Search

The purpose of the study was to assess the dependence of development of enteral nutrition intolerance on the disease form and condition severity during early AP with severe progression predictors. Materials and Methods. An open randomized controlled study has been carried out. The study included 64 patients, 31 of them having a severe and 33 — moderately severe forms of the disease. The criteria of enteral nutrition intolerance were: discharge via the nasogastric tube > 500ml simultaneously or > 500 ml/day, compared to the amount fed enterally over 24hrs; aggravation of pain; abdominal distension, diarrhea, nausea and vomiting. Indices possessing a predictive value were identified with the help of logit regression. The null hypothesis was rejected at pResults. The APACHE-II score (OR — 1.134, 95% CI: 1.068-1.2, p=0.01) and CPR concentration (OR — 1.006, 95% CI: 1.005-1.013, p=0.001) affect independently the development of a large gastric residual volume. The fact of surgery predicts large gastric residual volumes (OR — 1.821, 95% CI: 2.529-9.19, p=0.001), nausea and vomiting (OR — 2.077, 95% CI: 1.075-4.012, p=0.021). The SOFA score is associated with large gastric residual volumes (OR — 1.349, 95% CI: 1.18-1.539, p= 0.001), pain (OR — 1.203, 95% CI: 1.065-1.364, p= 0.003), nausea and vomiting (OR — 1.167, 95% CI: 1.028-1.324, p= 0.018). The moderately severe form is accompanied with a lower incidence of large gastric residual volumes (OR — 0.354, 95% CI: 0.201-0.611, p=0.001), pain (OR — 0.475, 95% CI: 0.284-0.795, p=0.004), nausea and vomiting (OR — 0.519, 95% CI: 0.304-0.888, p=0.018), and abdominal distension (OR — 0.342, 95% CI: 0.193-0.607, p=0.001). Conclusions. The development and severity of early enteral nutrition intolerance during early acute pancreatitis with severe progression predictors depend on the severity of condition (APACHE-II), extent of multiple organ dysfunction (SOFA), the fact of surgery, form of the disease, and C-reactive protein concentration. A combined use of independent factors increases their predictive value.

Polypous rhinosinusitis (PRS) is a hardly treatable disease due to the unknown etiology and recurrent course. Standard treatment regimens are aimed at removing polyps and reducing the activity of inflammation, while little attention is paid to pathogenesis factors such as oxidative stress and mucociliary insufficiency.To improve the combined treatment of PRS.The study involved 98 patients (50 people - the study group, 48 people - control group). The structure of the comorbid pathology of patients in the control group was selected so as to correspond to the pathology in the study group. Patients of both groups received combined treatment, including surgical treatment in accordance with the FESS principles, followed by the prescription of 200 mcg mometasone furoate in each half of the nose for 6 months. The treatment of patients of the study group also included the drug N-acetylcysteine - 3 ml (300 mg) in each maxillary sinus intrasurgicaly, then 600 mg orally in the morning after meals for 6 months. Survey methods included a questionnaire survey using the SNOT-22 questionnaire, the prevalence of the polypous process was assessed by endoscopy (Claus Bachert scale) and CT (Lund-Mackay scale), and mucociliary function was also evaluated by performing a saccharin test. The results were compared with each other before surgery and after 6, 12 and 24 months after surgery.Patients who have been taking N-acetylcysteine for a long time have a more pronounced and long-term improvement in their general condition (according to SNOT-22, an average by 1.7 times,Long-term use of N-acetylcysteine in PRS increases the effectiveness of surgical treatment, reduces the frequency of relapses, and also improves the general condition of patients.Полипозный риносинусит (ПРС) является трудноизлечимым заболеванием ввиду неизвестной этиологии и рецидивирующего течения. Стандартные схемы лечения направлены на удаление полипов и снижение активности воспаления, при этом мало внимания уделяется таким факторам патогенеза, как оксидативный стресс и мукоцилиарная недостаточность.Совершенствование комбинированного метода лечения ПРС.В исследовании приняли участие 98 пациентов (50 человек — опытная группа, 48 — контрольная группа). Структура коморбидной патологии пациентов основной группы была подобрана таким образом, чтобы соответствовать патологии в основной группе. Пациенты обеих групп получали комбинированное лечение, включающее хирургическое лечение в соответствии с принципами FESS с последующим назначением препарата мометазона фуроата по 200 мкг в каждую половину носа в течение 6 мес. В лечение пациентов опытной группы также был включен препарат N-ацетилцистеин — по 3 мл (300 мг) в каждую верхнечелюстную пазуху интраоперационно, затем по 600 мг перорально утром после еды в течение 6 мес. Методы обследования включали анкетирование по опроснику SNOT-22, распространенность полипозного процесса оценивалась по данным эндоскопии (шкала Claus Bachert) и КТ (шкала Lund—Mackay), также оценивалась мукоцилиарная функция путем проведения сахаринового теста. Результаты сравнивались между собой перед оперативным вмешательством и через 6, 12 и 24 мес после оперативного вмешательства.У пациентов, длительно принимавших N-ацетилцистеин, наблюдается более выраженное и долговременное улучшение общего состояния (по данным SNOT-22 — в среднем в 1,7 раза) по сравнению с пациентами контрольной группы. Также снижается частота рецидивов и повышается эффективность хирургического лечения (по шкале Lund—Mackey — 5,02 в опытной группе и 10,75 в контрольной; по данным С. Bachert — 1 балл и 3 балла соответственно).Длительное применение N-ацетилцистеина при ПРС повышает эффективность хирургического лечения, снижает частоту рецидивов, а также способствует улучшению общего состояния больных.

