484 research outputs found

    LOW-PROTEIN PASTA FOR CHILDREN PATIENTS WITHΒ PHENYLKETONURIA

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    There are provided data on the work carried out at All-Russian Research Institute for Starch Products to create enriched low-protein pasta based on starch for nutrition the children sick with a phenilketonuriaΒ β€” a hereditary disease (group of fermentopatiya), the bound to violation of amino acids metabolism, mainly phenyl alanine. Optimization of children nutrition is the socially important direction of domestic policy of the Russian Federation since their health directly depends on the good balanced nutrition, especially it is important for the children having diseases of genetic character.To expand the range of the enriched low-protein food the functional ingredients are picked up, recipes and technology of receiving three types of pasta are developed such as: noodles, vermicelli, Β«spider lineΒ», their nutrition and power values are defined. It is shown that in the received products protein content doesn’t exceed permissible value (<1.0%), fat from 3.3 to 3.6%, ashesΒ β€” to 0.14%, carbohydrates no more than 88.0% that conforms to requirements imposed to reduced-protein products of baby food.There are provided data on the work carried out at All-Russian Research Institute for Starch Products to create enriched low-protein pasta based on starch for nutrition the children sick with a phenilketonuriaΒ β€” a hereditary disease (group of fermentopatiya), the bound to violation of amino acids metabolism, mainly phenyl alanine. Optimization of children nutrition is the socially important direction of domestic policy of the Russian Federation since their health directly depends on the good balanced nutrition, especially it is important for the children having diseases of genetic character.To expand the range of the enriched low-protein food the functional ingredients are picked up, recipes and technology of receiving three types of pasta are developed such as: noodles, vermicelli, Β«spider lineΒ», their nutrition and power values are defined. It is shown that in the received products protein content doesn’t exceed permissible value (<1.0%), fat from 3.3 to 3.6%, ashesΒ β€” to 0.14%, carbohydrates no more than 88.0% that conforms to requirements imposed to reduced-protein products of baby food

    Recent advances in electrophoretic deposition of thin-film electrolytes for intermediate-temperature solid oxide fuel cells

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    Solid oxide fuel cells (SOFCs) have been attracting considerable attention as ecologically friendly and highly efficient power sources with a variety of applications. Modern directions in the SOFCs technology are related to lowering the SOFC operating temperature that require both advanced materials design and development of versatile technologies to fabricate SOFC with thin-film electrolyte membrane to decrease ohmic losses at decreased temperatures. Electrophoretic deposition (EDP) is one of the most technologically flexible and cost-effective methods for the thin film formation currently available. This review highlights challenges and approaches presented in literature to the formation dense thin films based on oxygen-conducting and proton conducting electrolytes, as well as multilayer and composite electrolyte membranes

    Peculiarities of electrophoretic deposition and morphology of deposited films in non-aqueous suspensions of Al2O3–Al nanopowder

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    The paper presents the results of a comprehensive study of the electrokinetic properties of non-aqueous suspensions of theΒ Al2O3–Al nanopowder obtained by the method of electric explosion of wires (EEW) with 0.3 wt.% of metallic aluminum in its composition. The dependence of zeta potential on the concentration of the Al2O3–Al suspension is revealed. The nature of long-term changes in zeta potential and pH in suspensions is established. Appearance of bubbles in the deposited coatings due to the interaction of metallic aluminum particles with the liquid suspension medium during electrochemical reactions on the electrodes is defined as the main feature of the electrophoretic deposition (EPD) process in the Al2O3–Al suspensions. The influence of the suspension preparation method on the deposited coatings’ morphology is demonstrated

    Methodological aspects of the use of dry components of chicken eggs for feeding children with phenylketonuria

