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Background. According to randomized clinical trial SOLO1 olaparib statistically significantly improves progression-free survival versus placebo as a maintenance monotherapy in patients aged 18 and over with newly diagnosed advanced ovarian cancer with BRCA mutations, who had response to first-line chemotherapy. As the data on overall survival (OS) in this trial remains interim it is still uncertain whether treatment with olaparib can provide any benefits in terms of OS.Objective: to evaluate a long-term OS for olaparib versus placebo as a maintenance monotherapy in patients with newly diagnosed advanced ovarian cancer with BRCA mutations, who had response to first-line chemotherapy.Materials and methods. A 10-year mathematic model of disease progression and survival on olaparib versus placebo was developed. Modelling was based on data on progression-free survival from SOLO1 trial and data on OS after platinum-sensitive and platinum-resistant relapses from OCEANS and AURELIA trials. Additionally, patients who haven’t been treated with olaparib after first-line therapy in base-case scenario were assumed to get olaparib as a second-line treatment after platinum-sensitive relapse; mortality modelling for these patients was based on data from SOLO2 trial.Results. Median OS for olaparib was 107 months versus 66 months for placebo. 46 % of patients treated with olaparib were alive by the end of 10-year modelling period, but only 28 % patients from the placebo group. Hazard ratio of death for olaparib versus placebo was 0.64 (95 % confidence interval 0.49–0.84). Probabilistic sensitivity analysis showed robustness of these results.Conclusion. Using olaparib as a maintenance therapy in patients with newly diagnosed advanced ovarian cancer with BRCA mutations, who had response on first line chemotherapy, statistically significantly reduces risk of death by 36 %, compared to placebo.

In addition to the typical signs, what are the pallor of the skin and mucous membranes, frequent, weak pulse, fainting, etc., internal bleeding that occurs as a result of rupture of the fetus during an ectopic pregnancy is accompanied by other, no less characteristic phenomena from various systems organism, which sometimes make it possible to timely confirm or establish a diagnosis and differentiate this suffering from other similar painful conditions.

Breast angiosarcoma (BAS) is an extremely rare and poorly studied neoplasm, the etiology of primary BAS remains controversial, and secondary BAS is most often radio-induced. Radio-induced breast tumors usually appear 10–20 years after the initial treatment; however, for BAS this period is much shorter and is about 4–7 years. This review presents literature data on the features of the clinic, diagnosis and treatment of BAS, as well as own clinical case observation of radio-induced sarcoma of the left breast, that developed 4 years after the primary breast cancer treatment.

Young women with reproductive tract neoplasms who receive treatment leading to termination of ovarian function often suffer from menopause symptoms that contribute to dramatic drop in quality of life. Climacteric symptoms in women with iatrogenic menopause are more severe than in case of natural menopause, especially in women with reproductive tract neoplasms. They lead to dramatic drop in quality of life and are one of the main reasons to stop applying endocrine therapy in women with hormone-positive tumors, which leads to decrease in disease free survival and to decline the prognosis. The most effective treatment option for climacteric symptoms of moderate to severe degrees is menopause hormone therapy; however, such therapy is not suitable for patients with estrogen-dependent tumors in past medical history due to the likelihood risk of progression of cancer, as well as the risk of venous thrombosis, the frequency of which in cancer patients increases. Non-hormonal pharmacological and non-pharmacological correction methods are used as first-line therapy for menopause disorders in women with estrogen-dependent tumors of the reproductive system. Among non-hormonal non-pharmacological correction methods actively study such methods as acupuncture, yoga, exercise to control weight, and a diet rich in phytoestrogens. The most effective non-hormonal methods of correcting vasomotor symptoms are serotonin and norepinephrine reuptake inhibitors. However, currently in Russia these drugs can be prescribed only by a psychiatrist. The finding of effective and safe non-hormonal methods to correct menopause symptoms in women with hormone-positive reproductive tract tumors is the important task in practice among doctors in different specialties.

