Evolution of <I>Vibrio cholerae</I> El Tor and Detection of Their Gene-Variants in the Caucasus

, rstC genes), and 7 strains – to the genotype I. Genotypes I and II (genetically altered ones) are the hybrid variants of the El Tor biovar producing CT of the first type

Протезирование аортального клапана у больных пожилого и старческого возраста: анализ предоперационных факторов риска

Background. Despite an increase in the number of surgeries performed in elderly patients, conventional aortic valve replacement is associated with high postoperative mortality in comparison to young adults. The risk of surgical intervention in elderly patients is associated not only with the age, but also with the presence of a large number of concomitant diseases.Aim. To evaluate the immediate results of conventional aortic valve replacement and assess the impact of preoperative risk factors on surgical treatment.Methods. A retrospective analysis of the results of aortic valve replacement was performed in patients older than 65 years operated in the period from 2011 to 2015 (a total of 253 cases). The mean age of the patients was 70.4±4.14 years. The mean EuroSCORE was 6.09±4.45%. The impact of more than 30 preoperative risk factors on the in-hospital mortality and development of postoperative complications has been analyzed.Results. The overall in-hospital mortality was 10.3%. In-hospital mortality of isolated aortic valve replacement was 4.8%. In-hospital mortality of aortic valve replacement combined with coronary artery bypass grafting was 8.8%. High postoperative mortality rate was reliably associated with the urgency of surgery, a positive history of stroke, obesity, chronic renal failure, chronic obstructive pulmonary disease, pulmonary hypertension, a positive history of malignant neoplasms, polyvascular disease, pre-operative atrial fibrillation, IV class NYHA, post-stenotic aortic dilation, severe calcification, small aortic root.Conclusion. Aortic valve replacement in elderly and advanced age patients have relatively similar results to those of the younger patients. High risk of surgery in advanced age patients is mainly associated with the presence of concomitant extracardiac pathology and preoperative risk factors.Актуальность. Несмотря на увеличение количества операций у больных старшей возрастной категории, протезирование аортального клапана характеризуется высокой госпитальной летальностью по сравнению с более молодым контингентом больных. Риск хирургического вмешательства в группе пожилых пациентов связан не только с возрастом, но и с наличием большого количества сопутствующих заболеваний.Цель. Изучить непосредственные результаты протезирования аортального клапана и оценить степень влияния дооперационных факторов риска на показатели хирургического лечения.Материалы и методы. Проведен ретроспективный анализ результатов протезирования аортального клапана у больных старше 65 лет, прооперированных в период с 2011 по 2015 гг. (всего 253 случая). Средний возраст пациентов был 70,4±4,14 лет. Риск операции по шкале EuroSCORE составил 6,09±4,45%. Проанализировано влияние на показатели летальности и послеоперационных осложнений более 30 различных факторов риска.Результаты. Общая госпитальная летальность составила 10,3%. Летальность при изолированном протезировании аортального клапана была на уровне 4,8%, а при сопутствующем коронарном шунтировании – 8,8%. С послеоперационной летальностью статистически достоверно были связаны срочность хирургического вмешательства, наличие острого нарушения мозгового кровообращения в прошлом, ожирение, хроническая почечная недостаточность, хроническая обструктивная болезнь легких, легочная гипертензия, злокачественные новообразования в анамнезе, мультифокальный атеросклероз, дооперационная мерцательная аритмия, IV функциональный класс сердечной недостаточности по NYHA, постстенотическое расширение восходящей аорты, выраженный кальциноз и узкое фиброзное кольцо аортального клапана.Заключение. Протезирование аортального клапана у пациентов пожилого и старческого возраста продемонстрировало результаты, близкие к показателям более молодой категории больных. Высокий риск операции у возрастных пациентов обусловлен, главным образом, сопутствующей экстракардиальной патологией и предоперационными факторами риска

Possibilities of rehabilitation after interruption of undeveloped pregnancy: complex impact of low-frequency ultrasonic cavitation and peloidotherapy on the state of cytokine status

