PATIENT MANAGEMENT TACTICS AT DIFFERENT STAGES OF GASTROINTESTINAL STROMAL TUMORS (GIST).

OBJECTIVE: The aim: To analyze the results of treatment even in limited groups of patients. PATIENTS AND METHODS: Materials and methods: Clinical cases of GIST based on the materials of the surgical clinic of the Central Municipal Hospital in Uzhgorod (Transcarpathian region) were discussed. Clinical, ultrasound and CT monitoring was provided. CT dynamics were assessed according to RECIST 1.1. CONCLUSION: Conclusions: Only surgery resection is enough in case of the "small" tumor originated from the stomach. Otherwise, in case of locally-widespread GIST it is expedient to refrain from radical surgical intervention. High-grade GIST was verified by the IHC examination with mutation of the KIT gene in exon 11. Imatinib mesylate 400 mg PO daily was prescribed. More than 1-year follow-up result: firstly more than 50% reduction of the tumor size with subsequent stabilization of the disease. Minimally invasive processes allow surgical interventions and do not require aggressive adjuvant therapy. The presence of a giant GIST is a serious diagnostic and treatment challenge. Only management of the patient by a multidisciplinary team allows to resolve diagnostic and treatment contradictions, to create the prospect of achieving complete or partial remission and long-term survival.

Peculiarities of breast cancer incidence rate in urban population and implementation of screening programs in health care system.

INTRODUCTION: In the structure of illnesses connected with malignant tumors (MT) among women's population of Ukraine breast cancer (BC) holds a leading position and was at the level of 19.3% in 2014. THE AIM: The aim of research is a comparative analysis of BC illnesses among women's population in regional centers of Prydniprovsk-Donetsk which is an intensive industrial zone (Dnipropetrovsk city) and Transcarpathian region, clean natural area (Uzhgorod city). The latter belongs to a recreational area because of its natural and climatic features. Also, the aim is to estimate an influence of screening program implementation on mortality of women from BC within one year period from diagnosis date. O bject and methods: We have used data of state statistics records as per F-7 and F-35 forms, which were received while processing the primary medical documentation (№ 090/о, № 027-1/о and № 30-6/о). The said was carried out by means of regional branches of National Cancer Register of Ukraine. Rough indexes of BC incidence rate and part of lethal outcomes among BC patients before one year after diagnosis in regional centers were considered. RESULTS: A considerable increase of incidence rate of BC has been detected in administrative centers of both regions. This incidence rate has reached 90 cases out of 100,000 female population. Substantial change in gender behavior due to influence of urban surrounding is a possible factor of high BC incidence rate of urban population. CONCLUSIONS: Mammography screening implementation contributes to general and annual decrease of BC mortality among women's population.

Exercise training improves cardiac performance in diabetes: in vivo demonstration with quantitative cine-MRI analyses.

Diabetic cardiomyopathy is a distinct myocardial complication of the catabolic state of untreated insulin-dependent diabetes mellitus in the streptozotocin-induced diabetic rat. Exercise training has long been utilized as an effective adjunct to pharmacotherapy in the management of the diabetic heart. However, the in vivo functional benefit(s) of the training programs on cardiac cycle events in diabetes are poorly understood. In this study, we used three groups of Sprague-Dawley rats (sedentary control, sedentary diabetic, and exercised diabetic) to assess the effects of endurance training on the left ventricular (LV) cardiac cycle events in diabetes. At the end of 9 wk of exercise training, noninvasive cardiac functional evaluation was performed by using high-resolution magnetic resonance imaging (9.4 T). An ECG-gated cine imaging protocol was used to capture the LV cardiac cycle events through 10 equally incremented phases. The cardiac cycle phase volumetric profiles showed favorable functional changes in exercised diabetic group, including a prevention of decreased end-diastolic volume and attenuation of increased end-systolic volume that accompanies sedentary diabetes. The defects in LV systolic flow velocity, acceleration, and jerk associated with sedentary diabetes were restored toward control levels in the trained diabetic animals. This magnetic resonance imaging study confirms the prevailing evidence from earlier in vitro and in vivo invasive procedures that exercise training benefits cardiac function in this model of diabetic cardiomyopathy despite the extreme catabolic state of the animals.