40 research outputs found
ΠΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ Π²Π΅Π½ΠΎΠ·Π½ΡΡ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ COVID-19
Background The main method for preventing thrombotic complications in patients with coronavirus infection is anticoagulant therapy (ACT). However, its use is not always possible, in particular in patients with bleeding. The only method of prevention in this case is elastic compression (EC) of the lower extremities.Aim of study To evaluate the effectiveness of lower extremity EC for the prevention of venous thromboembolic complications (VTEC) in patients with a new coronavirus infection.Material and methods The study was approved by the local Ethics Committee of the Ryazan State Medical University of the Ministry of Health of Russian Federation and registered on the ClinicalTrials.gov platform (identifier NCT05143567). The study included 69 patients without prophylactic compression (Group 1) and 65 patients who used prophylactic compression stockings (Group 2). The patients were treated in the covid hospital from July to November 2021. All patients had verified coronavirus infection, they took ACT and underwent ultrasound duplex scanning of the veins of the lower extremities upon admission, in the intensive care unit and upon discharge. We assessed the frequency of venous thromboembolic complications (VTEC), hemorrhagic complications, and mortality. To assess the severity of bleeding, the classification of the Committee of the International Society on Thrombosis and Haemostasis (ISTH) was used.Results In patients without prophylactic compression (Group 1) there were 7 VTEC cases (10.14%); deep vein thrombosis (DVT) β 4 (5.8%), pulmonary embolism (PE) β 3 (4.3%). All 6 cases (8.7%) with PE were fatal. It was noted that 2 cases of PE (2.8%) were verified upon autopsy, and not clinically. In patients of the 2nd group with the use of elastic compression, the overall incidence of VTEC was only one case (1.6%). When analyzing the frequency of bleeding in the 1st group, there was one pulmonary bleeding (1.4%), in the 2nd group there was also one case of intense intermuscular hematoma (1.6%). Significant bleeding was observed in one patient (1.4%) of the 1st group, and in 3 (4.8%) cases of the 2nd group. The minor bleeding was observed in 11 patients (15.9%) of the 1st group, and in 8 (12.7%) patients of the 2nd group. The mortality during hospitalization was 11 (15.9%) cases in patients of the 1st group (without EC) and 7 (11.1%) in patients of the 2nd group (with EC) (p=0.419).Conclusions The mortality in patients with coronavirus infection without compression therapy is higher than in patients with compression stockings (p=0.419). Patients wearing compression stockings in the hospital had a low incidence of VTEC (1.6% of cases in group 2 versus 10.14% of cases in group 1, p=0.039). The study groups had the same frequency of bleeding (group 1 β one case (1.4%), group 2 β one case (1.6%). The use of preventive compression at the inpatient stage of treatment of a new coronavirus infection makes it possible to prevent VTEC in patients with bleeding when anticoagulant therapy is not possible.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ ΠΡΠ½ΠΎΠ²Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ ΡΠ²Π»ΡΠ΅ΡΡΡ Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»ΡΠ½ΡΠ½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ (ΠΠΠ’). ΠΠ΄Π½Π°ΠΊΠΎ ΠΈ Π΅Π΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π½Π΅ Π²ΡΠ΅Π³Π΄Π° Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ, Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡΠΌΠΈ. ΠΠ΄ΠΈΠ½ΡΡΠ²Π΅Π½Π½ΡΠΌ ΡΠΏΠΎΡΠΎΠ±ΠΎΠΌ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ Π² Π΄Π°Π½Π½ΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΡ (ΠΠ) Π½ΠΈΠΆΠ½ΠΈΡ
ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠ΅ΠΉ.Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ ΠΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΠ Π½ΠΈΠΆΠ½ΠΈΡ
ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠ΅ΠΉ Π² ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ Π²Π΅Π½ΠΎΠ·Π½ΡΡ
ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ (ΠΠ’ΠΠ) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΠ΄ΠΎΠ±ΡΠ΅Π½ΠΎ Π»ΠΎΠΊΠ°Π»ΡΠ½ΡΠΌ ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΊΠΎΠΌΠΈΡΠ΅ΡΠΎΠΌ Π€ΠΠΠΠ£ ΠΠ Π ΡΠ·ΠΠΠ£ ΠΠΈΠ½Π·Π΄ΡΠ°Π²Π° Π ΠΎΡΡΠΈΠΈ ΠΈ Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ Π½Π° ΠΏΠ»Π°ΡΡΠΎΡΠΌΠ΅ ClinicalTrials.gov (ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΠΊΠ°ΡΠΎΡ NCT05143567). Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 69 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±Π΅Π· ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΡΠΈΠΊΠΎΡΠ°ΠΆΠ° (1-Ρ Π³ΡΡΠΏΠΏΠ°) ΠΈ 65 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΡΡ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΎΠ½Π½ΡΠΉ ΡΡΠΈΠΊΠΎΡΠ°ΠΆ (2-Ρ Π³ΡΡΠΏΠΏΠ°). ΠΠΎΠ»ΡΠ½ΡΠ΅ ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠ»ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π² ΠΊΠΎΠ²ΠΈΠ΄Π½ΠΎΠΌ Π³ΠΎΡΠΏΠΈΡΠ°Π»Π΅ Ρ ΠΈΡΠ»Ρ ΠΏΠΎ Π½ΠΎΡΠ±ΡΡ 2021 Π³. ΠΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Π±ΡΠ»ΠΈ Ρ Π²Π΅ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ, ΠΈΠΌ Π½Π°Π·Π½Π°ΡΠ°Π»ΠΈ ΠΠΠ’ ΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ Π΄ΡΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ΅ ΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π²Π΅Π½ Π½ΠΈΠΆΠ½ΠΈΡ
ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠ΅ΠΉ ΠΏΡΠΈ ΠΏΠΎΡΡΡΠΏΠ»Π΅Π½ΠΈΠΈ, Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΈ ΠΈ ΠΏΡΠΈ Π²ΡΠΏΠΈΡΠΊΠ΅. ΠΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ ΡΠ°ΡΡΠΎΡΡ Π²Π΅Π½ΠΎΠ·Π½ΡΡ
ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ (ΠΠ’ΠΠ), Π³Π΅ΠΌΠΎΡΡΠ°Π³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ, Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΠΆΠ΅ΡΡΠΈ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΠΠΎΠΌΠΈΡΠ΅ΡΠ° ΠΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ΅ΡΡΠ²Π° ΠΏΠΎ ΡΡΠΎΠΌΠ±ΠΎΠ·Ρ ΠΈ Π³Π΅ΠΌΠΎΡΡΠ°Π·Ρ (International Society on Thrombosis and Haemostasis, ISTH).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±Π΅Π· ΡΡΠΈΠΊΠΎΡΠ°ΠΆΠ° (1-Ρ Π³ΡΡΠΏΠΏΠ°) ΠΠ’ΠΠ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 7 ΡΠ»ΡΡΠ°Π΅Π² (10,14%); ΡΡΠΎΠΌΠ±ΠΎΠ· Π³Π»ΡΠ±ΠΎΠΊΠΈΡ
Π²Π΅Π½ (Π’ΠΠ) β 4 (5,8%), ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΡ Π»Π΅Π³ΠΎΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ (Π’ΠΠΠ) β 3 (4,3%). ΠΡΠ΅ 6 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (8,7%) Ρ Π’ΠΠΠ β ΡΠΎ ΡΠΌΠ΅ΡΡΠ΅Π»ΡΠ½ΡΠΌ ΠΈΡΡ
ΠΎΠ΄ΠΎΠΌ. ΠΡΠΌΠ΅ΡΠ΅Π½ΠΎ, ΡΡΠΎ 2 ΡΠ»ΡΡΠ°Ρ Π’ΠΠΠ (2,8%) Π±ΡΠ»ΠΈ Π²Π΅ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Ρ Π½Π° Π°ΡΡΠΎΠΏΡΠΈΠΈ, Π° Π½Π΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ.Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² 2-ΠΉ Π³ΡΡΠΏΠΏΡ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΈ ΠΎΠ±ΡΠ°Ρ ΡΠ°ΡΡΠΎΡΠ° ΠΠ’ΠΠ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° Π²ΡΠ΅Π³ΠΎ ΠΎΠ΄ΠΈΠ½ ΡΠ»ΡΡΠ°ΠΉ (1,6%). ΠΡΠΈ Π°Π½Π°Π»ΠΈΠ·Π΅ ΡΠ°ΡΡΠΎΡΡ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΉ Π² 1-ΠΉ Π³ΡΡΠΏΠΏΠ΅ Π±ΡΠ»ΠΎ ΠΎΠ΄Π½ΠΎ Π»Π΅Π³ΠΎΡΠ½ΠΎΠ΅ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠ΅ (1,4%), Π²ΠΎ 2-ΠΉ Π³ΡΡΠΏΠΏΠ΅ ΡΠ°ΠΊΠΆΠ΅ ΠΎΠ΄ΠΈΠ½ ΡΠ»ΡΡΠ°ΠΉ Π½Π°ΠΏΡΡΠΆΠ΅Π½Π½ΠΎΠΉ ΠΌΠ΅ΠΆΠΌΡΡΠ΅ΡΠ½ΠΎΠΉ Π³Π΅ΠΌΠ°ΡΠΎΠΌΡ (1,6%). ΠΠ½Π°ΡΠΈΠΌΡΠ΅ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ Π² 1-ΠΉ Π³ΡΡΠΏΠΏΠ΅ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈΡΡ Ρ ΠΎΠ΄Π½ΠΎΠ³ΠΎ Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ (1,4%), Π° Π²ΠΎ 2-ΠΉ Π³ΡΡΠΏΠΏΠ΅ β Ρ 3 (4,8%). ΠΠ°Π»ΡΠ΅ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ Π² 1-ΠΉ Π³ΡΡΠΏΠΏΠ΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½Ρ Ρ 11 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (15,9%), Π²ΠΎ 2-ΠΉ Π³ΡΡΠΏΠΏΠ΅ β Ρ 8 (12,7%). ΠΠ΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ Π²ΠΎ Π²ΡΠ΅ΠΌΡ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² 1-ΠΉ Π³ΡΡΠΏΠΏΡ (Π±Π΅Π· ΠΠ) ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 11 Π±ΠΎΠ»ΡΠ½ΡΡ
(15,9%) , Π²ΠΎ 2-ΠΉ Π³ΡΡΠΏΠΏΠ΅ (Ρ ΠΠ) β 7 (11,1%) (Ρ=0,419).ΠΡΠ²ΠΎΠ΄Ρ ΠΠ΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ Π±Π΅Π· ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π²ΡΡΠ΅, ΡΠ΅ΠΌ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΡΡΠΈΠΊΠΎΡΠ°ΠΆΠ° (Ρ=0,419). Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π½ΠΎΡΠΈΠ²ΡΠΈΡ
ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠΎΠ½Π½ΡΠ΅ ΡΡΠ»ΠΊΠΈ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅, ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Π° Π½ΠΈΠ·ΠΊΠ°Ρ ΡΠ°ΡΡΠΎΡΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ’ΠΠ (1,6% ΡΠ»ΡΡΠ°Π΅Π² Π²ΠΎ 2-ΠΉ Π³ΡΡΠΏΠΏΠ΅ ΠΏΡΠΎΡΠΈΠ² 10,14% ΡΠ»ΡΡΠ°Π΅Π² Π² 1-ΠΉ Π³ΡΡΠΏΠΏΠ΅, Ρ=0,039). Π ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π±ΡΠ»Π° ΠΎΠ΄ΠΈΠ½Π°ΠΊΠΎΠ²Π°Ρ ΡΠ°ΡΡΠΎΡΠ° Π±ΠΎΠ»ΡΡΠΈΡ
ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΉ (1-Ρ Π³ΡΡΠΏΠΏΠ° β ΠΎΠ΄ΠΈΠ½ ΡΠ»ΡΡΠ°ΠΉ (1,4%), 2-Ρ Π³ΡΡΠΏΠΏΠ° β ΠΎΠ΄ΠΈΠ½ (1,6%) ΡΠ»ΡΡΠ°ΠΉ). ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΡΠΈΠΊΠΎΡΠ°ΠΆΠ° Π½Π° ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠΌ ΡΡΠ°ΠΏΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π²ΡΠΏΠΎΠ»Π½ΡΡΡ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΡ ΠΠ’ΠΠ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡΠΌΠΈ ΠΏΡΠΈ Π½Π΅Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»ΡΠ½ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
Stress State at the Vertex of a Composite Wedge, One Side of Which Slides Without Friction Along a Rigid Surface
Results, meta-analysis and a first evaluation of UNOxR, the urinary nitrate-to-nitrite molar ratio, as a measure of nitrite reabsorption in experimental and clinical settings
Diabetes mellitus: pathophysiological changes and therap
Costs and Benefits of Labour Mobility between the EU and the Eastern Partnership Partner Countries - Country Report: Armenia
ΠΠΏΠ»ΠΈΠ² ΠΠ’ ΡΠ΅ΠΊΡΠΎΡΡ Π½Π° Π΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΡ ΠΊΡΠ°ΡΠ½ΠΈ: ΠΏΡΠΈΠΊΠ»Π°Π΄ ΠΡΡΠΌΠ΅Π½ΡΡ
