Ukrainian Issues in Geopolitical thought of the Twentieth and Twenty-First Centuries

Ukrainian lands in the twentieth and twenty-first centuries have been in proximity of great geopolitical changes several times. During that time the Ukrainian nation – due to various factors – encountered a number of “windows of opportunity” for achieving the realization of dreams about independence and national sovereignty. The author identified in the period considered four “general moments,” of which two have been completed successfully. The first of these occurred in 1990–1991, when for the first time in modern history, Ukrainians managed to achieve a lasting and relatively stable independence. The second of the “moments” – still unresolved – are events that began in the late autumn of 2013. The process, called “Revolution of Dignity”, represents a new quality in the history of the Ukrainian nation, therefore, that the Ukrainians have to defend the status quo (independence, territorial integrity, sovereignty, etc.) but not to seek to achieve an independent being. The analysis leads to the conclusion that the ability of Ukrainians to achieve and maintain independence is largely a function of the relative power of the Russian state as measured with respect to the shape and quality of international relations

Management of cancer-associated venous thrombosis

The association between malignancy and venous thromboembolic disease has been recognized for over a century and a half. During this time, a substantial body of literature has developed showing that malignancy is not only a hypercoagulable state characterized by an increased risk of thrombosis but also that components of blood coagulation reactions are capable of supporting tumor growth and dissemination. In recent years a succession of meticulously performed clinical trials has clarified optimal therapy intended to both prevent and treat thromboembolism that occurs in the setting of cancer. However, much remains to be accomplished in terms of practitioner education on the merits of optimal therapy. Of perhaps greater interest is the possibility that drugs capable of controlling cancer-associated hypercoagulability may provide a means for improving cancer survival while avoiding the toxicities characteristic of conventional anti-tumor therapy. Clearly, ample incentive exists for collaboration between basic and clinical scientists interested in improving the management of malignancy and its thromboembolic complications

Iron reduction response and demographic differences between diabetics and non-diabetics with cardiovascular disease entered to a controlled clinical trial

Iron-catalyzed oxygen free radical-induced oxidative stress mediates the pathogenesis of diabetes and cardiovascular disease (CVD). Diabetics (n=473) and non-diabetics (n=804) with CVD entered to a randomized trial of iron (ferritin) reduction by calibrated phlebotomy (www.clinicaltrials.gov, Identifier NCT00032357) had comparable iron measures at entry but diabetics had greater burden of CVD and comorbidities, lower hemoglobin and hematocrit levels, and higher glucose levels than non-diabetics. Entry iron measures were lower in diabetics on hypoglycemic therapy compared to diabetics untreated previously. Diabetics and non-diabetics had comparable iron measures during follow-up. Loess analysis of paired ferritin and hemoglobin, and paired ferritin and glucose levels in diabetics randomized to phlebotomy showed higher ferritin levels associated with lower hemoglobin and higher glucose levels. Progressive ferritin reduction in diabetics comported with rising hemoglobin and falling glucose levels neither of which reached levels observed in non-diabetics. We postulate that phlebotomy-triggered autophagy (ferritinophagy) released redox-active iron sequestered intracellularly worsening anemia and glucose utilization that corrected partially with ferritin reduction. Intracellular redox-active iron levels contributory to disease, not reflected in peripheral iron measures, may persist because of glycation of iron transport proteins in diabetes. These findings suggest novel strategies for disease prevention and improving outcomes in diabetes and CVD