In 2011, a standard approach to the treatment of primary ovarian cancer (OC) included a cytoreductive surgery, which could be performed after 2–3 cycles of neoadjuvant chemotherapy, and chemotherapy consisting of platinum and taxanes. Such approach was provided for all patients, regardless of tumour histology and any molecular biological and genetic factors. The most complete picture of management and therapy of patients can be made using the treatment of a specific patient as an example. After application to the N.N. Blokhin National Medical Research Center of Oncology in 2011, the patient with OC received standard primary therapy and subsequent treatment of the recurrent disease, which was accompanied by various types of adverse events resulting in the poor quality of life for the patient. The data that some patients with OC have a BRCA1/2 mutation that is significant for prognosis and treatment came to hand later and, unfortunately, the awareness of a significant germinal BRCA1 mutation was of no use to the woman any longer. The life expectancy of this patient was 47 months. This is the average life expectancy for patients with stage IIIC OC. Major changes have been brought in the primary therapy of OC. If a diagnosis of low-grade IIIC ovarian adenocarcinoma was established in this patient today, needless to say that the BRCA1 mutation would be identified during the first-line chemotherapy, and in case of full or partial treatment effect, we would prescribe olaparib as maintenance therapy to the patient. Considering the fact that the median progression-free survival has not yet been achieved in the patients of SOLO-1 study, who received olaparib therapy, and is only approaching 54 months, it can be assumed that even the first relapse could not have developed in this patient.

The involvement of axillary lymph nodes is one of the most important prognostic factors, significantly affecting the treatment strategy for early breast cancer (BC). The risk of axillary lymph node metastases depends directly on a number of factors (age of women, size of tumor, presence of lymphovascular invasion and biological characteristics of cancer). The evaluation of regional lymph node status in patients with early BC includes the clinical examination of regional zones and the ultrasound study (US), using these methods can help to study lymph nodes shape, borders, margins and structure. The sensitivity of ultrasound in the evaluation of regional lymph nodes status directly depends on the biological subtype of the tumor; the minimum level of ultrasound sensitivity in the evaluation of lymph nodes status is detected for luminal HER2-negative cancer (less than 40%), and maximum sensitivity is detected for triple negative and HER2-positive subtypes (6871%). Clinical examination and modern ultrasound are the most accessible methods for the evaluation of regional lymph nodes status, but the possibility to misjudge metastatic process can be detected in 1/4 of patients. Verification of the diagnosis in the preoperative phase (fine-needle aspiration biopsy/core-needle biopsy under ultrasound guidance) allows minimize the number of errors for the regional staging. The sentinel lymph node biopsy (SLNB) is the gold standard of regional treatment in patients with early stage BC, nowadays. The randomized trials (NSABP B-32, ACOSOG q0011) show the safety of recession of performing regional lymph node dissection in favor of SLNB not only in case of clinically negative lymph nodes, but also in patients with metastases in 2 sentinel lymph nodes, upon condition that organ-conservative treatment and subsequent radiation therapy will be used. High-quality regional staging, the choice of the therapeutic algorithm in accordance with the biological characteristics of carcinoma, the application of the most effective modern drug regimes, the optimal radiation therapy allow not only minimize the extent of surgery, but also achieve high long-term survival results, provide excellent functional results and high quality of life in patients with the involvement of axillary lymph nodes.

Ovarian cancer is the fifth leading cause of cancer-related death among women in the world. In spite of recent progress in treatment strategy, around 70 % of ovarian cancer patients relapse. The cytoreductive surgery followed by platinum-, taxane-containing chemotherapy is the standard approach to the primary treatment of ovarian cancer; a variant of neoadjuvant chemotherapy with interval cytoreduction may be used in patients with stage IIIC-IV disease.Given that angiogenesis plays a central role in progression of solid tumour growth and metastasis, recent studies have focused on anti-angiogenic treatment. Bevacizumab, a humanized IgG monoclonal antibody that inhibits the vascular endothelial growth factor receptor, is most promising antiangiogenic drug. Bevacizumab was approved on December 23, 2011 by the European Medicines Agency and on June 13, 2018 by the Food and Drug Administration as first-line treatment in epithelial ovarian, fallopian tube or primary peritoneal cancer stage III or IV in combination with carboplatin and paclitaxel. Based on sub-analyses, the recommended dosage of bevacizumab is 15 mg/kg every 3 weeks for a total of 22 cycles. Bevacizumab is a well-studied drug with a favourable safety profile that has been used in routine clinical practice for more than 10 years. However, the search for predictors to identify the category of patients, who will benefit most from bevacizumab therapy, is still in progress, and clinical trials that may improve the therapeutic potential in treating ovarian cancer in the near future due to introduction of new combinations of bevacizumab with PARP inhibitors and immuno-oncological drugs are under way. In view of acquisition of mature clinical trial data, a range of the most discussed issues regarding optimal use of bevacizumab in patients with ovarian cancer has been identified.

