The case report of botulinum toxin treatment of gastroparesis in a patient following allogenic bone marrow transplantation is described. The causes of gastroparesis and methods of prevention and treatment are discussed. It was noted that pyloric injection of botulinum toxin can improve symptoms and gastric emptying.

Multipotent mesenchymal stromal cells (MMSC) are described, the probable mechanisms of their action in sepsis and septic shock are discussed, and a review of planned studies of MMSC use in septic shock is presented. A clinical case is presented: effective MMSC therapy in a female patient with septic shock and neutropenia after a course of chemotherapy.

The article deals with description of multipotent mesenchymal stromal cells (MMSCs), the mechanisms, the effects and uses of MMSCs for the treatment of sepsis and septic shock, and overview of the experimental data on the use of MMSCs in sepsis obtained in studies in cell cultures and in different models of sepsis in animals.

OBJECTIVE:The aim of the study was to assess efficacy of high-doses ofantithrombin 111 (AT) for treatment of septic shock in patients with an agranulocytosis.DESIGN:Prospective, controlled study.PATIENTS:29 patients from 18 to 74 years old, with blood diseases complicated with septic shock Dates of study: from 2006 to 2012.METHODS:The patients were randomized into two groups. Group-1 included 14 patients, who did not receive AT and group-2 included 15 patients who received AT.RESULTS:Demographic indicators, condition severity according to APACHE II, level of thrombocytopenia, levels ofplasma procalcitonin, interleukin-6 (IL-6) and C-reactive protein (CRP) were the same in both groups. Level of AT was decreased in both groups; however it was higher in the group-1 (50% vs. 60%, p < 0.05). In the group-1, microorganisms were found in the blood of 9 patients. In the group-2, the microorganisms were found in the blood of 11 patients. Inflammation markers were decreased after the treatment of septic shock in both groups (p<0.05). The decreasing of procalcitonin in group-1 was from 43.8 to 1 ng/ml in 14 days and from 12.8 to 1.6 ng/ml in 7 days in group-2. The decreasing of CRP in group-1 was from 224 to 114 mg/l in 7 days and from 146 to 60 mg/l in 14 days in group-2. The decreasing of IL-6 in group-1 was from 1617 to 100 pg/ml in 3 days and from 5895 to 77 pg/ml in 7 days in group-2. A level of AT was increased only in group-2 (under 12% per day). 28-day survival was higher in group-2 (60 +/- 13% vs. 45 +/- 13%, p<0.05). We did not find any complications of the treatment with AT concentrate.CONCLUSION:Treatment of septic shock with high-doses of antithrombin III was effective and safe in patients with an agranulocytosis.

Aim, to reveal the determinants of the development of iron overload in patients with acute leukemias (AL) and aplastic anemia (AA).Subjects and methods. The investigation included 104 patients, including 64 with various types of AL, 31 with AA, and 9 with myelodysplastic syndromes (MDS). A group affiliation and an erythrocyte phenotype were determined from rhesus system antigens in all the patients and the HFE gene was studied to identify mutations. For control of siderosis, the authors determined serum iron (SI) by a colorimetric technique, by applying the kits of the ACAT firm (Russia), serum ferritin (SF) by an immunoradiometric method, by using the kits of Immunotech (Czechia). The volume of transfusion was estimated in the period of June 2007 to November 2009.Results. There is evidence for a relationship between the higher level of SF and the number of transfusions. SF was 1046.1 mu g/l in patients, H63D heterozygous carriers who had received less than 10 packed red blood cell transfusions and 2856 mu g/l in those who had 20 transfusions (p < 0.005). HFE gene mutation carriage accelerates iron accumulation and is an additional risk factor for siderosis. In patients with transfusion chimeras and a rare phenotype in terms of rhesus antigens, packed red blood cell transfusion results in a much more increase in iron stores.Conclusion. The most important factor of iron overload acceleration is no specific choice of packed red blood cells for patients with rare combinations of red blood cell antigens and for those with artificially induced chimeras.