Factors Influencing and Adverse Reactions of Voriconazole Clearance in Patients with Hematological Diseases / 中国实验血液学杂志

OBJECTIVE@#To monitor the changes of voriconazole minimum concentration(Cmin) in patients with hematological diseases, and evaluate the factors influencing and adverse reactions of voriconazole clearance in patients with hematological diseases, so as to provide a theoretical basis for reasonable clinical use of voriconazole.@*METHODS@#136 patients with hematological diseases who used voriconazole in Wuhan NO.1 Hospital from May 2018 to December 2019 were selected. The correlation between C-reactive protein, albumin, creatinine and voriconazole Cmin were analyzed, and the changes of voriconazole Cmin after glucocorticoid treatment was also detected. In addition, stratified analysis was used to explore the adverse events of voriconazole.@*RESULTS@#Among 136 patients, 77 were male (56.62%) and 59 were female (43.38%). There were positive correlations between voriconazole Cmin and C-reactive protein and creatinine levels (r=0.277, r=0.208), while voriconazole Cmin was negatively correlated with albumin level (r=-2.673). Voriconazole Cmin in patients treated with glucocorticoid was decreased significantly (P<0.05). In addition, sratified analysis of voriconazole Cmin showed that compared with voriconazole Cmin 1.0-5.0 mg/L group, the incidence of adverse reactions of visual impairment in voriconazole Cmin> 5.0 mg/L group was increased (χ2=4.318, P=0.038).@*CONCLUSION@#The levels of C-reactive protein, albumin and creatinine are closely related to the voriconazole Cmin, which indicate that inflammation and hyponutrition may prevent the clearance of voriconazole in patients with hematological diseases. It is necessary to monitor the voriconazole Cmin of patients with hematological diseases, and adjust the dosage in time to reduce adverse reactions.

Proceso de capacitación para mejorar el desempeño de enfermeros técnicos en el cuidado de pacientes con enfermedades hematológicas / T raining process to improve the performance of technical nurses in the care of patients with hematological diseases

Introducción: La capacitación se considera la herramienta más importante con que cuentan las organizaciones de salud para la formación y actualización de los profesionales de enfermería. Objetivo: Caracterizar el estado actual del desempeño de los enfermeros técnicos en el cuidado de pacientes con enfermedades hematológicas en el Instituto de Hematología e Inmunología. Métodos: Estudio descriptivo y transversal realizado en el Instituto de Hematología e Inmunología entre el 1º de julio de 2021 y el 30 de julio del 2022. Se aplicó una encuesta a 35 enfermeros técnicos, se realizó una observación del desempeño a través de una guía para identificar las principales dificultades en el cuidado de pacientes con enfermedades hematológicas. Se utilizó la estadística descriptiva, distribución de frecuencias absolutas y relativas. Resultados: Tenían menos de cinco años de graduados un 57,2 % del total de la muestra. Predominó como formas de superación el curso y el taller. El 65,7 % no recibió cursos de capacitación en los últimos cinco años y el 51,4 % tiene necesidades de superación profesional. Se evidenció insuficiencias en los indicadores relacionados con la participación en la toma de decisiones (71,4 %) respecto a conocimientos sobre enfermedades hematológicas y sus complicaciones (57,1 %), la autopreparación (54,3 %), la ejecución de técnicas específicas y de procedimientos invasivos (42,9 %). Conclusiones: El diagnóstico realizado permitió identificar las necesidades de aprendizaje de los enfermeros técnicos, con vistas a diseñar un proceso de capacitación para el fortalecimiento de la práctica del cuidado en pacientes con enfermedades hematológicas.

Introduction: Training is considered the most important tool available to health organizations for the training and updating of nursing professionals. Objective: To characterize the current state of the performance of technical nurses in the care of patients with hematological diseases at the Institute of Hematology and Immunology. Methods: Descriptive and cross-sectional study at the Institute of Hematology and Immunology, between July 1st, 2021 and July 30th, 2022. A survey was applied to 35 technical nurses, performance observation was carried out through a guide to identify the main difficulties in the care of patients with hematological diseases. Descriptive statistics, distribution of absolute and relative frequencies were used. Results: Of the total sample, 57.2% had less than five years of graduation; the course and the workshop predominated as forms of improvement; 65.7% have not received training courses in the last five years and 51.4% have professional improvement needs. Insufficiencies were evidenced in the indicators related to participation in decision-making (71.4%), knowledge about hematological diseases and their complications (57.1%), self-preparation (54.3%), execution of techniques specific and invasive procedures (42.9%). Conclusions: the diagnosis made made it possible to identify the learning needs of technical nurses, with a view to designing a training process to strengthen the practice of care in patients with hematological diseases.

