Добірка наукової літератури з теми "338.45: 658.588"

ABSTRACTThe purpose of this study is to describe the use of conjunction on utama news of Harian Singgalang edition Mei—Juni 2020. This type of research is qualitative research using descriptive methods. The data in this study were obtained from the results of a documentation study with the observation and note technique. The techniques used to analyze data are data identification, data presentation, and drawing conclusions. The research results found 978 times the use of conjunctions in 45 data sources with 638 sentences. Coordinative conjunctions were found 518 times, subordinative conjunctions were found 336 times, correlative conjunctions were found 14 times, conjunctions between sentences were found 102 times, and conjunctions between paragraphs was found 8 times. Based on the results of the study, it is concluded that the most common conjunctions found are coordinative conjunctions while the least conjunctions found are conjunctions between paragraphs. Besides, the use of correct conjunctions outweighs the use of improper conjunctions. Kata Kunci: Konjungsi, Kohesi, Berita Utama

Abstract Background: The MATISSE trials showed that a single dose regimen of fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the treatment of venous thromboembolism (VTE). In these trials, outpatient treatment of fondaparinux was encouraged but left at the investigator’s discretion. We analyzed the data in patients who received fondaparinux on an outpatient basis. Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7.5 mg (5.0 mg and 10.0 mg in patients <50 kg and >100 kg, respectively). In the MATISSE-DVT trial, fondaparinux was compared with twice-daily subcutaneous enoxaparin (1 mg/kg) in patients with deep-vein thrombosis (DVT). In the MATISSE-PE trial, it was compared with adjusted-dose intravenous unfractionated heparin (UFH) in patients with pulmonary embolism (PE). Outpatient treatment of DVT with enoxaparin was possible whereas outpatient treatment of PE with UFH was not feasible. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. The primary efficacy and safety outcomes were recurrent VTE during 3 months’ follow-up and major bleeding (MB) and death during the initial treatment period. Results: In MATISSE-DVT, 31.4% and 33.8% of the fondaparinux- and enoxaparin-treated patients, respectively, received therapy on an outpatient basis. In MATISSE-PE, 14.3% of the patients received fondaparinux on an outpatient basis, compared with none in the UFH group. In both MATISSE-DVT and -PE, efficacy and safety data from the patients who received fondaparinux on an outpatient basis were similar to those from the total population (Tables). The rates of recurrent VTE and MB in fondaparinux outpatients were similar to those in enoxaparin outpatients or UFH inpatients. Conclusion: Outpatient initial treatment of both DVT and PE with once-daily fondaparinux is feasible, effective and safe. MATISSE DVT Enoxaparin Fondaparinux All patients Outpatients All patients Outpatients *As treated patients n 1107 374 (33.8%) 1098 345 (31.4%) Age, yr (mean±SD) 61±17 60±16 61±17 58±17 Male/female 578/529 201/173 581/517 197/148 Hospital discharge, days (mean±SD) 7.0±6.2 1.8±1.9 7.6±7.7 1.6±1.7 ≥2 VTE risk factors, n (%) 283 (25.6) 122 (32.6) 293 (26.7) 97 (28.1) VTE, n (%) 45 (4.1) 16 (4.3) 43 (3.9) 7 (2.0) MB*, n (%) 13 (1.2) 3 (0.8) 12 (1.1) 5 (1.5) MATISSE-PE UFH Fondaparinux All patients Outpatients *As treated patients n 1110 1103 158 (14.3%) Age, yr (mean±SD) 62±17 63±16 57±16 Male/female 477/633 501/601 82/76 Hospital discharge, days (mean±SD) 10.2±6.8 9.7±7.7 4.4±2.2 ≥2 VTE risk factors, n (%) 260 (23.4) 241 (21.8) 35 (22.2) VTE, n (%) 56 (5.0) 42 (3.8) 5 (3.2) MB*, n (%) 12 (1.1) 14 (1.3) 0 (0)

ABSTRACT Low accessibility of the rRNA is together with cell wall impermeability and low cellular ribosome content a frequent reason for failure of whole-cell fluorescence hybridization with fluorescently labeled oligonucleotide probes. In this study we compare accessibility data for the 16S rRNA of Escherichia coli (gamma Proteobacteria, Bacteria) with the phylogenetically distantly related organisms Pirellula sp. strain 1 (Planctomycetes, Bacteria) and Metallosphaera sedula (Crenarchaeota, Archaea) and the 18S rRNA accessibility of Saccharomyces cerevisiae (Eucarya). For a total of 537 Cy3-labeled probes, the signal intensities of hybridized cells were quantified under standardized conditions by flow cytometry. The relative probe-conferred fluorescence intensities are shown on color-coded small-subunit rRNA secondary-structure models. For Pirellula sp., most of the probes belong to class II and III (72% of the whole data set), whereas most of the probes targeting sites on M. sedula were grouped into class V and VI (46% of the whole data set). For E. coli, 45% of all probes of the data set belong to class III and IV. A consensus model for the accessibility of the small-subunit rRNA to oligonucleotide probes is proposed which uses 60 homolog target sites of the three prokaryotic 16S rRNA molecules. In general, open regions were localized around helices 13 and 14 including target positions 285 to 338, whereas helix 22 (positions 585 to 656) and the 3′ half of helix 47 (positions 1320 to 1345) were generally inaccessible. Finally, the 16S rRNA consensus model was compared to data on the in situ accessibility of the 18S rRNA of S. cerevisiae.

