Vol 13, No 5 (2014)

Analysis of the parameters of mineral metabolism of blood was carried out for 73 patients with malignant tumors of epithelial tissues who were not previously exposed to antineoplastic treatment, and for 14 patients with recurrent cancer of epithelial tissue before treatment and after chemotherapy. The control group consisted of 31 healthy individuals. Just at the initial stages of carcinogenesis a statistically significant reduction in serum Na, the elevated levels of Ca, P and Mg were found. Analysis of the level of microelements in the blood plasma showed the decrease in the concentration of Cu, Li, the increase in the content of Sr. After chemotherapy the statistically significant changes were found for calcium and phosphorus, and in case of successful treatment the phosphorus level in the blood plasma significantly increased for the patients with recurrent malignant tumors of epithelial tissues. In the groups with positive dynamics in recurrent colon cancer and bladder cancer, the elevated levels of zinc, lithium and iron were observed in blood plasma. The opposite effect was observed in case of treatment failure and disease progression. Disorders of mineral homeostasis are the important link in the disintegration of the metabolic processes in carcinogenesis. Modifications of the parameters of mineral metabolism in blood plasma after the first period of treatment by chemotherapy can be used as the advanced markers to evaluate its effectiveness for malignant tumors of epithelial tissues.

Standardized enhanced recovery after surgery (ERAS) protocols are the gold standard of modern perioperative care. However, the safety of ERAS pathways in pancreatic surgery is still debatable. The aim of this study was to assess the feasibility of ERAS protocols in pancreatic cancer surgery. ERAS protocols for pancreatoduodenectomy were introduced in our surgical oncology department according to published ERAS society guidelines. The elements of the program were early physical mobilization, multimodal analgesia, early enteral feeding. Inclusion criteria were age <70, ECOG <2, ASA <2, diagnosis of peri-ampullary malignancy. Pancreatoduodenectomy with a standard lymphadenectomy was performed. 20 patients (14 female, 6 male, median age 61) were treated according to ERAS program. No in-hospital mortality occurred. Complications developed in 10 patients (Dindo-Clavie grade IIIB-IV - 4). Median length-of-stay in piostoperative period was 10 days with 1 readmission. Our preliminary results show that implementation of a pancreatoduodenectomy ERAS program allows to optimize perioperative therapy and doesn’t lead to an increase of morbidity. .

The purpose of this article is to study the general methodological principles of psychological rehabilitation organization of cancer patients as an essential component of the rehabilitation process, as well as the selection and justification of the main problems to be solved clinical psychologists in the rehabilitation of patients with cancer. It is shown that the concept of cultural-historical development of LS Vygotsky have some signs of compliance postnonclassical methodological model of scientific rationality. It argues the possibility of considering the basic provisions of the cultural-historical theory as relevant methodological basis for the solution of theoretical and applied problems in the field of clinical psychology, as well as in interdisciplinary clinical and psychological research at the present stage of development of scientific knowledge, in particular, to determine the goals and objectives of psychological rehabilitation of cancer patients. Highlighted the purpose and objectives of psychological rehabilitation. As an objective of psychological rehabilitation is to create conditions for potentiating an active, independent productive development of the personality in the new, albeit limited disease conditions. The rehabilitation process is understood as a system with the activities aimed at the restoration of personal and social status of the patient special method, the main content of which is through the mediation of the identity of the patient treatment and recovery actions and activities, as well as the creation of psychologically-based environment for the development of the individual in the face of illness, with effect of the restriction. The artile describes the methodological principles which must be followed to achieve the stated purpose of rehabilitation.

The aim of the study was evaluate the efficacy of dog therapy in child patients after oncologic diseases; To study the influence of dog therapy course on functional independency in rehabilitation after oncologic treatment in Childs with the effects of the oncologic diseases followed by the central nervous system damages; To study the influence of dog therapy on depression degree after oncologic treatment in Childs with the effects of the oncologic diseases followed up by the central nervous system damages. The study included 307 patients, male and female, in the age of 6,5 up to 12 years, after successful treatment of oncologic nonhematologic disease. All the patients got the standard social-psychological support, massage, physical therapy. Patients were divided into groups, which got the dog therapy and comparative groups which got the standard support and rehabilitation without dog-therapy. There were hold 4 group classes of 1 hour. Rehabilitation dog therapy course included exercises and games for development and recovery of normal childhood activities. The course was made up of 41 classes, 2 times per week with the duration of 20-40 minutes each.Before the therapy the patients had been evaluated with the functional independencies scale FIM, adapted Hamilton’s scale, Child Depression Inventory. For the evaluation two time points had been chosen: the one point 30 days before the oncologic treatment; the second point on finishing of rehabilitation course. The specialist involved into evaluation of the patients and the statistics didn’t know to which group the patient belongs. Statistically significant decrease of the depression ratio evaluated with the modified Hamilton scale was observed in the dog-therapy group - 8 (8;10) points in comparison with the comparative group - 18 (17; 19) points in which the patients got the standard rehabilitation only (р<0,000001). Also in the evaluation of the depression with the Child Depression Inventory (CDI) the statistically significant decrease of the depression degree was observed in the dog-therapy group - 67 (65; 68) points in comparison with the comparative group - 37 (35; 39) points in which the patients got the standard rehabilitation only (р<0,000001). After rehabilitation in the group of patients who got the dog-therapy the higher level of the functional independency was observed - 112 (105; 118) points in comparison with the group which got the traditional rehabilitation without the dog therapy 75 (73; 84) points (р<0,000001). In the group of patients who got the dog therapy, there were taken 39 (36; 43) doses of the drugs which is significantly lower (р<0,000001) than in the groups of patients who got the standard rehabilitation without the dog-therapy - 57 (53; 62) doses. 1. Dog therapy with the dogs trained as the rehabilitation agent and the special complex of exercises, used for the rehabilitation of the childs with the with the effects of the oncologic diseases followed up by the central nervous system damages, results in the increase of the functional independence and decrease of intensity of depressive disorder. 2. Dog-therapy results in decrease of the quantity of the analgesics used on the stage of rehabilitation of childs with the effects of the oncologic diseases followed up by the central nervous system damages and therefore in decrease of the drug burden and treatment costs 3. Dog therapy could be considered as the rehabilitation instrument for the patients with the effects of child oncology.

The primary aim of the current study is to estimate the effect of different physical activity levels on blood macro and trace element content in female students. According to the level of the physical activity all students were divided into three groups: high; medium and low level. The study involved 43 students of P G. Demidov Yaroslavl State University at the age of 18-22 years. Macro and trace element content in whole blood and serum samples was assessed by inductively coupled plasma mass spectrometry using NexION 300D+NWR213 (Perkin-Elmer, USA). Obtained results of two biological substrates are compared in order to find common changes in mineral metabolism for any kind of physical exertion. The elemental composition of the blood serum is more sensitive to the effects of physical activity in girls compared with whole blood. The content of certain elements (calcium, cobalt, potassium, selenium) in the blood serum can be regarded as biomarkers of increased physical load. .Imbalance of these macro- and trace elements may be a factor of the increased risk of injuries and disorders of cardiovascular and immune systems. Determination of the elemental composition of blood serum is reasonable put into practice health assessment of professional athletes and people who regularly and actively engaged in physical culture.

Establishment of the complex rehabilitation system for severe patients and the disabled people are one of the most topical problems of health system. It is to be comprehended as a versatile system of legal, medical, economical etc. means, which help people to regain their disturbed biopsychosocial functions, compensate them and adapt to the society.