Splanchnic vein thrombosis as a manifestation of latent myeloproliferative neoplasm associated with sticky platelet syndrome / Trombosis esplácnica como presentación de neoplasia mieloproliferativa latente asociada con síndrome de plaqueta pegajosa

Abstract Vein thrombosis of unusual sites such as the splanchnic region continues to be not only a diagnostic but also a therapeutic challenge for the clinician due to its manifestation and associated pathologies. Latent JAK2 (Janus kinase 2) positive myeloproliferative neoplasm associated with sticky platelet syndrome is unusual. We present a clinical case of a 38-year-old female patient who presented with sudden onset abdominal pain of a possible vascular origin. Splanchnic thrombosis was diagnosed in latent myeloproliferative neoplasm by identifying the JAK2V617F mutation and sticky platelet syndrome via platelet aggregometry. Off-label anticoagulation with rivaroxaban 20 mg/day was administered. During her outpatient follow-up, she did not suffer any new thrombotic episodes.

Resumen La trombosis venosa de sitios inusuales como la esplácnica continúa siendo un reto no solo diagnóstico sino también terapéutico para el clínico debido a su forma de presentación y las patologías asociadas. La neoplasia mieloproliferativa latente JAK2 (cinasa de Janus 2) positiva asociada con síndrome de plaqueta pegajosa es inusual. Se presenta un caso clínico de una paciente de 38 años de edad que debutó con dolor abdominal de inicio súbito que sugirió un posible origen vascular. Se diagnosticó trombosis esplácnica en relación con neoplasia mieloproliferativa latente por la identificación de la mutación de la JAK2V617F y síndrome de plaqueta pegajosa mediante agregometría plaquetaria. Se administró de manera off-label anticoagulación con rivaroxabán 20 mg/día. Durante su seguimiento ambulatorio no ha presentado nuevos episodios trombóticos.

Current status and influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies / 中国实用护理杂志

Objective:To investigate the current status of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies and analyze its influencing factors.Methods:Convenience sampling method was used to select 208 primary relatives and caregivers of patients with hematological malignancies who were hospitalized in the Department of Hematology, Nanjing Drum Tower Hospital from March to November 2020. Self-designed general information questionnaire, Chinese version of Anticipatory Grief Scale, caregiver burden scale and simple coping style questionnaire were used. The current status and influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological diseases were also analyzed.Results:The expected sadness score of caregivers of major relatives of hospitalized patients with hematological malignancies was 79(72, 91). The results of multiple linear regression analysis showed that the main influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies were the stage of treatment, the severity of subjective symptoms, whether to seek medical treatment in other places, the working status of caregivers of major relatives was unemployed, relationships with patients were parents, caregiver burden, and negative coping styles, which explained 83.1% of the total variation.Conclusions:Anticipatory grief is more serious among the caregivers of major relatives of hospitalized patients with hematological malignancies. It is recommended that nurses in the Hematology Department detect and assess the level of anticipatory grief of caregivers in a timely manner, and give corresponding interventions according to individual differences, so as to improve the physical and mental health of the caregivers, and then improve the quality of care and promote the recovery of patients.

Detection of platelet antibody and evaluation of platelet transfusion efficacy in patients with hematologic disease / 中国输血杂志

