Search

Head and neck cancer patients represent a risk group for the development of fly larvae infestation in neoplastic wounds. This condition can accelerate the disease progression and increase its lethality due to local or systemic complications. The aim of this study was to conduct a scoping review on head and neck cancer associated with myiasis in order to answer the focal question: what are the occurrence, diagnosis, aetiology, treatment and outcomes of head and neck cancer associated with myiasis? This paper was structured based on the five-steps methodology proposed by Arksey and O’Malley (Int J Soc Res Methodol 2005;1:19-32), and followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR), OSF Registries protocol. The electronic search was performed in the MEDLINE/PubMed, Embase and SciELO.org databases for articles published up to 28 February 2021. In total, 38 articles and 56 patients were included. Most patients were male (66%), and the mean age was 66.63 years. Cases were predominantly associated with squamous or basal cell cancer. The most affected anatomical sites were the eyes, scalp, ears and oral cavity, and the most frequent type of larva was Crisomyia (13%). Manual removal of the larvae was considered the standard treatment, associated or not with antibiotics, analgesics and antiparasitic drugs.

PURPOSE: We identified (1) differences in localized prostate cancer (PCa) risk group at presentation and (2) disparities in access to initial treatment for Asian American, Native Hawaiian, and Pacific Islander (AANHPI) men with PCa after controlling for sociodemographic factors. METHODS: We assessed all patients in the National Cancer Database with localized PCa with low-, intermediate-, and high-risk disease who identified as Thai, White, Asian Indian, Chinese, Vietnamese, Korean, Japanese, Filipino, Hawaiian, Pacific Islander, Laotian, Pakistani, Kampuchean, and Hmong. Multivariable logistic regression defined adjusted odds ratios (AORs) with 95% CI of (1) presenting at progressively higher risk group and (2) receiving treatment or active surveillance with intermediate- or high-risk disease, adjusting for sociodemographic and clinical factors. RESULTS: Among 980,889 men (median age 66 years), all AANHPI subgroups with the exception of Thai (AOR = 0.84 [95% CI, 0.58 to 1.21], P > .05), Asian Indian (AOR = 1.12 [95% CI, 1.00 to 1.25], P > .05), and Pakistani (AOR = 1.34 [95% CI, 0.98 to 1.83], P > .05) men had greater odds of presenting at a progressively higher PCa risk group compared with White patients (Chinese AOR = 1.18 [95% CI, 1.11 to 1.25], P < .001; Japanese AOR = 1.36 [95% CI, 1.26 to 1.47], P < .001; Filipino AOR = 1.37 [95% CI, 1.29 to 1.46], P < .001; Korean AOR = 1.32 [95% CI, 1.18 to 1.48], P < .001; Vietnamese AOR = 1.20 [95% CI, 1.07 to 1.35], P = .002; Laotian AOR = 1.60 [95% CI, 1.08 to 2.36], P = .018; Hmong AOR = 4.07 [95% CI, 1.54 to 10.81], P = .005; Kampuchean AOR = 1.55 [95% CI, 1.03 to 2.34], P = .036; Asian Indian or Pakistani AOR = 1.15 [95% CI, 1.07 to 1.24], P < .001; Native Hawaiians AOR = 1.58 [95% CI, 1.38 to 1.80], P < .001; and Pacific Islanders AOR = 1.58 [95% CI, 1.37 to 1.82], P < .001). Additionally, Japanese Americans (AOR = 1.46 [95% CI, 1.09 to 1.97], P = .013) were more likely to receive treatment compared with White patients. CONCLUSION: Our findings suggest that there are differences in PCa risk group at presentation by race or ethnicity among Asian American, Native Hawaiian, and Pacific Islander subgroups and that there exist disparities in treatment patterns. Although AANHPI are often studied as a homogenous group, heterogeneity upon subgroup disaggregation underscores the importance of further study to assess and address barriers to PCa care.

Objective To compare the effectiveness of five versus seven days of nitrofurantoin treatment for urinary tract infection (UTI) in diabetic women. Methods Data were collected retrospectively from Dutch general practitioners between 2013 and 2020. Nitrofurantoin prescriptions with a duration of five (5DN) or seven days (7DN) in women with diabetes were included. Inverse propensity weighting (IPW) was performed to calculate adjusted risk differences (RD) for treatment failure within 28 days. Secondary outcomes were 14-day treatment failure, severe treatment failure, and 28-day treatment failure in defined risk groups. Results Nitrofurantoin was prescribed in 6866 episodes, 3247 (47,3%) episodes with 5DN and 3619 (52,7%) episodes with 7DN. Patients in the 7DN group had more co-morbidities, more diabetes-related complications and were more insulin-dependent. There were 517/3247 (15.9%) failures in the 5DN group versus 520/3619 (14.4%) in the 7DN group. The adjusted RD for failure within 28 days was 1.4% (95% CI -0.6 to 3.4). Conclusion We found no clinically significant difference in treatment failure in diabetic women with UTI treated either five or seven days with nitrofurantoin within 28 days. A 5-day treatment should be considered to reduce cumulative nitrofurantoin exposure in DM patients.

Tumor lysis syndrome (TLS) is a commonly observed oncological emergency that requires prompt diagnosis and treatment. Rasburicase is a recombinant urate oxidase endorsed in TLS for the treatment of hyperuricemia. The effect of single-dose 7.5 mg rasburicase at longer follow-ups was not widely investigated.Eighty-two patients included in the study with clinical TLS and laboratory TLS. The primary endpoint was the normalization of uric acid (6mg/dL) within 24 hours of rasburicase administration, which was described as treatment success. The secondary endpoint was defined as having sustained response at the first week. The third endpoint was defined as the reaching the baseline renal function before TLS.We found that the use of a 7.5 mg dose of rasburicase controlled uric acid in 74 of 82 (90,2%) patients at the 24th hour. In the first week, uric acid remained at normal levels in 69 of 82 (84,1%) patients. At 24 hours, the TLS risk group was the only predictor for failing uric acid normalization; at the end of the first week, no predictive factor was identified for failing uric acid normalization.Rasburicase at 7.5 mg dose is an important agent for controlling laboratory and clinical TLS at 24 hours and extending its effect to the first week.

Community-acquired pneumonia remains one of the most pressing problems of bronchopulmonary pathology among military personnel. Risk group are newly organized military units, where outbreaks of infectious diseases occur, in particular acute respiratory ones, that caused the outbreaks of community-acquired pneumonia. Despite the fact that considerable progress was achieved in the diagnosis and treatment of community-acquired pneumonia and prevention of its complications, on the one hand, there was a significant evolution in the views on the understanding of the pathogenesis of infectious process, on the other — the indices of morbidity and mortality remain its growth dynamics around the world. We have examined separately 50 patients with community-acquired pneumonia, who were treated in April 2015. Of these, in 44 (88 %) patients we have detected a viral agent: adenovirus — in 34 patients, rhinovirus — in 14, influenza A — in 3, parainfluenza — in 1, coronavirus 229E — in 1, coronavirus OC43 — in 1 patient ; viral agent has not been detected in 6 patients.

Purpose In 2017, the Children's Hepatic Tumors International Collaboration-Hepatoblastoma Stratification (CHIC-HS) system was introduced. We aimed to evaluate the accuracy of Children's Hepatic Tumors International Collaboration-Hepatoblastoma Stratification (CHIC-HS) System for the prediction of event-free survival in Korean pediatric patients with hepatoblastoma. Materials and methods This two-center retrospective study included consecutive Korean pediatric patients with histopathologically confirmed hepatoblastoma from March 1988 through September 2019. We compared event-free survival (EFS) among four risk groups according to the CHIC-HS system. Discriminatory ability of CHIC-HS system was also evaluated using optimism-corrected C-statistics. Factors associated with EFS were explored using multivariable Cox regression analysis. Results We included 129 patients (mean age, 2.6±3.3 years; female:male, 63:66). The 5-year EFS rates in the very low, low, intermediate, and high-risk groups, according to the CHIC-HS system were 90.0%, 82.8%, 73.5%, and 51.3%, respectively. The CHIC-HS system aligned significantly well with EFS outcomes (p=0.004). The optimism-corrected C index of CHIC-HS was 0.644 (95% CI, 0.561-0.727). Age ≥8 (vs. age ≤2; HR, 2.781; 95% CI, 1.187-6.512; p=0.018), PRE-Treatment EXTent of tumor (PRETEXT) stage IV (vs. PRETEXT I or II; HR, 2.774; 95% CI, 1.228-5.974; p=0.009), and presence of metastasis (HR, 2.886; 95% CI, 1.457-5.719; p=0.002), which are incorporated as the first three nodes in the CHIC-HS system, were independently associated with EFS. Conclusion The CHIC-HS system aligned significantly well with EFS outcomes in Korean pediatric patients with hepatoblastoma. Age group, PRETEXT stage, and presence of metastasis were independently associated with EFS.

