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According to current interpretations, tonal regulation of major arteries is determined by the degree of endothelial function. Shear stress influence on the vascular endothelium is an important part of vascular physiology. The aim of this study was to evaluate endothelial dysfunction, dependent up on the stage of spondylogenic vertebrobasilar insufficiency using the indicator ISD (systole-diastolic index) in young patients with degenerative-dystrophic lesions of cervical spine. Our results show that there is significant association between the status of the endothelial wall and hemodynamic changes (the growth of the systole-diastolic ratio leads to an increase in vasoconstriction factors in the blood). Raised ET-1 together with increase in ISD in patients with spondylogenic vertebrobasilar insufficiency reflects a hemodynamically dependent link to endothelial dysfunction.

Introduction: Recent outbreaks of syphilis occurred predominantly in men who have sex with men (MSM). A significant proportion of syphilis cases occur in MSM who had more than one episode of syphilis. This group may play an important role in syphilis transmission. Aim: To identify factors associated with the risk of syphilis reinfection. Material and methods: Forty-four MSM patients with the first episode of syphilis who were treated at the Department of Dermatology at the Jagiellonian University School of Medicine in Krakow, Poland were included in this study. After completing the treatment, the RPR testing was done every 3 months for 2 years in every patient. In the study period, we identified 12 (22%) cases of syphilis reinfection, eight of which were asymptomatic. Clinical, demographic and behavior data from patients with only one episode of syphilis were compared with those collected from repeaters. Results: Individuals with syphilis reinfection had concomitant HIV infection more frequently, reported a higher number of sexual partners and had sex in sex on premises venues more frequently (p < 0.05). In the multivariate analysis, we found that being HIV-infected MSM and having sex in sex on premises venues independently correlated with a higher risk of syphilis reinfection (OR = 9.6, 95% CI: 2.2-42.5 and OR = 5.6, 95% CI: 1.4-22.5, respectively). Conclusions: Results of our study highlight a strong need for frequent and repeated screening among MSM patients (especially those with concomitant HIV infection) with the first episode of syphilis and taking detailed patient’s history regarding also demographic and behavior data. We should also improve prevention policies to reduce risk behaviors in this population.

A children’s hospice is regarded not only as a specific place but as a multi-faceted program of care for terminally ill children and their families. Hospices take care of people in need, taking into consideration their physical, emotional, social, and also spiritual needs. Hospice workers deal with treating the painful symptoms of the disease, bringing relief and respite to families as well as support during both the time of dying and the period of mourning. The main aim of these institutions is to improve the quality of the last days of patients’ lives by providing not only professional and attentive medical care but also psychological, pastoral, spiritual, and social support. The article presents the premises of hospice work and compares the situation in this respect in Poland and Ukraine.

The role of illicit drug abuse in total joint arthroplasty is largely unknown and is likely underestimated. Patients with drug addictions often suffer from septic osteoarthritis or a necrosis of the femoral head. Purpose of the study was to evaluate the operative management and clinical outcome of total hip replacement in patients with a history of intravenous drug abuse. This retrospective study included 15 patients with a history of intravenous drug abuse who underwent total hip arthroplasty. A total of 6 females and 9 males with an average age of 34.3 years were identified. Ten patients presented an acute bacterial coxitis (Coxitis-group) and five an aseptic osteonecrosis of the femoral head (Osteonecrosis-group). Ten patients with a bacterial coxitis underwent a two-staged total hip arthroplasty (THA), with temporary insertion of a drug-eluting spacer. Five patients with a necrosis of the femoral head were primarily treated with THA. All patients developed multiple re-infections after insertion of a drug-eluting spacer or THA. Only two patients finally achieved a THA without infection in the period of 3.9 years follow-up. The other 13 patients underwent a Girdlestone arthroplasty (7 patients) or total joint replacement with a chronic fistula (6 patients). THA in patients with illicit drug abuse shows a low success rate. Following septic osteoarthritis or osteonecrosis in drug-addicted patients, we recommend a two-stage procedure with temporary insertion of a drug-eluting spacer. THA might follow only under strict premises.