Π£ ΡΡΠ°ΡΡΡ Π΄ΠΎΡΠ»ΡΠ΄ΠΆΠ΅Π½ΠΎ Π²ΠΏΠ»ΠΈΠ² ΡΠ½ΡΠΎΡΠΌΠ°ΡΡΠΉΠ½ΠΈΡ
Ρ ΡΠ΅Π»Π΅ΠΊΠΎΠΌΡΠ½ΡΠΊΠ°ΡΡΠΉΠ½ΠΈΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΡΠΉ (ΠΠΠ’) Π½Π° Π΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΡ ΠΡΡΠΌΠ΅Π½ΡΡ, Π·Π΄ΡΠΉΡΠ½Π΅Π½ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ· ΡΡ ΠΏΠΎΠ΄Π°Π»ΡΡΠΎΠ³ΠΎ ΡΠΎΠ·Π²ΠΈΡΠΊΡ Π½Π° ΠΎΡΠ½ΠΎΠ²Ρ Π΄ΠΎΡΠ²ΡΠ΄Ρ ΠΊΡΠ°ΡΠ½-Π»ΡΠ΄Π΅ΡΡΠ² Ρ Π³Π°Π»ΡΠ·Ρ ΠΠΠ’. Π ΠΌΠ΅ΡΠΎΡ ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΠ·Π°ΡΡΡ Π΅ΠΊΠΎΠ½ΠΎΠΌΡΡΠ½ΠΈΡ
, ΠΏΠΎΠ»ΡΡΠΈΡΠ½ΠΈΡ
Ρ ΡΠΎΡΡΠ°Π»ΡΠ½ΠΈΡ
ΠΏΠ΅ΡΠ΅Π²Π°Π³ ΡΠΎΠ·Π²ΠΈΡΠΊΡ ΠΠΠ’ Π°Π²ΡΠΎΡΠΈ ΠΏΡΠΎΠ°Π½Π°Π»ΡΠ·ΡΠ²Π°Π»ΠΈ Π΄ΠΎΡΠ²ΡΠ΄ ΠΊΡΠ°ΡΠ½-Π»ΡΠ΄Π΅ΡΡΠ² Ρ ΠΠ’ ΡΠ΅ΠΊΡΠΎΡΡ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡΠ² Π°Π½Π°Π»ΡΠ·Ρ ΡΠ΅Π½Π΄Π΅Π½ΡΡΠΉ ΡΠΎΠ·Π²ΠΈΡΠΊΡ Π΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΠΈ ΠΡΡΠΌΠ΅Π½ΡΡ Π°Π²ΡΠΎΡΠΈ ΡΡΠΎΡΠΌΡΠ²Π°Π»ΠΈ ΠΎΡΠ½ΠΎΠ²Π½Ρ ΠΏΠ΅ΡΠ΅Π΄ΡΠΌΠΎΠ²ΠΈ ΡΡ ΠΏΠ΅ΡΠ΅ΠΎΡΡΡΠ½ΡΠ°ΡΡΡ Π· ΡΡΠ°Ρ
ΡΠ²Π°Π½Π½ΡΠΌ Π½Π°ΡΠ²Π½ΠΈΡ
ΡΠ° ΠΌΠΎΠΆΠ»ΠΈΠ²ΠΈΡ
ΠΏΠ΅ΡΠ΅Π²Π°Π³ Π²ΡΠ΄ ΠΏΠΎΡΠΈΡΠ΅Π½Π½Ρ ΠΠΠ’. Π£ ΡΡΠ°ΡΡΡ ΠΏΡΠ΄ΠΊΡΠ΅ΡΠ»ΡΡΡΡΡΡ, ΡΠΎ ΡΠ²ΡΡΠΎΠ²Π° Π΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΠ° ΠΏΠ΅ΡΠ΅Ρ
ΠΎΠ΄ΠΈΡΡ Π²ΡΠ΄ ΡΠ½Π΄ΡΡΡΡΡΠ°Π»ΡΠ½ΠΎΡ Π΄ΠΎ ΡΠ½ΡΠΎΡΠΌΠ°ΡΡΠΉΠ½ΠΎΡ (Π·Π°ΡΠ½ΠΎΠ²Π°Π½ΠΎΡ Π½Π° Π·Π½Π°Π½Π½ΡΡ
) Π΅ΠΏΠΎΡ
ΠΈ, Π΄Π΅ ΠΠΠ’ ΡΡΠ°ΡΡΡ Π½Π°ΠΉΠ³ΠΎΠ»ΠΎΠ²Π½ΡΡΠΈΠΌΠΈ ΡΠ΅ΡΡΡΡΠ°ΠΌΠΈ Ρ ΠΏΠΎΡΡΠ²Π½ΡΠ½Π½Ρ Π· ΡΠΎΠ±ΠΎΡΠΎΡ ΡΠΈΠ»ΠΎΡ Ρ ΠΊΠ°ΠΏΡΡΠ°Π»ΠΎΠΌ. ΠΠ΅ΡΠΎΡ ΡΡΠ°ΡΡΡ Ρ Π°Π½Π°Π»ΡΠ· ΠΎΠ±'ΡΠΊΡΠΈΠ²Π½ΠΈΡ
Ρ ΡΡΠ±'ΡΠΊΡΠΈΠ²Π½ΠΈΡ
Π΅ΠΊΠΎΠ½ΠΎΠΌΡΡΠ½ΠΈΡ
Ρ ΠΏΠΎΠ»ΡΡΠΈΡΠ½ΠΈΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΠΡΡΠΌΠ΅Π½ΡΡ, Π° ΡΠ°ΠΊΠΎΠΆ ΠΎΡΡΠ½ΠΊΠ° ΠΏΠΎΡΠ΅Π½ΡΡΠ°Π»Ρ ΡΡ Π΅ΠΊΠΎΠ½ΠΎΠΌΡΡΠ½ΠΎΠ³ΠΎ ΡΠΎΠ·Π²ΠΈΡΠΊΡ, Π·Π°ΡΠ½ΠΎΠ²Π°Π½ΠΎΠ³ΠΎ Π½Π° ΡΠΎΠ·Π±ΡΠ΄ΠΎΠ²Ρ ΠΠΠ’. ΠΠ° ΠΎΡΠ½ΠΎΠ²Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡΠ² Π΄ΠΎΡΠ»ΡΠ΄ΠΆΠ΅Π½Π½Ρ Π°Π²ΡΠΎΡΠ°ΠΌΠΈ Π±ΡΠ»ΠΎ ΡΡΠΎΡΠΌΠΎΠ²Π°Π½ΠΎ ΡΠΈΡΡΠ΅ΠΌΡ ΠΏΠ΅ΡΡΠΎΡΠ΅ΡΠ³ΠΎΠ²ΠΈΡ
Π·Π°Ρ
ΠΎΠ΄ΡΠ² ΡΠ° ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΡΠΉ Π΄Π»Ρ ΠΎΡΠ³Π°Π½ΡΠ² Π²Π»Π°Π΄ΠΈ ΠΏΠΎ ΡΠΎΠ·Π±ΡΠ΄ΠΎΠ²Ρ ΠΠΠ’ Π· ΠΌΠ΅ΡΠΎΡ Π·Π°Π±Π΅Π·ΠΏΠ΅ΡΠ΅Π½Π½Ρ ΡΡΠ°Π±ΡΠ»ΡΠ½ΠΎΠ³ΠΎ Π΅ΠΊΠΎΠ½ΠΎΠΌΡΡΠ½ΠΎΠ³ΠΎ Π·ΡΠΎΡΡΠ°Π½Π½Ρ ΠΊΡΠ°ΡΠ½ΠΈ. ΠΡΠΈ ΡΡΠΎΠΌΡ Π²ΠΈΠΎΠΊΡΠ΅ΠΌΠ»Π΅Π½ΠΎ ΠΎΡΠ½ΠΎΠ²Π½Ρ ΠΏΡΠΈΠ½ΡΠΈΠΏΠΈ ΡΠΎΠ·Π²ΠΈΡΠΊΡ ΠΠΠ’, ΡΠΊΡ ΠΌΠ°ΡΡΡ Π±ΡΡΠΈ Π·Π°ΡΠ½ΠΎΠ²Π°Π½Ρ Π½Π° ΠΏΡΠ΄Ρ
ΠΎΠ΄Π°Ρ
