Feasibility of umbilical cord blood as a source of red blood cell transfusion in preterm infants

BackgroundPreterm infants born earlier than 32 weeks of gestational age (GA) often need red blood cell (RBC) transfusions, which have been associated with an increased incidence of complications of prematurity, due to changes in tissue oxygenation. Transfusion of umbilical cord blood (UCB) could be beneficial for this group. The aims of this study were: (i) to determine the RBC transfusion needs in infants <32 weeks in Hospital Clinic of Barcelona; (ii) to identify the target GA group that would benefit most from UCB transfusion; and (iii) to assess the current availability of UCB as a potential source of RBC transfusion for these premature infants in our tertiary referral blood bank.Material and methodsA retrospective observational study was performed on infants born at <32 weeks GA, divided into two groups: (i) extremely low gestational age neonates (ELGAN) (from 23⁰ to 27⁶ weeks) and (ii) very preterm neonates (VPN) (from 28⁰ to 31⁶ weeks). Their complications and transfusion rates were compared. Processing and availability of UCB samples in the reference blood bank were assessed.ResultsOverall, 1,651 infants <32 weeks GA were admitted in the study period. While 12.5% of VPN received at least one RBC transfusion, the percentage increased to 60% among the ELGAN. Retinopathy of prematurity and bronchopulmonary dysplasia were diagnosed more frequently in the ELGAN group (p<0.001) than in the VPN group. The annual average volume of RBC transfusion in our study group was 1.35 L (95% CI: 1.07–1.64). The reference blood bank was able to produce 16 L (95% CI: 14–18) of UCB-RBC per year.ConclusionConsidering the data obtained about RBC transfusion needs and morbidities, the ELGAN group has been identified as the target group that would benefit most from UCB-RBC transfusions. We have demonstrated that our blood bank is able to produce enough RBC from UCB. Randomised control trials are warranted to study the potential benefits of UCB compared to adult blood for RBC transfusions.     

Remote Screening for Atrial Fibrillation by a Federal Cardiac Monitoring System in Primary Care Patients in Russia: Results from the Prospective Interventional Multicenter FECAS-AFS Study

Background:Screening for atrial fibrillation has the potential to significantly reduce cardiovascular morbidity and mortality. However, questions in regard to how to screen, on whom to screen, and the optimal setting of screening remain unanswered.Objective:To assess the applicability of a federal cardiac monitoring for atrial fibrillation (AF) screening and remote heart rhythm monitoring in patients at high cardiovascular risk in a mixed urban and rural population in Russia.Methods:This is a prospective multicenter cohort study including 3249 individuals with high cardiovascular risk (mean age 56 ± 12.8 years) from the larger Moscow region who were screened for AF using a smartphone-case based single-lead ECG monitor over a period of 18 month. The endpoints were considered as number of newly diagnosed AF; mean time to diagnosis; number of patients for the first time assigned to anticoagulation therapy; frequency of adverse events.Results:A trial fibrillation was diagnosed in 126 patients, 36 of them for the first time. The mean time to diagnosis was 3 ± 2 days. Of 36 patients, the CHA2DS2-VASc score was ≥1 in 34 cases, ≥2 in 29 cases. Anticoagulant therapy was first induced in 31 patients. One death in newly diagnosed group and two deaths in chronic group were registered. There were a total of eight hospitalizations: one in newly diagnosed and seven in chronic AF patients.Conclusion:Our results indicate that a Federal AF screening system in patients at high cardiovascular risk by using a smartphone-case based single lead ECG which is supported by centrally located ECG specialist and central data management is feasible and reliable when performed in a mixed urban and rural area. Further studies are needed to evaluate the full potential of this approach.     

High frequency of AML1/RUNX1 point mutations in radiation-associated myelodysplastic syndrome around Semipalatinsk nuclear test site

It is known that bone marrow is a sensitive organ to ionizing radiation, and many patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) have been diagnosed in radiation-treated cases and atomic bomb survivors in Hiroshima and Nagasaki. The AML1/RUNX1 gene has been known to be frequently mutated in MDS/AML patients among atomic bomb survivors and radiation therapy-related MDS/AML patients. In this study, we investigated the AML1 mutations in radiation-exposed patients with MDS/AML among the residents near the Semipalatinsk Nuclear Test Site (SNTS), where the risk of solid cancers and leukemias was increased due to the radiation effects. AML1 mutations were identified in 7 (39%) of 18 radiation-exposed MDS/AML patients. In contrast, no AML1 mutation was found in 13 unexposed MDS/AML cases. The frequency of AML1 mutations in radiation-exposed patients with MDS/AML was significantly higher compared with unexposed patients (p < 0.05).We also found a significant correlation between individual estimated doses and AML1 mutations (p < 0.05). Considering these results, AML1 point mutations might be a useful biomarker that differentiates radio-induced MDS/AML from spontaneous MDS/AML.     

Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan

ObjectivesThe lack of advance planning in a public health emergency can lead to wasted resources and inadvertent loss of lives. This study is aimed at forecasting the needs for healthcare resources following the expansion of the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Kazakhstan, focusing on hospital beds, equipment, and the professional workforce in light of the developing epidemiological situation and the data on resources currently available.MethodsWe constructed a forecast model of the epidemiological scenario via the classic susceptible-exposed-infected-removed (SEIR) approach. The World Health Organization’s COVID-19 Essential Supplies Forecasting Tool was used to evaluate the healthcare resources needed for the next 12 weeks.ResultsOver the forecast period, there will be 104 713.7 hospital admissions due to severe disease and 34 904.5 hospital admissions due to critical disease. This will require 47 247.7 beds for severe disease and 1929.9 beds for critical disease at the peak of the COVID-19 outbreak. There will also be high needs for all categories of healthcare workers and for both diagnostic and treatment equipment. Thus, Republic of Kazakhstan faces the need for a rapid increase in available healthcare resources and/or for finding ways to redistribute resources effectively.ConclusionsRepublic of Kazakhstan will be able to reduce the rates of infections and deaths among its population by developing and following a consistent strategy targeting COVID-19 in a number of inter-related directions.     

The influence of low-level laser therapy on parameters of oxidative stress and DNA damage on muscle and plasma in rats with heart failure

In heart failure (HF), there is an imbalance between the production of reactive oxygen species and the synthesis of antioxidant enzymes, causing damage to the cardiovascular function and increased susceptibility to DNA damage. The aim of this study was to evaluate the influence of low-level laser therapy (LLLT) on parameters of oxidative stress and DNA damage in skeletal muscle and plasma of rats with HF. Wistar rats were allocated into six groups: “placebo” HF rats (P-HF, n?=?9), “placebo” Sham rats (P-sham, n?=?8), HF rats at a dose 3 J/cm² of LLLT (3 J/cm²-HF, n?=?8), sham rats at a dose 3 J/cm² of LLLT (3 J/cm²-sham, n?=?8), HF rats at a dose 21 J/cm² of LLLT (21 J/cm²-HF, n?=?8) and sham rats at a dose 21 J/cm² of LLLT (21 J/cm²-sham, n?=?8). Animals were submitted to a LLLT protocol for 10 days at the right gastrocnemius muscle. Comparison between groups showed a significant reduction in superoxide dismutase (SOD) activity in the 3 J/cm²-HF group (p?=?0.03) and the 21 J/cm²-HF group (p?=?0.01) compared to the P-HF group. 2′,7′-Dihydrodichlorofluorescein (DCFH) oxidation levels showed a decrease when comparing 3 J/cm²-sham to P-sham (p?=?0.02). The DNA damage index had a significant increase either in 21 J/cm²-HF or 21 J/cm²-sham in comparison to P-HF (p?=?0.004) and P-sham (p?=?0.001) and to 3 J/cm²-HF (p?=?0.007) and 3 J/cm²-sham (p?=?0.037), respectively. Based on this, laser therapy appears to reduce SOD activity and DCFH oxidation levels, changing the oxidative balance in the skeletal muscle of HF rats. Otherwise, high doses of LLLT seem to increase DNA damage.     

Antioxidant properties of beta-carboline alkaloids are related to their antimutagenic and antigenotoxic activities

The beta-carboline alkaloids found in medical plants and in a variety of foods, beverages and cigarette smoke have a range of action in various biological systems. In vitro studies have demonstrated that these alkaloids can act as scavengers of reactive oxygen species. In this paper, we report the in vivo antioxidative properties of the aromatic (harmane, harmine, harmol) and dihydro-beta-carbolines (harmaline and harmalol) studied by using Saccharomyces cerevisiae strains proficient and deficient in antioxidant defenses. Their antimutagenic activity was also assayed in S. cerevisiae and the antigenotoxicity was tested by the comet assay in V79 cell line, when both eukaryotic systems were exposed to H(2)O(2). We show that the alkaloids have a significant protective effect against H(2)O(2) and paraquat oxidative agents in yeast cells, and that their ability to scavenge hydroxyl radicals contributes to their antimutagenic and antigenotoxic effects.     

HLA B27 allele types in homogeneous groups of juvenile idiopathic arthritis patients in Latvia

Juvenile idiopathic arthritis (JIA) is a heterogeneous condition and therapeutic strategies vary in different JIA types. The routinely accepted practice to start with Sulphasalazine (SS) as the first line treatment in patients with HLA B27 positive JIA proves to be ineffective in a large proportion of children.