Search

Aim.We aimed to assess safety and effectiveness of class III antiarrhythmic drug Refralon for conversion of atrial fibrillation (AFib) and flutter (AFl) in post-registration trial and to compare data of primary center (National medical research center in cardiology) with data of other hospitals.Material and Methods. We performed retrospective cohort study in 727 patients (451 enrolled in primary center and 276 enrolled in other hospitals) admitted between June 24, 2014 and June 24, 2019. Refralon was administered for conversion of AFib and AFl in intense care units in escalating doses (10-30 micrograms/kg) intravenously.Results.Conversion of AFib and AFl into sinus rhythm was achieved in 53,6% after administration of 10 mcg/kg dose, in 73% after administration of 20 mcg/kg dose and in 91,6% after administration of Refralon in dose up to 30 mcg/kg. No mortality and no major adverse cardiac events registered in our study. Asystole >3.0 sec observed in 5% (35 of 727) of patients): in 5% (24 of 451) of patients enrolled in primary center and in 4% (11 of 276) of patients enrolled in other hospitals; 95% confidence interval (CI) [-0.09; 0.113]. Asystole> 5.0 s observed in 1.7% of patients who further required non-urgent implantation of a permanent pacemaker due to manifestations of sinus node dysfunction. Cardiac conduction disturbances (exclusively sinus bradycardia) were registered in 7% (53 of 727) patients: in 8% (37 of 451) of patients enrolled in primary center and in 6% (17 of 276) of patients enrolled in other hospitals; 95% CI: [-0.1; 0.15]. Only 0.14% of patients had symptomatic sinus bradycardia that resolved after atropine injection. Ventricular arrhythmias (exclusively Torsade de pointes tachycardia in excessive QT interval prolongation) were registered in 1.7% (12 of 727) patients: in 2% (9 of 451) of patients in primary center and in 1% (3 of 276) of patients of other hospitals; 95% CI: [-0.06; 0.08]. QTc interval prolongation to values >500 ms documented in 19% (138 of 727) of patients: in 21% (95 of 451) of patients in primary center and in 16% (43 of 276) of patients in other hospitals; 95% CI: [-0.13; 0.24].Conclusion:In post-registration multicenter trial Refralon demonstrated good safety profile in conversion of AFib and AFl. Potential risk of TdP tachycardia mandates precautions with the use of the drug. In other hospitals Refralon did not demonstrate lower safety than in primary medical center.

The syndromology of dysfunction of the vocal cords varies widely from the absence of symptoms to mild shortness of breath to acute respiratory disfunction, which can mimic an asthma attack. The treatment of vocal dysfunction and bronchial asthma is different. An early fold diagnosis of vocal dysfunction can prevent improper treatment and, therefore, minimize the rising costs of health care.

Next-generation apparatus for monitoring the neutron flux (NFMA) has been developed for use in the generation-3+ reactor installations of project NPP-2006. The apparatus is a component of the control and protection system in the power generating units of Novovoronezh NPP-2. Technical and algorithmic innovations making the apparatus more competitive relative to world analogs, including from the standpoint of safety, reliability, diagnostics, convenience of service, and methodological characteristics, are used. The apparatus was put into commercial operation in the No. 1 unit of Novovoronezh NPP-2. The basic principles of the NFMA design are presented, innovative and conservative (conventional) solutions adopted in the development of the apparatus are described, and the results of physical measurements performed in the course of the startup procedures are presented.

The article is devoted to the actual problem of clinical allergy – diagnosis and treatment of allergic rhinitis (AR). The article highlights the issues of prevalence of AR, discusses classification, etiology, pathogenesis of the disease. Detailed discussion of approaches to its diagnosis and treatment, depending on the severity of AP and the presence of comorbidities. The mechanism of action of the drug desloratadine – non-sedating, long-acting antihistamine that has high affinity for H1-receptors. On the basis of a number of studies have shown that desloratadine is highly effective in relieving the symptoms of allergic rhinitis, is well tolerated and improves the quality of life of patients.

