Peach twig borer moth (Anarsia lineatella, Zeller), significant pest in almond plantations in the area of Herzegovina

Područje Hercegovine pruža idealne uvjete za uzgoj različitih voćnih vrsta. Iako je to područje poznato po uzgoju breskve, nektarine, trešnje i marelice, u posljednje se vrijeme sve više podižu nasadi badema. Upravo na bademima, breskvin moljac uočen je kao značajan štetnik izboja, a to do sada nije zabilježeno na području Hercegovine. Naime, u znanstvenoj i stručnoj literaturi, navodi se da se breskvin moljac ubušuje samo u izboje breskve i nektarine, a uopće se ne spominje kao štetnik badema. S druge strane, tijekom praćenja štetnika i obveznog zdravstvenog pregleda rasadnika uočena je njegova nazočnost na sadnicama breskve i nektarine - ona se uvijek kretala u granicama dopuštenih 2% napadnutih mladica. Međutim, breskvin moljac nije zabilježen kao štetnik izboja na sadnicama badema (u rasadniku), već je pronađen u izbojima badema u proizvodnom nasadu na lokalitetu Gnojnice. Riječ je o mladom nasadu badema (3 i 4 godine starosti), u kome je zastupljeno pet različitih sorata s ukupnim brojem od 110 stabala. Pregled stabala i mladica badema na prisutnost gusjenica breskvinog moljca obavljen je tijekom 2010., u četiri navrata, pri čemu je obuhvaćeno 110 stabala, odnosno 200 mladica kod svakog pregleda. U radu će biti prikazane osnovne morfološke odlike vrste, biologije štetnika, lokaliteti na kojima je obavljen monitoring štetnika, intenzitet pojave te štete na bademima u 2010. godini.The area of Herzegovina offers ideal conditions for growing different fruit crops. Even though this area is famous for peach, nectarine, cherry and apricot, almond plantations have been established recently as well. Peach twig borer moth has occurred in these almond plantations as important shoot pest, which hasn’t been recorded before in the area of Herzegovina. Although this pest is reported to be appearing in peach and nectarine orchards exclusively, it has also attacked shoots in almond orchards in Herzegovina. On the other hand, during the pest monitoring and obligatory sanitary nursery examination this pest has been reported on the peach and nectarine shoots. The official threshold is 2 % and we have never found more than 2 % in the nursery. However, the peach twig borer moth hasn’t been reported as shoot pest of the almond seedlings in the nursery, but was found in the almond shoots in the production orchard in the area of Gnojnice. We are going to present a young almond orchard (3 or 4 years old), with five different varieties and total number of one hundred and ten trees. The examination of trees and almond sprouts on the presence of peach moth larvae was made four times in 2010; 110 trees and 200 sprouts were observed during each examination. In our paper we are going to present the basic morphological variety characteristics, pest biology, localities of the pest monitoring, intensity of pest occurring and damage of almond shoots in 2010 as well

Exploring the relationship between smoking status and the total number of coronary arteries with significant stenoses in a young population with ST-segment elevation myocardial infarction

Background: A plethora of studies have proven the increase in cardiovascular risk associated with smoking in all age groups1, including the one at the focus of this study – the young2,3. With regard to the total number of coronary arteries (CA) with significant stenoses, one might expect current smokers to have more affected CA than non- and former smokers. Aim: To explore the relationship between smoking status and the total number of CA with significant stenoses in a young ST-segment elevation myocardial infarction (STEMI) population. Patients and Methods: Data were attained from medical records of 147 patients (mean age 43.9±6.5 years) hospitalized with STEMI at the University Hospital Centre Zagreb from January 2012 to October 2018, with a cut-off age at 45 years for men (n = 93) and 55 years for women (n = 54). Patients were divided in 2 groups based on smoking status – non- and former smokers (N = 29 (20%), with former smokers making up 9/29 or 31% of the group), and current smokers (N = 118 (80%)). To evaluate whether smoking status was associated with a higher total number of CA with significant stenoses, Pearson’s chi-squared test was performed. During post hoc testing, the p value was adjusted to maintain the familywise error rate at 0.05 (p = 0.008) and compared to p values of each subgroup. Results: The two groups had no significant differences in baseline characteristics (Table 1). In both groups, the majority of patients (58.6% vs. 74.6%) had only one affected CA, followed by two (27.6% vs. 19.5%) and three (13.8% vs. 5.9%) CA. Pearson’s chi-squared test showed no statistically significant difference in the total number of affected CA between the two groups (p = 0.176). Post hoc testing confirmed statistically insignificant associations in all subgroups (p > 0.008, Table 2). In multiple regression (F (2, 144) = 9.27, p < 0.001, R2 adjusted = 0.10), age (B = 0.03, p = 0.001) and family history for cardiovascular disease (B = 0.30, p = 0.003) remained associated with the number of affected CA

