The operation of the oncological services of the Russian Federation were complicated by the spread of the Severe Acute Respiratory Syndrome CoronaVirus-2, which worsened the diagnosis of lung cancer and led to the reorientation of medical institutions to the anti-epidemic mode.The aim. To evaluate the features of providing medical care for lung cancer to residents of the Magadan Region during the pandemic of COronaVIrus Disease-19 (COVID-19).Methods. The analysis of the Magadan Region database on patients with lung cancer was carried out. The databased is filled in with the information from state statistical reporting forms No.7 and No.35. General problems of the Magadan Region healthcare system were identified using materials of publications from the Medline, CrossRef, Pubmed and Scopus databases for 2019 – 2021; the potential solutions were also suggested.Results. The analysis of the incidence of malignant neoplasms in 2014 – 2020 yy. showed that lung tumors are in the lead among Magadan Region residents. The “rough” incidence rate of lung cancer in 2019 (58.8 per 100,000 inhabitants an increase from 2009 +20.74%) and the relative proportion of these tumors detected in 2020 in localized stages are ahead of the average values for the Russian Federation. In 2018 – 2021, the indicator of morphological verification of lung cancer and the proportion of advanced tumors continued to increase, but the one-year mortality rate was decreasing. In 2021, 10.3% of the residents of Magadan Region had low-dose computed tomography (CT) of the chest organs. 10 (1.8%) cases of lung cancer were detected. Localized lung cancer was detected in 32.5% of those cases (2020 – 24.5%, 2019 – 20.3%). The spread of the coronavirus infection has complicated work of the staff of the Magadan Region oncology service: remote medical consultations for patients living far from the regional center (Magadan) are to be developed. Insufficient number of low-dose CT machines in the medical institutions, understaffing in health facilities, insufficient use of chemotherapy in the treatment of patients with lung cancer, as well as problems of palliative care for patients with advanced stages of the tumor were identified.Conclusion. The main problems of the oncological service of the Magadan Region are the shortage of personnel, lack of equipment and the lack of a single information field in the medical institutions. These problems of specialized medical care for patients with lung cancer will have to be solved by the regional Ministry of Health, scientific schools, and universities.
Introduction. Symptoms of lower urinary tract dysfunction (LUTS) in older men are most often associated with benign prostatic hyperplasia (BPH). A low level of testosterone leads to various changes in the organs and systems of the body, including causing structural changes in the tissues of the genitourinary system, which negatively affects their function. The aim of this work was to study the effect of testosterone replacement therapy on LUTS with androgen deficiency in patients after surgical treatment of BPH. Materials and methods. The analysis of observation and treatment of LUTS in 101 patients operated on for BPH was performed. The patients are divided into three groups. Group A (n=48) included patients with normal testosterone levels receiving conservative therapy for moderate LUTS. Groups B (n=38) and C (n=21) included patients with SNIP and low testosterone levels. In order to correct the level of testosterone in patients in group C, after surgical treatment, androgen replacement therapy was prescribed. For primary diagnosis and evaluation of the effectiveness of the treatment vinitial and during periods of 1, 3, 6 and 12 months, general clinical examination methods, the International Pancreatic Symptom Scale (IPSS) questionnaire, urination diaries (DM), uroflowmetry, and ultrasound examination of the pancreas and bladder were used. Results. According to the IPSS questionnaire, patients in group B had more pronounced manifestations of LUTS compared with patients in groups A and C due to accumulation symptoms. At the same time, by prescribing androgen replacement therapy, it was possible to achieve an increase in the level of total testosterone in patients of group C to «physiological values», corresponding to patients in group A. According to the results of the analysis of DM data, it was found that in patients in all observation groups, the number of urination per day decreased (p<0.001) with an increase in the functional capacity of the bladder. The highest values of the maximum micturition volume, at the end of the observation period, were recorded in patients in group A, the minimum micturition volume and the most pronounced decrease in episodes of nocturia and nocturia index – in patients in group C. Temporal values of the accumulative bladder function also indicate a more pronounced decrease LUTS in group C. Conclusions. The use of androgen replacement therapy increases the effectiveness of LUTS treatment in patients with androgen deficiency after surgical treatment of BPH.
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