[Prognostic scale for early detection of various postoperative complications after thoracic aortic surgery: post-hoc analysis of biomarkers]. / Prognosticheskaya shkala dlya rannego vyyavleniya oslozhnennogo techeniya posleoperatsionnogo perioda u patsientov, operirovannykh na grudnom otdele aorty: post-hoc analiz dinamiki biomarkerov.

OBJECTIVE: To create the prognostic scale based on some biomarkers after thoracic and thoracoabdominal aortic repair. MATERIAL AND METHODS: We analyzed 114 patients with aortic aneurysm/dissection. The following biomarkers were studied: proadrenomedullin, NT-proBNP, procalcitonin, interleukins 6, 8, 10, tumor necrosis factor, presepsin, highly sensitive troponin I. Stages of the study: before induction of anesthesia, at the end of surgery and 6 hours later. RESULTS: The most informative predictors of postoperative complications were identified using comparative and ROC analyses: baseline presepsin≥204 pg/ml and interleukin 6 ≥4.3 pg/ml. The scale based on assessment of presepsin and troponin I at the end of surgery and preoperative risk allows analysis of the risk of complicated postoperative period. If all three predictors are present, the risk of complicated postoperative period increases by 1.96 times. The equation based on serum presepsin, interleukin-8 and interleukin-6/interleukin-10 ratio in 6 hours after surgery is characterized by acceptable characteristics (AUC 0.785, 95% CI 0.700-0.870). CONCLUSION: An algorithm based on risk stratification consisting of 3 prognostic scales at various stages of perioperative period determines the probability of postoperative complications with sensitivity 67.2% and specificity 94.6%. The total share of correct predictions in this sample was 80.7±3.7%.

[Impact of comorbid chronic heart failure with preserved left ventricular ejection fraction on the management of elderly cancer patients before and after total resections]. / Otsenka vliyaniya komorbidnoi khronicheskoi serdechnoi nedostatochnosti s sokhrannoi fraktsiei vybrosa levogo zheludochka na vedenie pozhilykh onkologicheskikh patsientov do i posle radikal'nykh operativnykh vmeshatel'stv.

OBJECTIVE: To determine the predictors of safe enhanced recovery after surgery in elderly cancer patients with comorbid chronic heart failure (CHF) and preserved left ventricular ejection fraction (LVEF). MATERIAL AND METHODS: There were 75 patients over 65 years old (mean 73.6±5.6 years) with cancer of abdominal and pelvic organs and comorbid cardiovascular diseases for the period from January 2018 to July 2020. All patients underwent total resections with enhanced postoperative recovery at the Petrovsky National Research Centre of Surgery. RESULTS: CHF with preserved LVEF was diagnosed in 42 (56%) patients (NYHA class I - 20 patients, class II - 19 patients, class III - 3 patients). ACE/ARA/neprilysin inhibitors were described in 74.7% of patients, beta-blockers - 70.7%, calcium channel blockers - 37.3%, diuretic therapy - 21.3%, antithrombotic therapy - 62.7%, statins - 54.7%, antiarrhythmic therapy - 12%. Preoperative correction of cardiac therapy was required in 60% of patients. Mean LVEF was 58.5±6.8%, pulmonary artery systolic pressure - 29±7.8 mm Hg, impairment of local myocardial contractility was observed in 6.7% of patients. Serum NT-proBNP level was 534.5±63.9 pg/ml, LDL-C - 3.3±1.1 mmol/l, GFR - 65.95±17.1 ml/min/1.73m2, glycated hemoglobin 6.37±0.67%. Perioperative risk of cardiovascular complications within 30-day postoperative period was assessed using the Revised Cardiac Risk Index (RCRI) score (6% in 59 patients, 10.1% in 11 patients, and 15% in 5 patients). Incidence of cardiovascular complications in early postoperative period was 4%, postoperative 30-day mortality rate - 1.3%. CONCLUSION: Our small study of surgical treatment of elderly cancer patients with comorbid CHF with preserved LVEF demonstrates the need for a personalized assessment of preoperative clinical and instrumental data to optimize cardiac therapy and perioperative monitoring. Multidisciplinary approach reduces perioperative mortality and cardiovascular morbidity from 7.2% to 4%.

[Liver transplantation for hepatoblastoma in children]. / Transplantatsiya pecheni pri gepatoblastome u detei.

