443 research outputs found
ΠΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠ½ΠΎΠ²Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠ±ΡΠ»ΡΠΆΠΈΠ²Π°Π½ΠΈΡ Π² ΡΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΌ Π±ΠΈΠ·Π½Π΅ΡΠ΅
ΠΡΠΎΠ±Π»Π΅ΠΌΠ° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠ±ΡΠ»ΡΠΆΠΈΠ²Π°Π½ΠΈΡ Π² ΡΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΎΠΌ Π±ΠΈΠ·Π½Π΅ΡΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΠΉ, Ρ.ΠΊ. ΡΡΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΡΠΈΠΎΡΠΈΡΠ΅ΡΠ½ΡΠΌ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π² ΠΠ ΠΡΡΠΌ. Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½Π° ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΠ±ΡΠ»ΡΠΆΠΈΠ²Π°Π½ΠΈΡ ΡΡΡΠΈΡΡΠΎΠ² Ρ ΡΡΠ΅ΡΠΎΠΌ ΡΠΏΠ΅ΡΠΈΡΠΈΠΊΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΡΡΠΈΡΡΡΠΊΠΎΠΉ ΡΡΠ΅ΡΡ.ΠΡΠΎΠ±Π»Π΅ΠΌΠ° Π²ΠΈΠ·Π½Π°ΡΠ΅Π½Π½Ρ ΡΠΊΠΎΡΡΡ ΠΎΠ±ΡΠ»ΡΠ³ΠΎΠ²ΡΠ²Π°Π½Π½Ρ Ρ ΡΡΡΠΈΡΡΠΈΡΠ½ΠΎΠΌΡ Π±ΡΠ·Π½Π΅ΡΡ Ρ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΡ, ΡΠΎΠΌΡ ΡΠΎ ΡΡΡΠΈΡΡΠΈΡΠ½Π° Π΄ΡΡΠ»ΡΠ½ΡΡΡΡ Ρ ΠΏΡΡΠΎΡΠΈΡΠ΅ΡΠ½ΠΈΠΌ Π½Π°ΠΏΡΡΠΌΠΊΠΎΠΌ ΡΠΎΠ·Π²ΠΈΡΠΊΡ Π² ΠΠ ΠΡΠΈΠΌ. Π ΠΎΠ·Π³Π»ΡΠ½ΡΡΠ° ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° Π²ΠΈΠ·Π½Π°ΡΠ΅Π½Π½Ρ ΡΠΊΠΎΡΡΡ ΠΎΠ±ΡΠ»ΡΠ³ΠΎΠ²ΡΠ²Π°Π½Π½Ρ ΡΡΡΠΈΡΡΡΠ² Π· ΡΠΌΠΎΠ²ΠΎΡ ΡΠΏΠ΅ΡΠΈΡΡΠΊΠΈ ΡΡΠ½ΠΊΡΡΠΎΠ½ΡΠ²Π°Π½Π½Ρ ΡΡΡΠΈΡΡΠΈΡΠ½ΠΎΡ ΡΡΠ΅ΡΠΈ.The problem of quality service in the tourist's business is very actuality, because the tourist's activity is the priority directions of development in the Crimea. Given the method of definition of the quality service in the tourist's business with registration of specific tourism sphere
ΠΡΡΠ½Π°Π» ΠΊΡΠΈΠΌΡΡΠΊΠΈΡ ΠΊΠ°ΡΠ°ΡΠΌΡΠ² βΠΠΈΠ·ΡΠΌ ΠΉΠΎΠ»β (βΠΠ°Ρ ΡΠ»ΡΡ β) Ρ ΡΠ²ΡΡΠ»Ρ ΡΡΠ°Π΄ΠΈΡΡΠΉ ΠΊΠ°ΡΠ°ΡΠΌΡΡΠΊΠΎΡ ΠΏΡΠ΅ΡΠΈ Ρ Π½Π°ΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΡ ΠΏΠΎΠ»ΡΡΠΈΠΊΠΈ ΠΡΠΈΠΌΡΡΠΊΠΎΡ ΠΠ Π‘Π
Π ΡΡΠ°ΡΡΠ΅ ΡΠΎΠ΄Π΅ΡΠΆΠΈΡΡΡ ΠΎΠΏΠΈΡΠ°Π½ΠΈΠ΅ ΠΊΠ°ΡΠ°ΠΈΠΌΡΠΊΠΈΡ
ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠ·Π΄Π°Π½ΠΈΠΉ Π½Π°ΡΠ°Π»Π° Π₯Π₯ Π²Π΅ΠΊΠ°, ΠΈΡ
ΡΠ΅Π»Π΅ΠΉ ΠΈ Π·Π°Π΄Π°ΡΠΈ, ΠΎΠ±ΡΠ΅ΠΌΠ°, ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΎΡΠ΄Π΅Π»ΠΎΠ², ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΡΡΡ ΠΎΡΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ Π² ΠΊΠ°ΡΠ°ΠΈΠΌΡΠΊΠΎΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΈΠΊΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΠΎΠ² Π½Π°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠ»ΡΡΡΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π½Π΅ΡΡΠ°Π½ΡΠ°, ΠΈΠ·ΡΡΠ°Π΅ΡΡΡ ΡΠ²ΡΠ·Ρ ΡΡΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠ·Π΄Π°Π½ΠΈΠΉ ΠΊΠ°ΡΠ°ΠΈΠΌΠΎΠ² Ρ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ-ΠΏΠΎΠ»ΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΆΠΈΠ·Π½ΡΡ ΠΊΠ°ΡΠ°ΠΈΠΌΡΠΊΠΎΠΉ ΠΎΠ±ΡΠΈΠ½Ρ.Π‘ΡΠ°ΡΡΡ ΠΌΡΡΡΠΈΡΡ ΠΎΠΏΠΈΡ ΠΊΠ°ΡΠ°ΡΠΌΡΡΠΊΠΈΡ
Π²ΠΈΠ΄Π°Π½Ρ ΠΏΠΎΡΠ°ΡΠΊΡ Π₯Π₯ ΡΡΠΎΠ»ΡΡΡΡ, Π·'ΡΡΠΎΠ²ΡΡ ΡΡ
Π½Ρ ΡΡΠ»Ρ Ρ Π·Π°Π²Π΄Π°Π½-Π½Ρ, ΠΎΠ±ΡΡΠ³, ΠΎΡΠ½ΠΎΠ²Π½Ρ ΡΠΎΠ·Π΄ΡΠ»ΠΈ; Π΄ΠΎΡΠ»ΡΠ΄ΠΆΡΡ Π²ΡΠ΄Π±ΠΈΡΡΡ Ρ ΠΊΠ°ΡΠ°ΡΠΌΡΡΠΊΡΠΉ ΠΏΠ΅ΡΡΠΎΠ΄ΠΈΡΡ ΠΏΡΠΎΡΠ΅ΡΡΠ² Π½Π°ΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΠ»ΡΡΡΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π½Π΅ΡΠ°Π½ΡΡ; Π²ΠΈΠ²ΡΠ°Ρ Π·Π²'ΡΠ·ΠΎΠΊ Π΅ΡΠ½ΡΡΠ½ΠΈΡ
Π²ΠΈΠ΄Π°Π½Ρ ΠΊΠ°ΡΠ°ΡΠΌΡΠ² ΡΠ· ΡΡΡΠΏΡΠ»ΡΠ½ΠΎ-ΠΏΠΎΠ»ΡΡΠΈΡΠ½ΠΈΠΌ ΠΆΠΈΡΡΡΠΌ ΠΊΠ°ΡΠ°ΡΠΌΡΡΠΊΠΎΡ Π³ΡΠΎΠΌΠ°Π΄ΠΈ.The article researches the Karaite mass media of the beginning of the XX century: its matters and tasks, volume, main sections, the reflection of the cultural renaissance in it and its connection with life of the Karaite community
Epidemiology and outcome of rib fractures:a nationwide study in the Netherlands
