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The article presents a review of modern literature data on molecular-genetic and biochemical profiles of malignant tumors of varying locations. It is shown that molecular-genetic and transcription profiles of pregnancy-associated malignant tumors are systems consisting of various components, many of which remain poorly researched. Additionally, morphological and biochemical characteristics of the placenta and tumor tissue are discussed. In the recent years, individual researchers and research groups have demonstrated heightened interests in this problem which undoubtedly soon will lead to a deeper and stronger understanding of mechanisms of progression and metastasis of oncological diseases during pregnancy. The knowledge of the principles of normal embryogenesis as a process of intrauterine development of a fetus, as well as investigation of molecular basis of pathogenesis of spontaneous abortion will undoubtedly help in determination of new targets and development of new therapeutical molecules for cancer treatment.

Purpose of the study. To analyze the long-term results from various strategies of endovascular treatment for coronary artery disease (CAD) in patients concomitant with cancer.Patients and methods. 74 patients with both CAD disease and cancer were treated in A. V. Vishnevskiy National Medical Research Center of Surgery from 01/01/2018 to 12/31/2022. By a multidisciplinary council, patients were divided into three groups: group 1 (n = 39) – staged treatment: percutaneous coronary intervention (PCI) is the first stage, the second is surgical treatment of cancer; group 2 (n = 14) – staged treatment: the first stage was surgical treatment of cancer, and the second stage was PCI; group 3 (n = 21) – PCI and open surgery were performed on the same day.Results. In the immediate period, 3 (4.0 %) deaths were observed: 2 (5.1 %) in group 1, 1 (4.8 %) in group 3, the cause of which was complications arising after oncological surgical interventions. One (2.6 %) patient from group 1 had acute myocardial infarction (AMI) due to acute stent thrombosis in the left anterior descending artery (LAD). The patient underwent successful emergency PCI. In the long-term period, 15 (25.4 %) patients died, out of which 11 (18.7 %) from progression of cancer, and 4 (6.7 %) from other causes. Among the major cardiovascular complications, the following were observed: 1 (3.2 %) AMI in group 1 and 1 (7.1 %) in group 2.Conclusion. In the long-term follow-up period, the leading cause of death (73,3 %) was progression of cancer. There were no detected from deaths AMI, which confirms the importance and feasibility of myocardial revascularization in this severe group of patients. PCI in patients with coronary artery disease in combination with cancer allows for effective and safe surgical treatment of malignant pathology without cardiac mortality both in the immediate and long-term follow-up periods.

Purpose of the study: analysis of modern scientific data on the molecular mechanisms of the CRISPR-Cas9 system in gene editing, advantages and disadvantages in cancer research and the development of new treatment methods. Material and Methods. A comprehensive electronic search of relevant published studies was conducted in the scientific databases PubMed/MEDLINE, ScienceDirect, Wiley and Google Scholar published between 2014 and 2024. The search was tailored to the specific requirements of each database based on the following keywords: CRISPR-Cas9, sgRNA, genome editing, cancer immunotherapy, CAR-T. The search yielded 487 studies on the topic of interest, of which 54 were used to write the literature review. Additionally, the article discretely highlights the importance and challenges of CRISPR-Cas9 in the production of genetically engineered T cells for potential use in treating certain types of cancer. Results. Accordingly, CAR-T (chimeric antigen receptor T-cell) therapy is widely used as one of the main components of immunotherapy in the treatment of leukemia, lymphoma and some solid tumors. The development of programmed single guide RNAs (sgRNAs) and new modifications of the Cas9 protein has made the technology flexible and universal. CRISPR-Cas9 is often used to modify T and NK cells by designing antigen receptors to improve their sensory circuits with complex functionality capable of recognizing and killing tumor cells. At the same time, delivery of the finished ribonucleoprotein (Cas9+sgRNA) complex into the cell avoids the constitutive processes of transcription and translation, which ensures the fastest possible gene editing. Conclusion. In this review, we reviewed the scientific evidence highlighting the promising impact of CRISPR technologies in cancer research and treatment. CRISPR-Cas9 is considered a unique and effective technology in the field of genetic and biomolecular engineering.

The aim of this study was to investigate the status of return to work and the influencing factors in patients with common cancers referring to three medical centers during the years 2020 to 2022. Material and Methods. In the present study (a retrospective cohort), all patients who visited three medical centers during the years 2020–2022 and were diagnosed with common cancers (non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, gastrointestinal cancers and sarcoma), were included in the study. Work ability index (WAI) was assessed based on selected questions from the WAI questionnaire. Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety, and Multidimensional Fatigue Inventory (MFI-20) was used to assess the level of fatigue. Then, the data obtained from individuals who returned to work were compared with those who did not return. Results. Out of 750 eligible patients, 135 individuals were enrolled in the study. 114 patients were male (84.4 %). The mean age of individuals was 50.2 ± 10.4 years. The most of individuals were diagnosed with gastric cancer (n=66, 48.9 %). After treatment, 36 (26.7 %) individuals returned to work, with the majority (24 individuals: 66.6 %) reporting a decrease in physical ability to do work. Sixty-six (73.3 %) patients did not return to work, with the most common reason being physical inability to work in 60 (66.6 %) individuals. Higher quality of life score was reported in individuals who returned to work. Conclusion. The rate of return to work was approximately 27 %. The return to work rate was highest among individuals with non-Hodgkin’s lymphoma and lowest among individuals with oesophageal cancer and Hodgkin’s lymphoma. The most influential factors affecting the return to work include disease recurrence and quality of life.

Introduction. Laryngeal cancer is the most common malignant neoplasm of the ENT organs. The preferred and primary therapy for this pathology is surgical intervention. The search for highly effective organ-saving methods of surgical treatment aimed at minimization of resection volume and preservation of functioning of the larynx continues. Current endolaryngeal surgery allows to improve functional results and is the most modern and advanced method.Aim. To compare functional and oncological results of surgical treatment of patients with laryngeal squamous cell carcinoma Т2N0M0 performed through transcervical and endolaryngeal accesses.Materials and methods. The results of surgical treatment of patients with squamous cell carcinoma of the vocal folds part of the larynx T2N0M0 performed between 2015 and 2020 at the Oncological Division of Head and Neck Tumors of the The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia were analyzed. The study included 49 men aged 52–72 years; the diagnosis was confirmed by histological examination. All patients underwent standard exams which led to diagnosis per the Tumor, Nodus and Metastasis international system.Results. Three-year recurrence-free survival after endolaryngeal resection of cancer of the vocal folds part of the larynx Т2N0M0 was 88.47 %, after transcervical resections it was 91.31 %. Analysis of functional and surgical results showed that compared to patients who underwent surgery through external access, in patients who underwent surgery with endolaryngeal access the rate of complications associated with the surgical wound in the early postoperative period was 13.04 % lower, frequency of cicatricial stenoses of the larynx was 20.06 % lower, and abnormalities of separating function of the larynx were 49.33 % rarer.Conclusion. In patients who underwent endolaryngeal resection of the larynx, better functional and surgical results were achieved compared to patients who underwent surgery through external access. Moreover, there was no statistically significant difference in oncological results between the study groups. This allows to conclude that minimally invasive endolaryngeal approaches are highly effective and functional in organ-saving surgeries for patients with squamous cell carcinoma of the vocal fold part of the larynx T2N0M0.

It has now been shown that overweight and obesity are associated with the development of at least 13 types of cancer, including cancer of the breast, colon and rectum, endometrium, esophagus (adenocarcinoma), gallbladder, stomach, kidney (renal cell), liver, ovaries, pancreas and thyroid glands, as well as multiple myeloma. Obesity-related cancers account for about 40% of all cancers. Thus, obesity is ahead of smoking as the most common modifiable risk factor for carcinogenesis. This review collects the latest data on the impact of obesity phenotypes on the risk of developing cancer, including a discussion of the contribution of the metabolically healthy obesity phenotype (MHO) to tumorigenesis. Possible mechanisms contributing to the emergence and progression of cancer are analyzed, for example: stimulation of cell proliferation, evasion of growth suppressors, inhibition of apoptosis and provision of replicative immortality, induction of angiogenesis, activation of invasion and metastasis, influence on genome instability, as well as chronic low-grade inflammation that contributes to the development of cancer. Understanding how obesity influences the above mechanisms may facilitate the development of new cancer prevention and treatment strategies for obese populations.