OBJECTIVE: To improve the outcomes in children with hepatoblastoma. MATERIAL AND METHODS: There were 160 children with focal liver lesions who underwent surgery at the department of liver transplantation in 2008-2019. Patients with malignant tumors made up 77% (n=123). Hepatoblastoma (HB) prevailed (86%, n=106). Liver transplantation was performed in 19 (18%) patients with HB. Median follow-up after transplantation was 24.3 months by December 2019. Follow-up period did not exceed 4 years in more than 2/3 of patients. RESULTS: Overall and disease-free 10-year survival was 87.1% and 82.7%, respectively. Similar values were observed after resections (91.1% and 86.6%). At the same time, actuarial 4-year survival after liver transplantation for HB was 68%. CONCLUSION: Improvement of treatment outcomes may be achieved through multidisciplinary interaction ensuring timely drug therapy and liver transplantation.

Comparative analysis of the impact of blood collection systems on the results of the study of indicators hemostasis system.

Comparative analysis of the impact of blood collection systems on the results of routine coagulation tests. The aim of this study was to conduct comparative analysis of the effects of blood collection systems on the results of routine coagulation tests. The study involved practically healthy women over 18 years of age female (n=30). Inclusion criteria: practically healthy individuals. Exclusion criteria: taking non-steroidal anti-inflammatory drugs, or oral contraceptives. Blood collection was carried out in the following systems: 1 system-Vacuette Premium,2 system- Improvacuter, 3 system- BD Vacutainer® Plus. Before and after centrifugation, visual assessment of tubes was performed.No signs for the presence of clots, hemolysis, or insufficient filling was observed. In each sample we measured prothrombin time (PV, sec), activated partial thromboplastin time (APTT, sec), and fibrinogen (F, g/l) by clotting method on the automatic coagulometer «Sta Compact¼ («Diagnostica Stago¼, France). The results of laboratory analyses were processed using parametric and non - parametric statistics using The Statistica 12.0 software. At the preanalytical laboratory stage, there were no differences when using systems for blood sampling: the clots and hemolysis were not detected in the samples, the level of filling of the sistems was sufficient. Comparative analysis revealed small, though statistically significant, differences for: PT when comparing Improvacuter wiht Vacuette Premium or BD Vacutainer®; APPT when comparing Improvacuter wiht Vacuette Premium. No differences were observed for Fg levels. Our results support the data available in the literature on the effects of blood-taking systems on hemostasis , which should be taken into account when purchasing blood collection systems.

[The effects of cloudberry extract on Drosophila melanogaster lifespan and stress resistance.]

We have previously shown that carotenoids increase lifespan of model organisms Drosophila melanogaster and Caenorhabditis elegans. In the present study, we investigated the effects of cloudberry extract, an abundant food for people in North, with a relatively large carotenoid content on Drosophila melanogaster lifespan parameters and resistance to different stress conditions. It was shown that the cloudberry extract increased the median lifespan and the age of 90% mortality of females up to 11-19%. The rate of aging was decreased up to 13%. The effects of cloudberry extract on lifespan of males were less expressed. In some cases, they were even negative. The extract had no effects on males and females' resistance to starvation. However, it decreased the resistance of males to oxidative stress.

[DIAGNOSTIC VALUE OF THE HOMEOSTASIS PARAMETERS IN SEPSIS DETECTING IN PATIENTS WITH INFECTIOUS-INFLAMMATORY COMPLICATIONS DURING THE POSTOPERATIVE PERIOD.]

Purpose of the study was to define the diagnostic value of clinical and laboratory criteria of sepsis during the postop- erative period Methods. The results of 269 blood tests (biochemical, coagulation, hematology and microbiology) which were per- formed in 115 patients in the early postoperative period (starting from the first postoperative day) and in the late post- operative periods were analyzed. RESULTS: Presepsin and procalcitonin have a similar diagnostic sensitivity in detection of sepsis - 89% (Psp>328.5 ng/l, PCT>1 ng/ml), but presepsin have a statistically significant lower specificity in comparison with procalcitonin (31% and 61%, respectively). This fact limits the use of presepsin in routine practice in multidisciplinary surgical hospital. Quantitative determination ofprocalcitonin is most preferably for the detection of septic complications in patients in the postoperative period, the results ofpresepsin must be interpreted only with other biochemical and hematological parameters.

[Kidney allotransplantation from alive related donor in patients with Alport syndrome].

AIM: To evaluate the results of kidney transplantation from alive related donor in patients with Alport syndrome and to compare with those in patients with kidney hypoplasia. MATERIAL AND METHODS: We have analyzed 8 and 27 medical records of patients with Alport syndrome and kidney hypoplasia respectively. Following parameters were used - Kaplan-Meier survival analysis, Wilcox overall risk, percentage of transplants loss and mortality (Fisher's exact test calculation). RESULTS: It is concluded that percentage of transplants loss and mortality rate as well as overall survival and risk were similar in both groups. CONCLUSION: Despite risk of anti-GBM nephritis development in patients with Alport syndrome results are comparable with those after transplatation for chronic renal failure caused by other reasons.

