81 research outputs found

    Isometry invariance of exact correlation functions in various charts of Minkowski and de Sitter spaces

    Full text link
    We consider quantum field theory with selfinteractions in various patches of Minkowski and de Sitter space-times. Namely, in Minkowski space-time we consider separately right (left) Rindler wedge, past wedge and future wedge. In de Sitter space-time we consider expanding Poincare patch, static patch, contracting Poincare patch and global de Sitter itself. In all cases we restrict our considerations to the isometry invariant states leading to maximally analytic propagators. We prove that loop corrections in right (left) Rindler wedge, in the past wedge (of Minkowski space-time), in the static patch and in the expanding Poincare patch (of de Sitter space-time) respect the corresponding isometries of the corresponding symmetric space-times. All these facts are related to the causality and analyticity properties of the propagators for the states that we consider. At the same time in the future wedge, in the contracting Poincare patch and in global de Sitter space-time infrared effects violate the isometries.Comment: 35 pages, 6 figures Additional references and minor clarifications added; version accepted to PR

    Steady Stokes flow with long-range correlations, fractal Fourier spectrum, and anomalous transport

    Full text link
    We consider viscous two-dimensional steady flows of incompressible fluids past doubly periodic arrays of solid obstacles. In a class of such flows, the autocorrelations for the Lagrangian observables decay in accordance with the power law, and the Fourier spectrum is neither discrete nor absolutely continuous. We demonstrate that spreading of the droplet of tracers in such flows is anomalously fast. Since the flow is equivalent to the integrable Hamiltonian system with 1 degree of freedom, this provides an example of integrable dynamics with long-range correlations, fractal power spectrum, and anomalous transport properties.Comment: 4 pages, 4 figures, published in Physical Review Letter

    ΠšΠΎΠΌΠ±ΠΈΠ½ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ΅ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π½Π΅ΠΊΠ»Π°ΠΏΠ°Π½Π½ΠΎΠΉ фибрилляции прСдсСрдий: изоляция Π»Π΅Π³ΠΎΡ‡Π½Ρ‹Ρ… Π²Π΅Π½ ΠΈ окклюзия ΡƒΡˆΠΊΠ° Π»Π΅Π²ΠΎΠ³ΠΎ прСдсСрдия