The prolonging war actions in Iraq have given rise to cumulative increase in environmental pollutions across country. Areas which have been extensively polluted include air, land, water and the health infrastructure to a greater extend. War has been ongoing for over two decades and the environmental damage couldn’t be avoided. War in Iraq contaminated the sand through the military actions that reconfigured the desert sands raising dust and causing air and land pollution simultaneously. The dust storms generated by military actions would reach the cities such as Erbil and Baghdad contaminating environmental surfaces and infrastructure. Evidence from experiments conducted by measuring the amount uranium levels in animal organs show that there is the presence of depleted uranium the Iraqi food chains and webs. Results further shows that the highest depleted uranium concentration is found in the Southern part of Iraq. Places like the Al-Twaitha nuclear research site are considered to be extensively polluted because of the destruction of nuclear reactors in the Gulf war of 1991. Furthermore, more barrels which had radioactive materials were stolen from the site in 2001. Soil samples around the site exhibited a high amount of CS-137 and Co-60 which are damaging to human beings and biodiversity. Health complications which have been observed include birth defects and cancer due to the radioactive chemicals emitted during war. As noted above, environmental damage in form of infrastructural damage remains an outcome of Iraq’s long war, and rapid industrialization in oil extraction and urbanization. The most affected cities in Iraq are Erbil, Basrah, Faluja, Baghdad, Mosul, and Thi-qar. This analysis concludes that the presence of an extensively contaminated environment due to the past and current wars, rapid industrialization is directly connected to the health complications being sustained.

Red beetroot (Beta vulgaris L.) is known as the popular vegetable in Russian cuisine, as well as a plant food that protects human health. Beetroot is rich in chemical compounds with antioxidant, anticarcinogenic, anti-inflammatory and other health-beneficial properties. Using the DNA-comet method (alkaline version), the effect of dry red beetroot extract was assessed as part of a meat product on spontaneous and induced DNA damage and presence of “abnormal comet” indicators in cells of various parts of the gastrointestinal tract (GIT) and liver of male F1 mice C.B.A. x C57 Bl /6. The obtained results showed that intraperitoneal administering of alkylating agent methyl methanesulfonate (MMS) to the mice at a dose of 40 mg/kg of the animal body weight statistically significantly increased the numerical value of DNA damage (% DNA in the tail) and the number of atypical DNA-comet in the liver, stomach, small and large intestines. Introduction of meat product with added red beetroot extract (20 g/kg of finished product) into the diet of the animals did not provide any significant effect on the scope of DNA damage caused by MMS in liver cells, but it led to a statistically significant decrease of this parameter by 58%, 59% and 48% in cells of the stomach, duodenum and rectum, respectively. The significant decrease of 29–54% in the release of atypical DNA-comet in the cells of all organs studied has been also confirmed, which proves decreasing in the cytotoxic effect of MMC in the gastrointestinal tract and liver. Thus, the antigenotoxic and cytoprotective effects of a meat product with addition of dry red beetroot extract have been recorded. This finding is able to have significant practical application, since the complications and issues in the gastrointestinal tract often occur and secondary tumors are induced in its parts during the chemotherapy of cancer located beyond the gastrointestinal tract. This result shows the potential ability of the developed meat product in protecting gastrointestinal tract cells from the genotoxic and cytotoxic effects of alkylating anticancer drugs

Background. The severe course of parenteral viral hepatitis and their further chronicity are associated with the presence of immunodeficiency disorders, frequency of which increases significantly in harsh climate. The article discusses the spread of parenteral viral hepatitis in the Arctic zone of the Republic of Sakha (Yakutia) and the issues of organizing medical care for patients with chronic viral hepatitis at the regional level.The aim of the study. To analyze the incidence rates of parenteral viral hepatitis in the Arctic regions of Yakutia in order to improve the health care system using the example of remote areas of hard access.Methods. The work uses materials from official statistics of the territorial department of Rospotrebnadzor for the Republic of Sakha (Yakutia) for 2000–2022 and information from the “Chronic viral hepatitis in the Republic of Sakha (Yakutia)” register. Results. In the Arctic regions of Yakutia, problems are observed in chronic forms of viral hepatitis B, C and D, as well as in their outcomes, such as cirrhosis and liver cancer, leading to early disability and mortality. In the general structure, hepatitis B infection prevails, which indicates the presence of family foci of infection. All this requires a complex of not only therapeutic, but also advanced anti-epidemiological measures.Conclusion. The difficult epidemiological situation regarding parenteral viral hepatitis, caused by extreme natural and climatic conditions, genetic characteristics of the indigenous population and the lack of medical institutions specializing in the treatment of chronic viral hepatitis, dictates the need to strengthen systematic on-site monitoring studies and telemedicine consultations in the Arctic zone of Yakutia. Thanks to this, residents of hard-to-reach areas of the Arctic zone of the Republic of Sakha (Yakutia) will be able to receive targeted subsidized care for the treatment of chronic hepatitis without traveling to Yakutsk.

Study of the causes of tongue and oral mucosa cancer is one of the pressing issues in practical medicine. Oral mucosa cancer accounts for about 10% of all cancer cases in other organs. The staff of the Dermatology Department at "Russian University of Medicine" share their experience in identifying precancerous conditions of the oral mucosa and vermilion border of the lips during outpatient visits. These conditions have a tendency to transform into squamous cell carcinoma. The paper describes young patients from the venereology department who had a combination of venereal disease (syphilis) and oncology (tongue cancer). The authors draw the attention of specialists to certain precancerous conditions and early signs of malignancy, the knowledge of which should maintain active oncological vigilance among doctors of other specialties.

Background. Radiation is an environmental factor that can lead to changes in the level of hormones in the body and to variables in the function of the body. The study examined the impact of radiation on certain hormones and vital indicators for understanding its physiological effects on human health. Methodology. The study was carried out on two groups of non-smokers, non-alcoholics, and peaceful people with chronic diseases, and each group (40 blood samples) aged 20–6 years and 3–5 ml of blood were collected from each person. The decomposed samples were excluded to avoid erroneous results: the two groups were a non-irradiated group and an irradiated group. The level of prolactin hormone, cortisol hormone, colon cancer protein (CEA), and pancreatic cancer protein(CA19-9) was measured in both groups using MINDRY precision laboratory techniques and devices. Results. Prolactin prolactin results showed a pronounced significant decrease in the irradiated group with the non-irradiated group. Cortisol: The results of the cortisol study showed a clear increase in people exposed to radiation compared to people who were not exposed to radiation. The results of colon cancer protein (CEA) and pancreatic cancer protein (CA19-9) showed a significant and clear increase in people exposed to radiation compared to people not exposed to radiation. Conclusion. This study showed that radiation exposure negatively affects hormone levels and vital disease indicators in the human body. This study highlights the importance of systematic monitoring and complete preventive health care in individuals exposed to radiation to assess health risks.

Objective: to conduct a STEP analysis (social, technological, economic, political) of macro-environmental factors influencing medical and drug care for patients with chronic myeloid leukemia (CML).Material and methods. The materials used were information from the official website of the Federal State Statistics Service of the Russian Federation (RF), financial reports of the Ministry of Finance of the RF, the Ministry of Industry of the RF, the Federal Customs Service of the RF, the Federal Treasury, the All-Russian Center for the Study of Public Opinion, data from the World Health Organization and the Ministry of Health of the RF, regulatory framework of the RF, data from the State Register of Medicines of the RF and information from domestic and foreign scientific publications. The object of the study was the Department of Hematology and Chemotherapy of the Regional Clinical Hospital No. 1 (Tyumen). Structural, statistical, analytical, situational-logical, mathematical, graphic methods, as well as content analysis, STEP analysis and ranking were used.Results. Providing medical and drug care to CML patients today is a vital and pressing problem in Russia and around the world. The effectiveness of pharmacotherapy directly depends on certain environmental factors, and each of them influences the functioning of a medical organization (MO) to varying degrees. Analysis of social factors made it possible to trace the dynamics and make a forecast regarding the capabilities of patients and MOs as well as the demand for drug therapy. Economic factors are based on the level of monetary income of the population and the expenditures of the RF budget on healthcare. The role of Russian export and import volumes is shown, first and foremost, the influence of these indicators on domestic prices, demand and on the macro-economic balance in general. Сreditor indebtedness changes the MO financial position and reflects the efficiency of using the monetary resources. Analysis of technological factors allowed assessing the equipment of the MO with medical facilities and drugs. The influence of such factors as the registration of new drugs for the treatment of CML patients and the digitalization program in health care was studied. Based on the analysis of political factors, the state’s interest in the development of domestic medicine and pharmacy was determined.Conclusion. The STEP analysis of external factors influencing medical and drug care for CML patients allowed identifying the most significant ones for optimizing pharmacotherapy in this category of patients, which is relevant for medical practice and the pharmaceutical industry.

