The purpose of the study. To analyze levels of sex hormones and cortisol in lung tissues of patients with lung cancer with previous COVID‑19 of different severity.

Materials and methods. The material for the study included samples of lung tissues obtained after open biopsy at radical surgery from 60 patients with morphologically verified stage I–IIIA non‑small cell lung cancer (NSCLC) (сT_1–3N_Х M₀). The mean age of patients was 59.11 ± 2.9 years. All patients had negative results of SARS‑CoV‑2 nasopharyngeal swab PCR testing at hospitalization. Based on the anamnestic data collected using a special questionnaire, the main and control groups were formed depending on COVID‑19 severity. The main group included 30 NSCLC patients (15 men and 15 women) after severe or moderate COVID‑19 who had required hospitalization; the control group included 30 patients with NSCLC after asymptomatic or mild SARS‑CoV‑2 infection. All patients underwent COVID‑19 infection for 3 months or more before the start of NSCLC treatment. Quantitative assessment of estradiol (E2), testosterone (T), progesterone (P4) and cortisol (C) was performed by RIA in 10 % homogenates of the tumor and resection line tissues.

Results. Resection line tissues in women of the main group showed an increase of E2 by 1.7 times, C by 1.6 times, P4 by 4.1 times, and a decrease of T by 1.3 times; in men, levels of T and P4 were increased on average by 1.8 times (p < 0.05). Tumor samples in men and women of the main group demonstrated increased E2 by 1.7 times, and C by 1.8 times in women only (p < 0.05).

Conclusions. Severe COVID‑19 changed the hormonal profile of unaffected lung tissues, especially in women, and the tumor itself. Most likely, we should expect the increase in the incidence of lung cancer, especially in females, and also changes in its course, response to antitumor therapy and, possibly, higher rates of complications and adverse outcomes.

The purpose of the study. To evaluate the immediate and long–term results of the introduction of nerve‑s paring radical hysterectomy into the practice of the center, namely, the frequency of complications, duration of surgery, blood loss, genitourinary disorders and compare the data obtained with the data of the world literature on this issue.

Patients and methods. In the period from August 2019 to October 2022, 55 patients diagnosed with cervical carcinoma who underwent nerve‑ sparing radical hysterectomy type III/C1 were treated in the conditions of the regional clinical oncological dispensary. The age category ranged from 31 to 69 years, the average age was 47.3 years. The following postoperative indicators were analyzed: duration of surgery, blood loss, amount of residual urine, duration of hospital stay after surgery, complications, mortality, number of lymph nodes examined. The analysis of long‑term oncological results in patients with a follow‑up period of more than 12 months (42–12 months) was carried out, the frequency of relapses, the frequency of progression, and mortality from progression were estimated.

Results. The obtained postoperative averages, such as: the duration of the operation, amounted to 286 minutes; blood loss – 216.1 ml, the volume of residual urine on the 5th day 52.4 ml, the duration of hospital stay after surgery 11.1 days, complications of the II degree according to Clavien–Dindo – 3.6 %, complications of the III degree according to Clavien‑ Dindo – 3.6 %, there was no postoperative mortality, the number of lymph nodes examined was 18.3. During the follow‑up period, the recurrence rate was 0 %, relapse‑free survival was 91 %, progression and mortality from progression were 7 % and 3.5 (4 and 2 patients), respectively. The effectiveness of the implementation of the methodology was evaluated by comparing it with the data given in the world literature on a similar issue. At the same time, it was found that the duration of the operation, blood loss, the frequency of complications and genitourinary disorders, the frequency of relapse and progression did not differ significantly from the data of the international literature.

Conclusion. The introduction of the technology of nerve‑ sparing hysterectomy of the uterus type III/C1, in cervical cancer surgery is relatively safe and approachable in a regional oncology hospital.

Purpose of the study. Assessment of safety and short‑term effectiveness of high and very high‑risk prostate cancer neoadjuvant chemo‑ hormonal treatment without distant metastases.

Patients and methods. Combined hormone chemo‑ radiation treatment of 33 patients with prostate cancer of high and very high risk of progression without distant metastases was performed. Metastases to regional lymph nodes were found in 9 patients according to the examination data (MRI, MSCT), no metastases were detected in 24 patients. All patients underwent combined chemohormonal therapy in the amount of 4 courses of docetaxel intravenously at a dose of 75 mg/m² every 3 weeks as the first stage of treatment. in combination with androgen deprivation therapy with agonists or antagonists of GnRH before performing radical radiation therapy (combined or remote). All patients underwent neoadjuvant hormone therapy: 16 patients – with the use of GnRH antagonists (Degarelix), 17 – with the use of GnRH agonists (Gozerelin/Leuprorelin/Triptorelin). The toxicity of the presented treatment regimen and its immediate effectiveness – the effect on the level of prostate‑s pecific antigen (PSA), prostate volume, and the quality of urination – were evaluated.

