Activiteit

Although pneumococcal vaccines are quite effective in reducing disease burden, factors such as imperfect vaccine efficacy and serotype replacement present an important challenge against realizing direct and herd protection benefits of the vaccines. In this study, a novel mathematical model is designed and used to describe the dynamics of two Streptococcus pneumoniae (SP) serotypes, in response to the introduction of a cohort vaccination program which targets one of the two serotypes. The model is fitted to a pediatric SP carriage prevalence data from Atlanta, GA. SR-18292 datasheet The model, which is rigorously analysed to investigate the existence and asymptotic stability properties of the associated equilibria (in addition to exploring conditions for competitive exclusion), is simulated to assess the impact of vaccination under different levels of serotype-specific competition and illustrate the phenomenon of serotype replacement. The calibrated model is used to forecast the carriage prevalence in the pediatric cohort over 30 years.

As COVID-19 is a new emerging disease, the hematological/immunological changes that develop in the infected patients remain unknown. This study aims to systematically review the hematologic autoimmune complications in these patients.

Data from three online databases including Medline (via PubMed), Scopus and Web of Science were searched on 19 December 2020, and after excluding duplicate, irrelevant and inappropriate records, eligible documents were identified. Afterwards, information such as patients’ history, presentations, paraclinical data, treatment course and outcome were extracted from the records.

A total of 58 documents were considered to be eligible for data extraction which described 94 patients with COVID-19 who developed hematologic autoimmune disorder in their course of infection. Of these patients with COVID-19, the most common hematologic autoimmune disorder was immune thrombocytopenic purpura (55 cases) followed by autoimmune hemolytic anemia (22 cases). Other hematologic autoimmune diso the first manifestation of the infection symptoms. Maybe, at least in this pandemic, it should be recommended to evaluate patients with unexpected and unexplained decrease in their hemoglobulin or platelet count for COVID-19. Another challenging issue is the treatment options. Given the multiorgan involvement and multifaceted nature of the infection, an individualized approach should be taken for each patient.

Bone marrow (BM) biopsy is the most common diagnostic procedure in hematology. Bleeding is an expected complication, and its risk is assumed to be increased in patients on anticoagulants. However, the effect of anticoagulation on BM biopsy safety is unclear and guidelines are lacking robust data in this regard. As such, physicians use their clinical judgement to guide periprocedural management of anticoagulation.

To provide the best available evidence regarding management of anticoagulation in patients who need BM biopsy.

We reviewed and summarized available guidelines directing management of periprocedural anticoagulation for BM biopsy, and share our experience and practices with BM biopsy at our institution.

The incidence of significant hemorrhage after BM biopsy is very low (0.007-1.1%). BM biopsy is classified as having a low to moderate bleeding risk. Interrupting anticoagulation is not consistently recommended. Strategies exist to minimize bleeding risk for anticoagulated patients. Patients with myeloproliferative neoplasms can develop an acquired von Willebrand syndrome which increases their risk for bleeding and therefore require extra vigilance to ensure appropriate hemostasis.

Withholding anticoagulation prior to BM biopsy is not routinely recommended. Instead, assessment and optimization of bleeding risk factors should be done on a patient by patient basis.

Withholding anticoagulation prior to BM biopsy is not routinely recommended. Instead, assessment and optimization of bleeding risk factors should be done on a patient by patient basis.

This study aimed to compare the cost-effectiveness of these two regimens in hemophilia A patients, under-12-years-old in southern Iran.

A cost-effectiveness study comparing prophylaxis versus on-demand was conducted on 34 hemophilia patients (24 and 10 patients were on the prophylaxis and on-demand regimens respectively) in 2017. The Markov model was used to estimate the economic and clinical outcomes. The costs were collected from the societal perspective, and the utility criterion was the ‘quality adjusted life year (QALY)’ indicator. The required data were collected using a researcher-made cost checklist, the EQ5D standard questionnaire and Hemophilia Joint Health Score. The probabilistic sensitivity analysis (PSA) was performed to determine the robustness of the results.

The means of costs, joint health score and QALY in the prophylaxis regimen were $478,963.1 purchasing power parity (PPP), 96.67, and 11.98 respectively, and in the on-demand regimen were $521,797.2 PPP, 93.46 and 10.99 respectively. The PSA confirmed the robustness of the model’s results. The results of the scatter plots and acceptability curves showed that the prophylaxis regimen in 97% of the simulations for the thresholds below $20950 PPP was more cost-effective than on-demand regimen.

Prophylaxis regimen showed the lower costs and higher effectiveness and utility in comparison with the on-demand regimen. It is recommended that prophylaxis should be considered as the standard care for treatment of hemophilic patients.

Prophylaxis regimen showed the lower costs and higher effectiveness and utility in comparison with the on-demand regimen. It is recommended that prophylaxis should be considered as the standard care for treatment of hemophilic patients.The biggest challenge for our society, in order to foster the sustainable circular economy, is the efficient recycling of wastes from industrial, commercial, domestic and other streams. The transition to a circular economy is the goal of the European Commission’s Circular Economy Action, which was first launched in 2015. In 2020 the above action plan announced initiatives along the entire life cycle of the product, with the aim to make sustainable products the norm in the EU. Therefore, it is anticipated that the above action will result in an increase in Europe’s economic competitiveness, sustainability, resource efficiency and resource security. Within this context, the suitability of ferroalumina as a raw material in the blast furnace is investigated. Ferroalumina is the product of the high-pressure filter press dewatering process of the Greek red mud generated during the production of alumina by means of the Bayer cycle. Ferroalumina is a low-cost raw material and its possible charging in the blast furnace and/or steelmaking aggregates is a step towards industrial symbiosis, where the wastes, namely by-products, of an industry or an industrial process, become the raw materials for another.