Hasil untuk "Diseases of the blood and blood-forming organs"

Ying Zhang, Yankun Yang, Yiwen Du et al.

Objective This review aims to summarize current progress in targeted therapy for acute myeloid leukemia (AML) with KMT2A rearrangement (KMT2Ar). This subtype of AML often shows resistance to chemotherapy and has a poor prognosis. The purpose is to emphasize potential therapeutic strategies and explore drugs currently under clinical development. Methods: We reviewed studies on the molecular characteristics of KMT2Ar AML and examined targeted drugs that can block key genetic and epigenetic mechanisms. Information on drug mechanisms, preclinical findings, and clinical trials was collected and analyzed.Results Several new agents targeting KMT2A-related pathways are being explored. Menin inhibitors show encouraging clinical activity, while other inhibitors, such as those targeting DOT1L, BET, and EZH2, have produced promising preclinical results. Early data suggest that combination therapy may be more effective in overcoming drug resistance than monotherapy.Discussion Providing a new therapeutic direction for the abnormal molecular networks in KMT2Ar AML offers a promising approach. However, most therapies are still in the early stages and clinical translation is limited. Further research is needed to improve the safety and long-term efficacy of the treatment.Conclusion There is an urgent need for effective targeted drugs for KMT2Ar AML. Continuous research and clinical trials will be key to improving patient prognosis and advancing precise treatment for this challenging leukemia subtype.

Chen Zhou, Yujin Yin, Juan Gu et al.

Objective To investigate the expression, function, and underlying mechanism of VGLL4 in AML.Methods Bioinformatic analysis of TCGA data by GEPIA website was performed. VGLL4 protein expression was analyzed by Western blot. We then performed functional assays (CCK-8, colony formation, and Transwell) to evaluate the effects of VGLL4 knockdown and overexpression on the proliferation, migration, and Matrigel matrix penetration ability of AML cell lines. Apoptosis was assessed by flow cytometry, and the expression of key Wnt/β-catenin pathway proteins was examined by Western blot.Results Compared with controls, VGLL4 was significantly upregulated in AML. Functionally, VGLL4 knockdown potently suppressed AML cell proliferation, migration, and Matrigel matrix penetration ability, promoted apoptosis, and downregulated the expression of key pathway proteins, including β-catenin and GSK3β.Conclusion VGLL4 acts as an oncogenic factor in AML, potentially through activating the Wnt/β-catenin pathway. Thus, we propose VGLL4 as a promising molecular target for AML therapy.

Lynda J. Thomson, Menaka Suri, Geno J. Merli et al.

Castet Sabine-Marie, Sepot-Boucherit Lola, Beranger Nicolas et al.

Haemophilia A and B (HA/HB) are congenital, X-linked recessive bleeding disorders caused by deficiency of clotting factor VIII (FVIII) or IX (FIX), respectively. People with haemophilia (PwH) have increased risk of spontaneous or traumatic bleeding in joints, muscles, or soft tissues, which can be severe in people with HA/HB with inhibitors (HAwI/HBwI). Despite advances in haemophilia treatment, there are remaining and emerging unmet needs in PwH.

