O45 OUTCOMES OF INCISIONAL HERNIA REPAIR SURGERY AFTER MULTIPLE RE-RECURRENCES: A PROPENSITY SCORE MATCHED ANALYSIS

Aim Patients with a re-recurrent hernia may account for up to 20% of all incisional hernia (IH) patients. IH repair in this population may be complex due to an altered anatomical and biological situation as a result of previous procedures and outcomes of IH repair in this population have not been thoroughly assessed. This study aims to assess outcomes of IH repair by dedicated hernia surgeons in patients who have already had two or more re-recurrences. Material and Methods A propensity score matched analysis was performed using a registry-based, prospective cohort. Patients who underwent IH repair after ≥ 2 re-recurrences operated between 2011 and 2018 and who fulfilled 1 year follow-up visit were included. Patients with similar follow-up who underwent primary IH repair were propensity score matched (1:3) and served as control group. Patient baseline characteristics, surgical and functional outcomes were analyzed and compared between both groups. Results Seventy-three patients operated on after ≥ 2 IH re-recurrences were matched to 219 patients undergoing primary IH repair. After propensity score matching, no significant differences in patient baseline characteristics were present between groups. The incidence of re-recurrence was similar between groups (≥ 2 re-recurrences: 25% versus control 24%, p = 0.811). The incidence of complications, as well as long-term pain, was similar between both groups. Conclusions IH repair in patients who have experienced multiple re-recurrences results in outcomes comparable to patients operated for a primary IH with a similar risk profile. Further surgery in patients who have already experienced multiple hernia re-recurrences is justifiable when performed by a dedicated hernia surgeon.

Fracture Healing Research—Shift towards In Vitro Modeling?

Fractures are one of the most frequently occurring traumatic events worldwide. Approximately 10% of fractures lead to bone healing disorders, resulting in strain for affected patients and enormous costs for society. In order to shed light into underlying mechanisms of bone regeneration (habitual or disturbed), and to develop new therapeutic strategies, various in vivo, ex vivo and in vitro models can be applied. Undeniably, in vivo models include the systemic and biological situation. However, transferability towards the human patient along with ethical concerns regarding in vivo models have to be considered. Fostered by enormous technical improvements, such as bioreactors, on-a-chip-technologies and bone tissue engineering, sophisticated in vitro models are of rising interest. These models offer the possibility to use human cells from individual donors, complex cell systems and 3D models, therefore bridging the transferability gap, providing a platform for the introduction of personalized precision medicine and finally sparing animals. Facing diverse processes during fracture healing and thus various scientific opportunities, the reliability of results oftentimes depends on the choice of an appropriate model. Hence, we here focus on categorizing available models with respect to the requirements of the scientific approach.

Outcomes of Incisional Hernia Repair Surgery After Multiple Re-recurrences: A Propensity Score Matched Analysis

Background Patients with a re-recurrent hernia may account for up to 20% of all incisional hernia (IH) patients. IH repair in this population may be complex due to an altered anatomical and biological situation as a result of previous procedures and outcomes of IH repair in this population have not been thoroughly assessed. This study aims to assess outcomes of IH repair by dedicated hernia surgeons in patients who have already had two or more re-recurrences. Methods A propensity score matched analysis was performed using a registry-based, prospective cohort. Patients who underwent IH repair after ≥ 2 re-recurrences operated between 2011 and 2018 and who fulfilled 1 year follow-up visit were included. Patients with similar follow-up who underwent primary IH repair were propensity score matched (1:3) and served as control group. Patient baseline characteristics, surgical and functional outcomes were analyzed and compared between both groups. Results Seventy-three patients operated on after ≥ 2 IH re-recurrences were matched to 219 patients undergoing primary IH repair. After propensity score matching, no significant differences in patient baseline characteristics were present between groups. The incidence of re-recurrence was similar between groups (≥ 2 re-recurrences: 25% versus control 24%, p = 0.811). The incidence of complications, as well as long-term pain, was similar between both groups. Conclusion IH repair in patients who have experienced multiple re-recurrences results in outcomes comparable to patients operated for a primary IH with a similar risk profile. Further surgery in patients who have already experienced multiple hernia re-recurrences is justifiable when performed by a dedicated hernia surgeon.