Comparison of branded and generic imatinib plasma concentrations in patients with chronic myelogenous leukemia: unicentric study

INTRODUCTION: For over a decade, imatinib has been the first-line treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML). Doubts on the bioequivalence and bioavailability of emerging generic compounds have been expressed. Adequate imatinib plasma concentration ([IPC] ≥1000 μmol/L) is associated with a better chance of optimal treatment response in patients with CML. In this study, we compared the achieved IPCs between the branded compound and its 2 generic forms. ----- PATIENTS AND METHODS: IPCs were compared in 24 consecutive patients with CML in the first chronic phase who changed from branded to generic imatinib. The median age was 49 years (range, 22-76 years). Fifteen of them were male. Six patients were switched to Neopax, 13 to Imakrebin, and 5 patients received both generics consecutively. All compounds were used in an equivalent dose of 400 mg orally once daily for at least 1 month before plasma concentrations were measured. High-performance liquid chromatography was used to determine imatinib plasma concentration from a specimen collected 21 to 24 hours after the last dose. ----- RESULTS: The median IPC achieved with branded imatinib was 1454 μmol/L (range, 485-2707 μmol/L) with 18 patients (75%) having IPC ≥ 1000 μmol/L. For Neopax and Imakrebin, median IPCs were 1717 μmol/L (range, 1249-3630 μmol/L) and 1458 μmol/L (range, 707-880 μmol/L), respectively, with 11 of 11 (100%) and 16 of 18 (89%) patients having IPC ≥ 1000 μmol/L. No significant difference in measured IPCs between all 3 compounds was found (P > .257). ----- CONCLUSION: When taken at equivalent doses, imatinib generics are bioequivalent and comparable in clinical efficacy and have the potential for substantial savings in the treatment cost for CML

Use of bendamustin instead of carmustin in autologous stem cell transplantation conditioning – toxicity and infectious complications comparison

