92 research outputs found
Visual Affect Around the World: A Large-scale Multilingual Visual Sentiment Ontology
Every culture and language is unique. Our work expressly focuses on the
uniqueness of culture and language in relation to human affect, specifically
sentiment and emotion semantics, and how they manifest in social multimedia. We
develop sets of sentiment- and emotion-polarized visual concepts by adapting
semantic structures called adjective-noun pairs, originally introduced by Borth
et al. (2013), but in a multilingual context. We propose a new
language-dependent method for automatic discovery of these adjective-noun
constructs. We show how this pipeline can be applied on a social multimedia
platform for the creation of a large-scale multilingual visual sentiment
concept ontology (MVSO). Unlike the flat structure in Borth et al. (2013), our
unified ontology is organized hierarchically by multilingual clusters of
visually detectable nouns and subclusters of emotionally biased versions of
these nouns. In addition, we present an image-based prediction task to show how
generalizable language-specific models are in a multilingual context. A new,
publicly available dataset of >15.6K sentiment-biased visual concepts across 12
languages with language-specific detector banks, >7.36M images and their
metadata is also released.Comment: 11 pages, to appear at ACM MM'1
Mass Varying Neutrinos, Quintessence, and the Accelerating Expansion of the Universe
We analyze the Mass Varying Neutrino (MaVaN) scenario. We consider a minimal
model of massless Dirac fermions coupled to a scalar field, mainly in the
framework of finite temperature quantum field theory. We demonstrate that the
mass equation we find has non-trivial solutions only for special classes of
potentials, and only within certain temperature intervals. We give most of our
results for the Ratra-Peebles Dark Energy (DE) potential. The thermal
(temporal) evolution of the model is analyzed. Following the time arrow, the
stable, metastable and unstable phases are predicted. The model predicts that
the present Universe is below its critical temperature and accelerates. At the
critical point the Universe undergoes a first-order phase transition from the
(meta)stable oscillatory regime to the unstable rolling regime of the DE field.
This conclusion agrees with the original idea of quintessence as a force making
the Universe roll towards its true vacuum with zero \Lambda-term. The present
MaVaN scenario is free from the coincidence problem, since both the DE density
and the neutrino mass are determined by the scale M of the potential. Choosing
M ~ 10^{-3} eV to match the present DE density, we can obtain the present
neutrino mass in the range m ~ 10^{-2}-1 eV and consistent estimates for other
parameters of the Universe.Comment: 29 pages, 7 figures. V. 3: Analysis of the dynamics of the Universe
and some refs. added; extended version to be published in PR
ΠΠ‘Π’Π ΠΠ― ΠΠ ΠΠΠΠΠΠΠ£ΠΠΠ§ΠΠΠΠΠ― ΠΠΠΠΠ‘Π’ΠΠ’ΠΠ§ΠΠΠ‘Π’Π¬
From the beginning of this century, clinicians started to pay more attention to the right ventricular dysfunction. It is related to the thorough studying of pathologies, during which the right ventricular dysfunction plays the key role, such as pulmonary hypertension, congenital heart disorders, andΒ thromboembolia of the pulmonary artery. Currently, it has been proved that acute right ventricular failure makes 3-9% of all acute heart failures, the hospital lethality in these clinical situations makes from 5 to 17%. The objective of the literature review is to provide anesthesiologists andΒ emergency physicians with information on modern approaches to diagnostics and treatment of acute right ventricular failure.The review presents data on normal anatomy and physiology of the right ventricle, morphological and functional changes when various forms ofΒ acute right ventricular failure develop. Diagnostics and comprehensive intensive care are described for the two most frequent types of acute right ventricular failure, which are reduction of right ventricular contractility and its overloading with afterload.ΠΠ°ΡΠ°Π»ΠΎ Π½Π°ΡΡΠΎΡΡΠ΅Π³ΠΎ ΡΡΠΎΠ»Π΅ΡΠΈΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΈΠ½ΡΠ΅ΡΠ΅ΡΠ° ΡΠΎ ΡΡΠΎΡΠΎΠ½Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠΈΡΡΠΎΠ² ΠΊ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ΅ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΡΠ°Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ°. Π‘Π²ΡΠ·Π°Π½ΠΎ ΡΡΠΎ Ρ Π³Π»ΡΠ±ΠΎΠΊΠΈΠΌ ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ, Π² ΡΠ΅ΡΠ΅Π½ΠΈΠΈ ΠΊΠΎΡΠΎΡΡΡ
