МЕТАБОЛИЧЕСКАЯ МОДУЛЯЦИЯ ПРОТИВООПУХОЛЕВОГО ЭФФЕКТА ЦИТОСТАТИКОВ В ЭКСПЕРИМЕНТЕ И КЛИНИКЕ

In the experimental intraperitoneal chemotherapy with cyclophosphamide for sarcoma 45 and peritumoral administration of the factors inhibiting the Krebs cycle (diphenhydramine and ATP) histological, ultrastructural and immunocytometric indicators characterizing the development of the involutive processes of the tumor and its regression were studied. Modeling of metabolic microenvironment on the background of systemic neoadjuvant chemotherapy in patients with the stages T3-4N0-3M0 breast cancer led to an increase in antitumor effect. Assessment of tumor response was correlated with cytochemical indicators of the status of the key enzymes of the Krebs cycle (SDH, -GPDH) in lymphocytes of peritumoral area.При экспериментальной  внутрибрюшинной химиотерапии циклофосфаном саркомы 45 и перитуморальном введениифакторов, ингибирующих цикл Кребса (дифенгидрамин  и АТФ) изучены гистологические,  ультрастуктурные и иммуноцитометрические показатели, характеризующие  развитие  инволютивных процессов  опухоли и ее регрессии.  Моделирование метаболического микроокружения на фоне проведения системной неоадьювантной химиотерапии у больных раком молочной железы Т 3–4N0–3М0  привело к увеличению непосредственного противоопухолевого эффекта.  Оценка ответа опухоли коррелировала  с цитохимическими показателями  состояния ключевых ферментов  цикла Кребса (СДГ,  -ГФДГ) в лимфоцитах перитуморальной зоны

X-linked agammaglobulinemia (XLA) : Phenotype, diagnosis, and therapeutic challenges around the world

Background: X-linked agammaglobulinemia is an inherited immunodeficiency recognized since 1952. In spite of seven decades of experience, there is still a limited understanding of regional differences in presentation and complications. This study was designed by the Primary Immunodeficiencies Committee of the World Allergy Organization to better understand regional needs, challenges and unique patient features. Methods: A survey instrument was designed by the Primary Immunodeficiencies Committee of the World Allergy Organization to collect both structured and semi-structured data on X-linked agammaglobulinemia. The survey was sent to 54 centers around the world chosen on the basis of World Allergy Organization participation and/or registration in the European Society for Immunodeficiencies. There were 40 centers that responded, comprising 32 countries. Results: This study reports on 783 patients from 40 centers around the world. Problems with diagnosis are highlighted by the reported delays in diagnosis>24 months in 34% of patients and the lack of genetic studies in 39% of centers Two infections exhibited regional variation. Vaccine-associated paralytic poliomyelitis was seen only in countries with live polio vaccination and two centers reported mycobacteria. High rates of morbidity were reported. Acute and chronic lung diseases accounted for 41% of the deaths. Unusual complications such as inflammatory bowel disease and large granular lymphocyte disease, among others were specifically enumerated, and while individually uncommon, they were collectively seen in 20.3% of patients. These data suggest that a broad range of both inflammatory, infectious, and autoimmune conditions can occur in patients. The breadth of complications and lack of data on management subsequently appeared as a significant challenge reported by centers. Survival above 20 years of age was lowest in Africa (22%) and reached above 70% in Australia, Europe and the Americas. Centers were asked to report their challenges and responses (n = 116) emphasized the difficulties in access to immunoglobulin products (16%) and reflected the ongoing need for education of both patients and referring physicians. Conclusions: This is the largest study of patients with X-linked agammaglobulinemia and emphasizes the continued morbidity and mortality of XLA despite progress in diagnosis and treatment. It presents a world view of the successes and challenges for patients and physicians alike. A pivotal finding is the need for education of physicians regarding typical symptoms suggesting a possible diagnosis of X-linked agammaglobulinemia and sharing of best practices for the less common complications.Peer reviewe

Improvement of the Environmental Performance of Chemical and Technological Production