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    Currently, one of the most important tasks facing science and production is the creation of functional product technologies for use in different diets of the population in order to preserve and improve health, as well as reduce the risks and consequences of various diseases, including hereditary ones, such as phenylketonuria (PKU). The All-Russian Research Institute of Starch Products develops technologies for the production of low-protein starch-based products/semi-products enriched with functional ingredients and intended for therapeutic nutrition of patients with PKU. As part of the pilot production, the production of these products is organized. Purpose of work:to justify the possibility of using dry components of chicken eggs (melange, protein, yolk) to enrich low-protein starch products (noodles, vermichel, Β«spiderΒ») intended for feeding children over 3 years old with phenylketonuria;evaluate organoleptic properties and efficiency of low-protein starch products enriched in hypophenylalanine diet of patients with phenylketonuria older than 3 years

    Medico-social rationale for adaptation of regional drug supply systems to personalized pharmaceutical care for persons of different ages

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    In this study, we identified indicators of the state of personalized pharmaceutical care for target population groups at the regional level, in a model region, with the aim to develop a differentiated approach to such care. The rationale for the choice of Moscow Region as a model region is based on its specific socioeconomic indicators and a comparison of these with respective average Russian values. A need was shown to modernize patient-oriented pharmaceutical care, especially for certain population groups, such as children, women of working age (mothers), and the elderl

    Electrophoretic deposition of coatings and bulk compacts using magnesium-doped aluminum oxide nanopowders

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    Received: 06.04.2021. Revised: 02.05.2021. Accepted: 03.05.2021. Available online: 07.05.2021.The authors are grateful to D.Sc. prof. A.P. Safronov (Ural Federal University) for valuable advice during the preparation of the manuscript, to the head of the laboratory of impulse processes Dr. I.V. Beketov and junior researcher Mr. A.V. Bagazeev (IEP UB RAS) for the development of the method for producing nanopowders (EEW method), and to scientific researcher Dr. A.S. Farlenkov (Ural Federal University) for conducting electron microscopic studies.The electrophoretic deposition (EPD) of coatings and bulk compacts in a wide range of thicknesses (from 23 to 1800 ΞΌm) from stable suspensions of a magnesium-doped aluminum oxide nanopowder with subsequent sintering of samples into dense ceramics was studied. The initial nanopowder was obtained by the method of electric explosion of an Al-Mg alloy wire with a Mg content of 1.3 wt. %. The study of the dispersion composition, kinetics of deaggregation under the ultrasonic treatment and zeta potential in the nanopowder-based suspensions was carried out. It was shown that a nearly linear increase in the deposited mass and thickness of EPD deposits occurred at a constant voltage of 20 V and an average deposition current of approximately 40 ΞΌA when the deposition time was varied from 1 to 180 min. Drying of the coatings with a thickness of less than 35 ΞΌm led to the formation of a net of small cracks, while drying of the bulk compacts with a thickness of more than 1 mm occurred without cracking. The ceramic bulk sample with a thickness of 1.2 mm and the density of 98.7% TD was successfully obtained by sintering at 1650 Β°C for 4 h. It was characterized by a dense grain structure with an average grain size of 5 ΞΌm and the presence of a small number of closed pores less than 1 ΞΌm in size. Sintering of ceramics was revealed to be accompanied by the formation of a MgAl2O4 crystalline spinel phase, localized mainly at grain boundaries.The work was partially carried out using the equipment of the shared access centers of the Institute of Electrophysics (IEP UB RAS) and Institute of High Temperature Electrochemistry (IHTE UB RAS), Composition of compounds

    Врансформация конституционной идСнтичности государства Π² условиях Π²Ρ‹Π·ΠΎΠ²ΠΎΠ² соврСмСнности

