New equation for determination of overpressure of fuel-air mixture blast

The problems of assessing the consequences of fuel-air mixtures and their prevention are topical and of practical interest. Such the explosions pose a real danger during processing, transportation and storage of fuels at various industrial and civil facilities. Forecast of possible consequences of explosions of fuel-air mixtures is a key element in development of protective measures. Today, various calculation methods have been developed and approved by different departments and organizations. The authors of the article have previously verified methods of Gosatomnadzor (RB G-05-039-96), Rostechnadzor (RD 03-409-01, PB 09-540-03, Method for assessment of consequences of accidental explosions of fuel-air mixtures, General explosion safety rules for explosive chemicals, petrochemicals and refineries), EMERCOM of Russia (GOST R 12.3.047-98, GOST R 12.3.047-2012, SP 12.13130.2009), Netherlands Organisation for Applied Scientific Research, Dorofeev, Baker-Strehlow and Baker-Strehlow-Tang for prediction of consequences of air-fuel mixture explosions at the example of real explosions. It is established that the detonation regime is best described by the Dorofeev's method and multi-energy method of Netherlands Organisation for Applied Scientific Research (ME-TNO) for deflagration regime. Thus, it is promising to create a synthesis method that could combine approaches of the methods. Detonation mode was picked out using the ME-TNO method and replaced by Dorofeev's method. Such a technique allowed proposing a new equation for predicting explosion pressure of fuel-air mixtures. As a result of the research, a new equation is proposed. An equation allows calculating the overpressure of explosion, which more accurately predicts the consequences of fuel-air explosions at petroleum and gas, petrochemical and chemical industries

Revision Anterior Cruciate Ligament Reconstruction: Current Approaches to Preoperative Planning (Systematic Review)

Background. The number of primary anterior cruciate ligament (ACL) reconstructions increases every year, which causes an increase in revision interventions due to ACL graft failure. When studying the literature, we identify many factors that together influence the outcome of revision ACL reconstruction, but are not always taken into account by surgeons. Aim of the review — is to perform a systematic review of studies that evaluated the outcomes of revision anterior cruciate ligament reconstructions and to identify optimal solutions to the most common problems encountered in preoperative planning. Methods. Information search was performed in the eLIBRARY, PubMed, and Scopus databases for the period from 2013 to 2022. Studies describing the main aspects of revision ACL reconstruction were selected for analysis. Inclusion criteria were the following: mean patient follow-up period of no less than 12 months, number of observations of no less than 10 cases. After evaluation of 898 articles, 22 articles were included in the systematic review. Results. Five main factors that should be taken into account in preoperative planning of revision ACL reconstruction have been identified: choice of the graft, necessity of reconstruction of the anterolateral complex, correction of tibial plateau deformity in the sagittal plane, determination of indications for one- or two-stage intervention, method of bone defect replacement in two-stage surgical treatment. Conclusion. The patient’s autogenous tissues should be preferred when choosing a graft. Correction of excessive anteroposterior tibial plateau inclination angle is performed only at the second revision intervention if the inclination angle exceeds 12º. Reconstruction of the anterolateral complex should be performed in young, active patients who are involved in pivot sports and in case of severe anterior instability. When determining the possibility of performing revision ACL reconstruction in one or two stages, the canal diameter is not a crucial parameter, as it is necessary to take into account the possibility of fusion of the canals from the previous surgery with the newly created ones. If the canals have correct entry points, one-stage revision reconstruction can be performed with the canal width not exceeding 10 mm and depending on the expected diameter and type of the prepared tendon graft. Bone grafting of the secondary dilated canals in two-stage intervention can be carried out using any material, but allogenous bone or synthetic grafts have certain advantages

The position of the fixed combination of indacaterol, glycopyrronium, and mometasone furoate in the management of bronchial asthma. The Report of Expert Panel of Russian Respiratory Society

