Low rates of restenosis in primary lateral carotid artery endarterectomy

Carotid artery endarterectomy (CAE) is a treatment of choice for symptomatic and asymptomatic high-grade carotid stenosis, showing great results in reducing stroke morbidity. The optimal technique of the arterial closure is, however, still under discussion, with both patch angioplasty and primary closure having numerous advantages and pitfalls. The definite evidence is still lacking. The aim of this study was to evaluate the results of the modified primary closure technique during CEA. Incidence of restenosis more than 8 months after the surgery was measured. A retrospective observational study to evaluate modified primary internal carotid artery closure was conducted in Republican Vilnius University Hospital from January 1st, 2014 to December 31st, 2018. The patients were enrolled in the trial during their routine follow-up by their surgeon.  During the visit, after an informed consent was signed, a qualified investigator performed carotid duplex ultrasound scan, documenting the restenosis rates. Patients also filled in the comorbidity assessment questionnaire, which included their smoking habits, history of hypertension and their adherence to antihypertensive medication as well as cholesterol levels and statin therapy, additional related comorbidities. Out of 342 patients that underwent CAE with primary closure in the Republican Vilnius university hospital from 2014 to 2018, 42 patients were identified as deceased, therefore a follow-up was impossible. Out of planned 150 (50%) consequently selected patients, 125 gave an informed consent to be enrolled into the study. Out of those 6 pre-occlusions were established during the review of the patient medical data and therefore were excluded from the study. In general, we analyzed the data of 119 patients and 125 CAE with a modified primary suture closure. The mean follow-up time was 35.78 months (SE 0.992; SD 11,046). At the time of a follow up, 3 (2,4%) carotid artery occlusions were identified and promptly evaluated. Restenosis rates varied: 5,6% of patients had low grade (<50%), 5,6% had moderate grade (50-69%) and 1,6% had high grade (70-99%) stenosis. The modified lateral CAE with primary closure technique, used in our hospital’s contemporary practice has shown to be a promising alternative to the classical primary suture, due to reduced restenosis rates. More prospective and randomized studies are needed to evaluate this technique in comparison to other CAE closure techniques

Classification of Training Tools of Physics in Higher School

У статті порушено проблему класифікації навчальних засобів фізики з урахуванням сучасних засобів навчання, що виникли як результат стрімкого розвитку сучасних інформаційних технологій. Pозглянуто найпоширеніші класифікації засобів навчання, у яких ці засоби розподіляються на основі наступних підходів: за складом об’єктів, за відношенням до джерел, за складністю, за способом використання, за особливостями будови, за характером впливу, за носієм інформації, за відношенням до технологічного прогресу, за рівнями змісту освіти. Більшість авторів у своїх класифікаціях практично не враховують ті засоби, які виникли як наслідок швидкого розвитку сучасних інформаційних технологій і, зокрема, розвитку всесвітньої мережі Інтернет. На нашу думку, постає необхідність принципово нової сучасної класифікації дидактичних засобів, у якій були б враховані сучасні тенденції. З урахуванням стрімкого розвитку фізичної науки засоби навчання фізики у вищій школі також мають бути сучасними. Тому вони потребують більш розширеного аналізу і більш ґрунтовної класифікації. На основі класифікації Д.Н. Луферова розроблено власну класифікацію засобів навчання фізики. Ми виділили дві основні групи дидактичних засобів з фізики: базові та інноваційні. Під базовими засобами навчання будемо розуміти традиційні інструменти діяльності вчителя і учнів. Базова частина навчально-методичного комплексу допускає варіювання складових в залежності від дидактичних цілей. Сюди входять матеріальні (підручники, посібники, плакати, різноманітне лабораторне та демонстраційне обладнання) та ідеальні (слово вчителя) об’єкти, без яких неможливий навчальний процес. До інноваційних засобів навчання ми віднесли додаткові навчальні засоби, що передбачають використання складних технічних пристроїв. До них входять технічні та комп’ютерні засоби навчання. Технічні засоби включають в себе: аудіальні, візуальні, аудіовізуальні. До комп’ютерних засобів відносяться мультимедійні і мережеві дидактичні засоби. У запропонованій нами оновленій класифікації засобів навчання фізики більша увага приділена сучасним дидактичним засобам, які виникли в процесі розвитку сучасних інформаційних технологій. Дана класифікація є досить простою і універсальною, завдяки чому вона може бути використана педагогами при організації навчального процесу з фізики з метою підвищення його ефективності.The problem of classification of educational means of physics, taking into account modern tools of training, which arose as a result of the rapid development of modern information technologies is considered in the paper. The article deals with the most common classifications of teaching methods in which these tools are divided and grouped on the basis of the following approaches: the composition of objects, the relation to the sources, the complexity, the way of use, the characteristics of the structure, the nature of influence, the carrier of information, the relation to technological progress, the levels of educational content. Most authors in their classifications do not take into account the means that arose as a consequence of the rapid progress of modern information technology, the development of the World Wide Web in particular. In our opinion, there is a need for a fundamentally new modern classification of didactic means, which would take into consideration current trends. In view of the rapid development of physical science, the means of teaching physics at higher educational establishments should go along the technical advancement. Therefore, they require more extensive analysis and a more thorough classification. On the base of classification of D.N. Lufarov our own classification of methods for teaching physics was developed. We have identified two main groups of physics teaching materials: basic and innovative. Under the basic means of teaching we will understand traditional tools of teachers’ activities. The basic part of teaching-methodical complex allows variation of components depending on the didactic objectives. Those components include material (textbooks, manuals, posters, various laboratory and demonstration equipment) and ideal (the word of the teacher) objects, without which the educational process is impossible. Innovative training tools are additional educational methods that involve the use of sophisticated technical devices. These involve technical and computer training facilities. Technical facilities include: audio, visual, audiovisual ones. Computer tools include multimedia and networked didactics. In the suggested, renewed, classification of methods for teaching physics, more attention is paid to modern didactic means that arose due to the development of information technologies. This classification is quite simple and universal, so it can be used by educators in organizing the process of teaching physics in order to increase its efficiency

