56 research outputs found

    Structure and propertties of ball milled utrahigh-molecular weight Polyethylene - clay composite

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    In this work the composite material based on polymer matrix filled with clay is studied. The preparation of powder composition consists of mechanical activation of substances and further common ball milling of polymer and clay in a high energy planetary ball mill. The process is divided into two stages; the first stage involves crushing of clay to obtain a nanosized powder, and in the second stage preparation of powdered nanocomposite is carried out. New clay-polymer composite shows considerable increase in modulus of elasticity and a decrease in coefficient of friction

    Pre- and postoperative left atrial appendage visualization: selecting the optimal method

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    Background: Atrial fibrillation (AF) is reported to be one of the main etiological factors of ischemic stroke. Transcatheter occlusion of the left atrial appendage (LAAO) is an alternative to anticoagulant therapy in the thromboembolism prevention in atrial fibrillation patients with a high bleeding risk. The role of contrast-enhanced cardiac computed tomography (CT) for preoperative assessment and postoperative control has not been sufficiently studied to the present moment.Objective: Comparison of the possibilities of transesophageal echocardiography (TEE) and computed tomography in pre- and postoperative imaging in the context of LAAO interventions.Material and methods: This retrospective cohort study included 38 patients divided into 2 groups: in the first group TEE was used for intervention planning and postoperative control, patients of the second group were examined with CT. The indicators obtained during LAA measurements were assessed, as well as the result of the intervention – according to the risk of peripheral leakage into the left atrial appendage.Results: The average left atrial appendage depth and orifice diameter according to transesophageal echocardiography were significantly smaller compared to computed tomography data (25.58 ± 4.65 versus 31.05 ± 6.41, p = 0.011; 17.21 ± 2.70 versus 18.55 ± 3.05 p = 0,006, respectively). In the computed tomography group, there was a not statistically significant trend towards a lower risk of leakage for 4–5 mm leaks (RR = 0.500; 95% CI 0.060–3.710) and for 2–3 mm leaks (RR = 0.500; 95% CI 0.150–1.540). In addition, 45 days after the intervention computed tomography revealed 5 cases of incomplete endothelialization of the device with the contrast agent leak into the LAA in the absence of peripheral leakage.Conclusion: Contrast-enhanced cardiac computed tomography, unlike transesophageal echocardiography, allows to detect incomplete occlusive device endothelialization, which may influence the choice of postoperative antithrombotic therapy. The use of computed tomography in an intervention planning for the LAAO may reduce the risk of peripheral leakage, however, this hypothesis needs to be confirmed in studies with a larger number of patients

    Tissue Doppler study in the diagnosis of functional disorders of the myocardium in patients with chronic heart failure

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    The article presents a comparative analysis of standard echocardiography and tissue Doppler method Rings atrioventricular valves in patients with chronic heart failure with a view to early diagnosis of functional disorders of the myocardium. It is shown that, in connection with the ability to detect myocardial dysfunction in the earlier periods of chronic heart failure and the possibility of dynamic observation of patients during therapy, appropriate complement adopt routine echocardiography by tissue Doppler

    Second chance for renal artery denervation

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    THE ROLE OF INTRAVASCULAR METHODS OF RESEARCH TO VERIFY THE DIAGNOSIS OF CORONARY HEART DISEASE IN WORKERS OF JSC “RUSSIAN RAILWAYS” RELATED TO THE SAFETY OF TRAIN TRAFFIC

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    The purpose of the study was to determine the role of the complex use of FFR and IVUS to verify the diagnosis of coronary heart disease in the examination of the professional suitability of Russian Railways employees, related to safety of train traffic. The study showed that survival rates free of major adverse cardiac events, transient rhythm disturbances, syncopal conditions and repeated hospitalizations for the angina pectoris, in groups with “unchanged” coronary arteries and intermediate stenoses of the coro-nary arteries with FFR negative result were not significantly different in the long-term period and amounted to 100 and 95.2%, respectively (p > 0.05), which makes to consider them as professionally suitable workers and return to work. When comparing this indicator in the subgroups of patients with FFR positive result undergoing stenting under the control of IVUS and patients with FFR negative result receiving optimal medical therapy, there were also no significant differences (97.3 and 95.2%, respectively, p > 0.05), which makes it possible to swich workers who have undergone stenting to "light" work, not related to the safety of train traffic

    Ethical and legal issues of hemotransfusion in surgical practice

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    The article presents the ethical, legal and health problems associated with blood transfusion in surgical practice. The authors believe that practical solutions of the ethical and legal conflicts between patient and physician related to blood transfusion, is the organization of bloodless surgery centers

    Treatment of coronary-cardiac fistulae

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    The role of modern methods for
 intravascular visualization of coronary arteries in diagnostics and treatment of coronary heart disease in the employees of the Russian
 Railways joint stock company related to train movements.

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    The aim of this study was to show the importance of modern non X-ray diagnostic techniques of coronary arteries for diagnosis and treatment of CHD. Material and methods. 110 patients, who took part in the study, were divided into two groups according to their coronarography: group 1 - patients with intermediate coronary stenosis (n = 80) and group 2 - patients with normal coronary arteries (n = 30). All patients of group1 underwent FFR measurement in the magistral arteries. On the base of FFR value the second group was conventionally divided into two subgroups: Ia (47.5% patients) - with a positive FFR value (≤0,8), in which the lesion was considered functionally significant and responsible for ischemia, and Ib (52.5% patients) - with a negative FFR value (&gt;0,8). In the case of positive FFR value patients underwent IVUS-guided PCI. Results. Survival index free of MACE and readmissions was not significantly different in the group II and subgroup Ib and were 100 and 95.2%, respectively (p &gt; 0.05). A comparison of this index in the subgroups Ia and Ib was no significantly different (97.3% and 95.2%, respectively, p &gt; 0.05). The rate of restenosis in the Ia subgroup, which required re-intervention, was 2.7%, which corresponds to the data in the literature. Late stent thrombosis was not revealed. Conclusions. Survival index free of MACE and readmissions is not different in the long-term period in the study groups.</jats:p
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