79 research outputs found

    Energy-efficient building management via model predictive control

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    The growing world population and energy consumption, along with the depletion of fossil energy resources and increasing concern regarding the pollution of the environment, make the world-energy problem the largest challenge for technology in the forthcoming decades [1]. Distributed generation could play a major role in the technological changes of the new electricity service paradigm. The use of localized energy sources is only one of the faces of energy management in buildings. A large part of the produced energy is used for heating and cooling systems, in order to maintain acceptable levels of comfort for the occupants of the apartments (hereafter referred to as "users"). Therefore, at a local level, there is a need for the definition and the testing of intelligent algorithms that can automatically manage distributed energy sources, at the same time taking into account the management of heating/ cooling systems

    Energy-efficient building management via model predictive control

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    The growing world population and energy consumption, along with the depletion of fossil energy resources and increasing concern regarding the pollution of the environment, make the world-energy problem the largest challenge for technology in the forthcoming decades [1]. Distributed generation could play a major role in the technological changes of the new electricity service paradigm. The use of localized energy sources is only one of the faces of energy management in buildings. A large part of the produced energy is used for heating and cooling systems, in order to maintain acceptable levels of comfort for the occupants of the apartments (hereafter referred to as "users"). Therefore, at a local level, there is a need for the definition and the testing of intelligent algorithms that can automatically manage distributed energy sources, at the same time taking into account the management of heating/ cooling systems

    Huntington’s disease modeling on HEK293 cell line

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    Huntington’s disease is a hereditary neurodegenerative disorder caused by CAG trinucleotide repeat expansion in the first exon of HTT gene. The mutant HTT protein has an elongated polyglutamine tract and forms aggregates in the nuclei and cytoplasm of the striatal neurons. The pathological processes occurring in the medium spiny neurons of Huntington’s disease patients lead to neurodegeneration and consequently to the death. The molecular mechanisms of the pathology development are difficult to study due to the limited material availability and late onset of the manifestation. Therefore, one of the important tasks is generation of an in vitro model system of Huntington’s disease based on human cell cultures. The new genome editing approaches, such as CRISPR/Cas9, allow us to generate isogenic cell lines that can be useful for drug screening and studying mechanisms of molecular and cellular events triggered by certain mutation on an equal genetic background. Here, we investigated the viability and proliferative rate of several mutant HEK293 cell clones with mutations in the first exon of HTT gene. The mutant clones were obtained earlier using CRISPR/Cas9 genome editing technology. We showed that mutant cells partially reproduce the pathological phenotype, that is, they have reduced proliferation activity, an increased level of apoptosis and high sensitivity to treatment with 5ΞΌM MG132 proteasome inhibitor compared to the original HEK293 Phoenix cell line. Our results indicate that the mutation in the first exon of HTT gene affects not only neurons, but also other types of cells, and HEK293 cell clones bearing the mutation can serve as in vitro model for studying some mechanisms of HTT functioning

    Association of polymorphic loci of susceptibility to diabetes mellitus type 2 in various ethnic groups of the Russian Federation

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    The multifactorial nature of type 2 diabetes mellitus (T2D) was confirmed by numerous researches. The first investigations devoted to molecular-genetic mechanisms of T2D were carried out on the basis of linkage disequilibrium (LD) studying and later the candidate genes of T2D have begun investigated. We have analyzed the literature data including the case-control studies in populations of Russia. There were revealed 33Β genes and 65 polymorphic markers in the analyzed works. The analysis of association of T2D in the ethnic groups of Russian Federation was carried out on following genes:Β ABCC8, ADIPOQ, ADIPOR1, ADIPOR2, C2CD4A/C2CD4A, CDKAL1, Β­CDKN2A/2B, CCL11, CCL20, CCL5, CYBA, FABP2, FTO, GCLC, GPX2, GSTP1, GSTT1, HHEX/IDE, IGF2BP2, IRS1, KCNJ11, KCNQ1, LPL, LRP5, MC4R, PPARG, SLC2A2, SLC30A8, SLC30A8, TCF7L2, TMEM18, WFS1, ZFAND6.Β The major of studies are replicative, i.e. repeating previous investigations of foreign authors, and were performed on Russian, Tatar and Yakut populations. At the same time not all the loci of genetic susceptibility have demonstrated the association with T2D in the population of Russia. In this work the systematic review of studies of molecular-genetic markers of T2D in the ethnic groups of Russian Federation was made for the first time