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    The subject. This article represents an attempt to research the notion of β€œconstitutional identity”, which has recently emerged as a relevant concept in constitutional law, through the prism of its transformation reacting the world’s challenges.The purpose of the research is to confirm or disprove hypothesis that both typical and extraordinary factors may influence differently on the transformation of constitutional identity.The methodology. The article is based on the dialectical method, as well as on the logical, historical, systemic methods. A comparative method was applied to study the features of the constitutional identity of States. Authors pay attention to the interaction of international and national policies.The main results, scope of application. Within the doctrine of constitutional identity it is presented a discussion with respect to terms and definitions of constitutional, state or national identity, constitutional identity of citizens. Moreover, such two notions as β€œindividuality” and β€œidentity” form a curious couple since β€œidentity” may contravene β€œindividuality”. Different factors which can influence on transformation of the constitutional identity, are listed (globalization (antiglobalism), universalization of constitutional values, COVID-19 pandemic, migration, etc.). In particular, different countries choose different models of reflecting the processes of globalization in their domestic constitutional legislation: from striving for unification to systematic confrontation. In this regard, it seems necessary to assess these factors, taking into account the experience of different states. Besides, the activities of international bodies can give rise to the universalization of constitutional values. For example, supranational bodies (in particular, the European Court of Justice) develop generalcial common culture. Another example is the current epidemiological crisis. The coronavirus infection has made its own adjustments to the constitutional identity of states. Examples of such transformation are full border closures or partial closures with individual states; amendments to the national legislation, according to which the issues of measures permissible for implementation by the state are being revised in order to ensure the life and health of the population.Conclusions. Definition the constitutional identity is an important strategic framework for national policy. However, there is no certain fixed constitutional identity of the state. On contrary, the identity of the state tends to be changeable. Transformation can be regarded as voluntary, forced or consciously responsive, expected or not. Voluntary transformation usually becomes a response to the evolutionary development of society, scientific and technological advances and discoveries. Forced transformation is likely to be a reaction to economic, epidemiological, political crises. Therefore, in order to determine the constitutional identity of certain state it is necessary to understand the cultural, historical, social and political contexts of its formation and current development in the conditions of the contemporary world.РассматриваСтся Π΄ΠΎΠΊΡ‚Ρ€ΠΈΠ½Π° трансформации конституционной идСнтичности ΠΈ Π΅Π΅ проявлСниС Π² ΠΏΡ€Π°Π²ΠΎΠΎΡ‚Π½ΠΎΡˆΠ΅Π½ΠΈΡΡ…, ΡΠΊΠ»Π°Π΄Ρ‹Π²Π°ΡŽΡ‰ΠΈΡ…ΡΡ Π² условиях Π²Ρ‹Π·ΠΎΠ²ΠΎΠ² соврСмСнности: глобализация ΠΈ Π°Π½Ρ‚ΠΈΠ³Π»ΠΎΠ±Π°Π»ΠΈΠ·ΠΌ, пандСмия коронавируса COVID-19, Π½Π°ΡƒΡ‡Π½Ρ‹Π΅ достиТСния, унивСрсализация конституционных цСнностСй – эти ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΠ΅ Ρ€Π°Π·Π½ΠΎΠΎΠ±Ρ€Π°Π·Π½Ρ‹Π΅ Ρ„Π°ΠΊΡ‚ΠΎΡ€Ρ‹ ΠΏΡ€Π΅Π΄ΠΎΠΏΡ€Π΅Π΄Π΅Π»ΡΡŽΡ‚ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎΡΡ‚ΡŒ трансформации конституционной идСнтичности ΠΈΠ»ΠΈ ΡΡ‚ΠΈΠΌΡƒΠ»ΠΈΡ€ΡƒΡŽΡ‚ Π΅Π΅. Бтавится Ρ†Π΅Π»ΡŒ провСсти Π°Π½Π°Π»ΠΈΠ· Ρ‚Π΅Ρ€ΠΌΠΈΠ½ΠΎΠ² ΠΈ понятий, ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΠ΅ΠΌΡ‹Ρ… Π² Π΄ΠΎΠΊΡ‚Ρ€ΠΈΠ½Π΅ конституционной идСнтичности, Π½Π°Ρ€Π°Π±ΠΎΡ‚ΠΎΠΊ ΡƒΡ‡Π΅Π½Ρ‹Ρ… Ρ€Π°Π·Π½Ρ‹Ρ… стран для опрСдСлСния Π΅Π΅ конституционно-ΠΏΡ€Π°Π²ΠΎΠ²ΠΎΠΉ ΠΏΡ€ΠΈΡ€ΠΎΠ΄Ρ‹, выявлСния Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠ², ΠΎΠ±ΡƒΡΠ»ΠΎΠ²Π»ΠΈΠ²Π°ΡŽΡ‰ΠΈΡ… ΠΈΠ·ΠΌΠ΅Π½Ρ‡ΠΈΠ²ΠΎΡΡ‚ΡŒ идСнтичности. УдСляСтся Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡ‚Π²ΠΈΡŽ ΠΌΠ΅ΠΆΠ΄ΡƒΠ½Π°Ρ€ΠΎΠ΄Π½ΠΎΠΉ ΠΈ Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΈΡ‚ΠΈΠΊΠΈ. Π”Π΅Π»Π°ΡŽΡ‚ΡΡ Π²Ρ‹Π²ΠΎΠ΄Ρ‹ ΠΎ Π²ΠΈΠ΄Π°Ρ… ΠΈ соврСмСнных ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ°Ρ… трансформации идСнтичности Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Ρ… государств