The goal is to develop a system model necessary for structuring the subject area, decomposing the functions performed by a web application; formalize the design methods, determine the general method of synthesizing Internet-oriented information systems. The main part of the development is the creation of a model, which components will be the objects of the domain, while attention should be paid to balance - the flexibility of the model and the development costs, taking into account the possibility of reuse. Too flexible components will have too many properties and will be difficult to customize adjust. On the contrary, models that implement too particular situation will be useless in terms of reuse, and, perhaps, the cost of its implementation will not make sense. For a more complete understanding of the functions and requirements for data processing, it is necessary to identify the main objects of the domain, information flows, logical connections, as well as rules and restrictions when working with data. The result of building a model should be a DBMS-independent data schema (metadata) corresponding to the internal data structure of the Web application, focused on the implementation of the required functions when interfacing with the user.

The calculation of safety parameters was carried out in the process of upgrading the fuel-handling machine (FHM) of the Novovoronezh nuclear power plant (NPP) unit no. 5 based on the results of quantitative safety analysis of nuclear fuel transfer operations using a dynamic logical-and-probabilistic model of the processing procedure. Specific engineering and design concepts that made it possible to reduce the probability of damaging the fuel assemblies (FAs) when performing various technological operations by an order of magnitude and introduce more flexible algorithms into the modernized FHM control system were developed. The results of pilot operation during two refueling campaigns prove that the total reactor shutdown time is lowered.

Background. To study the efficacy and safety of inhaled form of ruzam in adult patients with persistent mild and moderate atopic bronchial asthma (ba). Materials and methods. a placebo-controlled prospective, randomized, open label study of an efficacy of ruzam a solution for inhalations (in bottles on 2,5 or 5 ml) on 2,5 ml onсe a day through nebulizer during 2 weeks was conducted in adult asthmatic patients. The efficacy of therapy was evaluated by dynamics of symptoms and requirement in ƒ2-agonists, besides PEfr, spirometry, bronchial hyperresponsiveness (bhr), asthma control test (aCT ), level of the markers of the allergic inflammation were performed. Results. reduction of bа symptoms, increase morning PEfr, decrease of bhr and NОex level in patients who received ruzam compared with control group was observed. achievement of clinical control of bа in patients treated by ruzam was accompanied by statistically significant positive dynamics of markers of inflammation (ifNg, ECP) in blood serum and in supernatant of the induced sputum. it testifies about anti-inflammatory influence of ruzam. Conclusion. inhaled therapy with ruzam in a complex with iNCs basic therapy is an effective and safe method of treatment of persistent atopic bronchial asthma. This combination allows to reach clinical and functional control of ba faster and to reduce inflammation markers in blood serum and induced sputum.

Equations are derived for determining the key parameters of piston compressor of heat pump operating in off-design conditions. Upon diminution of dryness of the working medium to x = 0.4–0.6, the delivery coefficient and rated (indicated) efficiency of the compressor diminish by 25–35% and the power input for driving the compressor rises 2–2.4 times.

Different ways of increasing gas turbine power at high temperatures of ambient air are analysed.

Analysis of refrigerant influence on heat pump performance is given in this paper. Advantages of alternative refrigerants are shown.

Procedure is presented for studying the coefficient of biological tissue absorption of radiation with the wavelength lambda = 1.06 mkm. The absorption coefficient is determined by the temperature values of biological tissue experimentally measured with thermopairs. The coherent radiation current falls on the surface of biological tissue. A mathematical model is formulated for biological tissue heating with radiation. Solution of Furier equation obtained by means of Green function is given. Using the relationship found, the energy absorbed by the biological tissue was calculated and the absorption coefficient of radiation with lambda - 1.06 mkm was determined. The results were analysed and the error of the obtained values of absorption coefficients of biological tissues under study were determined.