Pub Date : 2023-06-27DOI: 10.46563/1560-9561-2023-26-3-168-177
T. Borovik, М.V. Fomina, S. Yatsyk, T. V. Bushueva, Nataliya G. Zvonkova, Аleksey А. Gusev, V. Skvortsova, I. Sokolov, I. Guseva, A. Fisenko, A. Alkhasov
Introduction. The results of treatment of children who are preparing or have already undergone major surgery depend on many factors, including the nutritional status — the presence/absence of malnutrition. Aim: to assess the nutritional risk and nutritional status in children with surgical diseases during pre- and postoperative periods. Materials and methods. A prospective, single-center, non-comparative study included 60 children aged from 1 month to 17.5 years with diseases of the esophagus, intestines, urogenital system, admitted for surgical treatment. In all patients, the anamnestic data of life and disease were analyzed, screening of nutritional risk was assessed according to the validated Russian version of the STRONG-kids screening tool, nutritional status was evaluated using the WHO AnthroPlus program (2009) and the anthropometric indices (Z-scores: weight/age, height/age, BMI/age), the biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were estimated. Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 24 (40%) patients, 58% of them suffered from diseases of the esophagus, 37% had pathology of the intestine and 36% — the genitourinary system. Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications and decreasing the length of hospital stay.
{"title":"Enteral nutrition support for children with surgical pathology over the periooperative period","authors":"T. Borovik, М.V. Fomina, S. Yatsyk, T. V. Bushueva, Nataliya G. Zvonkova, Аleksey А. Gusev, V. Skvortsova, I. Sokolov, I. Guseva, A. Fisenko, A. Alkhasov","doi":"10.46563/1560-9561-2023-26-3-168-177","DOIUrl":"https://doi.org/10.46563/1560-9561-2023-26-3-168-177","url":null,"abstract":"Introduction. The results of treatment of children who are preparing or have already undergone major surgery depend on many factors, including the nutritional status — the presence/absence of malnutrition. \u0000Aim: to assess the nutritional risk and nutritional status in children with surgical diseases during pre- and postoperative periods. \u0000Materials and methods. A prospective, single-center, non-comparative study included 60 children aged from 1 month to \u000017.5 years with diseases of the esophagus, intestines, urogenital system, admitted for surgical treatment. In all patients, the anamnestic data of life and disease were analyzed, screening of nutritional risk was assessed according to the validated Russian version of the STRONG-kids screening tool, nutritional status was evaluated using the WHO AnthroPlus program (2009) and the anthropometric indices (Z-scores: weight/age, height/age, BMI/age), the biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were estimated. \u0000Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 24 (40%) patients, 58% of them suffered from diseases of the esophagus, 37% had pathology of the intestine and 36% — the genitourinary system. \u0000Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications and decreasing the length of hospital stay.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84362048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-27DOI: 10.46563/1560-9561-2023-26-3-218-221
I. A. Kyarimov
The incidence and prevalence of urolithiasis have been increased over the last decade. Most kidney stones in children are composed of either calcium oxalate or calcium phosphate and often associated with metabolic disorders. Typical symptoms of urolithiasis in children include abdominal or lower back pain, hematuria, and in acute cases dysuria, fever, or vomiting also occur. Ultrasound of the urinary tract is the first choice for children urolithiasis because it can be used to detect most of symptomatic stones. X-rays or computed tomography are also used. Treatment for kidney stones includes diet, drug therapy, and surgery. Surgical treatments for urolithiasis in children include extracorporeal shock wave lithotripsy, contact lithotripsy, percutaneous nephrolithotomy and open lithotomy. This review describes the epidemiology, etiology, pathogenesis, and clinical symptoms and treatment of urolithiasis in children.