【Objective】 To investigate the factors influencing the production of platelet antibody and its effect on clinical platelet transfusion. 【Methods】 This is a single-center prospective observational study. The research subjects were patients with hematological diseases in West China Hospital of Sichuan University from October 1, 2018 to September 30, 2019, and their plasma were collected before platelet transfusion to detect platelet antibodies using solid-phase agglutination method. According to the results of platelet antibody screening, the patients were divided into platelet antibody positive group and negative group. The t test and nonparametric Mann-Whitney U test were used to compare the transfusion efficacy of two groups. Patients’ demographic and clinical information, including age, gender, diagnosis, the units of platelets and RBC transfused, were collected via HIS6.2.0 and whole process management system of blood in clinical (version 3.0) to analyze the influence of age, gender and the disease on the positive rate of platelet antibodies, as well as the profile of platelet antibodies in patients with different diseases, the correlation between the positive rate of platelet antibodies and the history of blood/platelets transfusion. In additional, the platelet transfusion process was observed on site. 【Results】 A total of 316 patients with hematologic diseases were included in this study, mainly with acute myeloid leukemia(188/316, 59.5%). All patients were transfused 1671 U platelet [1~17(5.3±3.1)U each person] and 1896 U RBC products [0~38(7.8±4.6)U each person] during the treatment. Out of the 316 patients, platelet antibodies were found in 85 (26.9%) of them. No significant differences in the positive rates of platelet antibody after transfusion were notice by genders or ages(P>0.05). The incidence of platelet antibody was related to diseases (P<0.05), with MDS as the highest (57.1%), followed by aplastic anemia (36.4%) and myeloid leukemia (27.7%). In additional, the positive rate of platelet antibody increased with the number of previous platelet transfusions(P<0.05). The 316 patients were divided into positive group and negative group according to the results of platelet antibody screening. The corrected count of increment (5.2×109/L vs 11.5×109/L, P<0.01) and absolute platelet increase(8×109/L vs 17×109/L, P<0.01)in positive group were lower than those in negative group. The positive group were transfused more units of platelets(1.7 U vs 1.2 U, P<0.01)and red blood cells(1.5 U vs 1.1 U, P<0.05)per week than negative group. The platelet transfusion interval was shorter in positive group than negative group (3.1 days vs 3.6 days, P<0.05), but there was no significant difference in red blood cell transfusion interval (3.1 days vs 3.8 days, P>0.05) between two groups. The minimum PLT count(5×109/L vs 9×109/L, P<0.01), average PLT count(27×109/L vs 40×109/L, P<0.01)and average Hb(71 g/L vs 77 g/L, P<0.05)in positive group were lower than those in negative group during hospitalization, but there was no significant difference in the minimum Hb(56 g/L vs 59 g/L, P>0.05)between two groups. According to transfusion events on site, the incidence of acute adverse reactions to transfusion was 13% (169/1 291). 【Conclusions】 The positive rates of platelet antibodies in patients with hematologic diseases were relatively high. In addition, the efficacy of platelet transfusion in positive group were worse than that in the negative group. It is recommended that platelet antibody testing should be routinely performed before transfusion in hematologic disease patients to select crossmatch-compatible platelets in order to improve the effectiveness of platelet transfusion.

Disfunción orgánica en pacientes pediátricos con leucemia linfoide aguda en el Instituto de Hematología e Inmunología / Organic dysfunction in pediatric patients with acute lymphoid leukemia at the Institute of Hematology and Immunology

Introducción: El pronóstico de las enfermedades hematológicas malignas ha experimentado un importante avance en las últimas décadas, sobre todo por las nuevas combinaciones de quimioterapia. Estos hechos han propiciado que muchos de estos pacientes, en algún momento de su enfermedad, sean tratados en unidades de cuidados intensivos, lo que no era frecuente hace dos décadas. Objetivo: Describir el desarrollo de la disfunción múltiple de órganos en pacientes pediátricos con leucemia linfoide aguda en terapia intensiva en el Instituto de Hematología e Inmunología. Métodos: Se realizó un estudio clínico, observacional, transversal en el que se incluyeron los pacientes pediátricos con leucemia linfoblástica aguda y disfunción múltiple de órganos, atendidos en el servicio de terapia intensiva en el periodo 2018 a 2020. Se analizaron las variables: sociodemográficas, estado nutricional, diagnóstico al ingreso, puntaje del score pSOFA, conducta fármaco-terapéutica. Resultados: El grupo de edad más afectado fue el de 1 a 4 años, en su mayoría normopesos, con complicaciones de choque séptico, distrés respiratorio, y con 33 por ciento de mortalidad mayor en aquellos pacientes con score pSOFA con más de 10 puntos. La conducta terapéutica más utilizada fue la administración de oxígeno, fluidoterapia y antibióticos de tercera y cuarta generación en la primera hora de ingreso al servicio. Conclusiones: Si el puntaje del score pSOFA es mayor de 10 puntos existe mayor riesgo de muerte y mortalidad pediátrica (90 por ciento )(AU)

Introduction: The prognosis of hematological malignancies has undergone an important advance in the last decades, mainly due to the new chemotherapy combinations. These facts have led many of these patients to be treated in intensive care units at some point during their illness. Objective: To describe the development of multiple organ dysfunction in pediatric patients with acute lymphoid leukemia in intensive care at the Institute of Hematology and Immunology. Methods: A clinical, observational, cross-sectional study was carried out that included pediatric patients with acute lymphoblastic leukemia and multiple organ dysfunction, treated in the intensive care service in the period from 2018 to 2020. The variables were analyzed: sociodemographic, nutritional status, diagnosis on admission, pSOFA score, drug-therapeutic behavior. Results: The most affected age group was 1 to 4 years old, mostly normal weight, with complications of septic shock, respiratory distress, and 33 percent higher mortality in those patients with a pSOFA score with more than 10 points. The most used therapeutic approach was the administration of oxygen, fluid therapy and third and fourth generation antibiotics in the first hour of admission to the service. Conclusions: If the pSOFA score is greater than 10 points, there is a greater risk of death and pediatric mortality (90 percent)(AU).