Invasive micropapillary carcinoma of the breast is a histologic subtype of breast cancer and associated with high incidence of lymphovascular invasion, lymph node metastasis and poor prognosis. The aim of this prospective study was to investigate the impact of precise pathologic diagnosis and individualized treatment on the outcomes of invasive micropapillary carcinoma of the breast. The study group included 2299 women with invasive micropapillary carcinoma diagnosed at Tianjin Medical University Cancer Institute and Hospital between January 2004 and December 2015. In the study group, specimens were examined with the method of whole-specimen orientation and serial sectioning, and patients received precise pathological diagnosis and individualized treatment. The control group of invasive micropapillary carcinoma consisted of 163 cases, identified through a retrospectively review of 9056 invasive carcinomas diagnosed at our institution between January 1989 and December 2003 using the standard pathology-evaluation method (i.e., not using the whole-specimen orientation and serial-sectioning method). The clinicopathological features, treatments and outcomes were compared between the two groups. The incidence of invasive micropapillary carcinoma in the study group was 6% (2299/39,714 cases), significantly higher than that of the control group (2%; 163/9056 cases). The 5-year disease-free survival in the study group was significantly higher than that in the control group (83.8 vs.45.4%; p

Introduction. Derived from the medial cord of the brachial plexus, the ulnar nerve presents several areas of increased vulnerability from the topographic and clinical point of view: the olecranian area and hypotenar eminence in the Guyon canal. Despite the frequency of ulnar nerve injuries, affecting pinch and grip performance and the fine movements of the hand, diagnosis and rehabilitation are stil a chalenge. Objectives. Our work intends to make an update on the importance of the clinical and functional evaluation in ulnar nerve entrapment in different areas and also to highlight the effectiveness of early intervention of the rehabilitation program (in interdisciplinary context) and the role of orthosis in the management of ulnar nerve injury functional consequences. Materials and methods. Analysis of biomedical literature related to ulnar nerve injuries. Medical studies from the last ten years were searched in the PubMed, Google Scholar, Medscape, and Archives of Physical Medicine and Rehabilitation (ACRM) databases. Discussion. Orthosis in ulnar tunnel syndrome are applied with the elbow at 30°-70° flexion and the wrist in neutral position. In Guyon canal syndrome orthoses are applied with the immobilisation of the wrist in neutral position and with the fingers left free.

Following a cluster of serious pseudomonas skin infections linked to a body piercing and tattooing premises, a look-back exercise was carried out to offer clients a screen for blood-borne viruses. Of those attending for screening 72% (581/809) had a piercing procedure in the premises of interest: 94 (16%) were under 16 years of age at the time of screening. The most common site of piercing was ear (34%), followed by nose (27%), nipple (21%) and navel (21%). A small number (

Article is devoted to questions of definition of a legal regime of the premises acting as objects of the hereditary relations by the Russian legislation. In work the main signs of this object of hereditary legal relationship are considered. Definition of premises is formulated taking into account the revealed features.

Goal: to review new definitions and criteria of sepsis and septic shock by Society Critical Care Medicine (SCCM) and European Society Intensive Care Medicine (ESICM) in the light of evolving understanding of interaction between the contagium and the host, appearance of potential problems and possible clinical benefits for the practice. Results. Upon results of the review the conclusion has been made that the sepsis is to be considered not only as progressing system inflammation but given the diversity of the response – as life threatening regulation disorder of the host reaction (disregulation) to the infection with acute multi-organ dysfunction reflecting the tissue damage of the host. SOFA score is to be used as a diagnostic tool. The introduction of the new concept into routine practice is limited since it can be difficult to define the contribution of the infection into already existing dysfunction due to the presence of some chronic disorder, since doctors do not adhere to using scales of multi-organic failure severity and it is impossible to test blood lactate in numerous medical units. Introduction of new criteria into practice can be beneficial for the justification of the care provision in hospital due to the risk of the unfavorable outcome and with the purpose of targeted monitoring. Quick SOFA is to be used to detect patients with the suspicion of sepsis and developing life threatening conditions beyond premises the intensive care departments.

The article provides an overview of the drugs used for disinfection in poultry farming (perepelovodstve) and the results of using Hyponate-BPO for the prophylactic treatment of premises and cells intended for quail maintenance.

