49 research outputs found
Feasibility of resonant diffraction radiation from inclined gratings for a nondestructive beam diagnostics
Characteristics of the resonant diffraction radiation (RDR) generated by ultrarelativistic particles passing near a tilted grating have been considered. Angular distribution of RDR can be used for diagnostics of a beam divergence. Such a technique is non-invasive practically
PROPHYLAXIS OF «ATYPICAL PNEUMONIA» AT TOMSKAYA PROVINCE
Materials of the organizing and methodical activities performed by the specialists of State Surveillance Center at Tomskaya Province, Public Health Department, Departmental Services with the support of the Province administration to prevent importation and dissemination of «atypical pneumonia» are represented
Multigap superconductivity in sesquicarbides LaC and YC
A complex structure of the superconducting order parameter in C
( = La, Y) is demonstrated by muon spin relaxation (SR) measurements
in their mixed state. The muon depolarization rate []
exhibits a characteristic temperature dependence that can be perfectly
described by a phenomenological double-gap model for nodeless
superconductivity. While the magnitude of two gaps is similar between
LaC and YC, a significant difference in the interband coupling
between those two cases is clearly observed in the behavior of .Comment: 5 pages, 4 figure
Influence of temperature gradient on diffracted X-ray spectrum in quartz crystal
In this work characteristics of hard X-ray (with energy higher than 30 keV) were investigated. In the experiment we measured spectra of X-ray reflected by a quartz monocrystal in Laue geometry under influence of the temperature gradient. The measurements were made by the spectrometer BDER-KI-11K with 300 eV resolution on the 17.74 keV spectral line of Am241 and the spectrometer XR-100CR with 270 eV resolution on the same spectral line. An existence of temperature gradient leads to increasing of the diffracted beam intensity. The intensity was measured dependently on the temperature of one of the edge of the crystal
MENINGIOMAS OF THE CEREBELLAR TENTORIUM: THE RESULTS OF SURGICAL TREATMENT
Aim of the study was to evaluate the surgeries of tentorial meningiomas in Neurosurgical Department No.1 of the Novosibirsk Institute of Traumatology and Orthopedics. Material and methods. Study includes 64 patients with tentorial meningiomas of different location, treated surgically from 2008 to 2017. Among them 55 (85.9 %) were female patients and 9 were male (14.1 %) with average age of 62.9 years in females and 56.7 years in males. For diagnostic purposes, the patients were performed brain magnetic resonance imaging and/or computed tomography with or without contrast agents. In this series, 83 % of the tumors were of large or giant (with diameter of more than 4 cm). In 63 cases the tumors were typical meningiomas and only 1 case was a malignant anaplastic meningioma. Results. All patients were treated surgically in one or two steps. Overall, there were 70 standard microsurgical resections. Electromyography with Neuropack-2 («NIHON KOHDEN Corp.», Japan) was performed to control brain stem function during the surgery, with short latency auditory evoked potentials (SLAEPs) received. When sinus walls were affected, the tumor matrix was processed with 20W neodymium laser in coherent mode and ablation. In 63 cases, gross-total resection was achieved: Simpson I (76.6 %, n = 49) and Simpson II (21.8 %, n = 14). One patient (1.6 %) was treated with subtotal resection because of complicated surgical approach and massive transverse sinus and sinus confluence bleeding. Post-operative mortality was 3.1 % (2 cases). SLAEP data did not demonstrate any significant irritation or damage to the brain stem with performed surgical approaches. There were no infections of the surgical wound, meninges, brain or CSF leaks after the surgery. Discussion. Tentorial meningiomas are rare brain tumors treated with gross-total tumor resection when possible. Performed surgeries resulted in mild functional decrease in quality of life, but Karnofsky scale for each patient was returning to its original state in 2 weeks. Complications, including neurological disability, presented in 19 % (n = 12) of the patients, and post-operative mortality did not exceed the common literature data. Most of the focal neurological disabilities have disappeared in 2 weeks after the surgery