EA Guido, ESA Piva, AM Tessarro

Objetivos: Sistematizar e analisar os dados das coletas externas (CE) realizadas no Hemocentro Regional de Maringá no período de 2018 a 2023 como estratégia de descentralização para a doação de sangue e manutenção do estoque no Hemocentro Regional de Maringá. Material e métodos;: Realizado estudo documental e retrospectivo das coletas externas realizadas pelo Hemocentro Regional de Maringá nos municípios que pertencem a 15ªRegional de Saúde do Estado do Paraná, utilizando como fonte de informações registros internos do setor de captação de doadores e dados do Sistema de Bancos de Sangue- SBS Web da rede HEMEPAR do Estado do Paraná dos anos de 2018 a 2023. Resultados: Na temporalidade analisada no Hemocentro Regional de Maringá foram coletadas 68.314 bolsas de sangue, das quais 5.435 foram provenientes de coletas externas, representando 7,96% do total coletado pelo Hemocentro. No ano de 2018 o percentual de bolsas da coleta externa foi de 12,70% em relação ao total do ano, em 2019 de 11,27%, em 2020 2,31%, em 2021 1,38%, em 2022 10,29% e 2023 8,71%. No período analisado foram realizadas 82 (oitenta e duas) coletas externas, com um total de 6.646 candidatos a doação de sangue. Em relação a descentralização da doação de sangue para os municípios da 15ªRegional de Saúde em 2018 as coletas se realizaram em 13 (treze) municípios, em 2019 em 15 (quinze) municípios; 2020 e 2021 em 3 (três) municípios; em 2022 14 (quatorze) municípios e 2023 em 10 (dez) municípios. Em relação ao tipo de doação 99,82 % das bolsas de sangue da CE são voluntárias e 37,66 % dos candidatos a doação são classificados como doadores de repetição. Ressalta-se que em 2021, o Hemocentro Regional de Maringá foi contemplado via Ministério da Saúde e Secretaria de Saúde do Estado do Paraná com uma nova unidade móvel para a realização das coletas externas que foram retomadas em março de 2022. Discussão: As doações de sangue oriundas das coletas externas são compostas majoritariamente de doações espontâneas ou voluntárias, ou seja, a doação é realizada por pessoas motivadas para manter os estoques de sangue do Hemocentro. Também é possível identificar que nos anos de 2020 e 2021 em decorrência da pandemia da COVID e a diminuição das coletas externas houve a queda de percentual de contribuição das bolsas de CE nos estoques do Hemocentro. Isso tornou necessário o desenvolvimento de outras estratégias de captação de doadores como a intensificação de contatos telefônicos e envio de e-mails convidando para a doação de sangue e implantação de novas ferramentas de comunicação como whatsapp, instagram e sistema de agendamento online. Conclusão: A coleta externa com unidade móvel é uma das ações que implementam a Política Nacional de Sangue e Hemoderivados, contribuindo para a manutenção dos estoques de sangue e hemocomponentes do Hemocentro Regional de Maringá. Esta iniciativa proporciona a descentralização do atendimento e facilita o acesso da população dos municípios da 15ªRegional de Saúde do Estado do Paraná à doação de sangue. Além disso, a nova unidade, projetada especificamente para coletas externas, tornou-se mais funcional e tem sido uma estratégia eficaz de marketing para as campanhas de doação de sangue.

Xun LI, Zhixian SONG, Hongmei AI et al.

Objective To explore how to identify rare unexpected antibodies using routine serology methods in blood transfusion department of grassroots hospitals. Methods A patient with gastrointestinal bleeding with inconsistent forward and reverse blood typing, positive antibody screening and incompatible blood matching in our hospital was selected as the research object. Mixed human O cell absorption method was used for blood type identification, and 10-panel reagent red blood cells, manual polybrene test, 2-mercaptoethanol(2-ME) test, blind match and pedigree study were used to explore the antibody characteristics. Results The serological test results of the patient′s serum were as follows: The blood group was type B and RhD positive, and negative for direct antiglobulin test; The antibody was IgM; The likelihood of this antibody being anti-s, anti-Fya or anti-k was low, and compound antibodies could not be excluded; The blood of the patient did not match with blood samples of 20 blood donors in the major side, while it matched with all the blood samples of her three sisters. Conclusion When the antibodies of high-prevalence antigen series in plasma cannot be identified, the matched blood may be found tthrough family survey for irradiation and transfusion.

