Pneumonia in patients with chronic kidney disease V D stage: pathogenetic aspects of complex therapy and outcomes

Abstract.The aim of our study was to increase the effectiveness of treatment of comorbid pneumonia in patients with CKD VD stage. Materials and Methods. 73 patients with CKD VD st. (59 on HD and 14 on PD) with mild to moderate comorbid pneumonia who received renal replacement therapy (RRT) during 2013-2016 were included in the observational prospective open-label randomized trial. Patients were randomized into two groups: group 1 (n = 42) included patients who in addition to the conventional therapy of pneumonia received medication «Lipin» as a complex therapy; group 2 included patients (n = 31) who received only basic (traditional) therapy. The groups were representative by the main demographic, social and clinical-laboratory findings, severity of pneumonia, duration and modality of RRT. The primary endpoints were death from any cause and episodes of rehospitalization. The overall assessment of the clinical efficacy of the therapy was based on a comparison of the duration of hospitalization, antibiotic therapy, intoxication syndrome, and regression of X-ray changes. Survival in observation groups was determined by the Kaplan-Meier method. Analyzed cases were included to October 31, 2018. The markers of oxidative stress (OS) were determined in 29 patients of group 1 and 14 patients of group 2 before treatment and after 14 days while treatment of  pneumonia was started. Results. The analysis demonstrated that during a 1-year period a 17 (25,76%) episodes of rehospitalization were recorded: 11 causes (35.5%) in group 1 and 6 (14.3%) in group 2 (χ² = 4.486, p = 0.035). In total, 29 deaths were recorded during the study period: 10 (23.8%) cases in group 1, and 19 (61.3%) - in group 2 (χ² = 8.957, p = 0.003, RR - 2.574, 95% CI: 1.400-4.733). The three- and five-year cumulative survival rates were 83% vs. 21% and 59% vs. 21%, in the group 1 and group 2, respectively (p = 0.00003). It was stated that the duration of hospitalization, antibiotic therapy, intoxication syndrome and X-ray regression were significantly lower in group 1 compared with group 2 (p <0.05). The comparative analysis of dynamics in the groups shows that increasing the treatment effectiveness at complex therapy background accompanied by a significant positive dynamics of OS markers (p <0,05). Conclusions Thus, the results of this study demonstrated the effectiveness of complex method of pneumonia treatment in patients with CKD stage 5D including Lipin medication compared traditional therapy. There is a significant difference in patient survival depending on the proposed and generally accepted treatment

PECULIARITIES OF CALCULATING STATIONARY HEATING OF WINDINGS OPERATING IN COMPLEX FORCED CONTROL SYSTEMS

General description of the research topic. A technique and an algorithm for calculating the thermal field of electromagnets operating in complex forced systems proposed by authors are considered. The widespread use of such devices in electromechanical switching devices allows not only to increase their speed but also significantly reduce the size, mass and energy losses, which indicates the relevance of this topic. The mathematical model of heating the windings of forced electromagnets proposed by the authors is a system of 1D differential equations of stationary heat transfer in a cylindrical coordinate system, supplemented by equations of electrical and magnetic circuits. This model allows to take into account the ripple of the currents in the windings and the losses in the magnetic core due to these ripples, contains certain signs of scientific novelty and represents the goal of the paper. The algorithm developed by the authors for calculating the thermal field of electromagnets operating in forced control systems is a complex iterative cycle. Its implementation is greatly simplified by using the Maple computing environment which allows to realize complicated and cumbersome mathematical transformations, automates the process of computations, and obtain results of numerical simulation in a convenient tabular and/or graphic form, which indicates the practical significance of this works. The results of comparison of computation results with experimental data presented in the paper indicate the adequacy of the model and algorithm proposed.Загальний опис теми дослідження. Розглядаються запропоновані авторами методика і алгоритм розрахунку теплового поля електромагнітів, що працюють в складних форсованих системах. Широке застосування в електромеханічних комутаційних апаратах подібних пристроїв дозволяє не тільки підвищити їх швидкодію, але також істотно зменшити розміри, масу і втрати енергії, що свідчить про актуальність даної теми. Запропонована авторами математична модель нагріву обмоток форсованих електромагнітів являє собою систему одновимірних диференціальних рівнянь стаціонарної теплопровідності в циліндричній системі координат, доповнену рівняннями електричного та магнітного кіл. Ця модель дозволяє врахувати пульсації струмів в обмотках, а також втрати в магнітопроводі, обумовлені цими пульсаціями, містить певні ознаки наукової новизни і є метою статті. Розроблений авторами алгоритм розрахунку теплового поля електромагнітів, що працюють в системах форсованого керування, являє собою складний ітераційний цикл, програмування якого істотно спрощується за рахунок застосування математичного пакету Maple, що дозволяє здійснювати складні і громіздкі математичні перетворення, автоматизувати процес розрахункових досліджень, отримувати результати комп'ютерного моделювання в зручній табличній та / або графічній формі, що свідчить про практичну значимість даної роботи. Наведені в статті результати зіставлення розрахунків з експериментальними даними, свідчать про адекватність запропонованих моделі та алгоритму

Stable propagation of a modulated positron beam in a bent crystal channel

The propagation of a modulated positron beam in a planar crystal channel is investigated. It is demonstrated that the beam preserves its modulation at sufficiently large penetration depths which opens the prospect of using a crystalline undulator as a coherent source of hard x-rays. This finding is a crucial milestone in developing a new type of lasers radiating in the hard x-ray and gamma-ray range.Comment: 11 pages, 4 figures, iopar

Hybridization-related correction to the jellium model for fullerenes

We introduce a new type of correction for a more accurate description of fullerenes within the spherically symmetric jellium model. This correction represents a pseudopotential which originates from the comparison between an accurate ab initio calculation and the jellium model calculation. It is shown that such a correction to the jellium model allows one to account, at least partly, for the sp2-hybridization of carbon atomic orbitals. Therefore, it may be considered as a more physically meaningful correction as compared with a structureless square-well pseudopotential which has been widely used earlier.Comment: 16 pages, 10 figure

Experimental study of the decay PHI(1020)--->ETA+GAMMA in multi-photon final state

In the SND experiment at VEPP-2M e^+e^- collider the phi(1020) ---> eta+gamma ---> 3pi^0+gamma decay was studied. The branching ratio B(phi--->eta+gamma) = (1.246 +- 0.025 +- 0.057)% was measured.Comment: 4 pages, 1 figure, 1 table, Submitted to JETP Let