Terapevt Arkh
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To study the efficiency of polychemotherapy (PCT) for hemoblastoses in acute respiratory failure (ARP). ⋯ The duration of lung lesion in leukemia was less than that in myeloma and lymphomas (2.5 +/- 5.3 versus 12.8 +/- 30.6 and 21 +/- 10.2 days, respectively). In the patients with leukemia and lymphomas, PCT was initiated earlier than in those with myeloma (1.5 +/- 0.5 versus 1.75 +/- 3.1 and 8.3 +/- 10.9 days, respectively). In 65.1% of the patients, PCT resulted in agranulocytosis, the rate and duration of which did not differ in the groups. APACHE II scores were 23.5 +/- 4.2; PaO2/FiO2 was 182.1 +/- 60.5. The groups did not differ in disease severity. Noninvasive ventilation was made in 22 patients. Artificial ventilation (AV) was used in 39 patients; it was successfully completed in 13 (33.3%) patients. The most common infectious complications were sepsis (60%), septic shock (27%), and bacteremia (16%). Sepsis was encountered twice more frequently in lymphomas and myeloma, and septic shock was 4 times more commonly in leukemias. In myeloma, bacteremia was seen more frequently than in leukemia (50 and 10%; p = 0.024); serum procalcitonin was > 10 ng/ml (100 and 35%); p = 0.028). In leukemias, lymphomas, and myeloma, 28-day survival was 60, 60, and 75%, respectively. The baseline APACHE II disease severity, the degree of hypoxemia, and the presence and duration of agranulocytosis did not determine prognosis. The poor predictors were consciousness impairment, AV, renal failure, and no response to chemotherapy.
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Biography Historical Article
[Life devoted to cardiology. The 110 anniversary of Professor A. L. Myasnikov's birth].
Alexander Leonidovich Myasnikov was a world-famous Russian therapist, cardiologist, clinician, founder of a large scientific school. He was a chief therapist of the USSR Navy during World War II, colonel of military medical service, talented public health official. ⋯ L. Myasnikov created grounds for further development of cardiology in Russia.
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To evaluate HCV genome variability in acute and chronic phases of viral hepatitis C. ⋯ It is shown that genetic heterogeneity and variability of an individual HCV population circulating in blood serum can not be a prognostic criterion in assessment of variants of acute hepatitis C course. No mutations in ISDR region were found in 25% of 16 patients studied. 75% cases had 1-3 replacements of amino acid sequences, most frequent mutation was replacements in position 2218 (histidin/arginin). The above results are close to those obtained in Japanese and European populations. Results of ISDR sequence-analysis conducted before treatment may predict efficacy of interferon-alpha2 treatment in an individual patient in future. Large-scale trials are necessary for detection of mutations responsible for resistance to interferon-alpha2 in patients living in Russia.
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To analyse clinical implications of chromosome 8 trisomy in Ph-negative cells of the bone marrow in patients with chronic myeloid leukemia (CML) treated with inhibitors of tyrosinkinases (ITK). ⋯ Detection of a Ph-negative clone with chromosome 8 trisomy at early stages suggests parallel existence of Ph-positive and Ph-negative clones. None of the patients had myelodisplasia.