Possibility of application of early rehabilitation program (ERAS) for patients with combined trauma

The article is devoted to the analysis of the effectiveness of the application of the early rehabilitation program (ERAS) to patients with combined trauma. The results of the study showed clinical advantages with reduction of the length of stay in the intensive care department and hospital by 1,5 times and 1,4 times respectively (p < 0,05), reduction of the risk of developing infectious complications (r = 0,256, p = 0,03) and fatality by 2,7 times (OR = 0,21; 95% DI 0,03 – 1,02; P = 0,053) in patients with severe combined trauma who used most elements of the ERAS program in medical care.Статья посвящена анализуэффективности применения программы ранней реабилитации (ERAS) пациентам с сочетанной травмой. Результаты исследования показали клинические преимущества с уменьшением продолжительности пребывания в отделении реанимации и стационаре в 1,5 раза и 1,4 раза соответственно (p < 0,05), снижение риска развитияинфекционных осложнений (r = 0,256, p = 0,03) и летальности в 2,7 раза (OR = 0,21; 95% ДИ 0,03 – 1,02; р = 0,053) у пациентов с тяжелой сочетанной травмой, которым при оказании медицинской помощи применялось большинство элементов программы ERAS

Testing conditions for CoMo HDS catalyst in the kinetic region: integrated approach using the math calculations and catalytic experiments

The main idea of the investigation was to define testing parameters with the lowest influence of internal and external diffusion on catalytic activity in hydrodesulfurization of dibenzothiophene. Traditional experimental methods were used to determine the conditions for the influence of internal and external diffusion. Simultaneous change of a linear feedstock rate and a catalyst loading at constant weight hour space velocity were used to determine the process temperature (240–260 °C) at which the impact of external diffusion is minimal. Catalytic tests, including the variation of the catalyst fraction size, were carried out to define the conditions with the lowest influence of internal diffusion. It was found that when the catalyst with the fraction size of 0.1–0.25 mm was used, the fluctuation of sulfur conversion was the smallest. Besides, to validate experimental results, the calculations were performed with mass balance equations and expressions used for HDS modeling. The resulting data and catalytic experiments demonstrated that the lowest influence of internal and external diffusion is achieved at a temperature process less than 260 °C and a catalyst fraction of 0.1–0.25 mm

ИСПОЛЬЗОВАНИЕ ШКАЛЫ qSOFA В ПРОГНОЗЕ ИСХОДА У ПАЦИЕНТОВ С СЕПСИСОМ В ОРИТ (результаты российского многоцентрового исследования РИСЭС)

The objective of the study: to define the informative value of qSOFA score in the prediction of sepsis outcomes in the patients admitted to the intensive care wards of medical units in the Russian Federation.Subjects and methods. The multi-center, prospective, and observational trial was conducted. The following data were analyzed in the patients admitted to intensive care wards: number of qSOFA and SOFA scores, the presence of SIRS criteria, levels of lactate, and the outcome of the admission to the intensive care wards. The informative value of different scores and lactate level was analyzed using ROC-analysis.Results. The following areas under ROC-curves were defined for prediction of a lethal outcome in the patients with sepsis: qSOFA – 0.644 (95% CI 0.593–0.693); SOFA – 0.731 (95% CI 0.683–0.776); SIRS – 0.508 (95% CI 0.456–0.560); [qSOFA + lactate ≥ 4 mmol/L] – 0.713 (95% CI 0.646–0.774).Conclusion. To predict a lethal outcome in the patients with sepsis admitted to intensive care wards, qSOFA surpasses SIRS criteria, but it is not as good as SOFA score. The informative value of the prediction model [qSOFA+lactate ≥ 4 mmol/L] surpasses qSOFA score in the prediction of the outcome in sepsis patients, and it is as good as SOFA score.Цель исследования: определить информационную ценность шкалы qSOFA в прогнозе летального исхода у пациентов с сепсисом, госпитализированных в отделения реанимации и интенсивной терапии (ОРИТ) лечебных учреждений Российской Федерации.Материалы и методы. Многоцентровое, проспективное, обсервационное исследование. Проанализирована следующая информация о пациентах с сепсисом при поступлении в ОРИТ: количество баллов по шкалам qSOFA и SOFA, наличие критериев SIRS, уровень лактата крови, а также исход госпитализации при оказании помощи в ОРИТ. Проведен ROC-анализ информационной значимости различных шкал и уровня лактата крови.Результаты. В прогнозе летального исхода пациентов с сепсисом определены следующие площади под ROC-кривыми: qSOFA – 0,644 (95%-ный ДИ 0,593–0,693); SOFA – 0,731 (95%-ный ДИ 0,683–0,776); SIRS – 0,508 (95%-ный ДИ 0,456–0,560); [qSOFA + лактат ≥ 4 ммоль/л] – 0,713 (95%-ный ДИ 0,646–0,774).Заключение. В прогнозе летального исхода у пациентов с сепсисом при поступлении в ОРИТ шкала qSOFA превосходит критерии SIRS, но уступает шкале SOFA. Информационная ценность прогностической модели [qSOFA + лактат ≥ 4 ммоль/л] превосходит шкалу qSOFA в прогнозе исхода у пациентов с сепсисом и не уступает шкале SOFA