The article describes the main stages of the development of views on the diagnosis of chronic gastritis with highlighting the issue of diagnosis as an integral part of the set of measures concerning the timely detection of preneoplastic changes in the gastric mucosa. The main views on the development of carcinogenesis are presented based on current knowledge about the factors influencing the course of this process. Among known measures to prevent the development of precancerous changes, today the most important ones are the reliable stratification of risk groups in terms of their development and the strategy for identifying and eliminating Helicobacter pylori as a recognized factor of carcinogenesis. The development of bacterial resistance to basic medications recommended in the schemes of eradication therapy causes a further search of ways to enhance their effectiveness. As shown in a number of studies, the results of which are presented in the article, the most reliable is the inclusion of bismuth subcitrate (De-Nol) in the schemes of eradication.

This document is an update to the clinical practice recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. The consensus has been developed by a multidisciplinary team made up of members of the Cardiovascular Risk Group of the Spanish Diabetes Society (SED). The work is a necessary update as, since the last review three years ago, there have been many clinical trials that have studied the cardiovascular outcomes of numerous drugs in the diabetic population. We believe that this guideline update may be of interest to all clinicians treating patients with diabetes.

BACKGROUND The currently utilized International Neuroblastoma Risk Group (INRG) staging system developed in 2009 uses image-defined risk factors as a measure of surgical risk, separating resectable neuroblastoma from those best preceded by chemotherapy. The previous International Neuroblastoma Staging System was based primarily on surgical findings. We hypothesized there would be a change to the role of the surgeon in neuroblastoma treatment in the more recent decade. METHODS This is a single center 20-year retrospective analysis of 104 patients with International Classification of Diseases-9 and -10 codes for neuroblastoma. Patient demographics, tumor site, cancer treatment modality, survival, biopsy technique, surgical intervention, and pathology staging were collected. Data was analyzed by analysis of variance (ANOVA) and Student's t test. RESULTS There was a decrease in open surgeries for extra-adrenal neuroblastomas in the later decade (77%, 31%, P = 0.01). There was a narrowing of the time interval to surgery in the later cohort, likely as a result of uniformity in surgical timing on treatment protocols relying on INRG staging. CONCLUSIONS Our findings mirror changes in practice patterns globally. We found an increase in minimally invasive approaches but did not find a difference in the role of the surgeon under the INRG staging system.

Objectives : We implemented a stratified risk analysis to predict the development of active tuberculosis (TB) in liver transplantation (LT) recipients based on IGRA and chest images in the TB-endemic area. Methods In this retrospective cohort study, LT recipients who tested for IGRA between May 2008 and December 2017 were included. Chest images compatible with old TB lesions were considered as positive images. LT recipients were divided into six groups: LT recipients with history of treated TB, image (+)/IGRA (+), image (+)/IGRA (-), image (-)/IGRA (+), image (-)/IGRA (-) and LTBI treated. The Cox regression model was used to analyze risk groups. Results Among the 717 eligible LT recipients included in this study, 21 patients developed active TB. Incidence rates of TB were 2,261, 724, and 119 cases/100,000 person-years in the 1st, 2nd, and ≥ 3rd year after transplantation, respectively. History of treated TB (HR 18.92; 95% CI 4.10–87.25) and image (+)/IGRA (+) (HR 10.86; 95% CI 2.75–42.89) were independent risk factors for developing active TB. IGRA (+) with a negative image was not a risk factor. Conclusions Our findings suggested that both IGRA and chest images should be considered to identify risk groups for LTBI treatment.

PURPOSE CNS relapse in patients with diffuse large B-cell lymphoma (DLBCL) is associated with poor prognosis with a median survival of about 2.5 months. Data demonstrating best prophylactic strategy remain controversial and need further definition. PATIENTS AND METHODS We present data of 110 patients with DLBCL treated with standard systemic therapy divided into four groups based on primary CNS prophylaxis strategy and CNS International Prognostic Index (IPI) risk categories. We compared their 3-year CNS relapse rate and overall survival in each group. RESULTS The CNS prophylaxis strategy consisted of intrathecal (IT) methotrexate (MTX) in group 1, high-dose (HD) MTX in group 2, combination IT and HD MTX in group 3, and IT and/or HD MTX with intensive chemotherapy in group 4. At 3 years, CNS relapse rate was 8.6% (4/46), 8.3% (1/12), 4.8% (2/42), and 18% (2/11) in groups 1-4 ( P = .64), respectively. According to CNS IPI, the CNS relapse rate was 16.6%, 10.1%, and 0% in high-, intermediate-, and low-risk groups, respectively. The 3-year overall survival rate was 69%, 75%, 80%, and 45% in groups 1-4 ( P = .71), respectively. CONCLUSION Our study while did not find statistical significance did indicate a lower incidence of CNS relapse with the addition of systemic HD MTX to IT MTX in the high-risk DLBCL population.

Objective: Limited data about the prognostic significance of BCL2 mutations and BCL2 copy number variations in diffuse large B-cell lymphoma (DLBCL) are available. This study aimed to comprehensively describe BCL2 genetic alterations in DLBCL patients, and examine correlation of BCL2, TP53 and other genetic alterations with outcomes in patients treated with R-CHOP. Methods: Probe capture-based high-resolution sequencing was performed on 191 patients diagnosed with de novo DLBCL. MYC, BCL2, and BCL6 protein expressions were detected by immunohistochemistry. Results: The presence of BCL2 alterations significantly correlated with poor progression-free survival (PFS) (5-year PFS: 13.7% vs. 40.8%; P = 0.003) and overall survival (OS) (5-year OS: 34.0% vs. 70.9%; P = 0.036). Importantly, patients who harbored BCL2 gain/amplifications (BCL2GA/AMP) also had a remarkably inferior 5-year PFS (11.1% vs. 38.3%; P < 0.001) and OS (22.1% vs. 69.6%; P = 0.009). In contrast, neither BCL2 mutations nor BCL2 translocations were significantly prognostic for survival. Multivariable analyses showed that the presence of BCL2 alterations, especially BCL2GA/AMP, TP53 mutations, and International Prognostic Index (IPI) were significantly associated with inferior PFS and OS. Novel prognostic models for OS were constructed based on 3 risk factors, including BCL2 alterations (Model 1) or BCL2GA/AMP (Model 2), TP53 mutations, and IPI, to stratify patients into 4 risk groups with different survival outcomes. Conclusions: This study showed that DLBCL patients treated with R-CHOP, BCL2 alterations, especially BCL2GA/AMP and TP53 mutations were significantly associated with inferior outcomes, which were independent of the IPI. The novel prognostic models we proposed predicted outcomes for DLBCL patients treated with R-CHOP, but further validation of the prognostic models is still warranted.