[The effect of gender on the results of related kidney transplantation].

AIM: To define the effect of donor and recipient gender on the results of kidney transplantation from living related donor. MATERIAL AND METHODS: Group of 271 patients who underwent kidney transplantation from living related donor was analyzed. There were 115 women and 156 men. Age varied from 1 to 63 years (mean 21.30±12.32). There were 127 children aged 1-18 years (mean 11.28±4.63) and 144 adults aged 19-63 years (mean 29.81±11.24). Donors included 162 women and 109 men. Overall survival was calculated using Kaplan-Mayer. Mortality and incidence of transplants failure were determined using Fisher's exact test. RESULTS: All patients were divided into 2 groups depending on recipients' gender and then into 4 subgroups depending on gender of donors and recipients. Comparative statistical analysis showed that transplants survival was higher in women vs. men (T=2.7, p=0.007). Survival of patients was similar in both groups. Moreover it was the best in subgroup of recipients-women with kidneys from donors-men. Difference was statistically significant (T=2.16, p=0.03). There was no significant difference in all other cases. CONCLUSION: The results of kidney transplantation are better in recipients-women than in men.

[Vaccination in patients with chronic renal failure in the pre- and posttransplantation period].

AIM: To clarify whether vaccination provokes renal graft rejection. SUBJECTS AND METHODS: A total of 131 vaccinations were performed in 92 patients with chronic kidney failure (CKF), including 7 and 85 patients vaccinated before and in different periods after kidney transplantation, respectively. The patients were examined using needle graft biopsy, measurement of proteinuria, and estimation of changes in blood creatinine levels and glomerular filtration rate. RESULTS: Vaccination was not fount to provoke rejection, as suggested by the results of needle biopsy of renal allografts and examination of their function. CONCLUSION: Vaccination is safe for patients with CKF as it causes no rejection episodes.

[THE INFLUENCE OF CYTOMEGALOVIRUS ON THE RESULTS OF KIDNEY TRANSPLANTATION].

To understand whether the presence of cytomegalovirus in blood influences the results of kidney transplantation from live relative donors, we analysed materials from 258 recipients divided into 2 groups. Group 1 included 113 patients with negative results of PCR for cytomegalovirus, group 2 contained 139 patients with positive PCR. We evaluated lethality, the loss of transplanted kidneys, frequency of rejection and infectious complications. Statistical treatment of the data obtained included Kaplan-Meier survival analysis, the Wilcoxon test showing the cumulative hazard risk, and comparative analysis by Fisher's and Student's tests. It was shown that cytomegalovirus present in blood increases lethality and the frequency of infectious complications in recipients of transplanted kidneys but does not influence their rejection. The cumulative survival rate was significantly higher and cumulative risk lower in group 1 than in group 2.

[Predictors of the results of kidney transplantation from living-related donors].

The aim of investigation is analysis of factors forecasting the results of kidney transplantation from living-related donors. This research is based on the analysis of 272 kidneys' transplantation from living-related donors. It was analyzed such parameters as recipients' age, donors' age, donors' sex, degree of relationship between donor and recipient, degree of HLA-compatibility, type of inductive immunosuppression (monoclonal antibodies, corticosteroids, polyclonal antibodies), recipient's sex, presence or absence of rejection episodes for whole postoperative period. We recognized that far not all above-mentioned parameters could predict the results of kidney transplantation from living-related donors.

[Polar lipid pool modification in leaves of hoary plantain (Plantago media L.) plants during their light adaptation under natural conditions].

Polar glycerolipids and photosynthetic pigments of Plantago media L. plants, growing on limestone outcrops of the Southern Timan, have been studied. Leaves of plants growing on well insolated and heated slopes are characterized by an intensive lipoperoxidation; the accumulation of chlorophylls and carotenoids in these plants is 1.5-2 times less and the content of polar lipids is 15-20% less than in plants growing in dense grass at the bottom of slopes. The accumulation of some classes of glycerolipids in leaves in the daytime provides for stabilization of photosystem complexes and the formation of the pool of zeaxanthin, a protective xanthophyll. Changes in the content and ratio of lipids represent an important part of the adaptive reorganizations of the photosynthetic apparatus caused by excess radiation under natural conditions.