Análisis de las temáticas y enfoques de los artículos publicados en la Revista NOVA en el periodo comprendido entre 2014 y 2019 / Analysis of the topics and approaches of the articles published in the Scientific Publication NOVA in the period between 2014 and 2019

Resumen Objetivo. Identificar los enfoques y temáticas publicadas en la Revista Nova en los últimos 5 años y realizar una descripción narrativa de los mismos. Metodología. Revisión documental y análisis de las contribuciones teóricas y empíricas producidas durante el periodo comprendido entre 2014 y 2019 de publicación de la Revista NOVA. Resultados. Se identificaron dos enfoques: área médica y ciencias biológicas y seis temáticas relevantes: 1. Enfermedades infecciosas y resistencia bacteriana, 2. Enfermedades raras y neurodegenerativas, 3. Enfermedades tropicales, 4. Enfermedades metabólicas y diagnóstico prenatal, 5. Enfermedades cardiovasculares y hematológicas, 6. Biotecnología y calidad del agua. Conclusiones. La Revista NOVA ha realizado importantes contribuciones a la divulgación científica desde las áreas de la salud y biológicas, particularmente en seis temáticas de relevancia para el país y el mundo.

Abstract Objective. Identify the approaches and topics published in Nova in the last 5 years and make a narrative description of them. Methodology. Documentary review and analysis of the theoretical and empirical contributions produced during the period of the last 5 years of publication of the NOVA. Results. Two approaches were identified: medical and biological sciences area and six relevant topics: 1. Infectious diseases and bacterial resistance, 2. Rare and neurodegenerative diseases, 3. Tropical diseases, 4. Metabolic diseases and prenatal diagnosis, 5. Cardiovascular and hematological diseases, 6. Biotechnology and water quality. Conclusions. NOVA Scientific Publication has made important contributions to scientific dissemination from the health and biological areas, particularly on six topics of relevance to the country and the world.

COVID-19 en pacientes con patologías hematológicas / COVID-19 in patients with hematological diseases

Resumen Los informes iniciales sugirieron que los pacientes con antecedentes o malignidad activa podrían tener un mayor riesgo de contraer el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2) y desarrollar complicaciones relacionadas con la enfermedad por coronavirus 2019 (COVID-19). Pacientes con patologías hematológicas benignas y malignas pueden estar inmunocomprometidos por los efectos de la terapia antineoplásica, medicamentos de apoyo como los esteroides y las propiedades inmunosupresoras del cáncer en sí. También podrían tener una respuesta inmunitaria aumentada a la infección secundaria a fármacos inmunomoduladores. Se espera que la COVID-19, causada por el SARS-CoV-2, sea una infección devastadora en muchos pacientes con enfermedades hematológicas. En México se reportaron los primeros casos confirmados el 1 de marzo de 2020; en nuestro servicio de hematología el primer caso reportado y confirmado fue en abril de 2020. Realizamos un estudio de serie de casos de 33 pacientes hospitalizados con patologías benignas y malignas que desarrollaron COVID-19. Las tasas de casos de COVID-19 en sujetos hospitalizados con patologías hematológicas fue del 15.7%. La mortalidad por COVID-19 fue del 54.54%. En pacientes con patologías hematológicas parece deberse principalmente a que los pacientes con cáncer activo sin respuesta completa que recibieron quimioterapia citotóxica u otro tratamiento contra el cáncer tienen un mayor riesgo de mortalidad por la COVID-19 en comparación con aquellos que no reciben tratamiento activo, pacientes de novo sin quimioterapia, pero en estadios avanzados de la enfermedad con comorbilidades y asociadas principalmente con coinfecciones bacterianas.