Results. Treatment regimen was highly effective concerning PSA decrease (from initial median level 79,67 ng/ml to 1,45 ng/ml after neoadjuvant treatment), all subjects responded well, no non‑responders observed. Median prostate volume decreased from 44 cm³ to 25 cm³ after treatment, which guaranteed availability and safety of further radical radiation treatment. Urinary function was restored in all subject with initial urinary retention.

Conclusion. Neoadjuvant chemo‑h ormonal treatment was highly effective in PSA level, prostate volume decrease and functional results improvement which secured further radical radiation treatment in one of its types. Toxicity was acceptable, adverse events did not exceed grade II in most cases and did not lead to treatment discontinuation in any cases, while quality of life remained high enough.

The study purpose. Identification of structural and functional changes in pelvic lymph nodes in experimental metastatic prostate cancer.

Materials and methods. The study included 30 male mice aged 3 months. All animals (n = 30) were divided into 2 groups. The first group (the main one, n = 20) included mice that had a model of metastatic prostate cancer created by transplanting an Ehrlich tumor into the prostate parenchyma. These animals were further divided into two equal subgroups: 1a (n = 10) – mice were withdrawn from the experiment on day 7; 1b (n = 10) – mice were withdrawn from the experiment on day 18. The second group (n = 10) included mice that were not manipulated, they made up the control group. After the end of the experiment, morphological analysis of the prostate gland and regional (pelvic) lymph nodes in mice of both groups was performed using light microscopy. Statistical processing of the results was carried out using the Statistica 8.0 software package. The differences were considered statistically significant at p < 0.05.

Results. When compared to the control group the mice of groups 1a and 1b, the prostate parenchyma was almost completely replaced by atypical cells, which demonstrates the presence of neoplastic processes in the prostate gland. In group 1a mice, the number of pelvic lymph nodes was 1.9 times as large, and in group 1b animals, this indicator was 2.7 times higher compared to the second group (p < 0.01). In animals of the first group, the proportion of mast cells in the pelvic lymph nodes increased by 121 % compared to the control group (p < 0.01). At the same time, we revealed a direct relationship of mast cells with the number of tumor cells and immunoblasts in the medullar sinuses, which indicates the participation of tissue basophils in tumor metastasis. We also recorded a significant increase in the area of the medullar sinuses of regional lymph nodes in animals of groups 1a by 12.4 % (p < 0.05) and 1b by 20.2 % (p < 0.01) against the background of an increase in the number of mast cells in this zone compared to the control group, which indicates the possible participation of mast cells in lymphangiogenesis.

Conclusion. Mast cells can potentially play a role in the development of malignant neoplasms of the prostate gland. The number of mast cells increases in pelvic lymph nodes in animals with a created model of metastatic prostate cancer. The obtained direct dependence of the increase in the number of mast cells and the increase in the number of tumor cells with immunoblasts suggests the participation of tissue basophils in the spread of metastases. It can be assumed that infiltration of lymph nodes by mast cells may correlate with a poor prognosis of prostate cancer, since these granulocytes contribute to tumor metastasis.

Purpose of the study. Comparing magnetic resonance imaging (MRI) abilities in differential diagnostic of three types of primary extra‑ axial brain tumors (benign and malignant meningiomas, and neuromas) based on standard semiotics and radiomic features.

Patients and methods. Retrospective research included 66 patients with primary extra‑a xial tumors who were divided into two groups: the instructional (39 patients) and the valid (27 patients). MRI was used towards all patients before surgery. The one method of statistical modeling – discriminant analysis – was used to compare the abilities of differential diagnostic based on semiotic features and radiomic parameters.

Results. The features of tumor semiotics MRI didn’t allow to differentiate effectively benign and malignant meningiomas. Several parameters were certainly varied for all those tumor types (neuromas, benign and malignant meningiomas). The modelling based on the discriminant analysis demonstrated that radiomic features can be used for primary extra‑a xial tumors differential diagnostic. The area of the radiomic model ROC‑curve took 0.86 which exceeds the result of the model based on semiotic features (AUC 0.78).

Conclusion. The best results of the tumors classification by radiomic model demonstrate expediency to continue research the primary extra‑ axial tumors differential diagnostic with support of histogram and textural parameters of MRI imaging.

The study purpose. To conduct a retrospective analysis of the results of providing urological care to patients with chronic balanoposthitis on the background of carbohydrate metabolism disorders..