The aim of the study was to evaluate the effectiveness of the combined effect of ultrasonic cavitation irrigation of the uterine cavity and peloid dyspnea with hyposulfitic mud on the change in the level of proinflammatory cytokines in women after the interruption of an undeveloped pregnancy. 80 women were included in the study after the interruption of an undeveloped pregnancy in a period of up to 12 weeks. In the complex of therapy, the patients underwent cavitation ultrasonic irrigation of the uterine cavity with 0.05% chlorhexidine solution in combination with the rectal administration of mud tampons and applications to the "panties" zone. Using the method of ultrasonic cavitation irrigation of the uterine cavity in combination with peloidotherapy in women with regressing pregnancy leads to a decrease in the level of primary mediators of the inflammatory response.In the group using only standard therapy, no significant reduction was observed.Целью исследования явилось оценить эффективность комплексного воздействия ультразвукового кавитационного орошения полости матки и пелоидотерпапии гипосульфитными грязями на изменение уровня провоспалительных цитокинов у женщин после прерывания неразвивающейся беременности. В исследование включены 80 женщин после прерывания неразвивающейся беременности в сроке до 12 недель. В комплексе терапии пациенткам проводилось кавитационное ультразвуковое орошение полости матки 0,05 % раствором хлоргексидина посредством аппарата Фотек серии ак100 в сочетании с ректальным введением грязевых тампонов и аппликаций на зону «трусиков». Использование метода ультразвукового кавитационного орошения полости матки в комбинации с пелоидетерапией у женщин после прерывания регрессирующей беременности приводит к достоверному снижению уровня первичных медиаторов воспалительного ответа. В группе с использованием только стандартной терапии значительного снижения не наблюдалось

THE INFLUENCE OF THE FILLER GRAIN COMPOSITION ON THE PROPERTIES OF THE HEAT-RESISTANT BASALTIC CONCRETE

Objectives. The optimal granulometric composition of filler compound ensures the production of concrete having improved  physical and mechanical characteristics, as well as minimal binder  consumption. The properties of heat-resistant concrete largely  depend on the type and the ratio of its components. Taking this into  account, the aim of the study is to determine the optimal grain composition of heat-resistant concrete.Methods. Methods for optimising the properties of heatresistant basaltic concrete with a composite binder and  mechanochemical activation of the filler grains were used during the  course of the research.A simplex-centroid experiment design is  applied for this purpose. The composite binder was subjected to  mechanochemical activation. Samples were made by vibration-pressing from a concrete mix with a cone draught of 2 cm.Results. The grain composition of heat-resistant concrete is proved  to be the most important variable factor, regulating which the  properties of concrete can be varied. The compositions of heat- resistant basaltic concrete with activated composite binder having a  maximum application temperature of 700 ºС are developed. The  influence of the grain composition of the basaltic filler on the  properties of basaltic concrete using mathematical experiment planning methods is determined. The regression equations for the ultimate tensile strength and bending stress of basaltic concrete are  obtained for heating temperature of 700ºC.Conclusion. The granulometric composition of heat-resistant basaltic concrete based on the activated binder is optimised for basic physical and technical properties. The optimal granulometric  design of the composition of heat-resistant concrete indicates that as the coarse fraction (particles greater than 0.63 mm) in the filler  composition increases, the ultimate tensile strength and bending  stress of heatresistant basaltic concrete is increased when heated to  a temperature of 700ºС. This is due to a more compact arrangement of sand grains