As a result of the tests, effective regimes and technology of aerosol disinfection of veterinary supervision by preparation Astradez Bioxy were developed. It was found that the aerosols of 8...10% of the preparation Astradez Bioxy disinfect the surfaces of the premises of the vivarium and poultry houses at consumption of 30 ml/m3 and an exposure of 6...24 hours. According to the results of the research, for veterinary practice, "Technology of disinfection of objects of veterinary and sanitary supervision with aerosols of the preparation "Astradez Bioxy" (approved by the RAS on 15.11.2016) was developed and approved by the RAS. The technology of aerosol disinfection was highly appreciated at the 19th Russian agroindustrial exhibition "Golden Autumn-2017", held in Moscow in VDNKh from October 4 to 7, 2017, was awarded a Diploma and a Gold Medal.

The number and composition of microscopic fungi in the air of the 5 University libraries, 2 classrooms and one hostel room were studied. The number of fungal diasporas in the air of two libraries exceeded the maximum permissible level (MPL – 500 KOE/m3) and was 581–966 KOE/m3. In summer, in the air of almost all the surveyed rooms, there was a higher abundance and a generic variety of microscopic fungi than in autumn. The mold complexes number and composition in the air of reading rooms and book depositories vary in different degrees and depend on the season, attendance of readers and the libraries sanitary condition. The abundance of microscopic fungi genera in the libraries air was higher than in the study rooms and the hostel room. It was shown that the microscopic fungi generic composition in the surveyed dwellings air has a small correspondence (the Jacquard coefficient is 0.05–0.41). In the libraries aeroplankton micromycetes of the Penicillium, Aspergillus genera and dark-colored fungi of the Alternaria genus dominated.

Aspergilli constitute a serious risk to the health of the inhabitants of infested rooms. Mycological analysis conducted in buildings infected with moulds in the area of the Lubuskie province (Poland) demonstrated the presence of 9 species of Aspergillus moulds: A. carbonarius A. clavatus, A. flavus, A. fumigatus, A. niger, A. ochraceus, A. terreus, A ustus and A. versicolor. The highest frequency (4 - frequently) was observed in the case of A. versicolor, while frequency 3 (fairly frequently) was characteristic of such species as A. flavus and A. niger. A. ustus was encountered with frequency 2 (individually), while frequency 1 (sporadically) referred to four species: A. carbonarius, A. clavatus, A. fumigatus and A. terreus. Because Aspergillus versicolor occurs with the highest frequency in buildings, and as a consequence of this, synthesizes toxic and carcinogenic sterigmatocystin (ST), it constitutes the greatest risk to the inhabitants of the infested premises. All species of Aspergillus present on building partitions are able to synthesise mycotoxins, are pathogens and may cause allergies.

Purpose. The article considers the practical features of forensic construction and technical examination of the premises damaged by the flood. Attention is paid to the composition of the documents required for the examination, and the necessary actions of an expert in the recovery of missing documents. The algorithm of actions of the expert in the research since the appointment of the examination until the expert report with case studies and examples. Methods. Used the method of field survey (expert inspection), as the most important phase of the examination. Displayed organizational difficulties, encountered by the experts during field survey, in particular the failure to provide the owner of the premises for inspection. Analyzed two alternatives for the calculation of replacement cost of repair of damaged areas on the flood: a resource method with the use of estimate standards and costs and the method of quantitative survey with the use of market prices for work and materials. Results and their discussions. General guidance relative to what you first need to pay attention to during the inspection. We point out the main types of damage to construction and finishing designs. An important quality of expert is the ability to distinguish between actual damage to the premises obtained in the bay, from the other defects formed due to the natural physical deterioration or received at the earlier bays. We separately touch the topic of notification of interested parties about the forthcoming expert inspection. Conclusions. Describes the requirements for devices and tools that the expert can use in the course of the examination. We pay attention to the issue of accounting when calculating the cost of repair of physical deterioration of materials

In residential and industrial premises, optimum conditions for human activity must be created. In areas without central heating supply, heating of a mobile living space is provided by solid fuel boilers. There may be fuel outages at a distance from an inhabited locality. Therefore, the purpose of the study is to create a heating system for a farmer’s house by using carbon-based fuel flexible materials and solar stations. Farmhouse heating system that heats mobile living quarters remote from power lines and communities through the use of carbon-based fuel flexible materials and solar stations is proposed by the authors. The technical result consists in that, in the claimed system, the heating device is a carbon-based fuel flexible material supplying electricity from the solar station. Carbon-based fuel flexible material is a thermal film (heating grid), which is made by interweaving longitudinal and transverse carbon filaments and, for safety reasons, covered with an electrical insulating material.

