Background Cisplatin, mitomycin C and anthracyclines demonstrate high activity in BRCA1-deficient tumors. This study aimed to evaluate the efficacy of the triplet combination of these drugs in BRCA1-driven high-grade serous ovarian carcinomas (HGSOCs). Methods Ten HGSOC patients with germ-line BRCA1 mutation received neoadjuvant chemotherapy (NACT) consisting of mitomycin C 10 mg/m2 (day 1), doxorubicin 30 mg/m2 (days 1 and 8) and cisplatin 80 mg/m2 (day 1), given every 4 weeks (MAP regimen). The comparator group included 16 women, who received standard NACT combination of paclitaxel 175 mg/m2 and carboplatin (6 AUC), given every 3 weeks (TCbP scheme). Results None of the patients treated by the MAP scheme demonstrated complete pathologic response in ovaries, while 4 women showed absence of tumor cells in surgically excised omental specimens. When chemotherapy response scores (CRS) were considered, poor responsiveness (CRS 1) was not observed in the MAP group, but was common for the TCbP regimen (6/16 (38 %) for ovaries and 5/16 (31 %) for omentum; p = 0.05 and 0.12, respectively). Median treatment-free interval (TFI) was not reached in women treated by the MAP, but was 9.5 months for the TCbP scheme (p = 0.1). The rate of the recurrence within 1 year after the completion of the treatment was 4/10 (40 %) for the MAP and 10/13 (77 %) for the TCbP (p = 0.1). Conclusions The attempt to intensify NACT by administering combination of 3 drugs did not result in high rate of complete pathologic responses. However, there was a trend towards higher efficacy of the MAP regimen versus conventional TCbP scheme with regard to CRS and clinical outcomes.

In experienced hands thoracic surgery yields excellent results for children suffering from pleural empyema stage II and III. Recent randomised prospective trials comparing fibrinolysis with VATS do not convince regarding the treatment protocols of their surgical arms. Fibrinolysis is nevertheless a valuable treatment in early stage II empyema, especially if thoracic surgical experience is not available. However, the further advanced the empyema presents, the sooner surgical experience should be gathered.

The effects of dexamethasone on the actions of histamine on isolated tissue and large bronchus preparations and the interactions of these substances with intramural neural structures were studied. Low histamine concentrations (10(-12)-10(-8) g/ml) decreased muscle responses induced by stimulation of preganglionic nerve fibers, while high concentrations (10(-7)-10(-4) g/ml) increased these responses. Dexamethasone at concentrations of 10(-7)-10(-6) g/ml decreased muscle responses, while concentrations of 10(-5)-10(-6) g/ml produced biphasic changes in responses. Dexamethasone decreased the effects of histamine at high concentrations. Atropine eliminated the effects of simultaneous application of histamine and dexamethasone on respiratory tract preparations; hexamethonium blocked the effects of substances associated with decreased responses and had virtually no effect on those potentiating responses. Novocaine eliminated the actions of histamine at low and high concentrations and the dilatory effect of dexamethasone. These experimental results led to the conclusion that changes in the responses of muscles from the rat respiratory tract induced by stimulation of preganglionic nerve fibers were modified by low concentrations of histamine and dexamethasone and that these modifications were associated with interactions of these substances with tracheobronchial receptors.

The number of healthcare workers is over two million in Russia. Many of them are exposed to hazardous physical, chemical and biological occupational factors acting along with psychological strain. The results of large epidemiological studies carried out in various countries revealed greater cancer risk in physicians and nurses: cancer of the breast, skin, brain and other sites. Higher cancer risk of lung, breast, uterine, ovary, brain is considered to be associated with ionizing radiation. The female healthcare workers who handle antineoplastic drugs showed a greater risk of birth defects in offspring, spontaneous abortions and breast cancer. In Russia, the growing number of accidents among healthcare workers following transmission of infection by carcinogenic biological factors such as HBV and HIV is observed. Higher risk of reproductive impairments, hyperplasia of the breast and uterine tissues, breast cancer are revealed in nurses working the night shift. In Russia, there is lack of epidemiological studies of cancer risk among healthcare workers, the number of medical personal exposed to occupational carcinogens is unknown. That all does not show the actual situation in our country and does not allow setting priorities in cancer prevention among medical workers.

The authors give historical reference to the first documentary descriptions of the clinical, radiological, microscopic images of altered bones characteristic of such a rare disease as fibrous dysplasia (FD). FD is caused by a congenital mutation of the GNAS1 gene, which leads to the formation of a fibrous disorganized bone matrix with primitive bone tissue that is not able to mature into lamellar bones. Monossal, polyossal forms of FD are distinguished, as well as multiple bone damage with pigmentation and endocrine abnormalities. In FD, skull bones are usually affected (in order of decreasing frequency): frontal, sphenoid, ethmoid, parietal, temporal and occipital bones. An enlargement in the size of the temporal bone leads to the development of stenosis of the external auditory canal, which is clinically manifested by bleeding from the ear, conductive hearing loss, as well as the development of cholesteratoma. A clinical case of a patient with bilateral localization of temporal bone FD and unilateral clinical manifestation on the left (stenosis of the external auditory canal and secondary cholesteatoma) is presented. At the age of 18, the patient was operated on for the exostosis of the auditory canal in the ENT department of the city hospital, which did not prevent further progression of the disease. After 10 years, the subtotal stenosis of the left auditory canal again developed, which was the reason for the re-operation. The patient underwent surgical treatment followed by dynamic observation and computed tomography of temporal bones for 10 years.