{"title":"Urolithiasis in children: modern possibilities of diagnosis and treatment","authors":"I. A. Kyarimov","doi":"10.46563/1560-9561-2023-26-3-218-221","DOIUrl":"https://doi.org/10.46563/1560-9561-2023-26-3-218-221","url":null,"abstract":"The incidence and prevalence of urolithiasis have been increased over the last decade. Most kidney stones in children are composed of either calcium oxalate or calcium phosphate and often associated with metabolic disorders. Typical symptoms of urolithiasis in children include abdominal or lower back pain, hematuria, and in acute cases dysuria, fever, or vomiting also occur. Ultrasound of the urinary tract is the first choice for children urolithiasis because it can be used to detect most of symptomatic stones. X-rays or computed tomography are also used. Treatment for kidney stones includes diet, drug therapy, and surgery. Surgical treatments for urolithiasis in children include extracorporeal shock wave lithotripsy, contact lithotripsy, percutaneous nephrolithotomy and open lithotomy. This review describes the epidemiology, etiology, pathogenesis, and clinical symptoms and treatment of urolithiasis in children.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75341632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-27DOI: 10.46563/1560-9561-2023-26-3-159-167
A. Е. Krasnovidova, O. Simonova, V. Chernevich, Aleksandr V. Pakhomov, A.P. Reykh, A. Pushkov
Introduction. Despite the genetic counseling, families with cystic fibrosis (CF) patients and modern possibilities of prenatal molecular genetic screening, the occurrence of CF in more than one child in a family is not rare. The same genotype is expected to determine the specific phenotype in CF patients, especially in siblings. However, broad clinical heterogeneity could indicate the influence of secondary genetic factors on the course of the disease. The aim of the study is to examine the genotype-phenotype correlation and disease course features in CF siblings, including twins. Materials and methods. A clinical retrospective cohort observational study included fifty three sibs (23 boys, 30 girls) aged from 6 months to 17 years 9 months (median age of 8.3 (4.8–12.9) years, age difference 5 ± 2 years) with a diagnosis of CF confirmed by molecular genetic methods. Group 1 consisted of 9 twin pairs (3 — monozygotic, 6 — dizygotic), group 2 — 35 complete sibs. Results. The mean age of diagnosis for older sibs is 2.5 years (8 months — 9,8 years; min — 1 months, max — 17 years) and for younger sibs — 8.5 months (1.3 months–3 years). Chronologically, the onset of CF was registered earlier in younger sibs than in older sibs in 3 (16.7%). In 6 (22.2%) of families, the pancreatic status of sibs varied from normal function to severe pancreatic insufficiency, with the occurrence of pancreatitis observed in only 4 (7.6%) patients. In 21 (77.8%) families with sibs infected by P.aeruginosa, 5 (23.8%) had a simultaneous primary culture of the pathogen, 8 (38,1%) had culture in both children but with an interval from 1 month to 9.5 years (Ме: 3.2 (5 months–4.9 years), and in 8 (38.1%) had culture in only 1 sibling. All younger sibs had the primary contamination at an earlier age with a 5.3 year (2–6.6 years;) difference. In 10 (37.0%) of the families, the pulmonary function of the sibs was variable. The number of bronchopulmonary exacerbations per year ranged in 8 (29.6%) of sib pairs and averaged 1.3 ± 0.5 in older sibs, 1.1 ± 0.3 in younger sibs, and 1.7 ± 1.3 in twins. The severity of hepatic involvement varied in 9 (33.3%) of sib pairs: no morbidity in 6 (33.3%), cystic fibrosis-associated fibrosis in 7 (38.9%), and cirrhosis with portal hypertension in 5 (27.8%). Conclusion. CF siblings, despite the same genotype, similar environmental conditions, and high risk of cross-infection, are characterized by wide phenotypic heterogeneity. Aside from the pathogenic CFTR variants, there are other genetic (modifier genes) and epigenetic (microRNA, DNA methylation) factors that could contribute to the clinical features of cystic fibrosis.
{"title":"Genotype-phenotype correlation in siblings with cystic fibrosis","authors":"A. Е. Krasnovidova, O. Simonova, V. Chernevich, Aleksandr V. Pakhomov, A.P. Reykh, A. Pushkov","doi":"10.46563/1560-9561-2023-26-3-159-167","DOIUrl":"https://doi.org/10.46563/1560-9561-2023-26-3-159-167","url":null,"abstract":"Introduction. Despite the genetic counseling, families with cystic fibrosis (CF) patients and modern possibilities of prenatal molecular genetic screening, the occurrence of CF in more than one child in a family is not rare. The same genotype is expected to determine the specific phenotype in CF patients, especially in siblings. However, broad clinical heterogeneity could indicate the influence of secondary genetic factors on the course of the disease. \u0000The aim of the study is to examine the genotype-phenotype correlation and disease course features in CF siblings, including twins. \u0000Materials and methods. A clinical retrospective cohort observational study included fifty three sibs (23 boys, 30 girls) aged from 6 months to 17 years 9 months (median age of 8.3 (4.8–12.9) years, age difference 5 ± 2 years) with a diagnosis of CF confirmed by molecular genetic methods. Group 1 consisted of 9 twin pairs (3 — monozygotic, 6 — dizygotic), group 2 — 35 complete sibs. \u0000Results. The mean age of diagnosis for older sibs is 2.5 years (8 months — 9,8 years; min — 1 months, max — 17 years) and for younger sibs — 8.5 months (1.3 months–3 years). Chronologically, the onset of CF was registered earlier in younger sibs than in older sibs in 3 (16.7%). In 6 (22.2%) of families, the