30 research outputs found
Induced astigmatism and concomitant high myopia correction with femtosecond laser-assisted intrastromal MyoRing implantation
Purpose. Analysis of the results of astigmatism correction after penetrating keratoplasty and concomitant high myopia using the MyoRing ring implantation, clinical case as an example.Material and methods. Patient G., 51 years old, underwent surgery to correct astigmatism and concomitant high myopia. MyoRing was implanted in the right eye within corneal transplant limits using femtosecond laser-assisted intrastromal MyoRing implantation. Before the surgery uncorrected visual acuity at the operated eye was 0.01; corrected visual acuity 0.06; spherical component of refraction was (-)6.0 D, cylindrical component was (-)8.0 D. Mean keratometry in the right eye was 43.96 D. Corneal hysteresis was 6.5 mm Hg, corneal resistance factor was 5.5 mm Hg, cornea thickness in center was 529 mkm. The patient was followed up for one year.Results. In 12 months after the surgery visual acuity of the right eye without correction was 0.7 and 0.8 with correction. Spherical component was (-)1.0 D, cylindrical component was (-)2.0 D. Mean keratometry in the right eye was 35.10 D. Corneal hysteresis was 7.2 mm Hg, corneal resistance factor was 6.3 mm Hg, cornea thickness in center was 533 mkm. The patient was satisfied with the result of operation.Conclusion. Femtosecond laser-assisted intrastromal MyoRing implantation for correction induced astigmatism after penetrating keratoplasty and concomitant high myopia is efficient, safe and provides strengthening of biomechanical properties of the cornea besides refractive and visual effect
Control of Organic Impurities in Semisynthetic Antibiotics
In 2012, the European Medicines Agency (EMA) adopted a guideline, which divided all antibiotics into groups according to the manufacturing process and established acceptance criteria for organic impurities for each of the groups.The aim of the study was to justify the requirements and methodological approaches to setting the limits for organic impurities in semisynthetic antibiotics.Materials and methods: the authors analysed the requirements established by the leading world pharmacopoeias and the State Pharmacopoeia of the Russian Federation regarding the control of organic impurities in semisynthetic antibiotics, using the example of four semisynthetic antibiotics: doxycyline hyclate, clarithromycin, meropenem, and ceftriaxone. The study used the methods of comparative analysis and content analysis. Results: the study demonstrated that the organic impurity profiles of the analysed active substances and the corresponding finished medicinal products often differ significantly across the leading pharmacopoeias, either qualitatively or quantitatively. The Russian, European, and United States pharmacopoeias provide for the use of impurity reference standards in the test procedures for the determination of impurities in active substances of the semisynthetic antibiotics in question, whereas the Japanese Pharmacopoeia allows the use of non-compendial reference substances in the assessment of the chromatographic system separation power.Conclusions: the ability of a pharmacopoeial text to cover a variety of medicinal products coming to the Russian market from different countries has become a vital issue. This includes covering the impurity determination procedures, reference standards, and limits used, because general-purpose methods and limits do not always allow for correct assessment of impurity profiles in substances produced by different manufacturing processes. The current USP practice is to include various impurity control procedures in monographs on medicinal products, and the limits may also vary. This approach may be applied in the State Pharmacopoeia of the Russian Federation as well
Correction of postkeratoplastic astigmatism by intrastromal corneal segments implantation using a femtosecond laser
