Aim. To present the current state of eosinophilia in hemoblastoses and solid tumors, illustrating the literature with clinical examples. A review of 33 foreign and domestic literature sources summarizes data on the pathobiology and clinical significance of tumor eosinophilia. Two clinical cases of hypereosinophilia in lymphoproliferative disease and solid tumors are presented. Conclusion. Peripheral blood eosinophils are an important diagnostic marker reflecting the severity of T2 inflammation and often predicting the effectiveness of anticytokine drugs that block IgE, IL-5, IL-4, IL-13, alarmins, and glucocorticosteroids. In clinical practice, it is important to consider that peripheral eosinophilia can also be an early marker of neoplastic processes, including solid tumors and lymphoproliferative and myeloproliferative diseases. Despite significant advances in pulmonary oncology and hematology, the Th2 immune response in general and eosinophilia in particular, both tissue and hematic, remain the focus of research interest. Further research has the potential to resolve the role and determine the place of eosinophilia as a prognostic and therapeutic biomarker.
The aim was to evaluate the long-term results of surgical treatment of arteriovenous fistula (AVF) thrombosis using the method of local intravenous catheter thrombolysis. Material and methods. Our study analyzed clinical data from 158 patients with AVF thrombosis from 2021 to 2024. Two groups of patients were formed: Group 1 (main group) included 77 patients who underwent the first stage of our developed method, “local intravenous catheter thrombolysis,” and the second stage, balloon angioplasty of the AVF. Group 2 (control group) included 81 patients who underwent surgical thrombectomy of the AVF. The study examined patient demographic parameters, key AVF parameters, and cumulative AVF patency to determine the duration of permanent vascular access function for 6 months and 1 year after surgery. Laboratory parameters were analyzed during 1 year of follow-up to identify predictors of the risk of AVF thrombosis. Results. In our study, the cumulative patency of the AVF in the study group over 6 months of observation was 84.4%, while in the control group it was 82.7%. The cumulative patency of the AVF in the study group over 1 year after surgery was 43.6%, while in the control group it was 39.2%, which is statistically significantly lower compared to the study group (p = 0.05). The identified laboratory parameters, such as phosphorus, alkaline phosphatase, glucose, and iron levels in the blood, in patients on program hemodialysis can serve as prognostic risk factors for AVF thrombosis. Conclusions. The method we developed is effective in improving the short-term and long-term patency of arteriovenous fistulas with thrombosis.
In article the importance of use of psychotherapeutic actions of self-control by employees of a dangerous profession is stated during the work in emergency situations. The state of health of fighters who before the direction in business trip were trained previously in self-control methods at different stages of performance of a fighting task, with a condition of group of the military personnel who didn’t pass preliminary training in energy saving methods is compared.
The purpose of this study was to analyze scientific provisions that select criteria for the definition, terminology and classification of fatty liver disease in the light of the evolution of ideas about key aspects of fatty liver disease. In the context of this problem, the decision taken in 2023 by the European Association for the Study of Liver Disease to review such a large-scale definitional diversity in order to streamline and standardize the “terminological field” of fatty liver disease seems very relevant and timely. In accordance with the new recommendations of the international consensus, the concepts of “non-alcoholic” and “fatty” have been removed from terminology due to the presence of stigmatizing formulations. Instead of current terms such as “non-alcoholic fatty liver disease”, “non-alcoholic steatohepatitis”, it is recommended to use the terms “fatty liver disease associated with metabolic dysfunction”, “steatohepatitis associated with metabolic dysfunction”. When combining “metabolic dysfunction-associated fatty liver disease” with excessive alcohol consumption, it is recommended to use the term “metabolic dysfunction-associated alcoholic liver disease.” According to international recommendations, the new nomenclature introduced is by no means a competitor, but rather complements the vacuum existing in current terminology and fatty liver disease. Standardization of nosological criteria and risk factors for fatty liver disease, taking into account the results of the International Conciliation Conference, will improve the stratification of patients with the most likely phenotypes of fatty liver disease and predict its course. Undoubtedly, the new nomenclature will help the clinician to adequately interpret the pathogenetic essence of various forms of the disease and will make it possible to more methodically substantiate and implement the algorithm of the optimal therapeutic and diagnostic approach based on the principles of evidence-based medicine.
With age, the number of chronic diseases requiring ≥ 5 medications increases. This leads to decreased treatment adherence and is a risk factor for adverse reactions and death. Aim: To compare the level of adherence in elderly and non-elderly patients depending on the number of comorbidities and the presence of polypharmacy. Material and methods. In a hospital setting, 120 patients over 60 years of age were assessed for comorbidities, treatment adherence, frailty, and individual need. Results. Patients were divided into groups with (Group 1) and without (Group 2) polypharmacy. The Charlson index was 9.7 ± 2.1 points in Group 1 and 6.5 ± 1.4 points in Group 2 (p = 0.03). In Group 1, 20 patients (33.3%) were adherent to therapy, while in Group 2, 48 (80%) were (p < 0.001). At discharge, patients in Group 1 were prescribed 7.4 ± 0.3 medications, while in Group 2, 3.1 ± 0.1 (p < 0.001). When modifying therapy, the number of tablets taken per day decreased to 5.93 ± 1.98 in Group 1 and to 2.73 ± 1.08 in Group 2 (p = 0.02). A high degree of individual need was identified in 32 (53.3%) patients in Group 1. Conclusion. Adherence to therapy in patients with polypharmacy was 2.4 times lower, and the need for inpatient treatment was 1.7 times higher than in patients without polypharmacy. Optimization of therapy in 66.7% of patients with polypharmacy allowed them to reduce the number of medications taken, and in 26.7%, to abandon polypharmacy.
