bluuebunny/crossref_metadata_2025 huggingface dataset:
Alloimmunization of patients by blood units harboring distinct DEL variants
Authors: St-Louis M. , Lebrun A. , Goldman M. , Lavoie M.
Published: May 2021

The alloimmunization potential of many RHDvariants is unknown, and it can be explored by lookback and traceback studies. Héma-Québec (HQ) investigated the RHDstatus of 3980 D– repeat blood donors. Thirteen were found to be RHDpositive: 4 RHD*ψ,and 1 RHD*487delACAG,which show a D– phenotype; and 1 RHD*885Tand 7 RHD*(93–94insT)causing a DEL phenotype when C antigen is present. Lookback studies were done to verify the alloimmunization potential of these eight DEL donors. Coincidentally, Canadian Blood Services (CBS) performed a traceback study by investigating the RHDstatus of donors after a D– recipient developed anti-D after transfusion of two D– red blood cell (RBC) units. Donor genotyping was done either manually (HQ) or using the Progenika Bloodchip platform (CBS). Donations were traced through computer records. Letters were sent to hospital blood bank physicians to verify the presence of anti-D in recipients and to donors to request repeat samples. A total of 118 RBC units were transfused, 82 to D– recipients. Anti-D was found in three patients transfused with RHD*(93– 94insT)DEL red blood cells. One donor presenting the same DEL variant was involved in the traceback study. Even without strong evidence clearly demonstrating the alloimmunization potential of DEL variants, whenever HQ or CBS identifies a donor harboring a DEL phenotype, his or her D status will be changed from D– to D+ to protect against the potential alloimmunization risk.
Immunohematology

2013;29:136–140.
Airway management (review of existing practice in the Russian Federation for 2020). Results of a multicenter study
Authors: Andreenko Alexander A. , Bratishchev I. V. , Dolbneva E. L. , Pikovsky V. Yu. , Stamov V. I.
Published: May 2021

Introduction. The problem of “difficult airways” will always remain relevant, since critical gas exchange disorders lead to the death or deep neurological disability of patients. Objectives. To analyze the frequency of development of situations of “difficult airways”, the level of equipment of hospitals to ensure the airway management, to study the level of training of doctors and the algorithms used by them (comparative assessment of the situation in the dynamics of 2014–2019). Materials and methods. The survey was conducted from 01.03.2019 to 30.10.2020 by means of an online survey (https://ru.surveymonkey.com/r/HMTX2RR) and distribution of questionnaires (43 questions) by e-mail to anesthesiologists-resuscitators in medical organizations of various profiles. Results. 1260 responses were received. Only 47 % of respondents studied the issues of airway management during primary training in the specialty. In situations of difficult intubation or ventilation, almost 78 % of respondents use the FAR recommendations, almost 83 % of the respondents indicated that the FAR recommendations help them in practice. According to the survey data, most hospitals do not meet the legal requirements. Only 44 % of hospitals have a round-the-clock endoscopy service. In comparison with the previous surveys, the number of respondents who followed the recommended algorithms of actions in the situation of “no intubation — no oxygenation” during elective (70 %) and emergency (75 %) general anesthesia increased. However, only 60 % of specialists correctly identified the indications for performing emergency cricothyrotomy. Conclusions. Over the past 11 years, there has been a certain positive trend in relation to the growth of the level of education of specialists, changes in their approaches and a greater tendency to follow existing recommendations. The overwhelming majority of hospitals still do not meet the requirements of the legal framework.
Perioperative management of patients with mental illness. Guidelines of the All-Russian Public Organization “Federation of Anesthesiologists and Reanimatologists”
Authors: Zabolotskikh Igor B. , Gritsan A. I. , Lebedinskii K. M. , Myasnikova V. V. , Muronov A. E. , Shapovalov K. G.
Published: May 2021

Mental disorders in persons over 18 years of age are quite common and are represented by a fairly extensive list of diseases. In patients with a similar pathology, there is also a need for interventions and manipulations under conditions of anesthesia. The article presents the principles of perioperative management in patients with the most common mental illnesses — affective disorders, schizophrenia, bipolar disorder, anxiety disorders, behavioral syndromes associated with physiological disorders (bulimia, anorexia). Prevention of recurrence of mental illness and withdrawal synchroma, prevention of incidents associated with the intake of drugs used to treat psychopathology are reflected.
Comparative study of monoclonal anti-IL6 antibodies in severe new coronavirus disease COVID-19 patients. Retrospective cohort study
Authors: Bobkova S. S. , Zhukov Aleksandr A. , Protsenko D. N. , Samoylenko V. V. , Tyurin I. N.
Published: May 2021

Introduction. Novel coronavirus infection (COVID-19) is characterized by systemic hyper-inflammation with elevated inflammatory cytokines, that has been recognized as a leading cause of severity COVID-19. Many clinical evidences have indicated the importance of anti-inflammatory immunomodulation therapy in severe COVID-19, especially anti-IL6 monoclonal antibodies.
Objectives. Comparative study of the monoclonal anti-IL6 antibodies in severe COVID-19 patients.
Materials and methods. Single-center observational retrospective cohort study included three groups of hospitalized COVID-19 patients treated with one-dose tocilizumab (Group 1, 200 patients), levilimab (Group 2, 100 patients), and olokizumab (Group 3, 100 patients). Main parameters at baseline included: C-reactive protein serum concentration, and lung CT score. End-points included: sepsis and in-hospital death.
Results. No significant difference in demographic characteristics and main parameters at baseline were found. A comparative analysis of clinical outcomes in the group revealed a statistically significant increase in the risk of sepsis and death in the levilimab group compared with the tocilizumab and olokizumab groups. When comparing the “Lethal outcome” indicator depending on the drug, we were unable to identify significant differences (p = 0.259, Fisher’s exact test for multi-field tables), as in the “Sepsis” outcome (p = 0.587, Fisher’s exact test for multi-field tables) When comparing tocilizumab for s/c and i.v. administration, we were unable to identify statistically significant differences (p = 0.293, Exact test Fisher) The odds of sepsis in the subcutaneous group were 2.28 times lower than in the intravenous group; the odds differences were not statistically significant (OR = 0.44, 95% CI 0.1–1.88).
Conclusions. The use in patients with severe COVID-19 of different drugs of monoclonal antibodies against interleukin 6 did not reveal significant differences in deaths between tocilizumab, levilimab and olokizumab. The identified differences between the drugs in the incidence of sepsis and death require further randomized controlled trials.
Perioperative management of patients with concomitant morbid obesity. Guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists”
Authors: Zabolotskikh Igor B. , Anisimov M. A. , Gorobets E. S. , Gritsan A. I. , Lebedinskii K. M. , Musaeva T. S. , Protsenko D. N. , Trembach N. V. , Shadrin R. V. , Shifman E. M. , Epstein S. L.
Published: May 2021