Environmental, Biological, Social Security: An Organizational and Legal Aspect

The paper is devoted to the analysis of current trends and prospects of development of legislation of the Russian Federation in the area of environmental, biological and social safety. Based on the results of the study of mechanisms of operation of modern legal systems in the context of increasing exponential threats and risks, the authors carry out the general evaluation of the ability of emergency situations legislation to respond to contemporary challenges. The paper also identifies factors that could have a decisive impact on the formation of new environmental and biological security.The author substantiates that, since any extreme environmental and biological situation is sudden, rapid, and it rapidly transforms from local to global, the emergency legislation should be as specific, clear, logical as possible, consistent with the goals and objectives of prevention of harm to life and health. In this regard, it should be revised primarily from the perspective of notions, variability of consequences, establishment of causality, description of basic solutions and responsibility. It is fundamentally necessary to change the paradigm from the elimination of accidents, disasters, fires and other man-made accidents to the presentation of emergencies as a systemic crisis of management and law. Special acts should clarify the criteria for “danger” and “safety”, taking into account socio-economic and environmental consequences, the competence of the authorities, security provision economy, permissible risks and losses, mechanisms and protocols for the operation of the entire state and public machinery in emergencies.In addition, the law-maker should adopt the legislation regulating the health system, which must have sufficient reserves of capacity and resources for emergencies, the legislation regulating financial reserves for the establishment of special accounts and emergency financing mechanisms, as well as information legislation regulating emergency situations.

EFFICIENCY OF VARIOUS METHODS FOR MANAGING THE CROP YIELD OF BAY MEADOWS IN THE KOMI REPUBLIC

Natural hayfields in floodplain meadows are seen as a source of high quality forage for animal husbandry. Due to annual silt and plant seed load, these agrocenoses are able to support themselves and self-repair. However, intensive use depletes them. Thus, the average hay yield decreses from 3.5-4.0 to 1.2-1.5 t/ha. The return of some elements of mineral nutrition, as well as the use of various microfertilizers and growth stimulators should bring the yield of floodplain meadows back to the level of natural biological situation. Sysola and Vycheda vareties with application of mineral fertilizers (R45К45+N30 and R45К45), two types of microfertilizers (boron and molybdenum), three growth stimulators (Verva, Epin-extra, Gumat) and two specimens on the basis of pectin polysaccharides with stimulating effect (PAo and HSw) were developed at the Institute of Biotechnologies in Agriculture of Komi FIC NTs UD RAS (Komi Republic, Syktyvkar) and tested in floodplain meadows of the river. The authors explored various combinations of these options. The experiment was conducted at three pilot sites in 2008-2010; 2013-2015 and 2016-2018. As a result of the research, it was found out that floodplain meadows intensively used as hayfields are most in need of replenishment with phosphorus and potassium. Application of various microelements and growth stimulators in the pure form increased yields by 30-40 % with a comparable energy coefficient and lower energy intensity of feed. The most effective method was the variant with application of Verva specimen together with the full dose of mineral fertilizers. This method increased the yield by 2 times, provided the maximum yield of forage units - 1.5-2.3 thousand / ha. At the same time, the energy intensity of forage was 20% lower than in the control variant.

A Mixture of Phenolic Metabolites of Quercetin Can Decrease Elevated Blood Pressure of Spontaneously Hypertensive Rats Even in Low Doses

Quercetin is proven to decrease arterial blood pressure when given orally. Its bioavailability is, however, low and, therefore, its metabolites could rather be responsible for this effect. In particular, the colonic metabolites of quercetin, 3,4-dihydroxyphenylacetic acid (DHPA), 4-methylcatechol (4MC), and 3-(3-hydroxyphenyl)propionic acid (3HPPA), have been previously shown to decrease the blood pressure in spontaneously hypertensive rats (SHR). Interestingly, the mechanisms of action of these three metabolites are different. The aim of this study is hence to investigate if these metabolites can potentiate each other and thus decrease blood pressure in reduced doses. Three double-combinations of previously mentioned metabolites were administered to SHR as infusions to mimic a real biological situation. All combinations significantly decreased the blood pressure in SHR but there were important differences. The effect of DHPA and 4MC was mild and very short. A combination of DHPA with 3HPPA caused more pronounced effects, which were also rather short-lived. The last combination of 3HPPA and 4MC caused a long-lasting effect. In conclusion, certain combinations of quercetin metabolites have a more pronounced antihypertensive effect than single metabolites.

