Abstract:

Objectives. The presentation of case report of cardiac and renal metastases from malignant pleural mesothelioma. Material and methods. An 80-year-old male with epithelioid mesothelioma for 9 years, without asbestos exposure was admitted to hospital with multiorgan failure manifested by acute respiratory heart and renal failure. Patient died despite the resuscitation. An autopsy followed by histological examination was performed. Results. The autopsy revealed a whitish lesion up to 6.6 cm and a lot of whitish lesions measuring 0.4 cm in diameter with irregular shape throughout the visceral pleura. Left ventricular wall of the heart was with solid whitish irregularly shaped lesion placed intramurally up to 0.6 cm in diameter and left ventricular free wall was 1.6, accordingly. Right ventricular free wall was 0.6 cm. A solid whitish lesion up to 1.1 cm in diameter was found in the middle third of left kidney as well. Histologically the visceral pleura lesion was presented by epithelioid mesothelioma consisted of tubules, papillae, solid and adenomatoid pathomorphism. Some sections of the myocardium of left ventricle and cortex of left kidney were with tumor cells presence. Conclusions. A case report of unusual metastatic lesion is presented to enrich an already existing literature database. Attention should be paid to the antemortem searching of clinically asymptomatic metastases.

Abstract:

Objectives. Improvement of diagnosis and surgical treatment of superior mesenteric artery aneurysms. Material and methods. The peculiarities of the clinical course, diagnosis and surgical treatment of superior mesenteric artery aneurysm were analyzed in 64-year-old patient. Results. In our observation, in a 64-year-old patient, by clinical examination, laboratory and diagnostic imaging the diagnosis of superior mesenteric artery branch aneurysm was confirmed, that has become a direct indication for surgical intervention - resection of aneurysm. Pathomorphologically fibromuscular dysplasia was detected. Follow-up: 3, 6 months after surgical treatment the patient has no complaints, at the control ultrasound examination magistral blood flow through superior mesenteric artery is detected, aneurysmatic expansions are not visualized. Due to the rarity of pathology, the results of surgical treatment of superior mesenteric artery aneurysms in literature are limited to a small number of observations. Most of them indicate on an infectious etiology of the disease – mycotic aneurysms. According to the U.S. registry for fibromuscular dysplasia, celiac and mesenteric arteries were involved in 37.5% of all cases, in the form of stenosis, dissection or visceral artery aneurysm. When the diagnosis of superior mesenteric artery aneurysm is confirmed there is no alternative to timely surgical treatment. Open surgical intervention traditionally remains a «gold» standard for superior mesenteric artery aneurysm repair and includes a resection of aneurysm or resection in combination with revascularization. Conclusions. Superior mesenteric artery aneurysm is a rare clinical condition that may be complicated by rupture with fatal bleeding and mesenteric ischaemia. This clinical case demonstrates that timely diagnosis and adequate surgical treatment of superior mesenteric artery aneurysm allow to prevent the occurrence of life-threatening complications and achieve complete recovery of the patient.

Abstract:

Objectives. To evaluate the effect of medicinal water of the Skhidnytsia region on rehabilitation of patients after nephrectomy for renal cell carcinoma of the kidney complicated by chronic kidney disease. Materials and methods. The study was conducted from 2007 to 2014. The investigators have reviewed medical records of 116 patients with renal cell cancer and concomitant chronic kidney disease. All patients have had radical nephrectomy with a therapeutic intent. All patients were randomized into two treatment groups. The first group enrolled 67 patients (31 males and 36 females); this patient subpopulation was dominated by patients diagnosed with urinary syndrome, which lasted over 3 months. Only 12 patients had glomerular filtration rate < 90 ml/sec. The patients in the first group did not have any spa resort treatment in the postoperative period. The second group enrolled 49 patients (21 males and 28 females). As in the case with patients of the first group, most patients in the second group have had urinary syndrome for more than three months. Glomerular filtration rate < 90 ml/sec was observed only in 13 patients of the second group. All patients of the second group have had spa resort treatment in the setting of the spa town of Skhidnytsia. Results. The duration of follow-up was 2 years. The patients returned to the spa town every six months, for a total of 4 spa resort treatment courses. The mean duration of each course was 17.9±1.3 days. Changes in creatinine level and glomerular filtration rate with time were assessed once every 6 months in both groups, for a total of 4 follow-up visits.

Abstract:

Objectives. To objectify the diagnosis of cervical intraepithelial neoplasia in the presence of papillomavirus infection in women with infertility by morphometric analysis of the cervical mucosa. Material and methods. The pieces of the cervix obtained during diagnostic biopsies of 157 infertile women with cervical intraepithelial neoplasia associated with papillomavirus infection were material for morphological examination. A specific quantitative diagnosis of real-time polymerase chain reaction with hybridization-fluorescence detection was used to identify papillomavirus infection. Immunohistochemical study was performed on paraffin sections of cervical tissue by conventional methods. Histological examination was performed on an AxioScop 40 (Zeiss) microscope. Metric parameters were calibrated on the tool for measuring "Mira". Results. Mild dysplastic ectocevix changes were generally characterized by preservation of anisomorphism and stratification of the surface and intermediate layers, focal basal cell hyperactivity with increasing nuclear-cytoplasmic ratio. The volumetric density of capillaries of a mucous membrane credibly increased in 2.8-times in moderate cervical intraepithelial neoplasia compared with the control group. The thickness of multilayered squamous non-keratinized epithelium with severe cervical intraepithelial neoplasia often did not differ from that with mild or moderate ones. Violation of histoarchitectonics due to loss of stratification and vertical anismorphism was noted in the ectocervix. There was a total basal hyperactivity, impaired maturation and differentiation of epithelial cells. Conclusions. The obtained morphometric data studies have revealed that disorders of the epithelial-stromal relationship especially in cases of severe cervical intraepithelial neoplasia may be one of the stages of carcinogenesis.

