Objective. To evaluate the efficacy and safety of prosidol in cheek tablets in the treatment of chronic pain syndrome in cancer patients.

Material and methods. The study was conducted at 152 cancer patients with chronic pain syndrome caused by  malignant neoplasms. The objectification of pain intensity was conducted on a 5 — point verbal scale assessments (SVA), assessed the state of physical activity of patients on a 5‑point scale ECOG, objectified the mental status and a night’s sleep: 0‑no pain; 1 — slight pain; 2 — moderate pain; 3 — severe pain; 4 points unbearable pain. We registered the duration of analgesic effect of prosidol, calculated single and daily doses of analgesic in the dynamics on the stages of therapy and its side effects. The results of the study were assessed on stages: 1 — initial, before treatment, 2 — first day of therapy, 3 — completion of the selection of doses of analgesic (3–4 days), 4 — a week after the start of treatment, 5–2 weeks after the start of treatment, 6 — at the end of the 3rd week of treatment.

Results. Initial single dose of buccal prosidol (20 mg) caused effective analgesia after 10 to 45 (21,3+8,9) minutes after the first dose and lasted from 1 to 8 (6,0+1,8) hours: 21.8% of patients complete elimination of pain (more than 50% from baseline); in 63.6% of the pain was reduced by 30–50%; reduction of pain less than 30% — in 14.6% of patients. In General, a significant decrease in the intensity of pain with 2,47+0.37 to 0.5 to+0.30 VAS score (p<0.05). The failures of the drug were observed. All patients continued prosidol therapy after a 3‑week study period. The initial average daily dose of prosidol was 82.2 + 9,7 mg; 1 week of therapy — 112,3+16 mg, by the end of the 3rd week increased to 148,2+57 mg/day mg Tolerability was judged as good. Side effects: drowsiness and nausea most noted for 1–3 days of therapy was expressed moderately or weakly in 85% of patients (drowsiness of 62.3%, nausea is 27.3%, vomiting in 15%; dry mouth is 65.5%, dizziness) to 27.6%). Night sleep was stabilized at 85% (relative to 13% in the initial stage); the number of patients with symptoms of depression decreased in 1.8–2.2 times.

Conclusion. Buccal Procidol in a daily dose of from 60 to 200 mg provides effective analgesia in the majority of cancer patients with moderate to strong chronic pain at moderately pronounced side effects which are not dangerous, respond well to medical treatment. Procida in sublingual tablets possesses the basic properties required of modern medicine to opioid therapy for chronic cancer pain: it is effective, safe, better tolerated than other drugs,
convenient for the independent application of patients in outpatient and home. The lack of buccal prosidol is the short duration of effects (average 4 hours).

Objective. Study based on long-term results of treatment of patients with resectable non-small cell lung cancer using surgical method specified prognostic factors.

Materials and methods. The analysis of surgical and multimodal treatment in 1420 patients with NSCLC. In 42.7% of patients metastases in the lymph nodes were absent in 28.1% revealed bronchopulmonary defeat and root nodes (N1), while 28.9% - mediastinal (N2). Radical surgery performed 92.8% of patients. Postoperative complications were diagnosed in 22.2%. The case fatality rate - 3.0%.

Results. The overall five-year survival of patients after radical treatment was 42,0 ± 1,6%, palliative - 19,8 ± 3,3%. When radical treatment for more than 5 years experienced a 65,0 ± 3,6% of patients with stage IA, 54,5 ± 3,4% - IB, 49,0 ± 5,2% - IIA, 40,8 ± 4,0% - IIB, 18,8 ± 2,5% - IIIA and 13,4 ± 5,8% - IIIB. In patients with N0 long-term results of treatment amounted to 58,4 ± 2,4%, were higher in squamous cell carcinoma (62,1 ± 3,5%), than adenocarcinoma (52,5 ± 4,6% p = 0.048) and largecancer (45,5 ± 7,7%, p = 0.008). Indicators of five-year survival after radical combined treatment in patients with N + were lower (30,9 ± 2,3%) and depended on the level of the lesion nodes (N1 or N2), interest areas of the mediastinum, the morphological structure of the tumor, as well as the volume of transactions.

Conclusions. Radical surgical and combined treatment (with postoperative radiotherapy) can be carried out by most of the patients with resectable non-small cell lung cancer with satisfactory long-term results. The main prognostic factors should be considered the type of the treatment, stage of disease, especially the state of regional hilar lymph nodes. Additional adverse prognostic factor in patients with N0 is adenogenous and macrocellular morphological type of cancer, at N1 - T4 tumors and macrocellular carcinoma, and N2 - Metastasis in some or all areas of the mediastinum and the volume of surgery - bilobectomy.

Objective. To analyze the recurrence after radical subcutaneous mastectomy or konohana of mastectomy.

