ТНЕ EFFECT OF HYPOPHYSECTOMY ON ТНЕ OCCURRENCE AND ТНЕ COURSE OF EXPERIMENTAL MYOCARDIТIS AND ARTHRIТIS

Тhе effect of the hypophysis and its hormones on the course of various pathological processes has been and still is the object of clinical and expeгirnental studies.Numeгous investigations confirm the role of the pituitary hormоnеs аnd particularly of АСТН in the course of diverse collagen disorders аnd their experimental models. These studies have given us grounds to initiate а follo1w-up study of the effect of hypophyssctomy on experimental myocarditis and arthritis in rats.Experiments wеге caгried out with 51 albino rats approximately identical in age аnd weight (between 130 and 180 g). The animals were divided into two groups: а control one (12 rats) and аn experimental оnе (39 rats).  At the begining of the experiments the animals from the latter group were subjected to hypophysectomy via paratracheal route. After the postoperative period was оvег (5 to 7 days оn the average) an electrocardiogram was made. Immediately after that а suspension of hemolytic streptococcus was intravenously administered after the method previously describled bу us. During the whole time of the ехрегiшепt the animals were clinically observed as regards their general condition, the status of their limbs, the рrеsеnсе of oedema ог erythema of the joints. EKG examinations wеге repeated twice in the intervals between the separate injections with streptococcus hemolyticus. Two weeks after the last injection (with streptococcus hemolyticus) the гats wеге killed with ether. All were dissected, biopsy material being taken fгоm the heart and the involved joints. Materials wеге fixed in 10% neutral formalin аnd were processed after the paгaffine and the freezing method: the slides wеrе stained with hemalaun-eosine, toluidineblue and Sudan III. The animals which died bеfоге the еnd of the experiments wеrе also dissected, biopsy material being also taken. А total of 620 histologic preparations were made from the myocardium and the involved joints

Stability of thin mill tool loaded with radial load

В роботі розглядається задача стійкості дискових фрез (пил), товщини яких змінюються в межах від 0,6 до 0,8 мм і моделюються круглою пластинкою навантаженою радіальною сило, що прикладена на границі. Задача моделює умови роботи такого інструменту, як дискова фреза, тонкий відрізний круг, для яких така сила може призвести до руйнування,а також може впливати на їх коливання. Одним з факторів, який може привести до її руйнування є втрата стійкості. Фрезу можна розглядати як круглу пластину. Основною задачею розрахунку на стійкість є визначення критичної сили,прикладеної на границі цієї пластини.When cutting disk cutter at its border force of cutting, which can be decomposed into radial and tangential components. Under the action of radial force thin cutters may lose stability, leading to their destruction. Thin cutter can be seen as a circular plate unit thickness radius R, which is rigidly fixed in the center and loaded radial force F, and on its outer edge radial concentrated moment and shear force available. The use of thin detachable cutters shows that very often the case of destruction, and taking into account these aspects of the problem is urgent. Problem determination of critical power actually divided into two phases. First - the definition of the stress-strain state of mill sunder the applied forces. This problem is seen as a problem of plane strain condition for the development of the method of application of the theory of functions of a complex variable, developed in the works M. Mushelishvili. The second stage – the definition of critical power, which uses the energy method. The main aim of the calculation is to determine the stability of the critical force applied to the plate boundary. To find the critical values of Pcr in this paper uses the energy stability criterion in the form of Brian.В работе рассмотрена задача устойчивости круглой пластинки нагруженной радиальной силой приложенной на границе. Задача моделирует условия работы такого инструмента, как дисковая фреза, тонкий отрезной круг, для которых такая сила может привести к разрушению, а также может влиять на ее колебания. Одним из факторов, который может привести к ее разрушению является потеря устойчивости. Основной задачей расчета на устойчивость является определение критической силы, приложенной на границы пластины