Background. After penetrating keratoplasty, mild to high induced corneal astigmatism was observed in each case. The existing choice of correction of postkeratoplastic astigmatism is aimed at fi nding an individual approach in order to compensate for it and not weaken the biomechanical properties of the corneal graft.The aim: to analyze the clinical, functional, and morphological results of postkeratoplastic astigmatism correction by implantation of intrastromal corneal segments using a femtosecond laser.Methods. 22 patients were examined before and 1 year after surgery. The operation was performed under local anesthesia: stage I β an intrastromal tunnel was formed using a femtosecond laser βFemto Visumβ 1 MHz (Optosystems, Russia); stage II β the intrastromal corneal segments were implanted. The results were assessed using standard and special research methods using optical coherence tomography Visante OCT (Zeiss, Germany), keratotopography (Tomey-5, Japan), optical corneal analyzer ORA (Reichert, USA), laser tindalemetry FC-2000 (Kowa, Japan) and confocal microscope Confoscan-4 (Nidek, Japan).Results. Before the operation, uncorrected visual acuity averaged 0.09 Β± 0.05, after a year β 0.50 Β± 0.16; best corrected visual acuity β 0.30 Β± 0.12 and 0.60 Β± 0.05 respectively; cylindrical component of refraction β β10.29 Β± 3.12 and β2.20 Β± 0.64 D respectively; mean keratometry value β 43.59 Β± 2.14 and 38.56 Β± 1.75 D respectively; corneal hysteresis β 7.92 Β± 1.22 and 8.95 Β± 1.05 mm Hg respectively; corneal resistance factor β 7.01 Β± 1.81 and 8.44 Β± 1.44 mm Hg respectively; protein fl ux in the moisture of the anterior chamber β 2.97 Β± 0.28 and 3.04 Β± 0.24 f/ms respectively; endothelial cell density β 1521 Β± 327 and 1475 Β± 419 cells/mm2 respectively.Conclusion. Intrastromal corneal segments implantation into a corneal graft using a femtosecond laser has efficiency and safety method in correcting postkeratoplastic astigmatism
A process-based model of methane consumption by upland soils
This study combines a literature survey and field observation data in an ad initio attempt to construct a process-based model of methane sink in upland soils including both the biological and physical aspects of the process. Comparison is drawn between the predicted sink rates and chamber measurements in several forest and grassland sites in the southern part of West Siberia. CH4 flux, total respiration, air and soil temperature, soil moisture, pH, organic content, bulk density and solid phase density were measured during a field campaign in summer 2014. Two datasets from literature were also used for model validation. The modeled sink rates were found to be in relatively good correspondence with the values obtained in the field. Introduction of the rhizospheric methanotrophy significantly improves the match between the model and the observations. The Q10 values of methane sink observed in the field were 1.2-1.4, which is in good agreement with the experimental results from the other studies. Based on modeling results, we also conclude that soil oxygen concentration is not a limiting factor for methane sink in upland forest and grassland ecosystems.Peer reviewe
ΠΠΎΠ½ΡΡΠΎΠ»Ρ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ Π² ΠΏΠΎΠ»ΡΡΠΈΠ½ΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠ°Ρ
In 2012, the European Medicines Agency (EMA) adopted a guideline, which divided all antibiotics into groups according to the manufacturing process and established acceptance criteria for organic impurities for each of the groups.The aim of the study was to justify the requirements and methodological approaches to setting the limits for organic impurities in semisynthetic antibiotics.Materials and methods: the authors analysed the requirements established by the leading world pharmacopoeias and the State Pharmacopoeia of the Russian Federation regarding the control of organic impurities in semisynthetic antibiotics, using the example of four semisynthetic antibiotics: doxycyline hyclate, clarithromycin, meropenem, and ceftriaxone. The study used the methods of comparative analysis and content