ХРОНИЧЕСКАЯ БОЛЕЗНЬ ПОЧЕК И ПОЧЕЧНАЯ НЕДОСТАТОЧНОСТЬ У БОЛЬНЫХ СПИДОМ

Цель исследования заключалась в изучении развития хронической болезни почек с формированием почечной недостаточности у ВИЧ-инфицированных больных в стадии СПИДа. Нами проанализированы основные показатели крови, клинико-лабораторные данные, состояние азотемии и скорость клубочковой фильтрации (СКФ) у 119 больных, находившихся на стационарном лечении Одесского областного Центра по профилактике и борьбе со СПИДом. Наличие признаков мочевого синдрома отмечалось в 82% случаев, при этом повышение уровня креатинина крови регистрировалось у 32,77% больных. Снижение СКФ менее 60 мл/мин имело место у 57,14% больных с гиперкреатининемией. Таким образом, у большинства больных СПИДом отмечается формирование ХБП. При этом, чем длительнее болеют пациенты, тем выше азотемия и тем ниже СКФ и, как следствие, быстрее развивается почечная недостаточность, причем ее развитие наступает в среднем за 7,94±0,92 лет

Application of chitosan-based wound dressings in local treatment of parenchymal organ wounds: a preclinical experimental study

Background. Injuries of various origins with damage to parenchymal organs remain one of the urgent issues of emergency surgery, despite all the achievements of medical science of the first quarter of the XXI century. One way to improve the quality of treatment for patients with this pathology consists in developing new wound dressings or modifying the properties of existing ones. Hemostatic efficacy is claimed to be one of the main requirements for such dressings.Objective. To perform a comparative analysis of the efficacy of the developed biodegradable wound dressings based on chitosan in the treatment of experimental wounds of parenchymal organs.Methods. The study involved laboratory animals (male rabbits weighing 2900 ± 150 g) to form experimental wounds of parenchymatous organs. The methodology involved wounding the liver via internal method, with the creation of a tissue defect of a given volume, or forming a linear incised wound with fixed parameters followed by application of a developed wound dressing. In the control group of animals, a collagen hemostatic sponge was used as a wound dressing. The animals used in the experiment were kept in accordance with GOST 33044-2014 “Principles of good laboratory practice”. The experiment involved studying the properties of two samples of wound dressings developed on the basis of modified Chitosan Soft (Ch-S) and Chitosan Hard (Ch-H) chitosan, having different properties due to their different structural parameters. The applied ultrasound control of the experimental wound area, with visualization of the samples of the investigated material in the process of biodegradation, enabled the features of the wound process to be studied in more detail. Statistical processing of the study results was carried out by methods of variational statistics, including the calculation of mean values (M), standard errors of mean values (± m). The criterion of the level of statistical significance considered a value of p <0.05. Histomorphological examination of samples was carried out using classical methods.Results. An experimental study conducted on laboratory animals in the treatment of liver wounds, followed by a comprehensive assessment of the results obtained, revealed high efficacy in the developed wound dressings in comparison with the control. The following parameters predicted in the development of wound dressing samples were confirmed: stable hemostatic and scaffold functions, biodegradability, adhesiveness and stimulating effect on bioreparative processes in the wound area. In addition, the ultrasound control algorithm in vivo was adapted in animals to assess the dynamics of the wound process and biodegradation of the studied wound dressings in wounds of parenchymal organs in the experiment, previously used in studying the dynamics of the wound process in soft tissues.Conclusion. The developed samples of chitosan-based wound dressings proved their efficacy in an experimental model of the wound process in parenchymal organs. The applied ultrasonic method for monitoring the biodegradation of the studied wound dressing, as well as the dynamics of the wound process in the liver tissue, revealed the correspondence between the visualized image and the histomorphological picture of the studied tissues, the structure and properties of the wound dressing

Vacuum Therapy in Complex Treatment of Purulent-Necrotic Diseases of Soft Tissues: Clinical Cases

