Rational Therapy Research Articles

The effects of rational emotive behaviour therapy on performance under pressure in adolescent soccer athletes: a randomised control design

ABSTRACTAlthough several studies have reported the effects of rational emotive behaviour therapy (REBT) with athletes, significant methodological limitations have been observed in the extant research. These include a lack of randomised control trials (RCT), a lack of objective performance measurement, and often poor internal and external validity. Accordingly, these limitations are addressed in the present study, and the effects of REBT on performance under pressure in adolescent soccer players are assessed using an RCT design. In this study, 24 adolescent soccer players were recruited. After completing pre-intervention measures of irrational beliefs, social anxiety, and performance under pressure, players were divided into two groups, an experimental (n = 12) and placebo control group (n = 12). The experimental group underwent ten REBT sessions and the placebo control group underwent ten sessions of video clips related to new soccer technologies. Indicators of irrational beliefs, social anxiety, and performance under pressure were collected at a post-intervention and at a four-month follow-up. Results demonstrated a significant decrease in irrational beliefs and social anxiety and an improvement in performance under pressure in the experimental group, compared to the placebo control group. These significant changes were maintained in the experimental group at follow-up. Results are discussed in relation to advancements to the extant research, and recommendations for future applied work are proffered.

Clinical case of Kavasaki syndrome

Kawasaki syndrome is rare in Europe. This relatively «young» disease was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. The causes of the disease are not clear. Most scientists tend to believe that the disease is triggered by existing foci of infection of viral or bacterial origin in the body, causing inflammation and damage to blood and lymphatic vessels. Kawasaki syndrome is a non­contagious disease, but cases of recurrence have been described.Patients with a high temperature, in the range of 38—40 °C, develop polymorphic rashes: roseola, erythema, urticaria, papules that can mimic measles or scarlet fever. Children are tearful, irritable, often wake up, suffer from diarrhea, abdominal pain. The rash affects the extremities and torso. The lower and upper extremities are swollen; especially pronounced swelling is on the palms, soles and fingers. After 1,5—2 weeks there is a lamellar peeling of the fingertips and toes. The interphalangeal joints are swollen, active movements in children’s joints cause pain and crying as a result. The mucous membranes of the oral cavity are hyperemic, the tongue is deep red (crimson), cheilitis is also diagnosed. There are three phases of the disease: acute — within 2 weeks since the onset, subacute — from 2 to 4 weeks, the recovery phase — from 1 to 3 months. In most patients, the cervical lymph nodes are affected, often one node is palpated ranging in size from 1 to 1.5 cm in diameter. There are no specific laboratory tests to diagnose the syndrome.Considering the sporadic nature and complexity of the diagnosis, we present a clinical case of Kawasaki syndrome in a 3.5­year­old boy. The probable cause of the disease was a combination of chickenpox virus and COVID­19. The variety of symptoms of the syndrome led to diagnostic errors and, accordingly, influenced the tactics of treatment of the primary care physician. Clinical manifestations, complications, route of the patient, complex treatment and rehabilitation are described.In our report, we have focused the attention of pediatricians, family physicians and dermatologists on the fact that Kawasaki syndrome is not a rare disease during the pandemic, and the combination of COVID­19 with other viral and microbial infections led to a multifold increase in the likelihood of serious complications. Timely diagnosis and rational therapy are the prevention of diagnostic errors and complications.

Influence of Occupational Stress on Work Engagement among Nigerian Library Personnel

The study examined occupational stress and job engagement among library personnel at selected Nigerian state and federal universities. A descriptive survey methodology was employed in the study. This study used questionnaires for ascertaining work engagement and occupational stress to survey 76 respondents. Results indicated that library personnel experienced high occupational stress, which displayed significantly low levels of job engagement. In contrast, those with a low level of occupational stress showed significantly increased levels of engagement at work. The data suggested that female library personnel reported experiencing more occupational stress than male library personnel and the mean difference was statistically significant, t (74) = -3.416, p =.001. The limitation of this research includes the smallness of sample size, which calls for a larger sample to validate the findings further. Rational emotive behavioral therapy can be adapted for managing the levels of work engagement and occupational stress in librarians.