This paper presents a method of aerodynamic separation of supply-exhaust airflows in a supply and exhaust climate control unit for livestock facilities in order to minimize back suction. The air removed from livestock buildings contains a large amount of moisture, carbon dioxide, ammonia, hydrogen sulfide and other harmful gases and in mine units, the outlet and inlet openings are located close enough, which is why exhaust air can be sucked together with the supply air. The paper presents a set of measures to minimize back suction. In particular, the distance between the supply and exhaust openings is substantiated. Moreover, it was proposed to give an additional velocity to the exhaust air due to the energy of natural traction. In order to solve this problem, a nozzle with a convergence angle of 45 ° was installed at the outlet of the unit. The effectiveness of the proposed solution was tested experimentally and it was found that when the inlet and outlet openings were located at a distance of more than 0.5 m, as well as when the exhaust jet was given a velocity of 3 m / s, the amount of back suction did not exceed 5%.

The goal of education at the present stage is development of a person able to participate in intercultural communication in modern multicultural conditions. Based on this goal, modern education should be based on the principles of a multicultural approach to education that can serve as a response to the challenges of ethnic diversity. In order to more fully disclose the value of a multicultural approach to education, we need to examine its premises. In the article, the premises for a multicultural approach to education are analyzed. It is revealed that there are some pedagogical, philosophical, and psychological premises for it.

Chronic hepatitis B virus (HBV) flares or reactivations are serious causes of morbidity or mortality in rheumatologic patients undergoing immunosuppressive therapy. The recent insights in the pathogenesis of rheumatic diseases led to the use of new immunosuppressive therapies indicated in case of failure, partial response, or intolerance of conventional synthetic disease-modifying anti-rheumatic drugs. Based on these premises, this review examines and discusses the main rheumatologic treatments that could require the initiation of prophylactic treatment or close monitoring of occult HBV infection in patients beginning antiviral therapy at the first signs of HBV reactivation, or antiviral treatment in chronic HBV-infected patients. We searched for relevant studies published in the last five years. Studies suggested that the presence of HBV infection is common in rheumatic patients and HBV reactivation during these immunosuppressant treatments is quite frequent in these kinds of patients. Therefore, before starting an immunosuppressive therapy, patients should be screened for HBsAg, anti-HBs, and anti-HBc and, on the basis of markers positivity, they should be carefully characterized for HBV infection phases. In conclusion, screening of HBV infection in patients undergoing immunosuppressive therapy with subsequent HBV monitoring, prophylaxis or treatment consistently reduces the risk of clinical consequences.

Background Management of large numbers of reverse transcriptase-polymerase chain reactions (RT-PCR) for diagnosis of coronavirus 2019 disease (COVID-19) requires robust infrastructures, located in dedicated premises with a high standard of biosafety procedures, and well-trained personnel. The handling of a "run-of-river sample" to obtain rapid reporting of results is challenging. Methods We studied the clinical performance of the Idylla™ SARS-CoV-2 Test (index test) on a platform capable of fully automated nucleic acid testing including extraction, amplification, and detection in a single-use cartridge to establish the diagnosis of COVID-19. The study was conducted on a prospective cohort of 112 volunteers with recent symptoms and an unknown SARS-CoV-2 status who came to free screening centers of the Nice metropolitan area. All subjects underwent bilateral nasopharyngeal sampling. One sample was processed using the index test, the other using the standard of care RT-PCR. Samples were treated blind. Results Most of the participants (70%) were sampled within 4 days of symptom onset. Forty-five (40.2%) were positive for COVID-19. No clinical symptoms were distinguished between SARS-CoV-2 RT-PCR positive and negative subjects except anosmia and dysgeusia. Positive and negative agreement between the index and the standard of care test was 100%. Conclusions The Idylla™ SARS-CoV-2 Test is very sensitive, specific, rapid and easy to use in a near-patient RT-PCR approach to distinguish between symptomatic SARS-CoV-2 positive and negative patients in selected settings.