According to the latest estimates of the World Health Organization, more than 1 billion people in the world are overweight. In economically developed countries, the proportion of the population with overweight reaches almost 50 %, of which 30 % are obese. In Russia, on average, 30 % of people of working age are obese and 25 % are overweight. Despite the significant economic costs for the prevention and treatment of obesity, mortality at the age of 20–35 with morbid obesity exceeds the average statistical 12 times, mainly from cardiovascular complications. The guidelines provides principles of perioperative management of patients with obesity.
Mastocytosis in Adults: A Retrospective Analysis of the Clinical Course and Treatment of 58 Patients
Authors: Potapenko Vsevolod Gennadevich , Baikov V.V. , Belousova I.E. , Belyakova E.A. , Barabanshchikova M.V. , Zaslavsky D.V. , Zyuzgin I.S. , Klimovich A.A.V. , Krivolapov Yu.A. , Kulibaba T.G. , Lisukova E.V. , Leenman E.E. , Mazurok L.A. , Maksimova A.M. , Morozova E.V. , Nizamutdinova A.S. , Skoryukova K.A. , Ukrainchenko E.A. , Medvedeva N.V.
Published: May 2021

Background. Mastocytosis is a disease caused by proliferation and accumulation of clonal mast cells in one or more organs. It is often associated with other hematological tumors. Aggressive forms of mastocytosis (AFM) require specific therapy. In non-aggressive forms of mastocytosis (NFM) symptomatic treatment is needed. Aim. To analyze the clinical course and treatment outcomes in different forms of adult mastocytosis. Materials & Methods. The retrospective analysis was based on the records of patients who received in-person and distance consultation within the period from 11/2008 to 11/2020. The analysis of complaints in disease onset and over time was carried out using questionnaires. NFM patients received symptomatic treatment with antihistamines. To all AFM patients chemotherapy was administered. Results. The analysis includes the data of 58 patients: 39 (67.2 %) women and 18 (32.8 %) men. The median age was 40 years (range 18-79 years), the median age on diagnosis was 39 years (range 1-79 years). In all patients skin rashes were reported. The median age of the first skin manifestations was 25 years (range 0.1-70 years). In-person monitoring was conducted in 34 (58.6 %) patients, 24 (41.4 %) patients received distance consultations. Median follow-up was 56.5 months (range 3-564 months). In 8 (13.7 %) patients mastocytosis was diagnosed in childhood with the median of 9 years (range 0-15 years). The diagnosis was morphologically confirmed in 46 (79.3 %) patients. Main complaints included pruritus (67.2 %), edema and erythema response to various irritants (62 %). In 45 (77.5 %) patients NFMs were reported. The regular symptomatic treatment of 78.8 % of NFM patients consisted only of antihistamines (57.9 %), and 2 (4.4 %) patients noted poor disease symptom control. One (2.2 %) patient died of associated chronic myelomonocytic leukemia. None of NFM patients required cytoreductive treatment. AFMs were diagnosed in 13 (22.4 %) patients, 5 (38.4 %) out of them had mast cell leukemia. The indications for starting chemotherapy were cytopenia (n = 3; 23 %), extensive osteolysis (n = 7; 53.8 %), ascitic syndrome with portal hypertension (n = 6; 46.1 %). Overall survival of AFM patients was 84.6 % (n = 11) with median follow-up of 80 months (range 12-131 months). Conclusion. NFM prognosis is favorable. Antihistamines are effective in relieving complaints of most patients. Cytostatic treatment of AFM in some patients provides long-lasting antitumor response.
Cytogenetic and Molecular Genetic Abnormalities of CIITA Gene in Patients with Primary Mediastinal (Thymic) Large B-Cell Lymphoma
Authors: Kuznetsova Svetlana Aleksandrovna , Surin V.L. , Mangasarova Ya.K. , U Novikova T.Y. , Grebenyuk L.A. , Magomedova A.U. , Kravchenko S.K. , Pshenichnikova O.S. , Sergeeva A.M. , Obukhova T.N.
Published: May 2021

