50 research outputs found

    Designing a test asset and validating the accuracy of GPS/GNSS speed measurement

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    Global Navigation Satellite System (GNSS) receivers are now widely used for navigation and speed measurements. The increasing demand for vehicles monitoring in regulatory and non-regulatory environments has led to a growing number of GNSS applications in the automobile industry. In addition, GNSS receivers are commonly used by civilian users for navigation and speed measurements. Manufacturers of GNSS receivers supply speed accuracy parameters in the receiver specification data sheets. However, little information is provided regarding specific conditions when the specified speed accuracy of GNSS receivers might be met. Also, there is limited research available about practical speed accuracy parameters of receivers in a variety of challenging GNSS environments. Finally, to the author’s knowledge, there is no research conducted to understand if adding more satellites from different constellations to GPS, for example, GLONASS provides an improvement in GNSS speed accuracy reporting. This thesis presents the design of a test asset system capable of testing GNSS receivers for speed accuracy and the Uncertainty of Measurements (UOM) analysis for this system. The test asset system utilises a variety of engineering solutions and is capable of maintaining high accuracy benchmarks in speed measurements. The test asset system has an UOM equal 0.4 km/h for the entire range of speeds used for GNSS speed testing. The system was designed, assembled and tested to ensure the system maintains its integrity and capability to test GNSS receivers for speed measurement. Subsequently, several field experiments were performed to collect GNSS speed data records in a variety of driving environments using different receivers. The receivers ranged from geodetic grade to low cost receivers. Test routes were selected specifically to reflect real world and challenging GNSS environments, such as freeways with overpasses and roads with tree canopies. Detailed analyses of outliers and statistical results are presented to demonstrate that GNSS receivers may not measure speed correctly under challenging environments. The results also show that different GNSS receivers perform differently in measuring speed. Methods to filter potentially unreliable speed records were also investigated

    THE ADVANTAGES OF USING LINUX IN THE SERVER WORLD

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    Linux and Windows are two operating systems that are constantly competing for control of the computer market. Both operating systems have shown considerable growth in the server world. Microsoft released its first server operating system (OS) in 1993, just about the time when the Linux OS began surfacing on the Internet. These two operating systems have much in common, but still they are quite different

    The importance of the physical culture in formation of future teacher’s personality

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    The importance of the physical culture in formation of future teacher’s personality as a factor of formation of professional readiness of future specialist for professional activity is consideredРассматриваСтся Π·Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ физичСской ΠΊΡƒΠ»ΡŒΡ‚ΡƒΡ€Ρ‹ Π² становлСнии личности Π±ΡƒΠ΄ΡƒΡ‰Π΅Π³ΠΎ ΠΏΠ΅Π΄Π°Π³ΠΎΠ³Π° ΠΊΠ°ΠΊ Ρ„Π°ΠΊΡ‚ΠΎΡ€ формирования ΠΏΡ€ΠΎΡ„Π΅ΡΡΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉ готовности Π±ΡƒΠ΄ΡƒΡ‰Π΅Π³ΠΎ спСциалиста ΠΊ ΠΏΡ€ΠΎΡ„Π΅ΡΡΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉ Π΄Π΅ΡΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚

    Rare complications after thoracoplasty in children with congenital pectus excavatum

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    In this study we presented 4 rare postoperative complications at children after 202 cases of thoracoplasty concerning pectus excavatum deformity of the thorax in the period between 2002 and 2014. The operations were performed by the method proposed by D. Nuss. We revealed following complications: fracture of a body of sternum in the field of its joint with the handle in 1,5 months after operation; massive hemorrhage in a cavity of the fibrous capsule created around a metalwork in 2 years after performance of the thoracoplasty; incarceration of a portion of the latissimus dorsi muscle under "shoulder" of metal construction in 1,5 years after operation; violation of venous outflow at the level of a subclavian vein and a partial compression of a subclavial vein in the early postoperative period. We analyzed possible reasons, clinical symptoms, diagnostics, methods of treatment and offered methods of prevention of these complications

    The Use of Multicolor Flow Cytofluorometry in White Blood Cell Differential: HematoFlow Conception