Patients and methods. A retrospective analysis of the results of treatment of phimosis due to chronic balanoposthitis in 95 patients was carried out. All patients were divided into two groups. The 1st group included men who showed signs of impaired carbohydrate metabolism (n = 41; 43.1 %). The 2nd group consisted of patients who had no metabolic disorders (n = 54; 56.9 %). The average age of 41 men of the first group was 48.2 ± 17.5 years, the second group of 54 men – 44.6 ± 15.3 years (p > 0.05). According to the indications, all patients underwent local therapy with antiseptics and antimicrobial drugs. In the presence of frequent relapses of balanoposthitis, persistent pain syndrome, the presence of phimosis according to the indications, circumcision of the foreskin was performed. In all patients, the time of surgery, the volume of blood loss during circumcision, and the duration of wound healing were evaluated. We considered the clinical case completed after complete regeneration of the wound.

Results. Conservative therapy of balanoposthitis in patients without impaired carbohydrate metabolism was effective in 85.1 %, and in men with type 2 diabetes mellitus (DM2) only in 9.7 %. Consequently, hyperglycemia reduces the effectiveness of conservative therapy of this disease by eight times. In patients with DM2, circumcision was performed 4.6 times more often than in the control group. The correlation of signs of hyperglycemia and the need for surgical treatment of balanoposthitis was 0.66. The duration of circumcision in group 1 was longer by 7.3 ± 3.6 min. compared with the second group (p < 0.05). Wound healing in patients with DM2 was observed almost twice as long (p < 0.05). Thus, with DM2, balanoposthitis is more difficult to treat. If balanoposthitis has a recurrent course, then circumcision can be considered as the final treatment option.

Conclusion. Balanoposthitis in patients with impaired carbohydrate metabolism often has a chronic form. In patients with DM2, conservative therapy of inflammation of the foreskin of the penis is effective in one out of ten cases. In adult men, balanoposthitis was more common in middle and old age. Among patients of this age, 11 (26.8 %) people had hyperglycemia for the first time. Consequently, men of the above age may be at risk and need more careful examination of the external genitalia and control of the level of glycemia.

Purpose. To evaluate the intensity of healing of an infected skin wound in rats using Trigonella foenum- graecum (Fenugreek) against the background of experimental steroid hyperglycemia.

Materials and methods. The rats included in the study (n = 20) were divided into two equal groups. First, a model of steroid hyperglycemia was created for all animals. Then the same animals (n = 20) were used to create models of infected skin wound. The rats of the first group (the main one) were treated with wound surface ointment containing Trigonella foenum- graecum. Also, Trigonella foenum- graecum extract was constantly added to the water for the rats of the first group. Intact vaseline ointment was applied to the wound of the second group (control) rats. After 5 days, we evaluated the wound regeneration activity, blood glucose levels, and blood panel in all animals.

Results. This study showed several positive aspects of the use of Trigonella foenum-g raecum in terms of treatment of infected skin wounds in animals with steroid hyperglycemia. The decrease in glucose levels almost to baseline values in the rats of the main group against the background of oral administration of Trigonella foenum-g raecum was recorded. By the end of the observation, the level of glycemia was almost two times less in animals of the first group compared to the second (p < 0.05). In animals of the first group, the number of leukocytes was higher compared to the second group, but this difference was not significant. However, we recorded a significant increase in the number of granulocytes by more than two times (p < 0.05), which indicates the immunomodulatory property of Trigonella foenum- graecum, which affected the regeneration activity of the infected wound in a positive way in rats of the first group.

Conclusion. As a result of this study, promising prospects have been obtained for the use of the plant‑ derived drug Trigonella foenum- graecum in the correction of hyperglycemia and the treatment of infected wounds. Application of fenugreek topically in the form of an extract reduced inflammation and improved wound healing in rats suffering from steroid hyperglycemia.

Gastric cancer (GC) is the fifth most common malignant neoplasm in the world among all malignant tumors. Currently, the “gold” standard of treatment for patients with non‑metastatic cancer of the stomach and esophageal–gastric junction is surgical treatment, which is complemented by perioperative chemotherapy according to the FLOT scheme, which includes four courses of therapy before surgery and four after. However, according to statistics, less than half of patients complete all adjuvant courses of FLOT chemotherapy due to the high toxicity of the regimen and a decrease in the functional status of patients in the postoperative period. In this regard, studies are being conducted to study the tolerability of total neoadjuvant chemotherapy, when all courses are held at the preoperative stage in order to carry out all stages of treatment in full. International studies have shown the results of the use of targeted (ramucirumab, trastuzumab, pertuzumab), immune drugs (pembrolizumab, nivolumab, ipilimumab), S‑1 in combination with chemotherapy as part of the combined treatment of gastric and esophageal‑ gastric junction cancer. The emergence of new therapeutic agents previously studied in metastatic GC may change approaches to the treatment of localized and locally advanced GC.

The review presents the features of perioperative therapy regimens in patients with resectable gastric and esophageal‑ gastric junction cancer in order to reduce the frequency of local and long‑term relapses and improve further prognosis.

