Aim. To analyze the factors associated with a poor outcome of pulmonary thromboendarterectomy (PTE) and complications of the hospital postoperative period; on the basis of this analysis to optimize preoperative preparation and therapeutic support of the operation. Materials and methods. The study included 47 patients with operable CTEPH, who underwent PTE in the Department of cardiovascular surgery of the national medical research center of cardiology from 2010 to 2018. Patients were observed during the intrahospital period, all were evaluated for clinical, instrumental, hemodynamic, and laboratory parameters. Diagnosis and treatment of complications, assessment of the relationship of factors associated with the development of these pathological conditions were carried out. Results. A comprehensive assessment of the parameters revealed that age over 50 years, the presence of proven antiphospholipid syndrome (AFS) were independently associated with a higher frequency of adverse surgical outcomes and in-hospital complications. Older age and a history of smoking were independently associated with a greater likelihood of developing reperfusion pulmonary edema. The probability of developing transient neurological complications is independently associated with a long duration of deep hypothermic circulatory arrest (DHCA), an increased level of D-dimer. A greater age and longer duration of ventilation are independently associated with the likelihood of developing acute kidney injury (AKI). A higher level of antithrombin III and the presence of AFS were independently associated with the likelihood of developing prolonged ventilation. Conclusion. When selecting candidates for surgery, in addition to the generally accepted clinical and instrumental parameters, it is necessary to take into account a history of Smoking, an increase in d-dimer, and the presence of AFS. Patients with this pathology need a more thorough risk assessment, correction of target levels of activated partial thromboplastin time (aPTT), activated clotting time (ACT) due to their falsely inflated indicators, and further development of standards for perioperative support. The main principle of cardiological support of the operation is the earliest possible diagnosis of all known perioperative complications and the rapid start of their treatment, which ensures the stabilization of the patient’s condition in 85% of cases in the hospital period. In the postoperative period, an early transition from ventilator to independent breathing is indicated for the prevention of associated complications, including AKI.
Current methos of treatment of oncological pathology significantly increase survival rates and patients’ lifespan. However, treatment of malignant tumors leads to development of adverse reactions decreasing its effectiveness and negatively affecting quality of life and survival. It was shown that short- and long-term cardiovascular complications significantly affect the results of therapy.The article presents data on current scientific research in cardio-oncology touching on the problems of cardiotoxicity, concomitant cardiological disorders in oncological patients, cardiac rehabilitation, and patients’ quality of life. The importance of multidisciplinary approach in the context of reducing the risk of cardiovascular complications is demonstrated.
Introduction. The article presents the results of validation of the Russian language version of the fatigue (FA12) module of the specialized Quality of Life Questionnaire – Core 30 (QLQ-C30) developed by the Study Group of Quality of Life of the European Organization for Research and Treatment Cancer (EORTC). The questionnaire has been successfully applied in Russian and international trials.Materials and methods. A sample of 55 patients (mean age 53.23± 2.01 years; 52.7 % men and 47.3 % women) at the N.N. Blokhin National Medical Research Center of Oncology was used to perform psychometric review of the fatigue module (FA12) of the QLQ-C30 questionnaire which confirmed its convergent validity and reliability – consistency (Cronbach coefficient α is 0.768).Results. The results of factor analysis confirmed adequacy of the structure of the Russian version of the fatigue module and its conformity with the basic factor model.Conclusion. The obtained results allow to state that the Russian version of the fatigue module is a reliable and valid instrument which can be used both in national and cross-cultural trials.
The article is devoted to summarizing the authors’ experience in the development of Russian-language versions of foreign quality of life questionnaires for cancer patients as well as their own questionnaires for studying various aspects of the quality of life in bone and soft tissue tumors of the musculoskeletal system. We briefly presented the results of the validation and testing of the modules of the «Cancer Quality of Life Questionnaire - Core 30» (EORTC QLQ-C30) developed by the Quality of Life Assessment Group at the European Organization for Research and Treatment of Cancer (EORTC) – «Fatigue» module (FA12), «Spiritual wellbeing» module (SWB32), «Bone Metastases» module (BM22), as well as the specialized Spine Oncology Study Group Outcomes Questionnaire (SOSG-OQ). We also presented the diagnostic tools developed by the authors’ themselves for studying the quality of life of patients with pelvic bone tumors and lower limb amputations due to cancer. The main objective of the article was to inform the scientific community, as well as practicing psycho-oncologists and oncologists about the existence of new diagnostic tools for assessing the quality of life of cancer patients. The article also outlines the prospects for development of diagnostic tools for quality of life of cancer patients.
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