Спонтанный пневмоперитонеум у больной без перфорации полого органа и перитонита

 Pneumoperitoneum normally occurs due to perforation of the hollow organ of the gastrointestinal tract, which is accompanied by the development of peritonitis. Cases of free gas without perforation and peritonitis are rare. Such situations are called “nonsurgical pneumoperitoneum”. This clinical case of a patient with pneumoperitoneum and no clinical picture of acute pathology in the abdominal cavity id reported in this article. Such patients should be carefully monitored by a surgeon to avoid unnecessary laparotomy. Пневмоперитонеум, как правило, возникает вследствие  перфорации полого органа желудочнокишечного тракта,  что сопровождается развитием перитонита. Случаи  обнаружения свободного газа в брюшной полости без перфорации полого органа и перитонита наблюдаются редко. Такие ситуации носят название «нехирургического пневмоперитонеума». В данной статье приводится описание клинического случая — пациентки с наличием  пневмоперитонеума и отсутствием клинической картины  острой патологии в брюшной полости. Такие пациенты  должны находиться под тщательным наблюдением хирурга, что позволяет избежать напрасной лапаротомии.

Isotopic composition on ground ice in Western Yamal (Marre-Sale)

The profile of Quaternary sediments near Marre-Salle polar station, Western Yamal Peninsula, has large bodies of tabular ground ice. This profile is considered strata-typical and critical in understanding of paleogeographic conditions of the Arctic in Pleistocene-Holocene. However, interpretation of the profile is under discussion. It consists of two distinct strata: upper layer of 10–15 m thick represented by continental sediments and lower one with a thickness of more than 100 m represented by marine sediments. Lower layer of saline marine clays has lenses of tabular ground ice (more than 20 m thick), the bases of which are below the sea level. Upper continental layer is characterized by syngenetic ice-wedges of different generations. Samples were collected from ice-wedges and tabular ground ice for chemical and isotope analysis. The results of the analysis allow to reconstruct paleogeographic conditions of the sedimentation and freezing of Quaternary sediments. Heavy stable isotope content and relationship between oxygen and hydrogen isotopes show that the ice bodies in the lower layer were formed in-situ within the ground. In the upper layer, heavier isotope content found in younger ice-wedges relative to the old-generation wedges. Formation of massive syngenetic Upper-Pleistocene ice-wedges occurred in conditions of colder winter temperatures than at present. Syngenetic Holocene wedges were formed after Holocene Optimum under winter conditions similar to present. Younger ice wedges formed smaller polygons, were smaller and often were developing in the locations of the degraded old wedges. Results of the isotope analysis of various types of ground ice near Marre-Sale allow reconstructing changes of marine sedimentation to continental one around Kargino time (MIS 3) and changes in climatic conditions in Arctic in Late Pleistocene and Holocene

Lederutdanning innen helse- og omsorgssektoren

Behovet for kompetente ledere i helse- og omsorgstjenesten i kommunene er stort, det samme gjelder den fylkeskommunale tannhelsetjenesten. Gjennom arbeidsseminarer og kvalitative intervjuer med kommunalsjefer og enhetsledere har vi kartlagt det eksisterende utdanningstilbudet og behovet for lederutdanning med vekt på tema og organisering

Technological possibilities of using natural gas in shaft furnaces for limestone roasting

One of the ways to improve the technology of limestone roasting in shaft furnaces is associated with improvement of conditions of combustion with natural gas when burning it directly in the layer. To implement this technology, it is necessary to ensure the development of two parallel processes: preparatory, in which the initial gas-air mixture is formed and heated to the ignition temperature, and the main one, during which a layer of combustion of gaseous fuel occurs. At air-blast tuyere feed and at coaxial jet supply of gaseous fuel under increased pressure when there are gas permeable nozzles in the path, a more powerful gas flow (natural gas) flows out of the nozzle at high speed into the external environment. It creates conditions for air flow ejection. Inside the annular space between the streams, a combustion zone is formed, on the inner and outer side of which there are circulating vortices directed along the axis of the jet to the nozzle. It improves stability of the gas-air mixture ignition. The considerable range of turbulent jets (at elevated pressures of the gaseous medium), as well as the possibility of sufficient complete mixing in the boundary layer, opens up the possibility of forming a gas-air mixture of a given composition along the front of the flare process, the movement of gas jets. To ignite the gas flow in the layer, it is necessary to ensure its preheating at least to a temperature of 800-1050 °C using a heat source located near its entrance. Energy efficiency of this direction is confirmed by experimental studies on a shaft furnace with a working space with diameter of 3 m. According to the results of experimental sounding of the heated zone of a limestone shaft furnace (in the mode of layer burning of natural gas), regularities were established in changing the temperature field of the burning layer with the formation of maximum temperature of 1200 °C at a distance of 200mm from the nozzle section. The depth of formation of the combustion zone was limited to the level of 110mm with the spread of the region of high temperatures over a distance of up to 1000 mm. Technological possibility of forming a region of high temperatures of 1100-1600 °C with a length of the high-temperature zone up to 2000mm was established. © 2020 National University of Science and Technology MISIS. All rights reserved