Abstract Initial reports suggested that patients with a history or active malignancy may be at increased risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and developing complications related to coronavirus disease 2019 (COVID-19). Patients with benign and malignant hematological pathologies may be immunocompromised by the effects of antineoplastic therapy, supportive medications such as steroids, and the immunosuppressive properties of the cancer itself. They may also have an increased immune response to infection secondary to immunomodulatory drugs. COVID-19, caused by SARS-CoV-2, is expected to be an infection devastating in many patients with hematologic diseases. The first confirmed cases in Mexico were on March 1, 2020; In our hematology service, the first case reported and confirmed was in April 2020. We conducted a case series study of 33 hospitalized patients with benign and malignant pathologies that developed COVID-19. The COVID-19 case rates in hospitalized subjects with hematological pathologies was 15.7%. The mortality from COVID-19 was 54.54%. In patients with hematological pathologies it seems to be mainly due to the fact that patients with active cancer without a complete response who received cytotoxic chemotherapy or other anti-cancer treatment cancer have a higher risk of mortality from COVID-19 compared to those who do not receive active treatment, patients de novo without chemotherapy, but in advanced stages of the disease with comorbidities and associated mainly with bacterial coinfections.

Manejo odontológico del paciente con anemia falciforme: revisión integrativa / Dental management of the patient with falciform anemia: integrative review / Manejo odontológico do paciente com anemia falciforme: revisão integrativa

La anemia falciforme (AF) es un trastorno genético autosómico recesivo que afecta la hemoglobina y los glóbulos rojos adquieren una forma de hoz. Este evento provoca episodios de vaso-oclusión y hemólisis y, en consecuencia, una amplia gama de manifestaciones clínicas. Objetivo: realizar una revisión bibliográfica integrativa sobre el cuidado dental para pacientes con anemia falciforme. Materiales y Métodos: Se realizó una búsqueda en las bases de datos de PubMed y SciELO, utilizando como estrategia una asociación de tér-minos relacionados ("Anemia de Células Falciformes" y " Atención Odontológica"). Resultados: Se incluyeron los artículos publicados a partir de 1990 y se excluyeron revisiones de literatura, lo que resultó en dieciocho artículos para análisis. La evidencia científica demostró que la atención odontológica preventiva es esencial para los pacientes con anemia falciforme, ya que puede reducir el número de ingresos hospitalarios. Las me-didas previas, durante y posteriores al tratamiento pueden incluir profilaxis antibiótica, uso de sedación, buen control de los niveles de oxígeno, hidratación del paciente y mantenimiento de una perfusión tisular adecuada. Sin embargo, persisten algunas dudas, sobre la seguridad del uso de anestésicos locales con vasoconstric-tores y la oseointegración de implantes dentales. Conclusión: El conocimiento de la enfermedad es esencial para el tratamiento dental de pacientes con anemia falciforme; durante la atención, se debe tener en cuenta ciertos cuidados para reducir los factores que promueven crisis agudas como acidosis, hipotensión, hipoxia, infección, vasoconstricción y estrés.

Sickle cell anemia (SCA) is an autosomal recessive genetic disorder that affects the hemoglobin molecule of red blood cells in sickle-shaped cells formation. This event causes vaso­occlusive crises and hemolysis, and consequently, a wide range of clinical manifestations. Objective: This study aimed to present an integrative review of the literature on dental care of patients with SCA. Material and Methods: A search was conducted in Pubmed and Scielo databases using as a search strategy an association of terms related to disease and dentistry ("Sickle Cell Anemia", "Dental Care"). Results: Studies published since 1990 were included while literature reviews were excluded, resulting in eighteen articles for analysis. The literature has shown that pre-ventive dental care is essential for patients with sickle cell anemia and is able to reduce the number of hospi-talizations. Pre, trans and post-treatment measures may include antibiotic prophylaxis, use of sedation, good control of oxygen levels, patient hydration, and maintenance of adequate tissue perfusion. Still, more studies are needed to clarify some dental uncertainties during the care given to patients with AF, such as the safety of local anesthetics with vasoconstrictors and the use of osseointegrated implants. Conclusion: The knowledge of the disease is essential for dental management. Certain precautions should be taken to reduce factors that promote acute crises, such as acidosis, hypotension, hypoxia, infection, vasoconstriction and stress.