HAG Inacia, KC Rodrigues

Objetivos: Considerando a importância da transfusão de sangue, quando corretamente indicada e realizada, como um tratamento multiprofissional com alto potencial de salvar vidas e a hemovigilância sendo um conjunto de procedimentos de vigilância que abrange todo o ciclo do sangue, prevenindo e/ou evitando a recorrência de eventos adversos, esse estudo tem como objetivo geral explorar qual a importância do papel do enfermeiro no cenário da hemoterapia e processos transfusionais. O mesmo se justifica pela importância da qualidade do serviço prestado, necessidade de conhecimento e foco na segurança dos doadores e receptores. Materiais e métodos: Trata-se de uma revisão bibliográfica do tipo integrativa, desenvolvida a partir da pergunta norteadora “Qual a importância do papel do enfermeiro na hemovigilância? ”, comparando diversos autores e linhas conceituais, na busca de constatar a convergência ou divergência entre tais. Os descritores em ciências da saúde (DeCS) utilizados foram: “Segurança do Sangue”, “Transfusão de Sangue”e “Enfermagem”, sendo utilizado o operador booleano “AND”para realizar o cruzamento de busca entre os descritores. Resultados: Ainda que o assunto e práticas abordadas neste trabalho sejam recentes e com uma consequente escassez de publicações a respeito, a relação da enfermagem nos procedimentos de hemovigilância vem sendo estudada por diversos pesquisadores. No geral, busca-se compreender a interferência positiva que o trabalho de qualidade exerce na vida dos pacientes, especialmente quanto à necessidade de conhecimento e entendimento de todo o ciclo do sangue e prevenção de falhas humanas que causem prejuízo ao tratamento do receptor. Discussão: Apesar da grande eficácia da utilização da hemotransfusão em vários casos, muitos autores ressaltam a necessidade e rigor da qualidade do serviço, devido aos riscos que pode vir a apresentar ao receptor dos hemocomponentes. São chamados de incidentes transfusionais todas as reações e efeitos adversos imunológicos (ligados aos mecanismos de resposta do organismo) ou não imunológicos (associadas à falha humana), imediatos ou tardios. Aprofundando nos riscos não imunológicos, é ressaltado o potencial da equipe de enfermagem, em sua responsabilidade durante o processo de hemovigilância, enquanto posição estratégica na detecção de erros ocorridos nas fases anteriores do ciclo do sangue, podendo evitar a ocorrência de eventos adversos relacionados à transfusão ou minimizar danos. Conclusão: Ao entender todo o processo do ciclo do sangue e a importância da hemovigilância, além das responsabilidades multiprofissionais da hemotransfusão, conseguimos compreender o papel do enfermeiro neste cenário e a necessidade do conhecimento e amplo entendimento das ações envolvidas. Sendo um campo de potencial expansão para a equipe de enfermagem, é possível concluir a importância de que estes estejam preparados para as atividades desempenhadas, conhecendo e entendendo os processos executados. Para tal, é importante a abordagem do assunto desde a formação acadêmica inicial e fortalecimento do saber através da educação permanente nas instituições de saúde. Por fim, entende-se a importância do enfermeiro, enquanto controle de riscos e danos do processo de hemoterapia, devendo estar apto a lidar com todo o processo.

Lin Zhang, Yannan Yang, Weihao Lin et al.

Abstract Background Lung adenocarcinoma (LUAD) is a major cause of cancer-related death worldwide, and the roles of complement-related genes in it have not been thoroughly investigated yet. In the study, we aimed to systemically examine the prognostic performance of complement-related genes, classify the patients into two different clusters and stratify the patients into different risk groups using a complement-related gene signature. Methods To achieve this, clustering analyses, Kaplan–Meier survival analyses, immune infiltration analyses were performed. LUAD patients from The Cancer Genome Atlas (TCGA) were classified into two subtypes (C1 and C2). A prognostic signature, consisting of four complement-related genes, was established using TCGA-LUAD cohort and validated in six Gene Expression Omnibus datasets and an independent cohort from our center. Results The prognosis of C2 patients is better than that of C1 patients and the prognosis of low risk patients is significantly better than high risk patients across the public datasets. In our cohort, the OS of patients in low risk group is better than that in high risk group but the difference is not significant. Patients with a lower risk score were characterized by a higher immune score, a higher level of BTLA, higher infiltration levels of T cells, B lineage, myeloid dendritic cells, neutrophils, endothelial cells, and a lower infiltration level of fibroblast. Conclusions In summary, our study has established a new classification method and developed a prognostic signature for LUAD, while future studies are needed for further exploration of the underlying mechanism.

