Newly Diagnosed Primary Immune Thrombocytopenia in Children: Which Guideline to Adhere?

Background: Immune thrombocytopenia purpura (ITP) is an autoimmune disorder of bleeding which is defined as having thrombocytopenia (platelet count below 100.000/µL). Most ITP cases in children are acute and recent various guidelines have established a wait-and-see protocol as management for children with ITP since it is assumed to be temporary and will most likely to resolve spontaneously. Objectives: For this case report, a case of primary ITP in a child will be discussed. In the following discussion section, several ITP consensus guidelines will be discerned and compared to see which is the more appropriate guideline to adhere in managing a newly diagnosed ITP case in children. The case report is used as a ‘trigger’ to dissect the core treatment suggestions described in the inspected consensus guidelines. Case Illustration: A 6-years-old female child presents to a hospital with a chief complaint of having red spots in her arms and legs since a day ago. The red spots she complained was the first time to be experienced. She had no prior fever, (bloody) diarrhea, nausea, and vomiting. Physical examination showed no remarkable abnormalities other than numerous petechiae in the upper and lower extremities. Discussion: The patient in this case was finally admitted and treated in the hospital as an inpatient with corticosteroid, antibiotics, and platelet concentrates despite the current guidelines that generally advocate against these treatments. This case report may give an insight regarding the factors needed to be considered before treating a child with newly diagnosed ITP. Conclusion: The Joint Working Group (JWG) consensus seems to be the most comprehensive guideline in treatment of newly diagnosed ITP in children, compared to the American Society of Hematology (ASH) and International Consensus Report guideline. Keywords: hematology, ITP, newly diagnosed, primary, thrombocytopenia Latar Belakang: Immune trombositopenia purpura (ITP) merupakan sebuah penyakit perdarahan otoimun yang didefinisikan sebagai adanya trombositopenia (trombosit dibawah 100.000/µL). Mayoritas kasus ITP pada anak bersifat akut dan konsensus terkini menyarankan protokol “wait and see” sebagai tatalaksana untuk anak dengan ITP karena dianggap hanya sementara dan cenderung akan membaik secara spontan. Tujuan: Untuk laporan kasus ini, sebuah kasus ITP primer pada anak akan dibahas. Pada bagian diskusi, beberapa panduan terkait ITP akan diulas dan diperbandingkan untuk melihat panduan mana yang paling sesuai untuk mengatasi kasus baru (newly diagnosed) ITP pada anak. Laporan kasus ini digunakan sebagai pengantar untuk membahas intisari tatalaksana ITP dalam konsensus-konsensus yang dipakai. Ilustrasi Kasus: Anak perempuan berusia 6 tahun datang ke rumah sakit dengan keluhan utama adanya bintik-bintik merah pada kedua lengan dan tungkainya sejak sehari lalu. Bintik-bintik merah tersebut baru pertama kali dialami. Dia tidak menderita demam, diare (berdarah), nausea, dan vomitus. Pada pemeriksaan fisik, hanya ditemukan petekie-petekie di kedua ekstremitas atas dan bawah. Pembahasan: Pasien dalam kasus ini dirawatinapkan dan diberi kortikosteroid, antibiotik, dan konsentrat trombosit sebagai tatalaksananya, meskipun panduan-panduan yang ada secara umum tidak menyarankan tatalaksana demikian. Laporan kasus ini diharapkan memberikan wawasan terkait faktor-faktor yang penting untuk dipertimbangkan sebelum merawat seorang anak dengan kasus baru ITP. Kesimpulan: Konsensus Joint Working Group (JWG) tampaknya menjadi panduan paling komprehensif dalam tatalaksana anak dengan kasus baru ITP, dibanding panduan American Society of Hematology (ASH) dan International Consensus Report. Kata Kunci: hematologi, ITP, newly diagnosed, primer, trombositopenia

Assessing recently improved precession-nutation models

<p>In 2020 new estimations of nutation amplitudes or precession parameters have been published or presented at main meetings. The derivation of corrections to improve the current precession-nutation models was encouraged by Resolution 5 of the 2019 General Assembly of the International Association of Geodesy (IAG). Besides, the GGOS/IERS Unified Analysis Workshop held in October 2019 recommended that effort to be prioritized among the tasks of the current IAU/IAG Joint Working Group on Improving Theories and Models of the Earth’s rotation (JWG ITMER).</p><p>This presentation is intended to present comparisons of some of those new semi-empirical and semi-theorical precession-nutation models developed by different authors from either VLBI solutions of individual analysis centers or combinations of them. The models recently introduced by the authors that were reported at the AGU 2020 Fall Meeting are included in this assessment.</p>

On the discovery of new elements (IUPAC/IUPAP Report)

Almost thirty years ago the criteria that are currently used to verify claims for the discovery of a new element were set down by the comprehensive work of a Transfermium Working Group, TWG, jointly established by IUPAC and IUPAP. The recent completion of the naming of the 118 elements in the first seven periods of the Periodic Table of the Elements was considered as an opportunity for a review of these criteria in the light of the experimental and theoretical advances in the field. In late 2016 the Unions decided to establish a new Joint Working Group, JWG, consisting of six members determined by the Unions. A first meeting of the JWG was in May 2017. One year later this report was finished. In a first part the works and conclusions of the TWG and the Joint Working Parties, JWP, deciding on the discovery of the now named elements are summarized. Possible experimental developments for production and identification of new elements beyond the presently known ones are estimated. Criteria and guidelines for establishing priority of discovery of these potential new elements are presented. Special emphasis is given to a description for the application of the criteria and the limits for their applicability.

New standards for measuring the diffusion capacity of the lungs by carbon monoxide by single breath method

The article provides an overview of the technical capabilities and updated standards for the study of diffusion capacity of the lungs using diagnostic systems using rapidly responding gas analyzers (RGA analyzers — rapidly responding gas analyzers) of carbon monoxide and indicator gas, presented by a joint working group of the European Respiratory Society (ERC) and the American Thoracic Society (ATS).