Hard-To-Treat Idiopathic Refractory Autoimmune Haemolytic Anaemia with Reticulocytopenia

Autoimmune haemolytic anaemia (AIHA) is an uncommon condition characterized by increased destruction of erythrocytes associated with reticulocytosis in the great majority of cases. We present the case of a 68-year-old woman with jaundice and malaise. Investigation revealed AIHA with reticulocytopenia. The patient failed to respond to prednisolone or to rituximab. Azathioprine and epoetin beta were subsequently started, the prednisolone dose was increased, and the patient began to respond after 1 month. In AIHA, reticulocytopenia is a very rare presentation and a sign of great severity and poor outcome. The scarcity of therapeutic options in refractory cases poses a major challenge for physicians.

The “Scourge of the Renaissance”. A Short Review About Treponema pallidum infection

Background: There is not a time in the history when epidemics did not loom large: infectious diseases have always had civilisation and evolution-altering consequences. Throughout history, there have been a number of pandemics: cholera, bubonic plague, influenza, smallpox are some of the most brutal killers in human history. Historical accounts of pandemics clearly demonstrate that war, unhygienic conditions, social and health inequality create conditions for the transmission of infectious diseases, and existing health disparities can contribute to unequal morbidity and mortality. The Renaissance was a period of European cultural, artistic, political and economic “rebirth” following the Middle Ages, but it was also the time when new infectious disease appeared, such as Syphilis. The epidemic spread of Syphilis began between the late 15th century and early 16th century due to the increased migration of peoples across Europe. The rapid spread of venereal syphilis throughout Europe suggests the introduction of a disease into a population that had not previously been exposed. Syphilis is a type of treponematosis, which includes syphilis, bejel, yaws, and pinta, but, while syphilis is venereal disease, the others are nonvenereal. Syphilis was, at the beginning, a disease of great severity due to its novelty, as the population had no time to gain any immunity against this venereal disease. Methods: The purpose of this study is to investigate the origin of syphilis and the evolution of the treatments from the empiric means to the discovery of penicillin, but also to understand how this venereal disease has largely influenced human lifestyle and evolution. Conclusions: The first of the three hypotheses about its origins is the Columbian hypothesis, which states that Columbus's crew acquired syphilis from Native Americans and carried it back to Europe in 1493 A. D. On the contrary, the second hypothesis (pre-Columbian) asserts that syphilis was present in Europe long before Columbus's voyage and was transferred to the New World by Columbus's men. The Unitarian theory argues that syphilis, bejel, yaws, and pinta are not separate diseases but they represent syndromes caused by slightly different strains of one organism. Nowadays, Syphilis’ origin is still uncertain and remains controversial. However, the large impact on the social behavior and international public health is an important reason to investigate about its origins and how to prevent the transmission.

The sience and art of moral responsibility for the future

The article is devoted to the actual problem of the probable future of our civilization and the moral responsibility of mankind for it. In the twentieth century, humanity was actually faced with the threat of man-made destruction of life on the planet. The tragedy of Hiroshima and Nagasaki with great severity raised the question not only about the morality of science, but also the personal responsibility of the scientist for his discoveries. In particular, in 1955, the Einstein-Russell Manifesto was signed, which initiated the widely known Pahous Movement for Peace and Disarmament. Art has responded to the nuclear threat. In 1950, R. Bradbury's story "There Will Be a Graceful Rain" was published. One of the first to address the subject of doomsday was American filmmakers: R. Weiss («The Day the Earth Stalle», 1951), S. Kramer («On the Shore», 1959), S. Kubrick («Doctor Stranzhla», 1964), S. Lumet («Security System», 1964). The idea of moral responsibility of each person for his future was raised on the Soviet screen in the films: «The Escape of Mr. McKinley» (1975, M. Schweitzer), «Sacrifice» (1986, A. Tarkovsky), «Letters of the Dead Man» (1986, K. Lopushansky), «Visitor to the Museum» (1989, K. Lopushansky). It was in the 1970s and 1980s that they became a painful awareness of the insecurity and fragility of human life. It has become clear that nuclear energy can be not only a policy or an economy, but above all a tool of self-destruction. It has been scientifically justified that the greatest threat to humanity lies not where it was not expected. Nuclear war is not only the mass destruction of people, total destruction, radiation, infectious diseases, etc. The main danger is the climate change of the planet, changes in the biosphere (the effect of nuclear winter), which humanity will not be able to survive. marked by a painful awareness of the insecurity and fragility of human life. But today, the biosphere is threatened not only by human waste, environmental pollution, but also by the gradual destruction of the natural environment, the frantic depletion of natural resources, etc. The main thing that threatens our civilization is moral irresponsibility to posterity. What has to happen for humanity to realize the danger of indifference? Personal responsibility for the future of everyone and everyone for the future of everyone is the main principle of survival. The eminent philosopher M. Berdyaev wrote: «The end of the world depends on man, and he will be one way or another, depending on the actions of man... The greatest religious and moral truth to which a man must grow is that he cannot be saved alone. My salvation also involves the salvation of others, my loved ones, the salvation of the whole world, the transformation of the world».