A anemia falciforme (AF) é uma alteração genética autossômica recessiva que afeta a molécula de hemoglo-bina das hemácias, resultando na formação de células em forma de foice. Esse evento provoca episódios de vaso-oclusão e hemólise, e consequentemente, uma ampla gama de manifestações clínicas. Objetivo: Este trabalho teve como objetivo apresentar uma revisão integrativa de literatura sobre os cuidados odontológicos ao paciente com anemia falciforme. Materiais e Métodos: Foi conduzida uma busca nas bases de dados Pubmed e Scielo, utilizando-se como estratégia uma associação de termos relacionados à doença e à odon-tologia ("Anemia Falciforme" e "Assistência Odontológica"). Resultados: Foram incluídos artigos publicados a partir de 1990 e excluídas revisões de literatura, resultando em dezoito artigos para análise. A literatura mostrou que o atendimento odontológico preventivo é essencial para o paciente com anemia falciforme, sendo capaz de diminuir a quantidade de internações hospitalares. As medidas pré, trans e pós-tratamento podem incluir a profilaxia antibiótica, o uso de sedação, um bom controle dos níveis de oxigênio, a hidratação do paciente e a manutenção da perfusão tecidual adequada. No entanto, algumas dúvidas persistem como a segurança dos anestésicos locais com vasoconstritor e a instalação de implantes osseointegrados. Con-clusão: O conhecimento da doença é primordial para o manejo odontológico desses pacientes e, durante o atendimento, certos cuidados devem ser tomados para diminuir os fatores que promovem as crises agudas como a acidose, hipotensão, hipóxia, infecção, vasoconstrição e estresse.

Mucormycosis in patients with hematological diseases: seven cases reports and literature review / 中华血液学杂志

Objective@#To explore the clinical characteristics, diagnosis, treatment and prognosis of patients with hematological diseases that complicated by mucormycosis, and to improve the understanding and clinical diagnosis and treatment of the disease.@*Methods@#The clinical data of 7 patients suffering from mucormycosis during September 2012 and September 2018 were retrospectively analyzed, and their clinical characteristics, treatment process and prognosis were analyzed.@*Results@#Of 7 patients, there were 4 males and 3 females, with a median age of 36 (19-79) years old. Two patients were diagnosed as acute myeloid leukemia as the underlying disease, the other 5 patients suffered from acute B lymphoblastic leukemia, peripheral T cell lymphoma, chronic myelocytic leukemia in blastic phase, myeloproliferative neoplasm and severe aplastic anemia after transplantation, respectively. Among them, disease types of mucormycosis were pulmonary in 4 patients, rhino-orbital-cerebral in 1 patient, cutaneous in 1 patient and disseminated in 1 patient. All the cases were confirmed by biopsy histopathology. The treatment drugs were amphotericin B or liposomal amphotericin B, and posaconazole. Surgical treatment was performed in 4 patients, 3 out of 4 achieved radical debridement, and the other one had local debridement. Two patients were cured, 1 patient was improved and 4 patients died.@*Conclusions@#The clinical manifestation and image feature of mucormycosis in patients with hematological diseases were diverse, and the mortality rate is high, diagnosis mainly depends on histopathology. Early diagnosis, control of underlying disease, improvement of immunosuppressive status, timely effective antifungal therapy and radical surgical debridement are the key points for improving the survival rate of patients with hematological diseases complicated by mucormycosis.

Clinical features and laboratory data analysis of Aeromonas bacteremia with hematological diseases / 中华血液学杂志

Objective@#To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection.@*Methods@#A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed.@*Results@#A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%.@*Conclusions@#Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.

Adherencia terapéutica y funcionalidad familiar en pacientes con enfermedades hematológicas / Therapeutic adherence in patients with hematological diseases and family function / Adesão terapeutica e funcionamento familiar em pacientes com doenças hematológicas / l'adhésion chez les patients souffrant de maladies hématologiques et fonctionnement de leur famille

Resumen Objetivo: Determinar la relación entre adherencia terapéutica y la funcionalidad familiar en pacientes con enfermedades hematológicas crónicas del Hospital General de Zona 46 del Instituto Mexicano del Seguro Social. Materiales y métodos: Se realizó un estudio descriptivo transversal, con pacientes del Hospital General de Zona 46 Instituto Mexicano del Seguro Social; aplicando la escala de adherencia terapéutica y el cuestionario de funcionamiento familiar FF-SIL. Resultados: El 76.2% (n=128) de los pacientes estudiados tiene moderada adherencia terapéutica, predomina el sexo masculino con 40.5% (n=68) comprendida en la edad de 31-45 años con un 42.2% (n=54) al igual que la funcionalidad familiar es mayor en el sexo masculino con un 50.6% (n=44) comprendida en la edad de 31-45 años con un 22.6% (n=38). Conclusiones: Existe relación en cuanto a la funcionalidad familiar y adherencia terapéutica. La mayoría de los pacientes estudiados presentó moderada adherencia formando parte de una familia nuclear moderadamente funcional.