Purpose Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. Methods A nationwide retrospective cohort study was performed with the use of the Dutch Trauma Registry which covers 99% of the acutely admitted Dutch trauma population. All patients aged 18 years and older admitted to the hospital between January 2015 and December 2017 with one or more rib fractures were included. Incidence rates were calculated using demographic data from the Dutch Population Register. Subgroup analyses were performed for flail chest, polytrauma, primary thoracic trauma, and elderly patients. Results A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. Of these, 573 (3.9%) patients had a flail chest, 4438 (29.9%) were polytrauma patients, 9273 (63.4%) were patients with primary thoracic trauma, and 6663 (44.9%) were elderly patients. The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n = 1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). The median hospital length of stay was 6 days (IQR, 3-11) and 37.3% were admitted to the intensive care unit (ICU). Conclusions Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality
Metabolic syndrome in adults with autistic traits:associated psychological, behavioral, and biological factors in females and males - a PharmLines initiative
Background: While cardiovascular diseases is highly prevalent and an important cause of mortality in autistic adults, knowledge on their increased cardiovascular risk is limited. Hence, this study aimed to investigate psychological, behavioral, and physical factors associated with metabolic syndrome (MetS) in adults with autistic traits. Methods: In total, 17,705 adults from the Lifelines Cohort were included and categorized using Autism Spectrum Quotient-10 sum-scores. The quartiles with highest (HQ-traits-group females: n = 2,635; males: n = 1803) and lowest levels of autistic traits (LQ-traits-group, n = idem) were analyzed. Using multivariable logistic regression, the associations between MetS and (self-reported and interviewed) psychological, behavioral, and physically measured factors in these stratified groups were investigated. Results: Among females, MetS was more common in the HQ-traits-group than in the LQ-traits-group (10.0% versus 7.5%, p < 0.01), while this was not the case among males (HQ-traits-group 13.8% versus LQ-traits-group 13.1%, p = 0.52). In both the female and male HQ-traits-group, the presence of MetS was associated with poorer self-reported health, less daily physical activity, and altered leukocyte counts. Conclusion: These findings underline the relevance of adequate cardiovascular prevention in adults with higher levels of autistic traits. Future research could gain more insight into the relationship between cardiovascular risk and autistic traits in females, and into tailored cardiovascular prevention.</p
Metabolic syndrome in adults with autistic traits:associated psychological, behavioral, and biological factors in females and males - a PharmLines initiative
Background: While cardiovascular diseases is highly prevalent and an important cause of mortality in autistic adults, knowledge on their increased cardiovascular risk is limited. Hence, this study aimed to investigate psychological, behavioral, and physical factors associated with metabolic syndrome (MetS) in adults with autistic traits. Methods: In total, 17,705 adults from the Lifelines Cohort were included and categorized using Autism Spectrum Quotient-10 sum-scores. The quartiles with highest (HQ-traits-group females: n = 2,635; males: n = 1803) and lowest levels of autistic traits (LQ-traits-group, n = idem) were analyzed. Using multivariable logistic regression, the associations between MetS and (self-reported and interviewed) psychological, behavioral, and physically measured factors in these stratified groups were investigated. Results: Among females, MetS was more common in the HQ-traits-group than in the LQ-traits-group (10.0% versus 7.5%, p < 0.01), while this was not the case among males (HQ-traits-group 13.8% versus LQ-traits-group 13.1%, p = 0.52). In both the female and male HQ-traits-group, the presence of MetS was associated with poorer self-reported health, less daily physical activity, and altered leukocyte counts. Conclusion: These findings underline the relevance of adequate cardiovascular prevention in adults with higher levels of autistic traits. Future research could gain more insight into the relationship between cardiovascular risk and autistic traits in females, and into tailored cardiovascular prevention.</p