Xuehong Zhang, Zhijie Hou, Dan Huang et al.

Abstract Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) is a refractory and recurrent subtype of B-cell ALL enriched with kinase-activating rearrangements. Incomplete understanding of the heterogeneity within the tumor cells presents a major challenge for the diagnosis and therapy of Ph-like ALL. Here, we exhibited a comprehensive cell atlas of one Ph-like ALL patient with a novel TPR-PDGFRB fusion gene at diagnosis and relapse by using single-cell RNA sequencing (scRNA-seq). Twelve heterogeneous B-cell clusters, four with strong MKI67 expression indicating highly proliferating B cells, were identified. A relapse-enriched B-cell subset associated with poor prognosis was discovered, implicating the transcriptomic evolution during disease progression. Integrative single-cell analysis was performed on Ph-like ALL and Ph+ ALL patients, and revealed Ph-like specific B-cell subpopulations and shared malignant B cells characterized by the ectopic expression of the inhibitory receptor CLEC2D. Collectively, scRNA-seq of Ph-like ALL with a novel TPR-PDGFRB fusion gene provides valuable insights into the underlying heterogeneity associated with disease progression and offers useful information for the development of immunotherapeutic techniques in the future.

R. Colombatti, C. Birkegård, M. Medici

TJL Vale, MC Azevedo, MDSO Cardoso et al.

Introdução: A sífilis é uma infecção sistêmica causada pelo Treponema pallidum, cuja transmissão pode ser através do sangue. Para eliminar esta possibilidade, se utiliza testes sensíveis e específicos na triagem sorológica dos doadores. Os testes utilizados são usualmente os treponêmicos ou os não treponêmicos. No IHEBE foi utilizado, em períodos distintos, os dois tipos de testes: não treponêmico, por método floculação, e o treponêmico, por método quimioluminescência. Objetivo: Verificar o impacto de descarte sorológico de bolsas de sangue e componentes por metodologias distintas. Material e métodos: Levantamento retrospectivo de dados estatísticos no período de janeiro de 2016 a julho de 2021. No período de 2016 a janeiro de 2020 foi realizado teste não treponêmico (floculação-VDRL) e de fevereiro de 2020 a julho de 2021 teste treponêmico (quimioluminescência). Os dados foram obtidos através dos índices de controles mensais por marcador sorológico. Resultados: Descarte sorológico por Sífilis teste não treponêmico, método floculação-VDRL nos anos: 2016 foi de 0,7% (n = 7.486 doadores), 2017 foi de 1% (n = 7.722 doadores), 2018 foi de 0,9% (n = 8.731 doadores), 2019 foi de 0,9% (n = 12.460 doadores), janeiro de 2020 foi de 0,9% (n = 1.221 doadores). Descarte sorológico por Sífilis teste treponêmico, método quimioluminescência no período de fevereiro a dezembro de 2020 foi de 2,7% (n = 12.662 doadores) e de janeiro a julho de 2021 foi de 2,71% (n = 8.732 doadores). Discussão: Os testes não treponêmicos são realizados pela metodologia de floculação. Os resultados, quando positivos, são liberados na forma clássica de títulos. Os resultados falso-positivos são as principais desvantagens deste teste, que podem acontecer devido à reação cruzada com outras infecções, gravidez, doenças autoimunes e uso de drogas ilícitas. Resultados falso-negativos podem ocorrer em casos de infecção muito precoce ou tardia. Os testes treponêmicos detectam anticorpos específicos que podem permanecer positivos por toda a vida. Observou-se que em virtude da especificidade do método, o aumento do descarte sorológico por Sífilis era esperado. Isso fez com que o IHEBE, no momento do planejamento para mudança de teste, estabelecesse um aumento da meta de comparecimento e coleta/dia; logo, novas estratégias na captação foram implementadas para garantia e segurança no atendimento aos pacientes. Em virtude deste aumento, o número de doadores inaptos em investigação também se elevou, e o consultório de atendimento aos inaptos precisou rever seus procedimentos operacionais padrão – POP. Conclusão: Após análise, observou-se incremento considerável de descarte por sífilis com a mudança de metodologia. Apesar da boa sensibilidade do teste não treponêmico e de seu baixo custo, optou-se pela mudança para o teste treponêmico devido a especificidade. Quando o Instituto decidiu que estava no momento de automatizar a pesquisa para Sífilis, fez-se necessário uma reunião de planejamento envolvendo os setores de captação, coleta, e liberação para elaboração de um plano de ação visando minimizar os impactos previsíveis da mudança de metodologia.