ΡΠΈΠ½ΠΊΠΎΠ²ΠΎΠ³ΠΎ ΡΠΏΡΠ²ΡΠΎΠ±ΡΡΠ½ΠΈΡΡΠ²Π° ΠΌΡΠΆ Π΄Π΅ΡΠΆΠ°Π²Π½ΠΈΠΌΠΈ Ρ ΠΏΡΠΈΠ²Π°ΡΠ½ΠΈΠΌΠΈ Π½Π°ΡΠΊΠΎΠ²ΠΎ-Π΄ΠΎΡΠ»ΡΠ΄Π½ΠΈΠΌΠΈ ΡΠ΅Π½ΡΡΠ°ΠΌΠΈ ΠΊΡΠ°ΡΠ½ΠΈ, Π· ΠΌΠ΅ΡΠΎΡ ΠΏΡΠ΄Π²ΠΈΡΠ΅Π½Π½Ρ Π΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π²ΠΏΡΠΎΠ²Π°Π΄ΠΆΠ΅Π½Π½Ρ ΡΠ½Π½ΠΎΠ²Π°ΡΡΠΉ Ρ Π³Π°Π»ΡΠ·Ρ ΠΠΠ’. ΠΠΈΠΊΠΎΡΠΈΡΡΠΎΠ²ΡΡΡΠΈ Π΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΠΎ-ΡΡΠ°ΡΠΈΡΡΠΈΡΠ½Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈ, Π°Π²ΡΠΎΡΠΈ ΠΎΡΡΠ½ΠΈΠ»ΠΈ Π²Π·Π°ΡΠΌΠΎΠ·Π²βΡΠ·ΠΎΠΊ ΠΌΡΠΆ Π΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡΡΡ ΡΡΠ½ΠΊΡΡΠΎΠ½ΡΠ²Π°Π½Π½Ρ ΠΠΠ’ ΡΠ° Π΅ΠΊΠΎΠ½ΠΎΠΌΡΡΠ½ΠΈΠΌ Π·ΡΠΎΡΡΠ°Π½Π½ΡΠΌ ΠΊΡΠ°ΡΠ½ΠΈ. ΠΠ²ΡΠΎΡΠΈ ΠΏΡΠ΄ΠΊΡΠ΅ΡΠ»ΡΡΡΡ, ΡΠΎ Π²ΠΏΠ»ΠΈΠ² ΠΠΠ’ Π½Π° Π΅ΠΊΠΎΠ½ΠΎΠΌΡΠΊΡ ΠΊΡΠ°ΡΠ½ΠΈ Π²ΡΠ΄ΡΡΠ²Π°ΡΡΡΡΡ ΡΠΊ Π½Π° ΠΌΠ°ΠΊΡΠΎ-,
ΡΠ°ΠΊ Ρ ΠΌΠ°ΠΊΡΠΎΡΡΠ²Π½ΡΡ
: Π²ΠΎΠ½ΠΈ Π²ΠΏΠ»ΠΈΠ²Π°ΡΡΡ Π½Π° ΠΏΡΠΎΡΠ΅Ρ ΠΎΡΡΠ½ΠΊΠΈ ΡΠ½ΡΠΎΡΠΌΠ°ΡΡΡ Ρ Π·Π½Π°Π½Ρ; Π°Π²ΡΠΎΠΌΠ°ΡΠΈΠ·ΡΡΡΡ ΡΠ° ΠΏΡΠΈΡΠΊΠΎΡΡΡΡΡ Π²ΠΈΡΠΎΠ±Π½ΠΈΡΡ ΡΠΈΠΊΠ»ΠΈ, Π·Π½ΠΈΠΆΡΡΡΡ Π²ΠΈΡΠΎΠ±Π½ΠΈΡΡ Π²ΠΈΡΡΠ°ΡΠΈ; Π²ΠΈΡΡΡΠΏΠ°ΡΡΡ Π½Π΅Π²ΡΠ΄βΡΠΌΠ½ΠΈΠΌ ΠΊΠΎΠΌΡΠ½ΡΠΊΠ°ΡΡΠΉΠ½ΠΈΠΌ ΡΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠΎΠΌ ΡΡΡΠΏΡΠ»ΡΡΡΠ²Π°, Π½Π΅ΡΡΡΠ΄ΠΎΠ²ΠΈΡ
ΠΎΡΠ³Π°Π½ΡΠ·Π°ΡΡΠΉ ΡΠ° ΠΏΡΠ΄ΠΏΡΠΈΡΠΌΡΡΠ².This article capitalizes possible impacts of ICT to the economy of Armenia with forecasts and distinction with ICT related succeeding several countries. It is introduced in article the current situation in Armenia and gives policy recommendations. Pointed in article, that the world economy is transforming from an industrial age to an
informational/knowledge based age, where the role of ICT is becoming increasingly powerful and vital compared to labor force and capital. The article aims to show that Armenia with its objective and subjective economic and political problems could become developed and wealthy with well-built ICT industry promoted strategy. Authors suggest the recommendations to the Government of Armenia needs in establishment of healthy operation of the political-economic body of the country based on market-oriented cooperation between public-private and research development centers/educational sectors of the country to better utilize the benefits of ICT industry. It is noticed in article, about the important role of several indicators that have been developed by international organizations and consulting companies to assess the correlation between ICT and economic growth as well as the major factors of ICT growth. Authors emphasis the impacts of ICT on a country are on both levels of the economy: macro and micro levels. On the macro level of national economy, ICT impacts the information and knowledge assessment process; speeds up and reduces the costs of production and transactions; and connects people, NGOs, enterprises, and communities. Bellow in article, is presented the cases of several countries for better illustration of the economic, political and social benefits of ICT industry growth. It is pointed that that the ICT industry has become the carrier of modern national economy