Abstract Objective: To determine the relationship between therapeutic adherence and family functionality in patients with chronic hematological diseases of the General Hospital of Zone 46 of the Mexican Institute of Social Security. Materials and methods: An observational cross-sectional study was conducted with patients from the General Hospital of zone 46, Instituto Mexicano del Seguro Social; applying the therapeutic adherence scale and the family functioning questionnaire FF-SIL. Results: 76.2% (n = 128) of the studied patients have moderate therapeutic adherence, the male sex predominates with 40.5% (n = 68) comprised in the ages of 31-45 with 42.2% (n = 54) at as well as the family functionality is higher in the male sex with 50.6% (n = 44) comprised in the ages of 31-45 with 22.6% (n = 38). Conclusions: There is a relationship in terms of family functionality and therapeutic adherence. The majority of the patients studied showed moderate adherence as part of a moderately functional nuclear family.

Resumo Objetivo: Determinar a relação entre a adesáo terapéutica e o funcionamento familiar em pacientes com doençãs hematológicas crónicas do Hospital Geral da Zona 46 do Instituto Mexicano de Seguraba Social. Materiais e métodos: foi realizado um estudo observacional transversal com pacientes do Hospital Geral da zona 46, Instituto Mexicano do Seguro Social; aplicando a escala de adesáo terapéutica e o questionário de funcionamento familiar FF-SIL. Resultados: A adesão terapéutica é moderada em 76,2% (n = 128) dos pacientes estudados, 40,5% (n = 68) sáo de sexo masculino, a faixa etária de 31 a 45 anos predomina com 42,2% (n = 54). Quanto ao funcionamento familiar este é maior no sexo masculino com 50,6% (n = 44), sendo a faixa etária mais predominante a de 31-45 anos com 22,6% (n = 38). Conclusões: Existe uma relação entre o funcionamento familiar e a adesão terapéutica. A maioria dos pacientes estudados apresentou uma adesáo moderada, no ámbito de uma familia nuclear moderadamente funcional.

Résumé Objectif: Déterminer la relation entre l'observance thérapeutique et la fonctionnalité familiale chez des patients atteints de maladies hématologiques chroniques soignés a l'«Hospital General de Zona 46 del Instituto Mexicano del Seguro Social¼. Matériels et méthodes: Une étude transversale descriptive a été réalisée avec des patients de l'«Hospital General de Zona 46 del Instituto Mexicano del Seguro Social¼, au moyen d'une échelle d'observance thérapeutique et du questionnaire de fonctionnement familial FF-SIL. Résultats: 76,2% (n = 128) des patients étudiés ont une observance thérapeutique modérée, avec une plus grande représentation du sexe masculin (40,5%, n = 68) et de la tranche d'áge 31-45 ans (42,2%, n = 54). La fonctionnalité familiale est plus élevée pour le sexe masculin avec 50,6% des cas (n = 44) et dans la tranche d''áge 31-45 ans avec 22,6% des cas (n = 38). Conclusions: Il existe une relation entre la fonctionnalité familiale et l'observance thérapeutique. La majorité des patients étudiés ont montré une observance modérée dans le cadre d'une famille nucléaire modérément fonctionnelle.

Detection of peripheral blood NK cell subsets in patients with malignant hematological diseases / 国际检验医学杂志

Objective To study the clinical value of detection of peripheral blood natural killer(NK) cells subsets in patients with malignant hematological diseases.Methods A total of 100 patients with malignant blood disease were enrolled from March 2014 to April 2016 as the observation group,including 50 cases in acute stage and 50 cases in mild stage.At the same time,100 health subjects were enrolled as the control group.The number of NK cells in peripheral blood and the changes of subgroups were compared.Results The number of NK cells in the different groups were compared,the absolute numbers and relative numbers of NK cells in the acute phase of leukemia and lymphoma were much lower than those in the control group(P<0.05).While the absolute number and relative number of NK cells in mild stage of leukemia and lymphoma were higher than that in acute phase(P<0.05).After treatment,the absolute number and relative number of NK cells in patients with leukemia and lymphoma were higher than before treatment(P<0.05).Before treatment,levels of CD56bright and CD56dim in patients with leukemia and lymphoma were statistically different with those of control group(P<0.05).After treatment,CD56bright and CD56dim levels were significantly improved in both groups(P<0.05).Conclusion The number of peripheral blood NK cells in patients with hematological malignancies could be reduced,and the cells function might be compromised.Detection of NK cell subsets could be with guiding significance in the treatment of malignant hematologic disease.

Progress of telomere and telomerase in hematological diseases / 白血病·淋巴瘤

Telomere and telomerase play important roles in protecting and maintaining the stability and integrity of chromosomes. Telomere and telomerase are closely related with multiple diseases, and their relationship with aging and tumors has become a hot topic in recent years. Relevant reports in the American Society of Hematology Annual Meeting in 2016 will be reviewed together with advances of telomere and telomerase in hematological diseases.

