РезюмеВ последние годы во всем мире наблюдается рост заболеваемости раком молочной железы (РМЖ), причем в 20% случаев при РМЖ происходит развитие внутрикожных метастазов. Возможности хирургического и лучевого лечения внутрикожных метастазов РМЖ достаточно ограничены, а эффективность полихимиотерапии с применением стандартных схем не превышает 22-27%, при этом срок ремиссии, как правило, составляет лишь 2-3 мес. Фотодинамическая терапия (ФДТ) является перспективным методом лечения внутрикожных метастазов РМЖ. Опыт применения ФДТ при данной нозологии достаточно ограничен, но полученные результаты демонстрируют его высокую эффективность и безопасность. Так, несколько российских исследований посвящены оценке эффективности ФДТ внутрикожных метастазов РМЖ с фотосенсибилизатором хлоринового ряда фотолон. По данным авторов, лечебный эффект был достигнут у 85-97% пациенток (доля пациенток с полным и частичным эффектом составляла 73-85%). Исследования эффективности ФДТ у пациенток с такой же нозологией с использованием фотосенсибилизатора фотосенс демонстрируют несколько меньшую эффективность -лечебный эффект был достигнут в 81,8% наблюдений, при этом доля пациенток с полным и частичным эффектом составляла только около 50%. За рубежом проведен ряд исследований на моделях метастазирующего РМЖ с использованием новых фотосенсибилизаторов (например, синопорфирина натрия) и новых комбинированных схем ФДТ (например, адъювантная ФДТ с 5-фторурацилом или капецитабином). Полученные результаты демонстрируют перспективность новых подходов: ФДТ с синопорфирином натрия ингибировала рост как самой опухоли, так и ее метастазов; применение адъювантных схем привело к повышению дифференцировки опухолевых клеток у животной модели, прекращению роста опухоли, а также метастатических очагов.Ключевые слова: рак молочной железы, кожные метастазы, фотодинамическая терапия, фотосенсибилизатор, фотохимическая реакция.Для цитирования: Рахимжанова Р.И., Шаназаров Н.А., Туржанова Д.Е. Фотодинамическая терапия внутрикожных метастазов рака молочной железы // Biomedical Photonics. AbstractIn recent years, an increase in the incidence of breast cancer has been observed throughout the world, and in 20% of cases, with the development of intradermal metastases. The possibilities of surgical and radiation treatment of intradermal breast metastases are quite limited, and the effectiveness of polychemotherapy using standard regimens does not exceed 22-27%, while the period of remission, in general, is only 2-3 months. Photodynamic therapy (PDT) is a promising treatment for intradermal metastases of breast cancer. The experience of using PDT in this nosology is quite limited, but the results show its high efficiency and safety. Thus, several Russian studies are devoted to assessing the effectiveness of PDT of intradermal breast metastases with Photolon, a chlorin series photosensitizer. According to the authors, the therapeutic effect was achieved in 85-97% of patients (the percentage of patients with full and partial effect was 73-85%). Studies on the effectiven...

The ambiguity of the X-ray picture and clinic in patients with coronavirus infection (CVI) was the reason for this analysis in order to avoid diagnostic errors and to achieve the effect of the treatment. Conducted a comparative description of three clinical cases of patients with coronavirus infection COVID-19. All three patients differed in different parameters of SARS Co-2 PCR. In the first two patients who underwent CT on the 7th and 10th days from the onset of the disease on control CT after treatment, a regressive positive dynamics was observed; in the third patient, after an early CT scan on the second day of illness and on the next CT scan performed on the 10th day after the appearance of the clinic and a positive PCR test, progression of signs of viral pneumonia was observed with an increase in the affected area. Thus, the earlier CT was performed, the less pronounced the changes in the CT picture (the lesion volume is up to 5% or no changes are detected). When performing CT scan, patients with a long-term clinic (7-10 days from the onset of the disease) showed a characteristic picture of lung damage - up to 25-30%. The analysis of CT scans performed in the described clinical cases at different times from the onset of the disease, regardless of the results of PCR, confirms the need for CT scans 5-7 days after the first clinical signs appear. Also, as a result of our work, we once again received confirmation from numerous studies conducted in the world on the absence of a correlation between SARS Co-2 PCR and CT data.