The aim of the study was to summarize the available data on the relationship between adipose tissue mediators and cancer in patients with metabolic syndrome. Material and methods. A literature search was conducted using the PubMed and eliBRARY databases. Of the 400 articles published over the past 20 years, 58 studies were included in the review. Results. There is evidence of an unfavorable course of cancer in patients with metabolic syndrome that is explained by the presence of common pathogenetic pathways. In this review, special attention is paid to adipose tissue mediators that regulate the course of inflammation. The involvement of adipose tissue mediators in the pathogenesis of cancer is discussed. The relationship between adipokines of adipose tissue and the effects of specialized pro-resolving mediators (SpRM), which are metabolites of polyunsaturated fatty acids (resolvins, protectins and maresins), are considered. the associations of mediators that regulate the intensity of inflammation with the metabolic syndrome and cancer are discussed. Conclusion. Further studies will contribute to a better understanding of the relationship between metabolic syndrome and cancer and the search for adequate predictive markers to select the most effective drug strategy for correcting metabolic syndrome.

Aim. The paper aimed to update the study on accelerated biological aging as a complication of cancer therapy with a focus on diagnosing and prognosing the disease course. The authors independently searched scientific literature for the systematic review within databases PubMed, Scopus and Cochrane in the period from 2018 to 2024, using combinations of keywords “cancer”, “biological aging”, “replicative aging”, “antitumor therapy”, “markers of cellular senescence”, “coronary artery calcium” and selected full-text publications written in English and Ukrainian with level 1–3 evidence. People affected by cancer grow old faster. This could be related to malignant growth biology as well as to methods of anticancer therapy received. Cytostatics, targeted, hormonal and immune drugs damage not only malignant, but also benign cells, which leads to violations of replication with sustained cell cycle arrest and other phenotypic signs – macromolecular damage, metabolic changes, production of a specific senescence-associated secretome. Clinically, this is manifested by reduced work capacity, weakness, chronic organ dysfunction, cardiovascular disorders, progression of coronary atherosclerosis, hypertension, diabetes, dyslipidemia, sarcopenia, cognitive disorders, a de novo development of tumors and premature death. Biological markers of cellular senescence include the expression of lipofuscin, Ki67, p21 WAF1/Cip1 or p16 INK4a. A clinical marker of aging is the deposition of calcium salts within coronary arteries based on the Agatston score detected using multidetector computed tomography. Conclusions. A better understanding of the cancer consequences associated with accelerated biological aging might suggest new therapeutic strategies and improve the quality of life among cancer survivors. Rehabilitation measures through changes in diet, caloric restriction, aerobic exercises and pharmacological senolytic therapy should be a part of a patient’s daily routine after completion of radical cancer treatment.

Introduction and objective. Receiving a cancer diagnosis can lead to significant mental distress, highlighting the necessity for comprehensive medical care that includes psychological support. Effective psycho-oncological therapy can help patients find fulfillment regardless of their prognosis, while also improving overall outcomes and treatment adherence. This article aims to review the medical literature on the mental health challenges faced by cancer patients and to explore potential treatment modalities. Review methods. Implementing Google Scholar and PubMed, a literature analysis was conducted, with particular attention paid to terms like "psychooncology," "anxiety," "depression," "cancer," "grief," and "PTSD." The period of consideration for articles was from 2017 to 2024. Brief description of the state of knowledge. Grief, anxiety, PTSD, despair, and other mental health problems can arise after receiving a cancer diagnosis. In order to improve treatment adherence and survival rates, psychological well-being must be addressed. Empirical evidence indicates that psychological disorders can hinder adherence to therapy and elevate the risk of death from cancer. Furthermore, as families often endure significant stress throughout the disease, psychological care is beneficial to both patients and their relatives. It is possible to enhance adherence and reduce symptoms by using an integrated strategy that takes into consideration both physical and mental health. Conclusions. An essential part of holistic cancer care is psycho-oncology, which enhances patients' general health and quality of life. Psycho-oncological therapy must be incorporated into standard cancer care in order to improve treatment outcomes and assist patients in overcoming their condition.

Liposomal formulations represent a significant advancement in the field of oncology, providing innovative solutions for the delivery of chemotherapeutic agents. These nanoscale carriers, made of phospholipid bilayers, enhance drug stability and allow for targeted delivery to tumor tissues, thereby improving the therapeutic index of anticancer medications. By altering the pharmacokinetics and biodistribution of these drugs, liposomes help reduce systemic side effects while increasing the concentration of therapeutic agents at the tumor site. Recent developments in liposomal technology have led to the creation of targeted liposomes, which can bind specifically to cancer cells, enhancing treatment accuracy. This review examines the various applications of liposomes in cancer treatment, discusses important clinical trials, identifies challenges in formulation and delivery, and considers future directions for integrating liposomal therapies into routine oncology practice. As ongoing research progresses, liposomes are poised to play a crucial role in advancing cancer treatment strategies and improving patient outcomes. Additionally, we discuss the challenges associated with their clinical translation and future perspectives in optimizing liposome formulations for personalized cancer therapies.

Hokkaido University (Tsumita T, 2022) researchers found that endothelial cells accumulate low-density lipoproteins (LDL) in tumor blood vessels. At the same time, the endothelium carries out neutrophil chemotaxis, which perform an immunosuppressive function contributing to cancer progression.Aim. To search for the relationship between the white blood cell (WBC) count and some lipid profile parameters in cancer patients with myocardial infarction (MI).Material and methods. We examined 319 patients who were treated at Dzhanelidze Research Institute of Emergency Medicine in 2018-2023, which were divided into three groups: MI in combination with an active cancer — 132 patients (Group I), MI+cancer in history — 58 patients (Group II), MI without cancer — 129 patients (Group III). Following laboratory data used in routine practice were assessed: WBC count, relative neutrophil count, total cholesterol, low-density lipoproteins.Results. Cancer patients with MI are characterized by higher WBC and neutrophil count than in other samples However, the total cholesterol level was significantly lower in this sample, and the LDL level was not significantly different. Patients with MI and previous cancer occupied an intermediate position between groups I and III in terms of studied parameters.Conclusion. In general, data on the role of cholesterol levels in cancer patients are contradictory. In particular, some studies have shown that elevated cholesterol levels are a potential risk factor for cancer. In our study, as in a number of others, no significant associations were identified between elevated cholesterol levels and the presence of cancer. Our study is a step towards understanding the connection between the cholesterol concentration and the immune response in cancer patients with MI.

The incidence and prevalence of oncological diseases, which are the second most frequent cause of death, is steadily increasing among the population of the Russian Federation. The advances in translational medicine, including immunotherapy, have revolutionized the cancer treatment strategies. A particular breakthrough has been achieved in two areas of immunotherapy that have modernized the cancer treatment: chimeric T-cell receptors and antibodies known as immune checkpoint inhibitors, which block cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein-1 (PD-1) and ligand programmed cell death receptor (PD-L1). Immune checkpoint inhibitors enhance the immune response of the tumor and can cause adverse effects as a result of hyperactivation of T cells. In turn, immunosuppressive drugs, which are often prescribed to mitigate the side effects associated with immune checkpoint inhibitors, are a risk factor for the development of infectious processes. The purpose of this review is to analyze the possible relationships between immune checkpoint inhibitors and the risk of infection, as well as to discuss the possible benefits of immune checkpoint inhibitors as a treatment for various types of infections, including viral, parasitic and fungal infections, as well as sepsis. Although immune checkpoint inhibitors have demonstrated the ability to significantly increase the life expectancy of patients with advanced cancer, they often lead to adverse events, which often require a treatment with immunosuppressive drugs, including corticosteroids, anti-TNF and other biological agents. The overall effect of immune checkpoint inhibitors on human infections remains poorly understood. Further research is needed to understand the basic mechanisms of the immunological effects of immune checkpoint inhibitors on various types of infections, since in some cases such effects may be beneficial.