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΏΡΠ°Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ° Π½ΠΎΡΡΡ ΠΊΠ»ΡΡΠ΅Π²ΡΡ ΡΠΎΠ»Ρ, ΡΠ°ΠΊΠΈΡ
ΠΊΠ°ΠΊ Π»Π΅Π³ΠΎΡΠ½Π°Ρ Π³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΡ, Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΠ΅ ΠΏΠΎΡΠΎΠΊΠΈ ΡΠ΅ΡΠ΄ΡΠ°, ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΡ Π»Π΅Π³ΠΎΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ. Π‘Π΅Π³ΠΎΠ΄Π½Ρ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΡΡΠ΅Π΄ΠΈ Π²ΡΠ΅Ρ
ΡΠ»ΡΡΠ°Π΅Π² ΠΎΡΡΡΠΎΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ Π½Π° Π΄ΠΎΠ»Ρ ΠΎΡΡΡΠΎΠΉ ΠΏΡΠ°Π²ΠΎΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΈΡ
ΠΎΠ΄ΠΈΡΡΡ 3β9%, Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½Π°Ρ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ Π² ΡΡΠΈΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΈΡΡΠ°ΡΠΈΡΡ
ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ ΠΎΡ 5 Π΄ΠΎ 17%. Π¦Π΅Π»Ρ ΠΎΠ±Π·ΠΎΡΠ° Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ β ΠΏΡΠ΅Π΄ΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΎΠ»ΠΎΠ³Π°ΠΌ-ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΎΠ»ΠΎΠ³Π°ΠΌ ΡΠ²Π΅Π΄Π΅Π½ΠΈΠΉ ΠΎ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π°Ρ
ΠΊ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΡΡΡΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΡΠ°Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ°.Π ΠΎΠ±Π·ΠΎΡΠ΅ ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΠΎΠΉ Π°Π½Π°ΡΠΎΠΌΠΈΠΈ ΠΈ ΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΡΠ°Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ°, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΎ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡΡ
ΠΏΡΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠΎΡΠΌ ΠΎΡΡΡΠΎΠΉ ΠΏΡΠ°Π²ΠΎΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ. ΠΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΈ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½Π°Ρ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ Π΄Π»Ρ Π΄Π²ΡΡ
Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΡ
ΡΠΈΠΏΠΎΠ² ΠΎΡΡΡΠΎΠΉ ΠΏΡΠ°Π²ΠΎΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠΎΠ²ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ β ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠΎΠΊΡΠ°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ ΠΏΡΠ°Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ° ΠΈ Π΅Π³ΠΎ ΠΏΠ΅ΡΠ΅Π³ΡΡΠ·ΠΊΠΈ ΠΏΠΎΡΡΠ½Π°Π³ΡΡΠ·ΠΊΠΎΠΉ
ΠΡΠ΅Π½ΠΊΠ° ΡΠΈΡΠΊΠ° ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ΠΌ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°
The aim of the study was to develop a risk model for upper gastrointestinal tract (GIT) bleeding in patients with brain injury of various etiologies.Material and methods. Case histories of 33 patients were included into a retrospective descriptive study: 22 patients had severe brain injury of various etiologies, and 11 patients after elective surgery for cerebral aneurisms with uneventful postop period were taken for comparison. The patients were grouped in two arms: Group 1 included patients with obvious signs of GIT bleeding (N=11) and Group 2 had no obvious signs of bleeding (N=22). Complaints, life and medical history, comorbidities, specialistsβ exams data, results of laboratory and instrumental examinations, therapeutic regimens were analyzed. Presence of disproportionate pathologic sympathetic overreaction to acute brain injury, i.e., paroxysmal sympathetic hyperactivity (PSH), was assessed on admission and on Days 1, 3 and 5 after brain injury.Β Results. A model for upper GIT bleeding risk assessment was designed using logistic regression. The resulting model gains high quality rating: ΟΒ²=33,78, 3; p<0,001; OR=315. The risk of upper GIT bleeding exceeded 95% in patients having combination of 4 symptoms in their medical history (presence of PSH on Day 1 after acute brain injury; Karnofsky performance scale index 75; lack of neurovegetative stabilization in the acute period of brain injury; gastric and/or duodenal ulcer).Conclusion. Determining the risk factors thresholds enables stratification of patients by the risk for upper GIT bleeding. Modification of the identified four risk factors (presence of PSH on Day 1after acute brain injury; Karnofsky performance scale index 75; lack of neurovegetative stabilization in the acute period of brain injury; gastric and/or duodenal ulcer) will probably reduce the occurrence of upper GIT bleeding in patients with acute brane injury of various etiology.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΏΠΎΡΡΡΠΎΠ΅Π½ΠΈΠ΅ ΠΌΠΎΠ΄Π΅Π»ΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈΠ· ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΈ Π΄Π²Π΅Π½Π°Π΄ΡΠ°ΡΠΈΠΏΠ΅ΡΡΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ΠΌ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ.Β ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΎΠΏΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠΈΠ»ΠΈ ΠΈΡΡΠΎΡΠΈΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ 33-Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²: 22 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² β Ρ ΡΡΠΆΠ΅Π»ΡΠΌ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ΠΌ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ, Π΄Π»Ρ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ, 11 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² β Ρ Π°Π½Π΅Π²ΡΠΈΠ·ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΡΠΎΡΡΠ΄ΠΎΠ² Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° Ρ Π½Π΅ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½Π½ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° ΠΏΠΎΡΠ»Π΅ ΠΏΠ»Π°Π½ΠΎΠ²ΡΡ
Π½Π΅ΠΉΡΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ². ΠΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠ°Π·Π΄Π΅Π»ΠΈΠ»ΠΈ Π½Π° 2 Π³ΡΡΠΏΠΏΡ: Ρ ΡΠ²Π½ΡΠΌΠΈ ΠΏΡΠΈΠ·Π½Π°ΠΊΠ°ΠΌΠΈ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈΠ· ΠΠΠ’ (n=11) ΠΈ Π±Π΅Π· ΡΠ²Π½ΡΡ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ (n=22). ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈ ΠΆΠ°Π»ΠΎΠ±Ρ, Π°Π½Π°ΠΌΠ½Π΅Π· Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΠΆΠΈΠ·Π½ΠΈ, ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, Π΄Π°Π½Π½ΡΠ΅ ΠΎΡΠΌΠΎΡΡΠΎΠ² ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ², ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΈ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π€ΡΠ½ΠΊΡΠΈΠΈ Π²Π΅Π³Π΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠΉ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ ΠΏΠΎ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡΠΌ ΠΏΠ°ΡΠΎΠΊΡΠΈΠ·ΠΌΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΈΠΌΠΏΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΠ°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ (ΠΠ‘ΠΠ) ΠΏΡΠΈ ΠΏΠΎΡΡΡΠΏΠ»Π΅Π½ΠΈΠΈ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ, Π½Π° 1-Π΅, 3-ΠΈ ΠΈ 5-Π΅ ΡΡΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΠ.Β Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ΅Π΄ΡΡΠ²Π°ΠΌΠΈ Π»ΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΈ ΠΏΠΎΡΡΡΠΎΠΈΠ»ΠΈ ΠΌΠΎΠ΄Π΅Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ²Π½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈΠ· Π²Π΅ΡΡ
Π½ΠΈΡ
ΠΎΡΠ΄Π΅Π»ΠΎΠ² ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ°. ΠΠΎΠ»ΡΡΠ΅Π½Π½Π°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ Π²ΡΡΠΎΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΎΠΉ ΠΊΠ°ΡΠ΅ΡΡΠ²Π°: ΟΒ²=33,78, 3; p<0,001; OR=315. ΠΡΠΈ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅ 4-Ρ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² (ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΠΠ‘ΠΠ Π² 1-Π΅ ΡΡΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°; ΠΈΠ½Π΄Π΅ΠΊΡ ΠΠ°ΡΠ½ΠΎΠ²ΡΠΊΠΎΠ³ΠΎ ΠΌΠ΅Π½Π΅Π΅ 75; ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ Π½Π΅ΠΉΡΠΎΠ²Π΅Π³Π΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠΉ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°; ΡΠ·Π²Π΅Π½Π½Π°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΈ Π΄Π²Π΅Π½Π°Π΄ΡΠ°ΡΠΈΠΏΠ΅ΡΡΡΠ½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ (ΠΠΠ)) ΡΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ²Π½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈΠ· Π²Π΅ΡΡ
Π½ΠΈΡ
ΠΎΡΠ΄Π΅Π»ΠΎΠ² ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ° ΠΏΡΠ΅Π²ΡΡΠ°Π» 95%.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΠΎΡΠΎΠ³ΠΎΠ²ΡΡ
Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ°Π·Π΄Π΅Π»ΠΈΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° Π³ΡΡΠΏΠΏΡ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠΉ ΠΈΠ· Π²Π΅ΡΡ
Π½ΠΈΡ
ΠΎΡΠ΄Π΅Π»ΠΎΠ² ΠΠΠ’. ΠΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ Π½Π° Π²ΡΡΠ²Π»Π΅Π½Π½ΡΠ΅ 4 ΡΠ°ΠΊΡΠΎΡΠ° ΡΠΈΡΠΊΠ° (ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡ ΠΠ‘ΠΠ Π² 1-Π΅ ΡΡΡ ΠΏΠΎΡΠ»Π΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°; ΠΈΠ½Π΄Π΅ΠΊΡ ΠΠ°ΡΠ½ΠΎΠ²ΡΠΊΠΎΠ³ΠΎ ΠΌΠ΅Π½Π΅Π΅ 75; ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ Π½Π΅ΠΉΡΠΎΠ²Π΅Π³Π΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠΉ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°; ΡΠ·Π²Π΅Π½Π½Π°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΈ ΠΠΠ) ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ, Π²Π΅ΡΠΎΡΡΠ½ΠΎ, ΡΠ½ΠΈΠ·ΠΈΡΡ ΡΠ°ΡΡΠΎΡΡ ΠΠΠ ΠΈΠ· Π²Π΅ΡΡ
Π½ΠΈΡ
ΠΎΡΠ΄Π΅Π»ΠΎΠ² ΠΠΠ’ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ΠΌ ΠΠ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ.