Background. Primary mediastinal (thymic) large B-cell lymphoma (PMBCL) is an aggressive malignant lymphoproliférative disease which accounts for 2-3 % of all non-Hodgkin's lymphomas. In 40 % of PMBCL cases rearrangements of the MHC class II activator, i.e. CIITA gene, are observed. CIITA abnormalities lead to decreasing protein expression and surface expression of MHC class II, which results in lack of adaptive cell immunity targeted at tumor cells. Aim. To assess the rate and spectrum of cytogenetic and molecular genetic abnormalities of CIITA gene in PMBCL patients. Materials & Methods. The study enrolled 37 patients with diagnosed PMBCL: 10 men and 27 women aged 21-61 years (median of 31 years). Sanger sequencing was performed in 36 patients. In 20 patients CIITA/16p13.13 FISH and in 15 patients standard cytogenetic analysis were carried out. Results. In 3 (8.3 %) out of 36 patients the sequencing method detected mutations impairing CIITA gene function, as well as microdeletion in exon 1, deletion and nucleotide substitution in a splice donor site. Multiple somatic variations in intron 1 were identified in 21 (58.3 %) patients: in 11 (52.4 %) cases there were deletions and single nucleotide variants (SNV); the other 10 (47.6 %) patients showed only SNVs. In 13 (61.9 %) out of 21 cases the abnormalities of promoter IV and/or alternative exon 1 were observed. In 5 (25 %) out of 20 patients the FISH assay identified CIITA gene translocation. Standard cytogenetic analysis detected complex karyotype in 7 (46.6 %) out of 15 patients. The comparison of data showed hypermutagenesis in 8 out of 10 patients with FISH-detected chromosome aberrations, and in 3 (37.5 %) of them complex karyotype aberrations were found as well. Conclusion. Molecular genetic methods identified different somatic variations in CIITA gene affecting its functionally important regions, which can be of special interest for further studying the biology of tumors, including PMBCL.
Nivolumab in a Primary Refractory Hodgkin’s Lymphoma Patient with Absolute Lymphopenia Prior to Chemotherapy: Literature Review and a Case Report
Authors: Bogatyreva Tatyana Ivanovna , Afanasov A.O. , Falaleeva N.A. , U Grivtsova L.Y. , U Terekhova A.Y.
Published: May 2021

The paper presents a case report of PET-adapted therapy of primary refractory classical Hodgkin’s lymphoma, stage ІІАХ, in a female patient with absolute lymphopenia prior to chemotherapy. It also provides literature review on the choice of clinical management for similar categories of patients. Nivolumab was prescribed to the patient in February 2019 due to Hodgkin’s lymphoma progression after the failure of 4 chemotherapy lines including brentuximab vedotin. A bulk of mediastinal lymph nodes was exposed to radiation. Complete metabolic response was retained 18 months after nivolumab therapy start and 6 months after its discontinuation. The initial lymphopenia in this patient with primary refractory Hodgkin’s lymphoma did not interfere with the realization of full clinical effect of nivolumab.
Familial Aggregation in Hodgkin’s Lymphoma
Authors: Shakhtarina Svetlana Vasilevna , Danilenko A.A. , Falaleeva N.A.
Published: May 2021

Background. Genetic predisposition to Hodgkin's lymphoma (HL) can be directly evidenced through observing familial HL. The literature data available on the familial aggregation samples of HL are extremely limited. Aim. To systemize and assess observation data on familial aggregation in patients with classical HL based on the sequence of tumor development in blood relatives. Materials & Methods. Data on families with HL diagnosed more than in one member were gathered from 4700 HL patients, who received chemotherapy from 1970 to 2019 at the AF Tsyb Medical Radiological Research Centre. Results. Among the blood relatives 27 HL cases were identified, which amounted to 0.57 % of the total of 4700 patients. The families were arranged into four groups: group I with HL diagnosis in a child born before HL detection and treatment of a parent (15 families); group II with HL diagnosis in a child born after HL treatment of a parent (4 families); group III with HL diagnosis in several children of a family with lymphoma-free parents (6 families); group IV - other categories (2 families). The total number of HL patients was 54. Group I comprised 30 patients (15 children and 15 parents), group II included 8 parents (4 daughters and 4 mothers), group III consisted of 12 patients, and group IV included 4 patients. Conclusion. The proportion of patients with familial aggregation of HL was 0.57 %. The age of all 54 HL patients enrolled in the study corresponded to the first age peak of HL onset. In the pairs “parent-child” children born before HL treatment of a parent accounted for 78.9 % and children born after HL treatment of a mother accounted for 21.1 % (all of them were girls). There were no HL cases in children born after HL treatment of a father. The data obtained show no effect of a parent's chemotherapy on the occurrence of HL in a child. This is confirmed by the HL cases of siblings whose parents never received HL treatment as well as by the diagnosis of this malignant tumor first in a grandson and then in his grandmother.
In memory of Academician A.I. Vorob'ev, Russian Academy of Medical Sciences and Russian Academy of Sciences Stability of Granulopoiesis Chronology under R(G)-DHAP Immuno-chemotherapy-Induced Cytotoxic Stress in Non-Hodgkin’s Lymphomas
Authors: Sychevskaya Kseniia Andreevna , Kravchenko S.K. , Babaeva F.E. , Misyurina A.E. , Kremenetskaya A.M. , Vorob'ev A.I.
Published: May 2021

Background. Chronology of granulopoiesis based on periodic hematopoiesis model has been thoroughly studied. However, the pattern of influence of immunotherapy-induced cytotoxic stress on the biological rhythm of a stem cell development requires further investigation. The interaction of antitumor drugs with normal hematopoietic cells is relevant for assessing the intensity of chemotherapy adverse events. Besides, there is a demand for studying hematopoiesis under cytotoxic stress to predict immunological reactivity as a condition for efficacy of immunotherapeutic agents, the effect of which is based on cell immunity. Aim. To study the chronological pattern of leukocyte count dynamics after R(G)-DHAP immunochemotherapy in non-Hodgkin’s lymphomas. Materials & Methods. The dynamics of leukocyte count changes after R(G)-DHAP immunochemotherapy was analyzed using the data of 39 treatment courses in 19 non-Hodgkin’s lymphomas patients. After 18 out of 39 cycles of treatment granulocyte colony-stimulating factor (G-CSF) was administered to prevent granulocytopenia, in other cases the previously planned hematopoietic stem cell mobilization was performed according to the accepted protocol. Results. Time to activation of spontaneous granulopoiesis depends neither on G-CSF stimulation, nor on the total dose of growth-stimulating factor and corresponds on average to Day 10 or Day 11 of the break from the last day of immunochemotherapy. The tendency of shorter agranulocytosis duration on prophylactic use of G-CSF is associated with transient hyperleukocytosis at an early stage after completing immunochemotherapy. Regimens with platinum-based drugs, like R(G)-DHAP, are suggested to be combined with immunochemotherapeutic agents in patients with the failure of first-line chemotherapy. The time interval preceding myelopoiesis activation within the first days of the break between the courses is likely to contribute to the initiation of treatment with immunotherapeutic drugs after second-line chemotherapy. Conclusion. The determination of granulopoiesis dynamics under R(G)-DHAP immunochemotherapy-induced cytotoxic stress enables to plan the optimum G-CSF regimen and to predict the optimum timing of immune antitumor effect combined with chemotherapy.
COVID-19 in Patients with Oncohematological Diseases
Authors: Danilenko Anatolii Aleksandrovich , Shakhtarina S.V. , Falaleeva N.A.
Published: May 2021