Abstract Abstract 4529 Published data about outcome after cryopreserved allogeneic peripheral blood stem cell transplantation are scarce and, so far, have only been compared to historic cohorts of fresh graft recipients. We have performed a matched pair analysis of 66 patients receiving either cryopreserved or fresh grafts from matched related donors at our institution between January 2005 and June 2011 with a median follow-up time of 576 days (range: 18–2080 days). For matching patients we calculated a propensity score including patient age, sex, diagnosis, performance status, remission status before transplantation (first remission vs. other), conditioning therapy (standard vs. reduced intensity), GvHD prophylaxis (with or without methotrexate) and CD34 cell count in the graft. Consequently, there were no significant differences between both groups for these parameters: median patient and donor age were 53 years (range: 18–68 and 23–76 years, respectively) for 34 male and 32 female patients with a performance status of ECOG 0 (n=60) or ECOG 1 (n=6). Diagnoses were AML (n=47), ALL (8), lymphoma (10) and CMPN (1). 31 patients were in first remission before transplantation. Reduced intensity conditioning therapy (n=52) and GvHD prophylaxis without methotrexate (n=41) were more frequent than standard conditioning (n=14) and prophylaxis with methotrexate (n=25), respectively. Median cell counts were also almost equal in fresh and cryopreserved grafts for CD34 cells (5.7×106/kg (range: 3.1–11.4×106/kg) vs. 5.1×106/kg (2.6–12.3×106/kg), respectively), total nuclear cells (10.0×108/kg (4.9–21.4×108/kg) vs. 9.6×108/kg (5.0–19.1×108/kg) and CD3 lymphocytes (3.8×108/kg (2.1–6.8×108/kg vs. 3.4×108/kg (0.6–4.5×108/kg)). All patients engrafted. Median neutrophil engraftment with an ANC >0.5×109/l was reached after 16 days (range: 10–21) vs. 15 days (10–31) (p=.15 by paired t-test) and platelet engraftment >20×109/l (for 3 consecutive days without requiring transfusion) occurred after 13 days (8–33) vs. 14 days (9–45) (p=.27). Median follow-up time was similar between both groups (566 vs. 586 days, p=.894) and mean overall survival time, as calculated by Kaplan-Meyer analysis, was 1113 days for patients receiving fresh compared to 1258 days for patients receiving cryopreserved grafts (p=.582 by log rank test). Relapse or progression occurred in 13 vs. 14 patients, giving a mean disease/progression-free survival time of 922 vs. 1114 days (p=.467). In summary, we did not observe any relevant outcome differences between patients receiving fresh or cryopreserved peripheral stem cell grafts of matched related donors. Therefore, the use of cryopreserved grafts can be considered safe and may even allow a more flexible transplant scheduling compared to fresh allografts. Disclosures: No relevant conflicts of interest to declare.

