Lamb Shift of Laser-Dressed Atomic States

We discuss radiative corrections to an atomic two-level system subject to an intense driving laser field. It is shown that the Lamb shift of the laser-dressed states, which are the natural state basis of the combined atom-laser system, cannot be explained in terms of the Lamb shift received by the atomic bare states which is usually observed in spectroscopic experiments. In the final part, we propose an experimental scheme to measure these corrections based on the incoherent resonance fluorescence spectrum of the driven atom.Comment: 4 pages, 1 figure, submitted for publicatio

Hospital Stage of Myocardial Infarction Treatment in 13 Regions of Russian Federation by Results of the International Research

Aim. To describe the characteristics of the patient with MI who is admitted to a hospital and to characterize the main diagnostic and treatment interventions in clinic. Material and methods. This study is observational and the part of big international project. It includes a representative sample of patients with MI admitted to 16 clinics in 13 regions of Russian Federation (Arkhangelsk region, Belgorod region, Bryansk region, Tver region, Saratov region, Rostov region, Samara region, the Republic of Tatarstan, Perm region, Tyumen region, Khanty-Mansiysk Autonomous district, Kemerovo region, Altai region). Patients were selected at random from among those experiencing a MI that were alive on the next morning after hospitalization. Enrollment took place from June 2015 to August 2016. Results. Of 1,128 patients included in the study, 872 were male (77.3%) and 256 females. 21.4% of patients had a previous MI, 8.3% had undergone PCI, and 2.2% CABG. Turning to cardiovascular risk factors, 46.2% of patients smoked prior to hospitalization, 34.6% were obese and 52.1% had a high cholesterol level. Only 40.0% of patients had no contact with the health care system within 12 months before the MI. Every fourth patient (25.1%) had undergone dispensarisation within 12 months before MI, women significantly often than men (33.5% and 22.6%, p < 0.001). Initial revascularization was performed in 73.2% of patients, PCI was the initial revascularization attempt in 49.4% of patients, and PCI with stenting in 46.7%. Conclusion. Patient with a MI in Russian clinics is likely to have had a history of cardiovascular disease, and to have regular contact with the health care system within 12 months before the development of cardiovascular event. We demonstrated the high rates of appropriate MI treatment, without significant gender and age difference (except for thrombolysis), however, there is a reserve for increasing the proportion of patients who are undergoing revascularization

Оценка внесосудистой воды легких во время обширных торакальных вмешательств и в послеоперационном периоде

Background. Postoperative lung injury is a cause of most fatal outcomes after extensive lung resections. Death rates due to postpneumonectomy pulmonary edema have remained unchanged within the past 20 years and are currently tending to 100%. Objective: to make prolonged lung edema monitoring in patients after extensive thoracic interventions. Subjects and methods. The observational study covered 27 patients who had undergone pneumonectomy (PE) (n=16) or lung resection (n=11). Invasive monitoring by the PiCCOplus system was performed to examine the systemic and pulmonary hemodynamics of all the patients during surgery and within 48 postoperative hours. Results. PE rather than lung resection was accompanied by a significant reduction in the extravascular lung water index (EVLWI). Most patients who had undergone PE were found to have a subclinical increase in EVLWI 36-48 hours after termination of the intervention. Conclusion. In this observational clinical study, isolated thermodilution showed an immediate decrease in EVLWI after PE and its increase at 36—48 postoperative hours. Lobar or segmental interventions failed to cause significant changes in EVLWI in the perioperative period. Key words: pneumonectomy, lung resection, lung edema, extravascular lung water, acute lung injury.Цель исследования . Послеоперационное повреждение легких является причиной большинства смертельных исходов после обширных резекционных легочных вмешательств. Летальность вследствие постпневмонэктомичес-кого отека легких остается неизменной на протяжении последних 20 лет и стремится к 100%. Целью данного исследования было проведение продленного мониторинга отека легких у пациентов после обширных торакальных вмешательств. Материал и методы. В обсервационное исследование включено 27 пациентов, которым была выполнена пневмонэктомия (n=16) или резекция легких (n=11). Всем больным проводили инвазивный мониторинг системной и легочной гемодинамики с использованием системы PiCCOplus во время вмешательства и на протяжении 48 часов послеоперационного периода. Результаты. Пневмонэктомия (ПЭ), но не резекция легких, сопровождалась достоверным снижением индекса внесосудистой воды легких (ИВСВЛ). Спустя 36—48 часов после окончания вмешательства у большинства пациентов, перенесших ПЭ, было выявлено субклиническое повышение ИВСВЛ. Заключение. В представленном обсервационном клиническом исследовании изолированная термодилюция показала немедленное уменьшение ИВСВЛ после ПЭ и его повышение к 36-48 часам послеоперационного периода. Долевые или сегментарные вмешательства не вели к значимым изменениям ИВСВЛ в пери-операционном периоде. Ключевые слова: пневмонэктомия, резекция легких, отек легких, внесосудистая вода легких, острое повреждение легких

