Combination approach to diagnosis and treatment of an elderly patient with chronic Ph-negative myeloproliferative neoplasm and concomitant surgical pathology. Clinical observation

Chronic myeloproliferative neoplasms (CMPN), Ph-negative, are of clonal nature, develop on the level of hematopoietic stem cell and are characterized by proliferation of one or more hematopoietic pathways. Currently, the group of Ph-negative CMPN includes essential thrombocythemia, primary myelofibrosis, polycythemia vera, myeloproliferative neoplasm unclassifiable.Identification of mutations in the Jak2 (V617F), CALR, and MPL genes extended understanding of biological features of Ph-negative CMPN and improved differential diagnosis of myeloid neoplasms. Nonetheless, clinical practice still encounters difficulties in clear separation between such disorders as primary myelofibrosis, early-stage and transformation of essential thrombocythemia into myelofibrosis with high thrombocytosis. Thrombocytosis is one of the main risk factors for thromboembolic complications, especially in elderly people.A clinical case of an elderly patient with fracture of the left femur developed in the context of Ph-negative CMPN (myelofibrosis) with high level of thrombocytosis is presented which in combination with enforced long-term immobilization and presence of additional risk created danger of thrombosis and hemorrhage during surgery and in the postoperative period

Epidemiological and clinical features of lymphoproliferative diseases in the head and neck region

Background. Lymphomas are a heterogeneous group of the lymphoid and hematopoietic system tumors. Neoplastic process often develops in head and neck area, including the integumentary tissues, orbit, nasal cavity, paranasal sinuses, oral cavity, pharynx, salivary glands, thyroid gland, as well as neck lymph nodes. The difficulties of head and neck lymphomas diagnosis are significant, since very often there is a combined non-tumor pathology. The high heterogeneity of lymphomas in the head and neck area requires structuring knowledge about their epidemiology and clinical manifestations.Objective: to study the epidemiological and clinical features of the head and neck lymphoproliferative diseases, which will lead to an improvement in diagnostic quality of this nosology's.Materials and methods. The frequency of head and neck lymphoproliferative diseases detection was estimated based on the study of epicrisis and clinical data of 174 patients hospitalized at the N.N. Blokhin National Medical Research Center of Oncology in the period from 2000 to 2020.Results. Taking into account the modern clinical and morphological classification of lymphomas of the World Health Organization (2017), information about the features of localization, characteristic signs of extranodal foci and lymph nodes is presented. Detection frequency of various subtypes non-Hodgkin's and Hodgkin's lymphomas were determined on a sufficient cohort of patients.Conclusion. Based on the analysis of clinical and morphological features of head and neck lymphomas, epidemiological and clinical features are described in detail, and differences in the symptoms and clinical manifestations of non-Hodgkin's and Hodgkin's lymphomas with a predominant head and neck involvement are revealed

Delayed neutron yield measurement on thermal neutron induced fission of 237Np using cross-correlation technique

The measurement procedure based on the continuous thermal neutron beam modulation with a mechanical chopper was developed for delayed neutron yield measurement of the thermal neutron induced fission of 237Np. The idea of the procedure is similar to that, widely used in modern computer communications for the non-authorized data access prevention. The data is modulated with predefined pattern before transmission to the public network and only recipient that has the modulation pattern is able to demodulate it upon reception. For the thermal neutron induced reaction applications the thermal neutron beam modulation pattern was used to demodulate the measured delayed neutron intensity signals on the detector output, resulting nonzero output only for the detector signals correlated with the beam modulation. The comparison of the method with the conventional measurement procedure was provided and it was demonstrated that the cross-correlation procedure has special features making it superior over the conventional one especially when the measured value is extremely small in comparison with the background. Due to strong sensitivity of measurement procedure on the modulation pattern of the neutron beam one can implement the modulation pattern of specific shape to separate the effect of the thermal part of the beam from the higher energy one in most confident way in the particular experiment. The remarkable property of our method is related to the unique possibility of separation the effects caused exclusively by the thermal neutrons using the neutron TOF measurement available on the IBR-2 pulsed reactor

