Managing anemia in lymphoma and multiple myeloma

Anemia is common in cancer, and lymphoproliferative disease is no exception. Erythropoiesis-stimulating agents (ESA) have been used for renal anemia since 1986, and considerably later in cancer anemia. The first studies were published around 1993, but the use of ESA did not become common in cancer anemia until in the late 1990s. Cancer anemia is still under-treated. This review gives an overview of the use of ESA in hematologic malignancies. A background is given about this treatment in the cancer field generally. The pathophysiology of cancer anemia is described with special emphasis on the disturbances in iron metabolism. Functional iron deficiency has been shown to be both frequent and important as a hindrance for response to ESA treatment, and recent studies are reported in some detail, where the use of intravenous iron was shown to improve the response rate of ESA treatment

Development of acute myocardial infarction in a young female patient with essential thrombocythemia treated with anagrelide: a case report

Essential thrombocythemia (ET) is a chronic myeloproliferative disorder with a prolonged clinical course. Since this disorder is considered to be at increased risk of thromboembolism, therapy is mainly focused on the decreased risk of thrombohemorrhagic events by use of cytotoxic agents. Anagrelide is a phosphodiesterase III inhibitor which is utilized in the treatment of ET for the reduction of platelets. However, patients treated with anagrelide might experience cardiovascular adverse effects including myocardial infarction (MI), although these events are rare. Herein, we report a case of a 30-year-old female with well controlled ET by anagrelide, who eventually developed an acute non-ST elevation myocardial infarction (MI). There has no found any cardiovascular risk factors in this ET patient, strongly suggesting that anagrelide might be the cause of MI. Therefore, cardiovascular function should be monitored in those patients prescribed with anagrelide

Почему казнили Павла Негребецкого?

The paper seeks to contribute to the discussion among historians about the value, as historical sources, of foreign diplomats stationed in Russia. Two young men, Hildebrand von Horn, an envoy extraordinaire of the Danish king, and the Swede Johan Gabriel Sparwenfeld, a student of the Russian language and Russian affairs on a scholarship granted by the Swedish king, met in the Russian capital during the summer of 1684. They had met before—in1682 inCopenhagen—but this time their roles were quite different, as they were in Moscow as representatives of countries with opposite political aims vis-à-vis Russia. Von Horn was inRussiafor the third time, knew many influential people at court and mastered the Russian language. He kept Sparwenfeld informed about what was going on behind the scenes at court. This information was written down by Sparwenfeld in his diary of the Russian journey, published by the author of this paper in 2002.In July 1684 von Horn told Sparwenfeld about the execution of “a noble and learned Pole, Negrebetskii”. This person, Pavel Negrebetskii, had had an important position at court during the reign of Fyodor Alekseevich but lost his influence after the death of the Tsar. In August the two friends once more discussed Negrebetskii, his torture, and the role of I. M. Miloslavskii in his fate. Negrebetskii was accused of having taken part in a conspiracy against Sof’ia and her supporters in the aftermath of the streltsy uprising in May 1682. The torture was stopped by Vasilii Vasil’evich Golitsyn, and Negrebetskii was hastily and secretly taken to theRed Squareand executed. Why was Negrebetskii executed in this way two years after his stated crime? After discussing various aspects of the question, this paper gives a possible answer. It seems that the real reason was that Negrebetskii did not stop trying to make the Polish king intervene on Naryshkina’s side in the struggle for power between the Miloslavskii and Naryshkin clans. In connection with the arrival of an Austrian embassy in Moscow in May–June1684, anew possibility for Negrebetskii to get in contact with Poland offered itself in the person of the Habsburg resident in Warsaw, I. Zierowsky. Negrebetskii, it seems, took advantage of the opportunity and tried to send a letter with Zierowsky to the Polish king, begging the king for help and support of Naryshkina and her son. The letter was intercepted, and Sof’ia and Miloslavskii decided to get rid of the irritating Pole once and for all. His execution also gave a clear signal to Peter’s supporters that their previous plans were known and that their activities were under surveillance. It was not possible to touch the main actors in the unrealized conspiracy for political reasons; the most active among them was Vasilii Vasil’evich’s cousin, Boris Alekseevich Golitsyn.So, the entries in Sparwenfeld´s diary about nightly conversations between two foreigners in the Russian capital help to shed light on how and when Pavel Negrebetskii died, and, hopefully, also why. DOI: 10.31168/2305-6754.2020.9.1.8  Статья является репликой в дискуссии об исторической ценности записей, которые вели работавшие в России иностранные дипломаты. Два молодых человека, Гильдебранд фон Горн, чрезвычайный посланник датского короля, и швед Юхан Габриель Спарвенфельд, королевский стипендиат, изучавший русский язык и культуру, встретились в Москве летом 1684 г. Они познакомились еще в 1682 г. в Копенгагене, но в Москве они общались в качестве представителей двух стран, имевших в России разные политические цели. Фон Горн был в России в третий раз, прекрасно говорил по-русски и был знаком с влиятельными лицами при дворе. Он рассказывал Спарвенфельду о закулисной жизни двора, которую хорошо представлял. Эту информацию Спарвенфельд записывал в дневник, который вел во время поездки (опубликован автором этой статьи в 2002 г.). В июле 1684 г. фон Горн рассказал Спарвенфельду о казни «одного поляка, знатного и ученого человека по имени Негребецкий». Речь шла о Павле Негребецком, занимавшем важное положение при дворе во время правления Федора Алексеевича, но потерявшем свое влияние после смерти царя. В августе друзья еще раз обсуждали дело Негребецкого, обстоятельства его пыток до казни, а также и роль И. М. Милославского в его судьбе. Негребецкий обвинялся в участии в заговоре против Софьи и ее сторонников, возникшем после стрелецкого бунта в мае 1682 г. Пытки были прекращены Василием Васильевичем Голицыным. Негребецкого секретно отвезли на Красную площадь и казнили. Почему Негребецкого казнили именно так, через два года после его предполагаемого преступления? После обсуждения различных аспектов данного вопроса в статье предлагается возможный ответ. Настоящей причиной поспешной казни было то, что Негребецкий продолжал склонять польского короля выступить на стороне Нарышкиной, матери Петра, в борьбе за власть между кланами Милославских и Нарышкиных. Поскольку в мае–июне 1684 г. в Москве находилось австрийское посольство, у Негребецкого появился надежный канал связи с Польшей в лице габсбургского резидента в Варшаве И. Жировского. Возможно, Негребецкий воспользовался случаем и попытался послать письмо польскому королю с просьбой о поддержке Нарышкиной и ее сына. Письмо было обнаружено, после чего Софья и Милославский наконец решили избавиться от раздражающего поляка. Его казнь позволила им дать отчетливый сигнал сторонникам Петра, что их прежние планы известны и что они находятся под наблюдением. Главных участников несостоявшегося заговора нельзя было трогать по политическим причинам (самый энергичным заговорщиком был Борис Алексеевич Голицын, двоюродный брат Василия Васильевича). Таким образом, запись ночных разговоров двух иностранцев в русской столице, кажется, помогла выяснить, как и когда умер Павел Негребецкий, а также высказать обоснованное предположение о причинах казни. DOI: 10.31168/2305-6754.2020.9.1.