Предоперационная диагностика патологии околощитовидных желез у пациентов с персистенцией или рецидивом первичного гиперпаратиреоза: ретроспективное исследование
INTRODUCTION: Localization of abnormal parathyroid glands in persistent or relapsed patients with primary hyperparathyroidism presents problems for surgeons before repeated surgery. There is no clear standard for the choice of diagnostic modality for localization of PG in this group of patients.OBJECTIVE: To search for the optimal diagnostic protocol of the parathyroid pathology preoperative diagnosis in patients with primary hyperparathyroidism with persistent or recurrent disease.MATERIALS AND METHODS: 55 patients diagnosed with persistence or recurrence of PHPT who underwent repeated surgical treatment were included in the study. Before surgical intervention all patients underwent laboratory and instrumental investigations in the volume of: blood tests for PTH, TTH, ionized calcium, 25(OH)D, creatinine, phosphorus, neck ultrasound, parathyroid scintigraphy by washout method, dual-isotope subtractive scintigraphy of parathyroid glands (early and delayed phases), SPECT of parathyroid glands (with uptake correction), computed tomography of the neck with intravenous bolus contrast.RESULTS: CT and planar subtraction dual-isotope scintigraphy showed the highest DA in the overall group (persistence and recurrence) (78% and 78%), with the DA of these methods differing slightly (88% and 92%) and overall accuracy being higher for CT (90% and 87%). Neck ultrasound showed the lowest rates among all methods (DA — 46%, DS — 80%, OA — 67%). Planar scintigraphy (washout) and SPECT were comparable in their informativeness: DA — 67% and 65%, DS — 96% and 98%, OA — 85% and 86%.DISCUSSION: The most commonly used current diagnostic search algorithm before reoperation is visualization of the thyroid gland by two modalities: Neck ultrasound and parathyroid scintigraphy (washout/subtraction) or SPECT-CT. In doubtful cases, the second step is computed tomography of the neck with contrast or PET/CT. It is extremely difficult to choose one optimal diagnostic method, as none of them has 100% diagnostic accuracy. In addition, each study has limitations, and the availability of some modalities is limited. In our study, the location of pathologically altered thyroid was correctly recognized in 90% of cases by CT with contrast and in 87% of cases by planar subtraction dual-isotope scintigraphy. The informativeness of neck ultrasound showed the lowest values of all modalities. SPECT and planar washout scintigraphy took an intermediate position in terms of diagnostic accuracy.CONCLUSION: Isolated ultrasonography of the neck has low diagnostic accuracy in patients with primary hyperparathyroidism with persistent or recurrent disease. We recommend the combination of US with contrast-enhanced computed tomography of the neck or US with dual isotope subtraction scintigraphy of the parathyroid glands, which have the same diagnostic accuracy. SPECT and planar washout scintigraphy can be used for the diagnosis of abnormal parathyroid glands in persistent or recurrent patients with primary hyperparathyroidism when more informative techniques are unavailable. When the techniques were combined, the combination of ultrasound/CT with contrast and ultrasound/planar subtraction dual isotope scintigraphy showed the best results with DA of 85% and 86%.