Armando N. Bastidas Torres, Davy Cats, Jacoba J. Out-Luiting et al.

Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma (pcAECyTCL) is a rare variant of cutaneous T-cell lymphoma with an aggressive clinical course and a very poor prognosis. Until now, neither a systematic characterization of genetic alterations driving pcAECyTCL has been performed, nor effective therapeutic regimes for patients have been defined. Here, we present the first highresolution genetic characterization of pcAECyTCL by using wholegenome and RNA sequencing. Our study provides a comprehensive description of genetic alterations (i.e., genomic rearrangements, copy number alterations and small-scale mutations) with pathogenic relevance in this lymphoma, including events that recurrently impact genes with important roles in the cell cycle, chromatin regulation and the JAKSTAT pathway. In particular, we show that mutually exclusive structural alterations involving JAK2 and SH2B3 predominantly underlie pcAECyTCL. In line with the genomic data, transcriptome analysis uncovered upregulation of the cell cycle, JAK2 signaling, NF-κB signaling and a high inflammatory response in this cancer. Functional studies confirmed oncogenicity of JAK2 fusions identified in pcAECyTCL and their sensitivity to JAK inhibitor treatment. Our findings strongly suggest that overactive JAK2 signaling is a central driver of pcAECyTCL, and consequently, patients with this neoplasm would likely benefit from therapy with JAK2 inhibitors such as Food and Drug Adminstration-approved ruxolitinib.

L Oliveira, MD Jacomassi, LJ Otuyama et al.