Background:Axial spondyloarthritis (axSpA) presents diagnostic challenges incurring a delay of up to a decade and relies considerably on radiographic and MRI evidence of sacroiliitis which has led to the development of classification criteria which also rely on imaging. However, it has been suggested that such criteria may not be appropriate for axSpA patients presenting with other forms of SpA, especially psoriatic, because imaging features may vary in frequency and/or may be atypical. This hypothesis has never been tested in a prospective inception cohort of patients presenting with undiagnosed back pain.Objectives:We aimed to compare the spectrum of radiographic and MRI abnormalities in the sacroiliac joint (SIJ) of an inception cohort of patients presenting with undiagnosed back pain and psoriasis, iritis, and colitis.Methods:We used data from the prospective multicenter Screening for Axial Spondyloarthritis in Psoriasis, Iritis, and Colitis (SASPIC) Study, which is aimed at early detection of axial SpA in patients referred by the respective specialist after first presenting with these disorders. Consecutive patients ≤45 years of age with ≥3 months undiagnosed back pain with any one of psoriasis, AAU, or colitis undergo routine clinical evaluation by a rheumatologist for axial SpA followed by imaging. In SASPIC I, MRI evaluation of the SIJ was ordered per rheumatologist decision. In SASPIC II, MRI evaluation was ordered for all patients. Radiographs and MRI scans were assessed by two central readers and comparisons of the three groups were based on concordant assessments of imaging features. Evaluation of MRI scans included both global assessment for presence/absence of axSpA with confidence scale (-10 to +10), active and structural lesions typical of axSpA per recent ASAS definitions, and granular assessment of individual lesions according to SIJ quadrants and halves in consecutive semicoronal slices through the SIJ. Groups were compared by ANOVA and the chi-square test.Results:A total of 240 patients were recruited, 143 from SASPIC I and 97 from SASPIC II, 101 (42.1%) being diagnosed with axSpA (65.3% male, mean age 34.4 years, mean symptom duration 8.7 years, B27 positive 55.4%). Mean age of colitis (N=101), psoriasis (N=61), iritis (N=78) patients were 33.4, 36.6, 34.3 years, respectively, mean symptom duration was 6.8, 7.2, 9.4 years, respectively, and % males were 45.5%, 52.5%, 51.3%, respectively. There were no significant group differences for unilateral versus bilateral radiographic sacroiliitis and no significant differences in the frequencies, type, or distribution of MRI lesions (Table 1).Conclusion:Data from the SASPIC prospective inception cohort does not support the view that imaging of the SIJ differs in psoriatic axSpA, which appears similar to axSpA associated with iritis or colitis. These data support the umbrella concept of axSpA.Imaging FeatureColitis (n=30)Psoriasis (n=19)Iritis (n=52)P valueUnilateral sacroiliitis (grade ≥2), N(%)1 (3.3%)0 (0%)2 (3.8%)0.69mNY criteria +, N(%)5 (16.7%)6 (31.2%)15 (28.8%)0.39Grade of sacroiliitis, mean(SD)1.8 (2.2)2.1 (2.7)2.2 (2.4)0.76MRI indicative of axSpA, N(%)15 (50.0%)11 (57.9%)32 (61.5%)0.60MRI indicative of axSpA (confidence ≥5/10), N(%)14 (46.7%)10 (52.6%)30 (57.7%)0.63MRI active lesion typical of axSpA, N(%)6 (20.0%)6 (31.6%)18 (34.6%)0.37MRI structural lesion typical of axSpA, N(%)11 (36.7%)7 (36.8%)18 (34.6%)0.98MRI with unilateral lesion (any)2 (6.7%)3 (15.8%)11 (21.2%)0.22MRI with unilateral lesion (BME)1 (3.3%)2 (10.5%)5 (9.6%)0.54MRI with unilateral lesion (Erosion)0 (0%)0 (0%)3 (5.8%)0.23MRI with unilateral lesion (Sclerosis)1 (3.3%)1 (5.3%)3 (5.8%)0.89MRI with unilateral lesion (Fat)0 (0%)0 (0%)0 (0%)NAMRI with iliac lesion17 (56.7%)12 (63.2%)32 (61.5%)0.88MRI with sacral lesion12 (40.0%)11 (57.9%)31 (59.6%)0.21Disclosure of Interests:Walter P Maksymowych Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, UCB, Consultant of: Abbvie, BMS, Boehringer, Galapagos, Gilead, Lilly, Novartis, Pfizer, UCB, Grant/research support from: Abbvie, Novartis, Pfizer, Ulrich Weber: None declared, Jon Chan: None declared, Raj Carmona: None declared, James Yeung: None declared, Sibel Aydin: None declared, Jodie Reis: None declared, Liam Martin: None declared, Ariel Masetto: None declared, Olga Ziouzina: None declared, Dianne Mosher: None declared, Stephanie Keeling: None declared, Sherry Rohekar: None declared, Rana Dadashova: None declared, Joel Paschke: None declared, Amanda Carapellucci: None declared, Robert G Lambert: None declared.

