Treatment of Childhood Acute Myeloid Leukemia in Bulgaria.

BACKGROUND: During the last four decades the prognosis of childhood acute myeloid leukemia (AML) has been substantially improved due to an increase in complete remission (CR) rates, event-free survival (EFS) and reduced early mortality. The relapsed AML still remains a therapeutic challenge. AIM: To report the AML treatment results of the Bulgarian pediatric oncohematological centers. MATERIALS AND METHODS: Retrospective analysis of the treatment results of children and adolescents (age from 0 to 20 years) with primary AML. Unified AML BFM- backbone type treatment protocol is used. RESULTS: This study included 97 newly diagnosed patients (44 girls and 53 boys) with AML in Bulgaria between 2003 and 2016. The median age at diagnosis was 10.2 years. The most frequent FAB-morphologic subtype was M2 followed by M4. First complete remission (CR1) was achieved in 83 patients (85.6%). The 13-year EFS was 49%, while the overall survival (OS) was 54.6%. Twenty seven (27.8%) patients relapsed, with only 5 of them being still alive towards the end of the study period. CONCLUSION: The EFS and OS for the children with AML in Bulgaria are comparable with those reported by other European groups. The prognosis of relapsed AML remains still unfavorable for the past 13 years.

Hemangioma of the parotid gland: case report.

Hemangiomas account for half of the parotid gland tumors occurring in children. After a rapid increase in the first months of life, some of them gradually regress (until complete disappearance) in a period of several years. Hemangiomas that do not regress over time, grow in size (possibly within a short period of time) or develop complications such as intralesional acute bleeding or thrombosis require aggressive therapy: intralesional corticosteroid injection, sclerotherapy. radiation therapy, laser photocoagulation. embolization, or surgical removal. We present the case of a 12-year-old boy with hemangioma of the left parotid gland diagnosed by CT scan, angio-CT with 3D reconstruction and angiography successfully treated by superselective intraarterial embolization with acrylic glue followed after 4 days by left superficial parotidectomy with facial nerve preservation.

Successful mobilization of peripheral blood stem cells in children with cancer using plerixafor (Mozobil) and granulocyte-colony stimulating factor.

This paper describes the successful mobilization of peripheral blood stem cells for autologous transplantation in three children with malignant diseases by using plerixafor (Mozobil; Genzyme Corporation, Cambridge, MA) and granulocyte-colony stimulating factor (G-CSF) after failed previous mobilizations. A median sixfold increase in the number of circulating CD34+ cells after plerixafor treatment as compared with the baseline level was observed. An optimal CD34+ cell count for transplantation with one or two leukapheresis sessions was achieved. Mobilization using plerixafor was found to be safe with no adverse events. Therefore, the combination of G-CSF and plerixafor in children results in effective increases in peripheral CD34+ cell counts and reduces the risk of mobilization failure.

[Statistical data on head trauma with frontal sinus involvement at the Emergency Hospital Clinic "Prof. Dr. Nicolae Oblu", Iasi, Romania]. / Elemente de statistica a traumatismelor craniocerebrale cu implicarea sinusurilor aerice frontale în Spitalul Clinic de Urgenta "Prof. Dr. Nicolae Oblu" Iasi.

UNLABELLED: We present here some interesting points of view concerning head and brain injury with frontal sinus involvement. MATERIAL AND METHODS: In general neurosurgical practice the frontal sinus traumatic involvement is about 3-5 per cent from all head trauma; we proposed to realise a extensive 5 years study to finnaly sumarise the characteristical elements for our geographical area. The amount of patients hospitalized in our clinic was about 80 000 in five years. RESULTS: Concerning our statistical data, there are 677 patients with frontal sinus injury, 490 from this were complicated with brain pathology. CONCLUSIONS: We concluded there are differences between our series and the other studies from developed countries, in our region the domestical (agricultural works) causes are about 10% higher.

Melatonin: Quantum-chemical and biochemical investigation of antioxidant activity.

Experimental and theoretical investigation of the antioxidant activity of melatonin is carried out. The theoretical approach comprises the evaluation of several appropriate descriptors of scavenging activity with the help of quantum-chemistry methods. The values obtained are compared with available data for substances with established antioxidant properties. One of the most widely used markers for in vivo free radical oxidation processes is malondialdehyde (MDA) as an end product of membrane lipid peroxidation. Experimental support of the computed scavenging parameters is provided by estimation of the effect of supplementary melatonin therapy on the plasma levels of MDA in CRF patients on maintenance HD therapy. Different reaction paths have been considered and related to the obtained data, allowing speculations about the reaction mechanism and the antioxidant potential of melatonin for practical purposes.

[Celioscopic exploration in polytrauma with neurosurgical component]. / Explorarea caelioscopica in politraumatismele cu componenta neurochirurgicala.

UNLABELLED: Caelioscopic surgery has been introduced in the medical practice for only two decades and imposed as a method due to its multiple advantages, expanding its application to therapy and exploration. If, initially the traumatic pathology of the abdomen has been used, this paper proposes the expansion of this method in polytraumatisms with neuralsurgical components, and not only. MATERIAL AND METHOD: This paper presents a study made on 67 cases with the Emergency Hospital of Piatra Neamt, of which 22 patients (33%) after the caelioscopic exploration requested surgical intervention. RESULTS: In 26 cases we have limited to caelioscopic exploration and eventually, peritoneal drainage, and 19 cases have only been monitored. Thus it is covered a segment of pathology to which paraclinical exploration, respectively abdominal echography and CT, does not provide a certain diagnosis in post-traumatic abdominal lesions. This method is relatively easy for a general surgeon and can be successfully applied in neural-surgical lesion associations, within a good cooperation of guard teams and much better within a polytraumatic centre. This is how morbidity and even mortality can be significantly reduces.

[Neurological and abdominal lesional associations in polytrauma]. / Asocieri lezionale neurologice si abdominale in politraumatisme.

UNLABELLED: Polytraumatisms have always been a concern in human history, their number increasing especially during wars. Their forecast depends on many factors, starting from means of transportation, first aid's promptitude, technical endowment which evolved a lot within the years. Amongst the thoracal-abdominal, the cranial-cerebral and vertebral-medullary injuries, the cranial-cerebral and the abdominal injuries are the most severe ones. We hereby present the evaluation scales according to various criteria (seriousness, prognosis, clinical valutation). In the case of abdominal and neurosurgical injuries the symptomatology can be modified by addition or defalcation, which may cause diagnostic errors with consequences upon morbidity and mortality. MATERIAL AND METHOD: We hereby present a study accomplished within three departments: Piatra Neamt Emergency Hospital, Piatra Neamt Coronary Office and Iasi Neurosurgery Clinic, and we find the injury associations in polytrauma cases. RESULTS: We notice a prevalence of the male sex, of the country people, of traffic accidents, of the active age 20-60 years old. The association within abdominal trauma and neurological injuries is of 16.97% in Iasi Neurosurgery Clinic. After being solved, the neurological injuries are sent to surgery departments, for solution or surveillance. CONCLUSION: In order to optimize the medical assistance for traumatized persons we hereby recommend a polytrauma centre establishment.