Вплив зайнятості на здоров’я трудового населення в Україні (Effect of employment on the health of working population in Ukraine)

У статті доведено залежність здоров’я населення від зайнятості: за відсутності можливостей для гідного працевлаштування спостерігається тенденція погіршення здоров’я економічно активної частини населення. Об- ґрунтовано, що відсутність гідних умов праці, безробіття, низька заробітна плата впливають на можливість працівників інвестувати у власне здоров’я. Зроблено висновок про необхідність підвищення соціальної відповідальності держави, роботодавців, активності профспілок зі створення реальних умов для збереження і відновлення здоров’я трудового населення, які безпосередньо пов’язані із забезпеченням гідної праці, зі зниженням рівня бідності, підвищенням доходів, поліпшенням умов праці. (We prove the health of the population depending on employment: in the absence of opportunities for decent employment trend deteriorating health of economically active population. It is proved that the lack of decent working conditions, unemployment, low wages, affect the ability of workers to invest in their own health.The conclusion about the need to improve the social responsibility of the state, employers, trade union activity to create real conditions for the preservation and restoration of the health of the working population, are directly related to the provision of decent work to poverty reduction, increased income, improved working conditions.

The system of EAS time analysis

The extensive air showers' (EAS) front shape, angle of incidence, disk thickness, particle distribution along the shower, on the delayed and EAS front advancing particles were determined. The suggested system of the EAS time analysis allows determination of the whole EAS longitudinal structure at the observation points. The information from the detectors is continuously recorded in the memory with the memory cell switching in 5 ns, this enables fixation of the moment of pulse input from the detector with an accuracy to + or - 2.5 ns. Along with the fast memory, a slow memory with the cell switching in 1 micron s is introduced in the system, this permits observation of relatively large time intervals with respect to the trigger pulse with an appropriately lower accuracy

Наследственные глаукомы: клинико-генетическая характеристика

The review is devoted to the genetic nature of congenital glaucoma (CG) and presents clinical and genetic forms of hereditary glaucoma and single nucleotide polymorphisms identified by genome-wide association studies (GWAS). Glaucoma is a genetically heterogeneous disease, and patients with the same clinical diagnosis often have different molecular causes. The role of mutations in the CYP1B1 gene has been proven in the pathogenesis of hydrophthalmos; the MYOC gene — in juvenile open-angle glaucoma; the PAX6 gene — in aniridia; mutations in the PITX2, FOXC1 genes have been identified in Axenfeld-Rieger anomaly/syndrome. It has been established that 4–43% of patients with open-angle glaucoma have a family history of a mutation in the MYOC, OPTN or TBK1 genes. Genetic studies of glaucoma are the first steps to developing a new generation of personalized treatments. The article describes the key features of the pathogenesis of various genetic forms of glaucoma and the possible course of its therapy. However, gene therapy requires further study of both long-term effects and efficacy. Molecular genetic diagnosis of glaucoma allows for personalized genetic counseling of family members with consideration of the genetic risks.Обзор посвящен генетической природе врожденной глаукомы (ВГ). Приводятся клинико-генетические формы наследственных глауком и единичные нуклеотидные полиморфизмы, идентифицированные на основании полногеномного поиска ассоциаций (GWAS). Глаукома является гетерогенным заболеванием, пациенты с одним и тем же клиническим диагнозом часто могут иметь различные молекулярные причины заболевания. В патогенезе гидрофтальма доказана роль мутации гена CYP1B1, при ювенильной открытоугольной глаукоме — гена MYOC, при аниридии — гена PAX6, при аномалии/синдроме Аксенфельда – Ригера выявлены мутации генов PITX2, FOXC1, аномалия Петерса характеризуется мутациями в генах PAX6, CYP1B1, PITX2, FOXC1. Установлено, что пациенты с открытоугольной глаукомой в 4-43% случаев имеют семейный анамнез, обусловленный мутацией в генах MYOC, OPTN либо TBK1. Генетические исследования глаукомы являются первыми шагами для разработки нового поколения персонализированных методов лечения. В статье описаны ключевые особенности патогенеза различных генетических форм глаукомы и направления их возможной терапии. Однако генная терапия требует дальнейшего изучения как отдаленных последствий, так и долгосрочной эффективности. Молекулярно-генетическая диагностика глаукомы позволяет персонализировано проводить медико-генетическое консультирование семьи с учетом генетических рисков

Многоцентровое наблюдательное неинтервенционное исследование применения комбинированных противотуберкулезных препаратов при лечении больных туберкулезом легких