Introduction. Current generally accepted clinical and laboratory criteria for antiphospholipid syndrome (APS) have been clearly determined, which include vascular thrombosis and pregnancy complications in patients with circulating antiphospholipid antibodies (aPLs). However, in the last several years, aPLs have become a common finding in patients with malignancies. Accumulating data provide strong evidence for such association and suggests that thrombosis in cancer patients may be related to aPLs activity. According to global publications, aPLs circulation in cancer patients varies from 15 to 74 %, which may be due to differences in clinical characteristics of cancer patients examined as well as distinct interpretations on aPLs diagnostic tests.Aim: to determine aPLs profile in patients with malignant neoplasms of the female reproductive system, identify an association between aPLs and thrombosis as well as degree of disease progression and outcome.Materials and Methods. A single-center observational study was conducted with 130 women, among which 70 subjects had adenocarcinoma of the uterine body, cervix and ovaries. 60 age-matched apparently healthy women lacking thrombotic complications were included into control group. All study participants were examined for circulating lupus anticoagulantas well as anti-cardiolipin antibodies (aCLs), anti-β2-glycoprotein 1 antibodies (anti-β2-GР1), annexin V antibodies, and anti-phosphatidylserine-prothrombin complex antibodies (anti-PS-PT) IgG and IgM by using enzyme-linked immunosorbent assay.Results. Moderate or low aPLs titers were found in 34.2 % of patients with uterine, cervical and ovarian cancer. Ten (14.2 %) of 70 women in main study group had thrombosis so that aPLs were detected only in 5 of 10 women with thrombosis. No significant differences between patients with thrombosis and without thrombotic complications in gynecological cancer were observed. In addition, assessed parameters had no impact on relapse-free survival in cancer patients. However, a significant relation was found between circulating aCLs (IgG, IgM) and anti-PS-PT (IgG, IgM) as well as degree of oncological process. In addition, a significant association was found between aCLs isotype IgG (p = 0.017) and disease relapse.Conclusion. Although thrombosis along with acute thrombosis is a hallmark of APS patients, they demonstrate other non-thrombotic manifestations, one of which is the impact on tumor growth invasion and progression.

Introduction. The tumor microenvironment (TME) consisting of non-tumor cells and other components plays a crucial role in cancer development by promoting uncontrolled tumor growth.Aim: to detail all the components in TME and their contribution to carcinogenesis by analyzing available publications.Results. Currently, TME study is of great interest in the medical field. Its crucial role in the tumor initiation, progression, and spreading is emphasized. Several constituents have been identified in TME including cancer-associated fibroblasts, neutrophils, adipocytes, tumor vasculature, lymphocytes, extracellular matrix, dendritic cells, neutrophil extracellular traps, etc. Thromboinflammatory reactions are also considered an important TME element.Conclusion. TME constituents can serve as new targets for both diagnostics and antitumor therapy.

Introduction and purpose: The article focuses on the analysis of young people's awareness of the consumption of energy drinks, especially those containing caffeine. The aim of the study is to understand the level of knowledge about the awareness and consumption of energy drinks among students aged 18-25. This study was conducted using surveys and involving 202 participants. Material and Methods: The study was conducted using online anonymous surveys, involving 202 participants. The participants were students aged 18-25 both women and men. The results were analyzed according to the age and gender. Moreover, based on the available literature examining aspects related to the consumption of energy drinks. Results: The study shows that the vast majority of respondents (94.06%) are aware of the impact of energy substances on the body. The charts also illustrate that caffeine, as the main ingredient in energy drinks, is well understood in terms of cardiovascular effects. Moreover, the student community is aware of the link between excessive sugar consumption and the risk of cancer development. Discussion: The study shows that young people are aware of the negative impact of energy drinks on health. Nevertheless, not all areas of knowledge are clear to them. The continuous increase in the level of education can undoubtedly contribute to the introduction of healthy eating habits among students. Most respondents declare to drink energy drinks again, it should draw our special attention. Conclusions: It is worth noting the need for further education, especially in the field of metabolic syndrome. It also highlights the role of research and education in shaping public health awareness. Finally, the article suggests that further research and targeted educational programs are critical to improving public health, especially in the context of energy drink consumption.

Introduction: Vitamin A, one of the most popular vitamins that people usually associate with eye health or beautiful skin, also has many other functions and uses. Recently many scientists conducted studies to determine if vitamin A could be a new weapon against cancers. Aim of the study: The aim of the study was to discuss recent findings regarding the impact of Vitamin A and other retinoids on potential applications in anticancer therapy. Materials and methods: This review of studies is based on scientific articles available in PubMed and Google Scholar databases. The names of the cancers were juxtaposed with term "Vitamin A" and with term "Retinoids" to gather data regarding the effect of retinoids on cancer treatment and prevention. Results: After analyzing the gathered publications, it is possible to conclude that retinoids can have a positive impact on cancer treatment. Some of them can induce apoptosis of cancer cells and others can reduce their proliferation. Moreover, retinoids can also play an important role in preventing cancers, such as ovarian, breast, cervical, or skin cancer. The role of retinoids in the prevention of prostate cancer remains unclear due to conflicting research results. Conclusion: The studies have shown promising results which indicate a need for further research into anticancer mechanisms of retinoids. Specifically, more research is needed to explore the positive impact of retinoid use in treating cancer diseases. The significant potential of retinoids may make it possible to include them in clinical practice and develop an effective therapeutic strategy for cancer treatment based on them.

Introduction and aim. Orthorexia nervosa is described as an obsession with consuming solely healthy foods accompanied by restrictive behaviors. Patients with chronic conditions frequently require dietary interventions alongside medication to manage symptoms and slow down disease progression. However, when dietary restrictions are taken to extremes, individuals may develop orthorexia nervosa, resulting in malnutrition and weight loss. This poses risks during treatment, where maintaining a balanced diet is vital. In this review we aim to display the prevalence of orthorexia nervosa in patients suffering from selected chronic diseases. Material and methods. A literature review was performed to investigate the prevalence of orthorexia nervosa in individuals with type 1 diabetes, inflammatory bowel disease, celiac disease, rheumatoid arthritis, and cancer. Description of the State of Knowledge. The occurrence of orthorexia reaches up to 7% in the general population, 72% in patients with type 1 diabetes mellitus, 77% in case of inflammatory bowel disease, 71% among individuals suffering from celiac disease, 75% in those with rheumatoid arthritis, and 50% in case of cancer. Orthorexia nervosa mostly affects females who are younger, have higher education levels, select organic foods, prepare their own meals, and have concurrent chronic illnesses. Distress associated with diagnosis is the primary factor contributing to the development of this condition. Orthorexia ultimately leads to malnutrition, weight loss, impaired social functioning, and poses a risk of complications in chronically ill patients. Conclusion. The prevalence of orthorexia nervosa in patients suffering from chronic illnesses is significantly higher compared to the general population. Therefore, early detection of this condition and intervention are necessary to improve patient management. Further research is needed to assess the frequency of orthorexia among individuals suffering from other chronic diseases.

The formation of neutrophil extracellular traps (NETs), described first in 2004 as a previously unknown neutrophil strategy for combating microbes, has been attracting a growing interest in research community. NETs play a key role in inflammation and infection exploiting effector functions such as degranulation, phagocytosis as well as production of reactive oxygen species (ROS). NETs play a crucial role in defense against systemic infections. Additionally NETs involved in inflammation, and in the pathogenesis of non-infectious diseases, such as autoimmune diseases and cancer.