Amaç: Bu çalışmanın amacı düşük riskli ve yüksek riskli gebelerde karşılaşılan konjenital kalp hastalıkları (KKH) sıklığının fetal ekokardiyografi (FE) tetkiki ile araştırılmasıdırMateryal Metod: Temmuz 2019-Ekim 2021 tarihleri arasında hastanemiz çocuk kardiyoloji polikliniğine başvuran ve FE uygulanan gestasyonel haftası 16 dan büyük 855 gebenin kayıtları geriye dönük olarak incelendi.Bulgular: Çalışma yaptığımız merkezimize yönlendirilerek FE incelemesi yapılan 855 gebenin 109'unda (%12,7) KKH saptandı. KKH sıklığı risk gruplarına göre verildi. Başvuru nedenlerine göre yüksek riskli grupta yer alan hastalarda DKH nın oranı % 15.2 iken düşük riskli gruptaki hastalarda % 9 olarak tespit edildi (p=0.008). Önemli DKH yüksek riskli grupta % 6.2 iken düşük riskli grupta % 2.7 idi (p=0.016). Fetal ekokardiyografi incelemesinde en sık rastlanan kardiyak anomali ventriküler septal defekt (42 fetusta %38.5) ve ikinci sıklıkta tespit ettiğimiz kardiyak anomali ise atriyoventriküler septal defekt idi (20 fetusta % 18.3).Sonuç: Çalışmamızda yüksek risk grubundaki gebelerde düşük risk grubundakilere göre daha yüksek oranda KKH bulundu ve özellikle önemli KKH yüksek risk grubundaki gebelerde daha sık saptandı., Aim: The aim of this study is to evaluate the frequency of congenital heart diseases (CHD) encountered in low-risk and high-risk pregnant women by fetal echocardiographic (FE) examination.Material and Method: The records of 855 pregnant women with a gestational week greater than 16 who applied to the pediatric cardiology outpatient clinic of our hospital between July 2019- October 2021 and underwent FE were analyzed retrospectively. Results: CHD was detected in 109 (12.7%) of 855 pregnant women who were referred to our center and underwent FE examination. Frequency of CHD was given according to risk groups. The rate of CHD in patients in the high-risk group was 15.2%, while it was 9% in patients in the low-risk group (p=0.008). Significant CHD was 6.2% in the high-risk group versus 2.7% in the low-risk group (p=0.016). The most common structural cardiac anomaly in FE examination was ventricular septal defect (38.5% in 42 fetuses), and the second most common cardiac anomaly was atriyoventricular septal defect (18.3% in 20 fetuses). Conclusion: In our study, it was found a higher rate of CHD in pregnant women in the high-risk group than in the low-risk group and especially significant CHD was detected more common in pregnant women in the high-risk group.

Occurrence of the premature birth in Ukraine is about 6%. Premature newborns are the highest risk group of developing chronic pathology of the nervous system, sensory organs, and respiratory system, causing neonatal mortality and disability; the latter is 22 times higher in premature newborns than in full-term ones. Besides, there is a large group of rare metabolic disorders that significantly disrupt the adaptation and nursing of newborns with signs of morpho-functional and enzymes immaturity. The efficacy of medical care of premature newborns to a great extent relates to prompt diagnosis as common somatic, as rare metabolic disorders.In view of the absence of specific symptoms, it is almost impossible to establish a diagnosis of inherited metabolic disordersduring the clinical examination of a neonate.Expanded newborn screening (ENBS) for inborn errors of metabolism (IEMs) proved to be an effective tool to single out newborns with genetic deficiency of certain metabolic enzymes.The practical experience of performingENBS indicates a problematic issue is the interpretation of results for preterm babies.This article is discussed the key factors affecting the predictive value of ENBS results in premature newborns, like peculiarities of blood sampling based on time intervals from delivery for certain nosologies, repeated sample taking for lab examination considering the basic principles of 2-nd Edition of CLSI "Guideline "Newborn Screening for Preterm, Low Birth Weight, and Sick Newborns, 2019". The CLSI Guideline presents the consensus solutions of a global team of neonatologists, metabolic paediatricians and medical geneticists regarding the accuracy, reliability and timing of laboratory determinations of IEM markers in the blood, as well as a set of factors to consider interpreting ENBS results for premature, low birth weight and newborns with perinatal pathology.The current procedure for neonatal screening for premature babies in Ukraine should be updated to modern requirements of the relevant clinical recommendations of world-recognized medical institutions, including CLSI. The critical issue in improving the quality and reliability of neonatal screening for preterm babies is multiple (repeated) blood sampling for laboratory determination of levels of biochemical IEM markers.A properly established and well- functioning system of expanded neonatal screening proved to be a highly effective tool for reducing early infant mortality and disability associated with inherited metabolic diseases.

BACKGROUND No risk-stratification strategies exist for patients with recurrent oropharyngeal cancer (OPC). METHODS Retrospective analysis using data from prospective NRG Oncology clinical trials RTOG 0129 and 0522. Eligibility criteria included known p16 status and smoking history, and locoregional/distant recurrence. Overall survival (OS) was measured from date of recurrence. Recursive partitioning analysis was performed to produce mutually exclusive risk groups. RESULTS Hundred and fifty-four patients were included with median follow-up after recurrence of 3.9 years (range 0.04-9.0). The most important factors influencing survival were p16 status and type of recurrence, followed by surgical salvage and smoking history (≤20 vs. >20 pack-years). Three significantly different risk groups were identified. Patients in the low-, intermediate-, and high-risk groups had 2-year OS after recurrence of 81.1% (95%CI 68.5-93.7), 50.2% (95%CI 36.0-64.5), and 20.8% (95%CI 10.5-31.1), respectively. CONCLUSION Patient and tumor characteristics may be used to stratify patients into risk groups at the time of OPC recurrence.

Purpose Current guidelines for surveillance strategy in cervical cancer are rigid, recommending the same strategy for all survivors. The aim of this study was to develop a robust model allowing for individualised surveillance based on a patient's risk profile. Methods Data of 4343 early-stage patients with cervical cancer treated between 2007 and 2016 were obtained from the international SCCAN (Surveillance in Cervical Cancer) consortium. The Cox proportional hazards model predicting disease-free survival (DFS) was developed and internally validated. The risk score, derived from regression coefficients of the model, stratified the cohort into significantly distinctive risk groups. On its basis, the annual recurrence risk model (ARRM) was calculated. Results Five variables were included in the prognostic model: maximal pathologic tumour diameter; tumour histotype; grade; number of positive pelvic lymph nodes; and lymphovascular space invasion. Five risk groups significantly differing in prognosis were identified with a five-year DFS of 97.5%, 94.7%, 85.2% and 63.3% in increasing risk groups, whereas a two-year DFS in the highest risk group equalled 15.4%. Based on the ARRM, the annual recurrence risk in the lowest risk group was below 1% since the beginning of follow-up and declined below 1% at years three, four and >5 in the medium-risk groups. In the whole cohort, 26% of recurrences appeared at the first year of the follow-up, 48% by year two and 78% by year five. Conclusion The ARRM represents a potent tool for tailoring the surveillance strategy in early-stage patients with cervical cancer based on the patient's risk status and respective annual recurrence risk. It can easily be used in routine clinical settings internationally.

Background Malignant pleural effusion (MPE) is common in malignant pleural mesothelioma (MPM). The survival of patients with MPM and MPE is heterogeneous. The LENT and BRIMS scores using routine clinical parameters were developed to predict the survival of patients with unselected MPE and MPM, respectively. This study aimed to stratify the survival of selected MPM patients with MPE. Methods Data were collected from subjects diagnosed with MPM and MPE. The LENT and BRIMS scores were applied using a combination of clinical variables to stratify subjects and compare survival characteristics. Results In total, 101 patients with MPM complicated by MPE were included in the study. The median follow‐up time was 71 months (interquartile range: 24–121 months). Overall median survival was 24 (interquartile range: 12–52 months). Based on the LENT score, the low‐, moderate‐, and high‐risk groups accounted for 65.3% (66 cases), 34.7% (35 cases), and 0%, respectively. The cumulative survival rates of the two groups were statistically significant (p = 0.031). The area under the curve (AUC) of the LENT score was 0.662. Based on the BRIMS score, the first, second, third, and fourth risk groups accounted for 1.0% (1 case), 42.9% (35 cases), 28.7% (29 cases), and 19.4% (36 cases), respectively. Survival was significantly higher in patients in the risk groups 1 and 2 than in patients in the risk groups 3 and 4 (p = 0.037). The AUC of the BRIMS score was 0.605. Conclusions Using routinely available clinical variables, both LENT and BRIMS scores could stratify selected MPM and MPE patients into risk groups with statistically different survival., The individual survival of patients with MPM combined with MPE varied greatly in this study. Both LENT and BRIMS scores could help stratify the survival risk of patients with MPM complicated by MPE with fair‐to‐good performance. More effective predictive models should be established in adequately designed prospective studies.