Abstract:

Cancer is one of the most diffused and deadly diseases worldwide. Unfortunately, due to the very heterogeneous nature of tumors, it has been very challenging finding efficient treatments. Standard clinical procedures present many adverse side effects and may often cause drug resistance with consequent therapy failure, onset of metastases and relapse. Combination therapy has demonstrated limited success due to the difficulties in matching different molecules pharmacokinetic properties and in tuning the best dosage in order to achieve the desired effects. Recently, innovations in the nanotechnology field have allowed to design ad hoc nanocarriers able to selectively deliver drugs to target cells and release them upon specific triggers. Artificial intelligence approaches have been also developed and advances in the computational modeling field have greatly impacted human healthcare. The possibility to exploit algorithms for predicting drug responsiveness based on data retrieved from databases is greatly improving clinical strategies and supporting therapeutic decisions. In this review, we report recent advances in the nanomedical and artificial intelligence fields and describe novel strategies adopted for counteracting cancer drug resistance. Limits and promises of these approaches are discussed, together with some examples of preclinical and clinical applications.

Abstract:

Objectives. To study the effect of 5-a-reductase inhibitor on the parameter of the apparent diffusion coefficient of MRI in the differential diagnosis of prostate cancer. Material and methods. In total, the study involved 219 persons. The study included patients with histologically verified PCa and BPH, all patients before MRI and PBP were treated with 5-ARI - finasteride for lower urinary tract symptoms, 5 mg once daily for at least 4 months. The main group receiving finasteride treatment included patients of the following subgroups: 20 patients with PCa, of which 11 with clinically nonsignificant variant (nsPCa) and 9 with clinically significant variant (csPCa) of the disease and 12 patients with BPH. The comparison group included patients of the following subgroups: 102 patients with PCa, of which 23 with nsPCa, 79 with csPCa and 70 patients with BPH. In all patients MRI of the prostate (1.5 T) and biopsy were performed. Results. In patients treated with finasteride in both the subgroup with PCa and BPH, the mean ADC values were lower than in the corresponding comparison subgroups. At the same time, the statistical analysis did not reveal significant differences between the main and comparison subgroups of patients with PCa (p> 0.05) and between the respective subgroups of patients with nsPCa and csPCa (p> 0.05). In contrast, we observed significant differences between the mean values of ADC in subgroups of patients with BPH who did not receive and received finasteride treatment for lower urinary tract symptoms before MRI and biopsy: 1.16 ± 0.16 vs 0.84 ± 0.12× 10−3 mm2/s (<0.001). Conclusions. There is a link between administration of 5-ARI (finasteride) for symptoms of lower urinary tract and/or BPH, and values of ADC, which had a significant impact on the differential diagnosis between PCa and benign prostate disease using MRI.

Abstract:

Optimal management of patients will be guided by ideal biomarkers, which can help clinicians to implement early detection, prognosis, prediction of benefit from therapies, recurrence or progression of human cancers, although biomarkers have not yet become clinically routine, especially in renal cell carcinoma (RCC). microRNAs (miRNAs) are chemically stable and can thus be detected in a broad range of clinical samples and hence, have diagnostic and prognostic value in many human malignancies. The discovery that miRNAs function as key regulators of carcinogenesis and tumor progression has initiated extensive research in the cancer field, leading to the development of newer anti-cancer therapies. Growing studies have identified some miRNAs as promising biomarkers and therapeutic targets of RCC. This review discusses the current status of miRNAs in RCC, focusing on miRNAs as potential diagnostic, prognostic, and predictive biomarkers and their therapeutic potential.

Abstract:

Objectives. To assess the efficiency of Febuxostat in preventing of further GFR decline in patients with hyperuricemia with and without diabetic nephropathy (DN) associated and chronic kidney disease (CKD). Material and methods. The prospective study enrolled 73 adult patients with hyperuricemia and CKD of 3A-4 stages (34 patients with DN and 39 without DN). In all cases, baseline and 6 months after beginning of the treatment uric acid serum levels, estimated glomerular filtration rate (eGFR). All patients with DN were randomized into two groups: treatment with febuxostat 40 mg daily (n=16) or placebo (n=18). Patients without DN were similarly randomized: treatment with the same dose of febuxostat (n=20) or placebo (n=19). Statistical significance was considered when P value was <0.05. Results. In patients with DN who received febuxostat or placebo and in patients without DN who received febuxostat or placebo mean baseline eGFR showed no difference (p>0.05). Six months after treatment with febuxostat, eGFR in patients with and without DN changed insignificantly and was 41.63±3.48 and 41.3±7.92 respectively (p>0.05). In patients with and without DN, who received placebo, there was a significant decrease in mean eGFR six months after the treatment: 24.0± 6.51 and 33.26±4.78 correspondingly (p<0.01). On 6-th month there was a statistically substantial difference in mean eGFR between subgroups of patients treated and not treated with febuxostat (p<0.05). Moreover, there was more pronounced decline in mean eGFR in patients with DN who received placebo, compared with subgroup without DN taking placebo (p<0.01). Conclusions. The study demonstrated promising ability of febuxostat to prevent eGFR decline in patients with hyperuricemia with and without diabetic nephropathy associated with chronic kidney disease.