The article studies the question of improvement of environmental performance of chemical and technological production of ammonia by automating the process of absorption of ammonia from purge gases. The basic principles of the automation process of absorption of ammonia and selected means of automation were determined, taking into account the characteristics of the technological mode. The functional scheme of the automation and the system of automated control of absorption of ammonia in the production of fixed nitrogen were developed. The designing of control system by consistent definition of principles, parameters and technical means of the automation was performed. The computer simulation of absorption in the software package Honeywell Experion Process Knowledge System was carried out. The process control strategy was developed on the basis of the microprocessor C200 Honeywell using software package Experion PKS. The computer simulation provided the results, which show the system response to change of input parameters. The circuit of emergency shutdown and clipping of the system from input parameters was developed

Using the Assessment Method of Environmental Risk of a Project in Strategic Territorial Planning

Considering the growing need for using strategic approaches to evaluation of ecological safety on the stage of project designing, the methods of assessment of impacts on the environment (AIE) need radical revision. Such changes are necessary to be directed to supplementing existing methods with the standards and regulations of development of territorial and strategic AIE. Therefore, the studies in the field of strategic environmental analysis (SEA), aimed at establishing relationships between SEA and AIE were conducted. It was found that it is a challenge that SEA bears a descriptive character, and at present, the intense work on drafting the laws on SEA in Ukraine is in process.The tool of supporting strategic environmental assessment of projects of development of territorial formations and urbo-ecosystems of different scales in conjunction with the AIE was proposed. This procedure is based on the application of techniques based on the use of indices and environmental risks, as well as the project approach. The applied approach will allow us to establish a relationship between a project, ecosystem and the territory

Using HScore for Evaluation of Hemophagocytosis in Multisystem Inflammatory Syndrome Associated with COVID-19 in Children

Hemophagocytic syndrome is a key point in the pathogenesis of severe forms of multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C). The factors associated with hemophagocytosis in patients with MIS-C were assessed in the present study of 94 boys and 64 girls ranging in age from 4 months to 17 years, each of whose HScore was calculated. In accordance with a previous analysis, patients with HScore ≤ 91 (n = 79) and HScore > 91 (n = 79) were compared. Patients with HScore > 91 had a higher frequency of symptoms such as cervical lymphadenopathy, dry cracked lips, bright mucous, erythema/swelling of hands and feet, peeling of fingers, edematous syndrome, hepatomegaly, splenomegaly, and hypotension/shock. They also had a higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and D-dimer levels, and a tendency to anemia, thrombocytopenia, and hypofibrinogenemia. They more often needed acetylsalicylic acid and biological treatment and were admitted to ICU in 70.9% of cases. Conclusion: The following signs of severe MIS-C were associated with HScore > 91: myocardial involvement, pericarditis, hypotension/shock, and ICU admission

Determination of Risk Factors for Severe Life-Threatening Course of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children

Multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a life-threatening condition that often requires intensive care unit (ICU) admission. The aim of this study was to determine risk factors for severe/life-threatening course of MIS-C. The study included 166 patients (99 boys, 67 girls) aged 4 months–17 years (median 8.2 years). The criterion of severity was the fact of ICU admission. To conduct a comparative analysis, MIS-C patients were divided into two groups: patients hospitalized in the ICU (n = 84, 50.6%) and those who did not need ICU admission (n = 82, 49.4%). Patients with a more severe course of MIS-C were significantly older. They had a higher frequency of signs such as rash, swelling, hepatomegaly, splenomegaly, and neurological and respiratory symptoms. Hypotension/shock and myocardial involvement were much more common in patients with severe MIS-C. These patients had a more significant increase in CRP, creatinine, troponin, and D-dimer levels. Additionally, the presence of macrophage activation syndrome was higher in patients admitted to the ICU. Conclusion: Nineteen predictors of severe course of MIS-C were found, out of which hepatomegaly, splenomegaly, D-dimer > 2568 ng/mL, troponin > 10 pg/mL were mainly associated with the probability of being classified as early predictors of severe MIS-C requiring ICU admission