Trends in Stroke Prevention between 2014 and 2018 in Hospitalized Atrial Fibrillation Patients.

In recent years, significant changes in stroke prophylaxis in patients with atrial fibrillation (AF) have been observed. Non-vitamin K antagonist oral anticoagulants (NOACs) are more commonly used in the prevention of thromboembolic complications in patients with AF. The aim of the study was to evaluate recommended stroke prophylaxis in patients with AF and to identify predictors of using NOACs in patients treated with anticoagulant therapy. The present study was a retrospective, observational, single-center study which included consecutively hospitalized patients in the reference cardiology center from January 2014 to December 2018. In the study group of 4027 patients with AF, to prevent thromboembolic complications, OACs were used in 3680 patients (91.4%), an antiplatelet drug(s) was used in 124 patients (3.1%), and 223 patients (5.5%) did not undergo any thromboembolic event prevention. In the group of 3680 patients treated with OACs, 2311 patients (62.8%) received NOACs and 1639 patients (37.2%), VKAs. Independent predictors of the use of NOACs were age (OR, 1.02; 95% CI, 1.01-1.03; P < 0.001), a previous thromboembolic event (OR, 1.29; 95% CI, 1.01-1.65; P=0.04), nonpermanent AF (OR, 1.61; 95% CI, 1.34-1.93; P < 0.001), and eGFR (OR, 1.22; 95% CI, 1.02-1.46; P=0.03). Between 2014 and 2018, an increase of patients treated with OACs, mainly with NOACs, was observed. Age, past thromboembolic complications, nonpermanent AF, and preserved renal function determined the choice of NOACs.

Hemoglobin F in primary myelofibrosis and in myelodysplasia.

Our study investigated two groups of adult patients with established diagnoses of primary myelofibrosis (21 patients) and myelodysplastic syndromes (MDS) (21 patients). The objective was to assess fetal hemoglobin (HbF) concentration and to investigate correlations with organomegaly and extramedullary hematopoiesis and with the level of anemia and blood transfusion requirement. In all patients, the diagnosis was confirmed by histopathological examination. Patients with myelofibrosis were investigated by ferrokinetics using 59Fe. The percentage of marrow sideroblasts was assessed in patients with refractory anemia with ringed sideroblasts. Increased values of HbF were found to occur both in patients with myelofibrosis and with MDS, although a higher incidence and higher concentrations were evident in patients with myelofibrosis. Statistically significant increases in HbF concentration were found when there was accompanying organomegaly, as compared to patients without this feature. The average HbF concentration in both groups of patients under study was twice as high in cases with as in those without marrow fibrosis. The difference was statistically significant. Increased HbF levels appear to correlate with extramedullary hematopoiesis. HbF concentration did not correlate with the level of anemia or with requirement for blood transfusion.

[Lysosomes of blast cells in various cytochemical types of acute leukemia]. / Obraz lizosomow komórek macierzystych w róznych typach cytochemicznych ostrych bialaczek

In 25 cases cytochemical types of acute leukemia were determined using the classification of Loeffler. Three cytochemical methods used were: p.a.S.-glycogen content, pox-peroxidase activity, and esterase activity determinatione. At the same time selective identification of lysosomes in perypheral blood blast cells was done using vital euchrisine staining and fluorescence microscopy. A correlation was observed between the cytochemical types of acute leukaemia and the lysosomal pattern. The fluorescence method of the identification of lysosomes is suggested for diagnosis of acute leukaemia.