About ensuring radiation, chemical and biological safety during mass action

Relevance. The risks of emergency situations during mass events require the coordination of activities of respective structures and departments of the host country.Intention. Assessment of ensuring radiation, chemical and biological safety during the 2018 FIFA World Cup matches and the 2017 FIFA Confederations Cup in Kazan on the example of the Department of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) in the Republic of Tatarstan, as well as the effectiveness of the forces and assets involved.Methodology. A retrospective analysis of interdepartmental cooperation and organization of control of the radiation, chemical and biological situation with the forces of Department of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) in the Republic of Tatarstan, the Ministry of Defense of the Russian Federation, the Ministry of Emergency Situations of the Republic of Tatarstan, performing safety tasks before and during the 2018 FIFA World Cup matches and the FIFA Confederations Cup 2017 in Kazan from 2015 to 2018.Results and Discussion. Before the 2018 FIFA World Cup and the 2017 FIFA Confederations Cup in Kazan, industrial and infrastructure facilities were identified, which malfunction could jeopardize radiation, chemical and biological safety during the events. Organizational events were held for these facilities. Potentially dangerous processes were temporarily suspended. Laboratory and instrumental studies were conducted at the stage of reconstruction of the involved objects. During the 2018 FIFA World Cup matches and the 2017 FIFA Confederations Cup in Kazan, a two-level radiation, chemical and biological control system was organized. Interdepartmental interaction and interchange of information at the subject level in the field of radiation, chemical and biological safety was organized. During the 2018 FIFA World Cup matches and the 2017 FIFA Confederations Cup in Kazan, the radiation, chemical and biological situation was intensively monitored. Task forces were on duty for radiation, chemical and biological emergencies.Conclusion. To ensure radiation, chemical and biological safety, a model of interdepartmental interaction was used for mass events. An integrated approach to ensuring radiation, chemical and biological safety has made it possible to maintain a stable radiation, chemical and biological environment. Interdepartmental experience with radiation, chemical and biological safety can be implemented before and during international mass events.

Inflammatory profile of oxidized phospholipids

SummaryLipid oxidation products and in particular oxidized phospholipids (OxPL) are increasingly recognized as inducers of chronic inflammation characteristic of atherosclerosis. OxPL stimulate production of chemokines and adhesion of monocytes to endothelial cells. However, accumulating data suggest that, in addition to the proatherogenic and proinflammatory effects, OxPL can stimulate antiinflammatory and tissue-protective mechanisms. Thus, depending on the biological situation, OxPL can either stimulate or inhibit inflammation. In this review, the inflammatory properties of OxPL are discussed together with the underlying receptor, signalling and transcriptional mechanisms.

Psychological Profile in Patients with Stages I and II Breast Cancer: Associations of Psychological Profile with Tumor Biological Prognosticators

We have earlier shown that breast cancer patients with moderately or well differentiated tumors seem to be able to inhibit stress evoked from anger in a successful manner, while those with poorer prognosis do not. We now report a study with an enlarged group of patients, investigating associations between tumor biological factors and psychological profile. 129 patients with Stages I and II breast cancer undergoing adjuvant radiation therapy were interviewed and tested with three projective personality tests assessing attitude to aggression and coping with stress and anxiety. Creative functioning was also tested. Patients with Stage I (smaller) tumors reported a “fighting spirit” attitude toward the disease, but they also showed depressive reaction patterns. Moreover, if the patient could successfully avoid or inhibit the stress evoked from perceiving an aggressive motif in the picture shown in the aggression test, the tumor biological situation was better. Patients who did not inhibit stress reactions on the aggression test and also on the anxiety test had a poorer tumor biological situation. Surprisingly, low speed of tumor cell proliferation (DNA S-phase fraction) correlared with high scores on the creativity test. Successful denial or inhibition of stress evoked by aggression combined with a creative, flexible attitude was associated with a better tumor biological situation.