Achieving the control of bronchial asthma (BA) in real clinical practice remains an unresolved problem, despite the expansion of therapeutic options in this area. Guidelines about when and for whom should a particular treatment be used continue to develop. Increasing of inhaled corticosteroid dose (ICS) in combination with a long-acting β2-agonist (LABA) does not always lead to the desired result, although a combined LABA-ICS inhaler could improve the course of asthma and increase adherence. The addition of tiotropium bromide to LABA-ICS requires the use of two inhalers. The targeted biological therapy is associated with the complexity of phenotyping and is possible only in specialized medical centers. Mometasone furoate, indacaterol acetate, and glycopyrronium bromide in fixed doses were combined in Breezhaler® inhaler for asthma maintenance therapy once per day. This way of treatment helps to realize full potential of maintenance inhalation therapy of bronchial asthma and to simplify the achievement of control over the disease in routine clinical practice.Достижение контроля над бронхиальной астмой (БА) в реальной клинической практике остается нерешенной проблемой, несмотря на существенное расширение терапевтических возможностей в этом направлении. Рекомендации о том, когда и для кого должны использоваться те или иные методы лечения, продолжают расширяться. При увеличении дозы ингаляционного глюкокортикостероида (иГКС) в комбинации с длительно действующим β2-агонистом (ДДБА) далеко не всегда достигается желаемый результат, хотя при использовании единого ингалятора иГКС / ДДБА может улучшиться течение БА и повыситься приверженность терапии. При добавлении тиотропия бромида к иГКС / ДДБА требуется использование 2 ингаляторов, а назначение таргетной биологической терапии связано со сложностью фенотипирования и возможно только в специализированных медицинских центрах. Мометазона фуроат, индакатерола ацетат и гликопиррония бромид объединены в фиксированную комбинацию, доставляемую с помощью ингалятора Бризхалер® 1 раз в день для поддерживающей терапии БА. Этот способ лечения помогает реализовать потенциал базисной ингаляционной терапии БА и упростить достижение контроля над заболеванием в повседневной клинической практик

Chronic fibrosing progressing interstitial lung disease: a decision of Multidisciplinary Expert Board

The natural course of some interstitial lung diseases (ILD) is characterized by progressive fibrosing phenotype resembling idiopathic pulmonary fibrosis (IPF). Until recently, the antifibrotic drug nintedanib was approved for treatment of the only fibrosing ILD which was IPF. A new indication for this drug which has been registered in Russian Federation in 2021 includes other fibrosing ILDs with progressive phenotype (PF-ILDs) and ILD associated with systemic scleroderma (SS-ILD). The aim of this publication is to describe general considerations of the decision of Multidisciplinary Expert Board on diagnosis and treatment of PF-ILDs including SS-ILD. Results. According to the extension in nintedanib use mentioned above, the Expert Board created an algorithm for diagnosis and treatment of patients with PF-ILDs and criteria for nuntedanib administration in PF-ILDs. Conclusion. Antifibrotic therapy is needed for patients with PF-ILDs with the failure of the stanrard therapy. In those patients antifibrotic treatment should be initiated as early as possible to better preserve the lung functionПри формировании фибротических изменений в легких многие интерстициальные заболевания легких (ИЗЛ) могут приобретать прогрессирующее течение. По прогнозу выживаемости, риску летальности и обострений такой фенотип ИЗЛ при отсутствии антифибротической терапии очень близок к идиопатическому легочному фиброзу. В 2020 г. в Российской Федерации разрешено использование антифибротического препарата нинтеданиб при фиброзирующих ИЗЛ с прогрессирующим фиброзным фенотипом (ПФФ) и при ИЗЛ, связанных с системной склеродермией. Целью работы Междисциплинарного Совета экспертов явилось ознакомление с основными положениями резолюции Междисциплинарного Совета экспертов о диагностике и лечении ИЗЛ ПФФ. Результаты. В декабре 2020 г. состоялся Междисциплинарный Совет экспертов, по результатам работы которого разработаны алгоритм диагностики и ведения пациентов с ИЗЛ ПФФ и критерии отбора больных для назначения антифибротической терапии. Заключение. Установлено, что в случае когда при стандартной терапии ИЗЛ ПФФ клиническое состояние пациента и легочная функция и / или фибротические изменения в легких по данным компьютерной томографии высокого разрешения не стабилизируются, показана антифибротическая терапия нинтеданибом. Начиная антифибротическую терапию в возможно более ранние сроки заболевания, можно замедлить прогрессирующее снижение легочной функции при более сохранных исходных показателях