Background Guidelines recommend walking to increase moderate to vigorous physical activity (MVPA) for health benefits. Objectives To assess the effectiveness, cost-effectiveness and acceptability of a pedometer-based walking intervention in inactive adults, delivered postally or through dedicated practice nurse physical activity (PA) consultations. Design Parallel three-arm trial, cluster randomised by household. Setting Seven London-based general practices. Participants A total of 11,015 people without PA contraindications, aged 45–75 years, randomly selected from practices, were invited. A total of 6399 people were non-responders, and 548 people self-reporting achieving PA guidelines were excluded. A total of 1023 people from 922 households were randomised to usual care (n = 338), postal intervention (n = 339) or nurse support (n = 346). The recruitment rate was 10% (1023/10,467). A total of 956 participants (93%) provided outcome data. Interventions Intervention groups received pedometers, 12-week walking programmes advising participants to gradually add ‘3000 steps in 30 minutes’ most days weekly and PA diaries. The nurse group was offered three dedicated PA consultations. Main outcome measures The primary and main secondary outcomes were changes from baseline to 12 months in average daily step counts and time in MVPA (in ≥ 10-minute bouts), respectively, from 7-day accelerometry. Individual resource-use data informed the within-trial economic evaluation and the Markov model for simulating long-term cost-effectiveness. Qualitative evaluations assessed nurse and participant views. A 3-year follow-up was conducted. Results Baseline average daily step count was 7479 [standard deviation (SD) 2671], average minutes per week in MVPA bouts was 94 minutes (SD 102 minutes) for those randomised. PA increased significantly at 12 months in both intervention groups compared with the control group, with no difference between interventions; additional steps per day were 642 steps [95% confidence interval (CI) 329 to 955 steps] for the postal group and 677 steps (95% CI 365 to 989 steps) for nurse support, and additional MVPA in bouts (minutes per week) was 33 minutes per week (95% CI 17 to 49 minutes per week) for the postal group and 35 minutes per week (95% CI 19 to 51 minutes per week) for nurse support. Intervention groups showed no increase in adverse events. Incremental cost per step was 19p and £3.61 per minute in a ≥ 10-minute MVPA bout for nurse support, whereas the postal group took more steps and cost less than the control group. The postal group had a 50% chance of being cost-effective at a £20,000 per quality-adjusted life-year (QALY) threshold within 1 year and had both lower costs [–£11M (95% CI –£12M to –£10M) per 100,000 population] and more QALYs [759 QALYs gained (95% CI 400 to 1247 QALYs)] than the nurse support and control groups in the long term. Participants and nurses found the interventions acceptable and enjoyable. Three-year follow-up data showed persistent intervention effects (nurse support plus postal vs. control) on steps per day [648 steps (95% CI 272 to 1024 steps)] and MVPA bouts [26 minutes per week (95% CI 8 to 44 minutes per week)]. Limitations The 10% recruitment level, with lower levels in Asian and socioeconomically deprived participants, limits the generalisability of the findings. Assessors were unmasked to the group. Conclusions A primary care pedometer-based walking intervention in 45- to 75-year-olds increased 12-month step counts by around one-tenth, and time in MVPA bouts by around one-third, with similar effects for the nurse support and postal groups, and persistent 3-year effects. The postal intervention provides cost-effective, long-term quality-of-life benefits. A primary care pedometer intervention delivered by post could help address the public health physical inactivity challenge. Future work Exploring different recruitment strategies to increase uptake. Integrating the Pedometer And Consultation Evaluation-UP (PACE-UP) trial with evolving PA monitoring technologies. Trial registration Current Controlled Trials ISRCTN98538934. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 37. See the NIHR Journals Library website for further project information.

Background: Cost-of-Illness Analysis (COI) constitutes the basis for the decision-making process on the budget and allocation in a modern health care system. Considering the wide prevalence of type 2 diabetes mellitus (Т2DM), it is important to perform COI in the Russian Federation (RF). Aim: The aim of the secondary objective FORSIGHT-Т2DM study was to conduct Cost-of-Illness Analysis (COI) of Т2DM in the Russian Federation in relation to taking into consideration the presence of complications and concomitant diseases. Materials and methods: COI of Т2DM was performed using the data obtained in Russian multicenter observational, pharmacoepidemiologic cross-sectional study of diabetes care for assessing routine healthcare pattern of T2DM in the Russian Federation (FORSIGHT-Т2DM). Information for each patient was collected from primary medical records and By asking patients to fill out a questionnaire. Total costs were calculated as the sum of direct medical costs (DCm), direct non-medical costs (DCn) and indirect costs (IC). Results: The final analysis included data from 2014 patients with T2DM residing in 45 cities of RF. Total direct medical costs (DCm) of treating Т2DM and its complications and comorbidities amounted to 105 337 rubles ($2742) per patient per year; direct non-medical costs (DCn) amounted to 24 518 rubles ($638) per patient per year; indirect costs (IC) amounted to 149 754 rubles ($3898) per patient per year. The total cost of T2DM in RF in 2014 year amounted to 279 609 rubles ($7278) per patient. The total cost of T2DM in RF in 2014 amounted to 279 609 rubles per patient. Conclusions: More than half (53,5%) of the total cost of T2DM is the loss of GDP due to patients disability. The DCm constitute 37,7% of the total cost of the disease, of which 57% is spent on treatment of T2DM complications and concomitant diseases, while only 10% is spent on glucose-lowering therapies.

