[Features of the course and adverse events risk of coronavirus infection COVID-19 in hematological diseases (data from the CHRONOS19 register for the Primorsky Territory, intermediate stage)]

AIM

To assess the characteristics of the course of coronavirus infection COVID-19 and to determine the risk factors for adverse events in patients of the regional hematological center.

MATERIALS AND METHODS

As part of an observational prospective cohort study, data from 144 medical records of patients in Primorsky Krai with hematological diseases and COVID-19 were analyzed. The data of the developed standardized questionnaire of the CHRONOS19 study were used. The primary endpoint (adverse outcome) was a composite point that included mortality from any cause during the observation period, development of acute respiratory distress syndrome, hospitalization in the intensive care unit, and the need for mechanical ventilation.

RESULTS

A study of the features of the course of COVID-19 in hematological patients showed an increase in the number of adverse events in patients with neoplastic blood diseases, especially in chronic lymphoproliferative diseases and acute myeloid leukemia. Significant predictors of an unfavorable course of COVID-19 include a refractory/recurrent variant of the course of a blood tumor, glucocorticoid therapy as part of the protocol for the treatment of the underlying disease, stage 3-4 lung damage according to computerised tomography scans at the onset of COVID-19, and the presence of diabetes mellitus.

CONCLUSION

Predictors of an unfavorable course of COVID-19 in hematological patients have been identified. Hematological patients in the context of the COVID-19 pandemic require a coordinated interdisciplinary approach involving hematologists and therapists, careful monitoring of clinical and laboratory parameters to reduce the risk of adverse events.

[Retrospective Analysis of Pathological Diagnosis of Central Nervous System Diseases in Tibet]

Objective To analyze the disease spectrum and clinicopathological characteristics of central nervous system(CNS)diseases diagnosed based on pathological findings in Tibet. Methods We collected the data of all the cases with CNS lesions in Tibet Autonomous Region People's Hospital from January 2013 to December 2020.The clinicopathological features were analyzed via light microscopy,immunohistochemical staining,and special staining. Results A total of 383 CNS cases confirmed by pathological diagnosis were enrolled in this study,with a male-to-female ratio of 188∶195 and an average age of(40.03±17.39)years(0-74 years).Among them,127(33.2%)cases had non-neoplastic diseases,with a male-to-female ratio of 82∶45 and an average age of(31.99±19.29)years;256(66.8%)cases had neoplastic diseases,with a male-to-female ratio of 106∶150 and an average age of(44.01±14.87)years.The main non-neoplastic diseases were nervous system infectious diseases,cerebral vascular diseases,meningocele,cerebral cyst,and brain trauma.Among the infectious diseases,brain abscess,granulomatous inflammation,cysticercosis,and hydatidosis were common.The main neoplastic diseases included meningioma,pituitary adenoma,neuroepithelial tumor,schwannoma,metastatic tumor,and hemangioblastoma.The meningioma cases consisted of 95.4%(103/108)cases of grade Ⅰ,3.7%(4/108)cases of grade Ⅱ,and only 1(1/108,0.9%)case of grade Ⅲ.Among the neuroepithelial tumor cases,the top three were glioblastoma,grade Ⅲ diffuse glioma,and ependymoma. Conclusions There are diverse CNS diseases confirmed by pathological diagnosis in Tibet,among which non-neoplastic diseases account for 1/3 of all the cases.Infectious and vascular diseases are the most common non-neoplastic diseases in Tibet,and tuberculosis and parasitic infections are relatively common.The types and proportion of brain tumors in Tibet are different from those in other regions of China,and meningioma is the most common in Tibet,with higher proportion than neuroepithelial tumor.

Sorting nexins: A novel promising therapy target for cancerous/neoplastic diseases

Sorting nexins (SNXs) are a diverse group of cytoplasmic- and membrane-associated phosphoinositide-binding proteins containing the PX domain proteins. The function of SNX proteins in regulating intracellular protein trafficking consists of endocytosis, endosomal sorting, and endosomal signaling. Dysfunctions of SNX proteins are demonstrated to be involved in several cancerous/neoplastic diseases. Here, we review the accumulated evidence of the molecular structure and biological function of SNX proteins and discuss the regulatory role of SNX proteins in distinct cancerous/neoplastic diseases. SNX family proteins may be a valuable potential biomarker and therapeutic strategy for diagnostics and treatment of cancerous/neoplastic diseases.

Knowledge on neoplastic diseases among young rural inhabitants

OBJECTIVE

The objective of the study was to analyze the level of knowledge on tumours and their prevention among rural inhabitants.