pancreatic status of sibs varied from normal function to severe pancreatic insufficiency, with the occurrence of pancreatitis observed in only 4 (7.6%) patients. In 21 (77.8%) families with sibs infected by P.aeruginosa, 5 (23.8%) had a simultaneous primary culture of the pathogen, 8 (38,1%) had culture in both children but with an interval from 1 month to 9.5 years (Ме: 3.2 (5 months–4.9 years), and in 8 (38.1%) had culture in only 1 sibling. All younger sibs had the primary contamination at an earlier age with a 5.3 year (2–6.6 years;) difference. In 10 (37.0%) of the families, the pulmonary function of the sibs was variable. The number of bronchopulmonary exacerbations per year ranged in 8 (29.6%) of sib pairs and averaged 1.3 ± 0.5 in older sibs, 1.1 ± 0.3 in younger sibs, and 1.7 ± 1.3 in twins. The severity of hepatic involvement varied in 9 (33.3%) of sib pairs: no morbidity in 6 (33.3%), cystic fibrosis-associated fibrosis in 7 (38.9%), and cirrhosis with portal hypertension in 5 (27.8%). \u0000Conclusion. CF siblings, despite the same genotype, similar environmental conditions, and high risk of cross-infection, are characterized by wide phenotypic heterogeneity. Aside from the pathogenic CFTR variants, there are other genetic (modifier genes) and epigenetic (microRNA, DNA methylation) factors that could contribute to the clinical features of cystic fibrosis.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88399799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. G. Grigoruk, Москвина A. Moskvina, L. M. Bazulina, Sergej Ju. Bakharev, Elena Je. Pupkova, S. A. Elchaninova
BACKGROUND: The duration and accuracy of verification of origin and morphological variant of adenocarcinoma in the cervical smear affect the effectiveness of the treatment of patients. Currently, few publications on the possibility of clarifying the origin of adenocarcinoma in a cervical smear using the traditional cytological method are not sufficient for evidence-based conclusions. AIMS: To identify patterns of cytological indicators of origin of adenocarcinoma in the biomaterial from the cervix. MATERIALS AND METHODS: In an observational one-stage retrospective study, a comparative analysis of cytological tests of cervical smears with the conclusion adenocarcinoma was carried out with clinical and anamnestic information and the results of histological, immunohistochemical, molecular and genetic examinations. Information about 143 patients in the cancer registry of the Altai Regional Oncological Dispensary (Barnaul) for 2021 was used for analysis. Cytology preparations were prepared by the traditional method, as well as by the method of liquid cytology, staining was carried out by the Papanicolaou (Pap Test) and Pappenheim methods. Testing for human papillomavirus (HPV) was carried out by immunohistochemical method and polymerase chain reaction. PIK3CA and KRAS mutations were detected by polymerase chain reaction. RESULTS: The cytological conclusion adenocarcinoma was confirmed by histology for all 143 women. There were cytology features of the morphological variant of AC, as well as to suggest the primary organ of adenocarcinoma, subsequently verified by visualization methods, histological, immunohistological examinations of biopsy and/or surgical material. The adenocarcinoma elements in the cervical smear was accompanied by adenocarcinoma in the endometrium, cervix, ovary/fallopian tube, colon (68.5, 17.6, 9.8 and 2.8% of cases, respectively; p 0.001). Differentiation of endometrial adenocarcinoma varied. Clear cell adenocarcinoma had specific cellular features. Cellular characteristics of HPV-associated and HPV-unassociated endocervical carcinomas differed from each other. Invasion of intestinal adenocarcinoma into the uterus and cervix was characterized by complexes with a palisade arrangement of cells in cervical smears. CONCLUSION: Cytolodiagnostics of adenocarcinoma in smear from the cervix has prospects for further improvement in the verification of the organ origin of carcinoma. It is assumed that it is rational to assess associations of cytology with histo-, cytochemical, molecular and genetic characteristics of adenocarcinoma.
{"title":"Difficulties and possibilities of cytodiagnosis of origin of adenocarcinoma in cervical smears","authors":"O. G. Grigoruk, Москвина A. Moskvina, L. M. Bazulina, Sergej Ju. Bakharev, Elena Je. Pupkova, S. A. Elchaninova","doi":"10.17816/onco197194","DOIUrl":"https://doi.org/10.17816/onco197194","url":null,"abstract":"BACKGROUND: The duration and accuracy of verification of origin and morphological variant of adenocarcinoma in the cervical smear affect the effectiveness of the treatment of patients. Currently, few publications on the possibility of clarifying the origin of adenocarcinoma in a cervical smear using the traditional cytological method are not sufficient for evidence-based conclusions. \u0000AIMS: To identify patterns of cytological indicators of origin of adenocarcinoma in the biomaterial from the cervix. \u0000MATERIALS AND METHODS: In an observational one-stage retrospective study, a comparative analysis of cytological tests of cervical smears with the conclusion adenocarcinoma was carried out with clinical and anamnestic information and the results of histological, immunohistochemical, molecular and genetic examinations. Information about 143 patients in the cancer registry of the Altai Regional Oncological Dispensary (Barnaul) for 2021 was used for analysis. Cytology preparations were prepared by the traditional method, as well as by the method of liquid cytology, staining was carried out by the Papanicolaou (Pap Test) and Pappenheim