Bladder cancer (BC) has an unpredictable prognosis. Pyroptosis is a novel form of programmed cell death. However, whether the pyroptosis-related genes have a prognostic value remains unknown. In this study, we downloaded the mRNA expression and clinical data of BC patients and used the LASSO Cox analysis was employed to build a signature. High-risk patients had a significantly lower overall survival (OS) (p < .0001). Single-sample gene set enrichment analysis (ssGSEA) indicated that the tumor immune microenvironment was different between the two risk groups. In conclusion, a pyroptosis-related signature can be used for OS prediction of patients with BCs.

Background Peripheral neuroblastic tumors (pNTs) are the most common childhood extracranial solid tumors. There are several therapeutic strategies targeting disialoganglioside GD2. Disialoganglioside GD3 has become a potential target. However, the mechanism by which pNTs express GD3 and GD2 remains unclear. We investigated the combined expression status of GD3 and GD2 in pNTs and delineated their clinicopathological values. Methods GD3 and GD2 expression was examined in pNT tissue samples (n = 35) using immunohistochemistry and multiple immunofluorescence imaging. Results GD3 and GD2 expression was positive in 32/35 and 25/35 samples, respectively. Combinatorial analysis of GD3 and GD2 expression in neuroblastoma showed that both were heterogeneously expressed from cell to cell. There were higher numbers of GD3-positive and GD2-negative cells in the low-risk group than in the intermediate-risk ( P = 0.014) and high-risk ( P = 0.009) groups. Cases with high proportions of GD3-positive and GD2-negative cells were associated with the International Neuroblastoma Staging System stage ( P = 0.004), Children’s Oncology Group risk group ( P = 0.001), and outcome ( P = 0.019) and tended to have a higher overall survival rate. Conclusion We demonstrated that neuroblastomas from low-risk patients included more GD3-positive and GD2-negative cells than those from high-risk patients. Clarifying the heterogeneity of neuroblastoma aids in better understanding the biological characteristics and clinical behavior.

Background: although the search for biomarkers of mental disorders that is aimed at improving diagnosis, individualizing therapy based on knowledge of pathophysiological processes and preventing the development of mental illness is actively underway for endogenous mental disorders, the study of biological markers in non-endogenous mental disorders and posttraumatic stress disorder (PTSD) in particular has received much less attention.Aim: to analyze current state of research dedicated to genetic and biochemical biomarkers that can be used to identify high risk groups and clarify the diagnosis of PTSD.Material and method: keywords “biomarkers”, “post-traumatic stress disorder”, “pathogenesis” have been used to fi nd in PubMed articles published in 2010–2020.Conclusion: research methods for elucidating the mechanisms of PTSD are actively developing, however, the identifi cation of specifi c biomarkers (biochemical, molecular, genetic, epigenetic, neuroimaging, psychophysiological) is a complicated task. This complexity is associated with numerous pathogenic mechanisms of PTSD and frequent comorbidity with mental disorders (depression, anxiety) and somatic diseases, as well as lack of specifi city of detected biomarkers.

The Tyumen Region, being the largest one in the Ural Federal District in terms of territory, has a high level of HIV prevalence, particularly among those taken into custody. This group of people involves the maximum number of injecting drug users, men having sexual encounters with other men and sex workers. All acquired diseases including the diseases aggravated during the service of sentence become the problem of the expirees as well as the entire civil society. From an epidemiological perspective it is important to search for the risk factors which are active among the prisoner population serving their sentence in the region and which cause HIV progression with fatal outcome, taking into account their unequal significance among the prisoner population and the civilians.Object of research. 365 HIV-infected, deaths were identified, including: the study group — 222 prisoners, HlV-infected and died at the regional hospital of the Federal penitentiary service of Tyumen for the period 2008-2018; the control group - 143 civil (law-abiding) patients, HIV-infected and died at the Regional infectious diseases hospital for the period 2011-2018.Purpose of research. Identification and assessment of priority risk factors for the expansion of the epidemic process of HIV infection with a fatal outcome in the zone of high concentration of the risk group.Methods of research. The following methods have been used in this work: methods of epidemiological research, methods of mathematical modeling and forecasting, as well as the method, of logistic regression, of step-by-step inclusion with ROC analysis.Results. To assess the epidemiological situation in terms of the HIV infection prevalence in the prison area a long-term and intra-annual dynamics of the epidemic process expansion in the region have been studied along with assessment of the priority risk factors, trends, forecasting of the HIV infection expansion in the penitentiary system specifying the social significance and risks to the civilian population over a long period.

Most researchers agree that the level of protective anti-HBs decreases with age after 3-fold immunization in the first year of life, which requires the introduction of a booster dose at least 5—7 years after the completed vaccination. It is necessary to continue monitoring those vaccinated against hepatitis B in the first year of life, including those from occupational risk groups.Objective: to assess the frequency and level of anti-HBs 18 or more years after the completed course of vaccination against hepatitis B according to the standard scheme in the first year of life and to identify risk groups that need revaccination.Of 116 donor students in Moscow, 18—22 years after the completed course of vaccination against hepatitis B according to the standard scheme carried out in the first year of life, in 42.3% of cases, the titer of specific antibodies was determined below the protective level (< 10 mME/ml). At the same time, the share of seronegative individuals among medical students was higher (52.8%). Of 116 donor students, in 38.8% of cases, the titer of protective antibodies was determined in low (10—100 mME/ml) and only in 13.8% — in high (100—1000 mME/ml) and in 5.2% — very high (> 1000 mME/ml) values. Markers of DNA HBV, HBsAg, and anti-HBcor were not detected in any cases. Medical students primarily need a revaccination against hepatitis B without a preliminary study of the initial titers of specific antibodies.

Q fever is an important zoonotic disease worldwide. The main sources of human infection are inhalation of aerosols containing Coxiella burnetii bacteria and exposition to infected materials during parturition or slaughtering. The high-risk group includes people who work directly with infected livestock, such as farmers, veterinarians, veterinary medicine students, slaughterhouse and laboratory staff. Here we present a pilot study of risk-group human seroprevalence to C. burnetii in Latvia. The study included 240 sera samples — 190 from the risk groups and 50 from the control group. Samples were tested with Coxiella burnetii (Q-fever) Phase 1 and 2 IgG ELISA kits. All sera from the control group were negative. The seroprevalence among risk group persons was 8.04–11.54%. No statistically significant differences were observed between genders. The highest percentage of seropositive and equivocal sera samples (25%) were detected in age categories 39–48 years and 49–58 years. Working as a practicing veterinarian or former veterinarian was the only risk factor identified as statistically significant, and belonging to the risk group in general. The geographical distribution of seropositive risk group participants indicated that they tend to located more in the northern, central, and eastern part of the country.

Objectives: Brucellosis is a neglected zoonotic disease in Pakistan, but it causes immense impact on livestock and public health. This study was done to determine the prevalence of Brucellosis in occupationally high-risk groups encompassing butchers, milkers, and cattle caretakers in district Swabi, Mardan, and Peshawar of Khyber Pakhtunkhwa, Pakistan. Methods: In this descriptive cross-sectional study, 300 blood samples were collected through a non-probability purposive sampling technique from occupationally high-risk groups including butchers, milkers, and cattle caretakers at district Swabi, Mardan, and Peshawar from December 1, 2017, to March 31, 2018. All the blood samples were centrifuged and the serum was separated for further testing. Serum agglutination test was used for the detection of Brucellosis and the reagents used for this method were purchased from Biosciences PTE Ltd, Singapore. Results: Out of 300 blood samples, 111 samples were positive and the overall prevalence of Brucellosis was 37% in occupationally high-risk groups. The overall 37% prevalence of Brucellosis comprised of 70% of B. abortus, 21.6% of B. melitensis, and 8.1% of both B. abortus and B. melitensis simultaneously. The prevalence of Brucellosis in butchers was 27.6%, milkers 13.3%, and cattle caretakers 45.7% while prevalence in males was 33% and in females 39.6%. The prevalence of Brucellosis in district Swabi was 45%, Mardan 33.3%, and Peshawar 30%. The socio demographic factors including age group, occupation, and locality showed statistically significant results. Conclusion: The prevalence of Brucellosis is considerably higher in occupationally high-risk groups in district Swabi, Mardan, and Peshawar, Pakistan.

Подані сучасні положення про можливості скринінгу і ранньої діагностики гепатоцелюлярної карциноми з використанням променевих методів візуалізації, неінвазивних серологічних і імуногістохімічних маркерів, а також показання і можливості морфологічного дослідження вогнищевих утворень печінки в пацієнтів із групи ризику.