analysis. Results: the study demonstrated that the organic impurity profiles of the analysed active substances and the corresponding finished medicinal products often differ significantly across the leading pharmacopoeias, either qualitatively or quantitatively. The Russian, European, and United States pharmacopoeias provide for the use of impurity reference standards in the test procedures for the determination of impurities in active substances of the semisynthetic antibiotics in question, whereas the Japanese Pharmacopoeia allows the use of non-compendial reference substances in the assessment of the chromatographic system separation power.Conclusions: the ability of a pharmacopoeial text to cover a variety of medicinal products coming to the Russian market from different countries has become a vital issue. This includes covering the impurity determination procedures, reference standards, and limits used, because general-purpose methods and limits do not always allow for correct assessment of impurity profiles in substances produced by different manufacturing processes. The current USP practice is to include various impurity control procedures in monographs on medicinal products, and the limits may also vary. This approach may be applied in the State Pharmacopoeia of the Russian Federation as well.Π 2012 Π³. ΠΠ²ΡΠΎΠΏΠ΅ΠΉΡΠΊΠΈΠΌ Π°Π³Π΅Π½ΡΡΡΠ²ΠΎΠΌ ΠΏΠΎ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΠΌ ΡΡΠ΅Π΄ΡΡΠ²Π°ΠΌ (European Medicines Agency, ΠΠΠ) ΡΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ΠΎ ΡΡΠΊΠΎΠ²ΠΎΠ΄ΡΡΠ²ΠΎ, ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΊΠΎΡΠΎΡΠΎΠΌΡ Π²ΡΠ΅ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° Π³ΡΡΠΏΠΏΡ Π² ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ ΠΈΡ
ΠΏΠΎΠ»ΡΡΠ΅Π½ΠΈΡ. ΠΠ»Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Ρ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ ΠΏΡΠΈΠ΅ΠΌΠ»Π΅ΠΌΠΎΡΡΠΈ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ.Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ: ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°ΡΡ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Ρ ΠΊ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ Π² Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ²Π°Ρ
ΠΏΠΎΠ»ΡΡΠΈΠ½ΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ².ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΠΉ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΈ Π²Π΅Π΄ΡΡΠΈΡ
Π·Π°ΡΡΠ±Π΅ΠΆΠ½ΡΡ
ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅ΠΉ ΠΊ Π΄ΠΎΠΏΡΡΡΠΈΠΌΠΎΠΌΡ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ Π² ΠΏΠΎΠ»ΡΡΠΈΠ½ΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠ°Ρ
Π½Π° ΠΏΡΠΈΠΌΠ΅ΡΠ΅ ΡΠ΅ΡΡΡΠ΅Ρ
ΠΈΠ· Π½ΠΈΡ
: Π΄ΠΎΠΊΡΠΈΡΠΈΠΊΠ»ΠΈΠ½Π° Ρ
ΠΈΠΊΠ»Π°Ρ, ΠΊΠ»Π°ΡΠΈΡΡΠΎΠΌΠΈΡΠΈΠ½, ΠΌΠ΅ΡΠΎΠΏΠ΅Π½Π΅ΠΌ ΠΈ ΡΠ΅ΡΡΡΠΈΠ°ΠΊΡΠΎΠ½. Π ΡΠ°Π±ΠΎΡΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΎΠ½Π½ΠΎ-Π°Π½Π°Π»ΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½Ρ-Π°Π½Π°Π»ΠΈΠ·Π°.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΠΏΡΠΎΡΠΈΠ»Ρ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ Π² ΠΌΠΎΠ½ΠΎΠ³ΡΠ°ΡΠΈΡΡ
Π²Π΅Π΄ΡΡΠΈΡ
Π·Π°ΡΡΠ±Π΅ΠΆΠ½ΡΡ
ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅ΠΉ Π½Π° ΠΎΠ΄Π½ΠΎΠΈΠΌΠ΅Π½Π½ΡΡ ΡΠ°ΡΠΌΠ°ΡΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΡΡ ΡΡΠ±ΡΡΠ°Π½ΡΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΠΉ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ, Π΄Π»Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΠΈΠ· ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ², ΠΊΠ°ΠΊ ΠΏΡΠ°Π²ΠΈΠ»ΠΎ, ΡΠ°Π·Π»ΠΈΡΠ°Π΅ΡΡΡ Π»ΠΈΠ±ΠΎ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ, Π»ΠΈΠ±ΠΎ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ. Π ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ°Ρ
ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ Π΄Π»Ρ ΡΠ°ΡΠΌΠ°ΡΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ±ΡΡΠ°Π½ΡΠΈΠΉ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΠΌΡΡ
ΠΏΠΎΠ»ΡΡΠΈΠ½ΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅Π΅ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ (ΠΠ€ Π Π€), ΠΠ²ΡΠΎΠΏΠ΅ΠΉΡΠΊΠΎΠΉ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅Π΅ ΠΈ Π€Π°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅Π΅ Π‘Π¨Π ΠΏΡΠ΅Π΄ΡΡΠΌΠΎΡΡΠ΅Π½ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΡ
ΠΎΠ±ΡΠ°Π·ΡΠΎΠ² ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ, ΡΠΎΠ³Π΄Π° ΠΊΠ°ΠΊ Π―ΠΏΠΎΠ½ΡΠΊΠ°Ρ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅Ρ Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠ°Π·Π΄Π΅Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ Ρ
ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ Π΄ΠΎΠΏΡΡΠΊΠ°Π΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π²Π΅ΡΠ΅ΡΡΠ², ΠΊΠΎΡΠΎΡΡΠ΅ Π½Π΅ ΡΠ²Π»ΡΡΡΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅ΠΉΠ½ΡΠΌΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠΌΠΈ ΠΎΠ±ΡΠ°Π·ΡΠ°ΠΌΠΈ.ΠΡΠ²ΠΎΠ΄Ρ: Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠΌ Π²ΠΎΠΏΡΠΎΡΠΎΠΌ ΡΡΠ°Π½ΠΎΠ²ΠΈΡΡΡ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅ΠΉΠ½ΠΎΠ³ΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ° ΡΡΠΈΡΡΠ²Π°ΡΡ ΠΌΠ½ΠΎΠ³ΠΎΠΎΠ±ΡΠ°Π·ΠΈΠ΅ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ², ΠΏΠΎΡΡΡΠΏΠ°ΡΡΠΈΡ
Π½Π° ΡΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ ΡΡΠ½ΠΎΠΊ ΠΈΠ· ΡΠ°Π·Π½ΡΡ
ΡΡΡΠ°Π½. ΠΡΠΎ ΠΊΠ°ΡΠ°Π΅ΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΠΌΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ, ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΡ
ΠΎΠ±ΡΠ°Π·ΡΠΎΠ², Π½ΠΎΡΠΌ, ΠΏΠΎΡΠΊΠΎΠ»ΡΠΊΡ Π΅Π΄ΠΈΠ½Π°Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° ΠΈ Π½ΠΎΡΠΌΡ Π½Π΅ Π²ΡΠ΅Π³Π΄Π° ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡ ΠΊΠΎΡΡΠ΅ΠΊΡΠ½ΠΎ ΠΎΡΠ΅Π½ΠΈΠ²Π°ΡΡ ΠΏΡΠΎΡΠΈΠ»Ρ ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ Π² ΡΡΠ±ΡΡΠ°Π½ΡΠΈΡΡ
, ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌ ΡΠΏΠΎΡΠΎΠ±ΠΎΠΌ. Π€Π°ΡΠΌΠ°ΠΊΠΎΠΏΠ΅Ρ Π‘Π¨Π Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΏΡΠ°ΠΊΡΠΈΠΊΡΠ΅Ρ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ Π² ΠΌΠΎΠ½ΠΎΠ³ΡΠ°ΡΠΈΠΈ Π½Π° Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΠ΅ ΡΡΠ΅Π΄ΡΡΠ²Π° ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ Π΄Π»Ρ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΏΡΠΈΠΌΠ΅ΡΠ΅ΠΉ, ΠΏΡΠΈ ΡΡΠΎΠΌ ΠΌΠΎΠ³ΡΡ ΡΠ°Π·Π»ΠΈΡΠ°ΡΡΡΡ ΡΠ°ΠΊΠΆΠ΅ ΠΈ Π½ΠΎΡΠΌΡ. Π’Π°ΠΊΠΎΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ ΠΈ Π² ΠΠ€ Π Π€
Risk factors for development of lung fat embolism in casualties with severe mechanical trauma
One of the common and difficult to predict complications of injuries is fat embolism. Lethality rate is up to 67% even with intensive modern therapy. The variety of manifestations of fat embolism, the lack of a unified theory of its occurrence and development, the multiplicity and ambiguity of risk factors for fat embolism make it necessary to study in detail the risk factors for the development of fat embolism for its effective prevention and timely therapy. The results of forensic studies of corpses have been studied. The risk of fat embolism is correlated with the functional state of the organism at the time of injury, the peculiarities of injury, the presence and duration of medical care. Statistical processing of the obtained data using the program MedCalc Statistical for biomedical research, software manual (2014) has been performed. Direct negative regression of the ratio of soft tissue and internal organ damage to the degree of fat embolism has been reliably revealed. A slight direct positive regression between the extent of skeletal bone damage and the degree of fat embolism has been found. The development of fat embolism is associated with the presence of infectious and inflammatory processes in the lungs in 30-40% of cases. The fact of polytrauma does not significantly affect the degree of fat embolism. It was reliably determined that a high degree of fat embolism in a smaller part of cases was diagnosed with a combination of soft tissue damage and internal organs. Currently, the existing schemes of medical care for victims do not have a significant impact on the development of fat embolism. A detailed analysis of the provisions of biochemical and colloidal-chemical theories of fat embolism development is necessary for the development and implementation of recommendations for the prevention of embolism in certain categories of traumatological patients.ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· ΡΠ°ΡΡΠΎ Π²ΡΡΡΠ΅ΡΠ°ΡΡΠΈΡ