methods. Testing for human papillomavirus (HPV) was carried out by immunohistochemical method and polymerase chain reaction. PIK3CA and KRAS mutations were detected by polymerase chain reaction. \u0000RESULTS: The cytological conclusion adenocarcinoma was confirmed by histology for all 143 women. There were cytology features of the morphological variant of AC, as well as to suggest the primary organ of adenocarcinoma, subsequently verified by visualization methods, histological, immunohistological examinations of biopsy and/or surgical material. The adenocarcinoma elements in the cervical smear was accompanied by adenocarcinoma in the endometrium, cervix, ovary/fallopian tube, colon (68.5, 17.6, 9.8 and 2.8% of cases, respectively; p 0.001). Differentiation of endometrial adenocarcinoma varied. Clear cell adenocarcinoma had specific cellular features. Cellular characteristics of HPV-associated and HPV-unassociated endocervical carcinomas differed from each other. Invasion of intestinal adenocarcinoma into the uterus and cervix was characterized by complexes with a palisade arrangement of cells in cervical smears. \u0000CONCLUSION: Cytolodiagnostics of adenocarcinoma in smear from the cervix has prospects for further improvement in the verification of the organ origin of carcinoma. It is assumed that it is rational to assess associations of cytology with histo-, cytochemical, molecular and genetic characteristics of adenocarcinoma.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76557369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. G. Grigoruk, T. A. Moskvina, Larisa M. Михайловна, T. Sinkina, Igor’ V. Vihljanov
AIMS: To estimate potentialities of cytological diagnostics of different types of lobular carcinomas of the breast while outpatient examination. MATERIALS AND METHODS: The data of cytological investigations of 444 patients with carcinoma, which were detected by fine-needle aspiration biopsy, were studied. Traditional cytological diagnostics, as well as the liquid-based technique of preparation of patterns were used, staining of patterns according to the Pappenheim and Papanicolaou methods. A standard protocol for immunocytochemical reactions was used. RESULTS: Lobular carcinoma was detected in 15 patients. Types of lobular carcinomas were verified by cytological method were retrospectively identified. Classical, solid and tubular types of lobular carcinoma (n=7,46.7%; n=5,33.3%; n=1,6.7%) differed from unspecified breast carcinomas. In the classical type, vacuoles with a target-like inclusion (probably a drop of mucin) were a significant feature. In the solid type, the absence of complexes with a large number of separately located similar tumor cells was noticed. The tubular type was distinguished by the presence of tubular structures. The liquid-based technique helps to differentiate lobular and unspecified carcinoma using an immunocytochemical reaction with E-cadherin. CONCLUSION: The results of the study indicate that lobular carcinomas of the breast are 3.4% of all breast carcinomas. Taking into consideration the differences in prognosis, it is important to differentiate between lobular and unspecified ductal carcinoma at the outpatient level of diagnostics, as this is deciding for treatment strategy choice.
{"title":"Lobular carcinomas of the breast: cytological diagnostics","authors":"O. G. Grigoruk, T. A. Moskvina, Larisa M. Михайловна, T. Sinkina, Igor’ V. Vihljanov","doi":"10.17816/onco197446","DOIUrl":"https://doi.org/10.17816/onco197446","url":null,"abstract":"AIMS: To estimate potentialities of cytological diagnostics of different types of lobular carcinomas of the breast while outpatient examination. \u0000MATERIALS AND METHODS: The data of cytological investigations of 444 patients with carcinoma, which were detected by fine-needle aspiration biopsy, were studied. Traditional cytological diagnostics, as well as the liquid-based technique of preparation of patterns were used, staining of patterns according to the Pappenheim and Papanicolaou methods. A standard protocol for immunocytochemical reactions was used. \u0000RESULTS: Lobular carcinoma was detected in 15 patients. Types of lobular carcinomas were verified by cytological method were retrospectively identified. \u0000Classical, solid and tubular types of lobular carcinoma (n=7,46.7%; n=5,33.3%; n=1,6.7%) differed from unspecified breast carcinomas. In the classical type, vacuoles with a target-like inclusion (probably a drop of mucin) were a significant feature. In the solid type, the absence of complexes with a large number of separately located similar tumor cells was noticed. The tubular type was distinguished by the presence of tubular structures. The liquid-based technique helps to differentiate lobular and unspecified carcinoma using an immunocytochemical reaction with E-cadherin. \u0000CONCLUSION: The results of the study indicate that lobular carcinomas of the breast are 3.4% of all breast carcinomas. Taking into consideration the differences in prognosis, it is important to differentiate between lobular and unspecified ductal carcinoma at the outpatient level of diagnostics, as this is deciding for treatment strategy choice.