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Proceedings of the National Academy of Sciences of Belarus, Medical series

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No 4 (2016)
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CLINICAL AND EXPERIMENTAL MEDICINE 

7-14 552
Abstract
Ewing sarcoma (ES) is the second most common primary bone tumor in children. The aim of this study was to evaluate the clinical outcomes and long-term survival for pediatric patients with localized bone ES. 72 previously untreated patients with localized ES, reported to the sub-cancer registry database from 1999 to 2014, were evaluated. Survival rate was estimated via the Kaplan-Meier method and compared using log-rank tests and Cox proportional hazard models. 15-year overall survival was 64.6  %. Common clinical prognostic factors (age, sex, tumors volume, response to treatment and others) were not different between patients with favorable and unfavorable outcomes.
Treatment results for patients with localized ES from the Republic of Belarus comply with generally accepted standards. Searching for new predictive markers is necessary for early detection of resistant to conventional treatment patients.
15-24 658
Abstract
Seven strategies of basophil gating were analyzed using multicolor flow cytometry. It was shown that the most effective and reliable gating strategies for BAT were IgEhi and CD123+HLA-DR–. The stability of basophil identification markers depending on the activation status of basophils was assayed. It was established that IgE and CD123 molecules exhibited no significant difference unlike molecules CD203c and CD193. It was shown that the IgEhi and CD123+HLA-DR– regions had the lowest contamination by other cell subsets, which indicates that the both gating strategies may be used successfully for basophil activation test.
25-31 414
Abstract
The effect of some amides of palmitic acid on the pain sensitivity was studied on rats using different tests of the pain response. Single injections (2.5 μmol/kg) of N-palmitoylglycine, N-palmitoylserinol, and N-palmitoyl-5-aminolevulinic acid were found to decrease the pain threshold in varying degrees both during thermal and mechanical stimuli submission. The data suggest that the amides mentioned above can take an important part in pain sensation presumable through the lipid signaling.
32-43 468
Abstract
Belarus is among the countries with a low infant mortality rate (2015 – 3 ppm). This is achieved thanks to a functioning multi-level system of care for children. As an example, the provision of medical aid to children with congenital anorectal disorders in the Republic of Belarus, including surgical care to children with congenital anorectal disorders, is analyzed, and the principles, which will ensure the best possible results with minimal material costs, are defined. The treatment of children in special institutions and the standardization of the approaches to determine the indications for surgery, operating tactics, and postoperative management allow one to optimize the results of treatment of patients with congenital anorectal anomaly. The application of the developed system of diagnostics and the treatment of patients with congenital malformations of ARC has provided a significant decrease in the long-term mortality from 20  % (1980), 7  % (1990) to 1.8  % (2014) (p < 0.001). A reduced length of hospital stay is: if earlier a child was in intensive care and resuscitation 7 ± 3.4 days, and DHC 22.2 ± 3.9 days, then in 2014 – 4.8 ± 1.2 and 14.7 ± 3.4 days, respectively (χ2 = 1.256, p = 0.429 and χ2 = 1.1694,
p = 0.919). The number of re-operations is reduced from 20  % (1980) to 5  % (2014).
44-56 764
Abstract
The role of a number of therapeutic interventions for non-muscle invasive bladder cancer (NMIBC) is poorly defined. Taking into account the prognostic heterogeneity of NMIBC and a possible interaction of treatment efficacy with a recurrence risk group, it is reasonable to compare the latter within certain prognostic strata. The objective of this study was to evaluate the effi-cacy of different therapeutic interventions on  recurrence-free survival in patients with NMIBC in different prognostic groups.
Retrospectively, we analyzed the results of treatment of 921 patients with NMIBC who were distributed into 4 recurrence risk groups. Recurrence-free survival was calculated using the Kaplan–Meier method and the statistical significance for the differences was assessed during a log rank test.
The median follow-up was 61 months. Transurethral resection (TUR) assisted by photodynamic diagnostic resulted in a significant improvement in recurrence-free survival in the high and very high risk groups. The advantage of TUR performed by an experienced surgeon and BCG immunotherapy was pronounced in the intermediate, high and very high risk groups. Single instillation of doxorubicin and reTUR do not substantially affect prognosis in any risk stratum.
Based on a stratified analysis of various treatments efficacy we defined the indications for TUR performed by an experienced surgeon, adjuvant BCG immunotherapy and photodynamic diagnosis in patients with NMIBC.
57-65 590
Abstract
Morphological figures of liver regeneration on the experimental model of organ resection of healthy animals and rats treated with retrorsine, as well as the influence of the transplantation of mesenchymal stem cells on the regenerative processes in liver are investigated.
It was revealed that the mechanism of regeneration of healthy liver after resection mainly involved mature hepatocytes with strengthening their mitotic activity and with increasing the nuclear apparatus. During the liver resection on the background of the retrorsin-induced injury the regeneration processes was greatly weakened. Intraportal transplantation of mesenchymal stem cells in liver resection contributed to improving the regenerative processes both in the healthy liver and in the case of the retrorsin-induced injury of the liver.
66-76 382
Abstract
The objective of the article was to investigate the clinical effectiveness of the method, the combined effects of remineralizing medicines on the basis of casein phosphopeptide-amorphous calcium phosphate fluoride and low-intensity laser (LLLT) in treatment of patients with an uncomplicated fracture of the tooth crown. The study included 90 patients (90 teeth) divided into the treatment group (combined methods of CPP-ACFP  + LLLT), the control group (CPP-ACFP), and the comparison group with basic therapy. In the treatment process of dental pulp electroexcitability indicators were evaluated (EDI), temperature and tactile sensitivity. In the group (combined methods of CPP-ACFP + LLLT) the normalization of all parameters studied occurred after one week of treatment, allowing for permanent fillings in this group by the end of this period. To evaluate the effectiveness of the treatment of teeth with an uncomplicated fracture of the crown in the remote terms, the method was used method to study the “tooth–filling” borders. The use of the combined method (CPP-ACFP + LLLT) allowed in most cases to get the highest score in the evaluation of the “tooth–seal” border in 24 months after treatment and one restoration was not subjected to replacement. Thus, the developed combined method (CPP-ACFP + LLLT) allowed obtaining the excellent results of treatment of an uncomplicated fracture of the tooth crown and can be recommended for use.
77-88 472
Abstract
The disturbances in the glutathione system and the development of oxidative stress were for the first time found in a subchronic animal model on Wistar albino rats receiving a physiologic dose of palm oil (5–10  % of the diet) Feeding with palm oil was found to reduce the liver prooxidant properties. as well as the liver detoxification properties, resulting in the sequestration of coenzyme A which contributes to the accumulation of fatty acid-β-oxidation products (probably in the form of acyl-CoA).
89-95 423
Abstract
This article presents the concept of the choice of total hip replacement in severe dysplastic coxarthrosis in adults (types 3–4 according to Grove). The criterion for the choice of surgical intervention is the relationship of the elements of the hip joint evaluated at the preoperative planning. Based on these data the analysis of joint replacement in 39 patients (48 of endoprosthesis replacement) was made. The advantage of two-stage arthroplasty in a patient with unilateral shortening more than 5 cm was considered.

