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

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

ALDH1A inhibition sensitizes colon cancer cells to chemotherapy

Abstract Background Recent evidence in cancer research, developed the notion that malignant tumors consist of different subpopulations of cells, one of them, known as cancer stem cells, being attributed many important properties such as enhanced tumorigenicity, proliferation potential and profound multidrug resistance to chemotherapy. Several key stem cells markers were identified in colon cancer. In our study we focused on the aldehyde dehydrogenase type 1 (ALDH1) expression in colon cancer-derived cell lines HT-29/eGFP, HCT-116/eGFP and LS-180/eGFP, and its role in the chemoresistance and tumorigenic potential. Methods The effect of pharmacological inhibition of ALDH activity by diethylaminobenzaldehyde (DEAB) and also effect of molecular inhibition by specific siRNA was evaluated in vitro in cultures of human colorectal cell lines. The expression level of different isoenzymes of aldehyde dehydrogenase was determined using qPCR. Changes in cell biology were evaluated by expression analysis, western blot and apoptosis assay. The efficiency of cytotoxic treatment in the presence of different chemotherapeutic drugs was analyzed by fluorimetric assay. Tumorigenicity of cells with specific ALDH1A1 siRNA was tested in xenograft model in vivo. Results Treatment by DEAB partially sensitized the tested cell lines to chemotherapeutics. Subsequently the molecular inhibition of specific isoforms of ALDH by ALDH1A1 or ALDH1A3 siRNA led to sensitizing of cell lines HT-29/eGFP, HCT-116/eGFP to capecitabine and 5-FU. On the model of athymic mice we observed the effect of molecular inhibition of ALDH1A1 in HT-29/eGFP cells by siRNA. We observed inhibition of proliferation of subcutaneous xenografts in comparison to control cells. Conclusion This research, verifies the significance of the ALDH1A isoforms in multidrug resistance of human colorectal cancer cells and its potential as a cancer stem cell marker. This provides the basis for the development of new approaches regarding the treatment of patients with colorectal adenocarcinoma and potentially the treatment of other tumor malignancies

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 (&lt;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

RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT).Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP). This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE) inhibitor, thiazid diuretic (indapamide) and dihydropyridine calcium antagonist (nifedipine XL).Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.Conclusion. High incidence of pseudorefractory HT (40,1%) is revealed. Significant prevalence of renal disturbances especially chronic interstitial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL) provides effective control of BP in refractory and pseudorefractory HT.</p