Toxic Relationship: Rational Emotive Behavior Therapy

There are many problems that occur in unhealthy relationships and the research aims to see how far rational emotive behavior therapy (REBT) can prevent toxic relationships, the research approach used is the field research method (qualitative) data sources are obtained from interviews and observation to respondents. The results of the study show that rational emotive behavior therapy has a significant impact on the handling of unhealthy relationships experienced by respondents. Providing rational emotive behavior therapy services can change the attitudes, perceptions and ways of thinking of irrational counselees to become rational and eliminate self-destructive emotional disturbances.

Cell Type-Specific Metabolic Response to Amino Acid Starvation Dictates the Role of Sestrin2 in Regulation of mTORC1

Targeting cancer metabolism has become one of the strategies for a rational anti-tumor therapy. However, cellular plasticity, driven by a major regulator of cellular growth and metabolism, mTORC1, often leads toward treatment resistance. Sestrin2, a stress-inducible protein, has been described as an mTORC1 inhibitor upon various types of stress signals. Immune assays and online measurements of cellular bioenergetics were employed to investigate the nature of Sestrin2 regulation, and finally, by silencing the SESN2 gene, to identify the role of induced Sestrin2 upon a single amino acid deprivation in cancer cells of various origins. Our data suggest that a complex interplay of either oxidative, energetic, nutritional stress, or in combination, play a role in Sestrin2 regulation upon single amino acid deprivation. Therefore, cellular metabolic background and sequential metabolic response dictate Sestrin2 expression in the absence of an amino acid. While deprivations of essential amino acids uniformly induce Sestrin2 levels, non-essential amino acids regulate Sestrin2 differently, drawing a characteristic Sestrin2 expression fingerprint, which could serve as a first indication of the underlying cellular vulnerability. Finally, we show that canonical GCN2-ATF4-mediated Sestrin2 induction leads to mTORC1 inhibition only in amino acid auxotroph cells, where the amino acid cannot be replenished by metabolic reprogramming.

Decreased sexual desire in a patient with infertility: a clinical сase

The article addresses the problem of decreased sexual desire in an infertile female with a decreased ovarian reserve who needs to use assisted reproductive technologies. Short-term psychotherapy as part of rational and cognitive-behavioral therapy was used; psychotherapeutic procedures with relaxing breathing techniques and a method of nonconscious audiovisual psychocorrection were described.

Konseling Kelompok Rational Emotive Behaviour Therapy Berbasis Nilai Budaya Jawa Untuk Meningkatkan Kebermaknaan Hidup Pada Masa Pandemi Covid-19

he meaning of life is a condition in which the individual has a high motivation for the life lived to achieve the goals and happiness of his life. However, the Covid-19 pandemic has also caused problems in various fields, one of which has an impact on decreasing life goals, life satisfaction, freedom of choice, passions, and responsibility for life. The purpose of this study is to help people improve their survival through counseling groups rational emotive behaviour therapy based on Javanese cultural values. This research method pre-experiments one group pretest posttest design with random sampling techniques. The results showed that counseling the rational emotive behaviour therapy group based on Javanese cultural values succeeded in improving the meaning of people's lives during the Covid-19 pandemic as evidenced by the results of statistical tests with the Wilcoxon Test seen by Asymp. Sig/Asymptotic significance of two sides is 0.043 and the probability value is less than 0.05. This confirms that the intervention in the form of Rational Emotive Behavior Therapy counseling services based on Javanese Cultural Values Can Increase the Meaningfulness of Life During the Covid-19 Pandemic

Integration of pharmacodynamics, network pharmacology and metabolomics to elucidate effect and mechanism of Artemisia capillaris Thunb. in the treatment of jaundice

