Risk stratification of thromboembolic complications development in surgical patients

Aim. Creating a mathematically based scale of risk stratification of thromboembolic complications in patients with acute abdominal organs pathology requiring urgent surgical treatment.Material and Methods. This work is based on data from 185 case reports of patients with acute surgical diseases of the abdominal organs that had undergone emergency operations. Clinical and statistical analyses were carried out and the most significant risk factors for venous thromboembolic complications were identified. By digitally estimating the specific gravity of each of the factors, the method of sequential probability ratio criterion was applied to the obtained data.Results and Discussion. Based on a retrospective analysis of clinical records, 13 most informative prognostic criteria for thromboembolic complications formed in the prognostic table were identified. Each sign, depending on its value, had a specific gravity. For the convenient using of the prognostic scale in practice, the indicators of natural logarithms are translated into arbitrary units (points). The results are checked on available archival records. The overall forecast reliability was 97%.Conclusion. The proposed prognostic scale made it possible to optimize the likelihood of a feasibility study in patients with acute diseases of the abdominal organs

The results of surgical treatment of patients with open abdominal injury

Objective: To study the evolution of approaches to surgical treatment in patients with open abdominal trauma.Material and methods: The results of surgical treatment of 141 patients with open abdominal trauma at the age of 32.6 ± 7.3 years have been studied. In the main group of 73 patients, surgical tactics have been determined according to the results of the Focused Assessment with Sonography for Trauma (FAST) protocol and diagnostic video laparoscopy. In the control group of 68 patients, indications for laparotomy have been presented based on the proven fact of a penetrating wound in the abdominal cavity.Results: In patients with unstable hemodynamics and signs of peritonitis there is no need for additional verification of the damage nature. In these cases, an emergency laparotomy is justified. In debatable cases diagnostic video laparoscopy should be the method of choice for the diagnosis. In 19 (27.9%) patients in the control group with the proven fact of a an abdominal penetrating wound during primary surgical treatment (PST), no injuries were detected during the examination of the abdominal organs and the laparotomy was exploratory.Conclusion: A rational approach to assessment of the injuries severity using the FAST protocol and diagnostic video laparoscopy in patients of the main group made it possible to completely avoid exploratory laparotomy and increase the proportion of minimally invasive interventions to 50–70%. The accuracy of laparoscopic diagnostics was 98%

Effect of Thermodeformation Treatment on the Structure and Mechanical Properties of Amorphous Ribbons Based on Zirconium

The structure and mechanical properties of amorphous tapes of an alloy Zr62,5Cu22,5Fe5Al10 was investigated in this work. Samples were obtained by melting on a spinning copper wheel. The changes happening in the structure of tapes after thermodeformation treatment was investigated using the methods of transmission electron microscopy and X-ray structural analysis. Vickers microhardness was measured to investigate the effect of the thermodeformation treatment on the mechanical properties of the tapes.В работе исследовалось металлическое стекло состава Zr62,5Cu22,5Fe5Al10. Образцы получали методом литья на вращающийся медный диск. Методами просвечивающей электронной микроскопии и рентгеноструктурного анализа изучены изменения, происходящие в структуре лент после термодеформационной обработки. Для исследования влияния термодеформационной обработки на механические свойства лент была измерена микротвердость по Виккерсу.Исследование выполнено при финансовой поддержке РФФИ в рамках научного проекта № 19-33-90224

NEW NUTRIENT MEDIUM ON THE BASIS OF DRY FIBRIN HYDROLYSATE FOR V. CHOLERAE CULTIVATION

The data on exploration of biological properties of experimental solid and liquid media on the basis of dry enzymatic hydrolysate of fibrinobtained from production waste of anti-rabies immunoglobulin is presened here. The culture media engineered meets the requirements of normative documents and. is highly competitive with the test medium in their qualitative characteristics. Suggested media can be used for V. cholerae cultivation, including submerged cultivation, in production of cholera preventive and. diagnostic preparations

Non-Waste Alternative Technologies in the Production of Heterologous Anti-Rabies Immunoglobulin