Актуальність. Ретинопатія недоношених (РН) є специфічною хворобою саме глибоко недоношених дітей і посідає одне з головних місць у структурі дитячої інвалідності по зору, однак цьому стану можна запобігти завдяки своєчасному хірургічному втручанню. Для запобігання тяжким ускладненням у всьому світі застосовують планові профілактичні огляди очного дна в дітей із групи ризику розвитку РН кожні 2 тижні. Це надійна та перевірена роками методика, недоліками якої можна вважати завдання дитині додаткового медичного навантаження та потреба в досить дорогому офтальмологічному обладнанні, наявності в медперсоналу специфічних навичок для проведення огляду очей недоношеної новонародженої дитини. Через це вважаємо актуальним пошук додаткових засобів прогнозування розвитку цієї хвороби. Зважаючи на наявність доказаного зв’язку рівня фактора росту ендотелію судин (ФРЕС) в середовищах організму з розвитком РН, ми зацікавились можливістю побудувати методику прогнозування розвитку РН на основі цього зв’язку. Мета: встановити зв’язок між змінами рівня ФРЕС у сльозовій рідині дітей із групи ризику розвитку РН із появою та/або прогресуванням цієї хвороби. Матеріали та методи. До дослідження увійшли 23 дитини з групи ризику розвитку РН (вага при народженні ≤ 1500 г та термін гестації ≤ 32 тижнів). Одночасно зі скринінговим оглядом очного дна проводився відбір сльозової рідини. Для цього використовували стерильний клаптик фільтровального паперу з подальшою заморозкою (патент України на корисну модель № 121473, МПК А61В 3/00 від 11.12.2017. Бюл. № 23). Рівень ФРЕС визначали методом імуноферментного твердофазного аналізу. Отримані дані підлягали статистичній обробці з використанням критерію Стьюдента та W-критерію Вілкоксона. Результати. Виявлено, що рівень ФРЕС у сльозі недоношених дітей із групи ризику розвитку РН підвищується при появі або прогресуванні цієї хвороби. В той же час ми бачимо відсутність змін рівня ФРЕС у сльозі новонароджених, які мали нормальний розвиток сітківки без проявів хвороби в динаміці. Висновки. Виявлено статистично значуще підвищення рівня ФРЕС у сльозі недоношених дітей у динаміці при прогресуванні ретинопатії або при відсутності позитивної динаміки., Актуальность. Ретинопатия недоношенных (РН) является специфическим заболеванием, связанным с недоношенностью. Она занимает одно из главных мест в инвалидизации по зрению в детском возрасте. Однако развитие серьезных осложнений при РН можно предотвратить своевременным вмешательством. Для этого во всем мире принята система скрининговых осмотров детей из группы риска развития РН каждые 2 недели. Это надежная и проверенная методика, которая, однако, имеет свои особенности: дополнительная нагрузка недоношенного ребенка медицинскими процедурами, необходимость наличия дорогостоящего специфического оборудования, специальных навыков у медперсонала для проведения осмотра глазного дна этой группы пациентов. Поэтому считаем актуальным поиск дополнительных возможностей прогнозирования развития РН. Связь уровня фактора роста эндотелия сосудов (ФРЭС) с развитием РН на сегодня доказана, и нам представляется интересной возможность разработки методики прогнозирования РН на основе этой связи. Цель: показать связь уровня ФРЭС в слезной жидкости детей из группы риска развития РН с появлением и/или прогрессированием этого заболевания. Материалы и методы. В исследование вошли 32 ребенка из группы риска развития РН (вес при рождении ≤ 1500 г и срок гестации ≤ 32 недель). Вместе со скрининговым осмотром проводили отбор слезной жидкости. Для этого использовали стерильную фильтровальную бумагу с последующей заморозкой (патент Украины на полезную модель № 121473, МПК А61В 3/00 от 11.12.2017. Бюл. № 23). Уровеь ФРЭС определяли методом иммуноферментного твердофазного анализа. Полученные данные были статистически обработаны с использованием критерия Стьюдента и W-критерия Вилкоксона. Результаты. Выявлено, что уровень ФРЭС в слезе недоношенных детей из группы риска развития РН повышается при появлении или прогрессировании этого заболевания. В то же время изменения отсутствовали у детей без проявлений РН в динамике. Выводы. Выявлено статистически значимое повышение уровня ФРЭС в слезе недоношенных детей в динамике при прогрессировании болезни или при отсутствии положительной динамики., Background. The retinopathy of prematurity (ROP) is a specific pathology of premature newborns. ROP can lead to blindness, but it is predictable with early treatment. To prevent severe complications, all pediatric ophthalmologists use screening for premature newborns every 2 weeks before the retina becomes to normal condition, or the ROP appears. But every-two-week screening disturbs such babies, needs the special equipment and high skills of ophthalmologists and nurses to provide this procedure. Such features make us to look for additional ways to diagnose the ROP. Today we know the relation between the vascular-endothelial growth factor (VEGF) levels and the ROP onset. In this study, we searched the method of the ROP prediction based on changing of VEGF levels. The purpose was to find the relation between the changes of VEGF level in the tears in premature newborns of the risk group and the state of ROP. Materials and methods. The study involved 32 newborns of the risk group for the ROP (weight of birth was less than 1500 g, gestation age was under 32 weeks). At the moment of screening, we took the tears from babies. To collect the tears, we used the sterile sheet of filter paper with further freezing. The VEGF level was determined by the solid immunoassay analysis. The data obtained were statistically processed with Student’s and Wilcoxon criterions. Results. VEGF level in tears in premature newborns of the risk group for ROP was found to be higher if associated with onset or the progression of this disease. Also no changes were determined in babies with normal retina growth without ROP. Conclusions. Statistically significant increase in VEGF level in tears was found in premature babies with ROP onset or its progression.

Despite the fact that the phenomenon of unrecovered coronary blood flow (no-reflow) has long been known, there is still no unanimous opinion about the predictors and, accordingly, the risk groups for its occurrence. This prevents predicting the further course of the disease and investigating the effectiveness of therapeutic and surgical methods for preventing the consequences of reperfusion in patients with ST-segment elevation myocardial infarction, which in turn worsens the postoperative and long-term prognosis in this group of patients. We used the search engines E-library, Google Scholar and Pubmed to search for studies on this issue. The article presents and analyzes research data covering the predictors of the no-reflow phenomenon. The difficulties in identifying them are also described, the issue of a diagnostic approach ans sampling for research is raised. A review of studies dedicated to the identification of predictors of the no-reflow phenomenon using optical coherence tomography and intravascular ultrasound is given.

Актуальність. Дані щодо кількості хворих із хронічною ішемією головного мозку серед дітей та підлітків поодинокі й нечисленні. Отже, актуальність дослідження стану та змін мозкової гемодинаміки, зокрема венозної циркуляції, у дітей, хворих на бронхіальну астму, не викликає сумніву й є вкрай гострим питанням. Мета. Вивчення особливостeй стану венозної гемодинаміки головного мозку у дітей, хворих на бронхіальнy астмy. Матеріали та методи. Проведено ультразвукове допплерографічне дослідження 101 хворих на бронхіальну астму та 30 здорових дітей віком 10–17 років. Хворих дітей було розподілено за гендерною приналежністю, ступенем контролю та тривалістю захворювання. Ультразвукова допплерографія здійснювалась з визначенням максимальної лінійної швидкості кровоплину в руслі базальної вени Розенталя. Результати. Встановлено явища персистуючої венозної дисгемії та веностазу у хворих дітей, особливо хлопчиків, незалежно від ступеня контролю бронхіальної астми. На показники венозної гемодинаміки також негативно впливала тривалість захворювання понад 5 років. Висновки. Oсобливості венозної циркуляції y дітей, хворих на бронхіальнy астмy, є ранніми доклінічними ознакaми цереброваскулярних порушень. Запропоновано віднести їх до групи ризику щодо виникнення цереброваскулярної патології в майбутньому. Доцільно доповнити диспансернe спостереження дітей, хворих на бронхіальнy астмy, дослідженням стану венозної гемодинаміки з використанням транскраніальної допплерографії та дуплексного сканування магістральних судин головного мозку, що забезпечить ранню діагностику цереброваскулярних порушень.

