of the parasternal lymph nodes and adjoining costal cartilages. A second group of 519 concurrently treated patients had a conventional radical mastectomy (Halsted-Meyer). Among the patients who had an extended radical mastectomy, metastases were found in parasternal lymph nodes in 17.7% of those who had no metastasis in axillary or subclavicular lymph nodes, 40.9% of those who had a single metastatic focus in axillary or subclavicular lymph nodes, and 54.2% of those who had multiple axillary and/or subclavicular nodal metastases. Comparison of the two groups for the interval to tumor recurrence showed that extended radical mastectomy provided a better disease-free survivorship at both 5 and 10 years. Among patients who had an extended radical mastectomy, results at 5 years were better by 10.1% for those who had no lymph node metastases at all, better by 15.6% for those who had a single axillary or subclavicular metastasis, and better by 16.6% when multiple axillary and/or subclavicular nodal metastases were present. Follow-up at 10 and 20 years also showed a margin favoring extended radical mastectomy. Among the patients who had metastases only in parasternal lymph nodes, the disease-free survival rate was 67.4% at 5 years and 46.2% at 10 years. Extended radical mastectomy should be considered the preferred operative procedure for patients 60 years of age or younger who have primary breast cancer (T1-2N0-1M0) of central or medial origin.

[Morphometric and biochemical peculiarities of fatty tissue in patients with cancer of the breast and lung]. / Morfometricheskie i biokhimicheskie osobennosti zhirovoi tkani u bol'nykh rakom molochnoi zhelezy i legkogo.

Subcutaneous adipose tissue was examined in 77 patients with breast cancer, 61 patients with lung cancer and in a control group of 23 male and 27 female with non-tumor pathology; the weight and age of controls matched those of cancer patients. The obesity in breast cancer patients was of the hypertrophic type, and of combined type (hypertrophic-hyperplastic) in patients who were more than 50% overweight. The increased level of adipose tissue in lung cancer patients was mostly due to the larger size of adipocytes. The concentration of unsaturated fatty acids in adipose tissue in breast cancer patients was in direct correlation with the level of this tissue and adipocyte size, while, in lung cancer group, this correlation was reversed. There was no inverse correlation between the size and c-AMP level of adipocytes in both cancer groups. Resistance to the inhibitory effect of glucose on lipolysis occurring in adipose tissue was more frequent in cancer patients than in controls. Antilipolytic effect of insulin in subcutaneous adipose tissue of breast cancer patients was less pronounced than in lung cancer group. Liposynthetic activity in adipose tissue was identical in all study groups. Lipolytic activity in adipose tissue was enhanced in both cancer groups, but in the breast cancer group it was in direct correlation with overweight, while in lung cancer patients--with the degree of tumor progression.

Metabolic immunodepression and metabolic immunotherapy: an attempt of improvement in immunologic response in breast cancer patients by correction of metabolic disturbances.

The effects of administration of phenformin and clofibrate to 32 breast cancer patients who underwent radical mastectomy and suffered from hormonal metabolic disturbances involving a decline in immunologic response were investigated. It was demonstrated that treatment with these drugs during 2--7 months results in an improvement in metabolic parameters and delayed hypersensitivity reaction to DNCB, tuberculin and candidin (75.5% of cases), an increase in T lymphocyte count (56.3%) and an improvement of the reaction of lymphocyte blast transformation (66.6%). The improvement in the immunologic status of the patients persisted for 6--8 weeks after the stoppage of phenformin administration; a gradual decline in immunologic response and return to the original level were recorded 4--6 months after stoppage and phenformin therapy. The effect of clofibrate on metabolic and immunologic parameters did not manifest itself as soon as 6--8 weeks after stoppage. Elimination of metabolic immunodepression, which gradually develops in the course of normal ageing and tumor process, should be the main objective of metabolic immunotherapy. To this end, therapeutic means, other than phenformin and clofibrate, may be used provided they exert the same effects on carbohydrate-fat metabolism. The desirability of study of the effects of a long-term course of drugs of this kind on the therapy of cancer patients is discussed.

[Cyclic adenosine monophosphate in the fatty tissue of breast and lung cancer patients]. / Soderzhanie tsiklicheskogo adenozinmonofosfata v zhirovoi tkani bol'nykh rakom molochnoi zhelezy i legkogo.

Content of cAMP was studied in fatty tissue of 33 patients with tumor of mammary gland, of 27 patients with tumor of lung tissue and of 27 persons (15 men and 12 women), which constituted the control group. A procedure involving competitive binding of the nucleotide with protein was used. The data obtained were related to the size and amount of adipocytes in fatty tissue. The size of adipocytes was distinctly larger and content of cAMP in fatty tissue was slightly lower in patients with tumor of mammary gland as compared with the corresponding controls. With ageing content of fatty tissue cAMP tended to increase in men and to decrease in women. Negative correlation between the content of cAMP in fatty tissue (pM per kg of body mass) and the size of adipocytes, characteristic for the control group, was not found in the patients with the both forms of tumor. Significance of impairments in synthesis of cAMP in adipocytes for development of specific metabolic patterns of adipose tissue in oncological patients is discussed.