MATERIAL AND METHODS

The research involved 500 residents of villages in Podkarpackie Province in south-east Poland. The age of the researched ranges from 18-30 years; mean age - 26.96±0.84 (range [18, 30], median 25.95%CI [18, 9, 29, 01]). The researched group was represented in 47.59% by women in 52.41% by men. In order to obtain the research material, a standardized questionnaire was applied which included questions focused mainly on assessment of the level of knowledge on tumours (causes, symptoms, ways of treatment, prevention), as well as questions with both spontaneous and prompted answers.

RESULTS

34.72% of respondents confirmed the occurrence of tumours in their family; the most frequently occurring was a lung tumour (9.4%). While assessing the degree of relationship it was proved that among parents' of the respondents, neoplastic disease had occurred in 3.22% of cases, and in 22.36% of cases it affected grandparents. In self-assessment, a low level of knowledge was indicated by 35.35% of respondents: average by 30.45%, hard to determine by 32%, while 2.18% stated that their level of knowledge was high. The most frequently enumerated risk factors were: smoking (36.61%), improper diet (15.03%), and improper lifestyle (9.83%). UV radiation was a risk factor for 16.18%; however, a solarium only for 1.93% of respondents. For 37.94%, a medical examination was a diagnostic method in neoplastic disease.

CONCLUSIONS

According to self-assessment, every third respondent stated having a low or average level of knowledge. The most frequently used source of knowledge was the Internet, and much more rarely a doctor or a nurse. Very few of the respondents could enumerate the tests applied in the early detection of neoplastic diseases.

Mitochondrial VDAC1: A Key Gatekeeper as Potential Therapeutic Target

Mitochondria are the key source of ATP that fuels cellular functions, and they are also central in cellular signaling, cell division and apoptosis. Dysfunction of mitochondria has been implicated in a wide range of diseases, including neurodegenerative and cardiac diseases, and various types of cancer. One of the key proteins that regulate mitochondrial function is the voltage-dependent anion channel 1 (VDAC1), the most abundant protein on the outer membrane of mitochondria. VDAC1 is the gatekeeper for the passages of metabolites, nucleotides, and ions; it plays a crucial role in regulating apoptosis due to its interaction with apoptotic and anti-apoptotic proteins, namely members of the Bcl-2 family of proteins and hexokinase. Therefore, regulation of VDAC1 is crucial not only for metabolic functions of mitochondria, but also for cell survival. In fact, multiple lines of evidence have confirmed the involvement of VDAC1 in several diseases. Consequently, modulation or dysregulation of VDAC1 function can potentially attenuate or exacerbate pathophysiological conditions. Understanding the role of VDAC1 in health and disease could lead to selective protection of cells in different tissues and diverse diseases. The purpose of this review is to discuss the role of VDAC1 in the pathogenesis of diseases and as a potentially effective target for therapeutic management of various pathologies.

[Arsenic - Poison or medicine?]

Arsenic (As) is commonly known as a poison. Only a few people know that As has also been widely used in medicine. In the past years As and its compounds were used as a medicine for the treatment of such diseases as diabetes, psoriasis, syphilis, skin ulcers and joint diseases. Nowadays As is also used especially in the treatment of patients with acute promyelocytic leukemia. The International Agency for Research on Cancer (IARC) has recognized arsenic as an element with carcinogenic effect evidenced by epidemiological studies, but as previously mentioned it is also used in the treatment of neoplastic diseases. This underlines the specificity of the arsenic effects. Arsenic occurs widely in the natural environment, for example, it is present in soil and water, which contributes to its migration to food products. Long exposure to this element may lead to liver damages and also to changes in myocardium. Bearing in mind that such serious health problems can occur, monitoring of the As presence in the environmental media plays a very important role. In addition, the occupational risk of As exposure in the workplace should be identified and checked. Also the standards for As presence in food should be established. This paper presents a review of the 2015 publications based on the Medical database like PubMed and Polish Medical Bibliography. It includes the most important information about arsenic in both forms, poison and medicine.

Spontaneous tumor lysis syndrome in a patient with metastatic hepatocellular carcinoma

OBJECTIVE

To report a case of spontaneous tumor lysis syndrome (STLS) of a solid tumor in a patient who had undiagnosed metastatic hepatocellular carcinoma.

CLINICAL PRESENTATION AND INTERVENTION

A 70-year-old man with a medical history of alcohol abuse, withdrawal seizure and hypertension presented to the emergency department after being found unresponsive by his landlord. The patient had a bulky mass in the liver, classic laboratory abnormalities, oliguric renal failure and elevated alpha fetoprotein. He had never been treated with cytotoxic therapy. He was treated aggressively with fluid resuscitation and sodium bicarbonate, but he continued to be oliguric and the deterioration of his renal function also continued. Due to a minimal response to treatment and a poor prognosis, he was discharged to hospice for palliative care.

CONCLUSION

This case showed that STLS should be in the differential diagnosis of a patient who has malignant disease and has developed classic laboratory abnormalities and renal failure even without previous cytotoxic therapy.