Surfactant therapy for pneumonia COVID-19 of obstetric patients
Introduction. Pregnant women may be at increased risk forΒ severe COVID-19 illness. Pregnant women are more likely to be hospitalized at ICU, needed theΒ mechanical ventilation compared to nonpregnant women ofΒ childbearing age. Building on theΒ experience ofΒ the effective use ofΒ the exogenous surfactant forΒ influenza A/H1N1Β treatment ofΒ pregnant women with COVID-19, theΒ surfactant therapy has also been included inΒ the treatment.The objective. To evaluate theΒ effectiveness ofΒ surfactant therapy inΒ the integrated treatment ofΒ severe COVID-19 pneumonia ofΒ pregnant women and postpartum women.Materials and methods. The study included 135Β pregnant and postpartum women with severe COVID-19 pneumonia. All ofΒ them received antiviral, anticoagulant, anticytokine and anti-inflammatory therapy. 68Β patients (main group) with an initially more severe course ofΒ the disease and aΒ greater degree ofΒ lung damage (pΒ = 0.026) received inhalations with Surfactant-BL, 67Β patients (control group) did not receive theΒ surfactant therapy. Patients received Surfactant-BL through aΒ mesh-nebulizer at aΒ dose ofΒ 75Β mg 2Β times aΒ day forΒ 3β5Β days.Result. Patients ofΒ the main group showed decreasing risks ofΒ requiring theΒ noninvasive ventilation (27.9% vs. 52.2%, ΡΒ = 0.014) and artificial lung ventilation (2.9% vs. 11.9%, pΒ = 0.047), theΒ length ofΒ stay inΒ the intensive care unit (ICU) was reduced (10.6Β vs. 13.1Β inpatient days, ΡΒ = 0.045). Π‘omplications such as pneumomediastinum and pneumothorax occurred less frequently inΒ the surfactant therapy group (24.2% vs. 52.4%, pΒ = 0.037) with aΒ high extent ofΒ lung damage (CT-3β4). With early surfactant therapy inΒ the standard oxygen therapy stage or high-flow oxygenation, gas exchange indicators were restored faster, thus avoiding mechanical ventilation and has reduced theΒ duration ofΒ intensive care (Ρ = 0.004) and prevented deaths.Conclusion. The use ofΒ surfactant therapy forΒ pneumonia associated with COVID-19 inΒ pregnant and postpartum women against theΒ background ofΒ ongoing complex therapy helps to prevent further lung damage, reduce theΒ mechanical ventilation risk and improve oxygenation earlier, especially with early start ofΒ surfactant therapy
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠΎΠ² ΠΎΠ±ΡΠ΅ΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ Π½Π° ΡΠΈΡΡΠ΅ΠΌΠ½ΡΠΉ Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΎΡΠ²Π΅Ρ ΠΏΡΠΈ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π°Ρ
Systemic inflammatory response syndrome (SIRS) is a severe complication in surgical patients associated with increased morbidity and mortality. Anesthetics are known to produce certain effects on the immune system and the manifestation of SIRS. The understanding of these beneficial mechanisms allows selecting optimal anesthetics in order to reduce the manifestation of SIRS and infectious complications in the postoperative period.Π‘ΠΈΡΡΠ΅ΠΌΠ½ΡΠΉ Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΎΡΠ²Π΅Ρ (Π‘ΠΠ) ΡΠ²Π»ΡΠ΅ΡΡΡ Π³ΡΠΎΠ·Π½ΡΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠ΅ΠΌ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ², ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°ΡΡΠΈΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡ ΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ·Π²Π΅ΡΡΠ½ΠΎ, ΡΡΠΎ Π°Π½Π΅ΡΡΠ΅ΡΠΈΠΊΠΈ ΠΎΠ±Π»Π°Π΄Π°ΡΡ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡΡ Π²Π»ΠΈΡΡΡ Π½Π° ΠΈΠΌΠΌΡΠ½Π½ΡΡ ΡΠΈΡΡΠ΅ΠΌΡ ΠΈ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ Π‘ΠΠ. ΠΠ½Π°Π½ΠΈΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ² ΠΏΠΎΠ΄ΠΎΠ±Π½ΠΎΠ³ΠΎ Π²Π»ΠΈΡΠ½ΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π²Π°ΠΆΠ½ΡΠΌ ΡΡΠ»ΠΎΠ²ΠΈΠ΅ΠΌ ΠΏΡΠ°Π²ΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ Π²ΡΠ±ΠΎΡΠ° ΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π°Π½Π΅ΡΡΠ΅ΡΠΈΠΊΠ° Ρ ΡΠ΅Π»ΡΡ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡ Π‘ΠΠ ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π² ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅
A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure. an expert panel consensus
Inotropes aim at increasing cardiac output by enhancing cardiac contractility. They constitute the third pharmacological pillar in the treatment of patients with decompensated heart failure, the other two being diuretics and vasodilators. Three classes of parenterally administered inotropes are currently indicated for decompensated heart failure, (i) the beta adrenergic agonists, including dopamine and dobutamine and also the catecholamines epinephrine and norepinephrine, (ii) the phosphodiesterase III inhibitor milrinone and (iii) the calcium sensitizer levosimendan. These three families of drugs share some pharmacologic traits, but differ profoundly in many of their pleiotropic effects. Identifying the patients in need of inotropic support and selecting the proper inotrope in each case remain challenging. The present consensus, derived by a panel meeting of experts from 21 countries, aims at addressing this very issue in the setting of both acute and advanced heart failure
Π ΠΠΠΠΠ§ΠΠΠ ΠΠΠΠ―ΠΠΠ ΠΠΠ ΠΠΠ’ΠΠ§ΠΠ‘ΠΠΠ₯ ΠΠΠΠΠ¬ΠΠΠ’ΠΠΠΠ ΠΠ ΠΠΠΠΠΠΠΠ£ ΠΠΠ’ΠΠΠΠΠ‘Π’Π Π¦ΠΠ’ΠΠΠΠΠΠ ΠΠ ΠΠ ΠΠΠ― ΠΠΠ ΠΠΠΠ₯ΠΠ Π£Π ΠΠΠ§ΠΠ‘ΠΠΠ₯ ΠΠΠΠ¨ΠΠ’ΠΠΠ¬Π‘Π’Π Π Π£Π‘ΠΠΠΠΠ―Π₯ ΠΠ‘ΠΠ£Π‘Π‘Π’ΠΠΠΠΠΠΠ ΠΠ ΠΠΠΠΠΠ ΠΠ©ΠΠΠΠ―
According to experimental data, morphine possesses certain anti-inflammatory properties, which can reduce the manifestations of system inflammatory response (SIR) after cardiopulmonary bypass. Objective: to investigate the effect of various narcotic analgesics on the activity of some SIR markers during peri-operative period of cardiac surgery with cardiopulmonary bypass. Subjects and methods. During the one-centered randomized prospective study, the changes in the concentration of interleukin-6, (IL-6), interleukin-8 (IL-8) and tumor necrosis factor (TNF) were followed up before cardiopulmonary bypass, and in 1, 3 and 24 hours after it in 60 patients, randomly divided into 2 groups. Patients of Group 1 (n = 30) received anesthesia with phentanyl, those from Group 2 (n = 30) received morphine. The groups did not differ in their clinical and demographic parameters and surgery types, performed in them. Results. The significant increase in the concentration of all inflammatory markers was observed in 1 hour after cardiopulmonary bypass was off, which was the evidence of SIR development. In the Group on morphine, the activity of markers was lower versus the Group on phentanyl. Thus, concentration of IL-6 in 3 hours after cardiopulmonary bypass made 155 (113; 180) versus 178 (102; 236) pg/ml (p = 0.006), IL-8 in 1 hour after cardiopulmonary bypass made 37.4 (25.4; 50.2) versus 52.6 (24; 91.4) pg/ml (p = 0,03), in 1 hour the level of TNF achieved 10.7 (8.6; 15.9) versus 15.7 (11.4; 23.1) pg/ml (p = 0.01), and in 3 hours it made β 9.7 (8.3; 13.8) versus 14.1 (9.6; 18.8) pg/ml (p = 0.04). However, there was no difference in the clinical course parameters between the Groups. Conclusion. The obtained results prove the morphine potential to reduce the expression of pro-inflammatory markers when used during cardiac surgery with cardiopulmonary bypass.