In this study we report the first comprehensive metagenomic analysis of the prokaryotic and eukaryotic virome occupying luminal and mucosa-associated habitats along the entire length of the gastrointestinal tract (GIT) in two animal species, the domestic pig and rhesus macaque. The highest loads and diversity of bacteriophages are found in the lumen of the large intestine in both mammals. Mucosal samples contain much lower viral loads but a higher proportion of eukaryotic viruses. Parenchymal organs contained significant amounts of bacteriophages of gut origin, in addition to some eukaryotic viruses. GIT virome composition is both region- and species-specific with a strong separation between upper and lower gut. Nonetheless, certain viral and phage species are found ubiquitously from the oral cavity to the distal colon. Correlations between individual phages and their potential microbial hosts in the GIT are overwhelmingly positive, which confirms earlier concepts of the temperate-like life cycles of the majority of gut phages and a prevalence of the “piggyback-the-winner” ecological dynamics.

Aim. Eribulin is an active cytostatic, associated with a wide range of mechanisms of antitumor effects, but eribulin efficiency and safety in patients with breast cancer (BC), associated with cerebral metastases are still poorly understood. Materials and methods. We analyzed the combined Russian experience of eribulin application in BC patients associated with brain metastases; the analysis included 459 Russian women with advanced BC who had received at least 2 course of eribulin during the period from 2014 to 2018; 35 of 459 patients had brain metastases (40.0% - luminal HER2-negative subtype, 31.4% - triple negative subtype and 28.6%h - HER2-positive BC). The median age was 52 years (39 - 80 years of age). In most cases, the patient had two or more metastatic brain lesions (68.6%; the median was - 3); brain radiotherapy was used in 62.8% of patients before eribulin treatment and in 5.8% of patients was held stereotactic radiation therapy during eribulin chemotherapy. We analyzed the efficiency of eribulin application (the therapy continued until disease progression, the development of unacceptable toxicity, or impossibility to apply the drug for any other reason). Results. The results showed that clinical efficacy (objective response rate + stabilization of disease lasting for more than 6 months) was 48.6%: partial response - in 20% of patients and stabilization of disease - 62.9%; tumor growth control was in 82.9%. Median PFS in all group of patients with brain metastases was 4.1 months and was similar to median PFS in patients who received radiotherapy before eribulin treatment or without eribulin - 4.1 vs 3.47 months; p=0.798. Conclusions. The application of eribulin in BC patients with brain metastasis are absolutely justified, the drug demonstrates the efficiency in a retrospective analysis in a Russian population. The determination of the optimal algorithm for the treatment of patients with metastatic BC associated with brain metastasis requires a multidisciplinary approach and further research.

More than 300 000 new cases of endometrial cancer (EC) are registered annually in the world. The prognosis for EC is determined by the stage of the disease. In Russia, stage III–IV EC is diagnosed in 16 % of patients, with the mortality rate in the first year of follow-up of 9.2 %. The management of recurrent/metastatic EC remains a challenging clinical problem. Hormone therapy and chemotherapy is effective in 30 % of patients, with median progression-free and overall survival rates of approximately 6 months and 12 months, respectively. The role of targeted therapy in the treatment of EC remains undefined. However, several studies demonstrated that combination of targeted therapy with chemotherapy resulted in significant improvement in overall survival of patients with advanced endometrial cancer. Published data on the study of checkpoint inhibitors for EC have shown promising results, however, further research is required to more completely understand how the immune system recognizes and eradicated cancer.

Aim: To perform a comparative analysis with simultaneous measurement of vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF1) and matrix metalloproteinase 7 (MMP7) in serum samples taken from healthy women and ovarian cancer patients; to perform association of these markers with their expression in primary tumors depending on clinical, morphological and biochemical characteristics of the disease and its prognosis. Materials and methods: We assessed 54 treatment-naïve patients with ovarian cancer aged from 23 to 74 years (mean ± SD, 53.2 ± 1.9), being at various FIGO stages of the disease. The control group consisted of 120 healthy women of matched age and reproductive status, in whom serum biomarker levels were studied. Patient survival was assessed by the Kaplan-Meier method, with survival curves compared with log-rank test. All analyses were done with “STATISTICA” and SPSS software. Results: Serum VEGF levels in ovarian cancer patients were significantly (p 505 pg/ml (upper quartile in the control). With 505 pg/ml taken as a threshold, the test had sensitivity of 79.6% and specificity of 75%. Another cut-off value of serum VEGF level between the patients with ovarian cancer and the control group (510 pg/ml) was derived from ROC curves and 75% sensitivity and 78.2% specificity. No acceptable cut-off value for serum IGF1 to differentiate between the patients with ovarian cancer and the controls could be obtained from the ROC curves. Serum MMP7 levels in the patients with ovarian cancer were significantly higher than those in the control group (Mann-Whitney test p