Abstract Abstract 2842 Background: As some patients (pts) with essential thrombocythemia (ET) may discontinue their cytoreductive treatment because of drug intolerance/inefficacy, combinations of drugs with different activity/tolerability patterns are being utilized in clinical practice. Objectives: To evaluate the clinical relevance and patterns of cytoreductive combination treatment in ET in Evaluation of Xagrid™ Efficacy and Long-term Safety (EXELS), an observational study in 3643 European pts with high-risk ET. Patients and Methods: Data on pts receiving cytoreductive treatments in combination for ≥30 days (COMB) were collected from a planned data cut in September 2011. This timepoint was 2.5 years after enrollment completed. Results: COMB was recorded in 347 pts (9.5%), the vast majority (87.6%) of whom received anagrelide + hydroxycarbamide (ANA+HC). Other combinations were anagrelide + interferon-α (ANA+IFN), anagrelide + pipobroman (ANA+PIPO; Table). Six patients also received anagrelide + other drugs (ANA+OTH). In 333 pts, the initial drug was HC (n=167; 50.2%), ANA (n=138; 41.4%), IFN (n=14; 4.2%), PIPO (n=9; 2.7%), or OTH (n=5; 1.5%), while the added drug was ANA (n=195; 58.6%), HC (n=123; 36.9%), IFN (n=12; 3.6%), PIPO (n=2; 0.6%), or OTH (n=1; 0.3%). Fourteen pts started ANA+HC concomitantly. The median duration of monotherapy treatment before COMB start was 139 months for HC, 53 months for ANA, 71 months for IFN, and 237 months for PIPO. In pts receiving ANA+HC, the median weekly dose of the initial drug, both before and during COMB, was 10.5 mg for ANA and 7.0 g for HC, while the median weekly dose of the added drug during COMB was 7.0 mg for ANA and 3.5 g for HC. In these pts, the median platelet count ≤6 months before COMB start, during COMB (first test), and during COMB (last test) was 581, 411, and 434 ×109/L, respectively (with counts ≤600 ×109/L in 52.9%, 79.2%, and 77% of cases, respectively); the median white blood cell count was 6.9, 6.8, and 6.8 ×109/L, respectively; the median hematocrit was 38.0%, 36.3%, and 39.0%, respectively; and median hemoglobin was 11.9, 11.6, and 12.0 g/dL respectively. Similar laboratory results were obtained in pts receiving ANA+IFN or ANA+PIPO. Before, during and after COMB, anti-aggregatory treatment, usually low-dose aspirin, was given in 66.3%, 71.8%, and 33.1% of pts, respectively. In the same time periods, thrombotic (3, 11, and 11 cases, respectively) and hemorrhagic events (1, 2, and 5 cases, respectively) occurred. The COMB discontinuation rate was 54.5% globally (186/341 pts). COMB was discontinued by stopping ANA in 67 cases (36.0%), HC in 76 (40.9%), IFN in 8 (4.3%), PIPO in 4 (2.2%), both ANA and HC in 19 (10.2%), both ANA and IFN in 3 (1.6%), both ANA and PIPO in 3 (1.6%), or by adding a third drug in 6 cases (3.2%). In the 158 pts who discontinued ANA+HC, reasons were: intolerance/side effects (n=79, 50.0%), lack of efficacy (n=35, 22.2%), investigator decision (n=34, 21.5%, mainly with switch to ANA monotherapy), patient preference (n=10, 6.3%), missing, other (including economic) or unknown (n=17, 10.2%). Similarly, intolerance/side effects was the most frequent reason for discontinuing ANA+IFN (12/20; 60.0%). Overall, there were 63 patients with suspected severe adverse reactions (SSARs) and 45 with predefined events (PDEs) during COMB. The most frequent SSARs were myelofibrosis, palpitations, myocardial infarction and tachycardia. The most frequent PDEs included cardiovascular symptoms, myocardial infarction, stroke and transformation. Pts on COMB, the majority of whom received ANA+HC, accounted for 3.8% of all pts at registration and 5.0–5.8% of all pts in the following 5 years. Conclusion: COMB was performed in almost 10% of the 3643 pts with ET in the EXELS study, mainly with use of ANA+HC (87.6%). COMB appears to be a useful approach to treating patients for whom monotherapy was not well tolerated or ineffective since platelet levels were reduced to <600 ×109/L in almost 80% of pts, and a switch to monotherapy with the added drug, usually ANA, frequently followed. Disclosures: Gugliotta: Shire: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Besses:Shire: Honoraria; Novartis: Honoraria. Griesshammer:Shire: Honoraria. Harrison:Novartis: Consultancy, Honoraria, Research Funding; YM Biosciences: Consultancy; S*Bio: Consultancy; Shire: Honoraria, Research Funding; Sanofi Avensis: Honoraria. Kiladjian:Shire: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Research Funding. Coll:Shire Pharmaceuticals: Employment. Smith:Shire Pharmaceuticals: Employment. Abhyankar:Shire Pharmaceuticals: Employment. Birgegård:Shire Pharmaceuticals: Honoraria; Pharmacosmos: Research Funding; Shire Pharmaceuticals Sweden: Consultancy.