    Π€Ρ–Π·ΠΈΠΊΠΎ-Ρ…Ρ–ΠΌΡ–Ρ‡Π½Ρ– Ρ‚Π° ΠΎΡ€Π³Π°Π½ΠΎΠ»Π΅ΠΏΡ‚ΠΈΡ‡Π½Ρ– ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠΈ рослинного ΠΌΠΎΠ»ΠΎΠΊΠ°, якС Π²ΠΈΠΊΠΎΡ€ΠΈΡΡ‚ΠΎΠ²ΡƒΡŽΡ‚ΡŒ Ρƒ Π³ΠΎΡ‚Π΅Π»ΡŒΠ½ΠΎ-рСсторанних комплСксах

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    The article highlights the current state of the production of dairy and vegetable food products. The results of studies of organoleptic and physical, chemical indicators of the quality of various herbal drinks: coconut, almond and oat, are presented, as well as an analysis and comparison with cow's milk, which is used in hotel and restaurant complexes in Bela Tserkva. For assessing the quality according to the organoleptic characteristics of the beverages, the following were examined: appearance, color, smell, taste and consistency. It was found that according to these indicators, herbal drinks comply with the regulatory documentation for these products. When assessing the quality by physical and chemical indicators, the mass fraction of fat, dry matter, titratable and active acidity, and density were established. The titratable acidity of milk-like drinks was within the normal range and did not exceed 10 ⁰T. The mass fraction of fat in coconut milk was 1.2 %, almond-rice milk – 1.3 % and oat milk – 2.4 %. Mass fraction of coconut milk solids was 7.6%, almond-rice 10.5% and oat milk 11.4%. The density of all types of herbal drinks was in the range of 1005–1015 kg/m3. The indicators of the quality of cow's milk, which is used in hotel and restaurant complexes, have been investigated in a comparative form. In terms of organoleptic indicators, the quality of cow's milk corresponds to the normative documentation. The fat mass fraction of cow's milk was 2.5 %, the mass fraction of solids was 12.5%, the titratable acidity