After initially appearing in Wuhan (China), the COVID-19 epidemic rapidly escalated to pandemic level. Due to its high mortality COVID-19 belongs to the group of the most dangerous viral infectious diseases of today. While elderly people are at greatest risk of death, some comorbidities, including also malignant tumors, considerably worsen the course of COVID-19. In view of inherent immunodeficiency exacerbated by immunosuppressive chemotherapy, oncohematological diseases most greatly affect the course of COVID-19. The review presents few published data on coronavirus disease affecting the prognosis of hematopoietic and lymphoid tumors. In addition, the control of mortality risk in these patients is discussed.
CAR-T Cells for the Treatment of Chronic Lymphocytic Leukemia: Literature Review
Authors: Gribkova Irina Vladimirovna , Zavyalov A.A.
Published: May 2021

Chronic lymphocytic leukemia (CLL) is the most common adult malignant lymphoid disease. Despite new highly effective targeted drugs, the prognosis of relapsed and resistant form of this disease is poor. CAR-T cell therapy using T-lymphocytes with chimeric antigen receptor (CAR) demonstrated its efficacy in the treatment of such oncohematological diseases as B-cell non-Hodgkin’s lymphomas and acute lymphoblastic leukemia. The present literature review focuses on the experience of using CAR-T cells for CLL therapy. It presents the advantages and drawbacks of this technique as well as the challenging issues to be solved for its implementation into broad clinical practice.
Hemostasis Disorders in Patients with De Novo Acute Leukemias
Authors: Polevodova O.A. , Galstyan Gennadii Martinovich , Troitskaya V.V. , Orel E.B. , Drokov M.Yu. , Parovichnikova E.N.
Published: May 2021

Aim. To study hemostasis disorders in patients with de novo acute leukemias (AL) prior to chemotherapy. Materials & Methods. The study enrolled 107 patients with newly diagnosed AL, aged 18-80 years and treated at the National Research Center for Hematology. Acute lymphoblastic leukemia (ALL) was identified in 37 patients, acute myeloid leukemia (AML) was diagnosed in 46 patients, and acute promyelocytic leukemia (APL) was reported in 24 patients. Hemorrhagic and thrombotic complications were analyzed; platelet count, APPT, prothrombin and fibrinogen concentration were determined; thromboelastography (TEG; native tests, functional fibrinogen tests) and rotation thromboelastometry (ROTEM; EXTEM, INTEM, FIBTEM, APTEM) were performed. The data were statistically processed using SAS 9.4 software. Results. At AL onset hemorrhagic syndrome was detected in 34 (32 %) out of 107 patients. It was manifested by petechia (n = 16), subcutaneous hematomas (n = 12), gingival (n = 10) and nose (n = 6) bleeding, uterine bleeding (n = 2), hematuria (n = 2), gastrointestinal bleeding (n = 1), brain hemorrhage (n = 6), and periorbital hematoma (n = 1). According to TEG and ROTEM hypocoagulation was more common in APL patients. Hyperfibrinolysis could be detected using only ROTEM in 54 % of APL patients, in 8 % of ALL and 4 % of AML patients. Compared to other AL patients those with APL showed different parameters of fibrinogen concentration of < 1.75 g/L (sensitivity 83.3 %, specificity 83.13 %), D-dimer concentration of > 2686 pg/L (sensitivity 72.73 %, specificity 64.79 %), MCFFIBTEM < 12.5 mm (sensitivity 80 %, specificity 80 %), and MAFF < 9.7 mm (sensitivity 86.96 %, specificity 90.12 %). Conclusion. The parameters that distinguish APL from other categories of AL patients are hypofibrinogenemia, higher D-dimer concentration, ROTEM changes, and hyperfibrinolysis.
Cardio-oncology and Oncohematology: Examination Algorithms, Prophylactic and Treatment of Cardiotoxicity, Trends in Rehabilitation
Authors: Emelina Elena Ivanovna , Gendlin G.E. , Nikitin I.G.
Published: May 2021