Digital signal processing application in nuclear spectroscopy

Digital signal processing algorithms for nuclear particle spectroscopy are described along with a digital pile-up elimination method applicable to equidistantly sampled detector signals pre-processed by a charge-sensitive preamplifier. The signal processing algorithms provided as recursive one- or multi-step procedures which can be easily programmed using modern computer programming languages. The influence of the number of bits of the sampling analogue-to-digital converter to the final signal-to-noise ratio of the spectrometer considered. Algorithms for a digital shaping-filter amplifier, for a digital pile-up elimination scheme and for ballistic deficit correction were investigated using a high purity germanium detector. The pile-up elimination method was originally developed for fission fragment spectroscopy using a Frisch-grid back-to-back double ionisation chamber and was mainly intended for pile-up elimination in case of high alpha-radioactivity of the fissile target. The developed pile-up elimination method affects only the electronic noise generated by the preamplifier. Therefore, the influence of the pile-up elimination scheme on the final resolution of the spectrometer investigated in terms of the distance between piled-up pulses. The efficiency of developed algorithms compared with other signal processing schemes published in literature

Ionization Chamber for Prompt Fission Neutron Investigations

In this work we report recent achievements in design of twin back-to-back ionization chamber (TIC) for fission fragment (FF) mass and kinetic energy measurement. Correlated FF kinetic energies, their masses and the angle of FF in respect to the axes in 3D Cartesian coordinates can be determined from analysis of the heights and shapes of the pulses induced by the fission fragments on the anodes of TIC. Anodes of TIC were designed as consisting of isolated strips each having independent electronic circuitry and special multi-channel pulse processing apparatus. Mathematical formulae provided for FF angles measured in respect to the coordinate axes. It was shown how the point of fission fragments origin on the target plane may be determined using the same measured data. The last feature made the TIC a rather powerful tool for prompt fission neutron (PFN) emission investigation in event-by-event analysis of individual fission reactions from non- point fissile source. Position sensitive neutron induced fission detector for neutron-imaging applications with both thermal and low energy neutrons was found as another possible implementation of the designed TIC.JRC.G.2-Standards for Nuclear Safety, Security and Safeguard

Vaccination against SARS-COV‑2 in oncology

The objective of the study a detailed, systematic review of the world literature data, which includes all aspects of recommendations for vaccination against SARS-COV‑2 in cancer patients.Materials and methods. Information search was carried out in PubMed, MedLine, Scopus, Web of Science, RSCI.The work included data from literature and information sources that were published before February 2021.Results. The data of retrospective and prospective clinical studies are analyzed. This paper reflects considerations and recommendations for the vaccination of cancer patients by Russian and foreign specialists in the context of COVID‑19 pandemic. The review presents current recommendations for vaccination against SARS-COV‑2 in patients with solid tumors, hematological malignancies, recipients of hematopoietic stem cells and cell therapy.Conclusion. To date, groups at increased risk of infection with the new coronavirus have been identified. These groups include patients with cancer. The presence of tumor does not allow a delay in start of therapy, and requires careful monitoring and observation. In this regard, despite the pandemic, the treatment of cancer patients must be continued regardless of the circumstances. Cancer patients should not be deprived of the opportunity to be vaccinated against SARS-COV‑2. Every patient should be decided individually. At the moment, there are no officially approved recommendations for vaccination against SARS-COV‑2 for cancer patients. Before the creation and approval of final recommendations for cancer patients, it is necessary to focus on compliance with sanitary and anti-epidemic measures and the prevention of COVID‑19 infection. The global cancer community continues to actively develop recommendations for the optimal vaccination against SARS-COV‑2 in cancer patients.The most relevant ones are outlined in this article

MALT lymphoma and erosive and ulcerative lesions of the stomach: modern diagnostic approaches and own clinical observation

Due to the pronounced polymorphism of stomach MALT-lymphoma endoscopic manifestations, often mimicking inflammatory changes of various etiologies, difficulties arise in the timely diagnosis of this disease. The alertness of the endoscopist and the use of integrated approaches to endoscopic diagnosis, taking into account the existing criteria for differential diagnosis, will undoubtedly improve the results of treatment