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    Aim. To develop reference intervals for white blood cell subpopulations in peripheral blood using Cytomics FC500 flow cytometer and CytoDiffTM reagent (Beckman Coulter). Materials & Methods. The trial included the analysis of blood samples of healthy donors (n = 315) using Cytomics FC500 flow cytometer and CytoDiffTM reagent cocktail composed of 6 antibodies in 5 colors (CD36-FITC, CD2-PE, CD294-PE, CD19-ECD, CD16-Cy5, CD45-Cy7) and enabling to count 17 cell populations. Results. The data obtained by means of multicolor flow cytofluorometry included the reference values of white blood cell populations in peripheral blood. In 1 first-time donor a lymphoproliferative disease was detected. It was subsequently confirmed by immunophenotyping; B-cell chronic lymphocytic leukemia was diagnosed. Conclusion. Multicolor flow cytofluorometry using CytoDiffTM is considered to be a new step toward an improved WBC differential evaluation aimed mainly at reducing the volume of blood smear analysis using light microscopy at large laboratories, enhancing objectivity, precision and reproducibility of results. WBC differential extended with the count of lymphocyte and monocyte subpopulations can be regarded as modern donor blood screening to detect changes in the pattern of lymphocyte subpopulations as grounds for further examination of donors

    FEATURES OF DIAGNOSTIC AND THERAPEUTIC TACTICS FOR BLUNT ABDOMINAL TRAUMA WITH DAMAGE TO THE PANCREAS

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    Abstract. Injuries of pancreas in the closed abdominal trauma remain the one of most challenging issues in diagnosis and choice of optimal therapy.Objectives. To analyze clinical results of the improved diagnostic and treatment tactics in patients with blunt abdominal trauma and damage to the pancreas.Material and methods. We report the results of treatment for 141 patients with pancreatic trauma treated from 1991 to 2015 at City Hospital No. 3 and City Hospital No. 40. All patients were divided into 2 groups. These groups were formed according to the time factor. The groups were comparable in age, gender, and pancreatic trauma severity. The study group consisted of 59 patients, treated in 2004-2015, and the comparison group consisted of 82 patients (1991–2003). The advanced diagnostic and treatment algorithm for the study group included modern instrumental diagnostic methods, such as ultrasound, computed tomography, diagnostic laparoscopy and improved surgical tactics to lower indications for omental plug, omentobursostomy, suturing capsule of pancreas and cholecystostomy.Results. This algorithm reduced the duration gap between hospitalization and surgery averagely from 10.7 to 4.0 hours, and the modified treatment tactics decreased the incidence of septic complications from 15.8% to 6.8%, and the mortality from 27.6% to 16.9%.Conclusion. As a rule, methods of radiodiagnosis detect only indirect signs of pancreatic injury in blunt abdominal trauma. It is advisable to perform omental plugging only as medical tactics of Β«damage controlΒ»

    ΠžΠ‘ΠžΠ‘Π•ΠΠΠžΠ‘Π’Π˜ Π›Π•Π§Π•Π‘ΠΠž-Π”Π˜ΠΠ“ΠΠžΠ‘Π’Π˜Π§Π•Π‘ΠšΠžΠ™ ВАКВИКИ ПРИ Π—ΠΠšΠ Π«Π’ΠžΠ™ Π’Π ΠΠ’ΠœΠ• Π–Π˜Π’ΠžΠ’Π Π‘ ΠŸΠžΠ’Π Π•Π–Π”Π•ΠΠ˜Π•Πœ ΠŸΠžΠ”Π–Π•Π›Π£Π”ΠžΠ§ΠΠžΠ™ Π–Π•Π›Π•Π—Π«