development: the country is better equipped, it would better benefit from the process taking place in the world market
P45 Impact of lymphoid infiltration of tumor on survival ofyoung patients with breast cancer
Prophylaxis of fibroids recurrence after conservative myomectomy in reproductive period
Conservative myomectomy is the unique treatment for women of reproductive period. Therefore it's very important to prevent recurrence of fibroids by individual antirecurrent treatment. Were examined 75 women, average age 32,4 Β± 3,1 years, duration disease (fibroids) 4,29Β±1,5 years (from 2 to 7 years). Initial diameter of fibroids 45,82Β±20,76 mm, after conservative myomectomy 16,55Β±2,56 ΠΌΠΌ. Number of fibroids /per woman 5,18Β±2,5. Pharmacotherapy were provided with agonists of GnRH agonists, intrauterine levonorgestrel containing the depot - the system, antiprogestins. No significant deferens of efficiency depended from type of pharmacotherapy was found: decreased of volume of uterus, number of fibroids nodes, diameter of dominant node
MANAGEMENT OF PREGNANCY AND LABOR IN MYOPIC PATIENTS
Aim. To study the course of pregnancy and labor in women suffering from myopia.Materials and methods. A comparative analysis of pregnancy outcomes among 100 women with myopia was held. There were 48 women in the study group who had a retinal laser correction within the period of pregnancy. The control group was represented by 52 women who did not undergo the correction.Results. We noted that the peripheral laser retinopexy made possible labor through natural birth canals for women of the study group. While the control group of women underwent abdominal delivery.Conclusion. The problem of myopia during pregnancy remains the focus of attention of obstetricians and ophthalmologists, since it is very important to choose the optimal method of delivery. In this case it is necessary to take into account not only the degree of myopia, but also the state of the retina. Peripheral vitreochorioretinal dystrophic changes (PVCDC) are indication for cesarean section. It was found that the timely use of LRP for retina makes possible reducing the percentage of surgical delivery, and thereby reduces the risk of post-surgery complications