The development of cytostatic therapy in the treatment of ovarian and cervical cancer has resulted in a deadlocked situation. Thus, the basic aim of the investigations was to examine the biological basis of these diseases, last years. Angiogenesis is one of the main factors of the tumor microenvironment, associated with tumor growth and metastasis. In this regard, new drugs that work by inhibiting angiogenesis have started to appear. One of the first drugs studied in randomized phase III studies was bevacizumab. The application of bevacizumab demonstrated the significant increase both in progression free-survival and life expectancy in high-risk group of patients with ovarian cancer and in patients with recurrent and advanced cervical cancer.

The treatment of patients with ovarian cancer remained unchanged over the past years: cytoreductive surgery and platinum-based chemotherapy regardless of the histological type of the tumor. A deeper understanding of ovarian cancer biology has paved the way to developing targeted drugs; the most studied are bevacizumab and olaparib (Lynparza) - the first among PARP inhibitors, which has been recently approved in the world and in Russia. Olaparib demonstrated a statistically significant efficacy in the treatment using supportive regimen in patients with recurrent platinum-sensitive ovarian cancer after successful platinum-based chemotherapy and with the presence of BRCA1/2 mutations and all these characteristics would significantly change the course of the disease in this group of patients.

e21580 Background: The thyroid gland is the most important regulator of the body's response to stressful influences, including malignant growth. Iodine is a constituent of thyroid hormones, and it plays an important role in anti-tumor protection. The purpose of the study was to analyze the levels of thyroid hormones in the thyroid gland of male and female mice with B16/F10 melanoma, as well as the effect of an organic iodine-based preparation on the survival of animals with transplanted melanoma. Methods: Levels of total (T3, T4) and free (FT3, FT4) thyroid hormones were measured by RIA in the thyroid of male and female С57ВL/6 mice (n = 80) with transplantable B16/F10 melanoma. The effect of an organic iodine-based preparation on the dynamics of the melanoma growth was studied in the main group of animals (n = 42) receiving per os 1,3-diethylbenzimidazolium triiodide in a single dose of 0.4 mg/kg throughout the experiment; the control group (n = 20) received distilled water. The tumor volume and survival of mice were measured. Results: The lowT3/lowT4 syndrome developed in females with transplantable B16/F10 melanoma starting from week 2 of the experiment, diagnosed by decreasing levels of FТ3 and FТ4 by 3 times and lower and normal levels of T3 and T4. In males, melanoma growth caused the thyroid hypofunction expressed in a decrease in the levels of T3 and T4 by 2 times, and FT3 and FT4 by 1.5 times. The latent period prior to the tumor onset was 10-12 days in females and 5-7 days in males. The survival of females was 5-6 weeks, males – 3-4 weeks. The administration of the organic iodine-based preparation extended the latent period in females up to 14-18 days, in males up to 10-14 days; the survival of females increased by 1.8 times, males by 1.5 times. 9% of females in the main group showed complete tumor resorption without relapses throughout their lives. Conclusions: The growth of transplantable B16/F10 melanoma in male and female С57ВL/6 mice was accompanied by suppression of the thyroid function with the development of uncontrolled hypothyroidism in males and the lowT3/lowT4 syndrome in females, which correlates with the survival of animals.