ВВЕДЕНИЕ: Локализация патологических околощитовидных желез при персистенции или рецидиве заболевания у пациентов с первичным гиперпаратиреозом представляет проблему для хирургов перед повторной хирургической операцией. Не существует четкого стандарта выбора диагностической модальности для локализации околощитовидных желез у данной группы пациентов.ЦЕЛЬ: Поиск оптимального диагностического протокола для предоперационной диагностики патологии околощитовидных желез у пациентов с первичным гиперпаратиреозом при персистенции или рецидиве заболевания.МАТЕРИАЛЫ И МЕТОДЫ: В исследование включены 55 пациентов, с установленным диагнозом персистенция или рецидив ПГПТ, прошедшие повторное оперативное лечение. Перед оперативным вмешательством всем пациентам были выполнены лабораторные и инструментальные исследования в объеме: анализ крови на ПТГ, ТТГ, ионизированный кальций, 25(OH)D, креатинин, фосфор, УЗИ шеи, сцинтиграфия околощитовидных желез методом вымывания, двухизотопная субтракционная сцинтиграфия околощитовидных желез (ранняя и отсроченная фазы), ОФЭКТ околощитовидных желез (с коррекцией поглощения), компьютерная томография шеи с внутривенным болюсным контрастированием.РЕЗУЛЬТАТЫ: Самые высокие показатели ДЧ в общей группе (персистенция и рецидив) показали КТ и планарная субтракционная двухизотопная сцинтиграфия (78% и 78%), при этом ДС этих методов незначительно различалась (88% и 92%), а общая точность была выше у КТ (90% и 87%). УЗИ шеи показал самые низкие показатели среди всех методов (ДЧ — 46%, ДС — 80%, ОТ — 67%). Планарная сцинтиграфия (вымывание) и ОФЭКТ были сопоставимы по показателям информативности: ДЧ — 67% и 65%, ДС — 96% и 98%, ОТ — 85% и 86%.ОБСУЖДЕНИЕ: Наиболее часто применяемый в настоящее время алгоритм диагностического поиска перед повторной операцией — это визуализация ОЩЖ двумя модальностями: УЗИ шеи и сцинтиграфия околощитовидных желез (вымывание/субтракционная) или ОФЭКТ-КТ. В сомнительных случаях вторым этапом проводится компьютерная томография шеи с внутривенным контрастированием или ПЭТ/КТ. Выбор какого-то одного оптимального диагностического метода крайне затруднителен, поскольку ни один из них не обладает 100% диагностической точностью. К тому же каждое исследование имеет ограничения, а доступность некоторых модальностей ограничена. В нашем исследовании расположение патологически измененных ОЩЖ было правильно распознано в 90% случаев при КТ с контрастированием и в 87% случаев при планарной субтракционной двухизотопной сцинтиграфии. Информативность УЗИ шеи показала самые низкие значения из всех модальностей. ОФЭКТ и планарной сцинтиграфии методом вымывания заняли промежуточную позицию по показателю диагностической точности. При комбинации методик наилучшие результаты показало сочетание УЗИ/КТ с внутривенным контрастированием и УЗИ/планарная субтракционная двухизотопная сцинтиграфия с показателями ДЧ 85% и 86%.ЗАКЛЮЧЕНИЕ: Изолированное ультразвуковое исследование шеи обладает низкой диагностической точностью у пациентов с первичным гиперпаратиреозом при персистенции или рецидиве заболевания. Мы рекомендуем использовать комбинацию методов УЗИ с компьютерной томографией шеи с контрастированием или УЗИ с двухизотопной субтракционной сцинтиграфией околощитовидных желез, обладающих одинаковой диагностической точностью. В случае недоступности более информативных методик ОФЭКТ и планарная сцинтиграфия методом вымывания могут использоваться для диагностики патологических околощитовидных желез при персистенции или рецидиве заболевания у пациентов с первичным гиперпаратиреозом
Дифференциальная диагностика вирусной и бактериальной внебольничной пневмонии у детей с использованием логистической регрессионной модели