Β Π‘ΠΎΠ³Π»Π°ΡΠ½ΠΎ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΠΌ Π΄Π°Π½Π½ΡΠΌ, ΠΌΠΎΡΡΠΈΠ½ ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΡΠ²ΠΎΠΉΡΡΠ²Π°ΠΌΠΈ, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΌΠΎΠ³ΡΡ ΡΠ½ΠΈΠ·ΠΈΡΡ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡ ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠ³ΠΎ Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° (Π‘ΠΠ) ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΡΠ΅Π΄ΡΡ ΠΈΡΠΊΡΡΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ (ΠΠ). Π¦Π΅Π»Ρ: ΠΈΠ·ΡΡΠΈΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π½Π°ΡΠΊΠΎΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π°Π½Π°Π»ΡΠ³Π΅ΡΠΈΠΊΠΎΠ² Π½Π° Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π‘ΠΠ Π² ΠΏΠ΅ΡΠΈΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ², Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π½ΡΡ
Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΠ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Ρ
ΠΎΠ΄Π΅ ΠΎΠ΄Π½ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ³ΠΎ, ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ, ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈΠ·ΡΡΠ°Π»ΠΈ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΠΉΠΊΠΈΠ½Π°-6 (ΠΠ-6), ΠΈΠ½ΡΠ΅ΡΠ»Π΅ΠΉΠΊΠΈΠ½Π°-8 (ΠΠ-8) ΠΈ ΡΠ°ΠΊΡΠΎΡΠ° Π½Π΅ΠΊΡΠΎΠ·Π° ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ (Π€ΠΠ) Π΄ΠΎ ΠΠ, ΡΠ΅ΡΠ΅Π· 1, 3 ΠΈ 24 Ρ ΠΏΠΎΡΠ»Π΅ ΠΎΠΊΠΎΠ½ΡΠ°Π½ΠΈΡ ΠΠ Ρ 60Β ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π² Π΄Π²Π΅ Π³ΡΡΠΏΠΏΡ. ΠΠ°ΡΠΈΠ΅Π½ΡΡ 1-ΠΉ Π³ΡΡΠΏΠΏΡ (n = 30) ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΡ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠ΅Π½ΡΠ°Π½ΠΈΠ»Π°, 2-ΠΉ (n =Β 30)Β β ΡΒ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠΎΡΡΠΈΠ½Π°. ΠΡΡΠΏΠΏΡ Π½Π΅ ΡΠ°Π·Π»ΠΈΡΠ°Π»ΠΈΡΡ ΠΏΠΎ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π΄Π΅ΠΌΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ ΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ°ΠΌ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΉ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠ΅ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ Π²ΡΠ΅Ρ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ ΡΠΆΠ΅ ΡΠ΅ΡΠ΅Π· 1 Ρ ΠΏΠΎΡΠ»Π΅ ΠΎΡΠΊΠ»ΡΡΠ΅Π½ΠΈΡ ΠΠ Π² ΠΎΠ±Π΅ΠΈΡ
Π³ΡΡΠΏΠΏΠ°Ρ
, ΡΡΠΎ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΠΎΠ²Π°Π»ΠΎ ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΠΈ Π‘ΠΠ. Π Π³ΡΡΠΏΠΏΠ΅ ΠΌΠΎΡΡΠΈΠ½Π° Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π±ΡΠ»Π° Π½ΠΈΠΆΠ΅, ΡΠ΅ΠΌ Π² Π³ΡΡΠΏΠΏΠ΅ ΡΠ΅Π½ΡΠ°Π½ΠΈΠ»Π°. Π’Π°ΠΊ, ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ ΠΠ-6 ΡΠ΅ΡΠ΅Π· 3 Ρ ΠΏΠΎΡΠ»Π΅ ΠΠ ΡΠΎΡΡΠ°Π²Π»ΡΠ»Π° 155 (113; 180) ΠΏΡΠΎΡΠΈΠ² 178 (102; 236) ΠΏΠ³/ΠΌΠ» (p = 0,006), ΠΠ-8 ΡΠ΅ΡΠ΅Π· 1 Ρ ΠΏΠΎΡΠ»Π΅ ΠΠ β 37,4Β (25,4;Β 50,2) ΠΏΡΠΎΡΠΈΠ² 52,6 (24; 91,4) ΠΏΠ³/ΠΌΠ» (p = 0,03), ΡΡΠΎΠ²Π΅Π½Ρ Π€ΠΠ ΡΠ΅ΡΠ΅Π· 1 Ρ Π΄ΠΎΡΡΠΈΠ³ 10,7 (8,6; 15,9) ΠΏΡΠΎΡΠΈΠ² 15,7 (11,4; 23,1) ΠΏΠ³/ΠΌΠ» (p = 0,01), ΡΠ΅ΡΠ΅Π· 3Β ΡΒ β 9,7Β (8,3; 13,8) ΠΏΡΠΎΡΠΈΠ² 14,1 (9,6; 18,8) ΠΏΠ³/ΠΌΠ» (p = 0,04). ΠΠ΄Π½Π°ΠΊΠΎ ΡΠ°Π·Π»ΠΈΡΠΈΠΉ Π² ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΠΆΠ΄Ρ Π³ΡΡΠΏΠΏΠ°ΠΌΠΈ Π½Π΅ Π±ΡΠ»ΠΎ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°ΡΡ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΠΌΠΎΡΡΠΈΠ½Π° ΡΠ½ΠΈΠΆΠ°ΡΡ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡ ΠΏΡΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ Π²ΠΎ Π²ΡΠ΅ΠΌΡ ΠΊΠ°ΡΠ΄ΠΈΠΎΡ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ² Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΠ.
ΠΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Π΄Π΅Π»ΡΡΠΈΠΉΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ ΠΈ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΠ±ΡΠ΅ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Β«Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΡ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ² ΠΈ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ²Β» Β«ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠΉ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ Β»
ΠΠΠ’Π£ΠΠΠ¬ΠΠΠ‘Π’Π¬: ΠΠ΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠ΅ΡΠ΅Π΄ ΠΈΡ
ΠΏΠ»Π°Π½ΠΎΠ²ΡΠΌ ΠΏΠ΅ΡΠ΅ΡΠΌΠΎΡΡΠΎΠΌ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΡΡΠΎΡΠΎΠ½Π½Π΅Π³ΠΎ ΠΌΠ½Π΅Π½ΠΈΡ ΠΊΠΎΠΌΠΏΠ΅ΡΠ΅Π½ΡΠ½ΡΡ
ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ² Π½Π΅ Π²ΡΠ·ΡΠ²Π°Π΅Ρ ΡΠΎΠΌΠ½Π΅Π½ΠΈΠΉ. ΠΠ°Π½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π°Π΄Π°ΠΏΡΠΈΡΠΎΠ²Π°ΡΡ ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ Π½Π° ΡΠ°Π±ΠΎΡΠΈΡ
ΠΌΠ΅ΡΡΠ°Ρ
Ρ ΡΡΠ΅ΡΠΎΠΌ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΎΡΠ½Π°ΡΠ΅Π½ΠΈΡ ΠΈΒ Π·Π½Π°Π½ΠΈΠΉ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ². Π¦ΠΠΠ¬ ΠΠ‘Π‘ΠΠΠΠΠΠΠΠΠ―: ΠΡΠΎΠ²Π΅ΡΡΠΈ Π°Π½Π°Π»ΠΈΠ· ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ, Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΈΒ Π΄ΠΎΡΡΡΠΏΠ½ΠΎΡΡΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ Π²Β ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ Β«ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠΉ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
Β» Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΠ΅Π»ΡΡΠΈ. ΠΠΠ’ΠΠ ΠΠΠΠ« Π ΠΠΠ’ΠΠΠ«: ΠΠΊΡΠΏΠ΅ΡΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° Π±ΡΠ»Π° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΏΠΎ ΠΈΠ½ΠΈΡΠΈΠ°ΡΠΈΠ²Π΅ ΠΊΠΎΠΌΠΈΡΠ΅ΡΠ° ΠΏΠΎ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΠΌ ΠΈΒ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΠ±ΡΠ΅ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Β«Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΡ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ² ΠΈΒ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ²Β» ΠΈΒ ΡΠΎΡΡΠΎΡΠ»Π° ΠΈΠ· ΡΡΠ΅Ρ
ΡΡΠ°ΠΏΠΎΠ². ΠΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΡΡΠ°ΠΏ Π·Π°ΠΊΠ»ΡΡΠ°Π»ΡΡ Π²Β Π°Π½Π°Π»ΠΈΠ·Π΅ ΠΊΠΎΠΎΡΠ΄ΠΈΠ½Π°ΡΠΎΡΠΎΠΌ ΡΠΊΡΠΏΠ΅ΡΡΠΈΠ·Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ Β«ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠΉ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
Β» ΠΈΒ ΠΎΡΠΎΡΠΌΠ»Π΅Π½ΠΈΠΈ Π°Π½ΠΊΠ΅ΡΡ-ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ°, ΡΠΎΡΡΠΎΡΡΠ΅ΠΉ ΠΈΠ· ΡΡΠ΅Ρ