Warfarin Versus Low-Molecular-Weight Heparin Therapy in Cancer Patients

Abstract Learning Objectives After completing this course, the reader will be able to: Define characteristics of the interface between deep vein thrombosis and malignancy. Evaluate patient factors that may complicate long-term warfarin use in patients with cancer. List advantages that may be realized with low-molecular-weight heparin (versus warfarin) therapy in cancer patients. Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com The association between cancer and venous thromboembolism (VTE) is well established. Importantly, VTE is a significant cause of mortality in cancer patients. Although long-term warfarin (Coumadin™; Bristol-Myers Squibb; New York, NY) therapy is the mainstay of treatment for cancer patients with VTE, there are many practical problems with its use in this population. In particular, achieving therapeutic drug levels is difficult in cancer patients due to the increased risk of drug interactions, malnutrition, vomiting, and liver dysfunction in these patients. Moreover, cancer patients are at an increased risk of adverse effects of warfarin therapy. In contrast, low-molecular-weight heparins (LMWHs) are associated with a lower risk of adverse events compared with warfarin in patients with cancer. These agents also offer practical advantages compared with warfarin, including more predictable anticoagulant effects and ease of administration in addition to possible antineoplastic effects. Several LMWHs have demonstrated superior efficacy to warfarin in the secondary prevention of VTE. In particular, the LMWH, dalteparin (Fragmin®; Pfizer; New York, NY), has recently been shown to have superior efficacy to warfarin in a large trial of patients with cancer and VTE without increasing the risk of bleeding. A randomized trial of dalteparin has also shown improved response rates and survival in patients with small cell lung cancer. In view of the availability of more effective and reliable alternatives to warfarin therapy in cancer patients, it is appropriate to reassess the role of warfarin therapy in patients with cancer and VTE. Further evaluation of the LMWHs for effects on cancer outcome is indicated

Operational Energy [video]

NPS Defense Energy Seminar. The speaker is Director, Navy Energy Coordination Office, Great Green Fleet Coordinator, Energy & Environmental Readiness (OPNAV N45

Tożsamość bezpieczeństwa przestrzeni Bałkanów Zachodnich w świetle teorii regionalnych kompleksów bezpieczeństwa

Autor opisuje sytuację Bałkanów Zachodnich w oparciu o teorię regionalnych kompleksów bezpieczeństwa. W myśl tej koncepcji bezpieczeństwo definiowane jest przede wszystkim w regionalnych kontekstach geograficznych. Zagrożenia są uznawane za najbardziej prawdopodobne i tak postrzegane (sekurytyzowane) w bezpośrednim sąsiedztwie.Udostępnienie publikacji Wydawnictwa Uniwersytetu Łódzkiego finansowane w ramach projektu „Doskonałość naukowa kluczem do doskonałości kształcenia”. Projekt realizowany jest ze środków Europejskiego Funduszu Społecznego w ramach Programu Operacyjnego Wiedza Edukacja Rozwój; nr umowy: POWER.03.05.00-00-Z092/17-00

Ferritin and Percent Transferrin Saturation Levels Predict Type 2 Diabetes Risk and Cardiovascular Disease Outcomes

Introduction: Type 2 diabetes (T2D) and cardiovascular disease (CVD) risk associate withferritin and percent transferrin saturation (%TS) levels. However, increased risk has been observed at levels considered within the “normal range” for these markers. Objective: To define normative ferritin and %TS levels associated with T2D and CVD risk. Methods: Six-monthly ferritin, %TS and hemoglobin levels from 1,277 iron reduction clinical trial participants with CVD (peripheral arterial disease, 37% diabetic) permitted pair-wise analysis using Loess Locally Weighted Smoothing plots. Curves showed continuous quantitative ferritin, hemoglobin (reflecting physiologic iron requirements), and %TS (reflecting iron transport and sequestration) levels over a wide range of values. Inflection points in the curves were compared to ferritin and %TS levels indicating increased T2D and CVD risk in epidemiologic and intervention studies. Results: Increasing ferritin up to about 80 ng/mL and %TS up to about 25% TS corresponded to increasing hemoglobin levels, and minimal T2D and CVD risk. Displaced Loess trajectories reflected lower hemoglobin levels in diabetics compared to non-diabetics. Ferritin levels up to about 100 ng/mL paralleled proportionately increasing %TS levels up to about 55%TS corresponding to further limitation of T2D and CVD risk. Ferritin levels over 100 ng/mL did not associate with hemoglobin levels and coincided with increased T2D and CVD risk. Conclusions: Recognition of modified normal ranges for ferritin from about 15 ng/mL up to about 80- 100 ng/mL and %TS from about 15% up to about 25-55% may improve the value of iron biomarkers to assess and possibly lower T2D and CVD risk

The role of thrombin in gliomas

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72592/1/j.1538-7836.2005.01446.x.pd