Пути снижения госпитальной летальности у пациентов с кардиогенным шоком при остром коронарном синдроме

Objective: to analyze a medical care system for acute coronary syndrome (ACS) in a large city in terms of in-hospital cardiogenic shock mortality risk management. Materials and methods. The health care facility management system for a risk for cardiogenic shock (CS) and its poor outcome (death) was a methodological basis of this study. The information from case histories of ACS patients consecutively admitted to the Kemerovo Cardiology Dispensary (Kemerovo, Russia) in the period 2006 to 2011 was used to develop an electronic database. Sampling included 19281 patients with ACS, 6537 with myocardial infarction (MI), 493 with CS. Results and discussion. The medical care system for patients with ACS encompasses an emergency team (a prehospital level), a specialized cardiac hospital (an in-hospital level) with a multistage therapeutic and diagnostic process in relation the severity of a patient’s status. The management is based on the principle of continuity of care, by applying the well-defined activity algorithms through valid information exchange and risk stratification for poor outcomes of ACS. An antishock team working just in the admission unit of a hospital was set up to treat high CS risk patients. A systems approach allowed the strategy of early specialized medical care to be developed with a priority of primary percutaneous coronary interventions (PCI) as reperfusion therapy in patients with ST-elevation MI. In 2006-2011, every three patients with suspected ACS had verified MI that was com_ plicated by CS in 7.5%. In the CS group, the in-hospital mortality rates totaled 88.0% of cases; that after primary Адрес для корреспонденции (Correspondence to): PCI was 62.2%. In the examined period, the introduction of innovation clinical and organizational approaches provided a reduction in this indicator by 17.6 and 37.5%, respectively. Conclusion. The efficiency of risk management for CS and its poor outcomes in patients with ACS is determined by the unique principles of medical care rendering at all levels on the basis of risk management methodology.Цель исследования . Анализ системы оказания медицинской помощи при остром коронарном синдроме (ОКС) в крупном городе с точки зрения управления риском госпитальной летальности от кардиогенного шока (КШ). Материалы и методы. Основой исследования выступает система менеджмента медицинской организации в отношении риска КШ и его неблагоприятного исхода (смерть). На основе сведений из историй болезни пациентов с ОКС, поступивших последовательно в Кемеровский кардиологический диспансер (г. Кемерово, Россия) в период с 2006 по 2011 год сформирована электронная база данных. Способ формирования выборки — сплошной (с ОКС — 19281, с инфарктом миокарда (ИМ) — 6537, кардиогенным шоком (КШ) — 493 пациентов). Результаты и обсуждение. В системе оказания помощи пациентам с ОКС участвуют скорая медицинская помощь (догоспитальный уровень), специализированный кардиологический стационар (госпитальный уровень) с многоэтапным лечебно-диагностическим процессом по степени тяжести состояния пациента. Управление осуществляется по принципу преемственности помощи, с использованием четких алгоритмов деятельности на основе достоверного информационного обмена, стратификации риска неблагоприятных исходов ОКС. Для лечения пациентов с высоким риском КШ создана противошоковая бригада, работающая с этапа приемного отделения стационара. Системный подход позволил развивать стратегию раннего оказания специализированной медицинской помощи с приоритетом первичных чрескожных коронарных вмешательств (ЧКВ), как метода реперфузионной терапии у пациентов с ИМпST. За 2006—2011 гг. у каждого третьего пациента с подозрением на ОКС верифицирован ИМ, который у 7,5% осложнился КШ. Госпитальная летальность в целом в группе КШ составила 88,0% случаев, при проведении первичного ЧКВ — 62,2%. Внедрение инновационных клинико-ор-ганизационных подходов обеспечило за исследуемый период снижение показателя на 17,6 и 37,5% соответственно. Выводы. Эффективность управления риском развития КШ и его неблагоприятных исходов у пациентов с ОКС определяется едиными принципами процесса оказания медицинской помощи на всех уровнях на основе методологии риск-менеджмента. Ключевые слова: острый коронарный синдром, кардиогенный шок, риск-менеджмент