e21557 Background: 10% of cancer patients have comorbidities accompanied by chronic pain. Neurotrophins and fibrinolytic system are involved in carcinogenesis and pain pathogenesis. The purpose of the study was to measure levels of neurotrophins in white matter of the brain of urokinase-deficient (uPA–) mice with B16/F10 melanoma growing in presence of chronic neuropathic pain (CNP). Methods: The study included female mice С57ВL/6 (normal genome uPA+, n = 40) and C57BL/6-Plautm1.1BugThisPlauGFDhu/GFDhu (urokinase gene-knockout uPA–, n = 28) with B16/F10 melanoma (M) implanted subcutaneously 2 weeks after bilateral sciatic nerve ligation (CNP model). Intact mice (I) were controls. Levels of brain-derived neurotrophic factor BDNF, nerve growth factor NGF-β and neurotrophins 3 and 4 (NT3, NT4) were measured by ELISA in white matter of the brain after 3 weeks of tumor growth in presence of CNP. Results: Tumor volume in (uPA–) females by week 3 of carcinogenesis was 0.04 cm3, which was 70 times smaller than in (uPA+) females. Tumor volume in (uPA–) females with CNP was 5.76 cm3, which was 144 times larger than in (uPA–) females without CNP, and in (uPA+) females – 2.5 cm3. The brain of I (uPA–) showed higher levels of NT3 (by 1.3 times, p < 0.05), NT4 (by 2.6 times) and NGF-β (by 1.9 times, p < 0.05) and lower BDNF (by 1.7 times, p < 0.05), compared to I (uPA+). Both strains of mice with M or CNP demonstrated decreased levels of NGF-β, more pronounced in animals with a combination of these factors. (uPA–) females with CNP+M showed a decrease of NT3 and BDNF by 2 times, with NGF-β 2.2 times higher than in (uPA+) mice. Conclusions: The study revealed underlying differences in levels of neurotrophins in the brain of (uPA–) females which could contribute to the creation of conditions for the inhibition of tumor growth. Changes in the levels of NGF-β in mice with melanoma or CNP were nonspecific. Changes in the BDNF, NT3 and NGF-β balance in the brain of (uPA–) mice may be part of the mechanism of greater stimulation of melanoma growth under the influence of CNP.

e22097 Background: Chronic neurogenic pain (CNP) as a comorbid disease is quite frequent, but its effect on malignant diseases is poorly studied. The risk of cutaneous melanoma in women is higher, but the disease course in men is more severe. The purpose of the study was to reveal the effect of CNP on the levels of sex hormones in the blood of patients with melanoma depending on their gender. Methods: Blood levels of estradiol (E2), estrone (E1), progesterone (P4), testosterone (T) and prolactin (PRL) were measured by ELISA in patients with Т3-4NxM0 melanoma (M): 21 women with CNP (pelvic pain - 7, osteochondrosis – 14), mean age 67.2±2.7 years; 17 men with CNP (osteochondrosis), mean age 65.6±3.1 years. The control group included patients with melanoma similar in age, gender and disease stages without CNP. Results: In women with M+CNP, E2 and P4 were decreased by 1.8 times, while E1 was 1.4 times, T – 2 times, PRL – 1.5 times higher, compared to controls. In men with M+CNP, blood levels of estrogens were unchanged, PRL was 2.5 times lower and P4 and T – 1.3 times higher, compared to the corresponding control levels. Conclusions: CNP upregulated blood levels of androgens in both male and female melanoma patients, and caused the inversion of estrogens only in women with the prevalence of E1 over E2. Gender differences in the CNP influence included the elevation of progesterone and a decrease of prolactin in the blood of men, and P4 deficiency with increased prolactin in women with M+CNP. The specific effect of CNP on the hormonal profile in patients with cutaneous melanoma should be considered in choosing antitumor treatment.

OBJECTIVE To investigate the variations in 11C-methionine uptake in the intact brain tissue and in glial brain tumors of different types. MATERIAL AND METHODS Forty patients (21 men, 19 women) with gliomas, Grade I-IV, underwent 11C-methionine PET-CT and contrast-enhanced MRI. Standardized uptake value (SUV), tumor-to-normal (T/N) ratios and tumor volume were analyzed. RESULTS The high inter-subject variability was detected in the intact brain tissue (SUV in the frontal lobe (FL) varies from 0.47 to 1.73). Amino acid metabolism was more active in women than in men (FL SUV 1.32±0.22 and 1.05±0.24, respectively). T/N ratio better differentiates gliomas by the degree of anaplasia compared to SUV. Gliomas of Grade III (T/N=2.64±0.98) were significantly different (p