Аim: to study the role of serum and ultrasonometric markers in the early diagnosis of malignant transformation of periductal fibrosis of the liver during the formation of cholangiocarcinoma against the background of chronic invasion of Opisthorchis felineus, in the population of endemic regions.Methods. A comprehensive one-stage comparative study was conducted in a case-control design, using the assessment of biochemical parameters (lactate, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, glucose, direct and indirect bilirubin, high-density lipoproteins and low-density lipoproteins, triglycerides, urea and total protein), immunological parameters (transforming growth factor beta) and tumor markers (CA 19-9, СYFRA 21-1) in blood serum samples obtained from patients with O. felineus infection, with and without periductal fibrosis, O. felineus-infected patients with cholangiocarcinoma and representatives of control groups. During the analytical stage, the relationship between the structural features of the liver ac- cording to the results of ultrasound examination (presence of opisthorchiasis-associated periductal fibrosis), clinical parameters, parasitological study data (infection intensity), and changes in biochemical, immunological parameters and tumor markers in patients against the background of O. felineus infection was assessed. Statistical analysis was performed using the R programming language (version 3.6.1).Results. Evaluation of the relationship between the presence of ultrasound signs of stage 1–2 opisthorchiasis-associated periductal fibrosis and changes in serum levels of the biochemical, immunologic parameters and oncomarkers in patients with O. felineus infection demonstrated that the levels of alkaline phosphatase, conjugated bilirubin, AST, glucose and CA 19-9 oncomarker were significantly higher in the serum of patients in the group with cholangio-carcinoma and opisthorchiasis (p < 0.01).Conclusion. The first pilot data on the relationship between ultrasonometric signs of periductal liver fibrosis and the increase of CA 19-9 oncomarker as well as biochemical parameters (alkaline phosphatase, direct bilirubin, aspartate aminotransferase, glucose), which can be used for early diagnosis of malignant transformation of periductal liver fibrosis with the formation of cholangiocarcinoma in O. felineus-infected population in endemic regions, were obtained.

Aim. Evaluation of comorbid pathology in SARS-CoV-2 infected in cancer practice as a predictor of severe outcomes. Testing the COVID-19 risk assessment tool in oncology (CORONET), to predict the likely severity of COVID-19 course in cancer patients on inpatient treatment. Materials and methods. A retrospective analysis of 173 cancer patient disease stories was conducted. The study was conducted as part of the program of the World-Class Research Center “Digital Biodesine and Personalized Health Care” of the University of Sechenov, with participation in the ESMO-CoCARE Register project. Based on the ESMO COVID-19 and CAncerREgistry (ESMO-CoCARE) registry, taking into account the entered our patient sample (n=173), a COVID-19 risk assessment tool in oncology (CORONET) was developed. Results. Cancer patients with comorbid pathology have been shown to have an increased risk of COVID-19 course of the disease from this sample by CORONET (mean conclusion score CORONET 2.44 pointsseverity). Prognosis of probable severity of outcomes in cancer patients infected with SARS-CoV-2 depends on associated diseases. The presence of a history of ≥3 comorbid pathologies in COVID-19 patients was detected in 106 people (61.27%). 15 patients were included in the risk of severe course. Retrospective analysis obtained actual confirmation of the prognosis of severe course of the disease in this group followed by death in all these patients (71.42% of all deaths). Indicators such as low albumin levels, high levels of C-reactive protein and neutrophils showed high prognostic significance of the likely severity of coronavirus infection in cancer patients on inpatient treatment for COVID-19. The mortality rate of patients admitted with COVID-19 and cancer was 12.14%. Conclusion. The most informative predictors of severe outcomes in COVID-19 in inpatient cancer patients to assess the prognosis of disease severity are: number of comorbidities, age, NEWS2 scale, ECOG patient activity status, albumin level, C-reactive protein level and absolute neutrophil level. The benefits gained in the use of the online decision support tool CORONET are considered convincing not only during the decision-making phase of hospitalization, but also in cancer patients on inpatient treatment.

Literature data and own experience of nutritional support in oncology has been analyzed. Nutritional support is an integral part of the management of cancer patients. Diagnosis of nutritional deficiencies is important, with an accent on early detection of muscle loss and severely malnourished patients. The main methods of nutritional support are oral nutritional supplements, enteral and parenteral nutrition, as well as dietary advice and maintenance of physical activity. Oral nutrition should always be used in the absence of absolute contraindications. The effectiveness and indications of prehabilitation measures require further study, but now it is possible to single out a category of patients in whom they can be fully implemented. It can be cases requiring neoadjuvant chemotherapy.

Introduction. Scientific reasoning for improving the organisation of cancer prevention and the providing onco-dermatological care to the population in the conditions of the public health system development. Materials and methods. The article includes the method of system approach as well as bibliosemantic, epidemiological, medical and statistical, sociological, expert assessment, content analysis, structural and logical analysis, modelling methods. Sources of information are the data from scientific literature, the Center for Medical Statistics of the Ministry of Health Care of Ukraine, the National Cancer Registry of Ukraine, the sociological research among various groups of participants in providing healthcare services and strategic documents of the national and international levels. Results. Unfavourable trends in skin malignancies spread, an increase in their contribution to the burden of the disease and the imperfection of the organisation of skin cancer prevention and the onco-dermatological care to the population were revealed. According to the principles of the state policy and the recommendations of the international organisations the directions of improving the preventive, therapeutic and diagnostic services were reasoned out on the basis of the data from the scientific literature, epidemiological research, spread, locational, gender and age peculiarities of skin cancer among the population, risk factors for their development, estimating the health care resource support, scale and results of the activities, studies of the patients, doctors and health care professionals' opinions. The modern functional-organisational model of the prevention system and control of skin cancer in the conditions of the public health system development with the definition of its principles, structures and functions was reasoned and worked out. Conclusions. The practical implementation of the measures for improving the prevention organisation and therapeutic and diagnostic work to fight skin cancer and the developed functional and organisational model of the system of prevention and control of onco-dermatological pathology in conditions of the public health development will effectively prevent onco-dermatological diseases, reduce the burden of skin cancer, improve people’s health and health care performance indicators and contribute to the health care sustainable development and the population’s well-being.

Introduction and purpose: Berberine is a plant alkaloid that naturally occurs in the fruits of common barberry (Berberis vulgaris). This alkaloid has long been used in natural medicine. It exhibits a range of bioactivities, such as antioxidant, anti-inflammatory, antidiabetic, anti-edema, and antimicrobial actions. Through the promising therapeutic effects of berberine in metabolic syndrome, as well as its impact on carcinogenesis, this compound is beginning to play a significant role in preventive medicine. Recently, particular attention has been paid to the anticancer properties of berberine, which are based on many biochemical pathways, particularly its pro-apoptotic and anti-inflammatory action. The study aimed to review the anticancer mechanisms of berberine and summarize them about individual cancers. State of knowledge: The article reviews the current literature on the anticancer properties of berberine for individual cancers, focusing primarily on its molecular mechanisms of action. In addition, the potential of berberine as a promising candidate forming the basis for drug production and its use in preventive medicine was analyzed. Summary: In summary, many studies have shown that berberine exhibits anticancer activity in many types of cancers, including breast, lung, stomach, liver, colorectal, ovarian, cervical, and prostate cancers. Berberine inhibits the growth of cancer cells, limits metastases, induces apoptosis, stimulates autophagy, and enhances the effectiveness of anticancer drugs. Despite its potential as a promising candidate for drug production, there are currently no approved pure berberine preparations for the treatment of specific ailments. Research on its effectiveness and safety is still ongoing.

Introduction and purpose. Preserving fertility is crucial for cancer patients, aligning with advancements in oncology. As survival rates improve, addressing treatment-related late effects gains importance. Many young patients, aware of therapy toxicity, consider future conception chances, impacting treatment decisions. With a trend toward delayed childbirth and a growing population facing unplanned family planning disruptions, the demand for fertility preservation is expected to rise. This paper provides a brief review of available methods for preserving fertility in cancer patients. State of knowledge. Freezing semen in liquid nitrogen vapor is a standard method for preserving reproductive potential in male cancer patients. Shielding during total-body radiation limits testicular volume reduction, indicating less damage to the germinal epithelium. Hormone suppression treatments are not protective in male cancer patients. Oocyte and embryo cryopreservation are considered secure methods before anticancer treatments, with oocyte cryopreservation being preferred for post-pubertal women. Ovarian tissue cryopreservation remains an alternative method without preliminary treatment, suitable when time is insufficient for ovarian stimulation. Ovarian transposition beyond the intended radiation area, performed laparoscopically, can retain ovarian function. GnRH agonist administration before and during chemotherapy aims to minimize the likelihood of premature ovarian insufficiency. Summary. Advancements in fertility preservation for cancer patients, ranging from traditional cryopreservation to innovative methods like ovarian tissue preservation, highlight a commitment to empowering individuals facing cancer diagnoses. Ongoing research expands possibilities, ensuring a diverse range of strategies that offer tangible and hopeful prospects at the intersection of cancer and reproductive health.