Purpose: to develop a logistic regression model for early differential diagnosis of viral and bacterial community-acquired pneumonia in children. Materials and methods. A prospective study of the clinical and laboratory features of community-acquired pneumonia (CAP) was carried out in 130 children. A complex approach using bacteriological, molecular genetic, serological diagnostic methods (material – nasopharyngeal swabs, pleural effusion, blood) was used to establish the etiology of CAP. Two etiological groups of CAP were distinguished: viral (n=76), bacterial (n=44). The binary logistic regression method was used to create a differential diagnosis model. Potential predictors of CAP etiology were anamnestic, clinical, laboratory (complete blood count), instrumental (chest x-ray) data. The quality of the constructed regression model was evaluated on a validation set of 42 children with CAP. Results. A statistically significant (p<0.001) regression model was created, which looks like: y=exp(2.04- 2.87×X1+2.2×X2+0.13×X3+0.12×X4-0.44×X5)/(1+exp(2.04- 2.87×X1+2.2×X2+ +0.13×X3+0.12×X4-0.44×X5)), where “y” is the probability of bacterial CAP in children, X1 – bronchoobstructive syndrome (BOS; no – 0, yes – 1), X2 – age (<4.5 years – 0, ≥4.5 years – 1), X3 – absolute neutrophil count (ANC, *109 cells/l), X4 – relative band count (Band,%), X5 – platelet distribution width (PDW,%). At y≥0.31, bacterial CAP is diagnosed with sensitivity of 81.8% and specificity of 81.6%, at y<0.31 viral CAP is diagnosed. Proposed predictors are widely available in clinical practice, which makes it possible to apply the method in outpatient and inpatient settings. The regression model confirmed the high classificatory ability using cross-validation. Conclusion. The regression model based on a complex of clinical (age, BOS) and laboratory signs (ANC, Band, PDW) has high statistical significance (p<0.001) and excellent diagnostic ability (84.2%) and can be used for early differential diagnosis viral and bacterial pediatric CAP in different health care settings. Цель: разработать логистическую регрессионную модель ранней дифференциальной диагностики вирусной и бактериальной внебольничной пневмонии у детей. Материалы и методы. Проведено проспективное исследование клинико-лабораторных особенностей внебольничной пневмонии у 130 детей. Для этиологической верификации использовался алгоритм с применением бактериологического, молекулярно-генетического, серологического методов диагностики (материал – отделяемое из носоглотки, кровь). Выделено две этиологические группы внебольничной пневмонии: вирусная (n=76), бактериальная (n=44). Для создания модели дифференциальной диагностики применялся метод бинарной логистической регрессии. В качестве потенциальных предикторов этиологии внебольничной пневмонии в обучающую матрицу вошли анамнестические, клинические, лабораторные (клинический анализ крови), инструментальные (рентгенограмма органов грудной клетки) данные. Качество построенной регрессионной модели оценивалось на тестовой выборке из 42 детей с внебольничной пневмонией. Результаты. Построена статистически значимая (p<0,001) регрессионная модель, которая имеет вид: y=exp(2,04-2,87×Х1+2,2×Х2+0,13×Х3+0,12×Х4-0,44×Х5)/ (1+ exp(2,04-2,87×Х1+2,2×Х2+0,13×Х3+0,12×Х4-0,44×Х5)), где y – вероятность бактериальной внебольничной пневмонии у детей, Х1 – бронхообструктивный синдром (нет – 0, есть – 1), Х2 – возраст (<4,5 лет – 0, ≥4,5 лет – 1), Х3 – абсолютное количество нейтрофилов (ANC, *109 клеток/л), Х4 – относительное количество палочкоядерных нейтрофилов (Band,%), Х5 – ширина распределения тромбоцитов по объему (PDW,%). При y≥0,31 диагностируется бактериальная внебольничная пневмония с чувствительностью 81,8%, специфичностью 81,6%; при y<0,31 – вирусная внебольничная пневмония. Используемые предикторы являются широкодоступными в клинической практике, что обусловливает возможность применения способа в поликлиниках и приемных отделениях стационаров. В кросс-проверке регрессионная модель подтвердила высокую классификационную способность. Заключение. Регрессионная модель, разработанная на основе комплекса клинических (возраст, БОС) и лабораторных признаков (ANC, Band, PDW), обладая высокой статистической значимостью (p<0,001) и достаточной диагностической способностью (84,2%), может применяться для ранней дифференциальной диагностики вирусной и бактериальной внебольничной пневмонии у детей на различных уровнях оказания помощи.