Building’ healt leakage investigation aimed at development of energy saving guidelines

This article is talking about developed technique of heat losses calculation for various purposes buildings. On the basis of performed calculations there were conducted detailed researches of the heat losses through buildingsfencing structures (wall, windows, floors, ceilings, etc.) for particular building, the installed capacity of its appliances was 208 kW. Executed researches enable ustomake a conclusion that the heat losses were 145,1 kW.Thus, 62,9 kW of capacity is excessive and therefore the equivalent number of heating units are to be excluded.Разработана методика расчёта потерь теплоты в зданиях различного назначения. На основе выполненных расчётов приведены детальные исследования потерь теплоты через ограждающие конструкции (стены, окна, полы, потолки, и проч.) конкретного здания, установленная мощность отопительных приборов которого 208 кВт. Выполненные исследования позволили заключить, что потери теплоты составляют 145,1 кВт. Таким образом, 62,9 кВт установленной мощности являются избыточными и, следовательно, эквивалентное число отопительных приборов необходимоисключить

Genetics of SLE:does this explain susceptibility and severity across racial groups?

The prevalence and severity of systemic lupus erythematosus (SLE) have been found to vary across populations of different ancestries. This review explores whether these differences can be explained by the genetic aetiology of the condition. Large genetic studies suggest that populations of different ancestry share the same risk loci but the individual risk alleles are more common in some, leading to a higher prevalence, severity, and earlier onset of the condition. Despite many of the loci being shared across populations, some have been found to be ancestry-specific and these are hypothesised to have undergone differential selective pressure in recent human history. Additionally, the effectiveness of some of the drugs used in SLE has been found to vary across ancestries, which might affect the progression of the disease, but it is unclear whether these differences are pharmacogenetic. We concluded that to understand the full role of genetics in the risk, presentation and response to treatment of SLE, larger studies including individuals from a wider representation of ancestries will be required.</p

Genetics of SLE: does this explain susceptibility and severity across racial groups?

Abstract The prevalence and severity of SLE have been found to vary across populations of different ancestries. This review explores whether these differences can be explained by the genetic aetiology of the condition. Large genetic studies suggest that populations of different ancestry share the same risk loci but individual risk alleles are more common in some, leading to a higher prevalence and severity and an earlier onset of the condition. Despite many of the loci being shared across populations, some have been found to be ancestry specific and these are hypothesized to have undergone differential selective pressure in recent human history. Additionally, the effectiveness of some of the drugs used in SLE has been found to vary across ancestries, which might affect progression of the disease, but it is unclear whether these differences are pharmacogenetic. We concluded that to understand the full role of genetics in the risk, presentation and response to treatment of SLE, larger studies including individuals from a wider representation of ancestries will be required.</jats:p

Low rates of restenosis in primary lateral carotid artery endarterectomy

Introduction. Carotid artery endarterectomy (CAE) is a treatment of choice for symptomatic and asymptomatic high-grade carotid stenosis, showing great results in reducing stroke morbidity. The optimal technique of the arterial closure is, however, still under discussion, with both patch angioplasty and primary closure having numerous advantages and pitfalls. The definite evidence is still lacking. The aim of this study was to evaluate the results of the modified primary closure technique during CEA. Incidence of restenosis more than 8 months after the surgery was measured. Methods. A retrospective observational study to evaluate modified primary internal carotid artery closure was conducted in Republican Vilnius University Hospital from January 1st, 2014 to December 31st, 2018. The patients were enrolled in the trial during their routine follow – up with their surgeon. During the visit, after an informed consent was signed, a qualified investigator performed carotid duplex ultrasound scan, documenting the restenosis rates. Patients also filled out the comorbidity assessment questionnaire, which included their smoking habits, history of hypertension and their adherence to antihypertensive medication as well as cholesterol levels and statin therapy, additional related comorbidities. Results. Out of 342 patients that underwent CAE with primary closure in the Republican Vilnius university hospital from 2014 to 2018, 42 patients were identified as deceased, therefore unable to show up for a follow-up. Out of planned 150 (50%) consequently selected patients, 125 gave an informed consent to be enrolled into the study. Out of those 6 near occlusions were established during the review of the patient medical files and therefore excluded from the study. All in all, we analyzed the data of 119 patients and 125 CAE with a modified primary suture closure. The mean follow - up time was 35,78 months with S.E. 0,992 (SD 11,046). At the time of a follow up, 3 (2,4%) carotid artery occlusions were identified and promptly evaluated. Restenosis rates varied: 5,6% of patients had low grade (<50%), 5,6% had moderate grade (50-69%) and 1,6% had high grade (70-99%) stenosis. Conclusion. The modified lateral CAE with primary closure technique, used in our hospital’s contemporary practice has shown to be a promising alternative to the classical primary suture, due to reduced restenosis rates. More prospective and randomized studies are needed to evaluate this technique in comparison to other CAE closure techniques