484 research outputs found
LOW-PROTEIN PASTA FOR CHILDREN PATIENTS WITHΒ PHENYLKETONURIA
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 doesnβt 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 doesnβt 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
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 Al2O3βAl nanopowder
The paper presents the results of a comprehensive study of the electrokinetic properties of non-aqueous suspensions of theΒ Al2O3βAl 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 Al2O3βAl 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 Al2O3βAl suspensions. The influence of the suspension preparation method on the deposited coatingsβ morphology is demonstrated
Methodological aspects of the use of dry components of chicken eggs for feeding children with phenylketonuria
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
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
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
Π’ΡΠ°Π½ΡΡΠΎΡΠΌΠ°ΡΠΈΡ ΠΊΠΎΠ½ΡΡΠΈΡΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈΠ΄Π΅Π½ΡΠΈΡΠ½ΠΎΡΡΠΈ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π° Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ Π²ΡΠ·ΠΎΠ²ΠΎΠ² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ
The subject. This article represents an attempt to research the notion of βconstitutional identityβ, which has recently emerged as a relevant concept in constitutional law, through the prism of its transformation reacting the worldβs 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 βindividualityβ and βidentityβ form a curious couple since βidentityβ may contravene βindividualityβ. 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.Π Π°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΡΡΡ Π΄ΠΎΠΊΡΡΠΈΠ½Π° ΡΡΠ°Π½ΡΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΊΠΎΠ½ΡΡΠΈΡΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈΠ΄Π΅Π½ΡΠΈΡΠ½ΠΎΡΡΠΈ ΠΈ Π΅Π΅ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ Π² ΠΏΡΠ°Π²ΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡΡ
, ΡΠΊΠ»Π°Π΄ΡΠ²Π°ΡΡΠΈΡ
ΡΡ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