Aims The aim hereof is to study the cardiovascular system disorders in the early post-castration period in patients with locally advanced cervical cancer and a possibility of correction of such disorders with the low-dose xenon therapy. Materials and methods The study involved 28 female patients of reproductive age (49.8 ± 0.5 years) diagnosed with locally advanced cervical cancer. The main test group consisted of 16 patients, who received the xenon therapy in addition to the main treatment in the early post-castration period. The reference group included 12 female patients without xenon therapy. The cardiovascular system functional state was evaluated with cardiac analyzer Cardiocode at three stages: before surgical intervention, on postsurgery day 3 and upon the completion of the therapy. Results and conclusions Early manifestations of the post-ovariectomy syndrome in the postsurgery period in female patients with locally advanced cervical cancer were accompanied by a disorder in the cardiovascular bio-adaptive and metabolic regulatory mechanisms of the uncompensated distress type, an excess of the phosphocreatine concentration and a decrease in the oxygen level in the myocardium. Upon the completion of the therapy in the reference group patients, changes in the coronary vessels hemodynamics, the dominance of the anaerobic energy exchange in the myocardium, pronounced neurovegetative and psychoemotional disorders have been revealed. The use of the low-dose xenon therapy in the main test group patients has contributed to normalization of myocardial metabolism, recovery of the aerobic energy exchange, and neutralization of neurovegetative and psychoemotional manifestations of the post-ovariectomy syndrome. Thus, the diagnostics of cardiovascular disorders in the early postsurgery period as well as the correction of the disorders and abnormalities with the low-dose xenon therapy are of great importance in the prevention of cardiovascular diseases in oncogynecologic patients with the post-ovariectomy syndrome.

e21036 Background: The high metastatic potential of melanoma and the need for long-term patient monitoring causes the search for tumor markers of this malignant neoplasm. Our aim was a comparative analysis of levels of tumor-specific proteins CD44 and S100 and protein composition in melanocytic lesions of the skin. Methods: We studied 86 samples of cutaneous melanoma and nevus tissues, their perifocal tissues and resection line tissues obtained during tumor excision from 23 patients with cutaneous melanoma pT1-4N0-1M0 and 14 patients with nevi. Intact skin samples obtained from non-cancer patients during reconstructive plastic surgery were used as the comparison group. All patients gave their written informed consent. Levels of CD44 (BenderMedSystems, USA) and S100 (Fujirebio, Sweden) were determined by ELISA in 10% homogenates of all tissues; total protein levels were determined by standard spectrometry and fractional composition of proteins were studied by turbidimetric method. Statistical processing of results was performed using the Statistika 6.0 program with Student’s t-test for two independent groups. Results: Melanoma was characterized by a sharp increase in S100B levels, 28 and 7 times exceeding the levels in intact tissues and nevi. The level of CD44 in melanoma tissue was increased only by 2 times, in nevus tissue - by 48%. The ratio of albumin and gamma globulins in the tissue of melanoma and nevi was 79% and 29% lower than in healthy skin. A more than twofold increase in the gamma globulin fraction in the melanoma tumor tissue against a decrease in albumin and the absence of changes in other globulins, as well as a moderate but statistically significant increase in the gamma globulin fraction in nevi tissue, indicates that S100B and CD44 proteins belong to the gamma globulin fraction. Conclusions: A highly specific increase of S100 levels and a less specific increase of CD44 levels in supernatant liquid of melanoma tissue homogenates, together with the predominance of the gamma globulin fraction, allow considering such factors as a prognostically unfavorable sign of tumor progression, which can be important when choosing a personalized treatment strategy.

Non-compaction of the ventricular myocardium (NCM) is a genetic cardiomyopathy usually due to mutationof the G4.5 gene located in the Xq28 chromosomal region. This congenital disorder is characterized by pronounced trabeculations and intertrabecular recesses resulting from abnormal embryogenesis between the fifth and eighth fetal weeks. The reported prevalence in the general population is between 0.014% and 1.3%. The classic triad of complications includes heart failure, ventricular arrhythmias and systemic embolic events, although some patients have an asymptomatic form. NCM is commonly diagnosed by echocardiography, but contrast ventriculography, CT and MRI can also be used. Here we present a case of left ventricle NCM, manifested after respiratory infection, in a pregnant patient with congenital thrombophilia and a history of myocardial infarction. LEARNING POINTS Non-compaction myocardium (NCM) in pregnant women has been associated with a poor prognosis. We should avoid routinely recommending young women with NCM to refuse pregnancy. A decision to continue pregnancy should be made by the patient in discussion with specialists.