Цель исследования Оценить результаты генной терапии у больных с ХОЗАНК II и III стадии в сроки до 3х лет.Материалы и методы Располагаем опытом использования первого зарегистрированного отечественного гентерапевтического препарата на основе гена vegf 165 в комплексном лечении больных с хроническими облитерирующими заболеваниями артерий нижних конечностей (ХОЗАНК) при II и III стадиях по А.В. Покровскому – Фонтейну в количестве 65 наблюдений. Из них прослежены отдаленные результаты лечения в сроки свыше 3-х лет у 45 человек (II ст. – 27 пациентов, III ст. n=18). Средний возраст больных составил 63,3±5,8. Оценка результатов проведена в зависимости от исходной стадии заболевания. Эффективность лечения оценивалась следующими методами: 1. Определение качества жизни (физического и психологического компонентов здоровья) производилось в помощью русифицированной версии стандартного опросника SF 36; 2. Дистанция безболевой ходьбы (ДБХ) определялась при проведении тредмил-теста (скорость ходьбы 1 км/час, угол наклона 0°); 3. Сохранность конечностей; 4. Выживаемость больных. Результаты и их обсуждение Значительно улучшились показатели качества жизни через 1 год наблюдения с последующим сохранением положительного результата в течение 3-х лет у всех пациентов с II стадией ХОЗАНК. Среднее значение физического компонента здоровья (ФКЗ) при включении в клиническое исследование (КИ) составило 29,0±6 баллов. В течение первого года показатель возрос до 42,2±8. В дальнейшем отмечен дальнейший рост до уровня 47,6±9 к концу срока наблюдения. Психологический компонент здоровья (ПКЗ): исходно 34,2±4,0 балла, за первый год наблюдения увеличился до 52,9±5, а за 2 и 3 годы стабилизировался и достиг отметки 54,8±6. Среднее значение ДБХ - 159±123 м, через 1 год - 676 ±542, через 2 года 704 ±475, через 3 года - 654±415м. Сохранность конечностей на протяжении всего срока наблюдения составила 100%, выживаемость – 88,9%.У пациентов с III стадией ХОЗАНК исходное значение ФКЗ составило 22,3±1,3 баллов. В течение первого года показатель возрос до 31,4±9,3 и в дальнейшем отмечено его постепенное увеличение до 37,5 ±9,0 к концу 3 года. Изменения ПКЗ были более значимы. При включении в КИ - 25,2±4,3 балла, за первый год наблюдения увеличение до 36,2±11. За 2 и 3 годы данный показатель продолжил свой рост и достиг отметки 51,1±8,3 балла. Исходно среднее значение ДБХ - 31,5±25м, через 1 год - 200 ±107, через 2 года - 274 ±72, через 3 года - 271±63м. Сохранность конечностей за весь период наблюдения - 78%. В трех наблюдениях в течение первого года и в одном в течение второго года выполнены ампутации нижних конечностей на уровне бедра по поводу прогрессирования хронической ишемии. Выживаемость в этой группе составила 100%.Выводы Применение одного курса лечения препаратом на основе гена vegf 165 у больных с II и III стадиями ХОЗАНК по А.В. Покровскому-Фонтейну приводит к стойкому положительному эффекту у значительного большинства пациентов в отдаленном периоде до трех лет и не требует повторных курсов генной терапии. У 82% пациентов отмечено улучшение как физического, так и, в большей степени, психологического компонентов качества жизни; отмечено значительное увеличение ДБХ, повысилась их повседневная активность. У всех пациентов отмечена хорошая переносимость препарата и отсутствие побочных действий; зафиксирована стабилизация полученных результатов. Выживаемость составила 93,3%.