ХАРАКТЕРИСТИКА ОСТРЫХ КИШЕЧНЫХ ИНФЕКЦИЙ У ДЕТЕЙ, ГОСПИТАЛИЗИРОВАННЫХ В СТАЦИОНАР Г. МОСКВЫ
The article presents the results of the study of the etiological structure and clinical features of acute intestinal infections of viral, bacterial and mixed etiology in children hospitalized in a specialized department of Children's Clinical Hospital №9 named G. N. Speransky, city of Moscow in 2008—2016. It was found that during 9 years of follow-up, the number of hospitalized patients with acute intestinal infections does not have an obvious tendency to decrease. More than half of hos-pitalized patients are children 1—7 years old. Among the reasons for acute intestinal infections of established etiology, viral agents (rotaviruses and noroviruses) prevail. Among bacterial intestinal infections, the most urgent are salmonellosis, campylobacteriosis and staphylococcal infection. В статье представлены результаты изучения этиологической структуры и клинических особенностей острых кишечных инфекций (ОКИ) вирусной, бактериальной и смешанной этиологии у детей, госпитализированных в специализированное отделение ДГКБ №9 им Г.Н. Сперанского г. Москвы в 2008—2016 гг. Установлено, что на протяжении 9 лет наблюдения количество госпитализированных пациентов с ОКИ не имеет очевидной тенденции к снижению. Более половины госпитализированных пациентов составляют дети в возрасте 1—7 лет. Среди причин ОКИ установленной этиологии преобладают вирусные агенты (ротавирусы и норовирусы). Среди бактериальных кишечных инфекций наибольшую актуальность представляют сальмонеллез, кампилобактериоз и стафилококковая инфекция.
Changes to the Fossil Record of Insects through Fifteen Years of Discovery
The first and last occurrences of hexapod families in the fossil record are compiled from publications up to end-2009. The major features of these data are compared with those of previous datasets (1993 and 1994). About a third of families (>400) are new to the fossil record since 1994, over half of the earlier, existing families have experienced changes in their known stratigraphic range and only about ten percent have unchanged ranges. Despite these significant additions to knowledge, the broad pattern of described richness through time remains similar, with described richness increasing steadily through geological history and a shift in dominant taxa, from Palaeoptera and Polyneoptera to Paraneoptera and Holometabola, after the Palaeozoic. However, after detrending, described richness is not well correlated with the earlier datasets, indicating significant changes in shorter-term patterns. There is reduced Palaeozoic richness, peaking at a different time, and a less pronounced Permian decline. A pronounced Triassic peak and decline is shown, and the plateau from the mid Early Cretaceous to the end of the period remains, albeit at substantially higher richness compared to earlier datasets. Origination and extinction rates are broadly similar to before, with a broad decline in both through time but episodic peaks, including end-Permian turnover. Origination more consistently exceeds extinction compared to previous datasets and exceptions are mainly in the Palaeozoic. These changes suggest that some inferences about causal mechanisms in insect macroevolution are likely to differ as well
2D Synchrotron Radiation Interferometer for Measuring the Transverse Dimensions of an Electron Beam in a Circular Accelerator
In the majority of cases, modern systems for measuring the transverse profile of the electron beam in storage rings of synchrotron type work in the x-ray range in order to overcome the resolution limit imposed by diffraction. In conjunction with devices of this type, use is frequently made of a synchrotron radiation interferometer operating in the visible wavelength range. With the help of such an interferometer, consisting of a screen with two slits (1D interferometer), it is possible to measure the transverse dimension down to a few micrometers. 1D interferometers are widely used in circular accelerators throughout the world, including a PETRA III (DESY) storage ring, where such an interferometer is used to determine the vertical dimension of the beam. It is proposed to use a 2D interferometer, consisting of a screen with four circular holes, making it possible to measure the vertical and horizontal dimensions simultaneously