    ВлияниС Π»Π°Π·Π΅Ρ€Π½ΠΎΠ³ΠΎ ΠΎΡ‚ΠΆΠΈΠ³Π° Π½Π° структуру, оптичСскиС ΠΈ элСктричСскиС свойства Ρ‚ΠΎΠ½ΠΊΠΈΡ… ΠΏΠ»Π΅Π½ΠΎΠΊ оксида Ρ†ΠΈΠ½ΠΊΠ°

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    Paper presents experimental results of research of influence of laser annealing on the optical and electrical properties ZnO films. Developed technological regimes of modifications of layers in the production of thin film solar modules.ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Ρ‹ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ исслСдования влияния Π»Π°Π·Π΅Ρ€Π½ΠΎΠ³ΠΎ ΠΎΡ‚ΠΆΠΈΠ³Π° ΠΏΠ»Π΅Π½ΠΎΠΊ оксида Ρ†ΠΈΠ½ΠΊΠ° Π½Π° ΠΈΡ… оптичСскиС ΠΈ элСктричСскиС характСристики. ΠžΡ‚Ρ€Π°Π±ΠΎΡ‚Π°Π½Ρ‹ тСхнологичСскиС Ρ€Π΅ΠΆΠΈΠΌΡ‹ ΠΌΠΎΠ΄ΠΈΡ„ΠΈΠΊΠ°Ρ†ΠΈΠΈ слоСв для использования Π² производствС Ρ‚ΠΎΠ½ΠΊΠΎΠΏΠ»Π΅Π½ΠΎΡ‡Π½Ρ‹Ρ… солнСчных ΠΌΠΎΠ΄ΡƒΠ»Π΅ΠΉ

    Structure and properties of aqueous dispersions of sodium dodecyl sulfate with carbon nanotubes

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    Β© 2016, Springer Science+Business Media New York.The dispersing action of the surfactant (sodium dodecyl sulfate, SDS) on the carbon nanotubes (CNT) in aqueous medium has been studied. Electron microscopy, molecular docking, NMR and IR spectroscopies were applied to determine the physical-chemical properties of CNT dispersions in SDSβ€”water solutions. It was established that micellar adsorption of the surfactant on the surface of carbon material and solubilization of SDS in aqueous medium contribute to improving CNT dispersing in water solutions. It was shown that the non-polar hydrocarbon radicals of a single surfactant molecule form the highest possible number of contacts with the graphene surface. Upon increase of the SDS in solution these radicals form micelles connected with the surface of the nanotubes. At the sufficiently high SDS concentration the nanotube surface becomes covered with an adsorbed layer of surfactant micelles. Water molecules and sodium cations are concentrated in spaces between micelles. The observed pattern of micellar adsorption is somewhat similar to a loose bilayer of surfactant molecules

    Π‘Π»ΡƒΡ‡Π°ΠΉ синдрома Кавасаки, ассоциированного с ΠΌΠΈΠΊΠΎΠΏΠ»Π°Π·ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠ΅ΠΉ

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    Based on the literature sources, modern ideas about Kawasaki syndrome, its diagnostic criteria and the possible trigger role of M. pneumoniae are given. The author describes his own observation of Kawasaki syndrome, probably associated with mycoplasma infection, in a boy of 4 years and 8 months. A special feature of the case was also the presence of a combined mycoplasma-enterovirus infection, which explained the wave-like course of the disease, as well as the delayed development of the respiratory syndrome.На основании Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Π½Ρ‹Ρ… источников Π΄Π°Π½Ρ‹ соврСмСнныС прСдставлСния ΠΎ синдромС Кавасаки, Π΅Π³ΠΎ диагностичСских критСриях ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΠΉ Ρ‚Ρ€ΠΈΠ³Π³Π΅Ρ€Π½ΠΎΠΉ Ρ€ΠΎΠ»ΠΈ M. pneumoniae. ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½ΠΎ описаниС собствСнного наблюдСния синдрома Кавасаки, вСроятно, ассоциированного с ΠΌΠΈΠΊΠΎΠΏΠ»Π°Π·ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠ΅ΠΉ, Ρƒ ΠΌΠ°Π»ΡŒΡ‡ΠΈΠΊΠ° 4 Π»Π΅Ρ‚ 8 мСсяцСв. ΠžΡΠΎΠ±Π΅Π½Π½ΠΎΡΡ‚ΡŒΡŽ случая Ρ‚Π°ΠΊΠΆΠ΅ являлось Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ сочСтанной ΠΌΠΈΠΊΠΎΠΏΠ»Π°Π·ΠΌΠ΅Π½Π½ΠΎ-энтСровирусной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ, Ρ‡Ρ‚ΠΎ объясняло Π²ΠΎΠ»Π½ΠΎΠΎΠ±Ρ€Π°Π·Π½ΠΎΠ΅ Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ заболСвания, Π° Ρ‚Π°ΠΊΠΆΠ΅ отсрочСнноС Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ рСспираторного синдрома