New data on the distribution of 37 species are reported. Eleven species are new to Russia: Lithurgus tibialis Morawitz, 1875, Anthidium spiniventre Friese, 1899, Icteranthidium ferrugineum (Fabricius, 1787), Hoplitis carinata (Stanek, 1969), Coelioxys acanthura (Illiger, 1806), C. decipiens (Spinola, 1838), Megachile albonotata Radoszkowski, 1886, M. pyrenaica (Lepeletier de Saint-Fargeau, 1841), M. burdigalensis Benoist, 1940, M. flavipes Spinola, 1838, and M. tecta Radoszkowski, 1888. Twenty species are new to the North Caucasus, five species are new to the south of the European part of Russia, and one species, Megachile leucomalla Gerstacker, 1869, is new to the North Caucasus and south of the European part of Russia; the latter species is also reported for the first time from Iran. Hoplitis ravouxi (Perez, 1902) is excluded from the list of the Russian fauna. A nest of H. carinata is described for the first time.

The effect of thermal annealing performed in the temperature range 400–800°С on the hydrolytic durability of borobasalt systems containing simulated radioactive waste from pyroelectrochemical technology was studied. Three types of simulated waste were examined: type 1, waste from reprocessing of reactor-grade plutonium; type 2, waste from reprocessing of weapons-grade plutonium; type 3, waste from gallium recovery from type 2 waste (virtually pure americium phosphate). Depending on the waste type and temperature, annealing can both increase and decrease the host material leach rate.

Objective – disclosure of the main advantages of prostate biopsy under the magnetic resonance imaging (MRI) control, consideration of technical aspects of its implementation. Materials and methods. Advances in multiparametric MRI have lead to improved detection of prostate tumors. The fusion of MRI data with transrectal ultrasound enables the targeted biopsy of suspicious areas. The results of fusion-biopsy were analyzed in 38 patients. The mean age of patients was 61.3 (44–70) years. All the patients underwent at least 1 transrectal prostate biopsies. The average number of biopsy cores was 24.3 (17–30), the average value of total prostate-specific antigen before saturation biopsy was 10,4 (0.20 to 34.16) ng/ml. Results . Prostate cancer was diagnosed in 52.7 % of cases (20/38). Better prostate cancer detectability during repeated saturation biopsy generally occurred due to the localized forms of the disease (93.3 %). Conclusion. Fusion biopsy allows prediction of a pathological stage of prostate cancer, Gleason grade of a tumor and its site localization with a greaterprobability. Most tumors detectable by saturation biopsy were clinically significant, which makes it possible to recommend fusion biopsy to some cohort of high prostate cancer risk patients.