The objective of the study: to run a multicenter non-interventional observational study to assess treatment outcomes in tuberculosis patients receiving combination drugs with fixed doses, and to evaluate tolerability and safety of these drugs.Subjects and methods. 13 TB units participated in this study which lasted from 2016 to 2018. The primary population (PP) included of 489 patients, after applying the exclusion criteria – the subpopulation (subPP) included 267 patients with newly detected pulmonary tuberculosis and relapses who received treatment as per chemotherapy regimen I or III. Descriptive statistics methods were used for statistical data processing.Results. Of all PP, 267 (54.6%) completed the main course of chemotherapy. (subPP). Out of 489 patients, treatment was discontinued in 118 (24.1%) of them. Primary drug resistance was detected in 30 (6.1%) patients out of 489 patients, secondary drug resistance – in 74 (15.1%) of 489. In subPP, by the end of the intensive phase the sputum conversion was achieved in 78 (96.3%) of 81 patients. Clinical and X-ray changes had been observed in this subgroup for 106.2 to 63.3 days (median 90). The duration of the intensive phase in the subPP made 107.9 ± 50.5 days. In safety assessment, 191 adverse events (AE) were registered in 149 (30.5%) of 489 patients. By severity, most AEs were minor (164 out of 191), moderate AEs were less frequent (20 out of 191), and there were 7 cases of serious AEs. 61 AEs in 57 (38.2%) out of 149 patients were confidently associated with in-take of the studied drugs. The structure of those AEs, transient transaminase level elevation prevailed (45 (73.8%) of 61 AEs, but there was a single case (1.6%) drug-induced hepatitis). Among the serious AEs, two cases were safely resolved by the end of the protocol, two of them were fatal in TB/HIV co-infection, and three cases were diagnosed with cancer.Цель исследования: оценка в многоцентровом неинтервенционном наблюдательном исследовании результатов лечения больных туберкулезом с использованием комбинированных препаратов с фиксированными дозами, переносимости и безопасности этих препаратов.Материалы и методы. В исследовании, проходившем с 2016 по 2018 г., участвовали 13 противотуберкулезных учреждений. Сформированы первичная популяция (РР) из 489 пациентов, после применения критериев исключения – субпопуляция (subPP) из 267 пациентов с впервые выявленным туберкулезом легких и рецидивом, которые получали лечение по I или III режиму химиотерапии. Для статистической обработки данных использовали методы описательной статистики.Результаты. Из РР основной курс химиотерапии завершили 267 (54,6%) (subPP). Досрочно прекратили лечение 118 (24,1%) пациентов из 489. Первичная лекарственная устойчивость выявлена у 30 (6,1%) из 489, вторичная – у 74 (15,1%) из 489. В subPP прекращение бактериовыделения обнаруживалось к концу интенсивной фазы в 78 (96,3%) случаях из 81. Клинико-рентгенологическая динамика отмечалась в этой подгруппе в течение 106,2 ± 63,3 дня (медиана 90). Длительность интенсивной фазы в subPP составила 107,9 ± 50,5 дня. При оценке безопасности зарегистрировано 191 нежелательное явление (НЯ) у 149 (30,5%) из 489 пациентов. По степени тяжести большинство НЯ были легкой степени (164 из 191), реже (20 из 191) – средней степени и 7 – серьезные НЯ. С приемом исследуемых препаратов установлена связь при 61 НЯ у 57 (38,2%) из 149 пациентов. В структуре этих НЯ преобладало транзиторное повышение уровня трансаминаз (45 (73,8%) из 61 НЯ, но в единичном случае (1,6%) зарегистрирован лекарственный гепатит). Среди серьезных НЯ два случая благополучно разрешились к завершению протокола, два ‒ закончились летальным исходом при сочетании ВИЧ-инфекции и туберкулеза, а в трех случаях диагностированы онкологические заболевания

ARRESTING OF COMPLICATED HYPERTENSIVE CRISES IN THE PHYSICIAN’S PRACTICE: URAPIDIL VALUE AND STUDY RESULTS

Aim. To compare the efficacy and safety of urapidil (i/v solution 5 mg/ml in 5 and 10 ml ampoules) and enalaprilat (i/v solution 1.25 mg/ml in 1 ml ampoules) in the treatment of complicated hypertensive crises in patients with arterial hypertension, 1-3 degrees. Material and methods. Patients with complicated hypertensive crisis (n=70) were included into the comparative randomized study. Patients were randomized for treatment with urapidil (the initial dose 12.5 mg; if there was no effect after 15 minutes it was possible to re-infused urapidil 12.5 mg) or enalaprilat (the initial dose 1.25 mg). The frequency of target blood pressure (BP) achievement, BP and heart rate dynamics, as well as safety of treatment were evaluated in groups during 6 hours. Results. The frequency of target BP achievement in the urapidil treatment group was higher than this in enalaprilat group (96.7 vs 73.3%; p<0.001), for the first hour systolic BP (SBP) in the urapidil group reduced from 210.5±13.6 to 157.8±8.3 mmHg (p<0.05), and diastolic BP (DBP) - from 115.7±8.5 to 86.9±9.1 mmHg (p<0.05). In the enalaprilat group in the first hour SBP reduced from 208.1 to 182.5 mmHg (p<0.05), DBP — from 114.8 to 95.0 mmHg (p<0.05). During next 6 hours the urapidil group demonstrated longer lasting antihypertensive effect in comparison with enalaprilat. Both drugs did not have a significant effect on heart rate and showed no significant adverse events. In next 72 hours no one acute vascular event was registered in the patients of both groups. Conclusion. Urapidil is an effective and safe drug for arresting of complicated hypertensive crises. Its efficacy is not inferior to this of enalaprilat