    Get PDF
    Atrial fibrillation might occur up to 2% of the general population, with a lifetime risk of 24% in persons > 40 years of age. Catheter ablation is increasingly being used to treat drug-refractory atrial fibrillation. The long-term efficacy of catheter ablation is disappointing, with success rates about 50%. Stroke is one of the major complications of atrial fibrillation because of atrial thrombus formation. The overall annual stroke risk is 5% in patients with atrial fibrillation, increasing up to 15% in high-risk patients. The left atrial appendage was the source of thrombi in >90% of the patients with non-valvular atrial fibrillation. Anticoagulation should be given to prevent thromboembolic events. However, anticoagulant therapy has several disadvantages, such as (major) bleedings, interactions with some dietary components and other medications, and a narrow therapeutic range. In addition, patients with atrial fibrillation, especially the elderly, have low compliance. Exclusion of the left atrial appendage from the systemic circulation could be an alternative. Thus, the combination of the left atrial appendage closure with the isolation of the pulmonary veins appears to be a rational method for the treatment of atrial fibrillation. This approach eliminates the need for anticoagulants and reduces the risk of stroke.Π Π°ΡΠΏΡ€ΠΎΡΡ‚Ρ€Π°Π½Π΅Π½Π½ΠΎΡΡ‚ΡŒ фибрилляции прСдсСрдий составляСт Π΄ΠΎ 2% Π² ΠΎΠ±Ρ‰Π΅ΠΉ популяции с ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ΠΌ риска Π΄ΠΎ 24% Ρƒ Π»ΠΈΡ† ΡΡ‚Π°Ρ€ΡˆΠ΅ 40 Π»Π΅Ρ‚. ΠžΡΠ½ΠΎΠ²Π½Ρ‹ΠΌ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ хирургичСского лСчСния фибрилляции прСдсСрдий являСтся катСтСрная радиочастотная изоляция Π»Π΅Π³ΠΎΡ‡Π½Ρ‹Ρ… Π²Π΅Π½. Однако долгосрочная ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ Π°Π±Π»Π°Ρ†ΠΈΠΈ составляСт ΠΎΠΊΠΎΠ»ΠΎ 50%. Π˜Π½ΡΡƒΠ»ΡŒΡ‚ являСтся ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· основных ослоТнСний фибрилляции прСдсСрдий ΠΈΠ·-Π·Π° образования Ρ‚Ρ€ΠΎΠΌΠ±ΠΎΠ² Π² Π»Π΅Π²ΠΎΠΌ прСдсСрдии. Π’Π΅Ρ€ΠΎΡΡ‚Π½ΠΎΡΡ‚ΡŒ ΠΈΠ½ΡΡƒΠ»ΡŒΡ‚Π° Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… фибрилляциСй прСдсСрдий составляСт 5%, ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΠ²Π°ΡΡΡŒ Π΄ΠΎ 15% Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с высоким риском тромбоэмболичСских событий. Ушко Π»Π΅Π²ΠΎΠ³ΠΎ прСдсСрдия являСтся источником Ρ‚Ρ€ΠΎΠΌΠ±ΠΎΠ² Π±ΠΎΠ»Π΅Π΅ Ρ‡Π΅ΠΌ Ρƒ 90% ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π½Π΅ΠΊΠ»Π°ΠΏΠ°Π½Π½ΠΎΠΉ фибрилляциСй прСдсСрдий. Для ΠΏΡ€ΠΎΡ„ΠΈΠ»Π°ΠΊΡ‚ΠΈΠΊΠΈ тромбоэмболичСских событий Π½Π°Π·Π½Π°Ρ‡Π°ΡŽΡ‚ΡΡ ΠΎΡ€Π°Π»ΡŒΠ½Ρ‹Π΅ антикоагулянты. Однако антикоагулянтная тСрапия ΠΈΠΌΠ΅Π΅Ρ‚ ряд нСдостатков, Ρ‚Π°ΠΊΠΈΡ… ΠΊΠ°ΠΊ кровотСчСния, взаимодСйствиС с Π½Π΅ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΌΠΈ ΠΏΡ€ΠΎΠ΄ΡƒΠΊΡ‚Π°ΠΌΠΈ питания ΠΈ лСкарствСнными срСдствами, ΡƒΠ·ΠΊΠΈΠΉ тСрапСвтичСский Π΄ΠΈΠ°ΠΏΠ°Π·ΠΎΠ½. ΠšΡ€ΠΎΠΌΠ΅ Ρ‚ΠΎΠ³ΠΎ, Π±ΠΎΠ»ΡŒΠ½Ρ‹Π΅ фибрилляциСй прСдсСрдий, особСнно ΠΏΠΎΠΆΠΈΠ»Ρ‹Π΅, ΠΈΠΌΠ΅ΡŽΡ‚ Π½ΠΈΠ·ΠΊΡƒΡŽ ΠΊΠΎΠΌΠΏΠ»Π°Π΅Π½Ρ‚Π½ΠΎΡΡ‚ΡŒ. Π˜ΡΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅ ΡƒΡˆΠΊΠ° Π»Π΅Π²ΠΎΠ³ΠΎ прСдсСрдия ΠΈΠ· кровообращСния являСтся Π°Π»ΡŒΡ‚Π΅Ρ€Π½Π°Ρ‚ΠΈΠ²ΠΎΠΉ ΠΎΡ€Π°Π»ΡŒΠ½Ρ‹ΠΌ антикоагулянтам. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±Ρ€Π°Π·ΠΎΠΌ, сочСтаниС окклюзии ΡƒΡˆΠΊΠ° Π»Π΅Π²ΠΎΠ³ΠΎ прСдсСрдия с изоляциСй Π»Π΅Π³ΠΎΡ‡Π½Ρ‹Ρ… Π²Π΅Π½ прСдставляСтся Ρ€Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹ΠΌ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ лСчСния фибрилляции прСдсСрдий. Π”Π°Π½Π½Ρ‹ΠΉ ΠΏΠΎΠ΄Ρ…ΠΎΠ΄ Π½ΠΈΠ²Π΅Π»ΠΈΡ€ΡƒΠ΅Ρ‚ ΠΏΠΎΡ‚Ρ€Π΅Π±Π½ΠΎΡΡ‚ΡŒ Π² антикоагулянтах ΠΈ сниТаСт риск ΠΈΠ½ΡΡƒΠ»ΡŒΡ‚Π°

