BackgroundThe International Prognostic Index and its modifications are used to estimate prognosis in non-Hodgkin lymphoma. However, the outcome is often different in patients with similar index scores.AimThe aim of this study was to elaborate a prognostic model for patients with mature B-cell non-Hodgkin lymphoma using a combination of predictive markers.Material and methodsThe study included 45 patients with mature B-cell non-Hodgkin lymphoma. Before the administration of treatment, clinical and laboratory parameters were measured. After the 35-month follow-up period, overall survival was studied in relation to the data obtained at initial examination.ResultsWe revealed nine adverse predictive markers for overall survival of enrolled patients: Eastern Cooperative Oncology Group (ECOG) performance status >1; erythrocyte sedimentation rate >30 mm/h; levels of hemoglobin <120 g/L, fibrinogen ≥6 g/L, interleukin-6 ≥2 pg/mL, tumor necrosis factor ≥1.45 pg/mL, soluble fibrin monomer complexes >4 mg/dL, high-density lipoprotein cholesterol <1.03 mmol/L in men, and <1.29 mmol/L in women; and short activated partial thromboplastin time. A prognostic model for the estimation of the risk of death within the ensuing 1.5–2 years in patients with non-Hodgkin lymphoma was constructed.ConclusionMarkers of inflammation, anemia, hypercoagulability, dyslipidemia, and poor ECOG status are associated with worse survival in patients with mature B-cell non-Hodgkin lymphoma.

Coronavirus disease 2019 (COVID-19) has created global problems around the world, and because of the great international health threat, the World Health Organization has recognized its spread as a pandemic. The severity of the disease may be mild, moderate, severe and critical. There are such peculiarities of COVID-19 as changes in the lungs with a tendency to develop rapidly progressive atypical pneumonia, the course of which is often complicated by acute respiratory failure and acute respiratory distress syndrome, and in the future, there is a risk of pulmonary fibrosis and, consequently, chronic respiratory failure. Quite common cases of long COVID, which includes ongoing symptomatic COVID-19 and post-COVID-19 syndrome, are characterized by persistent pulmonary dysfunction, muscle weakness, pain, fatigue, depression, anxiety, decreased exercise tolerance, occupational problems, and poor quality of life. Appropriate protocols have been developed for the treatment of patients with COVID-19, which are constantly updated and supplemented. Concerning methods of physical therapy and pulmonary rehabilitation in the management of patients with COVID-19, they are elaborated insufficiently, especially for patients in acute and post-acute phases of the disease. Rational use of means and methods of physical therapy in combination with pharmacological treatment and psychotherapy will allow mobilizing, as much as possible, restorative and compensatory resources of patients with COVID-19 in overcoming disease at all phases, irrespective of a place of treatment and rehabilitation. Therefore, standards of care for patients with COVID-19 should include an optimal set of methods of physical therapy and pulmonary rehabilitation, taking into account the period and severity of the disease, including critical disease in patients undergoing mechanical ventilation. The education of a patient and people from his immediate surroundings with the aim of their active participation in the process of treatment and rehabilitation is very important. In the implementation of pulmonary rehabilitation programs, methods of distant communication with patients should be used as much as possible, and if they are unable, live courses with strict adherence to anti-epidemic measures should be provided. Taking into account all aspects of treatment and rehabilitation will help patients recover as quickly as possible and return to active life, as well as prevent the development of complications of the disease and the spread of infection