Why was Pavel Negrebetskii Executed?

The paper seeks to contribute to the discussion among historians about the value, as historical sources, of foreign diplomats stationed in Russia. Two young men, Hildebrand von Horn, an envoy extraordinaire of the Danish king, and the Swede Johan Gabriel Sparwenfeld, a student of the Russian language and Russian affairs on a scholarship granted by the Swedish king, met in the Russian capital during the summer of 1684. They had met before—in1682 inCopenhagen—but this time their roles were quite different, as they were in Moscow as representatives of countries with opposite political aims vis-à-vis Russia. Von Horn was inRussiafor the third time, knew many influential people at court and mastered the Russian language. He kept Sparwenfeld informed about what was going on behind the scenes at court. This information was written down by Sparwenfeld in his diary of the Russian journey, published by the author of this paper in 2002. In July 1684 von Horn told Sparwenfeld about the execution of “a noble and learned Pole, Negrebetskii”. This person, Pavel Negrebetskii, had had an important position at court during the reign of Fyodor Alekseevich but lost his influence after the death of the Tsar. In August the two friends once more discussed Negrebetskii, his torture, and the role of I. M. Miloslavskii in his fate. Negrebetskii was accused of having taken part in a conspiracy against Sof’ia and her supporters in the aftermath of the streltsy uprising in May 1682. The torture was stopped by Vasilii Vasil’evich Golitsyn, and Negrebetskii was hastily and secretly taken to theRed Squareand executed. Why was Negrebetskii executed in this way two years after his stated crime? After discussing various aspects of the question, this paper gives a possible answer. It seems that the real reason was that Negrebetskii did not stop trying to make the Polish king intervene on Naryshkina’s side in the struggle for power between the Miloslavskii and Naryshkin clans. In connection with the arrival of an Austrian embassy in Moscow in May–June1684, anew possibility for Negrebetskii to get in contact with Poland offered itself in the person of the Habsburg resident in Warsaw, I. Zierowsky. Negrebetskii, it seems, took advantage of the opportunity and tried to send a letter with Zierowsky to the Polish king, begging the king for help and support of Naryshkina and her son. The letter was intercepted, and Sof’ia and Miloslavskii decided to get rid of the irritating Pole once and for all. His execution also gave a clear signal to Peter’s supporters that their previous plans were known and that their activities were under surveillance. It was not possible to touch the main actors in the unrealized conspiracy for political reasons; the most active among them was Vasilii Vasil’evich’s cousin, Boris Alekseevich Golitsyn. So, the entries in Sparwenfeld´s diary about nightly conversations between two foreigners in the Russian capital help to shed light on how and when Pavel Negrebetskii died, and, hopefully, also why