Urapidil: management of complicated hypertensive crises and effects on renal function. Therapeutist’s view

Aim. To compare the effectiveness of urapidil and enalaprilat in cardiac patients with complicated hypertensive crise (HC), including the effect of the medications on renal function. Material and methods. During 6 months, 70 patients with essential arterial hypertension (EAH), hospitalised with a diagnosis of complicated HC, were included in the study. Results. The therapy response rates were significantly higher in the urapidil vs. enalaprilat group (96,7% vs. 73,3%, p<0,001). During the first hour of the urapidil treatment, the levels of systolic blood pressure (SBP) decreased from 210,5±13,6 to 157,8±8,3 mm Hg (p<0,05), while the levels of diastolic blood pressure (DBP) decreased from 115,7±8,5 to 86,9±9,1 mm Hg (p<0,05). In the enalaprilat group, the respective SBP and DBP reduction was from 208,1 to 182,5 mm Hg (p<0,05) and from 114,8 to 95,0 mm Hg (p<0,05). Mean BP levels in the urapidil and enalaprilat groups decreased from 147,3±6,3 to 101,7±6,4 mm Hg and from 145,9±6,1 to 118,4±7,3 mm Hg, respectively. Over 6 hours, urapidil group patients demonstrated a more prolonged, sustained antihypertensive effect. Both medications did not affect heart rate (HR) levels. In neither group, clinically significant adverse effects were registered. The changes in glomerular filtration rate (GFR) or natriuresis were non-significant. Since after 6 hours, the patients were administered other combination therapy, the risk of acute vascular events was assessed during the following hours (up to 72 hours). No cases of acute cerebrovascular events or acute myocardial infarction were registered in either study group. Conclusion. Urapidil was more effective than enalaprilat in terms of responder number per 1 dose or BP reduction rate. Both medications did not affect HR, GFR, or natriuresis

Simulation of ESD Coupling into Cables Based on ISO 10605 Standard using Method of Moments

ESD events can damage or upset electronic vehicle systems, so discharges to the electronic systems or to the attached cables need to be considered. Discharges to the cables or to coupling structures close to the cables were investigated and a Method of Moments (MoM)-based methodology for ESD simulation is proposed. The simulation results for test benches according to ISO standards were verified against measurements

Human Body Impedance Modelling for ESD Simulations

Motivated by understanding the ESD-induced currents from body-worn, wire and hose connected medical equipment is exposed to, a computer simulation is presented to estimate the impedance of a human body relative to ground. This 3D model is the basis for transient field calculation. A Method of Moments (MoM) frequency domain solution is transformed into time domain via IFFT for further circuit level time domain simulations. The human body is modeled as a homogeneous dielectric with frequency-dependent complex permittivity. Dependence of the impedance on the position of discharge and posture of the human body is investigated. The simulation results are compared with measurements and demonstrate capturing of general tendencies of measured curves

The multicenter observational non-interventional study of combination anti-tuberculosis drugs used in treatment of pulmonary tuberculosis patients

The objective of the study: to run a multicenter non-interventional observational study to assess treatment outcomes in tuberculosis patients receiving combination drugs with fixed doses, and to evaluate tolerability and safety of these drugs.Subjects and methods. 13 TB units participated in this study which lasted from 2016 to 2018. The primary population (PP) included of 489 patients, after applying the exclusion criteria – the subpopulation (subPP) included 267 patients with newly detected pulmonary tuberculosis and relapses who received treatment as per chemotherapy regimen I or III. Descriptive statistics methods were used for statistical data processing.Results. Of all PP, 267 (54.6%) completed the main course of chemotherapy. (subPP). Out of 489 patients, treatment was discontinued in 118 (24.1%) of them. Primary drug resistance was detected in 30 (6.1%) patients out of 489 patients, secondary drug resistance – in 74 (15.1%) of 489. In subPP, by the end of the intensive phase the sputum conversion was achieved in 78 (96.3%) of 81 patients. Clinical and X-ray changes had been observed in this subgroup for 106.2 to 63.3 days (median 90). The duration of the intensive phase in the subPP made 107.9 ± 50.5 days. In safety assessment, 191 adverse events (AE) were registered in 149 (30.5%) of 489 patients. By severity, most AEs were minor (164 out of 191), moderate AEs were less frequent (20 out of 191), and there were 7 cases of serious AEs. 61 AEs in 57 (38.2%) out of 149 patients were confidently associated with in-take of the studied drugs. The structure of those AEs, transient transaminase level elevation prevailed (45 (73.8%) of 61 AEs, but there was a single case (1.6%) drug-induced hepatitis). Among the serious AEs, two cases were safely resolved by the end of the protocol, two of them were fatal in TB/HIV co-infection, and three cases were diagnosed with cancer