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The purpose of the study was to evaluate the effectiveness of physical therapy in the rehabilitation of persons who have suffered from COVID-19 pneumonia, in terms of its effect on health-related quality of life and functional status of patients. Materials and methods. Using the questionnaire, an anonymous survey of 68 people who suffered from COVID-19 pneumonia was conducted: 27 men and 41 women aged 18-90 years (median – 58 years). To determine the effectiveness of physical therapy, we used the assessment of quality of life on a 100-point percentage scale and the level of functioning on the scale of Post-COVID-19 Functional Status. Results and discussion. Among the examined persons, physical therapy was carried out only in 37 cases (54%). Two groups of patients were formed: group 1 (37 people) – with the use of physical therapy, group 2 (31 people) – without the use. Physical therapy methods were positioning, breathing exercises, aerobic exercises for different muscle groups, walking, and swimming. In group 1, 23 people out of 35 (66%) followed prone positioning, while in group 2 – only 4 people out of 21 (19%) (p=0.001). The vast majority of patients in group 1, 31 out of 34 (91%), were engaged in physical therapy on one's own (participation of rehabilitators was only in 2 cases, 6%), and they mainly used Internet resources to study the physical therapy techniques (18 out of 29, 62%). According to the quality of life before the onset of the disease, groups 1 and 2 did not differ from each other (respectively, 80.7 ± 13.3% vs 82.6 ± 11.5%, p >0.05). After the acute period of the disease, the quality of life decreased more prominent in people of group 1 and was 58.1 ± 17.0% against 66.8 ± 15.4% in group 2 (p=0.026). After recovery, the quality of life of patients of group 1 significantly increased in relation to the state after the acute period compared to group 2, namely by 15.9 ± 11.5% vs 9.7 ± 8.9%, respectively (p=0.019). In patients who started physical therapy in the acute phase of the disease (9 out of 25, 36%), compared to those who started physical therapy only in the post-acute phase (16 people, 64%), there was a significantly less pronounced decrease in the quality of life after the acute phase compared with the condition before the onset of the disease (respectively, by 11.1 ± 7.8% vs 30.0 ± 14.1%, p=0.002). In general, 28 patients out of 30 people (93%) of group 1 indicated the effectiveness of the rehabilitation, most often a good effect (21 people, 70%). Level of functioning on the Post-COVID-19 Functional Status scale significantly improved compared to the state before the start of rehabilitation (respectively, 0.83 ± 1.07 vs 1.9 ± 3.0, p=0.008). However, the quality of life after recovery in group 1 did not reach the level that was before the disease (respectively, 74.1 ± 13.0% vs 80.7 ± 13.3%, p=0.001), which was also observed in group 2. Conclusion. The results of the study indicate efficiency of the use of physical therapy for the rehabilitation of patients with COVID-19 pneumonia. Physical therapy should be started already in the acute phase of the disease, as it contributes to a less pronounced deterioration of the quality of life after this phase

Вступ: З'ясування впливу радіоактивного забруднення, спричиненого аварією на Чорнобильській атомній електростанції (ЧАЕС), на розвиток неоплазій гематогенного походження надалі залишається актуальною проблемою. Тому оцінювання онкологічної захворюваності внаслідок забрудненння великих територій радіонуклідами слід проводити не лише за епідеміологічними показниками, але й з врахуванням окремих клінічних випадків цієї патології як наслідок не тільки детерміністичних, але й стохастичних ефектів.Мета: Проаналізувати клінічні випадки пухлин з кровотворних та лімфоїдних клітин, асоційованих з аварією на ЧАЕС. Виявити гематологічні неоплазії, спричинені дією радіації, та опрацювати критерії їх диференціації із спонтанною захворюваністю.Методи дослідження: Ретроспективний аналіз доступної медичної документації пацієнтів з гематологічними неоплазіями, які проживають чи проживали на території Львівської області, та пухлини яких можуть бути асоційовані з аварією на ЧАЕС, за 25-річний період з1992 р. по 2017 р.Результати: З'ясовано, що інформація про офіційно зареєстровані випадки гематологічних неоплазій в осіб, визнаних потерпілими від аварії на ЧАЕС, передусім у тих, хто брав участь у ліквідації наслідків аварії, їх дітей та переселених осіб, і надалі залишаєься закритою. Лише в шести випадках вдалося провести ретроспективний аналіз медичної документації осіб з гематологічними новотворами, асоційованими з аварією на ЧАЕС. П'ятеро з них є дітьми ліквідаторів її наслідків, а одна -переселена з Київської області. В чотирьох випадках хворобу було діагностовано в дитячому, а в двох -в молодому віці (в 21 та 25 років). У чотирьох пацієнтів було діагностовано негоджкінську лімфому, а в двох інших -хворобу Годжкіна та гостру мієлобластну лейкемію. На підставі проведеного аналізу описано клінічний випадок негоджкінської лімфоми, яка найімовірніше пов'язана з аварією на ЧАЕС. В роботі аналізуються проблеми виявлення пухлин, спричинених забрудненням радіонуклідами внслідок аварії на ЧАЕС.Висновки: Випадки неоплазій, які можуть бути асоційовані з аварією на ЧАЕС, потребують всебічного аналізу, довготривалого спостереження над пацієнтами та висвітлення в науковій літературі.