Ethnopharmacological relevanceAs one of the most commonly used herbs, Artemisia capillaris Thunb. (ACT) display favorable effect in the treatment of jaundice. However, mechanism of ACT in the treatment of jaundice remains unclear at present, which limits its development and application. Aim of the studyTo investigate effect and mechanism of Artemisia capillaris Thunb. (ACT) in the treatment of jaundice using pharmacodynamics, network pharmacology and metabolomics. MethodsEffect of ACT in treating jaundice was evaluated by biochemical assays and pathological observation using the α-naphthyl isothiocyanate (ANIT)-induced mice. Jaundice-relieving mechanism of ACT was investigated by integration of network pharmacology and metabolomics. ResultsAfter the mice with jaundice were administrated ACT extract for 9 days, compared to that of the model group, serum D-BIL, T-BIL and ALP levels of the mice in the low, medium, high dose of ACT group decreased by 39.81%, 15.30% and 16.92%; 48.06%, 42.54% and 36.91%; 26.90%, 12.34% and 16.90%, respectively. The pathologic study indicated that ACT improved the symptoms of liver injury of the mice with jaundice. The network of herb (i.e., ACT)-components-targets-disease (i.e., jaundice) was established, which consisted of 17 components classified in flavonoids, chromones, organic acids, terpenoids, and 234 targets related to treatment of jaundice. Metabolomics analysis showed that, compared to that in the model group, level of 8 differential metabolites were upregulated and level of 29 differential metabolites were downregulated in the mice liver in the ACT group, respectively. The main metabolic pathways involved in treatment of jaundice by ACT were pantothenate and CoA biosynthesis, glutathione metabolism, biosynthesis of unsaturated fatty acids, primary bile acid biosynthesis in the liver, respectively. The integrated analysis of network pharmacology and metabolomics showed that 3α,7α,12α a-Trihydroxy-5β-cholanate, glycocholate, taurocholate, pantetheine 4′-phosphate, and d-4′-phosphopantothenate were the potential biomarkers for treatment of jaundice, and AKR1C4, ALDH2 and HSD11B were the potential drug targets in the treatment of jaundice by ACT. ConclusionThe study based on metabolomics and network pharmacology indicated that ACT can display favorable jaundice-relieving effect by its multiple components regulating multiple biomarkers, multiple targets and multiple pathways, and may be a rational therapy for the treatment of jaundice.

Physicians’ knowledge and preferences in tactics of management and rational pharmacotherapy of arterial hypertension in pregnant women (PHYGEST study)

Introduction: The issues of rational antihypertensive therapy in pregnant women are always extremely relevant, since high blood pressure in a pregnant woman is associated with serious risks for a mother and a fetus.
 The aim of the study: To determine the knowledge and preferences of physicians in the management of pregnant women with arterial hypertension.
 Materials and methods: A multicenter study was conducted in 2018–2021 using an anonymous questionnaire among 411 doctors from 8 regions of Russia.
 Results and discussion: The levels of knowledge and preferences of specialists in the issues of diagnosing and formulating a diagnosis of arterial hypertension and preeclampsia in pregnant women, prescribing basic and additional drugs for the treatment and prevention of hypertension were revealed, and the degree of compliance with the current clinical guidelines was assessed.
 Conclusion: Due to the insufficient level of knowledge of specialists, it is required to pay increased and special attention to this problem, strengthen control over compliance with clinical guidelines, and introduce it into postgraduate recommendations and continuing education programs.