Π²ΡΠ·ΠΎΠ²ΠΎΠ² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ: Π³Π»ΠΎΠ±Π°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΈ Π°Π½ΡΠΈΠ³Π»ΠΎΠ±Π°Π»ΠΈΠ·ΠΌ, ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΡ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ° COVID-19, Π½Π°ΡΡΠ½ΡΠ΅ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΡ, ΡΠ½ΠΈΠ²Π΅ΡΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΊΠΎΠ½ΡΡΠΈΡΡΡΠΈΠΎΠ½Π½ΡΡ
ΡΠ΅Π½Π½ΠΎΡΡΠ΅ΠΉ β ΡΡΠΈ ΠΈ Π΄ΡΡΠ³ΠΈΠ΅ ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠ΅ ΡΠ°ΠΊΡΠΎΡΡ ΠΏΡΠ΅Π΄ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΡΡΠ°Π½ΡΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΊΠΎΠ½ΡΡΠΈΡΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈΠ΄Π΅Π½ΡΠΈΡΠ½ΠΎΡΡΠΈ ΠΈΠ»ΠΈ ΡΡΠΈΠΌΡΠ»ΠΈΡΡΡΡ Π΅Π΅. Π‘ΡΠ°Π²ΠΈΡΡΡ ΡΠ΅Π»Ρ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ Π°Π½Π°Π»ΠΈΠ· ΡΠ΅ΡΠΌΠΈΠ½ΠΎΠ² ΠΈ ΠΏΠΎΠ½ΡΡΠΈΠΉ, ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΠΌΡΡ
Π² Π΄ΠΎΠΊΡΡΠΈΠ½Π΅ ΠΊΠΎΠ½ΡΡΠΈΡΡΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈΠ΄Π΅Π½ΡΠΈΡΠ½ΠΎΡΡΠΈ, Π½Π°ΡΠ°Π±ΠΎΡΠΎΠΊ ΡΡΠ΅Π½ΡΡ
ΡΠ°Π·Π½ΡΡ
ΡΡΡΠ°Π½ Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π΅Π΅ ΠΊΠΎΠ½ΡΡΠΈΡΡΡΠΈΠΎΠ½Π½ΠΎ-ΠΏΡΠ°Π²ΠΎΠ²ΠΎΠΉ ΠΏΡΠΈΡΠΎΠ΄Ρ, Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ², ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»ΠΈΠ²Π°ΡΡΠΈΡ
ΠΈΠ·ΠΌΠ΅Π½ΡΠΈΠ²ΠΎΡΡΡ ΠΈΠ΄Π΅Π½ΡΠΈΡΠ½ΠΎΡΡΠΈ. Π£Π΄Π΅Π»ΡΠ΅ΡΡΡ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΠΎΠΉ ΠΈ Π½Π°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈ. ΠΠ΅Π»Π°ΡΡΡΡ Π²ΡΠ²ΠΎΠ΄Ρ ΠΎ Π²ΠΈΠ΄Π°Ρ
ΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΏΡΠ°ΠΊΡΠΈΠΊΠ°Ρ
ΡΡΠ°Π½ΡΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈΠ΄Π΅Π½ΡΠΈΡΠ½ΠΎΡΡΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²
Π€ΡΠ·ΠΈΠΊΠΎ-Ρ ΡΠΌΡΡΠ½Ρ ΡΠ° ΠΎΡΠ³Π°Π½ΠΎΠ»Π΅ΠΏΡΠΈΡΠ½Ρ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠΈ ΡΠΎΡΠ»ΠΈΠ½Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ»ΠΎΠΊΠ°, ΡΠΊΠ΅ Π²ΠΈΠΊΠΎΡΠΈΡΡΠΎΠ²ΡΡΡΡ Ρ Π³ΠΎΡΠ΅Π»ΡΠ½ΠΎ-ΡΠ΅ΡΡΠΎΡΠ°Π½Π½ΠΈΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ°Ρ
