Vol 23, No 11 (2012)

The 12th International Breast Cancer Conference in St. Gallen (2011) adopted new approaches to planning its therapy. A simplified immunohistochemical classification was proposed as a useful alternative to a gene classification. The definition of the subtypes of breast cancer significantly alleviates the determination of indications for therapy because the subtypes are themselves characterized by many risk factors and predictors, which were separately used in earlier guidelines.

The paper considers the specific features of the clinical picture, diagnosis, treatment, and prevention of lung injuries resulting due to both iatrogenic and occupational exposure to a drug. It shows the specific features of lung injury caused by antibacterial, antihypertensive, nonsteroidal anti-inflammatory drugs during cytostatic therapy.

The diagnosis and treatment of colonic precancers and the detection of early-stage colorectal cancer (CRC) are able to reduce CRC morbidity and mortality. Elaboration of unified protocols for screening and diagnostic tactics in the detection of CRC will help optimize the use of early primary diagnostic methods for colonic epithelial tumors (colonoscopy, fecal occult blood test, fecal immunochemical test, virtual colonoscopy, determination of the molecular genetic profile of enterocytes in the feces) and confirmatory clinical diagnostic techniques (echography, computed tomography, magnetic resonance imaging, positron emission tomography). The use of unified standards for early diagnosis will increase the detection rate of early-stage colonic tumor diseases and will be able to choose an optimal treatment policy for CRC, which will, in the long run, contribute to the reduction of CRC mortality rates.

The paper considers the pathogenesis of thoracalgia in the urban population and gives appropriate recommendations for the diagnosis and treatment of patients.

Platinum drugs are widely used in oncology care. However, the use of cisplatin is limited by its nephrotoxicity that is absent in the third-generation platinum derivative oxaliplatin. There are pharmacokinetic, pharmacogenetic, and clinical data that substantiate that oxaliplatin may be prescribed for patients with insignificantly or moderately reduced kidney function (creatinine clearance > 20 ml/min).

The efficiency of combination therapy (the simultaneous use of antibacterial drugs and topical glucocorticoids) for exacerbations of different forms of bacterial sinusitis was determined. The study enrolled 60 patients aged 18 to 69 years. When the exacerbation of bacterial inflammation in paranasal sinuses was arrested with the antibiotic (moxifoxacin) and topical steroid combination proposed by the authors, the efficiency of treatment remained high and accounted for 88.9% for polypous and purulent sinusitis and 83.3% for the pyohyperplastic process following 6 months. Its efficacy for polypous lesion remained as before and that for hyperplasia slightly decreased (to 72.2%) after a year.

Chronic inflammation occurs more frequently in the presence of prostatic calculi than in their absence in patients with benign prostatic hyperplasia and cancer, as evidenced by an analysis of prostate secretion and a histological examination of tissue samples intraoperatively taken.

Examinations were made in 384 patients with cervical cancer (CIN I, CIN II, CIN III) in the presence of infection with human papillomavirus (HPV) and 84 patients without CIN and HPV. Comprehensive examination involved analysis of anamnestic data (the specific features of sexual behavior and used contraceptive methods, reproductive function), as well as colposcopy, cytological and histological studies of cervical biopsy specimens, polymerase chain reaction for HPV. Early onset of sexual intercourse, promiscuity, irregular barrier contraceptive use or its absence, an insignificant interval between menarche and onset of sexual activity were established to be social risk factors of CIN. Measures for primary prevention of CIN are presented.

The paper considers the anesthesiological aspect of perioperative maintenance in the most difficult patients to undergo total endoprosthetic replacement of large (hip and knee) joints. All patients formed a group at high cardiac risk for anesthetic and surgical complications classified as ASA III-IV.

The timely diagnosis and combination treatment of locally advanced bladder cancer significantly improve overall and relapse-free survival rates.

In perimenopausal women with chronic obstructive pulmonary disease, their hormonal status is characterized by an imbalance in hypophyseal (follicle-stimulating and luteinizing hormones) and sex (estrogen, progesterone) hormones and cortisol, which is indicative of the involvement of the neuroendocrine system in the inflammatory process.

One hundred and one patients with a mean age of 62,1±1,2 years and impaired glucose tolerance (IGT) were examined. A control group consisted of 16 apparently healthy individuals with a mean age of 22,6±0,6 years. The values of glycemia and lipid spectrum and the blood levels of insulin, C-reactive protein, adiponectin, resistin, endothelin, and omentin were determined. The patients with IGTin the presence of visceral obesity were observed to have atherogenic dyslipidemia, hyperinsulinemia, aseptic adipose tissue inflammation, and lower blood omentin levels. In women with IGT, blood resistin and endothelin concentrations were elevated; adiponectin levels tended to fall.

The history of establishment of a Moscow hospital that gives rise to Russian medicine is described; its role in the war of 1812 is accounted. The major milestones of the 300-year history of the military medical institution are given.