A list of 208 digger-wasp species (Hymenoptera, Apoidea: Ampulicidae, Sphecidae, Crabronidae) from the Black Sea coast and adjacent areas within Krasnodar Territory, Abkhazia, and Adygea is given. Gorytes schmiedeknechti Handlirsch, 1888, Miscophus albufeirae Andrade, 1952, Psenulus fulvicornis (Schenck, 1857), and Passaloecus pictus Ribaut, 1952) are new to the Russian fauna, and 47 species are recorded for the first time from Abkhazia. Ectemnius guttatus (Vander Linden, 1829) does not occur in the Western Caucasus; the record of the species from this region was based on a misidentified female of E. lituratus Pz. Tachysphex gibbus Kohl, 1885, stat. n. is considered a distinct species based on its ecological and morphological features.

Borobasalt systems were studied as host materials for incorporation of radioactive waste from pyroelectrochemical technology. For all the examined compositions, the leach rates are of the order of 10–7 g cm–2 day–1, which is quite acceptable for radionuclide immobilization. The synthesis temperature ensuring formation of homogeneous glasses is about 1250°С for all the examined compositions. The host material is capable to incorporate up to 40 wt % phosphate wastes, which seems quite sufficient from the viewpoint of technology. The system is only weakly sensitive to variations of the boric anhydride content.

An electrolytic method for preparing chemically resistant Am–Ni alloys was studied. Optimum electrolysis conditions ensuring the maximal (up to 95%) recovery of Am from the electrolyte with the alloy formation were found. The compositions of the alloys formed in the process were determined.

The effect of thermal annealing on the resistance of borophosphate systems to crystallization and the effect of crystallization on the hydrolytic stability of the materials were examined. Systems containing simulated Cs + Sr fraction were studied. Annealing at 400–500°C leads to a noticeable decrease in the leach rate. Annealing at a higher temperature, 600°C, leads to crystallization of the glass and to a considerable increase in the leach rate.

The effect of thermal annealing on the resistance of borosilicate systems to crystallization and the effect of this process on the hydrolytic stability of the materials were examined. The systems containing REE + TUE and Cs + Sr fractions were studied. For borobasalt matrices containing the REE + TUE fraction, annealing in the temperature rangte 400–600°C leads to an appreciable decrease in the leach rate in water. For the borobasalt system containing waste components of the Cs + Sr fraction, changes in the leach rate upon thermal annealing are not clearly observed up to the annealing temperature of 600°C.

An electrolytic method for preparing chemically resistant Pm-Ni alloys was developed. Optimal electrolysis conditions ensuring maximal Pm recovery from the electrolyte (up to 95%) with the alloy formation were determined. Side steps of the process were examined. The main of them is reduction of Pm in the bulk of the electrolyte with alkali metal subions.

The kinetics of dissolution of stoichiometric uraninite (UO2) synthesized by electroreduction (electrolysis) of uranyl chloride in a melt of an eutectic mixture of alkali metal salts was studied. It follows from the results obtained that, in the initial step of uraninite dissolution under both dynamic and static conditions, schoepite is not an intermediate phase. It is formed, apparently, in the further steps by oxidation of uranium dioxide. The diffusion coefficients of uranium in solutions over uraninite and schoepite were determined. It was found that, at least in the initial step of the dissolution, the forming uranyl hydroxide occurs in the solution either in the dissociated state or in the form of mononuclear hydroxo complexes.

A significant nuclear-physical feature of boron-containing systems, distinguishing them from all other, except fluoride, systems, is considerable flux of fast neutrons generated by the (α,n) reaction on boron nuclei. The neutron flux generated on boron nuclei is higher by approximately an order of magnitude than that excited on nuclei of other components of the borobasalt matrix. The calculated and measured neutron flux values are well consistent. The neutron generation is mainly determined by the reaction of α-particles with O, Si, and Al nuclei and is thus characteristic of any aluminosilicate system.

The effect of crystallization induced by self-α-irradiation on the leaching with water of basalt-like matrices with the incorporated α-emitting radioactive waste components was studied. Both the total leaching and the leaching of particular radionuclides (Pu and Am) were studied. Although radiation-induced crystallization leads to a certain increase in the leach rate, the effect is observed within a short period. Generally the crystallization of boron-containing basalt-like systems does not significantly impair their hydrolytic stability.