POSSIBLE PREDICTORS OF ATRIAL FIBRILLATION RECURRENCE IN LONG-TERM PROPHYLACTIC PROPAFENONE THERAPY

Aim. To identify possible predictors of atrial fibrillation (AF) recurrence in 6-month prophylactic propafenone therapy. Material and methods. Patients (n=63; aged 52.2±12.6 years; 25.4% women) with frequent AF recurrences who restored sinus rhythm with propafenone, were included into the study. Paroxysmal AF was observed in 84.1% of patients, and persistent AF — in 15.9% of patients. ECG, transthoracic echocardiography , chest radiography with the calculation of cardio-thoracic index (CTI) was performed at baseline. All patients received rpropafenone therapy (450–600 mg/day) during 6 months after sinus rhythm conversion. ECG and 24-hours ECG monitoring were performed in 1, 3 and 6 months of the therapy. Patients with 70–100% reduction in AF recurrence rate were included into the 1-st group, and patients with &lt;70% reduction – into the 2-nd group. Results. 92%, 88.5% and 78% of patients were included into the group 1 after 1, 3 and 6 months of follow up, respectively. AF recurrences were observed 4.5, 3.8, and 1.7 times more often in women than these in men after 1, 3 and 6 months, respectively , (p&gt;0.05). Mean age of patients in the group 2 was significantly older than this in patients of the group 1 (p&lt;0.05). CTI, left atrium size and volume, interventricular septum thickness (IVST) were significantly larger in group 2. Myocardium mass of the left ventricle (MMLV) after 6 months of therapy was larger by 13.9% in patients of the group 2 vs this in patients of the group 1 (p&lt;0.05). Conclusion. Insufficient preventive effect of propafenone was observed in 8%, 11.5% and 22% of patients in 1, 3 and 6 months of the follow-up, respectively. Propafenone prophylactic efficacy was slightly higher in men and younger patients. Patients with poor preventive effect of propafenone had a significantly larger baseline CTI, size and volume of the left atrium, IVST, and MMLV

POSSIBLE PREDICTORS OF ATRIAL FIBRILLATION RECURRENCE IN LONG-TERM PROPHYLACTIC PROPAFENONE THERAPY

Aim. To identify possible predictors of atrial fibrillation (AF) recurrence in 6-month prophylactic propafenone therapy. Material and methods. Patients (n=63; aged 52.2±12.6 years; 25.4% women) with frequent AF recurrences who restored sinus rhythm with propafenone, were included into the study. Paroxysmal AF was observed in 84.1% of patients, and persistent AF — in 15.9% of patients. ECG, transthoracic echocardiography , chest radiography with the calculation of cardio-thoracic index (CTI) was performed at baseline. All patients received rpropafenone therapy (450–600 mg/day) during 6 months after sinus rhythm conversion. ECG and 24-hours ECG monitoring were performed in 1, 3 and 6 months of the therapy. Patients with 70–100% reduction in AF recurrence rate were included into the 1-st group, and patients with &lt;70% reduction – into the 2-nd group. Results. 92%, 88.5% and 78% of patients were included into the group 1 after 1, 3 and 6 months of follow up, respectively. AF recurrences were observed 4.5, 3.8, and 1.7 times more often in women than these in men after 1, 3 and 6 months, respectively , (p&gt;0.05). Mean age of patients in the group 2 was significantly older than this in patients of the group 1 (p&lt;0.05). CTI, left atrium size and volume, interventricular septum thickness (IVST) were significantly larger in group 2. Myocardium mass of the left ventricle (MMLV) after 6 months of therapy was larger by 13.9% in patients of the group 2 vs this in patients of the group 1 (p&lt;0.05). Conclusion. Insufficient preventive effect of propafenone was observed in 8%, 11.5% and 22% of patients in 1, 3 and 6 months of the follow-up, respectively. Propafenone prophylactic efficacy was slightly higher in men and younger patients. Patients with poor preventive effect of propafenone had a significantly larger baseline CTI, size and volume of the left atrium, IVST, and MMLV.</p

TECHNOLOGY AND THE PROPERTIES OF THE FIRE-RETARDANT FIBROGIPSOVERMIKULITOBETONNYKH COMPOSITES WITH THE APPLICATION OF THE VOLCANIC ROCKS

Fire-retardant composites with the application of gypsum, unslaked lime, distended vermiculite, tuffaceous sand, basaltic fibers and resin of wood of that saponified are developed. The methods of the preparation of fire-retardant mixture and molding of articles made of the composites are investigated. Are given the results of experimental and theoretical studies of the fire resistance of armotsementnykh elements with the fire-retardant layer from the gipsovermikulitotufobetonnykh and fibrogipsovermikulitotufobetonnykh composites