Unatrag nekoliko godina u hematologiji i onkologiji globalno sve češći problem postaje prikladna opskrba „starijim i manje zanimljivim“ kemoterapeuticima. Zbog povremene nestašice karmustina, jednog od osnovnih kemoterapeutika pri kondicioniranju prije autologne transplantacije krvotvornih matičnih stanica (ATK S) u oboljelih od limfoma, u našem se centru od 2016. godine on zamjenjuje bendamustinom. U ovom radu retrospektivno analiziramo tijek ATK S-a u 41 bolesnika koji su primili bendamustin u sklopu protokola BeEA M te ga uspoređujemo s tijekom ATK S-a u 40 bolesnika koji su primili karmustin u sklopu protokola BEA M. Medijan oporavka vrijednosti neutrofila (> 0,5 × 109/l) u skupini koja je primila bendamustin iznosio je 11 dana, dok je u skupini kondicioniranoj karmustinom iznosio 10 dana. Medijan oporavka vrijednosti trombocita (> 20 × 109/l) bio je duži kod skupine koja je primala bendamustin (16 prema 13 dana) te su ti bolesnici bili duže ovisni o transfuzijama eritrocita (7 prema 5 dana). Infektivne komplikacije nisu bile češće nakon primjene bendamustina, ali smo nakon primjene karmustina imali veću pojavu mukozitisa II. – III. stupnja (35% prema 12%). Nakon primjene bendamustina zabilježen je jedan slučaj nefrotoksičnosti i kardiotoksičnosti terapije, dok kod primjene karmustina te komplikacije nisu zabilježene. Pri upotrebi bendamustina kod kondicioniranja u naših bolesnika u ovom trenutku nije utvrđena znatnija hematološka toksičnost u odnosu prema karmustinu, ali su prisutni dulji period oporavka vrijednosti trombocita te niža incidencija mukozitisa.Inadequate supply of „old and less interesting“ chemotherapeutic agents is becoming a global issue in hemato-oncology today. In 2016 we were faced with occasional carmustin shortage, one of the most commonly used in autologous transplant conditioning regimens for lymphoma in our centre, so we decided to use bendamustin instead. We performed a retrospective analysis of 41 patients treated at our centre who had received bendamustin within BeEA M protocol and compared them with 40 patients who had received carmustin within BEA M protocol. Both protocols were used as conditioning protocols before autologous stem cell transplantation. Neutrophil recovery median following transplantation (AN C>0,5x109/l) was 11 days in the bendamustin group in comparison to 10 days in the carmustin group.Platelets recovery median following transplantation (PLT>20x109/l) was longer in the bendamustin group (16 vs.13 days) as was blood transfusion dependency (7 vs. 5 days). Infectious complications were not more frequent after bendamustin, but grade II–III mucositis was more frequent in patients who received carmustin (35% vs.12%). Following bendamustin we had one reported case of nephrotoxicity and cardiac toxicity, not reported with carmustin. Bendamustin has shown similar hematologic toxicity compared to carmustin but a longer platelet recovery period and a lower mucositis incidence

Smjernice Hrvatskog društva za hematologiju HLZ-a i KROHEM-a za zbrinjavanje anemije uzrokovane manjkom željeza [Croatian Hematology Society and CROHEM guidelines for the treatment of iron deficiency anemia]

Iron deficiency anemia (IDA) is an important public health problem. Almost 30% of the world’s population (> 2 billion) has iron deficiency (ID) with or without anemia. Treatment of IDA requires teamwork. It is important to treat anemia and the underlying cause of anemia. Functional iron deficiency (FID ) is a state with insufficient iron absorption and incorporation into erythroid precursors, whereas iron stores (ferritin) are normal or increased. FID is associated with anemia of chronic disease (ACD), chronic kidney disease, inflammatory bowel disease, chronic heart failure and malignant diseases. Oral and parenteral iron preparations can be used for the treatment of IDA. Novel iron parenteral preparations allow rapid normalization of total body iron even with a single infusion, with high effectiveness and safety

Prognostic factors and international prognostic index variants in patients with b-large cell lymphoma - an observational study of KroHem, the Croatian cooperative group for hematologic diseases

