No abstract

The analysis of the current evidence base concerning the use of oral nutritional supplements (ONS) in gastric cancer (GC) has been made. Databases of scientific information eLIBRARY.ru and PubMed were used. Emphasis is placed on randomized clinical trials and meta‑analyses. The application of ONS is suggested for all patients who undergo to surgical treatment for GC. Its use allows increasing protein and energy consumption, improving the quality of life, some parameters of nutritional status and immunity (albumin, blood lymphocytes etc.). In patients with severe malnutrition (SM) ONS can significantly reduce the incidence of clinically important postoperative complications. The use of this type of medical nutrition in the first 5 days after surgery is safe and does not increase the rate of anastomotic leak. After gastrectomy (GE) its administration reduces the time of recovery of bowel motor function and the duration of hospitalization. After distal GE delay of gastric emptying may occur. In patients with SM, early start of enteral nutrition should be considered. After discharge from the hospital ONS can decelerate the progression of malnutrition, improve the tolerance of adjuvant chemotherapy and improve the quality of life. These effects are most clear after GE and in patients with a high risk of malnutrition (NRS‑2002 ≥ 3). There are no evident advantages of any particular type of ONS in patients with GC. When choosing a specific product, preference should be given to formulas with optimal nitrogen: non‑protein kilocalories ratio, osmolarity closest to physiological and individually selected organoleptic properties. It is recommended that the patient consume at least 200–250 ml of the mixture per day, and in the early postoperative period focus have to be made not on the target volume, but on signs of tolerability.

No abstract

Purpose: To evaluate the use of prostatic artery embolization (PAE) as a treatment option for patients with symptomatic benign prostatic hyperplasia (BPH) with prostate volumes of 80 cc and more. Materials and Methods: The study included 75 patients with high anesthesia-related risks for conventional surgery (TURP). All patients were surveyed for symptom burden, using IPSS and quality of life score. The prostate volume was determined by transrectal ultrasonography (TRUS). At baseline, prostate-specific antigen (PSA) level was obtained in all patients. Urodynamics was evaluated using uroflowmetry. Clinical outcomes were assessed at follow-up 1, 3, 6, 12, and 24 months after PAE. Results: The prostate volume decreased significantly at months 1 and 3 post-treatment; the prostate continued shrinking until month 12, and the size was then stabilized. At month 24, prostate volume decreased by 40.82%, from 134.0 ± 8.3 mL at baseline to 79.3 ± 6.6 mL. Postvoid residual (PVR) urine volume was significantly decreased from 55.9 ± 5.3 mL to 22.0 ± 1.8 mL 1 month after PAE ( p < 0.001). Qmax increased from 9.2 ± 0.3 mL/s to 15.7 ± 0.4 mL/s. IPSS score following PAE decreased from 28.2 ± 0.7 to 9.7 ± 0.8 ( p < 0.001). QoL improvement was observed from 4.8 ± 0.2 at baseline to 1.8 ± 0.2 at month 24 ( p < 0.001). Decreased activity and density of adenomatous tissue resulted in decreased total PSA levels: from 5.9 ± 1.1 ng/mL to 2.6 ± 0.2 ng/mL ( p < 0.001). TURP became feasible in 35 patients due to reduction of prostate volumes below 80 mL after PAE. Conclusions: PAE was effective in relieving LUTS and reducing prostate size, and may be considered as a preoperative approach for patients with large prostate.