Background. Radical surgeries for phlegmons, abscesses, necrotizing infection are often followed by extensive wounds which require an individual approach to their rapid closure by means of plastic surgery methods. In such a case, the optimal wound therapy is primary healing with the use of vacuum therapy.Cases description. The study involved three clinical trials of patients with acute purulent-necrotic diseases of soft tissues of various localizations, volumes and grades, for which vacuum therapy was used as a part of complex therapy. Surgical interventions are proved to be urgently performed in acute purulent-necrotic diseases. Early reconstructive skin and bone plastic surgery aimed at closing post-operative wound defects is also very important.Conclusion. In the demonstrated clinical cases, the purulent process was stopped and wound therapy was performed by means of primary healing, which undoubtedly ensures medical and social rehabilitation of such patients. Notably, vacuum drainage is not an independent method, but an important component in the complex active surgical treatment of purulent wounds

Main outcomes of the Phebus FPT1 uncertainty and sensitivity analysis in the EU-MUSA project

The Management and Uncertainties of Severe Accidents (MUSA) project was funded in HORIZON 2020 and is coordinated by CIEMAT (Spain). The project aims at consolidating a harmonized approach for the analysis of uncertainties and sensitivities associated with Severe Accidents (SAs) analysis, focusing on source term figures of merit. The Application of Uncertainty Quantification (UQ) Methods against Integral Experiments (AUQMIE – Work Package 4 (WP4)), led by ENEA (Italy), was devoted to apply and test UQ methodologies adopting the internationally recognized PHEBUS FPT1 test. FPT1 was chosen to test UQ methodologies because, even though it is a simplified SA scenario, it was representative of the in-vessel phase of a severe accident initiated by a break in the cold leg of a PWR primary circuit. WP4 served as a platform to identify and discuss the issues encountered in the application of UQ methodol ogies to SA analyses (e.g. discuss the UQ methodology, perform the coupling between the SA codes and the UQ tools, define the results post-processing methods, etc.). The purpose of this paper is to describe the MUSA PHEBUS FPT1 uncertainty application exercise with the related specifications and the methodologies used by the partners to perform the UQ exercise. The main outcomes and lessons learned of the analysis are: scripting was in general needed for the SA code and uncertainty tool coupling and to have more flexibility; particular attention should be devoted to the proper choice of the input uncertain parameters; outlier values of figures of merit should be carefully analyzed; the computational time is a key element to perform UQ in SA; the large number of uncertain input parameters may complicate the interpretation of correlation or sensitivity analysis; there is the need for a statistically solid handling of failed calculations

First outcomes from the PHEBUS FPT1 uncertainty application done in the EU MUSA project

The Management and Uncertainties of Severe Accidents (MUSA) project, founded in HORIZON 2020 and coordinated by CIEMAT (Spain), aims to consolidate a harmonized approach for the analysis of uncertainties and sensitivities associated with Severe Accidents (SAs) by focusing on Source Term (ST) Figure of Merits (FOM). In this framework, among the 7 MUSA WPs the Application of Uncertainty Quantification (UQ) Methods against Integral Experiments (AUQMIE – Work Package 4 (WP4)), led by ENEA (Italy), looked at applying and testing UQ methodologies, against the internationally recognized PHEBUS FPT1 test. Considering that FPT1 is a simplified but representative SA scenario, the main target of the WP4 is to train project partners to perform UQ for SA analyses. WP4 is also a collaborative platform for highlighting and discussing results and issues arising from the application of UQ methodologies, already used for design basis accidents, and in MUSA for SA analyses. As a consequence, WP4 application creates the technical background useful for the full plant and spent fuel pool applications planned along the MUSA project, and it also gives a first contribution for MUSA best practices and lessons learned. 16 partners from different world regions are involved in the WP4 activities. The purpose of this paper is to describe the MUSA PHEBUS FPT1 uncertainty application exercise, the methodologies used by the partners to perform the UQ exercise, and the first insights coming out from the calculation phase