Introduction. The high incidence of noise-induced hearing loss (NIHL) makes it possible to attribute the problem of prevention and prediction of the risk of NIHL to the number of socially significant ones. The aim of the study is to conduct a comparative assessment of the potential risk of hearing loss caused by noise according to GOST R ISO 1999-2017, and the actual risk of NIHL in workers of “noise” industries according to epidemiological research. Materials and methods. The calculation of the potential risk of hearing loss according to GOST R ISO 1999-2017 included assessing age, noise and total hearing loss at noise exposure with 85, 90, 95 and 100 dBA. The actual risk of NIHL was evaluated on survey data of 600 miners and 600 workers of processing plants. Results. The calculation of the probable risk according to GOST R ISO 1999-2017 and the assessment of the actual risk according to epidemiological studies showed that the risk of NIHL depends on both noise exposure and age. As the levels of noise affecting an employee increase, the risk of an NIHL becomes more determined by the effect of noise. At noise levels 85, 90 and 95 dBA, the probable risk calculated under GOST R ISO 1999-2017 coincides with the actual risk established according to epidemiological studies. At the same time, for miners exposed to high-intensity noise 100 dBА, the real risk was not as high as could be assumed from the calculated data. Conclusion. The results obtained allow stating that the GOST ISO 1999-2017 standard with a high degree of potential risk allows predicting the group risk of hearing loss due to noise exposure, to quantify the degree of risk and can be used for the formation of risk groups for NIHL and the development of programs for the preservation of hearing. Contribution: Preobrazhenskaia E.A. — the concept and design of the study, collection and static processing of material, writing a text, collection of literature data, editing; Sukhova A.V. — the concept and design of the study, collection and static processing of material, writing a text, collection of literature data, editing; Kriuchkova E.A. — the concept and design of the study, writing a text, collection of literature data, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Conflict of interest. The authors declare no conflict of interest. Acknowledgement. The study had no sponsorship.

Vaccination prevents 2-3 million deaths worldwide every year. Nevertheless, vaccine-preventable diseases (VPDs) still cause a considerable number of deaths especially in subjects belonging to "risk groups." These are represented by older adults, immunocompromised individuals and all subjects with underlying chronic medical conditions (cardiovascular, pulmonary, renal and liver chronic diseases, diabetes, immunodeficiency disorders). They have a weaker immune system and, if infected, are more likely to develop severe complications of their condition or of the preventable-infectious disease. This document summarizes the recommendations for vaccination of the main Global Institutional Organizations and analyses the risks of comorbidities associated with infectious disease and the benefits of vaccination for each specific group. The document provides a clear, practical and authoritative guide to adult vaccination.

Background The aim of this study was to evaluate the role of histopathological and biochemical parameters in the prediction of the presence and number of PSMA positive lesions consistent with the metastatic spread of prostate cancer on Ga-68-PSMA PET images. Methods Biochemical, histopathological and imaging data of 302 prostate cancer patients who underwent Ga-68-PSMA-11 PET/CT or PET/MR imaging for primary staging were retrospectively analyzed. Patients were divided into two groups as "PET positive" and "PET negative" according to the presence of pathologic extraprostatic PSMA involvement. "PET positive" patients were additionally divided into two groups: oligometastatic (1-3 metastatic lesion) and multimetastatic (>3 metastatic lesions). Results The mean age of patients was 66.8 +/- 7.6 years. Imaging modality was PET/MR in 223 (73.8%) and PET/CT in 79 (26.2%) of patients. Total PSA, PSA density (PSAD), ALP, and tumor ratio in biopsy specimens were found to be significantly higher in "PET positive" group compared to "PET negative" group and in multimetastatic group compared to oligometastatic group. PET positivity was observed in 3.8% of the low-intermediate risk groups (ISUP 1-3 and total PSA 20 ng/ml or PSAD >= 0.15 ng/ml/cc) with a relative risk of 12 (p < .001). The prediction models to predict the PET positivity and the presence of distant metastasis had AUCs of 0.901 and 0.925, respectively; with ALP, total PSA, and tumor ratio in needle biopsy specimen as significant independent predictors (p < .05). Conclusions In this study, Ga-68-PSMA-11 PET positivity was significantly higher in the high-risk patient group than in the low-intermediate risk groups. The prediction models used for predicting the PET positivity and the presence of distant metastasis on PET imaging were successful with high discriminatory powers. In addition to total PSA and ISUP GG, ALP and tumor ratio in biopsy specimens can be used to identify high-risk patients.

The analysis of the prevalence and morbidity of obesity in children and adolescents in Ukraine for a period of 2010–2013 was conducted. Obesity reaches 17.2 % among endocrine diseases, which take 4th place in the structure of prevalence according to the disease classes for children and adolescents. Analysis of time series in terms of obesity prevalence in the pediatric age group showed that the indicator has positive dynamics and, according to constructed mathematical models, was prone to the relative increase in the nearest future. A mathematical model is characterized by a high rate of approximation (R2 = 0.9659), which determines the increase in the prevalence of obesity in children and adolescents till 2017. The following preventive measures should be considered as important ones: expertise of microenvironment (living conditions, kindergartens, schools); study of morbidity according to official statistics; medical examinations of the child population with an analysis of health (physical development, resistance, morbidity); selection of risk groups of developing pathology; organization of follow-up; introduction of modern medical technology.

Профилактика вирусного гепатита А в странах со средним уровнем эндемичности остается актуальным вопросом современности. Наиболее эффективным методом профилактики в мире является вакцинация в сочетании с соблюдением удовлетворительных санитарно-гигиенических условий. Доказано, что прививки против вирусного гепатита А обеспечивают длительную и эффективную защиту, хорошо переносятся и не вызывают серьезных побочных реакций. В регионах со средним уровнем эндемичности по вирусному гепатиту А должна быть рассмотрена возможность вакцинации, особенно категорий населения, относящихся к группам риска.

Purpose of review Pancreatic ductal adenocarcinoma (PDAC) is third leading cause of cancer death in the United States, a lethal disease with no screening strategy. Although diagnosis at an early stage is associated with improved survival, clinical detection of PDAC is typically at an advanced symptomatic stage when best in class therapies have limited impact on survival. Recent findings In recent years this status quo has been challenged by the identification of novel risk factors, molecular markers of early-stage disease and innovations in pancreatic imaging. There is now expert consensus that screening may be pursued in a cohort of individuals with increased likelihood of developing PDAC based on genetic and familial risk. Summary The current review summarizes the known risk factors of PDAC, current knowledge and recent observations pertinent to early detection of PDAC in these risk groups and outlines future approaches that will potentially advance the field.

Background. Actually, treatment results of Hodgkin lymphoma (HL) are the most dramatic oncohematology achievements, therefore modern treatment protocols designed to toxicity reduction with the same high level of patients’ survival. Time of complete response occupies a central position in the prognostic factors for HL and helps to find a group of patients whose treatment could be de-escalated.Objective: to evaluate the efficacy of original domestic risk-adopted protocol RDC POG-HL 2003 with treatment de-escalation and refused radiation therapy (RT) for early-responded patients.Materials and methods. 192 patients were enrolled in prospective RDC POG-HL 2003 protocol from February 2003 to November 2020. Median age was 12.8 years (from 3 to 17). Local stages (IA–IIA) were diagnosed in 48 (25 %) patients, disseminated (IIB–IVB) – in 144 (75 %) cases. For local (IA–IIA) stages by RCD POG-HL 2003 treatment included DBVE + RT, for disseminated (IIB–IVB) – BEACOPP escalated (esc.) + RT. In case of 70 % and more tumor reduction after 4 induction courses of BEACOPP-esc., the following treatment included less intensive schemes (ABVD, COPP/ABV). Because of high risk of breast cancer in girls after mediastinal RT, it was possible to omit a RT in case of early response.Results. All patients with local stages are alive by the time of study end. Event- and relapse-free survivals in this group were 97.8 ± 2.5 % (median follow up 181.9 ± 4.8 months). Event-free survival for disseminated stages patients was 90.3 ± 3.3 % (median follow up 179.1 ± 4.2 months), relapse-free survival – 93.5 ± 2.1 % (median follow up 191.7 ± 2.3 months) and overall survival – 97.9 ± 1.2 % (median follow up 196.3 ± 2.6 months). In 48 (25 %) patients it was possible to omit RT without reducing survival rates.Conclusion. Differentiated HL treatment with respect to disease stage and time of complete response is a key to success of treatment. Such approach permits us to reduce cumulative therapy toxicity by its de-escalation and, in some cases, to omit RT.