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    Abstract. Injuries of pancreas in the closed abdominal trauma remain the one of most challenging issues in diagnosis and choice of optimal therapy.Objectives. To analyze clinical results of the improved diagnostic and treatment tactics in patients with blunt abdominal trauma and damage to the pancreas.Material and methods. We report the results of treatment for 141 patients with pancreatic trauma treated from 1991 to 2015 at City Hospital No. 3 and City Hospital No. 40. All patients were divided into 2 groups. These groups were formed according to the time factor. The groups were comparable in age, gender, and pancreatic trauma severity. The study group consisted of 59 patients, treated in 2004-2015, and the comparison group consisted of 82 patients (1991–2003). The advanced diagnostic and treatment algorithm for the study group included modern instrumental diagnostic methods, such as ultrasound, computed tomography, diagnostic laparoscopy and improved surgical tactics to lower indications for omental plug, omentobursostomy, suturing capsule of pancreas and cholecystostomy.Results. This algorithm reduced the duration gap between hospitalization and surgery averagely from 10.7 to 4.0 hours, and the modified treatment tactics decreased the incidence of septic complications from 15.8% to 6.8%, and the mortality from 27.6% to 16.9%.Conclusion. As a rule, methods of radiodiagnosis detect only indirect signs of pancreatic injury in blunt abdominal trauma. It is advisable to perform omental plugging only as medical tactics of Β«damage controlΒ».РСзюмС. ВравматичСскиС поврСТдСния ΠΏΠΎΠ΄ΠΆΠ΅Π»ΡƒΠ΄ΠΎΡ‡Π½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ‹ (ΠŸΠ–) ΠΏΡ€ΠΈ Π·Π°ΠΊΡ€Ρ‹Ρ‚ΠΎΠΉ Ρ‚Ρ€Π°Π²ΠΌΠ΅ ΠΆΠΈΠ²ΠΎΡ‚Π° ΠΏΠΎ трудности диагностики ΠΈ Π²Ρ‹Π±ΠΎΡ€Π° ΠΎΠΏΡ‚ΠΈΠΌΠ°Π»ΡŒΠ½ΠΎΠΉ Π»Π΅Ρ‡Π΅Π±Π½ΠΎΠΉ Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ ΠΎΡΡ‚Π°ΡŽΡ‚ΡΡ ΠΎΠ΄Π½ΠΈΠΌΠΈ ΠΈΠ· самых слоТных срСди Ρ‚Ρ€Π°Π²ΠΌ ΠΎΡ€Π³Π°Π½ΠΎΠ² Π±Ρ€ΡŽΡˆΠ½ΠΎΠΉ полости.ЦСль. Анализ клиничСских Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² ΡƒΡΠΎΠ²Π΅Ρ€ΡˆΠ΅Π½ΡΡ‚Π²ΠΎΠ²Π°Π½Π½ΠΎΠΉ Π»Π΅Ρ‡Π΅Π±Π½ΠΎ-диагностичСской Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ Ρƒ ΠΏΠΎΡΡ‚Ρ€Π°Π΄Π°Π²ΡˆΠΈΡ… с Π·Π°ΠΊΡ€Ρ‹Ρ‚ΠΎΠΉ Ρ‚Ρ€Π°Π²ΠΌΠΎΠΉ ΠΆΠΈΠ²ΠΎΡ‚Π° с ΠΏΠΎΠ²Ρ€Π΅ΠΆΠ΄Π΅Π½ΠΈΠ΅ΠΌ ΠŸΠ–.