Introduction: Polyphenolic compounds are widespread in nature, contained in large quantities especially in fruits, vegetables, cereals and nuts. In recent years numerous attempts have been made to characterize their biological effects, with particular emphasis on their protective potential against the development of chronic diseases, including cancer. Purpose of the study: The aim of the study was to collect and analyze publications on the use of polyphenols in the prevention and treatment of cancer, with particular emphasis on breast cancer, colon cancer, prostate cancer and lung cancer - the four most common cancers in the Polish population. Material and methods: A review of the literature available on PubMed was performed using various combinations of keywords: 'polyphenols' + 'cancer', 'polyphenols' + 'oncology', ‘polyphenols’ + ‘chemoprevention’, ‘polyphenols’ + ‘chemotherapy’, 'polyphenols' + 'lung cancer', 'polyphenols' + 'breast cancer', ‘polyphenols’ + ‘colorectal cancer’, 'polyphenols' + 'prostate cancer'/'prostate gland cancer'. Results: The analysis of the collected publications allows to conclude that polyphenols exert multidirectional anticancer effect through antioxidant, antiproliferative, anti-inflammatory, immunomodulatory and prosenescence activity. This effect has been demonstrated, among others, in relation to cellular models of colorectal cancer, prostate cancer, breast cancer, cervical cancer and lung cancer. Polyphenols also reduce side effects associated with the use of conventional anticancer therapies and increase their effectiveness. Conclusions: Polyphenols - both as independent compounds and components of complex anticancer treatment regimens - have chemopreventive and potentially chemotherapeutic effects. By influencing various stages of carcinogenesis - initiation, promotion and progression of cancer - they constitute a promising direction for the development of new, more effective forms of therapy and prevention of cancer.

Introduction: Basal cell carcinoma is the most common form of skin cancer. The lifetime risk is estimated as 33% to 39% in white men and 23% to 28% in white women. Because of that it is a very crucial disease for public health. In this article will be described main pathways of treatment which are especially recommended and are the most wide used for different types of basal cell carcinoma. Main division of interventions type used in treatment of basal cell carcinoma are surgical (physical) and non-surgical (medical). Surgical (physical) includes surgical standard excision, Mohs micrographic surgery, curettage and cautery, cryosurgery and laser therapy (ablative lasers, pulsed dye lasers). Non-surgical (medical) includes radiotherapy, topical imiquimod, topical 5- fluorouracil, photodynamic therapy, intralesional interferon. Aim of study: Literature review of the most recommended treatment of basal cell carcinoma. State of knowledge: In this publication will be desribed a current state of knowledge about basic and the most crucial basal cell carcinoma treatment. Conclusion: Because of incidence rate of basal cell carcinoma which is very high- there are many reports about treatment of this disease. Treatment of this disease, especially among low risk patients, is very effective.

Introduction and purpose: Over recent years, there has been a noticeable increase in cases of cancer around the world. At the same time, there is the problem of vitamin D deficiency, which may affect up to one-quarter of the population. The aim of this article is to link these two epidemics and organize knowledge about vitamin D and its multidirectional effects related to many diseases, especially cancer. State of knowledge: Many scientific works have proven that vitamin D has a beneficial effect not only on the known calcium-phosphate metabolism. Researchers emphasize its pleiotropic effect on many organs and systems in the human body, and thus on many diseases, including cancer. Studies show that vitamin D modulates the expression of many different miRNAs specific to various types of cancer. The results of in vitro and in vivo studies showed the effect of calcitriol on cell growth and development. It influences processes such as differentiation, proliferation, apoptosis, strengthens the immune system, and reduces oxidative stress. Summary: Based on accumulated research, we can conclude that vitamin D presumably regulates the entire process of tumorigenesis, from initiation to metastasis and cell-microenvironment interactions. However, some studies do not confirm these data or provide contradictory results. For this reason, it is necessary to deepen research on this topic in order to establish specific recommendations, therapeutic and preventive plans. However, vitamin D and its role in the pathogenesis of many diseases should not be underestimated. In cases of low vitamin D concentration in the body, its supplementation will be reasonable, considering the functional identity of this source compared to sun exposure or diet.

INTRODUCTION. Surgical treatment of colorectal malignancies, while increasing overall survival often determines the persistence ofthe pain syndrome, causing a decrease in the quality of life of patients. Pain-relieving medicines have side-effects and complications,which determines the search for and introduction of non-medicinal technologies. AIM. To evaluate the effectiveness of incorporating dynamic electroneurostimulation in the rehabilitation of patients after surgicaltreatment for colorectal cancer to correct pain syndrome, autonomic dysfunction and quality of life indices. MATERIAL AND METHODS. 60 male and female patients aged between 35 and 65 with a verified diagnosis of the colon and rectummalignant neoplasms after surgical treatment were examined in the conditions of the outpatient oncological care center at the StateMedical Institution “City Clinical Hospital No. 2” (Novosibirsk). They were divided into 2 groups: the 1st group (the main group, n=40)in addition to standard therapy received a 15-day course of dynamic electroneurostimulation (DENS) performed with «NEURODENSPCM» device, the 2nd group (the comparison group, n=32) received a standard treatment including chemotherapy, symptomaticpharmacotherapy and exercise therapy. The examination included assessment of pain syndrome using validated pain scales, thevegetative status, anxiety and depression, quality of life parameters. RESULTS AND DISCUSSION. The patients of the 1st group showed 1.2- and 2.4 times reduction of algias by the 5th and 15th day ofrehabilitation respectively. Upon completion of the rehabilitation the autonomic nervous system balance index (LF/HF) was adjustedby 4.8 and the centralization index by 6.0 times against the baseline, the anxiety and depression index on the HADS scale was reducedby 1.5 times, the quality of life on the SF-36 scale improved: physical functioning by 1.5 times, pain by 1.2 times, general health by 1.5times, which differed from the similar indicators in the 2nd group.Dynamic electroneurostimulation using NEURODENS-PCM device can have pain-relieving and vegetative-regulating effects due toactivation of antinociceptive brain structures and influence on suprasegmental parts of the autonomic nervous system. CONCLUSION. The inclusion of dynamic electroneurostimulation using «NEURODENS-PCM» device in the rehabilitation of patientsafter surgical treatment of malignant neoplasms in the colorectal region enables a faster relief of pain syndrome, adjustment of theneurovegetative regulation and the anxiety level, which contributes to improvement of the ' quality of life of patients.

Nowadays, the one-year survival rate of liver transplant recipients is 80-90 %. In the long term after surgery, there are increased risks of death compared with the general population. At the same time, in the structure of death of recipients, extrahepatic causes prevail over graft pathology. Cancers, cardiovascular diseases, infections, metabolic disorders, and kidney disease are key factors that negatively affect long-term outcomes of transplants. The article provides an overview and summary of current data on the prevalence, structure and prognostic value of various types’ of late post-transplant extrahepatic pathology in liver transplant recipients.

Introduction. Studies evidence about a relation between increased circulating free DNA (cfDNA) concentrations and chemotherapy, the majority of which have been focused on considering a tumor as a source of cfDNA. It has been suggested that neutrophils also contribute to this process, as cancer-related cfDNA characteristics resemble those of neutrophil extracellular traps (NETs). Therefore, the elevated concentration of cfDNA observed in chemotherapy patients may be associated with NETosis.Aim: assessment of NETosis markers in surgical treatment and adjuvant chemotherapy of patients with malignant neoplasms of the female reproductive system.Materials and Methods. A prospective non-randomized interventional controlled study was carried out by enrolling 111 patients with malignant breast diseases and female genital organs of various localizations and stages hospitalized for elective surgical treatment or chemotherapy course. The control group included 33 healthy women. 69 patients underwent surgical treatment. Adjuvant chemotherapy with paclitaxel and carboplatin was performed in 25 patients with ovarian cancer and 17 patients with breast cancer. In cancer patients, citrullinated histone H3 (citH3) and myeloperoxidase (MPO) were chosen as NETosis biomarkers allowing to distinguish NETs from other tumor-derived cfDNA thereby improving quality of research study. The concentration of NETosis markers was assessed before surgery or onset of chemotherapy upon admission to hospital and 14 days after surgery or 14 days after the second course of chemotherapy.Results. In all patients, the concentrations of NETosis markers before the start of therapy were significantly increased compared to the control group as well as 14 days after surgical treatment and 14 days after the second course of chemotherapy. However, in surgical patients, no significantly increased concentration of NETosis markers postvs. pre-surgery magnitude was observed. Upon that, patients underwent 2 courses of chemotherapy vs. baseline level were found to have significantly elevated magnitude of NETosis markers.Conclusion. The study revealed the relationship between administration of paclitaxel-containing chemotherapy in patients with ovarian cancer and breast cancer and a rise in NETs level. Chemotherapy is an essential component for management of patients with malignant neoplasms of the female reproductive system, therefore, development of new strategies to lower a risk of thrombosis and resistance to it is of crucial importance.

