Mechanisms of HIV transportation through blood-brain barrier, vascular plexus and interaction with cerebral cells having CD-4-receptors, ССR-5- and CXCR-4-coreceptors were studied. Cerebral damage developed through latent and acute periods also known as HIV-encephalopathy, HIV-associated neurocognitive dysfunction etc. Cerebral lesions are caused by a variety of chemical agents from pro-inflammatory cytokines to toxic HIV-proteins resulting in development of HIV-dementia through several years. Even early stage of this process revealed significant disturbances of glucose metabolism and evoked potentials EEG alterations which can serve as a marker of HIV-infection. Genetic differences of HIV in blood and spinal liquor with different drug resistance were revealed implying a new approach to therapy development.
Методика оценки клинических рекомендаций Классы данных/доказательств и уровни рекомендаций применены в соответствии с критериями доказательной медицины, одобренными Американской ассоциацией нейрохирургов (The American Association of Neurological Surgeons/AANS). Классы данных основаны на оценке дизайна исследований, а уровень рекомендаций-на качестве исследований и консенсусе мнений экспертов [1]. (табл. 1). 1. Категории пациентов, к которым относятся данные рекомендации Данные рекомендации относятся к взрослым пациентам с впервые выявленным очаговым метастатическим поражением головного мозга без лептоменингеального и пахименингеального поражения. Рекомендации не распространяются на пациентов с высокочувствительными к химиотерапии и лучевому лечению опухолями: лейкоз, лимфома, герминогенные опухоли. 2. Общие вопросы Частота метастатического поражения головного мозга неуклонно растет. По самым скромным оценкам, у 8-10% больных злокачественными опухоля
The results of an 11-year clinical observation and treatment of a patient with stage II basal cell carcinoma of the face (Т2N0M0) are presented. History of the illness is associated with a long (from 2001 to 2008) inadequate treatment, due to the incorrect diagnosis. After the proper diagnosis was established, from 2008 to 2019 at the Center for Laser and Photodynamic Diagnostics and Tumor Therapy of P.A. Herzen Moscow Oncology Research Center, the patient underwent organ-preserving treatment using the multi-course photodynamic therapy (PDT) and drug targeted therapy. In total, 23 courses of PDT were conducted with photosensitizers of the chlorin series and 5-aminolevulinic acid during this period. Since 2018, the patient is in the process of targeted drug treatment with Vismodegib. In the course of targeted drug treatment, a follow-up examination in 2019 revealed continued growth of the residual tumor, and another course of PDT was carried out. Throughout the observation period, the patient tolerated the treatment well, without complications, with a good quality of life and satisfactory cosmetic effect.
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