Difficulties and prospects of rational therapy of ischemic strokes

Despite significant progress in medical technology, many topical issues in neurology remain unresolved; among the latter, acute cerebrovascular accidents (strokes) continue to be one of the most important medical and social problems of the modern world, since their rates of morbidity, mortality and disability are steadily growing. The increase in the incidence of strokes over the past 30 years by 70% reflects the imperfection of modern medical strategies for the primary prevention of stroke and measures for their implementation among the population, which dictates the need to revise the prevailing ideas about the etiology, pathogenetic mechanisms and therapeutic approaches to managing patients with cerebrovascular pathology. The article presents a classification of strokes, a critical analysis of vascular risk factors (in particular, the emergence of new ones, such as acute coronavirus infection COVID-19), fundamental elements of the ischemic cascade, pathomorphological and pathophysiological consequences of ischemic damage to the central nervous system (necrosis and apoptosis of neurons, diaschisis in the penumbra zone), current theoretical (targets of drug exposure) and practical (therapeutic window) aspects of therapy and prevention of acute cerebrovascular accidents are outlined. The place and importance of the use of neuroprotective drugs in the combined therapy of patients with acute and chronic cerebrovascular pathology has been demonstrated. Particular attention is focused on neurometabolic drugs with a multimodal mechanism of action, which not only protect the neuronal cytoskeleton, but also increase the tolerance of brain tissue to hypoxia.

Efektivitas Pendekatan Rational Emotive Behavior Therapy Setting Kelompok untuk Meningkatkan Kontrol Diri Siswa dalam Pencegahan Penyalahgunaan Narkoba

Drug abuse is a negative/irrational behavior that can harm oneself and others. One of the causes of drug abuse is the low self-control of students. Clients who have problems with low self-control in drug abuse need to be counseled through rational emotive behavior therapy in group settings. The aims of this study were: (1) to test the significant difference in the level of self-control of the experimental group students before and after being given the rational emotive behavior therapy setting technique, (2) to test the significant difference in the level of self-control of the control group students before and after being given services without treatment specifically, (3) examine the effectiveness of the rational approach to emotive behavior therapy setting in groups in increasing self-control in preventing drug abuse. This study used a quasi-experimental non-equivalent control group design with pretest and posttest. The research subjects were students of class VIII-3 and VIII-4 at SMP Negeri 4 Padang Pariaman with a sample of 20 people who were divided into 2 groups consisting of 10 people as the experimental group and 10 people as the control group. The sampling technique was purposive sampling technique. Data were analyzed using the Wilcoxon signed Rank Test and Kolmogorov Smirnov 2 Independent Samples with the help of SPSS version 20. The results showed that the rational emotive behavior threapy approach was effective in increasing students' self-control in preventing drug abuse. This can be seen from: (1) there is a significant difference in the level of self-control of the experimental group students before and after being given the rational emotive behavior therapy setting technique, (2) there is a significant difference in the level of self-control of the control group students before and after being given services without treatment specifically, (3) there is the effectiveness of the rational approach to emotive behavior therapy setting in groups in increasing self-control in preventing drug abuse. The implementation of the rational emotive behavior therapy setting approach in groups should be intensified in the form of Guidance Counseling programs and designed as well as possible by counsellors or Guidance Counseling teachers.

New treatment and preventive options for acute respiratory infections in children

The article is dedicated to the issue of acute respiratory infections in children. Acute respiratory infections (ARI) are the most common infectious diseases among both adults and children. The article presents data on the 2020/2021 ARVI and influenza epidemic season in the Russian Federation, which was characterized by an earlier beginning of the rise in the incidence of ARVI and influenza, a wide geographic spread, the highest rates of respiratory infections in children aged 1–2 and 3–6 years, high intensity of the epidemic process, the predominant circulation of influenza A (H3N2) viruses, and the low incidence, absence of severe disease and low mortality among vaccinated against the flu. Modern options for specific prevention of ARI (vaccination against influenza and other infections as part of the national and regional schedules) and non-specific prevention (implementation of the healthy lifestyle principles, including a day regimen, age-adequate nutrition, environmental control, cold exposure training and therapeutic exercise, avoidance of second-hand smoking, vitamin therapy, reduction of potential exposure to sources of infection, use of anti-epidemic measures in the site of infection, regular ventilation and moist mopping, hand washing, elimination therapy, barrier protective devices, use of systemic bacterial lysates, synthetic molecules) are discussed. The principles of rational ARI therapy are provided. The use of essential oil combinations with a composition of oils at certain proportions is one of the promising directions for therapy and prevention of acute respiratory infections. The results of numerous studies assessing the efficacy and safety of the inhalation administration of natural essential oil compositions as part of the combination therapy and prevention of acute respiratory infections in children are provided, good tolerance and high efficacy of essential oil inhalations are observed.