Fungal and Viral Oral Infections in individuals with Onco-Hematologic Neoplasms in a University Hospital

Introduction: Individuals undergoing onco-hematologic treatment present higher risk for developing oral and/or systemic infections, due to the intense immunosuppression and compromise of the mucosal barriers during treatment. The aim of this study was to identify the fungal and viral oral infections that most frequently affected patients undergoing onco-hematologic treatment in a University Hospital, and relate them to the biopsychosocial data, underlying disease and treatment. Methods: This was a crosssectional study in which descriptive analysis of the data was performed, and the Exact Fisher test was applied to verify the association between the infections and the variables: sex, age group, educational level, underlying disease and treatment, considering a 5% probability of error. Results and Discussion: The clinical exam revealed that oral candidiasis was present in 8.92% of the individuals, and herpes simplex, in 4.5%. No significant associations were found between the variables and infections. The fungal and viral oral infections were little prevalente in individuals with hematologic neoplasms in the present study, suggesting that the action of dental surgeons in caring for the onco-hematologic patients at the Institution evaluated and the protocols use were efficient (AU)

Research progress on Epstein-Barr virus-associated hematological diseases / 中华临床感染病杂志

Epstein-Barr virus (EBV)infection is highly prevalent in general population,serum EBV antibody can be detected in about 90% of the adults.Forty years of researches have demonstrated that EBV infection is closely related to a variety of hematological diseases,such as infectious mononucleosis, EBV-related lymphoproliferative disorders,lymphoma and hemophagocytic syndrome.This paper reviews EBV-associated hematological diseases and its pathogenic mechanism.

Analysis of myelogram and clinical pathogenesis of 196 cases of patients with pancytopenia syndrom / 国际检验医学杂志

Objective To explore the etiological spectrum of pancytopenia ,in order to improve the diagnostic accuracy . Methods Retrospectively analysed myelogram and clinical data of 196 cases of patients with pancytopenia syndrom .Results The dominant cause of pancytopenia syndrom in 196 cases of patients was hematological diseases (accounted for 68 .9% ) ,including acute leukemia (14 .8% ) ,myelodysplastic syndrome (12 .2% ) ,aplastic anemia(11 .2% ) and immune‐related pancytopenia(10 .2% );while non‐hematologic diseases accounted for 31 .1% ,including connective tissue diseases (10 .7% ) ,chronic liver disease(7 .2% ) and in‐fection(6 .2% ) .Conclusion Etiology of pancytopenia syndrom is complex ,which should be comprehensively analysed with closely contacting clinics ,in order to clarify the cause ,reduce misdiagnosis and missed diagnosis and improve the diagnostic accuracy .

Progress in study of natural killer cells and their applications in Malignant hematological diseases: reports from the 56th American Society of Hematology annual meeting / 白血病·淋巴瘤

Natural killer cells (NK cells) are a class of cytotoxic lymphocytes and play an important role in anti-tumor immunity.There are many new advances from basic research to clinical applications in the 56th annual meeting of American Society of Hematology around the NK cells in Malignant hematological diseases.In this review,the progress will be given,which helps to understand the trend of NK cells in future clinical applications.

Progress in study of natural killer cells and their applications in hematological diseases: a report from the 2013 EHA annual meeting / 白血病·淋巴瘤

There were 17 literatures related to the clinical applications of natural killer cells in hematological diseases in the 18th annual meeting of the European Hematology Association (EHA).Here an overview of these literatures is given that helps to tnderstand how natural killer cells can be explored for future clinical interventions.

Analysis of bacterium distribution in hospitalized patients with hematopathy / 中国基层医药

Objective To survey the distribution and amibiotie resistance of bacterium isolated from hospitalized patients with hematolegical diseases.Methods Bacterial strains were isolated from patients with hematological disease.Antimicrobial susceptibility testing was done by the method of minimum inhibitory concentration.Results A total of 56 bacterial strains were isolated from all kinds of specimens,including blood,phlegm and urine.14.3% were gram-positive and 85.7% were gram-negative bacterium.Escheriehia coli and pseudomonas aeruginosa account for 21.4% of gram-negative bacterium,respectively.Detection rates of ESBLs in E.coli and K.pneumoniae were 75.0%(8/12)and 33.3%(2/6),respectively.Conclusion Our data may have great significance for the empirical use of antimicrobial agents in the treatment of infections in patients with hematological disease.