The treatment strategy for Paget’s breast cancer (PBC), as for other morphological forms, is determined by the spread of the invasive tumor process, as well as the absence or presence of adverse factors. Significant prognostic factors, e.g. the invasive component of Paget’s cancer, the involvement status of regional lymph nodes, morphological criteria, the grade of malignancy, overexpression of epidermal growth factor Her2/neu, the presence of BRCA 1/2 and CHEK2 gene mutations, as well as age, affect the prognosis of Paget’s disease. According to various sources, PBC in 90–98 % is combined with invasive or non‑invasive breast cancer. For the most part, the lesion is multifocal. There’s high expectation for PBC to form tumor node. A palpable tumor node in the mammary gland is detected in half of the patients. PBC has certain features and specificity in relation to treatment methods. The method of radical surgical treatment of patients is primarily based on performing oncoplastic resections. Sufficient breast volume is a significant criterion for the possibility of performing an organ‑ preserving operation. The organ‑ preserving treatment is oncologically safe in case of PBC. The removal of the nipple‑ areolar complex is mandatory in case of PBC. It is possible to improve survival statistics by analyzing the biological characteristics of the tumor and developing a more accurate approach to the treatment of patients in this category. Determining clear indications for organ‑p reserving operations is the main opportunity to improve the quality of life of patients and their further rehabilitation.

The development of acute renal injury is due to a number of factors both on the part of the patient (age, concomitant pathology, objective status) and the oncological process (stage of the disease, localization, volume of surgical intervention, access, etc.). Acute renal injury in patients with kidney cancer after surgical treatment may be accompanied by the development of early (hyperhydration, electrolyte balance disorders, hyperkalemia, acid‑base condition disorders, uremic intoxication) and late chronic kidney disease complications. The incidence of these complications increases with an increase in the volume of kidney resection, as a result of which it is important to take into account risk factors, timely diagnosis of the degree of kidney damage and medical measures aimed at restoring kidney function. Currently, the possibility of using various molecules as early markers of kidney damage, which help not only assess the presence of kidney damage, but also localize it, is being studied. For example, albumin, serum cystatin C, alpha 1‑microglobulin, P2‑microglobulin – markers of glomerular damage, NGAL, KIM‑1; L‑FABP, urine cystatin‑C, IL‑18 – reflect damage to the proximal tubule, GST, NGAL – distal tubule, calibindin D28 ‑ characterizes damage to the collecting duct, osteopontin, NHE‑3 – are associated with damage to the loop of Henle. Measures of a curative and preventive nature (infusion therapy, anti‑ischemic protection, modulation of ferroptosis, renal replacement therapy), as well as dynamic monitoring of the main biomarkers of renal damage are aimed at preventing the persistence of the pathological process with a possible outcome into chronic kidney disease, which is especially undesirable in patients with single kidney cancer. The main directions of medical and preventive measures in patients with acute kidney injury should be considered: 1) the fastest possible elimination or minimization of the effect of tumor tissue; 2) control and correction of life‑threatening complications of renal dysfunction (hyperhydration, electrolyte balance disorders (hyperkalemia), acid‑base state, uremic intoxication). Methods of anti‑ischemic protection include a number of surgical techniques aimed at 1) minimizing ischemia time, 2) reducing the intensity of volatile metabolic processes in the kidney, 3) training renal parenchyma for hypoxic conditions (receiving ischemic preconditioning).

Duration of renal ischemia represents an important modifiable factor affecting early and distant renal function in surgically exposed patients. The article analyzes modern scientific data on the problem of postoperative acute kidney injury in renal cancer surgery.

Prolongation of a healthy life duration is one of the priority tasks in terms of solving the problem of quality and safety of medical activity. Respiratory diseases account for the significant amount in the morbidity structure of the geriatric population. Such diseases include chronic obstructive pulmonary disease, chronic bronchitis, pneumonia, bronchial asthma and acute respiratory viral diseases, which, in combination with other pathological conditions, contribute to an increase in morbidity and mortality of the population in this group. These diseases among the geriatric population are characterized by a latent onset, the absence of obvious clinical manifestations, monotony of symptoms, the presence of combined pathologies, which can lead to erroneous diagnoses. X‑ray research methods play a key role in the diagnosis of pathologies of respiratory diseases. However, it is necessary to correctly assess the age‑related processes that cause morphological changes in the chest, and adequately differentiate them from the obvious manifestations of diseases. The role of the radiologist in this can be decisive. The joint work of geriatricians, radiologists, pulmonologists will help to provide a clear comprehensive assessment and interpretation of the visualization of various conditions of the respiratory system in the elderly.

In this review, the features of chest radiography in elderly patients associated with age‑related changes are analyzed and their differentiation with pathological manifestations is carried.