Abstract Introduction High dose therapy with autologous stem cell transplant (ASCT) represents the standard of care for untreated patients with multiple myeloma (MM) who are young and fit. Novel agents are changing the landscape of pre- and post-ASCT therapies, but benefits may not apply to all patients. We report 338 MM patients treated with up-front ASCT at University College Hospital London from September 1993 - December 2010. Results Patient characteristics are described in Table 1. 90 (27%) received novel agents (thalidomide, bortezomib or lenalidomide) prior to transplant, and the remainder had VAD (vincristine, doxorubicin, dexamethasone)-based regimens. Most patients (64%) had 1 line of therapy prior to ASCT, 26% had 2 lines and 11% >/=3 lines. Responses to first line therapy were 24% >/= VGPR, 45% PR, ORR 69%. Best response prior to ASCT was: 27% >/= VGPR, 59% PR, ORR of 86%. 42 patients (12%) had stable disease or worse pre-ASCT. Transplant-related mortality at 100 days was 3.3%, 166 patients (49%) attained >/= VGPR at 3 months and 126 (37%) PR. Maintenance/consolidation regimens were interferon or thalidomide-based. Median follow-up was 6.1 yrs, progression-free survival (PFS) 2.0 yrs and overall survival was (OS) 5.8 yrs from ASCT and 6.8 yrs from diagnosis. 266 patients have relapsed, and 169 have died. On multivariate analysis, international staging system (ISS) stage 1, female gender, use of novel agents first-line and disease response (>/=VGPR pre- and 3 months post-ASCT) predicted longer PFS (p's < 0.05). Timing of relapse was the most important predictor of survival (median OS 1.6yrs if relapse within 12 months vs 7.2yrs if not, HR = 6.7, p<0.001. Shorter OS was also associated with male gender, advanced ISS, non-IgG isotype, CD56-negativity, older age at ASCT, <PR post ASCT (p's < 0.05) and later year of ASCT (median OS 6.2 yrs 2005-10 v 4.9 yrs 1993-2004, HR = 0.8, p = 0.006). Use of novel agents at first line predicted longer OS on univariate but not multivariate analysis. Prior lines of therapy and time from diagnosis to ASCT did not impact PFS or OS. Post-ASCT maintenance/ consolidation therapy was associated with prolonged PFS (adj HR 0.6, [95% CI 0.4-0.8] and OS (adj HR 0.5 [0.3-0.7]. Adverse cytogenetics (CGN) was associated with reduced PFS (HR 1.7 [1.1 – 2.7]) and OS (HR 2.2 [1.2-4.0]). In patients with adverse CGN who did not relapse early, OS was similar to patients with standard risk CGN (OS 5.6 yrs v 7.2 yrs, p = NS, Fig 1). Outcomes for those relapsing early were similar in pre-2005 and later (>/= 2005) cohorts (OS 1.6 v 1.7 yrs, p = NS, Fig 2). Median post-relapse survival (PRS) was 2.6 yrs. Factors predicting longer PRS included IgG isotype, CD56-positivity, later year of ASCT and of relapse, younger age at ASCT, longer PFS from ASCT and the use of novel agents at relapse. Patients relapsing in 2005 and later had longer PRS (3.6 v 1.3 yrs, HR = 0.4, p = 0.0001). Prior treatment with maintenance/consolidation did not impact PRS (PRS 3.1 v 2.4 yrs, p = NS). Conclusions These data indicate that post-ASCT strategies and choice of agent at relapse may be as important determinants of outcome as disease response pre-ASCT. Early relapse was the most important predictor of death following ASCT and may outweigh the impact of adverse CGN. The adverse outcome of patients relapsing early is not salvaged using contemporary treatment strategies at relapse. The benefit of CD56 expression on OS, but not on PFS suggests this denotes disease that remains chemo-responsive disease through relapses. Maintenance or consolidation therapy following ASCT appears to prolong PFS and OS without impacting post-relapse survival. Disclosures: No relevant conflicts of interest to declare.