THE METHODOLOGY FOR THE SYNTHESIS AND CORRECTION OF THE "RISK PYRAMIDS" IN THE AIRPLANE SEGMENT OF COMMERCIAL AVIATION OF RUSSIA

The article presents the results of the "risk pyramids" analysis of commercial aviation for their adequacy to the current state of the aviation transport system of Russia. The necessity of annual updating of "risk pyramids" is shown, as the aviation transport system (ATS) of Russia is dynamic and the ATS state changes faster than the accident rate statistical indicators characterizing this state. The method of linear weighted moving average for the synthesis and annual correction of the "risk pyramids" parameters with an optimized averaging coefficient – 7 years is substantiated and proposed. The optimization of the averaging coefficient is performed by the criterion of the minimum mismatch between the averaged values of the "risk pyramids" parameters and the current (annual) values determined by the statistical data of an aviation events. The general and private "risk pyramids" of commercial aviation of Russia synthesized by results of the statistical factorial analysis of aviation events for 2009–2016 are presented. The synthesis of "risk pyramids" is made in accordance with the classification of aviation events in the civil aviation of Russia, separately by causative factors: "Human", "Aircraft", "Environment". The parameters of the "risk pyramids" reflect the conditional probability of an aviation event of great severity (for example, a catastrophe), if there were aviation events of less severity (for example, incidents). The parameters of the presented pyramids are intended for inclusion into the algorithms of indirect estimation of probability of aviation accidents for any airline and any period of flight work (from a month or more).

The Price

This chapter examines the consequences of the panics that occurred in and after 1819, 1837, 1857, 1873, in a minor way in 1884, with great severity in 1893 and again in 1907, and of the stock market crash of October 1929. The late years of the nineteenth century and the first decade of the twentieth were a good time to be rich. For one, there was no income tax. Historians refer to these years as the Gilded Age, but they might as well be called the age of gold. The chapter considers recognizable constants in the panics of the latter part of the nineteenth century and the first decade of the twentieth, including the expansion in business activity, particularly investment in the construction of canals and railroads. It also discusses speculation in railroads and common stocks, financed by money from banks, and the resulting bank failures.

On the Eelworm Disease of Primulas caused by Anguillulina dipsaci, Kühn

In Britain, the year 1937 is likely to be memorable in the history of cultivation of many species and varieties of plants belonging to the genus Primula, as witnessing, for the first time, attacks of great severity by the nematode, Anguillulina dipsaci in a number of plantations of Primulas, reducing the vitality of the plants wherever it occurred, and in many instances causing complete destruction of certain species. The plants classed as members of the Candelabra Section, which includes some of the finest and most extensively grown species and varieties in the whole genus, proved particularly susceptible but, while members of many of the other Sections of Primulas did not escape attack, the injury inflicted was not usually of such high order of severity.

A Small Outbreak of Dysentery associated with an Unusual Bacillus

In January, 1923, a small outbreak of dysentery occurred amongst the nursing staff of a certain institution. In all there were six cases. Only one case, the first which occurred, showed symptoms of any great severity. In the remaining five cases the symptoms were slight, and the patients were able to return to duty m seven or eight days from the commencement of the illness.

A COMPARATIVE STUDY OF THE DIPLOCOCCI OCCURRING IN EPIDEMIC CEREBRO-SPINAL MENINGITIS AND POSTERIOR BASIC MENINGITIS

The study carried out and recorded in this paper did not lead to the finding of any reliable criteria of difference between strains of Diplococcus intracellularis obtained from typical cases of epidemic meningitis and several cultures obtained from cases of posterior basic meningitis. The successful experiments made with monkeys show that the diplococcus obtained from cases of posterior basic meningitis is capable of setting up rapidly and acutely fatal forms of meningitis and in producing organic lesions of the cerebral tissues of great severity. This study would, therefore, suggest that the antimeningitis serum should be as useful in cases of posterior basic meningitis so-called, as it has been in epidemic meningitis, especially if it were employed early in the disease.

2. Cases of Poisoning by Goat's Milk

On 27th November 1861, eleven wardroom officers of the “Marlborough,” including the author, were simultaneously attacked with extreme faintness, nausea, bilious vomiting, and diarrhœa; the attacks lasting five or six hours—in some of the cases being of great severity, and attended with much depression. The treatment, which was successful in every instance, consisted in encouraging free vomiting, and the administration of stimulants and anodynes. At the same time a series of similar cases occurred in H.M.S. “Agamemnon,” and five other ships in the harbour.