The possibility of using intermetallic compounds or alloys of actinides with nickel for preparing matrices incorporating radioactive wastes was examined. Such intermetallic compounds or alloys are prepared by electrolytic deposition of a lanthanide or actinide from a melt of its salt in eutectic mixtures of alkali metal chlorides. The process is performed under the conditions when an actinide being reduced reacts with the cathode material to form a layer of an intermetallic compound. Based on the results of the physicochemical studies performed, an electrochemical process was developed for compacting highly radioactive toxic nuclides of Am, Pu, and REE in environmentally safe forms with high chemical, thermal, and radiation resistance: (a) in the form of alloys or intermetallic compounds containing up to 90 wt % radionuclide, with the leaching rate in water of 10−5–10−6 g cm−2 day−1; (b) in the form of layers of alloys or intermetallic compounds of the radionuclides on metal supports, with the radionuclide content of up to 80 wt % and leaching rate in water of ∼10−6–10−7 g cm−2 day−1.

The effect of thermal annealing on the resistance of borosilicate systems to crystallization and on the hydrolytic resistance of the materials was examined. The systems containing individual components of radioactive wastes of both REE + TUE and, for comparison, Cs + Sr fractions were examined. Under the experimental conditions (annealing temperature 800°C, time 100 h), the materials of all the examined compositions crystallize to certain extent. The matrices incorporating REE crystallize to the least extent. In all the cases, the crystalline phase contains mainly compounds of the component being incorporated and also Fe compounds. A distinctive feature of the matrices containing lanthanide oxide and of the boron-containing basalt matrix itself is increased resistance to leaching in water after annealing in the temperature range 400–500°C.

The effect of radiation-induced crystallization due to intrinsic α-irradiation on the water leaching of basalt-like matrices with immobilized α-emitting components of radioactive wastes was studied. Both total leaching and radionuclide (primarily, plutonium) leaching were measured. Although radiation crystallization resulted in some increase in the degree of leaching, this increase lies within the limits permitted for practical use of the test matrices.

The treatment of cicatrical stenosis of the trachea was performed in 193 patients at the age 8-65 years (132 of men and 61 women). The length of cicatrical stenosis shaped mainly by growth of granulation tissue and its different combinations consisted of 0.5 to 2.5 cm, getting 3.0 cm and more in 74 cases. The peculiar features of such cicatrical changes were characterized differently depending on its dominating localization on the length of the trachea--in the area of the neck or in the range of the mediastinum. Respiratory distresses, which were the main clinical manifestation of the disease, depended on the degree of stenisis of the trachea opening with the cicatrical process in each case. The decrease of size of the trachea opening with respect to natural size on 1/3 was considered as the first degree of stenosis, on 2/3 - II degree, more than on 2/3 - III degree. The efficiency of endoscopic methods of treatment was the most significant in cicatrical stenosis of trachea with the length not more than 0.5-1.5 cm and dramatically decreased with the increase of length. The cicatrical stenosis of trachea with the length more than 3.5-3.0 cm should be considered as the indication for radical surgical intervention such as resection and plasty of trachea with forming of intertracheal or laryngotracheal anastomosis.

Strict environmental regulations on emissions levels in combustion chambers of all kinds recently led to the development of various lean combustion concepts. One of the key problems in these systems is flame stabilization at equivalence ratii as low as 0.05-0.2. These conditions ensure very low NOx production rate, but at the same time require careful design of the burner, the combustion chamber and the flow pattern inside to provide stable flame attachment and combustion completeness.

Insufficiency of anastomosis is one of the main causes of peritonitis. Progressed cachexia due to great losses through intestinal fistulas in combination with peritonitis was the indication to jejunostoma creation. Jejunostomy by Middle in the treatment of postoperative peritonitis due to sutures insufficiency of upper anastomosis of gastrointestinal tract permits to optimize treatment: to realize adequate enteral nutrition, intestinal decompression, to return fistula's losses. Polyorganic insufficiency, number of repeated surgeries and volume of loss through fistulas influence results of the treatment. Respiratory distress-syndrome and errosive bleeding have the most prognostic significance among the syndromes of polyorganic insufficiency.