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Ρ‹ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ лСчСния 141 ΠΏΠΎΡΡ‚Ρ€Π°Π΄Π°Π²ΡˆΠ΅Π³ΠΎ с Π·Π°ΠΊΡ€Ρ‹Ρ‚ΠΎΠΉ Ρ‚Ρ€Π°Π²ΠΌΠΎΠΉ ΠŸΠ–, Π½Π°Ρ…ΠΎΠ΄ΠΈΠ²ΡˆΠΈΡ…ΡΡ Π½Π° Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ Π² городских Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Π°Ρ… β„– 3 ΠΈ β„– 40 Π³ΠΎΡ€ΠΎΠ΄Π° Π‘Π°Π½ΠΊΡ‚-ΠŸΠ΅Ρ‚Π΅Ρ€Π±ΡƒΡ€Π³Π° с 1991 ΠΏΠΎ 2015 Π³. ВсС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ Π±Ρ‹Π»ΠΈ Ρ€Π°Π·Π΄Π΅Π»Π΅Π½Ρ‹ Π½Π° 2 Π³Ρ€ΡƒΠΏΠΏΡ‹. Π“Ρ€ΡƒΠΏΠΏΡ‹ сформированы ΠΏΠΎ Π²Ρ€Π΅ΠΌΠ΅Π½Π½ΠΎΠΌΡƒ Ρ„Π°ΠΊΡ‚ΠΎΡ€Ρƒ ΠΈ Π±Ρ‹Π»ΠΈ сопоставимы ΠΏΠΎ ΠΏΠΎΠ»ΠΎΠ²ΠΎΠΌΡƒ ΠΈ возрастному ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠ°ΠΌ, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΏΠΎ тяТСсти ΠΏΠΎΠ²Ρ€Π΅ΠΆΠ΄Π΅Π½ΠΈΠΉ ΠŸΠ–. Π“Ρ€ΡƒΠΏΠΏΡƒ исслСдования составили 59 ΠΏΠΎΡΡ‚Ρ€Π°Π΄Π°Π²ΡˆΠΈΡ…, ΠΏΡ€ΠΎΠ»Π΅Ρ‡Π΅Π½Π½Ρ‹Ρ… Π² ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ с 2004 ΠΏΠΎ 2015 Π³., Π³Ρ€ΡƒΠΏΠΏΡƒ срав- нСния β€” 82 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° (1991–2003 Π³Π³.). Π’ основной Π³Ρ€ΡƒΠΏΠΏΠ΅ Π² диагностичСский Π°Π»Π³ΠΎΡ€ΠΈΡ‚ΠΌ Π±Ρ‹Π»ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½Ρ‹ соврСмСнныС ΠΈΠ½ΡΡ‚Ρ€ΡƒΠΌΠ΅Π½Ρ‚Π°Π»ΡŒΠ½Ρ‹Π΅ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹ диагностики, Ρ‚Π°ΠΊΠΈΠ΅ ΠΊΠ°ΠΊ ΡƒΠ»ΡŒΡ‚Ρ€Π°Π·Π²ΡƒΠΊΠΎΠ²ΠΎΠ΅ исслСдованиС, ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½Π°Ρ томография, диагностичСская лапароскопия, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΡƒΡΠΎΠ²Π΅Ρ€ΡˆΠ΅Π½ΡΡ‚Π²ΠΎΠ²Π°Π½Π° хирургичСская Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠ° β€” сокращСны показания ΠΊ Ρ‚Π°ΠΌΠΏΠΎΠ½ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΡŽ, омСнтобурсостомии, ΠΎΡ‚ΠΊΠ°Π· ΠΎΡ‚ ΡƒΡˆΠΈΠ²Π°Π½ΠΈΡ капсулы ΠΆΠ΅Π»Π΅Π·Ρ‹, холСцистостомии.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ИспользованиС Π΄Π°Π½Π½ΠΎΠ³ΠΎ диагностичСского Π°Π»Π³ΠΎΡ€ΠΈΡ‚ΠΌΠ° ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»ΠΎ врСмя, проходящСС ΠΎΡ‚ ΠΌΠΎΠΌΠ΅Π½Ρ‚Π° госпитализации Π΄ΠΎ оказания ΠΏΠΎΡΡ‚Ρ€Π°Π΄Π°Π²ΡˆΠ΅ΠΌΡƒ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ пособия Π² срСднСм с 10,7 Π΄ΠΎ 4,0 Ρ‡, Π° ΡƒΡΠΎΠ²Π΅Ρ€ΡˆΠ΅Π½ΡΡ‚Π²ΠΎΠ²Π°Π½ΠΈΠ΅ Π»Π΅Ρ‡Π΅Π±Π½ΠΎΠΉ Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ снизило частоту Π³Π½ΠΎΠΉΠ½ΠΎ-сСптичСских ослоТнСний с 15,8 Π΄ΠΎ 6,8%, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΎΠ±Ρ‰ΡƒΡŽ Π»Π΅Ρ‚Π°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ с 27,6 Π΄ΠΎ 16,9%.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. ΠœΠ΅Ρ‚ΠΎΠ΄Ρ‹ Π»ΡƒΡ‡Π΅Π²ΠΎΠΉ диагностики ΠΊΠ°ΠΊ ΠΏΡ€Π°Π²ΠΈΠ»ΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‚ Π²Ρ‹ΡΠ²ΠΈΡ‚ΡŒ лишь косвСнныС ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΈ поврСТдСния ΠŸΠ– ΠΏΡ€ΠΈ Π·Π°ΠΊΡ€Ρ‹Ρ‚ΠΎΠΉ Ρ‚Ρ€Π°Π²ΠΌΠ΅ ΠΆΠΈΠ²ΠΎΡ‚Π°. Π‘ Ρ†Π΅Π»ΡŒΡŽ ΡƒΠΌΠ΅Π½ΡŒΡˆΠ΅Π½ΠΈΡ риска развития Π³Π½ΠΎΠΉΠ½ΠΎ-сСптичСских ослоТнСний цСлСсообразно ΠΎΠ³Ρ€Π°Π½ΠΈΡ‡ΠΈΡ‚ΡŒ использованиС тампонирования сальниковой сумки лишь Ρ€Π°ΠΌΠΊΠ°ΠΌΠΈ Π»Π΅Ρ‡Π΅Π±Π½ΠΎΠΉ Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ Β«damage controlΒ»