Successful chemotherapy in the treatment of hematological diseases is determined not only by the efficacy of antitumor drugs, but by the timely correction of adverse events, among which especially important are cardiac complications associated with both already existing cardiovascular diseases and cardiotoxicity of cytostatic drugs. Of particular importance is also a frequent lack of systemic cardiological examination of oncohematological patients. The urgency of this issue was the reason for creating cardio-oncological clinics focused on the closest co-operation of cardiologists with drug chemotherapy experts. Hematological patients are a particular group among chemotherapy recipients. Potential curability of an oncohematological disease and achieving durable MRD-negative remission raise the importance of irreversible or long-term cardiac complications directly affecting the quality of life and life expectancy. Besides, in some cases long-term or life-long administration of certain cardiotoxic antitumor drugs requires a particular cardiological follow-up. A broad variety of cardiotoxic effects of antitumor drugs and peculiarities of their clinical manifestations call for the exact algorithms of cardiological examination to be observed for the timely detection and treatment of cardiovascular complications. The now available st udies and interdisciplinary work of cardiologists and oncologists (oncohematologists) can yield such algorithms for examination and the approaches to prophylactic and treatment of cardiotoxicity as well as to rehabilitation of patients.
National Clinical Guidelines on Diagnosis and Treatment of Ph-Negative Myeloproliferative Neoplasms (Polycythemia Vera, Essential Thrombocythemia, and Primary Myelofibrosis) (Edition 2020)
Authors: Melikyan Anait Levonovna , Kovrigina A.M. , Subortseva I.N. , Shuvaev V.A. , Morozova E.V. , Lomaia E.G. , Afanasyev B.V. , Ageeva T.A. , Baikov V.V. , Vinogradova O.Yu. , Gritsaev S.V. , Zaritskey A.Yu. , Ionova T.I. , Kaplanov K.D. , Martynkevich I.S. , Mitina T.A. , Polushkina E.S. , Pospelova T.I. , Sokolova M.A. , Sudarikov A.B. , Turkina A.G. , Shatokhin Yu.V. , Shmakov R.G. , Savchenko V.G.
Published: May 2021

The development of National clinical guidelines on diagnosis and treatment of Ph-negative myeloproliferative neoplasms comes in response to the need to standardize the approach to diagnosis and treatment. The availability of clinical guidelines can facilitate the choice of adequate treatment strategy, provides practicing physicians with exhaustive and up-to-date information on advantages and shortcomings of different treatment methods as well as lets health professionals better assess expected extents of treatment required by patients. In 2013 a working group was formed to develop and formulate clinical guidelines on the treatment of myeloproliferative neoplasms. These guidelines were first published in 2014, afterwards they were revised and republished. The dynamic development of current hematology presupposes constant updating of knowledge and implementation of new diagnosis and treatment methods in clinical practice. In this context clinical guidelines present a dynamic document to be continuously amended, expanded, and updated in accordance with scientific findings and new requirements of specialists who deal directly with this category of patients. The present edition is an upgraded version of clinical guidelines with updated information on the unification of constitutional symptoms assessment using MPN-SAF TSS questionnaire (MPN10), on applying prognostic scales in primary myelofibrosis, assessing therapy efficacy in myeloproliferative neoplasms, revising indications for prescription, on dose correction, and discontinuation of targeted drugs (ruxolitinib). The guidelines are intended for oncologists, hematologists, healthcare executives, and medical students.
Desafios do planejamento municipal na gestão de resíduos da construção civil no Município de Floresta, Paraná, Brasil
Authors: Palaro Letícia , Okumura Maria Lúcia Hiromi da Silva , Yamaguchi Natália Ueda
Published: May 2021

A construção civil tem sido um dos setores de maior relevância em relação ao desenvolvimento socioeconômico. Entretanto, esse crescimento desenfreado, tem gerado uma parcela significativa em relação aos problemas ambientais, problemas estes, que a sociedade vem enfrentando ao longo dos anos. Entre os impactos causados, pode-se citar como principal, o excessivo volume de resíduos gerados, que na maioria dos municípios brasileiros, não são depositados em locais apropriados, aumentando ainda mais os problemas ambientais. A expansão das cidades tem colocado o conforto e a qualidade de vida da população em risco, causando inúmeros agravos. O presente estudo propôs analisar a gestão de resíduos da construção civil (RCC) em uma cidade de pequeno porte que se encontra em processo de expansão, com o intuito de alertar sobre os impactos ambientais e sociais ocasionados por esse processo e relatar as dificuldades que o município enfrenta. Utilizou-se uma metodologia qualitativa, por meio de entrevistas aos responsáveis pela gestão dos RCC, e registros fotográficos dos pontos de descartes irregulares no município. Concluiu-se que a falta de uma gestão pública integrada, assim como o desinteresse tanto dos geradores quanto dos gestores, contribui para a disposição irregular dos RCC no município.
Aspectos socioambientais da proliferação de arboviroses na Região Metropolitana do Cariri, Ceará: A perspectiva dos Objetivos do Desenvolvimento Sustentável (ODS)
Authors: Leandro Cícero dos Santos , Barros Francisco Bernardo de , Moreira Priscilla Barbosa de Araújo , Santos Lucas Fernandes dos , Nadae Jeniffer de , Moura-Fé Marcelo Martins de
Published: May 2021

Os objetivos do desenvolvimento sustentável (ODS) são resultantes de preocupações que surgiram a partir do século XX. O ODS 11 preocupa-se com o desenvolvimento de cidades inteligentes e está diretamente relacionado aos ODS 3 e 6, que visam a garantir à população, saúde, água potável e saneamento básico, respectivamente, visto que os problemas de urbanização podem afetar os serviços urbanos, interferindo dessa forma na saúde da população. Nessa perspectiva, com o presente trabalho objetivou-se verificar o papel dos aspectos ambientais urbanos na ocorrência de arboviroses (dengue, zika e chikungunya) transmitidas pelo Aedes aegypti no Crajubar (Crato, Juazeiro do Norte e Barbalha), sob a ótica dos ODS. A pesquisa deu-se a partir de consulta na literatura científica e plataformas oficiais sobre o processo de urbanização e saneamento, bem como dados dos boletins epidemiológicos do Estado do Ceará. Foi possível observar que a falta de cobertura de rede de esgoto teve uma forte correlação com a proliferação do A. aegypti. Para o quesito coleta de resíduos a correlação foi moderada. Em relação ao acesso a água, a correlação se mostrou menos acentuada em relação às variáveis analisadas. De modo geral, percebe-se que há uma estreita ligação entre a deficiência no saneamento básico e o aumento da proliferação do A. aegypti nos municípios estudados. Pode-se concluir que assegurar o controle e disseminação das arboviroses em questão pode contribuir para alcançar as metas dos ODS, garantindo o bem-estar e a saúde das atuais e futuras gerações.
Adaptação do Índice de Vulnerabilidade Sócio-Climática (ISVC) em uma comunidade rural do semiárido do Brasil
Authors: Gadelha Denise Pinto , Carvalho Thamires Kelly Nunes , Lucena Reinaldo Farias Paiva de
Published: May 2021