Background: B-large cell lymphoma (B-LCL) is the most common form of NHL. 5-year survival rates vary between 40 and >90% depending on prognostic factors but the importance of many of them is disputed. Those found most important and reproducible in the pre-rituximab era were included in the IPI. Since the original description, various variants of this index have been published. Aims: To reassess the value of the IPI, revised IPI (R-IPI), age-adjusted IPI (aaIPI), stage-adjusted IPI and different possible clinical prognostic factors in an unselected population of patients with B-LCL receiving rituximab containing front-line therapy. Methods: 371 patients diagnosed with B-LCL during 2007 and 2008 and treated with rituximab plus chemotherapy in 16 Croatian hematology departments were included in this study. Patients were registered at the time of treatment start, and data on demographics, clinical features and laboratory parameters collected. Follow-up was performed yearly. The study was approved by the Croatian Central Ethics’ Committee. Prognostic values of IPI, R-IPI, aaIPI, stage-adjusted IPI, individual factors used in indices (age, PS, LDH, stage, number of extranodal organs involved), bulk, gender, anemia, bone marrow infiltration and the presence of B symptoms were evaluated with respect to overall survival (OS) and progression-free survival (PFS) were evaluated. Survival analyses were performed using the Kaplan-Meier method and comparisons using the log-rank test. Multivariate analysis is ongoing. Results: 5-year OS and PFS of the whole cohort were 50% and 49.5%. Significant negative prognostic factors in univariate analyses for OS and PFS were: age>65, LDH high, PS>1, stage>2, Hb<120 g/l, male gender, bone marrow infiltration and presence of B symptoms. Number of involved extranodal sites and presence of bulky disease did not influence prognosis. Regarding prognostic indices, conventional IPI was most useful, distinguishing 4 categories with reasonable proportions of patients. R-IPI was less useful; the differences in PFS between the three prognostic categories were significant, but there was no difference in OS between patients with scores 0 and 1-2. aaIPI distinguished only two categories; patients with score 0 had excellent prognosis, while there was no difference in outcomes between those with scores 1 and 2-3. Stage adjusted IPI distinguished three prognostic groups, but very few patients had a score 0. Summary and Conclusions: Our study suggests that conventional IPI remains the most useful prognostic index. Bulky disease does not seem to be of prognostic importance, probably because of widespread use of adjuvant radiotherapy to initial bulky sites after immunochemotherapy. As seen in some other studies, men have a worse prognosis, possibly related to differences in rituximab metabolism. Additional negative prognostic factors include anemia, B symptoms and bone marrow infiltration, possibly as markers of aggressive systemic disease

Outcome of older patients with b-large cell lymphoma (b-lcl) – an observational study of KroHem, the Croatian cooperative group for hematologic diseases

Background: Approximately half of the patients with diffuse large B-cell lymphoma (DLBCL) are older than 60 years and their outcome is inferior in comparison to younger patients. Aims: We aimed to assess the impact of age, risk factors and the type of treatment on event-free survival (EFS) and overall survival (OS). Methods: In this retrospective study, 304 patients with DLBCL older than 60 years or equal were included. A total of 218 patients were included in an observational study of patients treated with rituximab conducted at 15 general and university hospitals in 2007 and 2008. Additional patients were recruited from two clinical centers. Results: The median age was 73 years (range 60-90), 144 were men and 160 women. 205 patients were treated with R-CHOP, 27 with R-CVP, 24 with RCNOP (mitoxantrone instead of doxorubicin), 20 with R-DA-EPOCH, 9 with RCEOP (etoposide instead of doxorubicin), and 19 patients received other regimens or no chemotherapy. After a median follow up of 52 months for survivors, the estimated 5-year EFS and 5-year OS were 43% and 47%, respectively. Half of the patients are alive at the time of last follow up. Lymphoma, infections, and cardiac events were the leading causes of death. A total of 52% patients died during first-line treatment, 24% died in remission, and 24% died in relapse. There were 16 secondary malignancies reported. The aaIPI significantly correlated with EFS (p=0.002) and OS (p=0.001). Gender, bulky disease (>5cm), and extranodal involvement were not associated with survival, whereas B symptoms were significantly predictive of EFS (p=0.002) and OS (p<0.001). Age had a negative impact on survival: patients between 60 and 65 years fared well (5- year OS 65%), patients from 66 to 75 years of age worse (5-year OS 46%), and those older than 75 years the worst (5-year OS 38%); p=0.004 (Figure 1A). Treatment choice also influenced EFS and OS: R-CVP and R-CNOP had worst outcomes worst, whereas those of R-CEOP and R-DA-EPOCH were at least comparable to R-CHOP; p=0.025 for EFS, p=0.009 for OS (Figure 1B). Summary/Conclusions: R-CHOP remains the standard of care in elderly patients with B-LCL. The aaIPI and presence of B symptoms influence prognosis. Survival decreases with age; cut-offs at 65 and 75 years are discriminative. R-CNOP has only modest efficacy, similar to R-CVP. Etoposide may serve as an alternative to anthracyclines for patients with cardiac comorbidities, and R-DA-EPOCH may represent a good option for high-risk patients