Presented is a comprehensive approach to utilization of the wastes that appear in the process of heterologous anti-rabies immunoglobulin production (packed red cells, fibrin, and alcohol-containing products). Specific immunoglobulin is extracted from the surface of red blood cells using desorption technique. Additional yields of immunoglobulin after exposure of erythrocytes to non-ionic detergent amount to 10-19 % of the output. Rich protein supplement feeding for horses-producers is obtained from spray-dried packed red cells. Solid nutritious substrate for microbiological media production is obtained from fibrin using enzymic hydrolysis method. The efficiency of the fibrin hydrolysate-based media is 1.5-2 times higher in comparison with that of the media based on the digest of meat and casein, as demonstrated by the results of Vibrio cholerae scaled cultivation. Furthermore, worked out is the technology of ethanol regeneration after the rivanol-ethanolic precipitation of gamma globulin, alcohol content by volume being (93±1) % after the regeneration. It is demonstrated that the regenerated alcohol can be used as a precipitator in the process of anti-rabies serum fractioning. All in all, the developed techniques make it possible to utilize the wastes of anti-rabies immunoglobulin production and provide for further use of derivatives while producing medical immunobiological preparations

Kondo flow invariants, twisted K-theory and Ramond-Ramond charges

We take a worldsheet point of view on the relation between Ramond-Ramond charges, invariants of boundary renormalization group flows and K-theory. In compact super Wess-Zumino-Witten models, we show how to associate invariants of the generalized Kondo renormalization group flows to a given supersymmetric boundary state. The procedure involved is reminiscent of the way one can probe the Ramond-Ramond charge carried by a D-brane in conformal field theory, and the set of these invariants is isomorphic to the twisted K-theory of the Lie group. We construct various supersymmetric boundary states, and we compute the charges of the corresponding D-branes, disproving two conjectures on this subject. We find a complete agreement between our algebraic charges and the geometry of the D-branes.Comment: 58 pages. V4 : Problem with the bibliography correcte

USING THE THROMBODYNAMICS TEST IN THE INTEGRATED PERIOPERATIVE MONITORING OF THE BLOOD COAGULATION SYSTEM IN SURGICAL PATIENTS

Aim. The research was conducted to evaluate the possibilities of the "Thrombodynamics" test in the integrated monitoring of the blood coagulation system and the choice of the method of prophylaxis of thromboembolic complications in the postoperative period in surgical patients.Materials and methods. 123 patients were operated for acute surgical pathology of abdominal organs. The "Thrombodynamics" test was used in a complex assessment of the state of the blood coagulation system. After the statistical processing by the methods of variation statistics, the results were used to predict the risk of the occurrence and changes in the volume of therapy for thromboembolic complications, taking into account the current understanding of the thrombodynamic properties of the fibrinous clot. Correction of the hemostasis system was based on "Russian Clinical Recommendations for the Diagnosis, Treatment and Prevention of Venous Thromboembolic Complications" approved by the Expert Meeting on May 20, 2015.Results. It was found that 101 (82.1%) patients had abnormalities in the blood coagulation system after the surgery for acute abdominal cavity diseases complicated by peritonitis. We established the direct dependence of the predicted risk of thromboembolic complications on the degree of severity of secondary peritonitis. 52 (42.3%) patients needed a correction of thromboprophylactic therapy, which made it possible to exclude the occurrence of venous thromboembolic complications.Conclusion. The use of the "Thrombodynamics" test in the complex evaluation of the qualitative characteristics of the blood coagulation system in surgical patients with a complicated course of the disease in the perioperative period makes it possible to objectively assess the risks of the thromboembolic complications and to correct a thromboprophylactic therapy to exclude the thromboembolic complications

The Microstructure and Properties of Al–Mn–Cu–Zr Alloy after High-Energy Ball Milling and Hot-Press Sintering

