Preventive analgesia: a new trend in anesthesiology. An idea born and developed at the P.A. Herzen Institute of Oncology]

The authors summarize positive experience gained in the use of preventive anesthesia in oncosurgery. The new trend in anesthesiology has been developed at P. A. Herzen Institute of Oncology since the end of the eighties. A peripheral analgesic (aspisol, ketoprofene, ketorolac, etc.) was added to traditional premedication and anesthesia protocols in 522 patients subjected to extensive cavitary and other than cavitary surgery. Hemodynamic and metabolic parameters, homeostasis, stress criteria (hydrocortisone and glucose), pain intensity according to the verbal evaluation scale were studied at all stages of anesthesia and postoperative period, and side effects of postoperative analgesia were analyzed. Use of nonsteroid antiinflammatory drugs before the intervention and in the postoperative period prevented the development of strong postoperative pain and notably decreased the need in opioid analgesics in the presence of stable homeostasis. No serious side effects of analgesics, including hemorrhagic complications, were observed.     

Antibiotic prophylaxis of postoperative complications in surgical treatment of pulmonary, tracheal and mediastinal tumors]

A protocol of antibiotic protection, developed and used at Russian Research Center of Roentgenoradiology, is presented. This protocol of perioperative treatment is intended for control of a spectrum of bacterial infections retrospectively detected in patients with lung, tracheal, and mediastinal cancer. The efficiency of perioperative antibiotic prevention is demonstrated as exemplified by 105 patients of different age with various concomitant diseases.     

One-Pot/Simultaneous Synthesis of PHPMA-G-PLA Copolymers via Metal-Free Rop/Raft Polymerization and their Self-Assembly from Micelles to Thermoresponsive Vesicles

The present article reports a simple and straightforward approach to access thermoresponsive graft copolymers based on lactide (LA) and a methacrylic monomer, 2-hydroxypropyl methacrylate (HPMA), using a synthesized carboxy-functionalized trithiocarbonate-based chain transfer agent. One protocol involves a metal-free simultaneous synthesis through a combination of reversible addition-fragmentation chain transfer polymerization and organic acid-catalyzed ring-opening polymerization, which follows first-order kinetics. The resulting copolymers with a controlled structure exhibit remarkably narrow molecular weight distributions (Р< 1.10). Within this framework, the self-assembly of PHPMA-g-PLA graft copolymers (GCs) into nanoparticles (NPs) is demonstrated at concentrations of 0.2 and 0.5 wt.%, respectively. The displacement method, based on the rapid injection of the organic solvent (acetone) into an aqueous medium under vigorous stirring, produces spherical NPs such as micelles, vesicles, or non-spherical “lumpy rods”. The presence of a pseudo-thermoresponsive segment (PHPMA) in GCs facilitates stimulus-responsive self-assembly behavior. Well-defined spherical NPs—primarily vesicles of substantial size—develop upon heating above the glass transition temperature (T_g ≈35–36 °C) of the GCs in an acetone–water (80/20 wt.%) mixture. Last, specific interactions between the obtained PHPMA-g-PLA nano-objects and blood proteins in human plasma are studied using isothermal calorimetry.