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82819751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: The incidence of gastric cancer is still high and holds the leading place in the structure of oncological pathology in the world. Prognostic aspects in the treatment of generalized forms of gastric cancer are currently under revision. AIM: To study functional status of vascular endothelium in patients with gastric cancer in perioperative period and evaluate its influence on the outcomes of surgical treatment. MATERIALS AND METHODS: A prospective, randomized study was conducted from 2009 to 2019. Two populations were studied: healthy individuals (control group, n=40); patients diagnosed with gastric cancer (general group, n=122). Patients with gastric cancer underwent gastrectomy with lymphodissection. The functional state of the vascular endothelium was studied: the volume of circulating endotheliocytes (CCE); the level of von Willebrand factor (VF) and the degree of endothelium-dependent vasodilation (EDV). To study their prognostic significance we calculated a conventional cut-off point. RESULTS: The general group patients were divided into 2 subgroups: the main group the laparoscopic access (n=54) and the comparison group the laparotomy access (n=68). Endothelial dysfunction (EDF) correction with Glutargin 1.0 g per day in combination with Enalapril 2.5 mg per day was additionally used in the main subgroup. In the main group, the values of CCE and VF were lower (8.33.0 and 84.621.3, respectively) and the values of EDV were higher (13.73.9) in contrast to the comparison group (p 0.0001). Use of the EDF correction method in the main group resulted in a 4.4-fold and 5.1-fold decrease in CCE and VF concentrations, respectively, and a 4.3-fold normalization of EDV (p 0.0001). Increase of CCE concentration more than 7.0 per 103 platelets; PV more than 120 g/ml, as well as decrease of EDV below 14% in the study stages increased the risk of postoperative complications by 2.9; 1.7 and 1.8 times, respectively (p 0.0001). The incidence of surgical complications was 19.7% and non-surgical complications 31.1%. Hospital mortality was 3.3% and out-of-hospital mortality with up to three years follow-up was 13.1%. The number of purulent-septic complications in the main group was 2.9 times lower, and the rate of thrombotic complications was 4 times lower than in the comparison group (p 0.05). CONCLUSION: Combined use of laparoscopic technique by EDF medication correction reduces manifestations of stress reaction and decreases the potential risk of complications development in the postoperative period. Elevation of CCE, as well as EDV decrease beyond the relevant excision points in patients with gastric cancer in the perioperative period are prognostic predictors of the risk of purulent-septic and thrombotic complications development.
{"title":"Features of the endothelial status in patients with gastric cancer and its impact on surgical treatment outcomes","authors":"S. Olzhaev, Y. Shoykhet, A. Lazarev, B. Adjibayev","doi":"10.17816/onco123091","DOIUrl":"https://doi.org/10.17816/onco123091","url":null,"abstract":"BACKGROUND: The incidence of gastric cancer is still high and holds the leading place in the structure of oncological pathology in the world. Prognostic aspects in the treatment of generalized forms of gastric cancer are currently under revision. \u0000AIM: To study functional status of vascular endothelium in patients with gastric cancer in perioperative period and evaluate its influence on the outcomes of surgical treatment. \u0000MATERIALS AND METHODS: A prospective, randomized study was conducted from 2009 to 2019. Two populations were studied: healthy individuals (control group, n=40); patients diagnosed with gastric cancer (general group, n=122). Patients with gastric cancer underwent gastrectomy with lymphodissection. \u0000The functional state of the vascular endothelium was studied: the volume of circulating endotheliocytes (CCE); the level of von Willebrand factor (VF) and the degree of endothelium-dependent vasodilation (EDV). To study their prognostic significance we calculated a conventional cut-off point. \u0000RESULTS: The general group patients were divided into 2 subgroups: the main group the laparoscopic access (n=54) and the comparison group the laparotomy access (n=68). \u0000Endothelial dysfunction (EDF) correction with Glutargin 1.0 g per day in combination with Enalapril 2.5 mg per day was additionally used in the main subgroup. \u0000In the main group, the values of CCE and VF were lower (8.33.0 and 84.621.3, respectively) and the values of EDV were higher (13.73.9) in contrast to the comparison group (p 0.0001). \u0000Use of the EDF correction method in the main group resulted in a 4.4-fold and 5.1-fold decrease in CCE and VF concentrations, respectively, and a 4.3-fold normalization of EDV (p 0.0001). Increase of CCE concentration more than 7.0 per 103 platelets; PV more than 120 g/ml, as well as decrease of EDV below 14% in the study stages increased the risk of postoperative complications by 2.9; 1.7 and 1.8 times, respectively (p 0.0001). \u0000The incidence of surgical complications was 19.7% and non-surgical complications 31.1%. Hospital mortality was 3.3% and out-of-hospital mortality with up to three years follow-up was 13.1%. \u0000The number of purulent-septic complications in the main group was 2.9 times lower, and the rate of thrombotic complications was 4 times lower than in the comparison group (p 0.05). \u0000CONCLUSION: Combined use of laparoscopic technique by EDF medication correction reduces manifestations of stress reaction and decreases the potential risk of complications development in the postoperative period. Elevation of CCE, as well as EDV decrease beyond the relevant excision points in patients with gastric cancer in the perioperative period are prognostic predictors of the risk of purulent-septic and thrombotic complications development.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89762186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anastasia K. Musonova, V. Nazarov, Daria V. Sidorenko, A. Musaelyan, E. Alekseeva, D. Kuzovenkova, E. S. Kozorezova, S. Vorobev, S. Orlov, A. Mazing, S. Lapin, V. Emanuel