O presente estudo tem por objetivo adaptar o Índice de Vulnerabilidade Sócio-Climática (ISVC) para a avaliação de vulnerabilidade de pequenos agricultores residentes no semiárido nordestino. Especificamente, objetiva mapear a estrutura social e cultural da comunidade rural escolhida a partir de indicadores, e que auxiliam no diagnóstico de vulnerabilidade para pequenas localidades. O estudo foi desenvolvido no Município de Cabaceiras, Região do Cariri da Paraíba. O índice utilizado tem como base dados retirados do IDH (Índice de Desenvolvimento Humano) municipal, e dados de variáveis climáticas disponíveis no IRCM (Índice Regional de Mudanças Climáticas). A análise estatística foi realizada a partir do software R, e utilizado o pacote "PACMAN". Seguindo o cálculo do IVSC, o resultado obtido para o Município de Cabaceiras é IVSC = 5,60. Esse resultado é o produto da multiplicação do valor obtido para a variável climática (IRMC = 13), pela média geométrica do valor obtido para a variável social, que aqui será chamada de Indicadores de Vulnerabilidade Local (IVL = 0,43). O Índice de Vulnerabilidade Socio-Climática (IVSC), da forma como foi adaptado e calculado neste estudo, oferece praticidade em sua execução, podendo ser facilmente aplicado para todo o Estado da Paraíba e outras regiões do semiárido.
Avaliação do gerenciamento de resíduos sólidos através do Sistema de Indicadores de Sustentabilidade Pressão-Estado-Impacto-Reposta (PEIR) no Município de Uiraúna, Estado da Paraíba, Nordeste do Brasil
Authors: Ferreira Mateus Santiago , Barros José Deomar de Souza
Published: May 2021

Os impactos ambientais gerados pela sociedade chegaram a níveis assustadores nos últimos anos. Este cenário, também é movido pelo mau gerenciamento dos resíduos sólidos urbanos (RSU), os quais acumulados em locais inadequados geram grandes riscos à saúde humana e ao meio ambiente. Dessa forma, faz-se necessário gerencia-los de forma adequada para que a sua gestão aconteça de modo participativo, adotando ações sustentáveis com vistas à preservação dos recursos naturais e o bem-estar humano. Assim, a presente pesquisa teve por objetivo avaliar a sustentabilidade socioambiental dos resíduos sólidos urbanos através do Sistema de Indicadores de Sustentabilidade Pressão-Estado-Impacto-Resposta (P-E-I-R) no Município de Uiraúna-PB. Para tanto utilizamos o modelo PEIR desenvolvido pela Organização para a Cooperação e Desenvolvimento Econômico (OCDE) e Programa das Nações Unidas para o Meio Ambiente (PNUMA). Foram entrevistados atores sociais que possuem experiências diretas com a problemática dos resíduos sólidos no município anteriormente citado. Quanto a metodologia adotada trata-se de uma pesquisa de natureza aplicada. Quanto dos seus objetivos trata-se de uma pesquisa descritiva. Na sua forma de abordagem esta pesquisa apresenta características tanto quantitativas quanto qualitativas. Referente a seus procedimentos trata-se de um estudo de caso. A amostra soma um total de 70 atores sociais. Na coleta de dados foi empregado como instrumentos um questionário semiestruturado. Durante a pesquisa foi possível conhecer a realidade local de alguns agentes sociais, como os catadores de materiais recicláveis, moradores e agentes de limpeza. Ao longo da pesquisa foi identificada uma realidade de total descaso para com o meio ambienta. Os descartes, segundo os relatos, são realizados inadequadamente a céu aberto. A população local mostra-se distanciada em relação às questões socioambientais, principalmente, em relação ao descarte dos resíduos sólidos urbanos. Os resultados obtidos indicam que dos 31 indicadores ambientais avaliados, um total de 19 foram agrupados na categoria desfavorável contribuindo para piorar os indicadores ambientais do município pesquisado. Por outro lodo, o município conta com ações inovadores para o enfretamento dessa problemática tão urgente como uma associação de reciclagem a qual recebe apoio logístico e treinamento técnico da prefeitura municipal, gerando emprego e renda para população mais pobre do Município de Uiraúna. Também foi notado uma vontade política para enfrentar a problemática dos resíduos como o início da obra de construção do novo aterro sanitário.
AN EMPIRICAL STUDY ON HOMOPHOBIA AMONG POST GRADUATE STUDENTS IN KOLKATA
Authors: Sharma Mrittika , Saha Sujata
Published: May 2021