Materials and methods. In FMIC them.P. A. Herzen patients performed radical subcutaneous mastectomy (95,5%) or konohana radical mastectomy (4.5 per cent). When radical subcutaneous mastectomy keep the skin of the breast, the nipple-areola complex (NAC), submammary fold, remove the entire gland tissue together with the axillary, subclavian and subscapularis lymph nodes. Konohana mastectomy differs from subcutaneous mastectomy with removal of the nipple-areola complex. Distribution of patients according to tumor stage process as follows: 0 (ТisN0М0) - 33 (4,3%), I - 180 (23,2%), IIA - 283 (36,6%), IIB - 123 (15,9%), IIIA - 91 (11,7%), IIIБ - 1 (0,1%), IIIС - 41 (5,3 %) IY - 6 (0,8%), 16 (2,1%) patients the operation was performed after recurrence of breast cancer.

Results. In our study the recurrence was diagnosed in 37 (4,8%) patients. A minimum of recurrences of 8 months, maximum 10 years. Repeated local recurrences after treatment was 2. Local recurrence was diagnosed in 35 (4,5%) patients. Regional recurrence was diagnosed in 3 (0,4%) of patients, in one case after local recurrence. Regional recurrences detected in 2 (0,3%) cases in the armpit and 1 (0,1%) case in the infraclavicular region. The likelihood of regional recurrence is often associated with errors in surgical technique the operation. During follow-up revealed 3 (0,4%) cases of cancer Paget’s disease in the area of the nipple-areola complex. All 3 (0,4%) of cases the treatment was surgical and meant excision of the nipple-areola complex. In 1 (0,1%) patients diagnosed with breast cancer in the second breast after 7 years.In the area of the nipple-areola complex in the Central quadrant of the recurrence was diagnosed in 6 of the 35 local recurrence, which amounted to 17,1%. Among patients with konohana radical mastectomy recurrence in the Central quadrant is not revealed. The distribution of recurrence depending on the stage of breast cancer: in stage I of 5,5%, IIA - 3,5%, IIB - 5,7%, IIIA – 4,4% in S of 7,3%. In 2 cases after the first relapse of 16 was diagnosed with a relapse, which was 12.5%. In stage I breast cancer  as diagnosed with a relapse of 5,5%, which is probably due to the absence of radiation therapy in the postoperative period, since the initial stage and the operation volume is sufficient, the number of relapse - 10 and in any case, radiation therapy was not carried out.

Conclusion. Over the 5 years of observation for patients with breast cancer after radical subcutaneous mastectomy/ konohana radical mastectomy with simultaneous reconstruction, recurrence developed in 34 cases (4.4%) patients. The important fact is the detection of local recurrence after 10 years of follow-up (8,1%) after treatment, which confirms the need for dynamic monitoring of patients throughout life. The frequency of relapses affected by stage of breast cancer, young age of patients, the histogenesis and subtype of the tumor. When combined adverse prognostic factors should be used for reoperation on the breast. Radical subcutaneous mastectomy or konohana radical mastectomy with simultaneous reconstruction of an adequate volume of transactions in the cancer plan, and effective method of reabilitacii breast cancer patients. Relapse of breast cancer after these surgeries is not different from the risk of recurrence after radical mastectomy. Despite the presence of repeated operations, the preservation of the reconstructed breast cancer after recurrence of breast cancer was possible in 65, 7% of cases in our study.

Objective. Estimation of the effectiveness of low power brachytherapy sources I-125 in the combined treatment in group of patients of intermediate risk of localized prostate cancer.

Material and methods. The study included 126 patients with prostate cancer of intermediate risk. 104 patients (83,9%) were conducted low power brachytherapy I‑125 in combination with hormone therapy by analogues of LHWG. 22 patients (16.1%) received external beam irradiation in combination with brachytherapy I‑125 and hormonal treatment. Relapse-free survival of patients was evaluated in accordance with the criteria Phoenix (Nadir PSA + ng/ml). Evaluation of side effects of radiation treatment were carried out according to the RTOG criteria.

Results. PSA relapse-free survival in the group of brachytherapy and hormone treatment at the time of observation 5 years amounted to 97.1%. In the group of combined radiation therapy with brachytherapy, and hormonal treatment PSA relapse-free survival rate was 95.5%.In both groups, relapse-free survival was noted in 96,8% of cases. Tumor-specific and overall survival in both
groups was 100%. The major complications of treatment in both groups were radiation urethritis 1 to 2 degrees in 9.5% of cases (12 patients), urethral stricture in 5 patients (3.9% of cases), acute urinary retention in 1 patient (0.8% of cases) and late radiation rectitis of 2 degree in 1.58% of cases (2 patients).