Group Counseling: Reducing Cheating Behavior with a Rational Emotive Behavior Therapy Approach

Cheating behavior is an activitythat appear to accompany teaching and learning process activities that can erode positive personality in students because they use dishonest methods in achieving academic grades. This study aims to test the effectiveness of group counseling with a rational emotive behavior therapy approach to reduce students' cheating behavior. This type of research is a quantitative research with the type of experimental research. The type of experimental design in this study was Quasi Experiment with The Non-Equivalent Control Group Design. The population in this study were students of SMAN 6 Padang and students of SMAN 3 Padang as many as 543 students. The sample in this study was 400 students, and 16 students were taken which were divided into 8 students for the experimental group and 8 students for the control group. Sampling used purposive sampling. This study used a data collection tool in the form of a cheating behavior questionnaire. The results of this study indicate that group counseling services using a rational emotive behavior therapy approach are effective in reducing students' cheating behavior. So that this research can be used as input material as a basis for counseling teachers/counselors in providing group counseling services using a rational emotive behavior therapy approach in an effort to overcome and prevent students' cheating behavior.

The deubiquitinase OTUD1 regulates immunoglobulin production and proteasome inhibitor sensitivity in multiple myeloma

Serum monoclonal immunoglobulin (Ig) is the main diagnostic factor for patients with multiple myeloma (MM), however its prognostic potential remains unclear. On a large MM patient cohort (n = 4146), we observe no correlation between serum Ig levels and patient survival, while amount of intracellular Ig has a strong predictive effect. Focused CRISPR screen, transcriptional and proteomic analysis identify deubiquitinase OTUD1 as a critical mediator of Ig synthesis, proteasome inhibitor sensitivity and tumor burden in MM. Mechanistically, OTUD1 deubiquitinates peroxiredoxin 4 (PRDX4), protecting it from endoplasmic reticulum (ER)-associated degradation. In turn, PRDX4 facilitates Ig production which coincides with the accumulation of unfolded proteins and higher ER stress. The elevated load on proteasome ultimately potentiates myeloma response to proteasome inhibitors providing a window for a rational therapy. Collectively, our findings support the significance of the Ig production machinery as a biomarker and target in the combinatory treatment of MM patients.

Efficiency of Rational Emotive Behavior Therapy on Anxiety Traits and Irrational Ideas among Patients with Drug Addiction

Efficiency of Rational Emotive Behavior Therapy on Anxiety Traits and Irrational Ideas among Patients with Drug Addiction

Psychodrama Techniques To Improve Academic Self-Efficacy In Madrasah Aliyah Students

There are several symptoms experienced by students who have low academic self-efficacy, namely quickly giving up when working on difficult exam questions, only understanding some subject matter which they think is easy and not sure if their test scores pass in subjects they do not master. The purpose of this study was to determine the effectiveness of group counseling approach to rational emotive behavior therapy with psychodrama techniques to improve academic self-efficacy in class XI MA Madania Bantul Yogyakarta students. This study uses quantitative research methods using experimental types, this experimental research design uses a quasi-experimental research pattern with a nonequivalent control group design. The design of this study consisted of two sample groups selected by purposive sampling technique, namely the experimental group and the control group, each group consisting of 10 students. The data collection technique used is the Likert scale with the aim of measuring students' academic self-efficacy. The result of this research using independent t test is that the t-count value is greater than the t-table value (23.526 1.734). Based on the results of this test, there is a significant difference in values between the experimental and control groups. So it can be concluded that the hypothesis Ho is rejected and Ha is accepted. This means that psychodrama techniques are effective for increasing academic self-efficacy in class XI students of Madrasah Aliyah.Madania Bantul Yogyakarta.