<b>Objective: </b>Atrial fibrillation is strongly associated with stroke and accounts for 60% of cardioembolic stroke. Assessing thromboembolic risk is important for patients with atrial fibrillation. Approximately 90% of all thrombus are localized in the left atrium appendage (LAA). This study aimed to determine the efficacy of cardiac computed tomography (CT) for LAA thrombus detection.<br /> <b>Material and methods:</b> This retrospective study included 292 patients. LAA thrombus was confirmed or excluded by cardiac CT with the reference to transesophageal echocardiography (TEE). We excluded patients with allergic reactions to iodide, increased creatinine levels, thyroid disease (hyperthyroidism), pregnancy, and age &lt;18 years.<br /> <b>Results:</b> According to the cardiac CT, 103 of 292 people had LAA thrombus, while according to TEE, only 48 of patients had LAA thrombus. The sensitivity and specificity of CT were 97.7% and 77%, respectively. The sensitivity and specificity of the CT was higher in 2016–2020, when the delayed phase was added to the standard protocol, compared to 2012–2015 years. Older age, higher BMI, higher CHA₂DS₂-VASc and HAS-BLED scores, and larger LA and LVESV were significantly associated with LAA thrombus detection on cardiac CT. Higher LVESV and LVEDV indexes (LVESVI and LVEDVI) and lower LV ejection fraction measured by TEE were also predictors of LAA thrombus detection by cardiac CT.<br /> <b>Conclusion:</b> Our findings show that cardiac CT has high sensitivity and specificity for excluding or confirming LAA thrombus, and can also be exclusively used to determine the presence or absence of a thrombus.

The purpose of this research is the use 5 stages of standardized methodology of compression elastography based on a preliminary assessment of gray-scale images, qualitative and semi-quantitative elastography. The authors give comparative characteristics of diagnostic efficiency and reproducibility standard data and propose the elastography in 3419 people with focal lesions of the breast, thyroid, regional lymph nodes, pancreas. The article presents the ways of nationwide discussion of standardized recommendations for compression elastography. Analysis of the data shows the advantage of the proposed standardized methodology of compression elastography. The evaluation of diagnostic and prognostic values of routine and standardized methods sonoelastography was carried out. Statistics are distributed as follows: in a routine method, the specificity is 90.3%, the sensitivity is estimated at 82.4%, the accuracy - 86,7%, AUC is equal 0,892 with 95% confidence interval [0,872 – 0,974]. In a standardized method, the specificity is 93.8%, the sensitivity is 84.7%, the accuracy – 88.5%, AUC is 0,938 with 95% confidence interval [0,889 – 0,981]. The non-specificity of the standardized compression sonoelastography method allows its use in any pathology of internal organs and tissues. Strict adherence to the stages of the standardized elastography contributes to the formation of a precise protocol elastographic examination.

The aim of the study was to determine the risk group for detecting early signs of thrombus formation in the veins of the lower extremities during preventive ultrasound examination in patients with COVID-19.Materials and methods: The study included three groups of patients who were in intensive care units for COVID-19, of which 50 with acute venous thrombosis, 50 with venostasis in the veins of the lower extremities, and 50 patients without vein pathology, which constituted the control group. All patients were determined the level of D-dimer, fibrinogen and underwent duplex ultrasound scanning examination of the veins of the lower extremities.Results: A close correlation was established between the presence of venous thrombosis and the levels of D-dimer and fibrinogen (2.33, 4.66, p=0.0001). According to the data obtained, in the examined patients values >=2.33 µg/ml for D-dimer is a sign of thrombus formation with 87.76% sensitivity and 97% specificity. For fibrinogen values 0. >=4.64 g/L are indicative of thrombus formation with 83.67% sensitivity and 83.00% specificity. The two studied parameters D-dimer (AUC area = 0.9458) and fibrinogen (AUC area = 0.9024) were a very high-quality classifier model. Conclusion:The results of this study make it possible to form risk groups for the development of deep vein thrombosis (DVT) and to carry out timely prevention of this pathology. In patients with COVID-19 with severe respiratory failure and elevated levels of D-dimer (more than 2.33 mg/l) and fibrinogen (more than 4.64 g/l) duplex ultrasound is indicated.