    ΠšΠ°Ρ€Π΄ΠΈΠΎΠ³Π΅Π½Π½Ρ‹ΠΉ шок: ΠΎΠ±Π½ΠΎΠ²Π»Π΅Π½ΠΈΠ΅

    Get PDF
    Cardiogenic shock is a critical condition characterized by rapid development of multiple organ dysfunction in the absence of intensive care. The article describes AbstractΒ Β Β  modern concepts about pathophysiology and approaches to treat intensive care. The concept of phased therapy as well as methods of mechanical circulatory support are discussed. The working algorithm for choosing the optimal method was proposed.ΠšΠ°Ρ€Π΄ΠΈΠΎΠ³Π΅Π½Π½Ρ‹ΠΉ шок - критичСскоС состояниС, Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ·ΡƒΡŽΡ‰Π΅Π΅ΡΡ молниСносным Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ΠΌ ΠΏΠΎΠ»ΠΈΠΎΡ€Π³Π°Π½Π½ΠΎΠΉ нСдостаточности Π² условиях отсутствия интСнсивной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ. Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ описаны соврСмСнныС прСдставлСния ΠΎ направлСниях ΠΏΠ°Ρ‚ΠΎΡ„ΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, соврСмСнныС ΠΏΠΎΠ΄Ρ…ΠΎΠ΄Ρ‹ ΠΊ интСнсивной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ, рассматриваСтся концСпция «фазности» Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ, Π° Ρ‚Π°ΠΊΠΆΠ΅ Ρ€Π°ΡΡΠΌΠ°Ρ‚Ρ€ΠΈΠ²Π°ΡŽΡ‚ΡΡ способы мСханичСской ΠΏΠΎΠ΄Π΄Π΅Ρ€ΠΆΠΊΠΈ кровообращСния ΠΈ прСдлагаСтся Ρ€Π°Π±ΠΎΡ‡ΠΈΠΉ Π°Π»Π³ΠΎΡ€ΠΈΡ‚ΠΌ Π²Ρ‹Π±ΠΎΡ€Π° ΠΎΠΏΡ‚ΠΈΠΌΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΌΠ΅Ρ‚ΠΎΠ΄Π°

    Π‘Ρ€Π°Π²Π½Π΅Π½ΠΈΠ΅ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚ΠΎΠ² анСстСзиологичСского обСспСчСния ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ ΠΎΠΊΠΊΠ»ΡŽΠ΄Π΅Ρ€Π° ΡƒΡˆΠΊΠ° Π»Π΅Π²ΠΎΠ³ΠΎ прСдсСрдия Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с фибрилляциСй прСдсСрдий