Cost of health inequality to the NHS in Wales

Background: Forty years from the seminal work of Welsh GP Julian Tudor Hart on the Inverse Care Law, inequalities in health and healthcare remain deeply embedded in Wales. There is a wider gap (over 17 years) in healthy life expectancy between people living in the most and least deprived neighborhoods in Wales. This health inequality is reflected in additional healthcare use. In this study we estimate the cost of inequality associated with this additional healthcare use to the publicly funded National Health Service (NHS) in Wales. Methods: We retrieved administrative data on all NHS inpatient admissions, outpatient and accident and emergency attendances in Wales between April 2018 and March 2019 from Digital Health and Care Wales (DHCW). Hospital service use data were translated to costs using Healthcare Resource Group (HRG) and health service specific unit cost data and linked with area level mid-year population and deprivation indices in order to calculate the healthcare costs associated with socioeconomics deprivation. Results: Inequality in healthcare use between people from more and less deprived neighborhoods was associated with an additional cost of £322 million per year to the NHS in Wales, accounting for 8.7% of total NHS hospital expenditure in the country. Emergency inpatient admissions made up by far the largest component of this additional cost contributing £247.4 million, 77% of the total. There are also substantial costs of inequality for A&E attendances and outpatient visits, though not maternity services. Elective admissions overall have a negative cost of inequality, since among men aged 50–75 and women aged 60–70, elective utilization is actually negatively associated with deprivation. Conclusion: There are wide inequalities in health and healthcare use between people living in more deprived neighborhoods and those living in less deprived neighborhoods in Wales. Tackling health inequality through a combination of health promotion and early intervention policies targeted toward deprived communities could yield substantial improvement in health and wellbeing, as well as savings for the Welsh NHS through reduced use of emergency hospital care

Targeted prevention in primary care aimed at lifestyle-related diseases:a study protocol for a non-randomised pilot study

Background: The consequences of lifestyle-related disease represent a major burden for the individual as well as for society at large. Individual preventive health checks to the general population have been suggested as a mean to reduce the burden of lifestyle-related diseases, though with mixed evidence on effectiveness. Several systematic reviews, on the other hand, suggest that health checks targeting people at high risk of chronic lifestyle-related diseases may be more effective. The evidence is however very limited. To effectively target people at high risk of lifestyle-related disease, there is a substantial need to advance and implement evidence-based health strategies and interventions that facilitate the identification and management of people at high risk. This paper reports on a non-randomized pilot study carried out to test the acceptability, feasibility and short-term effects of a healthcare intervention in primary care designed to systematically identify persons at risk of developing lifestyle-related disease or who engage in health-risk behavior, and provide targeted and coherent preventive services to these individuals. Methods: The intervention took place over a three-month period from September 2016 to December 2016. Taking a two-pronged approach, the design included both a joint and a targeted intervention. The former was directed at the entire population, while the latter specifically focused on patients at high risk of a lifestyle-related disease and/or who engage in health-risk behavior. The intervention was facilitated by a digital support system. The evaluation of the pilot will comprise both quantitative and qualitative research methods. All outcome measures are based on validated instruments and aim to provide results pertaining to intervention acceptability, feasibility, and short-term effects. Discussion: This pilot study will provide a solid empirical base from which to plan and implement a full-scale randomized study with the central aim of determining the efficacy of a preventive health intervention. Trial registration: Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016). Registered 29 April 2016. The study adheres to the SPIRIT guidelines

Fast and expensive (PCR) or cheap and slow (culture)? A mathematical modelling study to explore screening for carbapenem resistance in UK hospitals

Background Enterobacteriaceae are a common cause of hospital infections. Carbapenems are a clinically effective treatment of such infections. However, resistance is on the rise. In particular, carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are increasingly common. In order to limit spread in clinical settings, screening and isolation is being recommended, but many different screening methods are available. We aimed to compare the impact and costs of three algorithms for detecting CP-CRE carriage. Methods We developed an individual-based simulation model to compare three screening algorithms using data from a UK National Health Service (NHS) trust. The first algorithm, “Direct PCR”, was highly sensitive/specific and quick (half a day), but expensive. The second, “Culture + PCR”, was relatively sensitive/specific but slower, requiring 2.5 days. A third algorithm, “PHE”, repeated the “Culture + PCR” three times with an additional PCR. Scenario analysis was used to compare several levels of CP-CRE prevalence and coverage of screening, different specialities as well as isolation strategies. Our outcomes were (1) days that a patient with CP-CRE was not detected and hence not isolated (“days at risk”), (2) isolation bed days, (3) total costs and (4) mean cost per CP-CRE risk day averted per year. We also explored limited isolation bed day capacity. Results We found that although a Direct PCR algorithm would reduce the number of CP-CRE days at risk, the mean cost per CP-CRE risk day averted per year was substantially higher than for a Culture + PCR algorithm. For example, in our model of an intensive care unit, during a year with a 1.6% CP-CRE prevalence and 63% screening coverage, there were 508 (standard deviation 15), 642 (14) and 655 (14) days at risk under screening algorithms Direct PCR, Culture + PCR and PHE respectively, with mean costs per risk day averted of £192, £61 and £79. These results were robust to sensitivity analyses. Conclusions Our results indicate that a Culture + PCR algorithm provides the optimal balance of cost and risk days averted, at varying isolation, prevalence and screening coverage scenarios. Findings from this study will help clinical organisations determine the optimal screening approach for CP-CRE, balancing risk and resources