Introduction: Several novel therapies have been developed in recent years improving multiple myeloma (MM) treatment, although autologous hematopoietic stem cell transplantation (HSCT) remains a fundamental strategy in eligible patients. HSCT is even more important where access to drugs such as bortezomib is not available in Brazilian public health system. Objective: To evaluate the outcomes after auto-HSCT in patients with MM treated at a public center in Brazil, identifying possible targets to improve assistance. Methods: Between Jan-2010 and Oct-2018, 233 patients who underwent the first HSCT for MM were included. This was an observational, retrospective, and single-center study with data collected through medical records after approval by the local research ethics committee. The primary outcome was Progression-Free Survival (PFS) – defined as time between HSCT and death, date of last follow-up or disease progression according to current International Myeloma Working Group (IMWG) criteria. Secondary outcomes were: Overall Survival (OS), Transplant-Related Early Mortality (TRM) and HSCT toxicities (according to the Common Terminology Criteria for Adverse Events). Univariate analysis was performed followed by multiple Cox regression with regression elimination selection method, considering the following predictive variables: International Staging System (ISS), ECOG Performance Status, Charlson index, number of treatments and pre-HSCT response, lactic dehydrogenase at diagnosis, age and time between diagnosis and HSCT. Results: At the time of HSCT, the median patient's age was 57 years (27-70) and 30% of them were over 60. There was a predominance of advanced stages by Durie-Salmon (87% stage IIIA/IIIB), ISS II/III (58%) and ECOG ≤2 (74%). Charlson's comorbidity index was ≥4 in 50.6% of the sample and 80% had undergone only one previous treatment line. 23.8% of the patients were in complete response (CR) prior to HSCT and the procedure was able to increase this proportion to 46.7% at post-HSCT restaging. This increased depth of response was seen in all subgroups stratified by ISS. With a median follow-up after HSCT of 47.8 months, the 2-year PFS was calculated to be 52% (95%CI 45-58%). Multivariate analysis showed significant risk of reduced PFS for Charlson index ≥4 (HR 1.52 95%CI 1.10-2.09) and pre-HSCT depth of response (partial response [HR 1.52 95%CI 1.10- 2.09] and very good partial response [HR 1.52 95%CI 1.10-2.09], compared to CR). The 2-year OS was 82% (95%CI 77-87%). TRM was 4.3% and 41.8% of the patients had at least one toxicity classified as grade ≥3, the main ones being: oral mucositis, nausea and diarrhea. Conclusions: With a median follow-up of 4 years, this study presents results of a Brazilian public center with similar rates of PFS and OS to those reported in the international literature prior to the advent of novel therapies for MM. HSCT proved to be safe and effective, with better outcomes in patients with fewer comorbidities and with deeper pre-HSCT responses, emphasizing the importance of incorporating new drugs to achieve even better results.

Wenji Sun, Shigang Wang, Jiafeng Zhang et al.

AbstractHigh mechanical shear stresses (HMSS) can cause damage to blood, which manifests as morphologic changes, shortened life span, biochemical alterations, and complete rupture of blood cells and proteins, leading to the alterations of normal blood function. The aim of this study is to determine the state of neutrophil activation and function alterations caused by HMSS with short exposure time relevant to ventricular assist devices. Blood from healthy donors was exposed to three levels of HMSS (75Pa, 125Pa, and 175Pa) for a short exposure time (0.5 s) using our Couette‐type blood‐shearing device. Neutrophil activation (Mac‐1, platelet‐neutrophil aggregates) and surface expression levels of two key functional receptors (CD62L and CD162) on neutrophils were evaluated by flow cytometry. Neutrophil phagocytosis and transmigration were also examined with functional assays. Results showed that the expression of Mac‐1 on neutrophils and platelet‐neutrophil aggregates increased significantly while the level of CD62L expression on neutrophils decreased significantly after the exposure to HMSS. The Mac‐1 expression progressively increased while the CD62L expression progressively decreased with the increased level of HMSS. The level of CD162 expression on neutrophils slightly increased after the exposure to HMSS, but the increase was not significant. The phagocytosis assay data revealed that the ability of neutrophils to phagocytose latex beads coated with fluorescently labeled rabbit IgG increased significantly with the increased level of HMSS. The transmigration ability of neutrophils slightly increased after the exposure to HMSS, but did not reach a significant level. In summary, HMSS with a short exposure time of 0.5 seconds could induce neutrophil activation, platelet‐neutrophil aggregation, shedding of CD62L receptor, and increased phagocytic ability. However, the exposure to the three levels of HMSS did not cause a significant change in neutrophil transmigration capacity and shedding of CD162 receptor on neutrophils.

Nur Efe İris, Serkan Güvenç, Tülay Özçelik et al.

Armin Rashidi, Stephen I. Fisher

Feryal Karaca, Çiğdem Usul Afşar, Erkut Erkurt et al.

Mahmoud Mohammed Sirdah, Maged M. Yassin, Sabreen El Shekhi et al.