    Get PDF
    Objective: comparison of general anesthesia (GA) and intravenous conscious sedation during left atrial appendage occlusion (LAAO).Materials and Methods. The study included 120 patients from LAAO Register at the National Medical Research Center of Cardiology, who were divided into GA (n = 100) and intravenous sedation (n = 20) groups. In-hospital outcomes were assessed, as well as outcomes and data of transesophageal echocardiography (TEE) at 45 days and 6 months.Results. 3 patients required intraoperative conversion of the anesthetic method to GA. The duration of the procedure, the time of fluoroscopy, the amount of contrast medium, and the technical success did not differ signifcantly between the two groups. The incidence of in-hospital complications in the GA group was 10%, and 15% in the intravenous sedation group (p = 0.453). There were no statistically signifcant differences between the groups in long-term outcomes and TEE data after 45 days and 6 months.Conclusion. Combined intravenous sedation with local anesthesia is an effective and fairly safe method of anesthesiological support for implantation of the occluder of the left atrial auricle. It can be used in patients with a high risk of GA, with predictable difculties of tracheal intubation, as well as if the patient wishes accordingly. The limitations of the use of intravenous sedation in combination with local anesthesia are anatomical variants of SFM that are difcult for occluder implantation, as well as the patient's low tolerance to ECG in consciousness.ЦСль: сравнСниС Π²Π°Ρ€ΠΈΠ°Π½Ρ‚ΠΎΠ² анСстСзиологичСского обСспСчСния – ΠΎΠ±Ρ‰Π΅ΠΉ анСстСзии (ОА) ΠΈ Π²Π½ΡƒΡ‚Ρ€ΠΈΠ²Π΅Π½Π½ΠΎΠΉ сСдации ΠΏΡ€ΠΈ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ ΠΎΠΊΠΊΠ»ΡŽΠ΄Π΅Ρ€Π° ΡƒΡˆΠΊΠ° Π»Π΅Π²ΠΎΠ³ΠΎ прСдсСрдия (Π£Π›ΠŸ).ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’ исслСдованиС Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΎ 120 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΈΠ· рСгистра ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ ΠΎΠΊΠΊΠ»ΡŽΠ΄Π΅Ρ€ΠΎΠ² Π£Π›ΠŸ НМИЦ ΠΊΠ°Ρ€Π΄ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ Ρ€Π°Π·Π΄Π΅Π»Π΅Π½Ρ‹ Π½Π° Π΄Π²Π΅ Π³Ρ€ΡƒΠΏΠΏΡ‹ с ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ использованной Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ анСстСзиологичСского обСспСчСния: ОА (n = 100) ΠΈ Π²Π½ΡƒΡ‚Ρ€ΠΈΠ²Π΅Π½Π½ΠΎΠΉ сСдации (n = 20). ΠžΡ†Π΅Π½ΠΈΠ²Π°Π»ΠΈ Π²Π½ΡƒΡ‚Ρ€ΠΈΠ³ΠΎΡΠΏΠΈΡ‚Π°Π»ΡŒΠ½Ρ‹Π΅ исходы, Π° Ρ‚Π°ΠΊΠΆΠ΅ исходы ΠΈ Π΄Π°Π½Π½Ρ‹Π΅ чрСспищСводной эхокардиографии (Π§ΠŸΠ­Ρ…ΠΎΠšΠ“) Ρ‡Π΅Ρ€Π΅Π· 45 Π΄Π½Π΅ΠΉ ΠΈ 6 мСс.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹: 3 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ понадобилась интраопСрационная конвСрсия ΠΌΠ΅Ρ‚ΠΎΠ΄Π° анСстСзии. Π”Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Ρ‹, врСмя Ρ„Π»ΡŽΠΎΡ€ΠΎΡΠΊΠΎΠΏΠΈΠΈ, количСство контраста, тСхничСский успСх статистичСски Π·Π½Π°Ρ‡ΠΈΠΌΠΎ Π½Π΅ Ρ€Π°Π·Π»ΠΈΡ‡Π°Π»ΠΈΡΡŒ ΠΌΠ΅ΠΆΠ΄Ρƒ двумя Π³Ρ€ΡƒΠΏΠΏΠ°ΠΌΠΈ. Частота Π²Π½ΡƒΡ‚Ρ€ΠΈΠ³ΠΎΡΠΏΠΈΡ‚Π°Π»ΡŒΠ½Ρ‹Ρ… ослоТнСний Π² Π³Ρ€ΡƒΠΏΠΏΠ΅ ОА составила 10%, Π° Π² Π³Ρ€ΡƒΠΏΠΏΠ΅ Π²Π½ΡƒΡ‚Ρ€ΠΈΠ²Π΅Π½Π½ΠΎΠΉ сСдации – 15% (p = 0,453). ΠŸΡ€ΠΈ ΠΎΡ†Π΅Π½ΠΊΠ΅ ΠΎΡ‚Π΄Π°Π»Π΅Π½Π½Ρ‹Ρ… исходов Ρ‡Π΅Ρ€Π΅Π· 45 Π΄Π½Π΅ΠΉ ΠΈ 6 мСс. статистичСски Π·Π½Π°Ρ‡ΠΈΠΌΡ‹Ρ… Ρ€Π°Π·Π»ΠΈΡ‡ΠΈΠΉ ΠΌΠ΅ΠΆΠ΄Ρƒ Π³Ρ€ΡƒΠΏΠΏΠ°ΠΌΠΈ Π½Π΅ Π²Ρ‹ΡΠ²Π»ΡΠ»ΠΎΡΡŒ.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. БочСтанная внутривСнная сСдация с мСстной анСстСзиСй являСтся эффСктивной ΠΈ достаточно бСзопасной ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈΠΊΠΎΠΉ анСстСзиологичСского обСспСчСния ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ ΠΎΠΊΠΊΠ»ΡŽΠ΄Π΅Ρ€Π° Π£Π›ΠŸ. Π•Π΅ ΠΌΠΎΠΆΠ½ΠΎ ΠΏΡ€ΠΈΠΌΠ΅Π½ΡΡ‚ΡŒ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с высоким риском ОА, ΠΏΡ€ΠΈ прСдсказуСмых трудностях ΠΈΠ½Ρ‚ΡƒΠ±Π°Ρ†ΠΈΠΈ Ρ‚Ρ€Π°Ρ…Π΅ΠΈ, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΏΡ€ΠΈ ΡΠΎΠΎΡ‚Π²Π΅Ρ‚ΡΡ‚Π²ΡƒΡŽΡ‰Π΅ΠΌ ΠΆΠ΅Π»Π°Π½ΠΈΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°. ΠžΠ³Ρ€Π°Π½ΠΈΡ‡Π΅Π½ΠΈΡΠΌΠΈ примСнСния Π²Π½ΡƒΡ‚Ρ€ΠΈΠ²Π΅Π½Π½ΠΎΠΉ сСдации Π² сочСтании с мСстной анСстСзиСй ΡΠ²Π»ΡΡŽΡ‚ΡΡ Ρ‚Ρ€ΡƒΠ΄Π½Ρ‹Π΅ для ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ ΠΎΠΊΠΊΠ»ΡŽΠ΄Π΅Ρ€Π° анатомичСскиС Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Ρ‹ Π£Π›ΠŸ, Π° Ρ‚Π°ΠΊΠΆΠ΅ низкая Ρ‚ΠΎΠ»Π΅Ρ€Π°Π½Ρ‚Π½ΠΎΡΡ‚ΡŒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° ΠΊ Π§ΠŸΠ­Ρ…ΠΎΠšΠ“ Π² сознании

    Equalized thermal neutron flux in aqueous uranium reactors

    No full text
    • …
    corecore