Early identification of treatment non-response in first-episode psychosis

Background Approximately one-third of patients with psychotic disorders does not respond to standard antipsychotic treatments. Consensus criteria for treatment resistance (TR) may aid the identification of non-response and subsequent tailoring of treatments. Since consensus criteria require stability of clinical status, they are challenging to apply in first-episode psychosis (FEP). This study aims to investigate (a) if an adaptation of consensus criteria can be used to identify FEP patients with early signs of TR (no early clinical recovery—no-ECR) after 1 year in treatment and (b) to what extent differences in antipsychotic treatments differentiate between outcome groups. Methods Participants with FEP DSM-IV schizophrenia spectrum disorders were recruited during their first treatment. A total of 207 participated in the 1-year follow-up. Remission and recovery definitions were based on adaptations of the “Remission in Schizophrenia Working Group” criteria and TR on adaptations of the “Treatment Response and Resistance in Psychosis” (TRRIP) working group criteria. Results 97 participants (47%) could be classified as no-ECR, 61 (30%) as ECR, and 49 (23%) as with partial ECR (P-ECR). Statistically significant baseline predictors of no-ECR matched previously identified predictors of long-term TR. Only 35 no-ECR participants had two adequate treatment trials and met the full TRRIP criteria. 21 no-ECR participants were using the same medication over the follow-up year despite the lack of significant effects. Conclusion The difference in the percentage of FEP participants classified as no-ECR versus TR indicates that we may underestimate the prevalence of early TR when using consensus criteria.publishedVersio

Разработка плана тактических действий по тушению пожаров в зданиях повышенной этажности (на примере жилого дома с административными помещениями, этажность 25)

Анализ пожаров в городе Новокузнецке показывает, что около 70% пожаров происходит в жилом секторе. При этом в жилье гибнет при пожарах около 80% людей по последним статистическим данным. Объектом исследования является жилой дом, расположенный в городе Новокузнецке, центральный район. Цель дипломного проекта – разработать тактические действия по тушению пожаров в зданиях повышенной этажности на примере вышеупомянутого объекта исследования. В процессе исследования был проведен аналитический обзор научных трудов и информационных статей по вопросам обеспечения пожарной безопасности в зданиях промышленной этажности, представлена характеристика исследуемого объекта и факторы, влияющие на развитие пожара в высотных зданиях.Analysis of fires in the city of Novokuznetsk shows that about 70% of fires occur in the residential sector. While the housing dies in fires, about 80% of people according to recent statistics. The object of study is a residential building located in the city of Novokuznetsk Central district. The aim of the project is to develop tactical actions on a touch-NIJ fires in high-rise buildings on the example of the above-mentioned object of study. In the process of the study was an analytical review of scientific papers and news articles on issues of fire safety in buildings, industrial heights, are the characteristic of the object studied and the factors affecting the development of fire in high-rise buildings

The PRAISE study: A prospective, multi-center, randomized, double blinded, placebo-controlled study for the evaluation of iloprost in the early postoperative period after liver transplantation (ISRCTN12622749)

Abstract Background Liver graft dysfunction can deteriorate to complete organ failure and increases perioperative morbidity and mortality after liver transplantation. Therapeutic strategies reducing the rate of graft dysfunction are of current clinical relevance. One approach is the systemic application of prostaglandins, which were demonstrated to be beneficial in reducing ischemia-reperfusion injury. Preliminary data indicate a positive effect of prostacyclin analogue iloprost on allograft viability after liver transplantation. The objective of the study is to evaluate the impact of iloprost in a multi-center trial. Methods/Design A prospective, double-blinded, randomized, placebo-controlled multicenter study in a total of 365 liver transplant recipients was designed to assess the effect of intravenous iloprost after liver transplantation. Primary endpoint will be the primary graft dysfunction characterized as presentation of one or more of the following criteria: ALAT or ASAT level > 2000 IU/ml within the first 7 postoperative days, bilirubine ≥ 10 mg/dl on postoperative day 7; INR ≥ 1.6 on postoperative day 7 or initial non-function. Secondary endpoints are parameters of post-transplant morbidity, like rates of infections, biliary complications, need of clotting factors or renal replacement therapy and the graft and patient survival. Discussion A well-established treatment concept to avoid graft dysfunction after liver transplantation does not exist at the moment. If the data of this research project confirm prior findings, iloprost would improve the general outcome after liver transplantation. Trial Registration German Clinical Trials Register: DRKS00003514. Current Controlled Trials Register: ISRCTN12622749.</p