In the present research an Al–7.7%Mn–4.9%Zr–3.2%Cu (wt%) alloy was processed by mechanical alloying (MA) followed by hot press sintering. The microstructure, phase composition, and mechanical properties of the MA granules and sintered samples were investigated. The dissolution of Mn, Zr, and Cu with further precipitation of the Al6Mn phase were observed during high-energy ball milling. In the alloy processed without stearic acid after milling for ~10 h, an Al-based solid solution with ~4.9 wt%Zr, ~3.2 wt%Cu and a ~5 wt%Mn with a grain size of ~16 nm and a microhardness of ~530 HV were observed. The addition of stearic acid facilitated Mn dissolution and precipitation of the Al6Mn phase during milling but led to the formation of the ZrH2 phase that decreased the Zr solute and the microhardness. Precipitation of the Al6Mn, L12–Al3Zr, and Al2Cu phases during annealing and sintering of the MA granules in the temperate range of 350–375 °C was observed, and an additional Al20Cu2Mn3 phase was precipitated at 400–450 °C. Hot-press sintering at 450 °C provided a low fraction of cavities of ~1.5%, the yield strength of 1100 MPa, ultimate compressive strength of 1200 MPa, strain at fracture of 0.5% at room temperature, the yield strength of 380 MPa, ultimate compressive strength of 440 MPa, and strain at fracture of 3.5% at 350 °C. The microstructural evolution during high-temperature deformation on the sample surface was studied and the differences in deformation behavior for the alloys sintered at different temperatures were discussed

ВЛИЯНИЕ ОТЖИГА ПРИ РАЗЛИЧНЫХ ТЕМПЕРАТУРАХ НА СТРУКТУРУ И ТВЕРДОСТЬ АМОРФНЫХ ЛЕНТ СПЛАВА Al85Y8Ni5Co2

Aluminum-based metallic glasses are the new promising family of materials. However, the effect of heat treatment on the structure and properties of Al–Y–Ni–Co amorphous alloys has not been widely studied so far. In this paper, Al85Y8Ni5Co2 amorphous alloy strips were obtained by hardening on a rotary copper wheel. The effect of vacuum annealing at temperatures ranging from 100 to 500 °C for 30 minutes on the structure and hardness of these strips was investigated. Transmission electron microscopy, X-ray diffraction analysis, and differential scanning calorimetry were used to study changes in the structure of strips after heat treatment. Vickers microhardness was measured to investigate the effect of annealing on the mechanical properties of strips. The results obtained allowed for the conclusions made about changes in hardness depending on the Al85Y8Ni5Co2 alloy strip structure. It was found that as the temperature rises, strip microhardness increases reaching a maximum value of 575±7 HV after annealing at 350 °C, then it decreases with a further increase in the annealing temperature. It was shown that the Al85Y8Ni5Co2 alloy strips remain completely amorphous and no crystalline phases are detected in their structures after annealing at temperatures up to 250 °C for 30 minutes. A sharp increase in hardness after annealing at 350 °C is associated with 10–30 nm nanocrystals of an aluminum solid solution formed in the amorphous matrix and surrounded by a residual amorphous matrix, while further hardness decrease is associated with the increasing sizes of these crystals and Al3Y and Al19Ni5Y3 intermetallics formed in the structure.Металлические стекла на основе алюминия являются новым перспективным семейством материалов. Однако влияние термической обработки на структуру и свойства аморфных сплавов системы Al–Y–Ni–Co до сих пор широко не изучено. В настоящей работе методом закалки на вращающемся медном диске получены аморфные ленты сплава Al85Y8Ni5Co2. Исследовано влияние отжига в вакууме при температурах от 100 до 500 °С в течение 30 мин на структуру и твердость данных лент. Для изучения изменений, происходящих в их структуре после термической обработки, использовались методы просвечивающей электронной микроскопии, рентгеноструктурного анализа и дифференциальной сканирующей калориметрии. Для исследования влияния отжига на механические свойства лент была измерена микротвердость по Виккерсу. На основании полученных результатов сделаны выводы об изменении твердости в зависимости от структуры лент сплава Al85Y8Ni5Co2. Установлено, что с повышением температуры их микротвердость увеличивается, достигая максимального значения 575±7 HV после отжига при 350 °С, затем она снижается при дальнейшем повышении температуры термообработки. Показано, что после отжига при t 250 °С в течение 30 мин ленты сплава Al85Y8Ni5Co2 остаются полностью аморфными: в структуре отсутствуют кристаллические фазы. Резкое увеличение твердости после отжига при 350 °С связано с образованием в аморфной матрице нанокристаллов алюминиевого твердого раствора размером 10–30 нм, окруженных остаточной аморфной матрицей, а дальнейшее ее снижение обусловлено увеличением размера этих кристаллов и появлением в структуре интерметаллидов Al3Y и Al19Ni5Y3