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 β°T. The mass fraction of fat in coconut milk was 1.2 %, almond-rice milk β 1.3 % and oat milk β 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 1005β1015 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 β°T, 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£ ΡΡΠ°ΡΡΡ Π²ΠΈΡΠ²ΡΡΠ»Π΅Π½ΠΎ ΡΡΡΠ°ΡΠ½ΠΈΠΉ ΡΡΠ°Π½ Π²ΠΈΡΠΎΠ±Π½ΠΈΡΡΠ²Π° ΠΌΠΎΠ»ΠΎΡΠ½ΠΎ-ΡΠΎΡΠ»ΠΈΠ½Π½ΠΈΡ
Ρ
Π°ΡΡΠΎΠ²ΠΈΡ
ΠΏΡΠΎΠ΄ΡΠΊΡΡΠ². ΠΠ°Π²Π΅Π΄Π΅Π½ΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΈ Π΄ΠΎΡΠ»ΡΠ΄ΠΆΠ΅Π½Ρ ΠΎΡΠ³Π°Π½ΠΎΠ»Π΅ΠΏΡΠΈΡΠ½ΠΈΡ
ΡΠ° ΡΡΠ·ΠΈΠΊΠΎ-Ρ
ΡΠΌΡΡΠ½ΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΡΠ² ΡΠΊΠΎΡΡΡ ΡΡΠ·Π½ΠΈΡ
ΡΠΎΡΠ»ΠΈΠ½Π½ΠΈΡ
Π½Π°ΠΏΠΎΡΠ²: ΠΊΠΎΠΊΠΎΡΠΎΠ²ΠΎΠ³ΠΎ, ΠΌΠΈΠ³Π΄Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ° Π²ΡΠ²ΡΡΠ½ΠΎΠ³ΠΎ, Π° ΡΠ°ΠΊΠΎΠΆ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π°Π½Π°Π»ΡΠ· ΡΠ° ΠΏΠΎΡΡΠ²Π½ΡΠ½Π½Ρ Π· ΠΊΠΎΡΠΎΠ²βΡΡΠΈΠΌ ΠΌΠΎΠ»ΠΎΠΊΠΎΠΌ, ΡΠΊΠ΅ Π²ΠΈΠΊΠΎΡΠΈΡΡΠΎΠ²ΡΡΡΡ Ρ Π³ΠΎΡΠ΅Π»ΡΠ½ΠΎ-ΡΠ΅ΡΡΠΎΡΠ°Π½Π½ΠΈΡ
ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ°Ρ
ΠΌ. ΠΡΠ»Π° Π¦Π΅ΡΠΊΠ²Π°. ΠΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½Ρ ΠΎΡΡΠ½ΠΊΠΈ ΡΠΊΠΎΡΡΡ Π·Π° ΠΎΡΠ³Π°Π½ΠΎΠ»Π΅ΠΏΡΠΈΡΠ½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ Π½Π°ΠΏΠΎΡΠ² Π΄ΠΎΡΠ»ΡΠ΄ΠΆΡΠ²Π°Π»ΠΈ: Π·ΠΎΠ²Π½ΡΡΠ½ΡΠΉ Π²ΠΈΠ³Π»ΡΠ΄, ΠΊΠΎΠ»ΡΡ, Π·Π°ΠΏΠ°Ρ
, ΡΠΌΠ°ΠΊ ΡΠ° ΠΊΠΎΠ½ΡΠΈΡΡΠ΅Π½ΡΡΡ. ΠΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΠΎ Π·Π° ΡΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ ΡΠΎΡΠ»ΠΈΠ½Π½Ρ Π½Π°ΠΏΠΎΡ Π²ΡΠ΄ΠΏΠΎΠ²ΡΠ΄Π°ΡΡΡ Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΡΠΉ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΡΡΡ Π½Π° Π΄Π°Π½Ρ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈ. ΠΡΠ΄ ΡΠ°Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½Ρ ΠΎΡΡΠ½ΠΊΠΈ ΡΠΊΠΎΡΡΡ Π·Π° ΡΡΠ·ΠΈΠΊΠΎ-Ρ
ΡΠΌΡΡΠ½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ Π²ΡΡΠ°Π½ΠΎΠ²Π»ΡΠ²Π°Π»ΠΈ ΠΌΠ°ΡΠΎΠ²Ρ ΡΠ°ΡΡΠΊΡ ΠΆΠΈΡΡ, ΡΡΡ
ΠΈΡ
ΡΠ΅ΡΠΎΠ²ΠΈΠ½, ΡΠΈΡΡΠΎΠ²Π°Π½Ρ ΡΠ° Π°ΠΊΡΠΈΠ²Π½Ρ ΠΊΠΈΡΠ»ΠΎΡΠ½ΡΡΡΡ, Π³ΡΡΡΠΈΠ½Ρ. Π’ΠΈΡΡΠΎΠ²Π°Π½Π° ΠΊΠΈΡΠ»ΠΎΡΠ½ΡΡΡΡ ΠΌΠΎΠ»ΠΎΠΊΠΎΠΏΠΎΠ΄ΡΠ±Π½ΠΈΡ
Π½Π°ΠΏΠΎΡΠ² Π±ΡΠ»Π° Π² ΠΌΠ΅ΠΆΠ°Ρ