    Spreading the Experience of Preschool Educational Establishments

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    The paper observes the issue of spreading the innovative experience of municipal preschool educational establishments (MPEE). The author outlines the ways of spreading the ideas of Β«Development Program of MPEEΒ» and Β« Educational Program of MPEEΒ» worked out according to the federal state requirements. Theoretical methodological basis of the research combines the fundamental studies of the last century’s Russian teachers and psychologists: L. S.Β Vygodsky, A. N. Leontyev, L. I. Bozhovitch, A. V. Zaporozhets, V. V. Davydov, etc. Based on their studies, a series of teaching methodical manuals was developed in the Institute of Reflexive Psychology of Creativity and Humanizing the Education at the International Academy of Humanizing the Education, Sotchi–Magdeburg: Β«Russian Education 2020 – the Model of Preschool EducationΒ» and Β«Pedagogic Innovations in MPEE of Innovative TypeΒ».In author’s opinion, the outcome of the research can promote the modernization efficiency in preschool education

    ГАНГРЕНА Π”ΠžΠ›Π˜ Π›Π•Π“ΠšΠžΠ“Πž ПРИ Π•Π• ΠšΠ˜Π‘Π’ΠžΠ—ΠΠž-ΠΠ”Π•ΠΠžΠœΠΠ’ΠžΠ—ΠΠžΠ™ ΠœΠΠ›Π¬Π€ΠžΠ ΠœΠΠ¦Π˜Π˜

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    The article describes a case of successful treatment of a child not elder than 1 year old with a gangrene in the right upper lobe of the lung against the background of its cystic adenomatoid malformation. The disease manifested as pneumonia. The diagnosis was confirmed following multispiral computed tomography. The first stage of surgery was drainage of the pleural cavity. Thoracotomy and upper lobe lobectomy were done after a child’s condition had stabilized. Gangrene in the cystic and adenomatoid piece of the lobe was confirmed macroscopically and histologically.Β Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ описан случай ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎΠ³ΠΎ лСчСния Ρ€Π΅Π±Π΅Π½ΠΊΠ° Π² возрастС ΠΎΠ΄Π½ΠΎΠ³ΠΎ Π³ΠΎΠ΄Π° с Π³Π°Π½Π³Ρ€Π΅Π½ΠΎΠΉ Π²Π΅Ρ€Ρ…Π½Π΅ΠΉ Π΄ΠΎΠ»ΠΈ ΠΏΡ€Π°Π²ΠΎΠ³ΠΎ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π½Π° Ρ„ΠΎΠ½Π΅ Π΅Π΅ кистозно-Π°Π΄Π΅Π½ΠΎΠΌΠ°Ρ‚ΠΎΠ·Π½ΠΎΠΉ ΠΌΠ°Π»ΡŒΡ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ. ΠšΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠΎΠ΅ проявлСниС заболСвания Π½Π°Ρ‡Π°Π»ΠΎΡΡŒ с ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ. Π”ΠΈΠ°Π³Π½ΠΎΠ· ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π΅Π½ послС выполнСния ΠΌΡƒΠ»ΡŒΡ‚ΠΈΡΠΏΠΈΡ€Π°Π»ΡŒΠ½ΠΎΠΉ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠΉ Ρ‚ΠΎΠΌΠΎΠ³Ρ€Π°Ρ„ΠΈΠΈ. ΠŸΠ΅Ρ€Π²Ρ‹ΠΌ этапом ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ лСчСния Π±Ρ‹Π»ΠΎ Π΄Ρ€Π΅Π½ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠ»Π΅Π²Ρ€Π°Π»ΡŒΠ½ΠΎΠΉ полости ΠΈ послС стабилизации состояния Ρ€Π΅Π±Π΅Π½ΠΊΠ° Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° торакотомия, вСрхнСдолСвая лобэктомия. ΠœΠ°ΠΊΡ€ΠΎΡΠΊΠΎΠΏΠΈΡ‡Π΅ΡΠΊΠΈ ΠΈ гистологичСски ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π΅Π½Π° Π³Π°Π½Π³Ρ€Π΅Π½Π° кистозно-Π°Π΄Π΅Π½ΠΎΠΌΠ°Ρ‚ΠΎΠ·Π½ΠΎ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½Π½ΠΎΠΉ Π΄ΠΎΠ»ΠΈ.