Present paper gives a birds eye view about the empirical study on homophobia among post graduate students group in Kolkata. The importance of the present study is to identify the differences in the irrational fear about the shamefulness of homosexuality among boys and girls studying post graduation in Kolkata. The sample of the study consisted of 15 boys and 15 girls with age group of 21-23 years were drawn from different post graduate colleges in Kolkata. The scales used were Homophobia scale by Wright, L. W., Adams, H. E., &Bernat, J. (1999). The Homophobia scale includes items that examine social avoidance and aggressive acting, when individuals are measured with this scale. A t-test was used to identify the significant differences between boys and girls in terms of homophobia level among them. The results of the study clearly indicate that there is no significant difference among the sexes with respect to the irrational fear about discrimination, rejection from the community regarding homosexuality.
PHYTOCHEMICAL SCREENING AND EVALUATION OF THE ANTIHYPERCHOLESTEROLEMIC ACTIVITY OF THE CAKE OF SAFOU (DACRYODES EDULIS) IN RATS (RATTUS NORVEGICUS)
Authors:   Laboratory of Nutrition and Food Safety (LNSA), Nangui-Abrogoua University, 02 BP 801 Abidjan 02, Cote dIvoire., Aka Roger Roland Ano Arrisson , Ndri Koffi Emmanuel ,   Advanced Teachers Training College of Abidjan (ENS), Department of Sciences and Technologies, 08 BP 10 Abidjan 08, Cote dIvoire., Jules Marius Djetouan Kacou ,   Laboratory of Nutrition and Pharmacology, UFR of Biosciences, FÃ©lix Houphouet-Boigny University, 22 BP 582 Abidjan 22,Cote dIvoire., Ocho-Anin Atchibri Louise ,   Laboratory of Nutrition and Food Safety (LNSA), Nangui-Abrogoua University, 02 BP 801 Abidjan 02, Cote dIvoire.
Published: May 2021

Safou (Dacryodes edulis) is consumed by the Ivorian population for its therapeutic virtues. The present study aims to make known the phytochemical composition and antihypercholesterolemic activity of safou cake. For this, phytochemical screening of the aqueous extract of the pulp cake of the safou was carried out. In addition, the antihypercholesterolemic activity of cake was tested in rats (Rattus norvegicus). Results obtained indicate that the aqueous extract of cake contains secondary metabolites such as polyphenols, flavonoids, saponins, polyterpenes and sterols and alkaloids. Moreover, this extract allowed, at a dose of 300 mg / kg of PC, to decrease the blood concentration of compounds such as VLDL-C, LDL-C, triglycerides, total cholesterol and total lipids.On the other hand, at a dose of 100 mg / kg of PC of this extract, the blood level of HDL-C increased significantly in hypercholesterolemic rats (PË‚0.05). This study confirms the antihypercholesterolemic activity of safou cake.Therefore, safou cake could be used to prevent oxidative stress, arterosclerosis, high blood pressure, diabetes and ischemic cardiovascular disease.
TO STUDY THE INCIDENCE OF SENSORINEURAL HEARING LOSS POST MENINGITIS IN NEONATES
Authors:   Registrar Department of Pediatrics and Neonatology, SKIMS Soura, Kashmir, India., Ullah Wani Ubaid , Quyoom Hussain Sheikh ,   Registrar Department of Pediatrics and Neonatology, SKIMS Soura, Kashmir, India., Ahmad Wani Khursheed ,   Professor Department of Pediatrics and Neonatology, G B Pant Hospital, GMC Srinagar, Kashmir, india.
Published: May 2021

Background:Post meningitis hearing impairment is an important public health problem. Neonatal meningitis is an important cause of mortality and morbidity in neonates in future life. An important consequence is hearing loss. Hearing plays a basic and important role in language, speech and intellectual development. Late detection causes irreversible stunting of the language development potential of the child. Early detection and intervention would help to maximize linguistic competence and literacy development for children who are deaf or hard of hearing. The study of brainstem evoked response audiometry provides an opportunity to evaluate the functional integrity of auditory pathway from inner ear to upper brainstem. Aim:This study was conducted to determine the incidence of sensorineural hearing loss following meningitis in neonates. Material and Methods:The present study was conducted in the Department of Pediatrics, Government Medical College Srinagar. All the patients,Term neonates with CSF culture proven bacterial meningitis. , were referred to the Department of ENT, SMHS Hospital Srinagar, of the institution for thorough ENT checkup, to exclude any ear pathology and BERA (Brainstem Evoked Response Audiometry). Results:In our study total number of cases were 87. Majority of our studied children i.e. 47 (54%) were < days of age whereas 40 (46%) children were 8-28 days of aged. The mean age of our study patients was 15.7+3.71.Out of 87 patients in our study, male predominance was observed with 55.2% males versus 44.8% females with a male to female ratio of 1.2:1. Hearing loss was observed in 11 (12.6%) of our study children.Bilateral hearing loss was seen in 5 of the 11 children (5.7%) while as unilateral hearing loss was observed in 6 of the 11 children (6.9%). Out of a total of 11 (12.6%) patients who had hearing loss, 6 (6.9%) were having mild hearing loss, followed by 3 (3.4%) children with profound hearing loss while as moderate and severe hearing loss was observed in 1 (1.1%) patients each. Conclusion: Hearing loss is not a rare complication asociated with meningitis in neonates, early detection and appropriate treatment is needed to prevent language , speech and intellecual damage.
USE OF CHLOROQUINE IN ASYMPTOMATIC ELDERLY COVID19 PATIENTS, A PLACEBO OR RATHER A SOURCE OF COMPLICATIONS: A CASE REPORT
Authors:   Cardiologist and PhD at Ibn Zohr University, Agadir, Morocco, Provincial Hospital Ibnou Baja, Taza, Morocco., I Benyamna
Published: May 2021

Coronavirus 19 is a virus that caused a pandemic that started in Wuhan, CHINA in December 2019. Whatever it is a respiratory tropism virus, it can cause thromboembolic complications. The disease seems to be more severe in older patients with this virus. However, the introduction of treatment for this purpose remains to be discussed in asymptomatic older subjects. We report the case of a 90-year-old man positive for covid 19 but totally asymptomatic on admission. The administration of chloroquine combined with azithromycin caused digestive side effects leading to dehydration, probably resulting in cerebral venous thrombosis on the 5th day of treatment. The review of the literature and in the absence of large cohort studies demonstrating the value of these treatments, leads us to propose treatment on a case-by-case basis and even better to avoid it in asymptomatic elderly subjects without comorbidities.
ECLAMPSIA AT 16 WEEKS GESTATION ASSOCIATED WITH PARTIAL MOLAR PREGNANCY
Authors:   Department of Gynecology Obstetric, University Hospital Mohammed VI, Marrakech., Aitbenkaddour Y. , Elbehja K. ,   Department of Gynecology Obstetric, University Hospital Mohammed VI, Marrakech., Louridi N. ,   Department of Gynecology Obstetric, University Hospital Mohammed VI, Marrakech., Ouadi H. ,   Department of Gynecology Obstetric, University Hospital Mohammed VI, Marrakech., Soummani A. ,   Department of Gynecology Obstetric, University Hospital Mohammed VI, Marrakech., Hazmiri FZ. ,   Department of Anatomopathology , University Hospital Mohammed VI, Marrakech., El Adib AR. ,   Department of Anesthesiology, Intensive Care and Emergency Medicine, University Hospital Mohammed VI, Marrakech.
Published: May 2021

