Prognostic criteria of paracentetic - drainage method effectiveness for treatment of extra-organ infected fluid collection in abdominal cavity

Introduction: One of the most important current surgical tasks is the treatment of the intraabdominal abscess patients, because there is neither positive tendency to reduce the amount of acute inflammatory diseases of abdominal cavity organs nor the tendency to reduce the postoperative suppurative complications. There is no doubt today about efficiency of transcutaneous abscess drainage under ultrasound guidance, but there are some contradictory opinions about efficiency of paracentetic treatment as compared to conventional surgical procedure. Research goal is to study the effectiveness criteria of paracentetic-drainage method in extra-organ infected fluid intraabdominal collections treatment and their dependence on collection echostructure and etiology. Material and methods: The retrospective analysis was carried out on 53 medical case-histories of extraorgan intra-abdominal abscess patients treated in surgical department of Regional clinical hospital No 1 in Kemerovo. The ultrasonic data, such as size, wall structure and characteristics of content were analyzed. The patients were divided into two groups: the 1st group (37 patients, n=37) consisted of patients who underwent only abscess paracentesis or drainage under ultrasound guidance; the 2nd group consisted of patients (n=16) who underwent open abscess drainage after inefficient paracentetic-drainage. Results: the etiology analyses of intraabdominal collections showed the paracentetic-drainage approach to be more often efficient for surgery on hepatobiliary system of patients with fluid collections in subhepatic area (42%). The most frequent cause for fluid formations in the 2nd group patients was acute pancreatitis, pancreatonecrosis - 45.3%. The volume of fluid collection in the 1st group patients was significantly less (74.4±0.3 ml) than in the 2nd patients group (117.8±2.3 ml). The formation echostructure analyze of both groups showed the 1st group to have formations with well-defined shapes (x2 = 2.55; p=0.01) and smaller size (x2 = 5.71; p=0.017). Heterogeneous echostructure and infiltrated fluid collections around were characteristically to the 2nd group patients. The analysis also showed that infected fluid collections containing pus in the 1st patients group were smaller in volume than in the 2nd group (73.84±0.3 ml to 111.75±0.5 ml respectively). According to the leukocyte index of intoxication (LII) analysis there is no reliable difference between LII in the 1st and the 2nd groups (p-29). But it is certain that LII reduces on the 3rd day after the drainage (the 1st group patients from 1.9 to 1.3; the 2nd group patients from 4.6 to 1.45). Conclusion: The efficiency of transcutaneous paracentesis under ultrasound guidance depends on etiology and echostructure of intraabdominal abscess. In case of pancreatic necrosis the minimal invasive method has an insignificant effect as the final treatment stage because of sequesters

Maxillary Sinus Pneumocele

Hyperpneumatization of the paranasal sinuses is a rare condition. Hypersinus, pneumosinus dilatans, and pneumocele are the three types of excessive pneumatization according to the traditional classification proposed by Urken et al. (1987). If in the first case, no treatment is required, but the latter two may be accompanied by aesthetic and/or functional disorders or may result in pressure effects on adjacent anatomical objects, therefore they require surgical correction. Maxillary sinus pneumocele is described in few publications. The presented case demonstrates typical clinical and radiographic signs of the maxillary sinus pneumocele, as well as hypersinus on the contralateral side. Cone beam computed tomography scans in combination with anamnestic and clinical data provide key information for the diagnosis of maxillary sinus pneumocele, as well as for differential diagnosis with other variants of their excessive pneumatization

Entanglement in a quantum annealing processor

Entanglement lies at the core of quantum algorithms designed to solve problems that are intractable by classical approaches. One such algorithm, quantum annealing (QA), provides a promising path to a practical quantum processor. We have built a series of scalable QA processors consisting of networks of manufactured interacting spins (qubits). Here, we use qubit tunneling spectroscopy to measure the energy eigenspectrum of two- and eight-qubit systems within one such processor, demonstrating quantum coherence in these systems. We present experimental evidence that, during a critical portion of QA, the qubits become entangled and that entanglement persists even as these systems reach equilibrium with a thermal environment. Our results provide an encouraging sign that QA is a viable technology for large-scale quantum computing.Comment: 13 pages, 8 figures, contact corresponding author for Supplementary Informatio