    Π“Π½ΠΎΠΉΠ½ΠΎ-нСкротичСский ΠΏΠ°Ρ€Π°ΠΏΡ€ΠΎΠΊΡ‚ΠΈΡ‚ Ρƒ Ρ€Π΅Π±Π΅Π½ΠΊΠ° 5 Π»Π΅Ρ‚: клиничСскоС наблюдСниС

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    Authors present a rare clinical case of successful treatment of a 5-year-old child with purulent-necrotic paraproctitis, which developed against the background of a primary immune deficiency state. Clinical case. A 5-year-old boy became acutely ill, against the background of diarrhea with hyperthermia. An area of hyperemia, edema, and tissue infiltration appeared in the perianal region. In anamnesis, with frequent respiratory infections and dysfunction of the intestinal tract in the form of diarrhea. He was admitted to the Regional Childrens Hospital on the 10th day of illness from the regional hospital, where antibiotic treatment was started. Upon admission, the condition was serious in the perianal region with an extensive wound necrotic tissues and a plaque of fibrin. To create favorable conditions for wound healing, a preventive sigmostomy operation was performed. Multidrug-resistant Pseudomonas aeruginosa was found in the wound culture. Thus, courses of antibiotics treatment, infusion therapy, and surgical debridement of the perianal wound and its local treatment were performed. Upon immunological status examination, a primary immunodeficiency was revealed, for which drugs with immunoglobulin G were administered. As a result of the treatment, the wound healed by secondary intention, thus, an operation was performed to close the sigmostoma. The child was discharged in satisfactory condition under the supervision of an immunologist and a surgeon. Discussion. In this case, preventive sigmostomy is justified; however, authors limit themselves to surgical intervention on the perineum in other cases. Pseudomonas aeruginosa shows its pathogenicity in patients with impaired immunity. Therefore, courses of antibiotics, infusion therapy, and immunomodulatory therapy along with surgical treatment, favorable result were achieved. Conclusion. Children with purulent-necrotic paraproctitis, which developed against the background of a primary immune deficiency should be hospitalized as early as possible in a specialized hospital.ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½ΠΎ Ρ€Π΅Π΄ΠΊΠΎΠ΅ клиничСскоС наблюдСниС ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎΠ³ΠΎ лСчСния Ρ€Π΅Π±Π΅Π½ΠΊΠ° 5 Π»Π΅Ρ‚ с Π³Π½ΠΎΠΉΠ½ΠΎ-нСкротичСским ΠΏΠ°Ρ€Π°ΠΏΡ€ΠΎΠΊΡ‚ΠΈΡ‚ΠΎΠΌ, Ρ€Π°Π·Π²ΠΈΠ²ΡˆΠΈΠΌΡΡ Π½Π° Ρ„ΠΎΠ½Π΅ ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎΠ³ΠΎ ΠΈΠΌΠΌΡƒΠ½ΠΎΠ΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π½ΠΎΠ³ΠΎ состояния. ОписаниС наблюдСния. ΠœΠ°Π»ΡŒΡ‡ΠΈΠΊ, 5 Π»Π΅Ρ‚, Π·Π°Π±ΠΎΠ»Π΅Π» остро, ΠΊΠΎΠ³Π΄Π° Π½Π° Ρ„ΠΎΠ½Π΅ Π΄ΠΈΠ°Ρ€Π΅ΠΈ с Π³ΠΈΠΏΠ΅Ρ€Ρ‚Π΅Ρ€ΠΌΠΈΠ΅ΠΉ Π² ΠΏΠ΅Ρ€ΠΈΠ°Π½Π°Π»ΡŒΠ½ΠΎΠΉ области появился участок Π³ΠΈΠΏΠ΅Ρ€Π΅ΠΌΠΈΠΈ, ΠΎΡ‚Π΅ΠΊΠ° ΠΈ ΠΈΠ½Ρ„ΠΈΠ»ΡŒΡ‚Ρ€Π°Ρ†ΠΈΠΈ Ρ‚ΠΊΠ°Π½Π΅ΠΉ. Π’ Π°Π½Π°ΠΌΠ½Π΅Π·Π΅: частыС рСспираторныС ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ ΠΈ дисфункция ΠΊΠΈΡˆΠ΅Ρ‡Π½ΠΎΠ³ΠΎ Ρ‚Ρ€Π°ΠΊΡ‚Π° Π² Π²ΠΈΠ΄Π΅ Π΄ΠΈΠ°Ρ€Π΅ΠΈ. Госпитализирован Π² ΠžΠ±Π»Π°ΡΡ‚Π½ΡƒΡŽ Π΄Π΅Ρ‚ΡΠΊΡƒΡŽ Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρƒ Π½Π° 10-Π΅ сутки заболСвания ΠΈΠ· Ρ€Π°ΠΉΠΎΠ½Π½ΠΎΠΉ Π±ΠΎΠ»ΡŒΠ½ΠΈΡ†Ρ‹, Π³Π΄Π΅ Π±Ρ‹Π»ΠΎ Π½Π°Ρ‡Π°Ρ‚ΠΎ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π°Π½Ρ‚ΠΈΠ±ΠΈΠΎΡ‚ΠΈΠΊΠ°ΠΌΠΈ. ΠŸΡ€ΠΈ поступлСнии состояниС тяТСлоС, Π² ΠΏΠ΅Ρ€ΠΈΠ°Π½Π°Π»ΡŒΠ½ΠΎΠΉ области ΠΎΠ±ΡˆΠΈΡ€Π½Π°Ρ Ρ€Π°Π½Π° с нСкротичСскими тканями ΠΈ Π½Π°Π»Π΅Ρ‚ΠΎΠΌ Ρ„ΠΈΠ±Ρ€ΠΈΠ½Π°. Для создания благоприятных условий для заТивлСния Ρ€Π°Π½Ρ‹ Π±Ρ‹Π»Π° ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π° опСрация ΠΏΡ€Π΅Π²Π΅Π½Ρ‚ΠΈΠ²Π½ΠΎΠΉ сигмостомии. Π’ посСвС ΠΈΠ· Ρ€Π°Π½Ρ‹ ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½Π° полирСзистСнтная Pseudomonas aeruginosa. ΠŸΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡŒ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ курсами Π°Π½Ρ‚ΠΈΠ±ΠΈΠΎΡ‚ΠΈΠΊΠΎΠ², инфузионная тСрапия, Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° хирургичСская ΠΎΠ±Ρ€Π°Π±ΠΎΡ‚ΠΊΠ° Ρ€Π°Π½Ρ‹ ΠΏΠ΅Ρ€ΠΈΠ°Π½Π°Π»ΡŒΠ½ΠΎΠΉ области ΠΈ мСстноС Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅. ΠŸΡ€ΠΈ обслСдовании иммунологичСского статуса выявлСно ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎΠ΅ ΠΈΠΌΠΌΡƒΠ½ΠΎΠ΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π½ΠΎΠ΅ состояниС, ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρƒ ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ³ΠΎ вводились ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Ρ‹ с ΠΈΠΌΠΌΡƒΠ½ΠΎΠ³Π»ΠΎΠ±ΡƒΠ»ΠΈΠ½ΠΎΠΌ G. Π’ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π΅ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ лСчСния Ρ€Π°Π½Π° Π·Π°ΠΆΠΈΠ»Π° Π²Ρ‚ΠΎΡ€ΠΈΡ‡Π½Ρ‹ΠΌ натяТСниСм, ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π° опСрация закрытия сигмостомы. Π Π΅Π±Π΅Π½ΠΎΠΊ выписан Π² ΡƒΠ΄ΠΎΠ²Π»Π΅Ρ‚Π²ΠΎΡ€ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΌ состоянии ΠΏΠΎΠ΄ наблюдСниС ΠΈΠΌΠΌΡƒΠ½ΠΎΠ»ΠΎΠ³Π° ΠΈ Ρ…ΠΈΡ€ΡƒΡ€Π³Π°. ΠžΠ±ΡΡƒΠΆΠ΄Π΅Π½ΠΈΠ΅. Π’ Π΄Π°Π½Π½ΠΎΠΌ случаС ΠΎΠΏΡ€Π°Π²Π΄Π°Π½ΠΎ ΠΏΡ€Π΅Π²Π΅Π½Ρ‚ΠΈΠ²Π½ΠΎΠ΅ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ сигмостомии, хотя Π² Π΄Ρ€ΡƒΠ³ΠΈΡ… Π½Π°Π±Π»ΡŽΠ΄Π΅Π½ΠΈΡΡ… Π°Π²Ρ‚ΠΎΡ€Ρ‹ ΠΎΠ³Ρ€Π°Π½ΠΈΡ‡ΠΈΠ²Π°Π»ΠΈΡΡŒ хирургичСским Π²ΠΌΠ΅ΡˆΠ°Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΠΎΠΌ Π½Π° промСТности. Pseudomonas aeruginosa проявляСт свою ΠΏΠ°Ρ‚ΠΎΠ³Π΅Π½Π½ΠΎΡΡ‚ΡŒ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡΠΌΠΈ ΠΈΠΌΠΌΡƒΠ½ΠΈΡ‚Π΅Ρ‚Π°. ΠŸΠΎΡΡ‚ΠΎΠΌΡƒ, наряду с хирургичСским Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ΠΌ, курсами Π°Π½Ρ‚ΠΈΠ±ΠΈΠΎΡ‚ΠΈΠΊΠΎΠ², ΠΈΠ½Ρ„ΡƒΠ·ΠΈΠΎΠ½Π½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠ΅ΠΉ, Ρ‚ΠΎΠ»ΡŒΠΊΠΎ ΠΏΡ€ΠΈ Π½Π°Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΈ ΠΈΠΌΠΌΡƒΠ½ΠΎΠΌΠΎΠ΄ΡƒΠ»ΠΈΡ€ΡƒΡŽΡ‰Π΅ΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π±Ρ‹Π» достигнут благоприятный Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π”Π΅Ρ‚Π΅ΠΉ с Π³Π½ΠΎΠΉΠ½ΠΎ-нСкротичСским ΠΏΠ°Ρ€Π°ΠΏΡ€ΠΎΠΊΡ‚ΠΈΡ‚ΠΎΠΌ, Ρ€Π°Π·Π²ΠΈΠ²ΡˆΠΈΠΌΡΡ Π½Π° Ρ„ΠΎΠ½Π΅ ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎΠ³ΠΎ ΠΈΠΌΠΌΡƒΠ½ΠΎΠ΄Π΅Ρ„ΠΈΡ†ΠΈΡ‚Π½ΠΎΠ³ΠΎ состояния Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎ ΠΊΠ°ΠΊ ΠΌΠΎΠΆΠ½ΠΎ Ρ€Π°Π½ΡŒΡˆΠ΅ Π³ΠΎΡΠΏΠΈΡ‚Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ Π² спСциализированный стационар
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