ΡΡ ΠΈ ΡΠ»ΠΎΠΆΠ½ΠΎ ΠΏΡΠ΅Π΄ΡΠΊΠ°Π·ΡΠ΅ΠΌΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΡΡΠ°Π²ΠΌ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΆΠΈΡΠΎΠ²Π°Ρ ΡΠΌΠ±ΠΎΠ»ΠΈΡ. ΠΠ΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ, Π½Π΅ΡΠΌΠΎΡΡΡ Π½Π° ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ, ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ Π΄ΠΎ 67%. Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΌΠ½ΠΎΠ³ΠΎΠΎΠ±ΡΠ°Π·ΠΈΠ΅ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ, ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ Π΅Π΄ΠΈΠ½ΠΎΠΉ ΡΠ΅ΠΎΡΠΈΠΈ Π΅Π΅ Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΡΡΡ ΠΈ Π½Π΅ΠΎΠ΄Π½ΠΎΠ·Π½Π°ΡΠ½ΠΎΡΡΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ Π³Π»ΡΠ±ΠΎΠΊΠΎΠ³ΠΎ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π΄Π»Ρ Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΈ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΡΠ»ΠΈ ΠΈΠ·ΡΡΠ΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΡΠ΄Π΅Π±Π½ΠΎ-ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΡΡΠΏΠΎΠ². ΠΠ»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΡΠΈΡΠΊΠ° ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ ΡΡΠΈΡΡΠ²Π°Π»ΠΈΡΡ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ° Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΡΡΠ°Π²ΠΌΡ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΡΠΊΠ°Π½Π΅ΠΉ ΠΈ ΠΎΡΠ³Π°Π½ΠΎΠ², Π½Π°Π»ΠΈΡΠΈΠ΅ ΠΈ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ. Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ° ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ MedCalc Statistic for biomedical research, software manual 2014. Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ Π²ΡΡΠ²Π»Π΅Π½Π° ΠΏΡΡΠΌΠ°Ρ ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΠΎΠ±ΡΠ΅ΠΌΠ° ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ ΠΌΡΠ³ΠΊΠΈΡ
ΡΠΊΠ°Π½Π΅ΠΉ ΠΈ Π²Π½ΡΡΡΠ΅Π½Π½ΠΈΡ
ΠΎΡΠ³Π°Π½ΠΎΠ² ΡΠΎ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ; ΠΌΠ΅ΠΆΠ΄Ρ ΠΎΠ±ΡΠ΅ΠΌΠΎΠΌ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΊΠΎΡΡΠ΅ΠΉ ΡΠΊΠ΅Π»Π΅ΡΠ° ΠΈ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π²ΡΡΠ²Π»Π΅Π½Π° Π½Π΅Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΠΏΡΡΠΌΠ°Ρ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ. ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ ΡΠΎΠΏΡΡΠΆΠ΅Π½ΠΎ Ρ Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΠΎ-Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ² Π² Π»Π΅Π³ΠΊΠΈΡ
Π² 30-40% ΡΠ»ΡΡΠ°Π΅Π². Π‘Π΄Π΅Π»Π°Π½Ρ Π²ΡΠ²ΠΎΠ΄Ρ ΠΎ ΡΠΎΠΌ, ΡΡΠΎ ΡΠ°ΠΊΡ ΠΏΠΎΠ»ΠΈΡΡΠ°Π²ΠΌΡ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈ Π½Π΅ Π²Π»ΠΈΡΠ΅Ρ Π½Π° ΡΡΠ΅ΠΏΠ΅Π½Ρ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ, Π½ΠΎ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ Π²ΡΡΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π²ΡΡΠΎΠΊΠ°Ρ ΡΡΠ΅ΠΏΠ΅Π½Ρ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π² ΠΌΠ΅Π½ΡΡΠ΅ΠΉ ΡΠ°ΡΡΠΈ ΡΠ»ΡΡΠ°Π΅Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½Π° ΠΏΡΠΈ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΌΡΠ³ΠΊΠΈΡ
ΡΠΊΠ°Π½Π΅ΠΉ ΠΈ Π²Π½ΡΡΡΠ΅Π½Π½ΠΈΡ
ΠΎΡΠ³Π°Π½ΠΎΠ². Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ ΡΡ
Π΅ΠΌΡ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΏΠΎΡΡΡΠ°Π΄Π°Π²ΡΠΈΠΌ Π½Π΅ ΠΎΠΊΠ°Π·ΡΠ²Π°ΡΡ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ. Π ΡΠ²ΡΠ·ΠΈ Ρ Π²ΡΡΠ΅ΡΠΊΠ°Π·Π°Π½Π½ΡΠΌ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌ Π΄Π΅ΡΠ°Π»ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΊΠΎΠ»Π»ΠΎΠΈΠ΄Π½ΠΎ-Ρ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΠΎΡΠΈΠΉ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π΄Π»Ρ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΈ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΡ
ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΉ ΡΡΠ°Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
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