Background. The most effective method for early diagnosis of any disease, and especially such rare as acromegaly, is considered to be population screening in high­risk groups, the introduction of which in Ukraine requires the development of methodological approaches and economic substantiation. The purpose of the study: based on a comparative analysis, to determine the informativity and specificity of questions that will be included in the questionnaire of primary screening for acromegaly. Materials and methods. The survey was conducted in two groups of people: group 1 — patients with diagnosis of acromegaly verified in the neuroendocrinology center of State Institution “V. Danilevsky Institute for Endocrine Patho­logy Problems of the National Academy of Medical Sciences of Ukraine” (n = 123); group 2 (n = 550) — persons from the risk group, namely, those who came to an outpatient visit to a general practitioner, therapist, cardiologist, endocrinologist for various reasons and in the presence of somatic and/or endocrine pathology. The evaluation of the obtained data was carried out by the analysis of variance using the software complex SPSS 19.0 (IBM Corp., Armonk, NY, USA). Results. The first set of questions in the developed questionnaire is the evaluation of phenotypic characteristics, that is, the patient’s assessment of changes in his/her appearance. The second set of questions is the determination of complaints by patients that can be a sign of the presence of a pathological process in the central nervous system and pituitary gland. Based on the comparative analysis, in the final version, the questionnaire had 11 questions, which reflect the most significant signs and clinical manifestations of permanent excessive growth hormone. The questionnaire is intended for interviewing individuals at risk in order to carry out opportunistic screening for acromegaly. Conclusions. The proposed method for evaluating the significance of clinical signs of acromegaly allows us to determine with a high degree of pro­bability the final questions for the screening questionnaire.

Purpose: The survey was conducted on Korean men to examine information acquisition channel for prostate cancer high risk group as part of the “Blue Ribbon Campaign” of the Korean Urological Oncology Society.Materials and Methods: An online survey of 500 men aged 50 years old or older was completed to query investigation of the status of prostate cancer awareness and information acquisition from February 4 to February 9, 2021.Results: Most men in their 50s and older are well aware that prostate cancer can also occur in young men in their 40s, so the rate of misunderstanding of the timing of prostate cancer screening after their 60s is very low. Two-thirds of all respondents (67.2%) were also confirmed that prostate cancer had no initial symptoms and was not included in the national cancer screening. Seventy-five percent of people look up information on their own in case of suspected prostate cancer, and 51.6% seek out knowledge on their own to prevent prostate cancer. Of the respondents, 27.4% of men contacted prostate cancer-related information within the past year, and the percentage of people contacted through ‘Internet/Phone,’ ‘People Around’ and ‘Television’ was high. The most trusted channel among prostate cancer information channels was ‘medical professionals,’ but the experience rate was not high, and the channel with high experience rate and reliability was shown as ‘television.’Conclusions: Much effort is still needed to understand the information acquisition behavior of Korean men and to improve awareness of early screening for prostate cancer.

Objective: Acute myeloid leukemia (AML) is primarily a malignant disorder affecting the elderly. We aimed to compare the outcomes of different treatment patterns in elderly AML patients and to propose a prognostic scoring system that could predict survival and aid therapeutic decisions. Methods: Patients aged ≥ 60 years who had been diagnosed with AML at 7 hospitals in China were enrolled (n = 228). Treatment patterns included standard chemotherapy, low intensity therapy, and best supportive care (BSC). Results: The early mortality rates were 31%, 6.8%, and 6.3% for the BSC, low intensity therapy, and standard chemotherapy groups, respectively. The complete remission rate of the standard chemotherapy group was higher than that of the low intensity therapy group. The median overall survival (OS) was 561 days and 222 days for the standard chemotherapy and low intensity therapy groups, respectively, and were both longer than that of the BSC group (86 days). Based on multivariate analyses, we defined a prognostic scoring system that enabled classification of patients into 3 risk groups, in an attempt to predict the OS of patients receiving chemotherapies and low intensity therapies. Low and intermediate risk patients benefited more from standard chemotherapies than from low intensity therapies. However, the median OS was comparable between standard chemotherapies and low intensity therapies in high risk patients. Conclusions: Our prognostic scoring system could predict survival and help select appropriate therapies for elderly AML patients. Standard chemotherapy is important for elderly AML patients, particularly for those categorized into low and intermediate risk groups.

The incidence of thyroid cancer is rapidly rising, primarily due to the increased use of imaging studies and incidentalomas. In the USA, the incidence has quadrupled. The last decades have seen remarkable advances in diagnosis and surgery for thyroid cancer. We will discuss the surgical advances in this manuscript. The American Thyroid Association and many other organizations around the world have been quite instrumental in developing the guidelines for the management of thyroid cancer, which have streamlined the treatment approaches. There have also been advances made in the management of medullary and anaplastic thyroid cancer, which will be a different subject not included in this manuscript. The major surgical advances include the following: impact of molecular markers, risk group stratifications, de-escalation in surgery, nerve monitoring, and endoscopic surgery. We will discuss some of these surgical nuances in this review article.

Background. Low plasma concentration of L-homoarginine (hArg) is associated with the progression of cardiovascular disease. However, the association between plasma hArg and cardiovascular complications in hypertension is not established. Objective. To assess and compare hArg levels as a biomarker of cardiovascular risk in hypertension. Design and methods. We included 60 hypertensives with moderate (n = 12), high (n = 16) and very high (n = 32) cardiovascular risk. Blood plasma tests including hArg were assessed. The control group included 30 age-matched regular donors. Results. The level of hArg was significantly lower in hypertensives compared to ocontrols (р < 0,001). There were negative correlations between hArg and echocardiography parameters of left ventricular hypertrophy. In the higher cardiovascular risk groups hArg was lower (р = 0,042). ROC-analysis showed AUC 0,860 (95 % confidence interval 0,787–0,933) with the threshold for hArg ≤ 1,69 µM, sensitivity 72,0 % and specificity 93,3 %. Conclusion. The hArg plasma level is associated with the expression and enzyme activity of the protein arginine: glycinamidinetransferase in various tissues. The hArg level ≤ 1,69 µM can be considered a cumulative laboratory biomarker of high cardiovascular risk. Further studies of prognostic and diagnostic role of hArg are needed.

Objective To compare the 2012 American Urological Association (AUA) and 2020 AUA/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) microscopic hematuria (MH) guidelines as applied in 1,018 patients with MH, to confirm of risk groups and to investigate the natural history of patients with MH. Materials and Methods Patients who had undergone a complete urological evaluation for MH according to the 2012 AUA MH guidelines were identified retrospectively. All the patients were then classified into low-, intermediate-, or high-risk for urinary tract malignancy according to the updated 2020 AUA/SUFU MH guidelines, for a second evaluation. The results of the first and second evaluations using the previous 2012 AUA and updated 2020 AUA/SUFU MH guidelines, respectively, were then compared. Results A total of 1018 patients with MH were identified. The urinary tract malignancy rate was 3.3% (34 of the 1,018 patients). According to the 2020 AUA/SUFU MH guidelines, there were 218 patients (21.4%) in the low-risk group, 447 patients (43.9%) in the intermediate-risk group, and 353 patients (34.6%) in the high-risk group. All the 34 patients with malignancy were from the intermediate- or high-risk group who require further urological evaluation. There was no patient with newly developed urinary tract malignancy at the median follow-up time of 28 months (12-58). Conclusion The use of the updated 2020 AUA/SUFU MH guidelines may reduce the number of diagnostic procedures without compromising the diagnosis of life-threatening malignant lesions.