Опыт лечения больного острым ишиоректальным парапроктитом, осложненным гангреной Фурнье, с применением локального отрицательного давления

The authors describe a clinical case of successful treatment of a patient with an ischiorectal abscess complicated by extensive purulentnecrotic phlegmon on the anterior abdominal wall and right thigh. Topical negative pressure wound technique (NPWT) was used. Its combination with surgical debridement and rational systemic antibiotic therapy has been shown to contribute to successful treatment of this life-threatening pathology.В статье представлено клиническое наблюдение успешного лечения пациента с ишиоректальным абсцессом, осложненным обширной гнойно-некротической флегмоной передней брюшной стенки и правого бедра. В лечении применена методика локального отрицательного давления. Показано, что ее использование в сочетании с хирургической обработкой раны и рациональной системной антибактериальной терапией способствует успешному лечению данной угрожающей жизни патологии

The Problem of the so-called "change" of the tick-borne encephalitis virus genotype in the middle Urals for the last 60 years

Although the history of the tick-borne encephalitis in Urals dates back to 75 years ago, the problem of the spread and evolution of the tick-borne encephalitis virus (TBEV] largely remains terra incognita. Any research in this area is of great basic and practical importance. A few years ago, a hypothesis about the change of the TBEV genotype in the Sverdlovsk region in the 50-60-year period was put forward. In other words, replacement of the Far-Eastern genotype by Siberian genotype was suggested. The goal of this work was to discuss this hypothesis and the fallacy of this view. Recent large-scale data show the long history of the formation of Siberian TBEV virus population In the Middle Urals, as well as a foreign nature of Far-Eastern genotype through their introduction in the past. The concept of the decisive role of anthropogenic factor in the spread of TBEV In the Urals is discussed as an alternative to the hypothesis of the genotype change

Analysis of differences in the motivation of the owner-managers and hired managers of regional enterprises

The article deals with the differences in the motivation of owner-managers and hired managers. The purpose of the article is to identify the signs of the differences and similarities in the motivation of hired managers and owner-managers on the basis of the analysis of the results of the study of these issues by other authors, as well as with the help of our research. The hypothesis of the study consists in the assumption that the motivational profile of owner-managers differs from the motivational profile of hired managers in greater riskiness and thrift. The research methodology involves conducting a sociological survey of 100 managers of small and medium-sized enterprises in Kemerovo, half of which are employed and the other half are business owners. Questioning was carried out by several methods: oral, by e-mail, in writing through the Center for Business Support and through other means. The data we processed in the SPSS Statistic program. The results of the study unexpectedly have rejected a basic hypothesis: the average data for the degree of risk and thrift of hired managers is highly competitive with the received indices of owner-managers. There is the only difference in the distribution of characteristics. The level of riskiness and thrift of the hired managers tends to the be average among them and has a slight variation in the estimates, while the owner-managers much differ from each other on these parameters, have a large variation in the values of indicators, show a lot of the diametrically opposed estimates. The study of the motives of of owner-managers activity allows to the authorities to develop recommendations on the improvement of the existing and new programmes for the support of small and medium-sized business; on the formation of executive candidate pool. It also can contribute to revealing the categories of population with expressed entrepreneurial and managerial motivational profiles at a stage of professional education for their fastest involvement in effective work.Рассмотрены сходства и различия мотиваций руководителей, работающих по найму и являющихся собственниками бизнеса. Представлена мотивационная типология руководителей-собственников

Tick-borne encephalitis virus: Reference strain Sofjin and problem of its authenticity

The Sofjin strain is one of the first isolates of tick-borne encephalitis virus and, due to its wide distribution in virus collections, it has become the reference strain. Until now, GenBank has recorded several sequences associated with the Sofjin strain that have significant differences between each other. We have sequenced the complete genome of the Sofjin strain from a virus collection and a genome fragment of the two vaccine Sofjin strains. According to phylogenetic analysis, we concluded that the GenBank sequences belong to three independent groups of Sofjin strains of the Far Eastern subtype. Their genetic differences are not a result of microevolution associated with numerous passages. Retrospective analysis of the peculiarities of origin and distribution for each of these groups showed the authenticity of one of them. For the first time, we have determined a complete genome sequence of the authentic reference TBEV strain Sofjin. Two other groups of strains named Sofjin were probably the result of cross-contamination or laboratory error. The high probability of contamination requires the introduction of a new standard for virological laboratories, the key point of which is the obligatory genetic identification of all collection strains. © Springer Science+Business Media, LLC 2011