Personalized treatment of malignant tumors during pregnancy.

The combination of pregnancy and cancer is a challenge for the patient and a problematic clinical dilemma for the doctor. In this retrospective observational cohort study, we have tried to analyze our experience in the management of such patients. This review includes 41 patients with malignant neoplasms detected during pregnancy who received treatment at the Almazov National Medical Research Centre from 2015-2021. The majority of patients received treatment during pregnancy (n=26, 63.4%): chemotherapy - 19 (46.3%) (in 2 cases in combination with surgery), surgical treatment - 7 (17, 1%) patients. In most cases, delivery was at term (n=28, 68.3%). All children born at term were mature and had no growth restriction, regardless of whether the mothers received treatment during pregnancy or not. When detecting cancer during pregnancy, an immediate follow-up examination is required to assess the extent of the tumor and current fetal state. If pregnancy prolongation is requested, the treatment should not be postponed, except for systemic chemotherapy in the first trimester of pregnancy, pelvic radiation at any term.

[PROGNOSTICATION OF "HARD" TRACHEAL INTUBATION IN PATIENTS, SUFFERING PURULENT-INFLAMMATORY DISEASES OF THE JAW-FACIAL REGION].

Clinical follow-up was conducted in 75 patients, to whom the operation and intensive therapy were performed in 2006-2015 yrs for phlegmon of the neck. Difficulties while providing passability of respiratory ways have occurred in 73.3% patients. It was established, that the predictors of "hard" tracheal intubation in patients, operated on for cervical phlegmon, are follows: the cervical tissues oedema, restriction of the mouth opening lesser than 3 cm, odontogenous phlegmon of oral cavity and the neck, rigid epiglottis, the larynx oedema. Presence of these factors demands application of endoscopic methods for tracheal intubation in such patients.

[PECULIARITIES OF TRACHEAL EXTUBATION IN PATIENTS, OPERATED ON FOR PHLEGMON OF THE NECK].

The results of anesthesiological support of 75 patients, operated on for phlegmon of the neck, were presented. An acute respiratory insufficiency rate, occurring after tracheal extubation, necessitating an emergent tracheostomy conduction, have constituted 13.5%. Preliminary conduction of diagnostic direct laryngoscopy and the "air source" test permits to predict a noncomplicated tracheal extubation trustworthy. Tracheal extubation after the operation must be conducted not earlier than in 10 - 72 h.

[Effects of water use conditions on cancer morbidity]. / Vliianie uslovii vodopol'zovaniia na onkozabolevaemost' naseleniia.

The study demonstrated that the cancer situation is tense in the Tsimlyansk area and it can be referred to a high malignant tumor morbidity and mortality zone. The sources of water supply of populated localities may be involved in the formation of malignant tumor morbidity rates.

[The effect of local decompression on ovarian function in women operated on for benign epithelial tumors of the ovaries]. / Vliianie lokal'noi dekompressii na funktsional'noe sostoianie iaichnikov zhenshchin, operirovannykh po povodu dobrokachestvennykh épitelial'nykh opukholei iaichnikov.

Mathematical modelling led the authors to the conclusion that local abdominal-vaginal decompression in females operated on for BETO contributes to recovery of functional relations between hormone production by the ovaries, protease-protease inhibitors system, vascular system of the ovaries. It is the impairment of this relationship that is responsible for postoperative complications. Local decompression is recommended as a beneficial physical factor in combined rehabilitation of BETO females.

[Use of an experimental analytical method for equilibrating nutrient broths for Clostridium perfringens type A growth and toxin formation]. / Ispol'zovanie éksperimental'no-analiticheskogo metoda dlia balansirovki zhidkikh pitatel'nykh sred dlia rosta i toksinoobrazovaniia Clostridium perfringens tipa A.