INTRODUCTION: Anaplastic thyroid carcinoma (ATC) is the most aggressive type of thyroid cancer accounting for 12% of all malignancies. Systemic therapy remains the main treatment strategy. Targeted therapy and immunotherapy are prescribed when certain molecular genetic aberrations are detected. THE AIM: To investigate the molecular genetic profile of samples of anaplastic thyroid carcinoma. MATERIALS AND METHODS: The study included 37 patients with ATC. Mutation V600E BRAF, mutations in the gene NRAS and KRAS were detected by allele-specific polymerase chain reaction (AS-PCR). Microsatellite instability (MSI) was determined by fragment analysis in according to ESMO recommendations. Mutations in the promoter region of the TERT gene were used by Sanger sequencing. NTRK1, EML4-ALK, PAX8/PPARy и RET/PTC translocations were determined in all patients with ATC by real-time polymerase chain reaction (PCR). RESULTS: According to the results of the study, the frequency of the V600E mutation in the BRAF gene was 32.4% (12/37). The frequency of aberrations in the NRAS, KRAS genes in anaplastic thyroid carcinoma was 13.5% (n=5). The prevalence of point mutations in the promoter gene TERT in food samples of ATC was 24.3% (n=9). MSI was found in 2.7% (1/37) of cases of anapalastic thyroid carcinoma. NTRK1, EML4-ALK, PAX8/PPARy and RET/PTC translocations were not detected in cases with anaplastic thyroid carcinoma. CONCLUSION: The further study of the main specific molecular targets in cancer cells will allow to personalize the tactics of patients with anaplastic thyroid carcinoma.
{"title":"Molecular genetics features of anaplastic thyroid carcinoma","authors":"Anastasia K. Musonova, V. Nazarov, Daria V. Sidorenko, A. Musaelyan, E. Alekseeva, D. Kuzovenkova, E. S. Kozorezova, S. Vorobev, S. Orlov, A. Mazing, S. Lapin, V. Emanuel","doi":"10.17816/onco115251","DOIUrl":"https://doi.org/10.17816/onco115251","url":null,"abstract":"INTRODUCTION: Anaplastic thyroid carcinoma (ATC) is the most aggressive type of thyroid cancer accounting for 12% of all malignancies. Systemic therapy remains the main treatment strategy. Targeted therapy and immunotherapy are prescribed when certain molecular genetic aberrations are detected. \u0000THE AIM: To investigate the molecular genetic profile of samples of anaplastic thyroid carcinoma. \u0000MATERIALS AND METHODS: The study included 37 patients with ATC. Mutation V600E BRAF, mutations in the gene NRAS and KRAS were detected by allele-specific polymerase chain reaction (AS-PCR). Microsatellite instability (MSI) was determined by fragment analysis in according to ESMO recommendations. Mutations in the promoter region of the TERT gene were used by Sanger sequencing. NTRK1, EML4-ALK, PAX8/PPARy и RET/PTC translocations were determined in all patients with ATC by real-time polymerase chain reaction (PCR). \u0000RESULTS: According to the results of the study, the frequency of the V600E mutation in the BRAF gene was 32.4% (12/37). The frequency of aberrations in the NRAS, KRAS genes in anaplastic thyroid carcinoma was 13.5% (n=5). The prevalence of point mutations in the promoter gene TERT in food samples of ATC was 24.3% (n=9). MSI was found in 2.7% (1/37) of cases of anapalastic thyroid carcinoma. NTRK1, EML4-ALK, PAX8/PPARy and RET/PTC translocations were not detected in cases with anaplastic thyroid carcinoma. \u0000CONCLUSION: The further study of the main specific molecular targets in cancer cells will allow to personalize the tactics of patients with anaplastic thyroid carcinoma.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91157210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-28DOI: 10.46563/1560-9561-2023-26-2-82-88
T. Borovik, Maria V. Fomina, S. Yatsyk, T. Bushueva, N. G. Zvonkova, A. Gusev, V. Skvortsova, I. Sokolov, I. Guseva, A. Fisenko, A. Alkhasov
Introduction. To improve the quality of surgical treatment and prevent postoperative complications, there is needed an integrated multidisciplinary professional approach including a combination of nutritional support with therapeutic methods and psychological assistance that reduces stress throughout the perioperative period. Clinical guidelines and standards to manage the patients on this issue in pediatric surgical hospitals have not been developed. Objectives: to assess the nutritional risk of malnutrition and nutritional status in children with surgical diseases, to elaborate algorithms for nutritional support over the pre- and postoperative periods. Materials and methods. The single center non-comparative study included sixty children aged from 1 month to 17 years 5 months, with diseases of the esophagus, intestine, and genitourinary system, were admitted for surgical treatment at the Research Institute of Pediatric Surgery of the Federal State Autonomous Institution «National Medical Research Center for Children’s Health» of the Ministry of Health of Russia. All patients underwent a nutritional risk screening according to a validated Russian version of the STRONGkids. Clinical and anamnestic data were analyzed. Anthropometric indices (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus program (2009), and biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were evaluated. Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 26 (43%) patients, 58% of them suffered from diseases of the esophagus, 37% — the intestine pathology, and 36% of the genitourinary disorders. Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications, and allow diminishing the length of the hospital stay.