ΡΠ°Π·Π΄Π΅Π»ΠΎΠ²: ΠΎΡΠ΅Π½ΠΊΠ° ΡΠ΅Π·ΠΈΡ-ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ; ΠΎΡΠ΅Π½ΠΊΠ° ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈΒ ΠΎΠ±ΡΠ°Ρ ΠΎΡΠ΅Π½ΠΊΠ° ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΌ ΡΡΠ°ΠΏΠ΅ ΡΠ°Π·ΠΎΡΠ»Π°Π½Π° Π°Π½ΠΊΠ΅ΡΠ°, ΠΈΒ ΡΠ΅ΡΠΏΠΎΠ½Π΄Π΅Π½ΡΠ°ΠΌ ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½ΠΎ ΠΎΡΠ΅Π½ΠΈΡΡ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ ΠΏΠΎ Π΄Π΅ΡΡΡΠΈΠ±Π°Π»Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ Π .Β ΠΠ°ΠΉΠΊΠ΅ΡΡΠ°. ΠΠ½Π°Π»ΠΈΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΡΠ°ΠΏ Π·Π°ΠΊΠ»ΡΡΠ°Π»ΡΡ Π²Β ΡΠ°ΡΡΠ΅ΡΠ΅ ΡΡΠ΅Π΄Π½Π΅Π²Π·Π²Π΅ΡΠ΅Π½Π½ΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ, ΠΌΠ΅Π΄ΠΈΠ°Π½Ρ ΠΈΒ ΠΌΠΎΠ΄Ρ. ΠΡΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ ΠΈΒ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΡΡΠΈΡΡΠ²Π°Π»ΠΈΡΡ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΌΠ΅Π΄ΠΈΠ°Π½Ρ ΠΈΠ»ΠΈ ΠΌΠΎΠ΄Ρ Π»ΡΠ±ΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ, ΡΡΠ΅Π΄Π½Π΅Π²Π·Π²Π΅ΡΠ΅Π½Π½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ°; Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΌΠ΅Π΄ΠΈΠ°Π½Ρ ΠΈΠ»ΠΈ ΠΌΠΎΠ΄Ρ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ, ΡΡΠ΅Π΄Π½Π΅Π²Π·Π²Π΅ΡΠ΅Π½Π½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ°. Π ΠΠΠ£ΠΠ¬Π’ΠΠ’Π«: ΠΒ ΡΠΊΡΠΏΠ΅ΡΡΠΈΠ·Π΅ ΠΏΡΠΈΠ½ΡΠ»ΠΈ ΡΡΠ°ΡΡΠΈΠ΅ 15Β ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ². ΠΡΠ½ΠΎΠ²Π½ΡΠ΅ Π·Π°ΠΌΠ΅ΡΠ°Π½ΠΈΡ ΠΈΒ Π΄ΠΎΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ Π·Π°ΠΊΠ»ΡΡΠ°Π»ΠΈΡΡ Π²Β ΡΡΠΎΡΠ½Π΅Π½ΠΈΠΈ ΡΠ΅ΡΠΌΠΈΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΊΠΎΠ½ΠΊΡΠ΅ΡΠΈΠ·Π°ΡΠΈΠΈ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΡ
ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ ΠΈΒ ΡΡΠΈΠ»ΠΈΡΡΠΈΠΊΠΈ. Π£ΡΠ°ΡΡΠ½ΠΈΠΊΠΈ Π΄Π΅Π»ΡΡΠΈΠΉΡΠΊΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΠ»ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ Π²Β ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ. ΠΠ΅ΡΠΈΡΠΈΡ ΠΎΠ±ΠΎΡΡΠ΄ΠΎΠ²Π°Π½ΠΈΡ Π΄Π΅Π»Π°Π΅Ρ ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½Π½ΠΎ Π²ΡΠΏΠΎΠ»Π½ΠΈΠΌΡΠΌΠΈ Π»Π΅ΡΠ΅Π±Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΡ. ΠΡΠΎΡ ΡΠ°ΠΊΡ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π°Π΅Ρ Π½ΠΈΠ·ΠΊΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ cΡΠ΅Π΄Π½Π΅Π²Π·Π²Π΅ΡΠ΅Π½Π½ΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ. ΠΠ«ΠΠΠΠ«: ΠΠΎΡΡΠΈΠ³Π½ΡΡ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΡ ΠΏΠΎ 20 ΠΈΠ· 21 ΡΠ΅Π·ΠΈΡ-ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ, ΠΏΠΎ 4 ΠΈΠ· 8 ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈΒ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½Π½ΡΠΌ ΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²ΠΊΠ°ΠΌ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΡ
ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ. ΠΠ΅Π»ΡΡΠΈΠΉΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» ΠΏΠΎΡΠΌΠΎΡΡΠ΅ΡΡ Π½Π° ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ Ρ ΠΏΠΎΠ·ΠΈΡΠΈΠΈ ΠΏΡΠ°ΠΊΡΠΈΠΊΡΡΡΠΈΡ
Π²ΡΠ°ΡΠ΅ΠΉΒ β Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ²-ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ², Π²Β ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π²Β ΡΡΡΡΠΊΡΡΡΠ½ΡΡ
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