A successful attempt to use analytico-experimental approach to the evaluation of experimental data for the scientifically based calculation of the composition of complex culture media, intended for growing pathogenic microorganisms, has been made. The method is based on the evaluation of the specific growth-stimulating and toxin-forming activity of the components of a given culture medium, which are determined by the number of cells grown in the variants of the medium with the limited amount of one of its components. The use of the analytico-experimental balancing method makes it possible to develop culture media with the optimal composition ensuring the definite yield of the target product rather quickly and economically by experimenting on the minimal number of variants equal to the number of the components of the medium. The investigation carried out by means of the analytico-experimental method has revealed that on the basis of peptic serum albumin hydrolysate, pancreatic casein hydrolysate and fodder yeast extract, alongside the culture medium described in an earlier work and containing these components in the proportion 4:2:1, two other media, containing the above components in the proportion 2:4:1 and 3:4:2, can be obtained, these media providing the optimal conditions for, respectively, the toxin formation and growth of C. perfringens, type A.

[Effect of iron on the growth and toxin formation of Clostridium perfringens type A cultures]. / Izuchenie vliianiia zheleza na rost i toksinoobrazovanie kul'tur Clostridium perfringens tipa A.

The influence of iron at different concentrations on the growth and toxin formation of the cultures of C. perfringens strain 28 BP6K, type A, in media having different composition and protein base has been studied. As revealed by the results of these studies, bivalent iron at concentrations of 1-30 mg%, while having no essential influence on the growth and development of the culture, not only produces no stimulating effect on toxin formation, but even inhibits it. The concentrations of iron, both producing the optimum effect on toxin formation and inhibiting it, are not identical for different kinds of culture media and depend on their nature and composition. In culture media with fodder yeast extract added, and especially in media based on fermentative fodder yeast hydrolysate, the cultures have shown the increased stability of toxin formation in the presence of higher concentrations of iron.

[Antigenic fractions of Clostridium oedematiens toxin and their immunogenic properties]. / Antigennye fraktsii toksina Clostridium oedematiens i ikh immunogennye svoistva.

The results of the isolation of antigenic fractions and their complexes from Cl. oedematiens toxin and the study of their antigenic properties are presented. The purified, concentrated toxin has been found to consist of high- and low-molecular antigens differing in immunogenicity and affinity to aluminium hydroxide used as sorbent. Preparations obtained from low-molecular antigens easily adsorbed by the low doses of the sorbent possessed high specific and immunogenic activity.

[Comparative study of the physico-chemical properties of peptones used to the production of dry alkaline agar for cholera diagnosis]. / Sravnitel'noe izuchenie fiziko-khimicheskikh svoistv peptonov, ispol'zuemykh v proizvodstve sukhogo shchelochnogo agara dlia diagnostiki kholery

The authors present the results of chemical and physico-chemical study of dry peptones (made in the USSR) used in the production of dry alkaline nutrient agar for the diagnosis of cholera, in comparison with peptones used for other purposes. The batches and types of peptones studied differed by the fractional peptide composition and by the physico-chemical characteristics. Positive results were obtained in the biological test in using peptones with marked hydrolysis with the amine nitrogen content of not less than 200--230 mg%, with an elution curve approaching the Hottinger's peptone curve, well soluble in buffer phosphate solution at 5% concentration.

[Detoxification of a purified concentrated C1. oedematiens toxin]. / Obezvrezhivanie ochishchennogo kontsentrirovannogo toksina C1. oedematiens

One of the stages of a new technological scheme for obtaining C1. oedematiens toxoid (detoxication with formaldehyde of a purified concentrated toxin) was elaborated under experimental conditions. It was found that under the effect of increased formalin concentrations (0.4--0.2%) or of prolonged action of heat there developed in the toxin a reduction of antigenic activity, expressed on immunoelectrophoregrams in the form of a change of surface potential of one of the electrophoretic fractions. Detoxication of the purified concentrated C1. oedematients toxin occurred in the course of 3 days without any losses of its antigenic activity under the following conditions: formalin concentration 0.1%, temperature 37-38 degrees C, pH L.7--6.9. No reversion of toxicity of the preparations detoxified under the mentioned conditions was revealed under the action of formalin-binding agent (sodium sulfite) on them.