was at the level of 18 ⁰T, the active acidity pH was 6.6, and the density was 1028 kg/m3. Analysis of various types of vegetable and cow's milk, which are used in hotel and restaurant complexes in the city of Bela Tserkva, in terms of physicochemical and organoleptic quality indicators, allows us to consider herbal drinks as substitutes for traditional products capable of providing the human body with essential nutritional factors.Π£ статті висвітлСно сучасний стан Π²ΠΈΡ€ΠΎΠ±Π½ΠΈΡ†Ρ‚Π²Π° ΠΌΠΎΠ»ΠΎΡ‡Π½ΠΎ-рослинних Ρ…Π°Ρ€Ρ‡ΠΎΠ²ΠΈΡ… ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚Ρ–Π². НавСдСно Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΈ Π΄ΠΎΡΠ»Ρ–Π΄ΠΆΠ΅Π½ΡŒ ΠΎΡ€Π³Π°Π½ΠΎΠ»Π΅ΠΏΡ‚ΠΈΡ‡Π½ΠΈΡ… Ρ‚Π° Ρ„Ρ–Π·ΠΈΠΊΠΎ-Ρ…Ρ–ΠΌΡ–Ρ‡Π½ΠΈΡ… ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΡ–Π² якості Ρ€Ρ–Π·Π½ΠΈΡ… рослинних Π½Π°ΠΏΠΎΡ—Π²: кокосового, мигдального Ρ‚Π° вівсяного, Π° Ρ‚Π°ΠΊΠΎΠΆ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π°Π½Π°Π»Ρ–Π· Ρ‚Π° порівняння Π· коров’ячим ΠΌΠΎΠ»ΠΎΠΊΠΎΠΌ, якС Π²ΠΈΠΊΠΎΡ€ΠΈΡΡ‚ΠΎΠ²ΡƒΡŽΡ‚ΡŒ Ρƒ Π³ΠΎΡ‚Π΅Π»ΡŒΠ½ΠΎ-рСсторанних комплСксах ΠΌ. Π‘Ρ–Π»Π° Π¦Π΅Ρ€ΠΊΠ²Π°. Π—Π° провСдСння ΠΎΡ†Ρ–Π½ΠΊΠΈ якості Π·Π° ΠΎΡ€Π³Π°Π½ΠΎΠ»Π΅ΠΏΡ‚ΠΈΡ‡Π½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ Π½Π°ΠΏΠΎΡ—Π² дослідТували: Π·ΠΎΠ²Π½Ρ–ΡˆΠ½Ρ–ΠΉ вигляд, ΠΊΠΎΠ»Ρ–Ρ€, Π·Π°ΠΏΠ°Ρ…, смак Ρ‚Π° ΠΊΠΎΠ½ΡΠΈΡΡ‚Π΅Π½Ρ†Ρ–ΡŽ. ВстановлСно, Ρ‰ΠΎ Π·Π° Ρ†ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ рослинні Π½Π°ΠΏΠΎΡ— Π²Ρ–Π΄ΠΏΠΎΠ²Ρ–Π΄Π°ΡŽΡ‚ΡŒ Π½ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²Π½Ρ–ΠΉ Π΄ΠΎΠΊΡƒΠΌΠ΅Π½Ρ‚Π°Ρ†Ρ–Ρ— Π½Π° Π΄Π°Π½Ρ– ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚ΠΈ. ΠŸΡ–Π΄ час провСдСння ΠΎΡ†Ρ–Π½ΠΊΠΈ якості Π·Π° Ρ„Ρ–Π·ΠΈΠΊΠΎ-Ρ…Ρ–ΠΌΡ–Ρ‡Π½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ Π²ΡΡ‚Π°Π½ΠΎΠ²Π»ΡŽΠ²Π°Π»ΠΈ масову частку ΠΆΠΈΡ€Ρƒ, сухих