{"title":"Malnutrition in pediatric surgical patients","authors":"T. Borovik, Maria V. Fomina, S. Yatsyk, T. Bushueva, N. G. Zvonkova, A. Gusev, V. Skvortsova, I. Sokolov, I. Guseva, A. Fisenko, A. Alkhasov","doi":"10.46563/1560-9561-2023-26-2-82-88","DOIUrl":"https://doi.org/10.46563/1560-9561-2023-26-2-82-88","url":null,"abstract":"Introduction. To improve the quality of surgical treatment and prevent postoperative complications, there is needed an integrated multidisciplinary professional approach including a combination of nutritional support with therapeutic methods and psychological assistance that reduces stress throughout the perioperative period. Clinical guidelines and standards to manage the patients on this issue in pediatric surgical hospitals have not been developed. \u0000Objectives: to assess the nutritional risk of malnutrition and nutritional status in children with surgical diseases, to elaborate algorithms for nutritional support over the pre- and postoperative periods. \u0000Materials and methods. The single center non-comparative study included sixty children aged from 1 month to 17 years 5 months, with diseases of the esophagus, intestine, and genitourinary system, were admitted for surgical treatment at the Research Institute of Pediatric Surgery of the Federal State Autonomous Institution «National Medical Research Center for Children’s Health» of the Ministry of Health of Russia. All patients underwent a nutritional risk screening according to a validated Russian version of the STRONGkids. Clinical and anamnestic data were analyzed. Anthropometric indices (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus program (2009), and biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were evaluated. \u0000Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 26 (43%) patients, 58% of them suffered from diseases of the esophagus, 37% — the intestine pathology, and 36% of the genitourinary disorders. \u0000Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications, and allow diminishing the length of the hospital stay.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73042256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-28DOI: 10.46563/1560-9561-2023-26-2-118-124
Z. Sadeeva, I. Novikova, Natalya M. Alyabyeva, Anna V. Lazareva, Ekaterina A. Samoilova, O. Karaseva, Olga G. Yanushkina, M. Vershinina, A. Fisenko
Introduction. Serratia marcescens is an opportunistic gram-negative microorganism, currently has been detected with increasing frequency in various clinical biomaterials from sick persons is the causative agent of nosocomial infections. The aim of the work is to determine microbiological and clinical features of S. marcescens in bloodstream infections in children. Materials and methods. Nineteen isolates of S. marcescens were isolated from blood cultures. Antibiotic sensitivity was determined by broth microdilution method. Carbapenemase gene were determined using real-time polymerase chain reaction. Biofilm formation was studied on abiotic surfaces using polystyreneplates. Population diversity was determined by multilocus genotypic analysis. Results. Carbapenems, fosfomycin and biseptol showed the highest antimicrobial activity in vitro. Resistance to aminoglycosides, aztreonam, cefepime, and ticarcillin/clavulanate was over 50%. According to PCR data, only OXA-48 carbapenemases were found in 11% of isolates, NDM — in 5%, and a combination of carbapenemases — in 15%. Biofilms of moderate intensity were formed in 13 (68%) isolates, and weak biofilms — in 6 (32%). According to the genotypic analysis, a large proportion of isolates with multiple resistance were included in one group. All of them were singled out over one year from one department — perhaps there was a single source. In 3 cases, patients were diagnosed with sepsis, 1 of them had an unfavourable outcome. Bacteremia occurred on the 3rd day after the initial isolation of S. marcescens. An unfavourable outcome occurred on the 10th day of bacteremia. S. marcescens in this case had multiple resistance and a combination of resistance genes, also belonged to genotypic group I, which is often found in our work. Conclusion. S. marcescens in bloodstream infections is a serious problem for pediatric patients. Natural resistance to polymyxins, as well as acquired resistance to carbapenems and aminoglycosides, cause particular alertness and attention to this microbial agent.