LONG TERM SURVIVAL OF MYOCARDIAL INFARCTION PATIENTS COMPLICATED WITH CARDIOGENIC SHOCK

Aim. To study the parameters of long term survival of patients with myocardial infarction (MI), complicated with cardiogenic shock (CS) and the main medical and social factor influencing survival rate. Material and methods. The patients included in the study were treated in Kemerovo Cardiological dispensary in 2006-2011 yy. Number of patients was 6462, of those with cardiogenic shock — 493. Statistics was done with the standard licensed software "Statistica 6.0". For survival estimation we used the methods of tables construction on life duration and multiplying Kaplan-Meier marks. Results. During 2006-2011 yy. CS developed in 7,6%. Among patients more prevalent were older and retired ages, the comorbidity level was high (anamesis of MI and stroke, diabetes and chronic obstructive lung disease). Annual survival rate in CS was 9,6%, triannual — 7,9%.Conclusion. Long term survival rate is negatively correlated with the age and does not depend on the patients' gender. Retired and older age, disability, anamnesis of MI, significant aortic stenosis, prominent chronic heart failure, multivessel coronary disease are associated with lower long-term survival rate. Reperfusion therapy by percutaneous intervention, the use of intraaortal balloon contrapulsation and renal replacement therapy in the complex CS therapy significantly improve long term survival of patients

Psychosomatic peculiarities of lipomas course in the maxillofacilal area

Dzhereley A. A., Romanenko I. G., Kryuchkov D. Yu., Gorobets S. M. Psychosomatic peculiarities of lipomas course in the maxillofacilal area. Journal of Education, Health and Sport. 2015;5(7):163-170. ISSN 2391-8306. DOI 10.5281/zenodo.19470 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%287%29%3A163-170 https://pbn.nauka.gov.pl/works/579617 http://dx.doi.org/10.5281/zenodo.19470 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011 – 2014 http://journal.rsw.edu.pl/index.php/JHS/issue/archive   Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 21.04.2015. Revised 28.05.2015. Accepted: 30.06.2015.   Psychosomatic peculiarities of lipomas course in the maxillofacilal area Dzhereley A. A., Romanenko I. G., Kryuchkov D. Yu., Gorobets S. M. Federal State Autonomous Educational Institution of Higher Education "Crimean Federal University named after V.I. Vernadskiy" Medical Academy named after S.I.Georgievsiy Dentistry Department     Summary Patients with lipomas in the maxillofacial area show some types of psychological reactions. But the most focused attention of the doctor in the postoperative period is required by the patients of euphoric-anosognosic psychosomatic group due to the high level of compliance between psychological reactions and somatic indicators. Was determined of three psychosomatic groups: anxiety-obsessive-phobic, euphoric-anosognosic and harmonious. The most focused attention of the doctor in the postoperative period is required by the patients of euphoric-anosognosic psychosomatic group due to the high level of compliance. Keywords: lipomas, maxillofacial area, psychological reactions, postoperative period