Ρ€Π΅Ρ‡ΠΎΠ²ΠΈΠ½, Ρ‚ΠΈΡ‚Ρ€ΠΎΠ²Π°Π½Ρƒ Ρ‚Π° Π°ΠΊΡ‚ΠΈΠ²Π½Ρƒ ΠΊΠΈΡΠ»ΠΎΡ‚Π½Ρ–ΡΡ‚ΡŒ, густину. Π’ΠΈΡ‚Ρ€ΠΎΠ²Π°Π½Π° ΠΊΠΈΡΠ»ΠΎΡ‚Π½Ρ–ΡΡ‚ΡŒ ΠΌΠΎΠ»ΠΎΠΊΠΎΠΏΠΎΠ΄Ρ–Π±Π½ΠΈΡ… Π½Π°ΠΏΠΎΡ—Π² Π±ΡƒΠ»Π° Π² ΠΌΠ΅ΠΆΠ°Ρ… Π½ΠΎΡ€ΠΌΠΈ Ρ– Π½Π΅ ΠΏΠ΅Ρ€Π΅Π²ΠΈΡ‰ΡƒΡ” 10 ⁰В. Масова частка ΠΆΠΈΡ€Ρƒ кокосового ΠΌΠΎΠ»ΠΎΠΊΠ° становила 1,2 %, мигдально-рисового – 1,3 % Ρ‚Π° вівсяного – 2,4 %. Масова частка сухих Ρ€Π΅Ρ‡ΠΎΠ²ΠΈΠ½ кокосового ΠΌΠΎΠ»ΠΎΠΊΠ° становила – 7,6 %, мигдально-рисового 10,5 % Ρ‚Π° вівсяного – 11,4 %. Густина всіх Π²ΠΈΠ΄Ρ–Π² рослинних Π½Π°ΠΏΠΎΡ—Π² Π±ΡƒΠ»Π° Π² ΠΌΠ΅ΠΆΠ°Ρ… 1005–1015 ΠΊΠ³/ΠΌ3. Π£ ΠΏΠΎΡ€Ρ–Π²Π½ΡΠ»ΡŒΠ½Ρ–ΠΉ Ρ„ΠΎΡ€ΠΌΡ– дослідТСно ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠΈ якості ΠΌΠΎΠ»ΠΎΠΊΠ° коров’ячого, якС Π²ΠΈΠΊΠΎΡ€ΠΈΡΡ‚ΠΎΠ²ΡƒΡŽΡ‚ΡŒ Ρƒ Π³ΠΎΡ‚Π΅Π»ΡŒΠ½ΠΎ-рСсторанних комплСксах. Π—Π° ΠΎΡ€Π³Π°Π½ΠΎΠ»Π΅ΠΏΡ‚ΠΈΡ‡Π½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ ΡΠΊΡ–ΡΡ‚ΡŒ ΠΌΠΎΠ»ΠΎΠΊΠ° коров’ячого Π²Ρ–Π΄ΠΏΠΎΠ²Ρ–Π΄Π°Ρ” Π½ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²Π½Ρ–ΠΉ Π΄ΠΎΠΊΡƒΠΌΠ΅Π½Ρ‚Π°Ρ†Ρ–Ρ—. Масова частка ΠΆΠΈΡ€Ρƒ ΠΌΠΎΠ»ΠΎΠΊΠ° коров’ячого становила 2,5 %, масова частка сухих Ρ€Π΅Ρ‡ΠΎΠ²ΠΈΠ½ 12,5 %, Ρ‚ΠΈΡ‚Ρ€ΠΎΠ²Π°Π½Π° ΠΊΠΈΡΠ»ΠΎΡ‚Π½Ρ–ΡΡ‚ΡŒ Π±ΡƒΠ»Π° Π½Π° Ρ€Ρ–Π²Π½Ρ– 18 ⁰В, Π°ΠΊΡ‚ΠΈΠ²Π½Π° ΠΊΠΈΡΠ»ΠΎΡ‚Π½Ρ–ΡΡ‚ΡŒ рН – 6,6, густина – 1028 ΠΊΠ³/ΠΌ3. Аналіз Ρ€Ρ–Π·Π½ΠΈΡ… Π²ΠΈΠ΄Ρ–Π² рослинного Ρ– коров’ячого ΠΌΠΎΠ»ΠΎΠΊΠ°, які Π²ΠΈΠΊΠΎΡ€ΠΈΡΡ‚ΠΎΠ²ΡƒΡŽΡ‚ΡŒ Ρƒ Π³ΠΎΡ‚Π΅Π»ΡŒΠ½ΠΎ-рСсторанних комплСксах ΠΌ. Π‘Ρ–Π»Π° Π¦Π΅Ρ€ΠΊΠ²Π° Π·Π° Ρ„Ρ–Π·ΠΈΠΊΠΎ-Ρ…Ρ–ΠΌΡ–Ρ‡Π½ΠΈΠΌΠΈ Ρ‚Π° ΠΎΡ€Π³Π°Π½ΠΎΠ»Π΅ΠΏΡ‚ΠΈΡ‡Π½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ якості дозволяє розглядати рослинні Π½Π°ΠΏΠΎΡ— як Π·Π°ΠΌΡ–Π½Π½ΠΈΠΊΠΈ Ρ‚Ρ€Π°Π΄ΠΈΡ†Ρ–ΠΉΠ½ΠΈΡ… ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚Ρ–Π² Π·Π΄Π°Ρ‚Π½ΠΈΡ… Π·Π°Π±Π΅Π·ΠΏΠ΅Ρ‡ΡƒΠ²Π°Ρ‚ΠΈ ΠΎΡ€Π³Π°Π½Ρ–Π·ΠΌ людини Π΅ΡΠ΅Π½Ρ†Ρ–Π°Π»ΡŒΠ½ΠΈΠΌΠΈ Ρ„Π°ΠΊΡ‚ΠΎΡ€Π°ΠΌΠΈ ТивлСння