The aim of the present study was to determine the distribution of high-risk human papillomavirus (HR-HPV) genotypes in childbearing age women, teenage girls, HIV-infected women, women with high-grade precancerous lesions and cervical cancer, sex workers, men, and otolaryngology tumor cases in Burkina Faso. This descriptive cross-sectional study with several target groups, consisted of 2386 samples from Burkina Faso. HR-HPV genotypes were characterized using real-time multiplex PCR. The prevalence of HR-HPV ranged from 15.63 to 72.31% depending on the target population and the nature of the samples. The most predominant genotypes in descending order were HPV-56, HPV-52, HPV-39, HPV-59, HPV-51, HPV-35, HPV-31, HPV-18, HPV-68, HPV-16, HPV-66, HPV-58, HPV-45, and HPV-33. The results of the present study show a wide variation in the distribution of HR-HPV genotypes in Burkina Faso. Genotypes 16 and 18 covered by HPV vaccines only accounted for 32.23% of HR-HPV cases.

A total of 65 Przeworsk culture features were discovered in the Żelazna Nowa cemetery. This number included a rectangular groove feature, urned cremations (6), alleged/damaged urned cremations (14), unurned cremations (14), alleged/fully or partly damaged unurned cremations (27), pits containing no bone material (4), undtermined cremations (2), pits containing no archeological material (1). All of the explored burials are cremations. However, a more detailed analysis encounters problems due to the state of preservation of the graves. Features 3, 19A and 19B, 30, 33, 37, 39 have been confidently identified as urned cremations. In many other features fragments of ceramic vessels were found, which may be remains of damaged urns: 18, 21, 23, 25, 31, 35, 44, 46, 47, 48, 49, 56, 57, and 58. Certain unurned cremations are 4, 6, 7, 8, 11–13, 15–17, 22, 24, 32, and 34. The interpretation of the remaining features is uncertain. Among the features uncovered in the cemetery were pits containing no bones: 5, 60, 61, 62, as well as pits containing no archaeological material at all: 55. The majority of unurned cremations contained pyre debris, while no such remains were observed in the following damaged unurned cremations: 15, 40–42, 45, 61, 62. There were a few cases of double burials identified. Three unurned cremations (6, 13, 15) and one urned cremation (39) contained bones of Infans I and an undetermined individual, while feature 19 contained two urns with individual burials: Infans II and an undetermined individual. Urned cremations, and one alleged unurned cremation (56), are distinguished by a higher standard of furnishing and a considerably larger amount of bone remains. This can be given two interpretations: a higher status of those buried there, or different rituals used for urned and unurned cremations. In two graves the urn was covered with an upturned vessel (features 33 and 37). In one case, an apotropaic behaviour characteristic of the Przeworsk culture was recorded, involving driving sharp objects into the pit’s bottom: in grave 41 these were two spearheads.

Introdução: A infecção pelo papilomavirus humano entre as mulheres que fazem sexo com mulheres ainda é pouco conhecida e escassos estudos apoiam a transmissão sexual entre essa população. Objetivo: Descrever a prevalência e genotipagem de infecção pelo papilomavírus humano entre mulheres que fazem sexo com mulheres. Métodos: Estudo descritivo que incluiu 110 mulheres que declararam fazer sexo com mulheres nos últimos 12 meses, maiores de 18 anos e residentes no interior de São Paulo. Os dados foram obtidos por entrevista e exame físico ginecológico entre janeiro de 2019 e janeiro de 2020. Apesquisa e genotipagem para o papilomavírus humano foi realizada pelo Kit XGEN MULTI HPV CHIP, que possibilita a identificação de 35 genótipos, sendo os de alto risco (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73 e 82) e baixo risco (6, 11, 40, 42, 43, 44, 54, 55, 61, 62, 67, 69, 70, 71, 72, 81 e 84). Os dados foram analisados por estatística descritiva. A pesquisa recebeu parecer favorável do comitê de ética local (parecer n. 3.009.410). Resultados: A maioria das participantes se autodeclarava branca (73,6%), não vivia com parceiras (86,4%), recebia penetração vaginal (92,7%) e fazia uso inconsistente de preservativo nas relações sexuais (89,1%). Aproximadamente um terço delas referiu troca de parcerias sexuais nos três meses que antecederam a coleta de dados (32,7%). A prevalência geral de papilomavírus humano foi de 56,4% e os genótipos de alto risco encontrados foram 16,18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 68, 73, 82, e de baixo risco 6, 11, 40, 42, 43, 44, 54, 55, 61, 62, 67, 70, 71, 72, 81. Conclusão: mulheres que fazem sexo com mulheres possuem altas prevalências de papilomavírus humano, com destaque para os genótipos de alto risco encontrados, demonstrando sua vulnerabilidade aos agravos relacionados ao papilomavírus humano.