HMG-CoA inhibitors have been widely used in primary and secondary prevention of atherosclerosis for more than 30 years. The evidence base for statins includes dozens of randomized clinical trials (RCT), involving hundreds of thousands patients. According to the results of the latest meta-analyses, reducing low-density lipoprotein cholesterol (LDL-CH) level by 1 mmol/l in statin-treated patients could decrease cardiovascular risk by 0,8 %. Atorvastatin (Liprimar®) is a modern synthetic statin, which has been thoroughly studied in several RCTs over the last 15 years. These trials demonstrated its effectiveness and tolerability in patients with chronic coronary heart disease, acute coronary syndrome (ACS), Type 2 diabetes mellitus, and arterial hypertension. In the studies comparing atorvastatin (10-80 mg/d) to other statins, baseline LDL-CH levels were reduced by 53 % in atorvastatintreated patients. Atorvastatin therapy was also well tolerated. Compared to placebo, atorvastatin therapy in the dose of 10 and 80 mg/d was associated with the incidence of hepatic transaminase elevation of 0,1 % and 0,6 %, respectively. This evidence base (in particular, the results of the trials on 80 mg/d atorvastatin therapy in ACS patients) has been a cornerstone of modern clinical guidelines, recommending target LDL-CH levels of 2 mmol/l. Currently, atorvastatin is the most widely prescribed statin in the majority of both developed and developing countries. Increasing initial dose and prescribing high-dose atorvastatin therapy (40-80 mg/d) could facilitate an improvement in treatment quality and a reduction in high levels of cardiovascular mortality inRussia.

The evidences for statin use in cardiology are presented. Especially hypolipidemic efficacy of atorvastatin is demonstrated in according to comparative studies. Results of clinical studies on atorvastatin efficacy and safety in different groups of patients are also presented.

In human milk we previously found catalytic antibodies (abzymes) catalyzing hydrolysis of DNA, RNA, NMP, NDP, and NTP and also phosphorylation of proteins and lipids. In the present study we have analyzed nuclease activities of antibodies in blood of women during pregnancy and lactation. Blood of healthy male and female volunteers lacked catalytically active antibodies, whereas antibodies from blood of pregnant women hydrolyzed DNA and RNA and their relative activity varied over a wide range. Relative blood abzyme activities significantly increased after delivery and at the beginning of lactation. The highest abzyme activity was observed in blood of parturient women. Although the dynamics of changes in antibody DNase activity during pregnancy was rather individual for each woman, there was a common trend in the increase in antibody activity in the first and/or third trimester of the pregnancy. The DNase activity of IgG and IgM from blood of healthy pregnant women was 4-5 times less than that from pregnant women with pronounced autoimmune thyroiditis.

Safety and efficiency of intracoronary transventricular transplantation of autologous mononuclear bone marrow cells in rats with postinfarction cardiosclerosis were studied. The cells migrated to the damaged area and were detected only in the cicatricial tissue; they have fibroblast-like phenotype and some of them were stained with Fapα (marker of reactive fibroblasts). More active proliferation of non-muscular cells and formation and maturation of collagen fibers in the cicatricial tissue were observed after transplantation of mononuclear cells. This led to thickening of the cicatricial wall, but the size of the scar and index of dilatation of the left ventricle remained unchanged. The number and volume density of newly formed blood vessels in the damaged area increased after transplantation, but no labeled cells were seen in the vascular walls. It can be hypothesized that stimulation of neoangiogenesis is mediated by paracrine mechanisms, which also explains improvement of global contractility of the left ventricle (increased contractility index in functional tests). Thus, transplantation of mononuclear bone marrow cells leads to thickening and strengthening of the cicatricial wall, stimulates angiogenesis, and improves global myocardial contractility. However, no morphological signs of reverse remodeling of the left-ventricular myocardium were revealed.

e20110 Background: Methodological aspects of modern technologies of ultrasound scanning (US) are still relevant in oncosurgery of skin cancer as there is need to clarify some parameters of tumor pr...

e20010 Background: For the study of the pathogenesis of melanoma interest is a comparative study of tumor markers in melanoma tissue early stage and melanocytic nevi. Methods: 40 samples of early s...

Levels of cAMP were decreased and cGMP increased in progressive systemic sclerosis (PSS) fibroblasts compared with normal fibroblasts. PSS cells took up unusually large quantities of Ca++. The epinephrine-induced increases in cAMP were diminished sixfold and epinephrine-induced Ca++ uptake was abnormal in PSS cells. Considerable heterogeneity was observed in rheumatoid arthritis fibroblasts. Membrane-bound abnormalities in (PSS) cells may be of importance in the defective control of collagen production in progressive systemic sclerosis.