Functional characteristics and clinical effectiveness of platelet concentrates treated with riboflavin and ultraviolet light in plasma and in platelet additive solution.

BACKGROUND AND OBJECTIVES: Pathogen reduction technologies may affect platelet quality during storage. We studied functional characteristics and clinical effectiveness of platelet concentrates (PCs) treated with Mirasol in plasma and in platelet-additive solution SSP+. MATERIALS AND METHODS: Mirasol-treated, gamma-irradiated and untreated apheresis PCs were examined on days 0, 1, 3 and 5 of storage. Phosphatidylserine, P-selectin and active glycoprotein IIb/IIIa were analysed using flow cytometry before and after platelet stimulation. Platelet count increments, the numbers of inefficient transfusions and post-transfusion reactions were analysed to estimate clinical effectiveness. RESULTS: A significant increase in all platelet activation markers occurred during storage in all PC groups. Activation markers in Mirasol-treated samples were already significantly higher compared with the control ones on the day of harvesting, and continued to grow during the storage. Mirasol treatment increased the number of platelets with a mitochondrial membrane potential loss. On the 3rd day of storage, 50% of Mirasol-treated platelets did not respond to activation; on the 5th day, none did. This agreed well with a decrease (approximately twofold) in the effectiveness of Mirasol-treated PC transfusions. Transfusions of PCs stored in SSP+ were accompanied by fewer inefficient transfusions and post-transfusion reactions than of PCs stored in plasma. CONCLUSION: Treatment with Mirasol decreased platelet function, particularly profoundly on the 5th day of storage, and led to a decrease in the effectiveness of transfusions. SSP+ did not affect laboratory parameters significantly compared with plasma, but decreased the percentage of transfusion complications.

[Accommodation examination in myopia associated with nondifferentiated connective tissue dysplasia].

Features of accommodative response in children with myopia associated with nondifferentiated connective tissue dysplasia (NCTD) were studied using computered accommodography. A variety of accommodative response patterns were found in myopia associated with NCTD, that is indicative of a great functional potential of ciliary muscle. Theoretic side is discussed for normal accommodative response and for muscle fibers hyperfunction as well.

[Healthcare quality assessment for children with severe injury in the Rostov region].

A two-level medical care quality control system for children with severe injury has been developed and tested in accordance with the guidelines of the Ministry of Health of the Rostov region. This control system functions within the existing regional system for departmental control of the Ministry of Health of the Rostov Region, which organizes medical provision of children with traumatic injuries. The first level is to exercise current control over informing about a child's admission to an intensive care unit or ward at a health care facility (HCF) of any level in the region; ambulance team going to a HCF in the region. The second level is a stepwise control that also includes two directions: to submit monthly information on died children under 18 years of age by HCF; annual reports by the principal anesthetists-resuscitators of the region's towns and districts, which includes an analysis of the results of treatment in children with severe injury.

[Age-related and etiological features of severe injury in children].

A comparative retrospective analysis of condition severity was made in different age groups: 61 road traffic injured children (Group 1) and 63 children with injuries of another etiology (Group 2) on admission. There no substantial differences in their condition severity: severe and extremely severe conditions were seen in 77.8 and 11.5% in Group 1 and 79.4 and 6.35% in Group 2, respectively. The age-related features of the pattern of traumatic injuries were established in relation to their etiology.

[Umbilical blood is a source of hemopoietic stem cells for transplantation].

AIM: To develop and introduce into practice scientifically validated methods of collection, testing and storage of hemopoietic stem cells of umbilical blood (UB) for non-relative transplantations. MATERIAL AND METHODS: UB and UB concentrate of 1004 mature newborns were studied with morphological, immunocytometric and cultural methods. RESULTS: The established reference values of the number of leukocytes and hemopoietic stem cells (HSC) are essential for examination whether UB is useable for production of the transplantation material. Obtained with the procedure of UB concentration based on sedimentation of erythrocytes due to hydroxyethylstarch, transplantation material has volume 20.0 ml, contains 39.0 +/- 0.48 x 10(6)/ml leucocytes and 1.37 +/- 0.029% CD34+cells and does not differ from umbilical blood by percentage of basic subpopulations of leucocytes and HSC. Assessment of efficacy of leucoconcentration procedure in different pregnancy courses, delivery and technological stages of UB collection gives grounds to consider the methods optimal for use in UB bank, while testing is thought adequate for examination of the material for transplantation fitness. CONCLUSION: Introduction of the study results into practice optimizes the work of stem cell banks and allows production of effective transplantation material.

[Long-term results of combined treatment of acute promyelocytic leukemia in children and adolescents with gene therapy].

AIM: To analyse the results of treatment of children and adolescents with acute promyelocytic leukemia (APL) including polychemotherapy and ATRA (protocols APL 93, 98 and 2003). MATERIAL AND METHODS: The course of the disease, modification of the treatment protocols with reduction of anthracyclines and ATRA doses, results of molecular monitoring of PML/RARalpha transcript have been analysed for 107 APL patients. RESULTS: For prognosis of the disease important are initial characteristics of the patient and the time of the tumor regress assessed by molecular methods--establishment of molecular remission and molecular recurrence. CONCLUSIONS: In APL it is necessary to conduct molecular monitoring especially in patients at high risk and with poor prognosis in a decrease of treatment intensity for toxicity relief. Detection of molecular recurrence is indication for treatment. To raise efficacy of APL recurrence therapy it is necessary to design a special updated protocol.