Epidemiology of combined clavicle and rib fractures:a systematic review
Purpose The aim of this systematic review was to provide an overview of the incidence of combined clavicle and rib fractures and the association between these two injuries. Methods A systematic literature search was performed in the MEDLINE, EMBASE, and CENTRAL databases on the 14(th) of August 2020. Outcome measures were incidence, hospital length of stay (HLOS), intensive care unit admission and length of stay (ILOS), duration of mechanical ventilation (DMV), mortality, chest tube duration, Constant-Murley score, union and complications. Results Seven studies with a total of 71,572 patients were included, comprising five studies on epidemiology and two studies on treatment. Among blunt chest trauma patients, 18.6% had concomitant clavicle and rib fractures. The incidence of rib fractures in polytrauma patients with clavicle fractures was 56-60.6% versus 29% in patients without clavicle fractures. Vice versa, 14-18.8% of patients with multiple rib fractures had concomitant clavicle fractures compared to 7.1% in patients without multiple rib fractures. One study reported no complications after fixation of both injuries. Another study on treatment, reported shorter ILOS and less complications among operatively versus conservatively treated patients (5.4 +/- 1.5 versus 21 +/- 13.6 days). Conclusion Clavicle fractures and rib fractures are closely related in polytrauma patients and almost a fifth of all blunt chest trauma patients sustain both injuries. Definitive conclusions could not be drawn on treatment of the combined injury. Future research should further investigate indications and benefits of operative treatment of this injury
The effect of early broad-spectrum versus delayed narrow-spectrum antibiotic therapy on the primary cure rate of acute infection after osteosynthesis
Purpose: Infection near metal implants is a problem that presents challenging treatment dilemmas for physicians. The aim of this study was to analyse the efficacy of two treatment protocols for acute fracture-related infections. Methods: Seventy-one patients in two level-1 trauma centres in the Netherlands were retrospectively included in this study. These trauma centres had different standardised protocols for acute infection after osteosynthesis: 39 patients were selected from protocol A and 32 from protocol B. Both protocols involve immediate surgical debridement and soft tissue coverage, but differ in antibiotic approach: (A) immediate empirical combination antibiotic therapy with rifampicin, or (B) postponed (1β5Β days) targeted antibiotic therapy. The primary outcome of these protocols was success, defined as a fracture healing in the absence of infection. The secondary outcome was antibiotic resistance patterns. Logistic regression was conducted on patients and treatment-related factors in association with primary success. Results: Primary success was achieved in 72% of protocol A patients, in 47% of those in protocol B (P = 0.033), and with prolongation of treatment success was achieved in 90% and 78% of patients, respectively. Protocol A exhibited a better primary success rate (adjusted OR 3.45, CI 1.13β10.52) when adjusted for age and soft tissue injury. There was no significant difference in antibiotic resistance between the two protocols. Conclusion: Both protocols yielded high overall success rates. Immediate empirical antibiotics can be used safely without additional bacterial resistance and may contribute to increased success rates
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