The intellectual information system for management of geological and technical arrangements during oil field exploitation

The intellectual information system for management of geological and technical arrangements during oil fields exploitation is developed. Service-oriented architecture of its software is a distinctive feature of the system. The results of the cluster analysis of real field data received by means of this system are shown

Разработка методического подхода к поддержке и анализу исполнения стандартов лечебно-диагностических процессов многопрофильного стационара

Standardization is one of the most important tools for ensuring the quality of medical care. The paper presents analysis results of a number of existing federal and regional standards that regulate the processes of providing medical care, which confirm the need and expediency of developing internal standards for diagnostic and treatment processes (DTP) in a medical institution. The authors also formulate requirements for their minimum content. The importance of the effective implementation of the developed internal DTP standards necessitates the development of a methodological approach to standard execution support and analysis.The approach presented in the article is methodically based on the use of modified operogrammes, which allow taking into account the DTP specifics and resource equipment of a particular medical institution. The authors propose key areas for standard execution support and possible forms of implementation in information systems, as well as basic directions for standard execution analysis with integral indicators for assessment of those standards.Approbation of the developed methodological approach was carried out on the example of the N.V. Sklifosovsky Research Institute for Emergency Medicine in terms of DTP standard execution support and analysis in relation to ordering laboratory, instrumental tests and consultations at various stages of the patient treatment process. The results of the approbation confirmed that the introduction of the methodological approach increases the effectiveness of the implementation of the developed DTP standards in the activities of a medical institution, and also ensures the achievement of a number of important systemic management effects.Одним из важнейших инструментов обеспечения качества медицинской помощи является стандартизация. В работе представлены результаты анализа ряда действующих федеральных и региональных стандартов, регламентирующих процессы оказания медицинской помощи, которые подтверждают необходимость и целесообразность разработки внутренних стандартов лечебнодиагностических процессов (ЛДП) медицинского учреждения, авторами также сформулированы требования к их минимальному содержанию. Важность эффективного внедрения разрабатываемых внутренних стандартов ЛДП обусловливает необходимость разработки методического подхода к поддержке и анализу исполнения стандартов. Представленный в статье подход методически основывается на применении модифицированных оперограмм, которые позволяют учесть специфику и ресурсное оснащение ЛДП конкретного медицинского учреждения. Авторами предложены ключевые направления поддержки исполнения стандартов и возможные формы реализации в информационных системах, а также базовые направления анализа исполнения стандартов с интегральными показателями их оценки. Апробация разработанного методического подхода проведена на примере ЛДП ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ» в части поддержки и анализа исполнения стандартов ЛДП по назначениям лабораторных, инструментальных исследований и консультаций на различных этапах процессов лечения пациентов. Результаты апробации подтвердили, что применение данного методического подхода повышает эффективность внедрения разработанных стандартов ЛДП в деятельность медицинского учреждения, а также обеспечивает достижение ряда важных системных управленческих эффектов

Features of influence of smoking on the intimate rhythm variation in persons of youthful - of medical students

In 50 young men and 76 girls - students of medical high school was variability of an intimate rhythm estimated by means of the program «Status PF». Results of the research have shown gender features of influence of smoking on parameters cardiorhythm. It has appeared that smoking more considerably influences regulation of an intimate rhythm at girls, raising a level of its sympathetic activation. During analysis of changes of cardiorhythm parameters in students at various duration and intensity of smoking it has appeared, that at smoking duration less than 3 years and more than 10 cigarettes sympathetic influence on heart cardiorhythm considerably decreases in young men and girls