Аim: to present two clinical cases of successful surgical treatment of patients with a combination of complete transposition of internal organs and cancer of the biliopancreatoduodenal zone.Key points. A 65-year-old man underwent gastropancreatoduodenal resection for cancer of the large duodenal papilla. In addition to the situs vicserum inversus, this patient revealed a special variant of vascular anatomy, namely: separate separation of the left and right hepatic arteries from the ventral trunk. A 70-year-old man, in addition to complete transposition of internal organs, had a combination of cancer of the terminal part of the common bile duct and heterotaxy syndrome in the form of polysplenia, aplasia of the hepatic segment of the inferior vena cava, agenesis of the dorsal pancreatic rudiment (“short” pancreas), intrapancreatic course of the right hepatic artery extending from the superior mesenteric arteries, rotational abnormalities of intestinal development. This patient underwent a total pancreatectomy. In both cases, the main difficulties in mobilizing the pancreatoduodenal complex arose due to anatomical disorientation and the absence of standard (familiar) topographic and anatomical landmarks for the surgeon.Conclusion. In all patients with tumors of the biliopancreatoduodenal zone, a detailed assessment of the vascular anatomy of this area is required before surgery, with the study of the course of the main visceral vessels and their large branches using multispiral computed tomography in vascular mode. If heterotaxy syndrome is suspected, additional examination is necessary to identify hidden developmental anomalies, which allows surgeons to be prepared for an unusual situation. Gastropancreatoduodenal resection or total pancreatectomy in situs viscerum inversus is a technically complex intervention and should be performed in large multidisciplinary medical institutions, and the operating team should have extensive experience in operations on the organs of the biliopancreatoduodenal zone.

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: de Boer AGEM, Tamminga SJ, Boschman JS, Hoving JL. Non-medical interventions to enhance return to work for people with cancer. Cochrane Database Syst Rev. 2024;3(3):CD007569. DOI: 10.1002/14651858.CD007569.pub4

Background. The therapy of chronic pain in cancer patients is a highly topical issue for the modern health care system. Intense pain syndrome involves the prescription of strong opioid analgesics (ОА), most of which are classified as narcotic drugs and are under strict governmental control. In this situation, increasing the use of drugs that are equivalent in dosages to morphine and do not require a special narcotic drug prescription may increase the availability of pain relief for cancer patients and will be less associated with drug addiction.Objective: to analyze the regulatory, organizational, clinical, and economic criteria that determine the choice and influence the prescription of strong ОА for adequate pain relief in cancer patients with chronic pain syndrome (CPS). Material and methods. The article determines legal and regulatory framework regulating the sphere of providing patients with ОА, presents an expert evaluation of existing barriers that limit the availability of adequate pain treatment, and shows ways to solve these issues. We present the results of an original Russian clinical and economic study evaluating the use of prolonged forms of ОА (tapentadol and morphine) for the treatment of moderate and severe CPS in patients with cancer in the Russian healthcare system. The evidence for comparative clinical efficiency and safety of ОА under consideration is analyzed. The costs of therapy with the drugs in equivalent dosages that provide 1 year of adequate analgesia for intensive CPS in oncology patients are compared.Results. Differences in the regulatory status of opioids, including requirements for prescribing, storage, record keeping, and use, were shown to affect the availability of pain medication. According to a systematic review of the comparative efficiency and safety of prolonged forms of ОА in the therapy of cancer patients with moderate and severe CPS and a meta-analysis of randomized controlled trials, no differences were found for any of the outcomes studied in the tapentadol and morphine groups: frequency of achieving pain control – risk ratio (RR) 0.88 (95% confidence interval (CI) 0.78–1.00), frequency of using emergency (additional) pain relief – RR 1.16 (95% CI 0.95–1.42), frequency of gastrointestinal adverse events – RR 0.82 (95% CI 0.60–1.12). This suggests comparable efficiency and safety of the drugs. The difference in average cost of 1 patient course of therapy for 1 year between tapentadol and morphine was 17,653.02 rubles (–16.8%). Additional funds released in case of treating the cohort of 100 patients with tapentadol instead of morphine made 1,765,301.96 rubles, which means 20 more patients could be treated with tapentadol for 1 year.Conclusion. The use of modern effective non-invasive forms of ОА (tapentadol in particular) that have no restrictions imposed by regulatory documents on narcotic drugs prescription will increase availability, as well as reduce costs of adequate therapy of moderate and severe CPS in patients with cancer as compared to the use of equivalent daily doses of morphine.

Combined oral contraceptives (COCs) containing synthetic analogs of sex steroids are considered the most effective and popular method of contraception worldwide. The low rate of hormonal contraceptive use is often because of the fear of side effects due to existing myths. Complex questions that most often arise among doctors and patients when choosing COCs include the risk of thrombosis and cancer, the effect on fertility after the use of COCs, the use of COCs in patients with COVID-19, etc. COCs are highly effective, well-studied, and pose minimal risks that are well understood, described in the labels, and can be avoided with proper use.

The microbiota, together with the host, form a symbiotic relationship in which the microbiota plays a key role in maintaining the homeostasis of the human body, performing a number of significant functions such as energy metabolism, maturation and maintenance of the immune system, vitamin synthesis, regulation of bile acid reabsorption in the intestine, and much more. Scientific research in recent years has made a significant contribution to understanding the complex relationship between the microbiota and a range of human pathologies, including malignant neoplasms. The review considers the mechanisms of the possible influence of bacteria on the development and progression of cancer with an emphasis on the procarcinogenic properties of the microbiota. The most important factor in the mechanism of influence of the microbiota on carcinogenesis are toxins produced by microorganisms that induce direct damage to host cell DNA, causing DNA mutations, disruption of its exact replication, and also provoke an imbalance in the proliferation and apoptosis of host cells, their rapid aging and oncogenesis. The probable mechanisms of participation of microorganisms in the development of cancer through the activation of TLRs and NLRs receptors, which have a tumor-activating effect, are considered. A brief review is given on the mechanisms of carcinogenesis associated with the metabolic activity of the microbiota due to the processes of regulation of the production of secondary bile acids, activation of pro-carcinogenic compounds: phenols, ethanol, sulfides, ammonia, nitrosamines. The influence of the microbiota on the metabolism of sex hormones and the development of hormone-dependent cancers mediated by the mechanisms of enterohepatic circulation and estrogen deconjugation is described. The study of the carcinogenic mechanisms of action of the microbiota in the host organism opens up prospects for the development of new successful personalized approaches to the diagnosis, treatment, and prevention of cancer. Changing the composition of the microbiota should become a way to fight cancer, along with surgical treatment, chemotherapy, radiation therapy, targeted therapy and immunotherapy.

Many patients with different malignancies require analgesic therapy not only at advanced stages of the disease, but also during their diagnosis and treatment, as well as after treatment completion to ensure pain relief. New highly effective painkillers with a lower adverse event burden are critical to improve the quality of life of cancer patients with chronic pain syndrome. Tafalgin (tyrosyl-arginyl-phenylalanyl-glycinamide) is a highly specific μ1-opioid receptor agonist. It is an innovative Russian drug for subcutaneous administration, which has no analogues abroad. This article discusses the results of phase I–III clinical trials assessing tafalgin efficacy, safety, and potential to improve patients’ quality of life.