    Comparative analysis of the results using direct lateral interbody spondilodesis and transforaminal lumbar interbody spondilodesis in patients with degenerative diseases of the lumbar spine

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    Introduction Various spondylodesis techniques are used in patients with degenerative diseases of the lumbar spine, but the benefits of these techniques have not been proven.Objective of the study was to assess the effect of the type of fusion on the incidence of implant instability and related revision surgeries.Material and Methods This monocentric prospective study included 133 patients with degenerative stenosis of the lumbar spine and confirmed instability of spinal motion segments. Patients underwent transforaminal lumbar interbody fusion (TLIF) with a single cage or direct lateral interbody fusion (DLIF) using standard-sized cages. The conventional open technique was used to supplement TLIF with pedicle screws while percutaneous screw placement was applied in patients treated with DLIF. The duration of follow-up was 18 months. Fisher's exact test was used to assess differences in the incidence of fixator instability based on MSCT and revision interventions. Logistic regression was used to assess the association between potential risk factors and complication rates.Results The use of DLIF detected by MSCT (32.9 vs 3.6%, p < 0.0001) resulted in a significant reduction in the incidence of screw instability and associated revision interventions (11.8 vs 0%, p = 0.0122). The results of logistic regression, taking into account factors such as bone density and the number of levels at which spondylodesis was performed, confirm the relationship between the reduced incidence of complications and the use of DLIF technology. Conclusion Using DLIF instead of TLIF in patients with degenerative stenosis at the lumbar spine level can lead to a significant reduction in the frequency of screw instability and associated revision surgeries

    Augmentation of pedicle screws using bone grafting in patients with spinal osteoporosis

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    The aim of the study was to develop a new method of vertebral augmentation based on autologous and allogeneic bone chips to be used in pedicle screw fixation and to compare this method with the technique based on polymethyl methacrylate (PMMA). Materials and Methods. This prospective non-randomized study included 164 patients with degenerative pathologies or traumatic injuries of the lumbar spine and transitional thoracolumbar segments; 153 of the operated patients were followed up for 18 months. In these patients, radiodensity of the cancellous bone tissue was below 110 HU by the Hounsfield scale. Patients with degenerative spinal disorders underwent pedicle screw fixation using transforaminal interbody fusion; patients with traumatic spinal injuries underwent intermediate pedicle screw fixation, and those with a loss of vertebral body height by \u3e50% underwent anterior fusion. The patients were divided into three groups: in group 1 (n=39), bone tissue augmentation was performed using PMMA; in group 2 (n=21), augmentation was done with bone chips; in group 3 (n=93), no augmentation was performed (control group). The follow-up period was 12 months; cases with fixator breakage or loosening were recorded. Results. After augmentation with PMMA, 11 cases (28.2%) of fixator destabilization were detected. With bone chips, fixator instability developed in 2 patients (9.5%) only, whereas in patients operated without augmentation, the instability was observed in 43 cases (46.2%). With PMMA augmentation, the incidence rate of fixator destabilization did not significantly differ from that in the control group (p=0.0801), while the use of bone chips resulted in a statistically significant decrease of this index compared to the control group (p=0.0023). A logistic regression analysis confirmed the superiority of the developed method over the PMMA-based vertebral augmentation. Conclusion. The use of bone chips for vertebral augmentation provides a statistically significant decrease in the incidence of pedicle screw fixator destabilization in the post-operative period. By reducing the risk of proximal loosening and eliminating the risk of bone cement drainage into the spinal canal and vascular bed, the proposed method may become especially effective in patients with impaired bone density
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