[Urinary biomarkers of kidney injury in patients treated with anti-VEGF drugs].

BACKGROUND: Antiangiogenic drugs are widely used in oncological practice and are aimed at inhibiting angiogenesis. Despite the high antitumor efficacy, their use may be limited by nephrotoxicity, and therefore the search for early biomarkers of kidney damage remains relevant, which will preserve a favorable safety profile of therapy. AIM: To determine urinary biomarkers of tubular and podocyte damage in patients receiving treatment with antiangiogenic drugs. MATERIALS AND METHODS: The study included patients (n=50) who received intravenous anti-VEGF drugs (aflibercept, bevacizumab, ramucirumab) in various chemotherapy regimens. Concentrations of tubular damage markers KIM-1 (Kidney Injury Molecule-1) and NGAL (Neutrophil Gelatinase-Associated Lipocalin), hypoxia marker HIF-1 (Hypoxia-Inducible Factor 1-alpha) in urine samples were determined by enzyme-linked immunosorbent assay (ELISA) before treatment, and during 8 weeks of treatment. To assess the risk factors for kidney damage, a logistic regression analysis was performed with the inclusion of the main clinical and laboratory parameters. RESULTS: A decrease in the calculated GFR of CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Formula) of less than 60 ml/min per 1.73 m2 at week 8 of treatment was noted in 42% of patients. An increase in NGAL, KIM-1, HIF-1 and nephrin in urine during the first two weeks of therapy predicted the development of renal damage by the 8th week of follow-up. When constructing ROC-curves, the high sensitivity and specificity of these urinary indicators as prognostic markers were established. Among the clinical and laboratory indicators, independent unfavorable prognostic factors of nephrotoxicity were an initial decrease in eGFR, a history of hypertension, an increase in the concentration of KIM-1 and HIF-1 in urine during the first two weeks of therapy. CONCLUSION: The predictors of renal damage in the treatment with antiangiogenic drugs were previously an increase in NGAL, KIM-1 and HIF-1 in urine during the first two weeks after the start of therapy.

[Successful treatment of an aortoduodenal fistula after operation on the abdominal portion of the aorta]. / Uspeshnoe lechenie aorto-duodenal'noi fistuly posle operatsii na briushnom otdele aorty.

Gastrointestinal haemorrhage is a common cause of emergency admission of patients to surgical hospitals. Within the structure of nosological entities, not unreasonably referred to the rarest causes of gastrointestinal bleeding is the formation of an aortointestinal fistula whose early diagnosis is of paramount importance. The clinical picture may be different but it is mostly represented by gastrointestinal haemorrhage. The incidence of gastrointestinal fistulas following a surgical intervention ranges from 0.6 to 2.3%. Unless timely diagnosed and with incorrect therapeutic decision-making, the mortality rate amounts to 90%. In this article we present a clinical case report regarding successful treatment of a patient presenting with a secondary aortoduodenal fistula occurring 5 years after previously performed aortofemoral bypass grafting and complicated by relapsing intestinal bleeding and acute ischaemia of the right lower extremity.

[Antiviral therapy of chronic hepatitis C: 30 years success story].

Exactly 30 years ago, hepatitis C virus was identified. Over the years, tremendous success has been achieved in the treatment of hepatitis C, which is currently considered to be an almost completely curable disease. The review presents the main stages in the development of hepatitis C antiviral therapy, the efficacy of various treatment regimens. The greatest progress in treatment was noted over the past 5 years when drugs with direct antiviral action appeared and began to be widely used, including in Russia, which ensure the elimination of the virus in 90-95% of cases.

[The problems associated with the treatment of stenosing laryngotracheitis in the children (the results of the 35 year-long experience)]. / Problemy lecheniia stenoziruiushchego laringotrakheita u detei (rezul'taty 35-letnego opyta).

Stenosing laryngotracheitis (SLT) affecting the children is considered to be an emergency pediatric condition associated with ENT pathology. Its treatment presents a serious challenge for otolaryngologists, pediatricians, specialists in communicable diseases, allergologists, etc. We have undertaken a retrospective analysis of the available data with a view to summarizing the tendencies in the evolution of SLT morbidity. The results of the 35 year-long experience with the use of the currently available therapeutic strategies for the treatment of the children suffering from stenosing laryngotracheitis are presented. Special emphasis is laid on the advantages of the combined treatment of the patients presenting with this condition based at a specialized infectious department with the participation of an otorhinolaryngologist.

[ANAPHYLACTIC SHOCK AT 3,5 MONTH-LIFE CHILD (Case report).]

The article presents a clinical case of severe anaphylactic reaction to first introduced as complementary foods in the diet of the 3.5 months-life child formula based on cow milk.protein. Issues for discussion: the distribution of anaphylactic reactions in children, especially early age, causes, clinical features and the complex life-saving activities.

[Use of products made of antimicrobial materials in the prevention of foot mycoses]. / Primenenie izdelii iz antimikrobnykh materialov dlia profilaktiki mikozov stop.

Field trials were conducted to evaluate effectiveness of mycoses prophylaxis gained by use of antimicrobial insoles and foot-binding with fungicide agents. The trials involved 100 novice soldiers. Bacteriology and bacterioscopy studies diagnosed 47 soldiers as having subclinical mycosis of feet. Using antimicrobial insoles and foot-binding caused considerably lower occurrence of pathogenic fungi in the skin samples; using antimicrobial insoles with regular foot-binding resulted in no changes of the skin microflora. The authors recommend wide application of antimicrobial stuff with fungicide agents for prophylaxis of feet mycosis.

[Use of insoles made of antimicrobial materials as prophylactic means in foot mycoses]. / Primenenie stelek iz antimikrobnykh materialov v kachestve profilakticheskogo sredstva pri mikozakh stop.

Stationary dermatologic examination covered 32 sufferers from epidermophytosis of soles, who used 3 types of antimicrobial insoles chosen through laboratory investigations. Clinical trials proved that antimicrobial insoles, if applied during 2 weeks, result in considerably decreased occurrence of causal fungus in the patients' surface skin scarring. The results proved fungicidal and bactericidal activity of insoles including furagin, nitrofurilacroleine, polyhexamethylene guanidine, so such insoles could be recommended as prophylactic measure for mycoses of soles.

[Study of animals with transplanted tumors]. / Issledovanie zhivotnykh s perevivnoi opukhol'iu.

A formula of temperature homeostasis of the body during inoculated tumor development was described. The basic data were temperature parameters of tumor S-45 inoculated to 180 rats subcutaneously and intramuscularly. Thermography was used as a method of investigation. An analysis of the results obtained led to a conclusion of a principal difference in the nature of heat processes in the body with tumors at different depths. In addition to it, the heat status of a tumor reflected the state of the vascular system making it possible to assess a necessary degree and nature of therapeutic exposure. Taking into account two periods of a heat status of the body one could choose the most effective therapeutic method during tumor development. The above material formed the basis for producing a heat model of tumor in order to improve methods of cancer diagnosis and therapy.

[Characteristics of the growth rate of the transplantable sarcoma 45]. / Kharakteristika skorosti rosta perevivnoi sarkomy 45.

The growth dynamics of the experimental tumour was analyzed in 180 mongrel rats with sarcoma-45 inoculated intramuscularly and subcutaneously. One of the approaches to the calculation of doubling time is estimated. It is suggested that the changes of the C-45 tumour size may be described according to the function V = A exp(T/B)--C.