Eclampsia is a complication of severe preeclampsia.ItÃ‚Â’s commonly defined as new onset of grand mal seizure activity and/or unexplained coma during pregnancy or postpartum in a woman with signs or symptoms of preeclampsia. It typically occurs during or after the 20th week of gestation or in the postpartum period. [1, 2].OtherwiseÃ‚Â‚hydatidiform mole can be associated with very early-onset preeclampsia .In both pathologies Ã‚Â‚various maternal symptoms arise from placental abnormalities. We present a very early case of eclampsia complicating a partial molar pregnancy associated with an exceptional Presssyndrom. Keyword: pre-eclampsia, hydatiform moleÃ‚Â‚ placental dysfunction.
MANAGEMENT STRATEGIES OF PATENT DUCTUS ARTERIOSUS IN PRETERM INFANTSREVIEW ARTICLE
Authors:   Paediatric Senior Specialist, Hatta Hospital, Dubai, DHA., M.H. Shehadeh Ammar , Bilal Alkhawam MHD ,   Paediatric Cardiology Specialist, Hatta Hospital, Dubai, DHA., Mohamed Haider Amjad ,   Consultant Pediatric, Head of Pediatric and NICU department, Belhoul Specialty Hospital.
Published: May 2021

Patent ductus arteriosus (PDA) is a frequent congenital heart defect. It becomes even more common in preterm infants with a high burden of consequences and adverse effects. Recently, the emergence of a constellation of different management protocols urged for a comprehensive summery of the best evidence-based interventions. A detailed electronic search for evidence was carried out, including Cochrane, systemic and narrative reviews. Variable controversial aspects of PDA diagnosis and management were discussed. Brief echocardiographic and laboratory PDA diagnosis followed by a review of symptomatic and asymptomatic PDA Surgical and nonsurgical management strategies included. Early interventionfor asymptomatic PDA depending on echo scoring, and grading all symptomatic PDAs clinically and echographically can guide management and decrease the need for surgical ligation.
CASE REPORT ON FINDING OF ABNORMAL PRESENTATION OF FETUS IN A PARTIAL SEPTATE UTERUS DURING CESAREAN SECTION WITH PARTIAL PLACENTAL SEPTAL IMPLANTATION
Authors:   M.B.B.S , M.S., Vijaywargiya Komal , Bhatnagar Suneeta ,   M.B.B.S , M.D ( ANAESTHESIA ) Senior Consultant Anaesthetist And Teaching Faculty For Diploma Anaesthesia ( cps Course ) in p. C. Sethi Hospital , Indore., Ruia Aayushi ,   M.B.B.S , M.S, Resident At P.C.Sethi Hospital , Indore.
Published: May 2021

Congenital uterine anomalies are seen 1-3% of women, usually asymptomatic and therefore unrecognized until desire of childbearing.[1] Uterine septum is the most frequent (35-48%) structural uterine anomaly and associated with the poorest reproductive outcome. Even if association of septum with infertility is not certain, it is well recognized that it worsens obstetric outcomes with high abortion (44%) and preterm delivery rate (22%).[1] In this case report, we aim to present a term pregnancy with successful outcome with placental implantation on uterine septum.
ADULT CHRISTIAN EDUCATION: A TRAINING OF KINGDOM WORKERS
Authors: Olusola Fasipe (Ph.D) Emmanuel
Published: May 2021

Christian adult learners are to be trained to demonstrate Christlikenessand become agents of change in the society where there is the decadence of morality and godliness. Sadly, many Christian institutions that engage in adult education are not preparing their students to function as agents of change in a corrupt society. Instead, most Christian institutions have concentrated on the development of adult learners both intellectually and theologically. The purpose of adult Christian education is to train workers for the kingdom of Christ. Upon completing their training, adult Christians are to be sent to the world as transformation and development agents. They are to engage in good moral conduct as the redeeming salt and light of the world and respond to violence and injustice in society. Therefore, adult learners teachers should be aware that adult Christians teaching and training should not focus mainly on training intellectuals but must also include moral education and spirituality.
The theory conceptualization of comparative vocational education study
Authors:   Bashkir state pedagogical University named after M. Akmulla, Benin V.L. , Pleshakova A.Yu. ,   Ural State Mining University
Published: May 2021

Authors structure the theory of comparative vocational education study; determine the theory’s prerequisites, core and consequences. The theory prerequisites are presented in terms of VUCA-world, globalization and deglobalization, due to the variety of developed comparative studies approaches. The core of the theory is an ontological model based on the principle of transdisciplinarity, contextual and communicative approaches, method of the "network" and fractal matrix tables method. They as well have their qualitative, quantitative and interpretative methods and includ educational transfer as the main mechanism and term for the best educational practices export. The consequences of the theory are originated from the ontological model that actualizes the predictive function of comparative studies, and consist in the possibility of generating derived ontologies based on the forecast graph, their new levels, sublevels and connections between them, modeling transfer practices and changes in the system that accepts transfer, foreseeing and the emergence of new phenomena of education.