MICA and MICB are non-classical MHC molecules that indicate cellular stress. They act as ligands for NKG2D receptors found on NK cells, thereby triggering a cytotoxic response against damaged, infected, or transformed cells. The production of soluble forms of MICA/MICB occurs via the cleavage of their extracellular domains (ECDs). The expression of MICA/MICB molecules in tumor sections or the levels of their soluble forms in blood have potential as diagnostic tools for cancer. They can predict important clinical outcomes for cancer patients, such as overall and recurrence-free survival. However, their extensive molecular polymorphism complicates the development of monoclonal antibodies (mAbs) for diagnostic use. Therefore, the diagnostic value of mAb-based assays may vary depending on the frequencies of allelic variants in local human populations. We examined the ECD amino acid sequences of more than 280 MICA and 50 MICB allelic variants. Additionally, we identified 172 and 58 single nucleotide polymorphisms (SNPs) located in the coding regions of the respective genes and resulting in amino acid replacements. The most frequent amino acid replacements (> 10%) in the ECD occur at 11 and 4 sites of MICA and MICB, respectively. We found that the frequencies of SNPs in the identified hot spots strongly correlate with each other in different human populations, despite the diversity of allelic variant frequencies. The functional role of only one site is known. The replacement of valine with methionine at position 152 enhances the affinity of MICA to NKG2D receptor. As the hot spots are dispersed throughout the entire ECD sequences, they may play a role other than modulating affinity with the NKG2D receptor interaction. We recommend that Ag sets used to validate anti-MICA/MICB mAbs meet two criteria. First, they should include both MICA and MICB alleles, as these genes have highly similar sequences. Second, the alleles should cover the variability observed in the identified hot spots.

Introduction. Malignant tumors are the second most common cause of death in the population of Ukraine. Breast cancer is the most common cancer among women, and lung cancer among men. At the same time, there is a negative trend towards an increase in new cases of prostate cancer among the male population. In turn, gastric cancer is among the most common types of tumors in both male and female population of Ukraine. The aim. Comparison of indicators of the quality of life of patients with breast cancer, prostate cancer, lung cancer, gastric cancer and identification of the main problems in their quality of life in order to optimize the medical care system for them. Materials and methods. A questionnaire was conducted among patients with lung cancer (n=411), prostate cancer (n=408), breast cancer (n=400) and gastric cancer (n=404) on stage of their inpatient treatment in oncological institutions in nine regions of Ukraine, using the EORTC QLQ-C30 questionnaire. Results and discussion. The best indicator of Global Health Status/QoL was found in patients with breast cancer (53,22 points on a 100-point scale), while the lowest was found in patients with lung cancer (49,12 points). Breast cancer patients are also characterized by the best results in all items of the functional scale and the QLQ-C30 symptom scale. In turn, patients with gastric cancer recorded the worst indicators both on the functional scale and on the QLQ-С30 symptom scale. Conclusions. Based on the low quality of life indicators of cancer patients, it is important to create socio-psychological support for cancer patients and their family members, which will include the development and implementation of standardized psychological assistance and mental health care at all stages of diagnosis, treatment and rehabilitation.

Hypercoagulation is a typical condition for cancer patients. In addition, various arms of the hemostasis system become involved in tumor growth, invasion, metastasis, neoangiogenesis as well as immunoevasion. The magnitude of activated hemostasis is driven by tumor phenotype. Parameters characterizing coagulation, intensity of fibrinolysis processes, platelet aggregation and activation as well as endothelial activation mirror magnitude of hemostasis activation in oncological process, but may also be considered as candidate markers of tumor progression and predictors of oncological diseases outcome. This review summarizes the study data assessing a value of predictive hemostasis biomarkers for overall survival and response to therapy in oncogynecology and mammology. The most promising biomarkers have been identified and used in the future for risk stratification as well as personalized patient management.

The purpose of the study was to summarize and analyze the available data on modern methods of additional imaging using indocyanine green (ICG) used in abdominal surgical oncology.Material and Methods. The search and analysis of publications over the last 7–10 years was carried out using RSCI (Russian Science Citation Index), E-library, PubMed, Scopus, MedLine, Elsevier, Web of Science, ScienceDirect systems. The following keywords were used for the search: “ICG-fluorescent navigation”, “ICG-fluorescence”, “gastric cancer”, “colorectal cancer”, “indocyanine green”.Results. The role of ICG-fluorescent navigation in abdominal oncology, in particular, in surgery for cancer of the stomach, colon and rectum, identification of peritoneal carcinomatosis and liver metastases, as well as in biliary surgery and cholangiography, was shown. Intraoperative visualization of sentinel lymph nodes and mapping of lymph nodes in patients with gastric and colorectal cancers were described. In addition, the information on the diagnostic value of vascular imaging in colorectal surgery, detection of the boundaries of hepatocellular carcinoma and surrounding tissues, as well as real-time liver metastases using indocyanine green, was provided. Special attention was paid to ICG-mediated cholecystectomy and cholangiography. ICG fluorescence imaging in colorectal and gastric cancer surgery makes it possible to individualize the surgical approach and provide functional surgery associated with the performance of a sufficient and prophylactically excessive volume of surgical intervention more effectively. Conclusion. The presented data confirm the relevance of the search for a vector of improving the imaging methods used in abdominal surgical oncology, which requires even more even more multicenter prospective cohort studies to determine the best ways of improving the technique.

Background. In recent years, there has been an increase in the incidence of vulvar precancer (lichen sclerosus), as well as vulvar cancer. Since this disorder is rare, treatment planning and therapy itself are often suboptimal, which results in a high recurrence rate. Treatment of patients with local recurrence is even more difficult. Improper therapy often leads to fatal outcomes.Aim. To develop an innovative therapeutic approach to local recurrent vulvar cancer that includes combination (intraarterial and systemic) chemotherapy and surgery.Materials and methods. This pilot study included two patients with a second episode of local recurrent vulvar cancer. The first patient was denied special treatment, whereas the second one was offered abdominoperineal resection of the rectum. At the first stage, the patients received combination chemotherapy; at the second stage, they had combination reconstructive surgeries.Results. Combination chemotherapy was highly effective as demonstrated by the reduction of the recurrent tumor to a resectable size. Combination and reconstructive surgeries allowed us to preform radical treatment and preserve functions of the adjacent organs.Conclusion. Combination treatment was highly effective in patients with local recurrent vulvar cancer, when the tumor was located near the urethra, vagina, and anus or invaded them. Combination chemotherapy ensured good tumor regression, while surgery gave hopes for a favorable outcome.

Introduction Coffee stands as the second most widely consumed beverage globally, following water.[1] Recent research on the effects of coffee consumption underscores its positive outcomes when adhering to recommended doses—typically ranging from 2 to 5 cups a day, amounting to a maximum of 400 mg of caffeine daily. This newfound perspective highlights the potential benefits of moderate coffee intake on our overall health and well-being. Aim of the study The objective of this study was to comprehensively review the existing knowledge regarding the impact of coffee consumption on diverse aspects of the gastrointestinal tract. Materials and methodology A literature review was conducted utilizing the PubMed, Google Scholar, and Google databases. Articles were systematically searched in both English and Polish, employing the keywords: coffee, caffeine, digestive system, digestion, and cancer. Results Recent research highlights coffee's diverse benefits, aiding digestion, hastening transit, and showing potential in cancer prevention. It stimulates gastric acid, enhances bile and pancreatic secretion, reduces gallstone risk, promotes large intestine movement, and modulates intestinal flora. Importantly, coffee isn't a primary factor in conditions like reflux, ulcers, inflammatory bowel diseases, or cancer. Conclusions Further research is essential to deepen our understanding of coffee's impact on the digestive system and its systemic effects on the body. Additionally, promoting awareness of safe daily caffeine doses that can contribute to health is worthwhile.

Artificial intelligence has been rapidly penetrating every element of our lives for quite some time. However, its presence in health care has remained elusive. This is particularly apparent in the field of dermatology, where, given the characteristics of this discipline of medicine, it would seems that its presence should be abundant. Malignant skin lesions are still high in the statistics in terms of cancer mortality while being one of the easiest to treat when diagnosed early. There are many reasons why artificial intelligence is not used in daily practice as an aid for cancers detection. However the most important one is the ongoing insufficient quality of the algorithms, which, despite great results in laboratory settings, do not produce good enough outcomes in clinical settings. Other important reasons are that people still distrust and fear artificial intelligence and simply the legal lack of adaptation of countries to its lawful and safe use. Despite the work of scientists and legislators the road to seeing artificial intelligence as a helping tool for dermatologists on a daily basis is still very long and requires the attention of scientists and the whole medical community.

An important condition for providing quality and safe care is to understand the differences between men and women in epidemiology, pathophysiology, risk factors, clinical performance of diseases, response to treatment and use of medical care. The first part of the review was devoted to the evolutionary mechanisms of differences in life expectancy and potential strategies for increasing life expectancy in men. The second part of the review examines sex and gender differences using the example of 3 groups of diseases, which, according to the World Health Organization, are the main causes of death in the European Region, in the programming of health and disease, as well as the reasons for the male-female health-survival paradox.