Conclusions. It is possible to draw tentative conclusions about the high rate of survival without progression in both treatment groups on the background of the relatively low frequency of adverse reactions. It is necessary further follow-up for patients with estimating of survival for a longer period.

Objective. APOE genotype association with the level of iron in plasma and the risk of endometrial neoplastic diseases has not been studied. The aim of the work was to analyze the genotypic associations of the apolipoprotein E (APOE) with iron and lipid levels in endometrial hyperplasia (EH)/endometrial cancer (EC) patients and healthy women.

Materials and methods. The biochemical blood levels of iron and cholesterol metabolism detected in women d with diagnosed endometrial hyperplasia (53), endometrial cancer (87) and healthy women (70) are determined on an automated analyzer «OLYMPUS AU – 400”. The genotyping was performed with a PCR-RFLP (polymerase chain reaction with restriction fragment length polymorphism) technique.

Results. A statistically significant decrease in the levels of serum iron, transferrin saturation, high-density lipoprotein on the one hand, and a statistically significant increase in body mass index, triglycerides, very low density lipoproteins, atherogenic index in patients with endometrial adenocarcinoma was observed. Statistically significant differences in the distribution of E3, E4, E2 allele frequencies between patients and healthy women (P = 0.048) was revealed. E3 allele frequency was reduced, and the E2 allele
was increased in patients with EC. It was shown that the serum iron level was significantly increased in EC patients and healthy carriers of the genotype E3/E2 (P= 0,0014 and 0,0363 respectively). There was significantly elevated triglyceride level in carriers of the minor genotypes E2/E4, E4/E4 among patients with EH (0,0389).

Conclusions. Genotype E3/E2 compared with other APOE genotypes under study is associated with elevated levels of iron and the risk of endometrial cancer. The association APOE 2/2, 2/4, 4/4 as well as 3/2 with endometrial neoplastic diseases requires further investigation. The data obtained can be the basis for the creation of a marker system for determining a high level susceptibility to malignant disease of the female reproductive system.

The article presents a brief overview of the main methods of breast cancer screening. Proven effectiveness of mammography as a screening method in reducing mortality from breast cancer, specified limits of the method. The main trend of increasing the effectiveness of screening is the transition to digital technologies. Properly organized screening with the active participation of the population reduces mortality from breast cancer by 30%.

Review of the literature devoted to the problem of early pregnancy losses. Presented modern classification, The etiology and pathogenesis of complications, diagnostic criteria and differential diagnosis, and treatment standards and opportunities for prevention.

The pain syndrome accompanying metastatic damage of bones, significantly reduces quality of patients life. In recent decades, medical practice implemented methods systemic radionuclide therapy of bone metastases using different radionuclides, which allows to stop both the pain and the progression of the disease. Results of their application give the grounds to consider the perspective development in nuclear medicine of the direction on treatment bone metastatic defeats by means of systemic radionuclide therapy.

Metformin, traditionally used for the therapy of diabetes mellitus, possesses a number of diverse pleyotropic effects. The drug, in addition to the glucose-lowering actions, has a beneficial effect on components of the metabolic syndrome, significantly reduces body weight.

Prostate cancer (PC) is one of the most actual problems of modern oncourology. Hormone therapy (HT) using medical castration is the main method of treatment of patients with metastatic PC. HT with usage of the new class of drugs that block the receptors for luteinizing hormone releasing hormone (LHRH) is a promising and effective method of castration therapy that has a number of significant advantages over the use of analogues LHRH. This article presents a
review of studies that compared the effectiveness and side effects of HT using antagonists and analogues LHRH.

A solitary fibrous tumor (SFT) are rare mesenchymal neoplasms and due to the fact of their low occurrence, there are no large-scale researches of this nosology today. The article describes the report of 37‑year old woman with the case of solitary fibrous tumor of the kidney. A laparoscopic radical right nephrectomy was performed. Histological and immunological studies revealed a solitary fibrous tumor of the kidney. The patient did well postoperatively and remains disease-free at the present time.

In the recent years, the effectiveness of the treatment of even advanced cases of metastatic renal cell carcinoma is relatively high due to the possibility of targeted therapy, removal of metastatic lesions. Therefore, the issue of the quality of life of such patients often comes to the fore. This paper presents a clinical case of radical surgical treatment of metastasis located in the humerus, resulting in partial recovery of the limb function which eventually led to the improvement of the patient’s quality of life.

The formation of the modern Russian healthcare has occurred almost
throughout the last fifty years. For more than 20 years it’s undergoing active reform, that called – Modernization. During these years the rationalization and improvement of different parts and problem areas of the health system underwent. Key link in healthcare chain – is a massive and publicly available outpatient care. The article describes the main stages of development of ambulatory care in Russia.