{"title":"Characteristics and properties of Serratia marcescens isolated in bacteremia in children","authors":"Z. Sadeeva, I. Novikova, Natalya M. Alyabyeva, Anna V. Lazareva, Ekaterina A. Samoilova, O. Karaseva, Olga G. Yanushkina, M. Vershinina, A. Fisenko","doi":"10.46563/1560-9561-2023-26-2-118-124","DOIUrl":"https://doi.org/10.46563/1560-9561-2023-26-2-118-124","url":null,"abstract":"Introduction. Serratia marcescens is an opportunistic gram-negative microorganism, currently has been detected with increasing frequency in various clinical biomaterials from sick persons is the causative agent of nosocomial infections. \u0000The aim of the work is to determine microbiological and clinical features of S. marcescens in bloodstream infections in children. \u0000Materials and methods. Nineteen isolates of S. marcescens were isolated from blood cultures. Antibiotic sensitivity was determined by broth microdilution method. Carbapenemase gene were determined using real-time polymerase chain reaction. Biofilm formation was studied on abiotic surfaces using polystyreneplates. Population diversity was determined by multilocus genotypic analysis. \u0000Results. Carbapenems, fosfomycin and biseptol showed the highest antimicrobial activity in vitro. Resistance to aminoglycosides, aztreonam, cefepime, and ticarcillin/clavulanate was over 50%. According to PCR data, only OXA-48 carbapenemases were found in 11% of isolates, NDM — in 5%, and a combination of carbapenemases — in 15%. Biofilms of moderate intensity were formed in 13 (68%) isolates, and weak biofilms — in 6 (32%). According to the genotypic analysis, a large proportion of isolates with multiple resistance were included in one group. All of them were singled out over one year from one department — perhaps there was a single source. In 3 cases, patients were diagnosed with sepsis, 1 of them had an unfavourable outcome. Bacteremia occurred on the 3rd day after the initial isolation of S. marcescens. An unfavourable outcome occurred on the 10th day of bacteremia. S. marcescens in this case had multiple resistance and a combination of resistance genes, also belonged to genotypic group I, which is often found in our work. \u0000Conclusion. S. marcescens in bloodstream infections is a serious problem for pediatric patients. Natural resistance to polymyxins, as well as acquired resistance to carbapenems and aminoglycosides, cause particular alertness and attention to this microbial agent.","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85180286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-28DOI: 10.46563/1560-9561-2023-26-2-125-129
Arina G. Trofimova, A. Fisenko, S. Arzumanov
Introduction. Informing the population about chronic kidney disease is an important factor for preventing or combating the disease, and maintaining the health of the younger generation. Objective: to study the level of awareness of parents about chronic kidney disease. Methods. In a specially designed form, an anonymous survey of 112 parents of children treated at the department regarding chronic kidney disease was conducted. Statistical processing of the obtained results was carried out. Results. In most children (91.6%), the diagnosis of chronic kidney disease was established at the stage C3–C5 in the hospital. Moreover, in 100% of cases, this diagnosis was a “random finding”; 75.9% of respondents showed lack of information about the disease and its treatment, and the level of awareness is directly related to the stage of the disease. Moreover, as a result of insufficient information, the parents admitted to fail to comply with the terms of visiting the child, a nephrologist (22.9%), the recommendations to limit the diet of protein (19.3%) and potassium (36.2%), fluid volume (61.5%). At the same time, the parents believed the cause of the progression of chronic kidney disease in the child to be the lack of follow-up (43.7%), late diagnosis (33.7%), improper treatment (13.3%), and the late beginning of the treatment (9.6%). Conclusion. The work proved a low degree of awareness about chronic kidney disease, which contributes to the late diagnosis of the disease and low adherence to treatment. This problem requires improving methods and forms of informing the population, including expanding the capacity of outpatient care (preventive examinations, health education in nephrology schools).
{"title":"Analysis of parents’ awareness on the chronic kidney disease in children","authors":"Arina G. Trofimova, A. Fisenko, S. Arzumanov","doi":"10.46563/1560-9561-2023-26-2-125-129","DOIUrl":"https://doi.org/10.46563/1560-9561-2023-26-2-125-129","url":null,"abstract":"Introduction. Informing the population about chronic kidney disease is an important factor for preventing or combating the disease, and maintaining the health of the younger generation. \u0000Objective: to study the level of awareness of parents about chronic kidney disease. \u0000Methods. In a specially designed form, an anonymous survey of 112 parents of children treated at the department regarding chronic kidney disease was conducted. Statistical processing of the obtained results was carried out. \u0000Results. In most children (91.6%), the diagnosis of chronic kidney disease was established at the stage C3–C5 in the hospital. Moreover, in 100% of cases, this diagnosis was a “random finding”; 75.9% of respondents showed lack of information about the disease and its treatment, and the level of awareness is directly related to the stage of the disease. Moreover, as a result of insufficient information, the parents admitted to fail to comply with the terms of visiting the child, a nephrologist (22.9%), the recommendations to limit the diet of protein (19.3%) and potassium (36.2%), fluid volume (61.5%). At the same time, the parents believed the cause of the progression of chronic kidney disease in the child to be the lack of follow-up (43.7%), late diagnosis (33.7%), improper treatment (13.3%), and the late beginning of the treatment (9.6%). \u0000Conclusion. The work proved a low degree of awareness about chronic kidney disease, which contributes to the late diagnosis of the disease and low adherence to treatment. This problem requires improving methods and forms of informing the population, including expanding the capacity of outpatient care (preventive examinations, health education in nephrology schools).","PeriodicalId":52396,"journal":{"name":"Russian Journal of Pediatric Hematology and Oncology","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74765072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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