Π½ΠΎΡΠΌΠΈ Ρ Π½Π΅ ΠΏΠ΅ΡΠ΅Π²ΠΈΡΡΡ 10 β°Π’. ΠΠ°ΡΠΎΠ²Π° ΡΠ°ΡΡΠΊΠ° ΠΆΠΈΡΡ ΠΊΠΎΠΊΠΎΡΠΎΠ²ΠΎΠ³ΠΎ ΠΌΠΎΠ»ΠΎΠΊΠ° ΡΡΠ°Π½ΠΎΠ²ΠΈΠ»Π° 1,2 %, ΠΌΠΈΠ³Π΄Π°Π»ΡΠ½ΠΎ-ΡΠΈΡΠΎΠ²ΠΎΠ³ΠΎ β 1,3 % ΡΠ° Π²ΡΠ²ΡΡΠ½ΠΎΠ³ΠΎ β 2,4 %. ΠΠ°ΡΠΎΠ²Π° ΡΠ°ΡΡΠΊΠ° ΡΡΡ
ΠΈΡ
ΡΠ΅ΡΠΎΠ²ΠΈΠ½ ΠΊΠΎΠΊΠΎΡΠΎΠ²ΠΎΠ³ΠΎ ΠΌΠΎΠ»ΠΎΠΊΠ° ΡΡΠ°Π½ΠΎΠ²ΠΈΠ»Π° β 7,6 %, ΠΌΠΈΠ³Π΄Π°Π»ΡΠ½ΠΎ-ΡΠΈΡΠΎΠ²ΠΎΠ³ΠΎ 10,5 % ΡΠ° Π²ΡΠ²ΡΡΠ½ΠΎΠ³ΠΎ β 11,4 %. ΠΡΡΡΠΈΠ½Π° Π²ΡΡΡ
Π²ΠΈΠ΄ΡΠ² ΡΠΎΡΠ»ΠΈΠ½Π½ΠΈΡ
Π½Π°ΠΏΠΎΡΠ² Π±ΡΠ»Π° Π² ΠΌΠ΅ΠΆΠ°Ρ
1005β1015 ΠΊΠ³/ΠΌ3. Π£ ΠΏΠΎΡΡΠ²Π½ΡΠ»ΡΠ½ΡΠΉ ΡΠΎΡΠΌΡ Π΄ΠΎΡΠ»ΡΠ΄ΠΆΠ΅Π½ΠΎ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠΈ ΡΠΊΠΎΡΡΡ ΠΌΠΎΠ»ΠΎΠΊΠ° ΠΊΠΎΡΠΎΠ²βΡΡΠΎΠ³ΠΎ, ΡΠΊΠ΅ Π²ΠΈΠΊΠΎΡΠΈΡΡΠΎΠ²ΡΡΡΡ Ρ Π³ΠΎΡΠ΅Π»ΡΠ½ΠΎ-ΡΠ΅ΡΡΠΎΡΠ°Π½Π½ΠΈΡ
ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ°Ρ
. ΠΠ° ΠΎΡΠ³Π°Π½ΠΎΠ»Π΅ΠΏΡΠΈΡΠ½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ ΡΠΊΡΡΡΡ ΠΌΠΎΠ»ΠΎΠΊΠ° ΠΊΠΎΡΠΎΠ²βΡΡΠΎΠ³ΠΎ Π²ΡΠ΄ΠΏΠΎΠ²ΡΠ΄Π°Ρ Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΡΠΉ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΡΡΡ. ΠΠ°ΡΠΎΠ²Π° ΡΠ°ΡΡΠΊΠ° ΠΆΠΈΡΡ ΠΌΠΎΠ»ΠΎΠΊΠ° ΠΊΠΎΡΠΎΠ²βΡΡΠΎΠ³ΠΎ ΡΡΠ°Π½ΠΎΠ²ΠΈΠ»Π° 2,5 %, ΠΌΠ°ΡΠΎΠ²Π° ΡΠ°ΡΡΠΊΠ° ΡΡΡ
ΠΈΡ
ΡΠ΅ΡΠΎΠ²ΠΈΠ½ 12,5 %, ΡΠΈΡΡΠΎΠ²Π°Π½Π° ΠΊΠΈΡΠ»ΠΎΡΠ½ΡΡΡΡ Π±ΡΠ»Π° Π½Π° ΡΡΠ²Π½Ρ 18 β°Π’, Π°ΠΊΡΠΈΠ²Π½Π° ΠΊΠΈΡΠ»ΠΎΡΠ½ΡΡΡΡ ΡΠ β 6,6, Π³ΡΡΡΠΈΠ½Π° β 1028 ΠΊΠ³/ΠΌ3. ΠΠ½Π°Π»ΡΠ· ΡΡΠ·Π½ΠΈΡ
Π²ΠΈΠ΄ΡΠ² ΡΠΎΡΠ»ΠΈΠ½Π½ΠΎΠ³ΠΎ Ρ ΠΊΠΎΡΠΎΠ²βΡΡΠΎΠ³ΠΎ ΠΌΠΎΠ»ΠΎΠΊΠ°, ΡΠΊΡ Π²ΠΈΠΊΠΎΡΠΈΡΡΠΎΠ²ΡΡΡΡ Ρ Π³ΠΎΡΠ΅Π»ΡΠ½ΠΎ-ΡΠ΅ΡΡΠΎΡΠ°Π½Π½ΠΈΡ
ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ°Ρ
ΠΌ. ΠΡΠ»Π° Π¦Π΅ΡΠΊΠ²Π° Π·Π° ΡΡΠ·ΠΈΠΊΠΎ-Ρ
ΡΠΌΡΡΠ½ΠΈΠΌΠΈ ΡΠ° ΠΎΡΠ³Π°Π½ΠΎΠ»Π΅ΠΏΡΠΈΡΠ½ΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΠ°ΠΌΠΈ ΡΠΊΠΎΡΡΡ Π΄ΠΎΠ·Π²ΠΎΠ»ΡΡ ΡΠΎΠ·Π³Π»ΡΠ΄Π°ΡΠΈ ΡΠΎΡΠ»ΠΈΠ½Π½Ρ Π½Π°ΠΏΠΎΡ ΡΠΊ Π·Π°ΠΌΡΠ½Π½ΠΈΠΊΠΈ ΡΡΠ°Π΄ΠΈΡΡΠΉΠ½ΠΈΡ
ΠΏΡΠΎΠ΄ΡΠΊΡΡΠ² Π·Π΄Π°ΡΠ½ΠΈΡ
Π·Π°Π±Π΅Π·ΠΏΠ΅ΡΡΠ²Π°ΡΠΈ ΠΎΡΠ³Π°Π½ΡΠ·ΠΌ Π»ΡΠ΄ΠΈΠ½ΠΈ Π΅ΡΠ΅Π½ΡΡΠ°Π»ΡΠ½ΠΈΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΠΆΠΈΠ²Π»Π΅Π½Π½Ρ
Comparative analysis of the results using direct lateral interbody spondilodesis and transforaminal lumbar interbody spondilodesis in patients with degenerative diseases of the lumbar spine
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
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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