Objective. Increasing survival in patients with secondary brain damage, and identifying the factors of favorable and adverse prognosis.

Material and method. In P. A. Hertsen Moscow Oncology Research Institute from 2007 to 2013 there were treated 268 patients with brain metastases. The mean age was 55.8 years (from 24 to 81 years). Metastases of colorectal cancer identified in 7.8%, cases of lung cancer in 34%, melanoma 9.3 %, breast cancer in 26%, kidney cancer in 11%, with non-identified primary tumor in 4.5%, other tumors accounted for 6.7%. Solitary metastasis was diagnosed in 164 (61,19%) patients, oligometastasis (2-3) - 72 (26,87%) patients with polymetastasis (more than 3) – 32 (11,94%) patients. In 106 (39,55%) of patients with brain metastases it was the only manifestation of the generalization process. To control the radical removal of the tumor in 93 (34,7%) patients we used the method of fluorescence navigation (FN) with the drug Alasens. In 66 (24,6%) patients intraoperatively was held a session of photodynamic therapy (PDT). In 212 (79,1%) cases, the removal of metastasis performed totally, 55 (20,9%) patients stated Subtotal removal.

Results. The observation period for the patients ranged from 3 to 79 months. Survival median among the entire group of patients with metastatic brain lesion was 12 months. Overall survival was significantly dependent on RPA class, the volume of postoperative treatment, histological type of primary tumor, number of intracerebral metastases and the timing of the relapse-free period.

Conclusions. Factors that affects the overall survival are the features of the histology of the primary lesion, multiplicity of metastatic lesions, RPA class and the synchronous nature of the metastasis. The median of overall survival of patients who did not receive after surgical treatment of a particular type of therapy was only 4 months. If to use the combined treatment (surgical treatment with the irradiation of the whole brain) median survival was 9-10,5 months (depending on the method of irradiation). When you use drug treatment the median overall survival was 11 months. In the complex treatment survival rates were highest 12 months.

Introduction

Currently the organ-preserving surgical treatment (oncological arthroplasty) may be provided in 90% of patients with malignant lesions of the long bones and large joints. Due to the development and improvement of surgical techniques, the application of new antibacterial drugs, the development of new systems of modular endoprosthesis managed to achieve a meaningful reduction of complications, such as infection, instability of the endoprosthesis, and receive good and excellent functional results after surgery, mainly in lesions of the bones of the lower extremities. The risk of complications in conducting oncoloicaly arthroplasty upper extremity is also low, but functional performance after these operations is significantly lower.

Objective.To analyze and evaluate the results of applying the "Anatomical" and "Reverse" shoulder replacements in patients with neoplastic lesions of the proximal humerus.

Materials and methods. Depending on the type of metal implants patients were divided into two groups. "Anatomical" implant was installed in 28 patients (13 men and 15 women) and "Reverse" prosthesis in 14 patients (6 men and 8 women). The average age was in the first group 32±4 years and the second 38±3 years, respectively. Primary bone tumors were diagnosed in 19 (68%) patients first and 12 (86%) patients of the second group.

Results. The average follow-up period was 42 months. 4 patients with primary malignant bone tumors had the progression of the disease during the period from 6 to 14 months. In 2 of them they diagnosed the metastatic lung disease, in one case – the recurrence of tumor and also in one patient there was the relapse with metastases to the lungs. In the group of patients with "Anatomical" arthroplasty of the shoulder joint functional status after surgery was assessed according to the scale MSTS (Musculo-skeletal tumor standing System) in the range of 60-80 points - 3, 40-60 points - 6 and less than 40 points in 19 patients, respectively. Patients who selected "Reverse" prosthesis of functional status on a scale MSTS were in the range of from 80 to 100 points in 6 patients , 60-80 points - 6, 40-60 points - 2 patients, respectively. They marked the improvement in functional status with Reverse arthroplasty in 75% of cases.

Conclusion. The use of modular "Return" implants in organ-preserving treatment of patients with neoplastic lesions of the proximal humerus, compared to the "Anatomical" arthroplasty, is a more promising technique, because it allows significantly improved functional outcome and social adaptation after surgery.

Republic of Dagestan is a region with medium and severe iodine deficiency, which is associated with the development of endemic goiter and subclinical hypothyroidism. Children with goiter with or without it with SG had the worst indicators of physical, psychological and sexual development, tended to chronic somatic pathology.

Objective. To examine the connection between the elevated TSH level with indicators of physical and sexual health of boys.

Material and method

There were examined 297 adolescents aged 11-13 years (76 persons) in the beginning of puberty and 14-17 years (221 people) in the middle and the end of puberty. The anthropometric studies of height, weight were conducted, body mass index BMI was calculated, the degree of sexual development: R - pubic body hair, G-degree sexual development, testicular volume by Prader and the size of the penis, index of virilization, level tireotroponogo hormone (TSH) were assessed.

Results showed that physical development of boys already in the early stages of dysfunction of the thyroid gland tends to lag behind. This is more evident in the mid to completion of puberty (boys and adolescents 14-17 years of age), secondary sexual characteristics in boys 11-13 years more marked in those with a TSH level of 0.5 to 2.6 IU/l compared with peers with TSH levels from 4.2 to 10.0 IU/l In the subgroup of 14-17 year old boys and teenagers, there is a tendency to the phenomenon of "macroorchidism" beginning at the stage of subclinical hypothyroidism.