REVIEWS 

96-102 340
Abstract
The history of restoration of lost structures of the external nose has more than two millennia. An overview of the development of the nasal reconstruction from the ancient times until now is presented. The basic methods of nasal defects reconstruction using different plastic material and surgical guidelines are described. The defect characteristics influencing the achievement of the optimal clinical and functional outcomes are noticed. The approaches to solving the problem and the directions of evolution of reconstructive rhinoplasty are characterized. A brief description of the current state of the problem is presented.
103-113 509
Abstract
It is shown that development of subacute, recurrent and chronic low back pain is the result of maladaptive neuroplasticity condition of the central nervous system due to abnormal functional, neurochemical and anatomical modification of the brain neural networks. In this connection, a diagnostic study of patients with recurrent and chronic low back pain should be directed not only to the identification of musculoskeletal abnormalities, but also changes in cerebral neuroplasticity. Treatment and rehabilitation measures should be also aimed improving cerebral neuroplasticity. One of the promising methods for improving neuroplasticity are a manual therapy and targeted training therapy.
114-125 560
Abstract
A brief review of the current publications is referred to the analysis of the molecular and genetic characteristics of Mycobacterium tuberculosis and the genetic factors of macroorganism that may influence the susceptibility/resistance
to tuberculosis and thus may affect the prevalence, manifestation, and outcome of tuberculosis. The genotype Beijing plays a key role in the spread of M. tuberculosis with multidrug resistance. Fifty eight percent of M. tuberculosis isolates collected from different regions of Belarus belonged to the genotype Beijing and had an identical MIRU VNTR profile. The resistance to anti-tuberculosis drugs in M. tuberculosis is formed due to mutations in the following genes: to isoniazid – in genes katG, inhA, acpM-kasA), to rifampin – in rpoB, to streptomycin – in rrs, rpsL, to ethambutol – in embB, to ethionamide – in inhA, to pyrazinamide – in pncA, to fluoroquinolones – in gyrA.

SCIENTISTS OF BELARUS 



ISSN 1814-6023 (Print)
ISSN 2524-2350 (Online)