Paternal age at childbirth and eating disorders in offspring

Background Advanced paternal age at childbirth is associated with psychiatric disorders in offspring, including schizophrenia, bipolar disorder and autism. However, few studies have investigated paternal age's relationship with eating disorders in offspring. In a large, population-based cohort, we examined the association between paternal age and offspring eating disorders, and whether that association remains after adjustment for potential confounders (e.g. parental education level) that may be related to late/early selection into fatherhood and to eating disorder incidence. Method Data for 2 276 809 individuals born in Sweden 1979–2001 were extracted from Swedish population and healthcare registers. The authors used Cox proportional hazards models to examine the effect of paternal age on the first incidence of healthcare-recorded anorexia nervosa (AN) and all eating disorders (AED) occurring 1987–2009. Models were adjusted for sex, birth order, maternal age at childbirth, and maternal and paternal covariates including country of birth, highest education level, and lifetime psychiatric and criminal history. Results Even after adjustment for covariates including maternal age, advanced paternal age was associated with increased risk, and younger paternal age with decreased risk, of AN and AED. For example, the fully adjusted hazard ratio for the 45+ years ( v . the 25–29 years) paternal age category was 1.32 [95% confidence interval (CI) 1.14–1.53] for AN and 1.26 (95% CI 1.13–1.40) for AED. Conclusions In this large, population-based cohort, paternal age at childbirth was positively associated with eating disorders in offspring, even after adjustment for potential confounders. Future research should further explore potential explanations for the association, including de novo mutations in the paternal germline

Identifying research priorities for the study of atypical anorexia nervosa: A Delphi study

Objective: Individuals meeting all criteria for anorexia nervosa (AN) except that weight falls within or above the normal range despite significant weight loss are categorized as having atypical AN (AAN). Existing research has provided mixed evidence concerning the diagnostic demarcation of AN and AAN. The aim of the present study was to identify research priorities for furthering the understanding of AN and AAN as diagnostic entities. Method: Employing the Delphi methodology, experts in the field were invited to suggest research questions that need to be explored in the demarcation of AN from AAN. This yielded 24 research areas, that were presented in subsequent rounds where panelists were asked to prioritize areas of primary interest. Results: Fifty-three panelists completed all three Delphi rounds. Consensus was only reached on three items considered to be of primary interest: medical, neurobiological, and neurological factors; epidemiology and natural course; and treatment response in AAN compared to AN. In contrast, questions of premorbid weight and determining the need for and nature of a body mass index cutoff differentiating between AAN and AN were seen as being of low priority. Discussion: These findings reveal a relatively low degree of consensus on the demarcation of AN from AAN in the field of eating disorders. A reason could be that the definition and use of the AAN category vary in research and clinical practice. In order to achieve further diagnostic clarity, research on the demarcation of AAN and AN should focus on the identified prioritized research areas

Risk of eating disorders in international adoptees: A cohort study using Swedish national population registers

Aims: Compared to the general population, adoptees are more often referred to specialist psychiatric treatment, exhibit increased risk of suicide and display more symptoms of attention-deficit/hyperactivity-disorder. However, little is known about the impact of being an adoptee on the risk of developing an eating disorder. The aim of the present study was to assess whether international adoptees have a higher risk for eating disorders than native Swedes .Methods: In the present retrospective cohort study, data from the Swedish total population registers on individuals born between 1979 and 2005 were used to assess whether international adoptees residing in Sweden (n = 25 287) have a higher risk for anorexia nervosa (AN) and other eating disorders (OED) than non-adoptees with Swedish-born parents from the general population (n = 2 046 835). The patterns of these results were compared to those for major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and anxiety disorders to determine whether any observed effects were unique to eating disorders or reflected a more general impact on mental health outcomes. Results: A survival analysis adjusting for relevant demographic covariates revealed an elevated risk of all examined psychiatric disorders in international adoptees: hazard ratios (95% confidence intervals) are 1.21 (1.04-1.41) for AN, 1.60 (1.44-1.79) for OED, 1.90 (1.81-2.00) for MDD, 1.25 (1.09-1.44) for OCD, and 1.69 (1.60-1.78) for anxiety disorders. Conclusions: Elevated risk of eating disorders as well as of MDD, OCD, and anxiety disorders was found in international adoptees. A parallel pattern between AN and OCD was observed, which both display less elevated rates than the other diagnoses. A considerable number of biological, environmental, and societal factors have been suggested to explain the observed differences in mental health between adoptees and non-adoptees, but they remain primarily theoretical

Self-image and suicide in a Swedish national eating disorders clinical register

Using a prospective design, to examine the relation between self-image (assessed using the Structural Analysis of Social Behavior) and suicide attempts/completions in women with anorexia nervosa-restricting type (ANR), anorexia nervosa-binge/purge type (ANBP), bulimia nervosa (BN), binge eating disorder, and eating disorder not otherwise specified (EDNOS); and to assess whether these self-image variables add unique predictive value to suicide when considering other baseline predictors