FOCUS ON OPTIMISM AND HAPPINESS: PSYCHOLOGICAL FOUNDATIONS FOR DEVELOPING THE SOCIAL WORK CLIENTS’ STRENGTS

Understanding the value and autonomy of the client in the intervention process are postulates on which the modern social work practice is based and which are complementary integrated in a relatively new strengths-based approach (SBA).This paper aims to characterize the theoretical basis of SBA. It is based on a retrospective review of the literature, presenting those psychological concepts on which social work interventions are based, aimed at developing clients' resources and raising their self-esteem and self-efficacy in dealing with life challenges or in solving life’s tasks.It has been determined that SBA is based primarily on humanistic philosophy and positive psychology and seeks or strives to maximize the client's resource potentia in order to improve their quality of life. It's a philosophy and a way to consider clients as resourceful and resilient in the face of challenges. It was found that the implementation of SBA requires the integration of knowledge psychology, in particular the theory of self-actualization (A. Maslow), the need for self-realization (K. Rogers), the development of faith in one's own ability (R. May) , the desire for self-development (J. Bugental), and directions positive psychology - cognitive-behavioral, rational emotional-behavioral therapy (A. Beck and A. Ellis), theory of "learned optimism"(M. Seligman), theory of self-efficacy (A. Bandura) "flow", psychology (M. Csikszentmihalyi), goal-setting (C. Snyder), growth mentality (С. Dvek), understanding of happiness (D. Gilbert), self-determination (K. Sheldon) and strengths perspective (С. Peterson). At the same time, a strengths-based approach combines self-help psychology through the study of self-consistency and the use of psychocybernetics tools. The strengths-based approach as a direction of modern social work is based on such categories of humanistic and positive psychology as "self-concept", self-actualization, potential, resources, subjective well-being, client perspective, experience, positive thinking in order to maximize the client’s resource potential and empowerment, which reinforces its relevance and demand.

Evaluation of a Sumoylation Inhibitor as an Intrinsic and Extrinsic Radiosensitizer

<h3>Purpose/Objective(s)</h3> Radiation therapy (RT) reduces tumor burden through both intrinsic initiation of tumor cell death and enhancement of anti-tumor immunity. However, radiation treatments are not universally efficacious due to variation in radiosensitivity and anti-tumor immunity. Low proliferative rate, hypoxia, and T cell effector dysfunction can significantly degrade response to RT. Here we evaluate a rational combination therapy pairing radiosensitization and immune activation in conjunction with standard of care RT. Recent studies demonstrated the sumoylation inhibitor, TAK-981, has intrinsic capacity to reduce the proliferation of tumor cells <i>in vitro</i> as a monotherapy and decrease tumor volumes in syngeneic murine colon carcinoma models (CT26 and MC38) in combination with PD-1 or CTLA-4 checkpoint blockade. In these models a dendritic cell dependent type I interferon pathway was implicated to mediate the anti-tumor immune response and enhanced in vivo tumor control in TAK-981 and checkpoint blockade combination therapy, similar to previously elucidated mechanisms of immune activation following hypofractionated radiotherapy. Additionally, multiple intrinsic and extrinsic protein mediators (Myc, IRF3, p21) of tumor cell response to radiation are regulated by the post-translational modification of sumoylation. Consequently, we evaluated whether combining RT with TAK-981 resulted in enhanced tumor radiosensitivity in vitro and improved local tumor control in vivo, consistent with enhanced anti-tumor immune response in murine tumor models. <h3>Materials/Methods</h3> We utilized a longitudinal real time microscopic proliferation assay to evaluate RT response. Titrations of TAK-981 were added to established in vitro tumor cell cultures 4 hours prior to increasing doses of single fraction photon RT. Impacts of RT, TAK-981 or the combination treatment were assessed based upon cell proliferation for 72 hours. We assessed efficacy of this novel combination in vivo using the MC38 colorectal carcinoma model. C57BL6 mice with established tumors (> 50mm2) received TAK981 (15mg/kg) alone three times weekly or in combination with single fraction 8 Gy RT and compared to RT alone to evaluate local tumor control and impacts on overall survival. <h3>Results</h3> Our data demonstrates a synergistic and dose dependent reduction in MC38 colon carcinoma in vitro proliferation in response to combination RT and TAK-981. In vivo MC38 tumor models demonstrate no effect of TAK-981 alone compared to vehicle treated mice while co-administration with a single 8 Gy fraction of radiotherapy synergistically enhanced tumor control and overall survival compared to RT alone. <h3>Conclusion</h3> Our preliminary data support potential dual synergistic roles for the sumoylation inhibitor TAK-981 with radiotherapy, functioning as both an intrinsic radiosensitizer and immunomodulator.