    Клинико-Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Π΅ особСнности острых рСспираторных вирусных ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΉ Ρƒ госпитализированных Π΄Π΅Ρ‚Π΅ΠΉ

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    The aim of the study was to study the clinical and laboratory features of acute respiratory viral infections in hospitalized children.The analysis of medical records of 623 patients admitted to the clinic, aged from 1 month to 16 years 11 months 29 days, was carried out. All patients were diagnosed with ARVI on the basis of clinical symptoms with laboratory confirmation in the study of naso- or oropharyngeal smears by PCR.Three groups of children were identified: with respiratory syncytial (RSV) β€” 384 children (61,6%), metapneumovirus β€” 142 (22,8%) and bocavirus β€” 97 (15,6%) infections. It has been established that in the general structure of acute respiratory viral infections in hospitalized children, RSV and rhinovirus are the leading pathogens β€” 28,8β€”48,6% and 22,1β€”41,3%, respectively, depending on the calendar year. The main clinical form was acute bronchitis in 80,5% of cases of confirmed infection, with RS-viral etiology in 79,5% (n = 287) of cases, with metapneumo- and bocavirus infections in 85,6% (n = 95) and 77,8% (n = 56) of children, respectively. Bronchiolitis was characteristic of RSV infection in 10,5% of cases (n = 38). From 10 to 19,4% of cases, the course of these viral infections was complicated by the development of pneumonia.ЦСль исслСдования: ΠΈΠ·ΡƒΡ‡ΠΈΡ‚ΡŒ клиничСскиС ΠΈ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Π΅ особСнности острых рСспираторных вирусных ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΉ Ρƒ госпитализированных Π΄Π΅Ρ‚Π΅ΠΉ.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· мСдицинской Π΄ΠΎΠΊΡƒΠΌΠ΅Π½Ρ‚Π°Ρ†ΠΈΠΈ 623 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², госпитализированных Π² ΠΊΠ»ΠΈΠ½ΠΈΠΊΡƒ, Π² возрастС ΠΎΡ‚ 1 мСсяца Π΄ΠΎ 16 Π»Π΅Ρ‚ 11 мСсяцСв 29 Π΄Π½Π΅ΠΉ. Π£ всСх ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² установлСн Π΄ΠΈΠ°Π³Π½ΠΎΠ· ΠžΠ Π’Π˜ Π½Π° основании клиничСских симптомов с Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹ΠΌ ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π΅Π½ΠΈΠ΅ΠΌ ΠΏΡ€ΠΈ исслСдовании Π½Π°Π·ΠΎ- ΠΈΠ»ΠΈ ΠΎΡ€ΠΎΡ„Π°Ρ€ΠΈΠ½Π³Π΅Π°Π»ΡŒΠ½Ρ‹Ρ… ΠΌΠ°Π·ΠΊΠΎΠ² ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ ПЦР.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’Ρ‹Π΄Π΅Π»Π΅Π½ΠΎ 3 Π³Ρ€ΡƒΠΏΠΏΡ‹ Π΄Π΅Ρ‚Π΅ΠΉ: с рСспираторно-ΡΠΈΠ½Ρ†ΠΈΡ‚ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ (Π Π‘Π’) 384 Ρ€Π΅Π±Π΅Π½ΠΊΠ° (61,6%), мСтапнСвмовирусной – 142 (22,8%) ΠΈ бокавирусной β€” 97 (15,6) инфСкциями. УстановлСно, Ρ‡Ρ‚ΠΎ Π² ΠΎΠ±Ρ‰Π΅ΠΉ структурС ΠžΠ Π’Π˜ Ρƒ госпитализированных Π΄Π΅Ρ‚Π΅ΠΉ Π Π‘Π’ ΠΈ риновирус ΡΠ²Π»ΡΡŽΡ‚ΡΡ Π²Π΅Π΄ΡƒΡ‰ΠΈΠΌΠΈ ΠΏΠ°Ρ‚ΠΎΠ³Π΅Π½Π°ΠΌΠΈ β€” 28,8β€”48,6% ΠΈ 22,1β€”41,3% соотвСтствСнно, Π² зависимости ΠΎΡ‚ ΠΊΠ°Π»Π΅Π½Π΄Π°Ρ€Π½ΠΎΠ³ΠΎ Π³ΠΎΠ΄Π°. Основной клиничСской Ρ„ΠΎΡ€ΠΌΠΎΠΉ являлся острый Π±Ρ€ΠΎΠ½Ρ…ΠΈΡ‚ Π² 80,5% случаСв ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π΅Π½Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ, ΠΏΡ€ΠΈ этом Π Π‘-вирусной этиологии β€” Π² 79,5% (n = 287) случаСв, ΠΏΡ€ΠΈ ΠΌΠ΅Ρ‚Π°ΠΏΠ½Π΅Π²ΠΌΠΎ- ΠΈ бокавирусной инфСкциях β€” Π² 85,6% (n = 95) ΠΈ 77,8% (n = 56) соотвСтствСнно. Π‘Ρ€ΠΎΠ½Ρ…ΠΈΠΎΠ»ΠΈΡ‚ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€Π΅Π½ Π±Ρ‹Π» для Π Π‘Π’ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Π² 10,5% случаСв (n = 38). ΠžΡ‚ 10 Π΄ΠΎ 19,4% случаСв Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π΄Π°Π½Π½Ρ‹Ρ… вирусных ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΉ ослоТнялось Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ΠΌ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ

    РСспираторныС вирусныС ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Π² ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠΈ Π½ΠΈΠΆΠ½ΠΈΡ… Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… ΠΏΡƒΡ‚Π΅ΠΉ (ΠΎΠ±Π·ΠΎΡ€ Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹)

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    The sharp increase in viral pneumonia against the background of the pandemic of the new coronavirus infection SARS-CoV-2 requires more attention to the study of the role of viruses in damage to the lower respiratory tract, including their etiological significance in the development of community-acquired pneumonia. Modern possibilities of laboratory diagnostics make it possible not only to identify and study respiratory viruses, but also to help differentiate active viral infections as a cause of lower respiratory tract disease from virus carriers. The review describes the epidemiological and clinical features of the most relevant or less studied pneumotropic viral infections in children (respiratory syncytial, adenovirus, bocavirus, metapneumovirus), including their role in the etiology of pneumonia in children. Understanding the viral etiology of pneumonia in children will reduce the antibacterial load, which will help to reduce the side effects of chemotherapy and slow the emergence of antimicrobialresistant bacterial strains.Π Π΅Π·ΠΊΠΈΠΉ рост вирусных ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΉ Π½Π° Ρ„ΠΎΠ½Π΅ ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ Π½ΠΎΠ²ΠΎΠΉ коронавирусной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ SARS-CoV-2 Ρ‚Ρ€Π΅Π±ΡƒΠ΅Ρ‚ большСго внимания ΠΊ ΠΈΠ·ΡƒΡ‡Π΅Π½ΠΈΡŽ Ρ€ΠΎΠ»ΠΈ вирусов Π² ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠΈ Π½ΠΈΠΆΠ½ΠΈΡ… Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… ΠΏΡƒΡ‚Π΅ΠΉ, Π² Ρ‚ΠΎΠΌ числС ΠΈΡ… этиологичСского значСния Π² Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠΈ Π²Π½Π΅Π±ΠΎΠ»ΡŒΠ½ΠΈΡ‡Π½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ. Π‘ΠΎΠ²Ρ€Π΅ΠΌΠ΅Π½Π½Ρ‹Π΅ возмоТности Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½ΠΎΠΉ диагностики Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‚ Π²Ρ‹ΡΠ²Π»ΡΡ‚ΡŒ ΠΈ ΠΈΠ·ΡƒΡ‡Π°Ρ‚ΡŒ рСспираторныС вирусы, Π½ΠΎ ΠΈ ΠΏΠΎΠΌΠΎΠ³Π°ΡŽΡ‚ Π΄ΠΈΡ„Ρ„Π΅Ρ€Π΅Π½Ρ†ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ Π°ΠΊΡ‚ΠΈΠ²Π½ΡƒΡŽ Π²ΠΈΡ€ΡƒΡΠ½ΡƒΡŽ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΡŽ ΠΊΠ°ΠΊ ΠΏΡ€ΠΈΡ‡ΠΈΠ½Ρƒ заболСвания Π½ΠΈΠΆΠ½ΠΈΡ… Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… ΠΏΡƒΡ‚Π΅ΠΉ ΠΎΡ‚ Π²ΠΈΡ€ΡƒΡΠΎΠ½ΠΎΡΠΈΡ‚Π΅Π»ΡŒΡΡ‚Π²Π°. Π’ ΠΎΠ±Π·ΠΎΡ€Π΅ Π΄Π°Π½ΠΎ описаниС эпидСмиологичСских ΠΈ клиничСских особСнностСй Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π°ΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½Ρ‹Ρ… ΠΈΠ»ΠΈ ΠΌΠ΅Π½Π΅Π΅ ΠΈΠ·ΡƒΡ‡Π΅Π½Π½Ρ‹Ρ… ΠΏΠ½Π΅Π²ΠΌΠΎΡ‚Ρ€ΠΎΠΏΠ½Ρ‹Ρ… вирусных ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΉ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ (рСспираторно-ΡΠΈΠ½Ρ†ΠΈΡ‚ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ, адСновирусной, бокавирусной, мСтапнСвмовирусной), Π² Ρ‚ΠΎΠΌ числС ΠΈΡ… Ρ€ΠΎΠ»ΠΈ Π² этиологии ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ. ПониманиС вирусной этиологии ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ‚ ΡΠ½ΠΈΠ·ΠΈΡ‚ΡŒ Π°Π½Ρ‚ΠΈΠ±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½ΡƒΡŽ Π½Π°Π³Ρ€ΡƒΠ·ΠΊΡƒ, Ρ‡Ρ‚ΠΎ Π±ΡƒΠ΄Π΅Ρ‚ ΡΠΏΠΎΡΠΎΠ±ΡΡ‚Π²ΠΎΠ²Π°Ρ‚ΡŒ ΡƒΠΌΠ΅Π½ΡŒΡˆΠ΅Π½ΠΈΡŽ ΠΏΠΎΠ±ΠΎΡ‡Π½Ρ‹Ρ… явлСний Ρ…ΠΈΠΌΠΈΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΈ Π·Π°ΠΌΠ΅Π΄Π»ΠΈΡ‚ Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΠ΅ рСзистСнтных ΠΊ ΠΏΡ€ΠΎΡ‚ΠΈΠ²ΠΎΠΌΠΈΠΊΡ€ΠΎΠ±Π½Ρ‹ΠΌ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π°ΠΌ ΡˆΡ‚Π°ΠΌΠΌΠΎΠ² Π±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠΉ.

    Клинико-этиологичСская характСристика ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с нСблагоприятным исходом ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΎΠ½Π½Ρ‹Ρ… Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ

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    Purpose: to study the clinical and etiological features of pneumonia in children with a poor outcome of infectious diseases.Materials and methods. The retrospective analysis of clinical, anamnestic, laboratory, instrumental data of 46 children who died from infectious diseases during the period from December 2009 to November 2019 was carried out, of which 26 patients had pneumonia at autopsy. The etiology of pneumonia was determined in vivo and postmortem using cultural, molecular genetic, serological methods and immunohistocytochemical examination of lung tissue. Pneumonia was classified into primary and secondary.Results. In patients with pneumonia in the structure of generalized infections (n=26) secondary forms prevailed (septic – 14 cases, ventilator-associated (VAP) – 5, aspiration – 2); primary pneumonia was detected in 5 children. Clinical polymorphism and frequent absence of typical symptoms of pneumonia (cough, shortness of breath, auscultatory and percussion changes) were shown, that led to intravital underdiagnosis of pneumonia in 31% of patients. The probable etiology of pneumonia was detected in vivo and postmortem in 58% and 98% of cases respectively. S. pneumoniae (40%) and H. influenzae type b (40%) were main pathogens in primary pneumonia, N. meningitidis (36%) and S. pneumoniae (29%) – in septic pneumonia, commensals of naso- and oropharynx (S. salivarius) – in aspiration pneumonia, nosocomial bacteria (S. aureus and coagulase-negative staphylococci) – in VAP. In children with HIV infection, pneumonia was associated with opportunistic pathogens (P. jirovecii, C. neoformans). In 87% of cases polymicrobial associations were found in lower airways, that makes it difficult to identify the main causative agent of pneumonia.Conclusions. Most of symptoms of pediatric pneumonia in the structure of generalized infections are nonspecific. Post-mortem study improves the etiological verification of pneumonia and allow to suggest the most pathogenetically and thanatogenetically significant pathogen.ЦСль: ΠΈΠ·ΡƒΡ‡ΠΈΡ‚ΡŒ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-этиологичСскиС особСнности ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с нСблагоприятным исходом ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΎΠ½Π½Ρ‹Ρ… Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ рСтроспСктивный Π°Π½Π°Π»ΠΈΠ· ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-анамнСстичСских ΠΈ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½ΠΎ-ΠΈΠ½ΡΡ‚Ρ€ΡƒΠΌΠ΅Π½Ρ‚Π°Π»ΡŒΠ½Ρ‹Ρ… Π΄Π°Π½Π½Ρ‹Ρ… 46 ΡƒΠΌΠ΅Ρ€ΡˆΠΈΡ… ΠΎΡ‚ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΎΠ½Π½Ρ‹Ρ… Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π΄Π΅Ρ‚Π΅ΠΉ Π² ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ с дСкабря 2009 Π³. ΠΏΠΎ Π½ΠΎΡΠ±Ρ€ΡŒ 2019 Π³., ΠΈΠ· ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… Ρƒ 26 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π½Π° аутопсии выявлСна пнСвмония. Этиология ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΡΠ»Π°ΡΡŒ ΠΏΡ€ΠΈΠΆΠΈΠ·Π½Π΅Π½Π½ΠΎ ΠΈ посмСртно с ΠΏΠΎΠΌΠΎΡ‰ΡŒΡŽ ΠΊΡƒΠ»ΡŒΡ‚ΡƒΡ€Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ, молСкулярно-гСнСтичСского, сСрологичСского, ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² ΠΈ иммуногистоцитохимичСского исслСдования Ρ‚ΠΊΠ°Π½ΠΈ Π»Π΅Π³ΠΊΠΈΡ…. ПнСвмония ΠΊΠ»Π°ΡΡΠΈΡ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Π»Π°ΡΡŒ Π½Π° ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½ΡƒΡŽ ΠΈ Π²Ρ‚ΠΎΡ€ΠΈΡ‡Π½ΡƒΡŽ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π£ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠ΅ΠΉ Π½Π° Ρ„ΠΎΠ½Π΅ Π³Π΅Π½Π΅Ρ€Π°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½Ρ‹Ρ… ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΉ (n=26) ΠΏΡ€Π΅ΠΎΠ±Π»Π°Π΄Π°Π»ΠΈ Π²Ρ‚ΠΎΡ€ΠΈΡ‡Π½Ρ‹Π΅ Ρ„ΠΎΡ€ΠΌΡ‹ пораТСния Π»Π΅Π³ΠΊΠΈΡ… – сСптичСскиС (n=14), вСнтилятор-ассоциированныС (Π’ΠΠŸ; n=5) ΠΈ аспирационныС (n=2); пСрвичная пнСвмония выявлСна Ρƒ 5 Π΄Π΅Ρ‚Π΅ΠΉ. ΠŸΠΎΠΊΠ°Π·Π°Π½Ρ‹ клиничСский ΠΏΠΎΠ»ΠΈΠΌΠΎΡ€Ρ„ΠΈΠ·ΠΌ ΠΈ частоС отсутствиС Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€Π½Ρ‹Ρ… для ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ симптомов (кашСль, ΠΎΠ΄Ρ‹ΡˆΠΊΠ°, Π°ΡƒΡΠΊΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΈΠ²Π½Ρ‹Π΅ ΠΈ ΠΏΠ΅Ρ€ΠΊΡƒΡ‚ΠΎΡ€Π½Ρ‹Π΅ измСнСния) Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ Π² тяТСлом состоянии, Ρ‡Ρ‚ΠΎ обусловило ΠΏΡ€ΠΈΠΆΠΈΠ·Π½Π΅Π½Π½ΡƒΡŽ гиподиагностику ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρƒ 31% Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…. ВСроятная этиология ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ выявлСна ΠΏΡ€ΠΈΠΆΠΈΠ·Π½Π΅Π½Π½ΠΎ Π² 58% случаСв, ΠΏΠΎΡΡ‚ΠΌΠΎΡ€Ρ‚Π°Π»ΡŒΠ½ΠΎ – Π² 98%. ΠŸΡ€ΠΈ ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ основными этиопатогСнами являлись S. pneumoniae (40%) ΠΈ H. influenzae Ρ‚ΠΈΠΏΠ° b (40%), ΠΏΡ€ΠΈ сСптичСской – N. meningitidis (36%) ΠΈ S. pneumoniae (29%), ΠΏΡ€ΠΈ аспирационной – коммСнсалы носо- ΠΈ Ρ€ΠΎΡ‚ΠΎΠ³Π»ΠΎΡ‚ΠΊΠΈ (S. salivarius), ΠΏΡ€ΠΈ Π’ΠΠŸ – прСдставитСли нозокомиальной Ρ„Π»ΠΎΡ€Ρ‹ (S. aureus ΠΈ ΠΊΠΎΠ°Π³ΡƒΠ»Π°Π·ΠΎΠΎΡ‚Ρ€ΠΈΡ†Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ стафилококки). Π£ Π΄Π΅Ρ‚Π΅ΠΉ с Π’Π˜Π§-ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠ΅ΠΉ пнСвмония Π²ΠΎ всСх случаях Π±Ρ‹Π»Π° ассоциирована с возбудитСлями оппортунистичСских Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ (P. jirovecii, C. neoformans). Π’ 87% случаСв Π² Π½ΠΈΠΆΠ½ΠΈΡ… Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… путях ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠΈΠ²Π°Π»ΠΈΡΡŒ ΠΏΠΎΠ»ΠΈΠΌΠΈΠΊΡ€ΠΎΠ±Π½Ρ‹Π΅ ассоциации, Ρ‡Ρ‚ΠΎ затрудняСт выявлСниС основного возбудитСля ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π‘ΠΎΠ»ΡŒΡˆΠΈΠ½ΡΡ‚Π²ΠΎ синдромов ΠΈ симптомов Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ с ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠ΅ΠΉ Π½Π° Ρ„ΠΎΠ½Π΅ Π³Π΅Π½Π΅Ρ€Π°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½Ρ‹Ρ… ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΉ нСспСцифичны. ΠŸΠΎΡΠΌΠ΅Ρ€Ρ‚Π½ΠΎΠ΅ исслСдованиС аутопсийного ΠΌΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Π° ΡƒΠ»ΡƒΡ‡ΡˆΠ°Π΅Ρ‚ ΡΡ‚ΠΈΠΎΠ»ΠΎΠ³ΠΈΡ‡Π΅ΡΠΊΡƒΡŽ Π²Π΅Ρ€ΠΈΡ„ΠΈΠΊΠ°Ρ†ΠΈΡŽ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρƒ Π΄Π΅Ρ‚Π΅ΠΉ, позволяя ΠΏΡ€Π΅Π΄ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚ΡŒ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ патогСнСтичСски ΠΈ танатогСнСтичСски Π·Π½Π°Ρ‡ΠΈΠΌΡ‹ΠΉ Π²ΠΎΠ·Π±ΡƒΠ΄ΠΈΡ‚Π΅Π»ΡŒ Π² случаях сочСтанного пораТСния Π»Ρ‘Π³ΠΊΠΈΡ…
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