OBJECTIVE: Nutritional deficiencies are very significant to the overall health of humans at all ages and for both genders, yet in infants, children and women of childbearing age these deficiencies can seriously affect growth and development. The present work is aimed to assess homocysteine and vitamin B12 status in females with iron deficiency anemia from the Gaza Strip.METHODS: Venous blood samples were randomly collected from 240 female university students (18-22 years old) and parameters of the complete blood count, serum ferritin, homocysteine and vitamin B12 were measured. Statistical analysis included the t-test and analysis of variance (ANOVA) using the IBM SPSS software (version 18). Statistical significance was set for p-values <0.05.RESULTS: The results revealed that 20.4% of the students have iron deficiency anemia. The mean serum vitamin B12 level in females with iron deficiency anemia (212.9 ± 62.8 pg/mL) was significantly lower than in normal controls (286.9 ± 57.1 pg/mL) and subjects with microcytic anemia and normal ferritin (256.7 ± 71.1 pg/mL). Significantly higher serum homocysteine levels were reported in the iron deficiency anemia group (27.0 ± 4.6 µmol/L) compared to normal controls (15.5 ± 2.9 µmol/L) and in subjects with microcytic anemia and normal ferritin (18.1 ± 2.7 µmol/L). Statistically significant negative correlations were reported for serum homocysteine with serum ferritin, vitamin B12, hemoglobin, and hematocrit levels.CONCLUSION: Important associations were found between serum homocysteine and markers of iron deficiency. Monitoring homocysteine levels might be essential to understand the development of different clinical conditions including anemia. It seems necessary to conduct prospective trials to determine whether treating anemia ameliorates homocysteine levels.

Syed Mohammad Irfan, Jamal Uddin, Hasan Abbas Zaheer et al.

OBJECTIVE: To determine the prevalence of Hepatitis-B, Hepatitis-C and Human Immunodeficiency infections in replacement blood donors. METHODS: From January 2004 to December 2011, 108,598 apparently healthy donors donated blood at our Blood Bank. Screening was done by Microparticle Enzyme Immuno Assay (MEIA) method on Axsym System (Abbott Diagnostic, USA) and in year 2011 by Chemiluminescent Immunoassay (CIA) method on Architect i2000 (Abbott Diagnostic, USA). From 2010 onward, HIV reactive donors were advised for confirmatory tests and reported back with the results. RESULTS: Of the 108,598 total donors, 108,393 (99.8%) were replacement donors with a mean age of 28.92 (17-55) years. Of this, only 164 (0.15%) were females. Among the replacement donors, 4,906 (4.5%) were found to be reactive for Hepatitis-B, C and Human Immunodeficiency Virus. All the reactive patients, except one, were males. HbsAg was positive in 2,068 (1.90%) and anti-HCV in 2832 (2.61%) donors, while 111 (0.10%) were positive for Human Immunodeficiency Virus. Co-infectivity was observed in 103 (0.09%) cases. The prevalence appeared to be higher in younger age group (17-30 yrs). Only 16.6% cases should be patients returned with results of the confirmatory tests for HIV and were found positive. CONCLUSION: Hepatitis-B and C sero-prevalence in our series of replacement donors appears high compared to most studies from neighboring countries and relatively low in comparison to earlier studies from Pakistan. Prevalence of HIV, however, appears low and turn out of HIV positive cases for confirmatory tests is low.

M. N. Torgashov, A. I. Paltsev, V. S. Myakotnykh

Investigated peculiarities of violations of lipid metabolism and symptoms of post-traumatic stress disorder (PTSD) in 161 patients – veterans of the military actions on the territory of Afghanistan and the Northern Caucasus in the age 25–69 years. The dependence of the formation of dyslipidemias and related changes of atherosclerosis in the young age of neuroendocrine effects, accompanying the effects of combat stress and promoting accelerated aging. After 15-25 years of participating in hostilities, the intensity of PTSD and its influence on the development of violations of lipid spectrum may decline, and the leading role in the pathogenesis of dyslipidemias goes to age-related changes that accompany a process of accelerated aging veterans of combat operations, and to pathological disorders of metabolism in the liver associated with alcohol abuse and the consequences suffered infectious diseases.