Coronavirus disease 2019 (COVID-19) emerged in mid-December 2019 and has rapidly spread worldwide. We conducted a retrospective analysis of data from patients with COVID-19 to construct a simple risk prediction score to be implemented in prehospital settings. Patients were classified into critical and non-critical groups based on disease severity during hospitalization. Multivariate analysis was performed to identify independent risk factors and develop a risk prediction score. A total of 234 patients were included in the study. The median age of the critical group was significantly older than that of the non-critical group (68.0 and 44.0 years, respectively), and the percentage of males in the critical group was higher than that in the non-critical group (90.2% and 60.6%, respectively). Multivariate analysis revealed that factors such as age ≥ 45 years, male sex, comorbidities such as hypertension and cancer, and having fever and dyspnea on admission were independently associated with the critical COVID-19 infection. No critical events were noted in patients with a total risk factor score of ≤ 2. Contrastingly, patients with a total risk factor score ≥ 4 were more likely to have critical COVID-19 infection. This risk prediction score may be useful in identifying critical COVID-19 infections.

The paper summarizes the current knowledge about the influence of SARS-CoV-2 on the thyroid gland and benign thyroid diseases, with emphasis on the situation in Poland. Based on the latest scientific literature published up to May 1, 2021 and the PubMed, Google Scholar, EMBASE and Web of Science database searches, keywords related to SARS-CoV-2 and its impact on the thyroid gland and benign thyroid diseases were searched. COVID-19-related thyroid disorders include non-thyroid syndrome, hypothyroidism and thyrotoxicosis. The authors paid special attention to the treatment of thyroid disease during the pandemic. The emphasis was on radioiodine therapy, which is of high clinical value due to the lower risk of neutropenia or agranulocytosis. It is currently unknown whether COVID-19 may lead to de novo thyroid dysfunction or if it can aggravate an existing thyroid disease. Patients with uncontrolled thyrotoxicosis are in a risk group for complications (e.g., cytokine storm) from any infection (especially from SARS-CoV-2 infection). Moreover, this group of patients should receive more extensive care, bearing in mind the neutropenia from taking antithyroid drugs, which may mask the symptoms of COVID-19.

Hepatocellular carcinoma (HCC) is the primary malignancy in the liver with high rate of death and recurrence. Novel prognostic model would be crucial for early diagnosis and improved clinical decision. The study aims to provide an effective lncRNA-based signature to predict survival time and tumor recurrence for HCC. Based on public database, lncRNA-based classifiers for overall survival and tumor recurrence were built with regression analysis and cross validation strategy. According to the risk-score of the classifiers, the whole cohorts were divided into groups with high and low risk. Afterwards, the efficiency of the lncRNA-based classifiers was evaluated and compared with other clinical factors. Finally, candidate small molecules for high risk groups were further screened using drug response databases to explore potential drugs for HCC treatment.

Healthcare facilities have always played an important role in transmission of bloodborne infections. Procedures involving blood and blood fluids pose a risk of transmitting hepatitis B, hepatitis C and HIV not only to healthcare workers, but also to patients. To assess the role of healthcare facilities in transmission of bloodborne infections and to identify risk groups among patients as well as transmission factors, a total of 75 outbreaks of hepatitis B, hepatitis C and HIV have been analyzed with reference to the data published in different countries in 2008–2020. The comparative analysis was conducted for the outbreaks in the United States during 1992–2008 and 2008–2019. Most of the outbreaks of bloodborne infections at healthcare facilities were caused by non-adherence to standard precautions among healthcare workers: Reusing disposable items; improper handwashing; reusing gloves; non-disinfecting surfaces, reusable equipment and devices; non-sterilizing reusable instruments. In terms of bloodborne infections, high-risk facilities include hemodialysis centers, oncohematology clinics, outpatient clinics, nursing homes, residential care facilities, and diabetes treatment centers. High-risk groups include patients undergoing hemodialysis, oncohematological patients, and patients with diabetes. Diagnosis of bloodborne infections on a regular basis, hepatitis B vaccination among high-risk patients, investigation of outbreaks, adoption of rules and procedures combined with training and compliance control of healthcare workers contribute to solution of the problem associated with nosocomial transmission of bloodborne infections.

Prostate cancer (PCa) is one of the most frequently diagnosed malignancies of men in the world. Due to a variety of treatment options in different risk groups, proper diagnostic and risk stratification is pivotal in treatment of PCa. The development of precise medical imaging procedures simultaneously to improvements in big data analysis has led to the establishment of radiomics - a computer-based method of extracting and analyzing image features quantitatively. This approach bears the potential to assess and improve PCa detection, tissue characterization and clinical outcome prediction. This article gives an overview on the current aspects of methodology and systematically reviews available literature on radiomics in PCa patients, showing its potential for personalized therapy approaches. The qualitative synthesis includes all imaging modalities and focuses on validated studies, putting forward future directions.

BACKGROUND Recurrence of hepatocellular carcinoma (HCC) after liver transplantation is a major cause of morbidity and mortality. To date, there is no widely accepted pathologic assessment tool to predict HCC recurrence. In 2007, we developed a pathologic risk score that stratified patients into low, intermediate, or high risk for recurrence based on explant pathology. The aim of this study was to externally validate this risk score. METHODS We retrospectively evaluated 124 patients over a 10-year period who underwent liver transplantation for HCC. Using explanted pathology reports, each patient was stratified according to the pathologic risk score and followed over time for HCC recurrence. RESULTS Recurrence occurred in 15 patients (12%) after a mean follow-up of 25 months. Using the pathologic risk score, 10 (8%), 21 (17%), and 93 (75%) patients were stratified into high, intermediate, and low risk of recurrence, respectively. Among these risk groups, recurrence occurred in 50%, 28.5%, and 4.3% (P < .01) of patients, respectively. Using the optimal cutoff value ≤3.5, our risk score had a sensitivity of 80% and specificity of 79% with an area under the receiver operator characteristic curve of 0.8. Those with lower risk scores had higher recurrence-free survival (P < .0001). CONCLUSIONS Our pathologic risk score accurately risks stratified patients for HCC recurrence after liver transplant. It can be used to tailor surveillance strategies for those deemed to be at elevated risk for recurrence.

There is a lack of consensus regarding the management of post-chemotherapy residual mass in classical seminoma. The use of fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) may aid the detection of residual masses harbouring viable disease and help to tailor therapy. The aim of this study was to evaluate if PET-CT could identify patients who will benefit from locoregional radiotherapy.This ethics-approved study included patients with advanced classical seminoma primarily treated with standard platinum-based first-line chemotherapy. Patients were either observed or given adjuvant radiotherapy based on the clinician's preference and followed up. For this study, patients were stratified into two groups based on FDG PET-CT residual nodal maximum standardised uptake value (SUVmax): low risk (SUVmax3) and high risk (SUVmax ≥3). Further subgroup analysis was carried out for patients with residual nodal size ≥3 cm and SUVmax ≥3, and this was considered as the very high risk group. The diagnostic accuracy of FDG PET-CT was assessed and survival was compared between the different groups.Sixty-nine patients were included in the study: 48 patients were observed and 21 received radiotherapy. The low and high risk groups contained 50.7% and 49.3% of the patients, respectively. The very high risk subgroup had 24 patients. At a median follow-up of 44 months, locoregional failures in the radiotherapy and observation cohorts were 0% and 30% (P = 0.059) in the very high risk subgroup and 5.8% and 29.4% (P = 0.078) in the high risk group. The positive predictive value for the very high risk and high risk groups was 30% and 17.1%, respectively. The benefit of locoregional control failed to translate into overall survival benefit.A tailored, FDG PET-based risk-adapted treatment approach can refine the management of post-chemotherapy residual masses in seminoma. In this study, with the largest cohort of advanced seminoma patients treated with radiotherapy reported to date, radiotherapy seems to benefit patients with post-chemotherapy residual mass SUVmax ≥3.

Objective: to study the clinical and economic efficiency of mass fluorographic examinations of the population for tuberculosis (TB).Subjects and methods. The study used the data of fluorographic examinations for TB among 2,632,169 people and in its risk groups (n = 44,597) in the Republic of Karelia in 2008–2018.Results. It was found that the increased efficiency of detection of TB could not reduce its one-year mortality in firstly identified patients. The average cost of detecting one TB case during mass examinations was more than 500,000 rubles for this period.Conclusion. Mass fluorographic examinations of the population cannot reduce TB mortality rates and are extremely expensive. To lower the mortality rate and to improve the detection of TB, there is a need for screening high-risk groups for this disease at least once every 6 months.