The number of drugs that is effective in urothelial cancer is very little. Cisplatin remains the basic drug for first line, but its use may be limited because of significant toxic reactions, that develop in a great number of patients. In case of impossibility of use of platinum derivatives treatment may be limited to the use of gemcitabine as monotherapy. It is much more difficult to resolve the issue regarding patients progressing after 1st line treatment. The effectiveness of ifosfamide, taxanes, topotecan, epitilon B, pemetrexed, nab-paclitaxel, pralatrexate, targeted drugs or their combinations had not lived up to expectations.
Vinflunine (Javlor) is the innovative chemotherapeutic drug that is effective for the treatment of platinum-refractory urotelial cancer, including a phase-3 trial. We have our own positive experience with Javlor in older age group of patients, that is presented in the article

Cancer breast cancer is a heterogeneous disease with genotypic and phenotypic variability. Phenotypic diversity of tumors is directly related to genotypic variations, which can be determined with analyzing gene expression in a comprehensive immunohistochemical study. Today there are many methods of surgical treatment – from minimally invasive to radical, variable according to the number of stages, the volume of reconstructive techniques. Today organ-preserving operations are prefered by surgeons all the world.

Human pluripotent stem cells (hPSCs) are capable of indefinite proliferation and can be differentiated into any cell type of the human body. Therefore, they are a promising source of cells for treatment of numerous degenerative diseases and injuries. Pluripotent stem cells are also associated with a number of ethical, safety and technological issues. In this review, we describe various types of hPSCs, safety issues that concern all or some types of hPSCs and methods of clinical-grade hPSC line development. Also, we discuss current and past clinical trials involving hPSCs, their outcomes and future perspectives of hPSC-based therapy. 

We present a brief overview of major innovative scientific research conducted at the research oncological Institute n. a. P. A. Herzen over the last decade, and the results of their the introduction into clinical practice.

On the basis of 36 patents of the for the invention in Russian Federation we developed new medical technologies for diagnosis, treatment and rehabilitation of cancer patients, permission for clinical use in the territory of the Russian Federation issued by the Federal service on surveillance in healthcare and social development.

Diagnosis and treatment of functioning and non-functioning neuroendocrine tumors is a challenging task. Surgeru remains the only radical method of treatment of these tumors, but tumors often are diagnosed at the stage of metastasis, when only palliative treatment is possible. Octreotide in patients with neuroendocrine tumors remains a drug with proven efficacy that can suppress the clinical symptoms of carcinoid syndrome and has antiproliferative activity, which can improve the quality of life and prolong survival.

Sarcomas in the head and neck are rare, and account for approximately 5-15% of all sarcomas in adults, is less than 1% of all neoplasms of the head and neck. Due to anatomical and physiological features of the structure of the nasopharynx, surgical treatment of tumors of this localization is associated with a number of technical difficulties, the high risk of non-radical removal of the tumor, it was therefore necessary for adequate surgical access. The article describes video-assisted access for removal of tumors of the nasopharynx with good visualization of the tumor process simultaneously after laryngectomy with the formation of pharyngotomy, providing the opportunity to monitor the postoperative area of the nasopharynx and early detection of continued tumor growth in patients with soft tissue sarcoma of the nasopharynx and combined lesions of the larynx.

The personnel potential of the Russian health care system has been analyzed. The main issues and trends in the development of our personnel, the dynamics of human processes in health care organizations have been revealed. The correlation of modernization processes with quantitative and qualitative indicators of their personnel has been determined. The role of the personnel policy of the industry in the development of HR processes in the health system has been characterized.

Objective. The study of coping behavior of patients with breast cancer (I, II stages) in the postoperative period with «externally visible postoperative defect".

Materials and methods. We studied the psychological characteristics of 35 patients with breast cancer (I, II stage), who underwent radical mastectomy, women were characterized in the postoperative period as "externally visible postoperative defect" ("e.v.p.d."), 35 patients with breast cancer (I, II stage) who underwent ablative and reconstructive plastic surgery, women were characterized in the postoperative period as "without an externally visible postoperative defect" ("without an e.v.p.d.").

The results and conclusions. The results of the study of women in both groups indicate that the patients are moderately using coping strategies for coping with the disease, preferring the strategy of "problem resolution" and "search of social support". Patients with breast cancer "with externally visible postoperative defect in comparing with patients with breast cancer "without an externally visible postoperative defect" often use positive religious coping in coping with the disease. The group of women with «externally visible postoperative defect" usually operate with negative religious coping. Both groups of women focused on the perception of social support. In a greater degree of social support they perceive from family and significant for them. Women with breast cancer and "externally visible postoperative defect” compared with women “without an externally visible postoperative defect" are not satisfied with your opportunities, have a feeling of weakness, doubt ability to evoke respect, sympathy, understanding and approval from others. They seek to change, doubt their self-worth, willing to put themselves in the guilt of their mistakes, failures, have low self-esteem. The group of patients with breast cancer "with externally visible postoperative defect" has an external locus of control. Patients with breast cancer "with externally visible postoperative defect" basically give a fatalistic sense to their disease. Indicators of anxiety and depression was significantly higher in the group of female patients with breast cancer "with externally visible postoperative defect" and located in the "clinically significant clinically significant anxiety and depression."

The personnel potential of the Russian health care system has been analyzed. The main issues and trends in the development of our personnel, the dynamics of human processes in health care organizations have been revealed. The correlation of modernization processes with quantitative and qualitative indicators of their personnel has been determined. The role of the personnel policy of the industry in the development of HR processes in the health system has been characterized.

Malignant neoplasms are taking second place in the structure of mortality and continue to be a major public health problem, both in the Russian Federation and in Moscow. The relevance of medical care to patients with malignant neoplasms is determined by their social significance, as well as the complexity of detection and treatment, the continuing increase in the incidence.
The aim of the Department of health and Oncology service of the city is to solve this problem.

Objectives: discussion of modern treatment options for metastatic breast cancer (MBC), the determining of the optimal treatment for subgroups of patients with poor prognosis.