Efektivitas Konseling Rasional Emotive Behavior Therapy (REBT) Untuk Meningkatkan Kesehatan Mental Mahasiswa

This study aims to analyze the effectiveness of rational emotive behavior therapy (REBT) counseling to improve the mental health of students of the BK Uhamka study program in 2021. The method used in this study was a quasi-experimental one group pretest-posttest design. The approach used in this research is a quantitative approach. The number of samples in this study amounted to 11 students of UHAMKA counseling guidance in 2021 with sampling using the purposive sampling method. This research instrument uses a questionnaire. As for the data analysis technique using the Wilcoxon T test. The results of this study indicate that the Wilcoxon T test with calculations using SPSS ver. 26 prove simp. Sig. (2-tailed) = 0.003. Because the value is 0.003 &lt;0.05, so Ho is rejected, in other words there is a significant effect before and after giving the pretest-posttest. So it can be concluded that group counseling services using REBT techniques are effective in improving students' mental health. It can be seen from the 11 students who took counseling with the REBT technique that their pretest and posttest scores increased or in other words experienced changes after being given counseling services with the REBT technique.

ОПЫТ ПРИМЕНЕНИЯ ЭФМОРОКТОКОГА АЛЬФА У ДЕТЕЙ И ПОДРОСТКОВ: КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ

Despite availability of prophylactic therapy for hemophilia A with factor VIII concentrates with a standard half-life, patients continue to experience episodes of bleeding and joint damage. The reasons for this may be the relatively short half-life of the factor VIII drug and the low adherence of patients to treatment. The appearance of clotting factor concentrates with an extended half-life makes it possible to reduce the frequency of infusions and increase the residual activity of the deficient factor. The article presents clinical observations of the use of Efmoroctocog alfa (recombinant human coagulation factor VIII, Fc fusion protein (rFVIIIFc)) in a 16-year-old adolescent and a 7-year-old child with severe and moderate forms of hemophilia A. In order to select the most rational therapy regimen and evaluate the effectiveness of treatment, the authors have conducted individual assessments of patients’ pharmacokinetic (PK) parameters. The drug administration in both patients was twice per week. To assess individual PK, the WAPPS-Hemo was used in order to calculate individual PK parameters based on a small plasma samples collected during routine prophylactic treatment. During the PK study, 3 blood samples were taken to determine the level of factor VIII in a one-step method. In a 16-year-old patient, the half-life of Efmoroctocog alfa (t1/2) was 24.25 hours. The activity of factor VIII prior to the next injection was 7.4%. In addition, 81% of time the factor VIII activity was above 15%. In a 7-year-old patient, the t1/2 of the drug was 12.75 hours. The minimum residual activity of factor VIII was 2.1%, 86% of time the activity of factor VIII was above 3%. Conclusion: high efficacy and safety were demonstrated based on the results of the use of Efmoroctocog alfa in routine clinical practice in previously treated pediatric and adolescent patients with severe and moderate hemophilia A, as well as the reduction in the frequency of infusions per week from 3 to 2.