Modern approaches to the treatment of genital prolapse in obese women

Introduction. The problem of female genital prolapse (GP) remains in the sportlight of gynecologists, because despite the variety of surgical methods, there are still recurrences of the disease, which are associated not only with the failure of the restored ligaments, fascia, muscles, damaged pelvic floor and perineum, but with the imperfection of the operation. The solution of this problem is especially important in the treatment of patients with extragenital pathology, in particular obesity. The purpose: to optimize the treatment of genital prolapse in obese patients by determining an individual approach to planning surgical treatment taking into account the degree of obesity and concomitant pathology. Materials and methods. We examined 65 patients of which 20 had genital prolapse and obesity (main group), 25 had genital prolapse and normal weight (comparison group), 20 women did not have gynecological diseases and extragenital pathology made up control group. To diagnose obesity and determine its degree we calculated body mass index (BMI). To determine the degree of GP its quantitative assessment was used (POP-Q; 1996). Surgical intervention included transvaginal extirpation of the uterus without appendages, anterior colporrhaphy, colpoperineoraphy with levatoplasty, sacrospinal colpopexy. Transabdominal and laparoscopic colposacropexy in obese women were not used due to the presence of relative contraindications for laparoscopy (cardiovascular disease, respiratory pathology, adhesions, the condition after hernias’ surgery). Therefore, all operations on women with GP and obesity were performed transvaginally due to the inability to perform abdominal access. In comparison group transvaginal surgery was performed. All the groups under study were representative. Before the use of polypropylene mesh "Polymesh" to minimize purulent-septic complications associated with the use of synthetic prostheses aquadissection was performed with 0.9% saline with the addition of 1 g of ceftriaxone per 200 ml. After the operation, the women used suppositories with hyaluronic acid (revitax). Results. The results of surgical treatment have been analyzed and the following data were obtained: recurrences in the main and in the comparison group were 4% (2 women in whom operations were performed with the use of their own tissues without  mesh prosthesis). Infectious complications, dyspareunia and pelvic pain were not observed. Conclusions. Surgical treatment of GP in obese women by using polypropylene mesh "Polymesh" for colposacropexy after transvaginal uterine extirpation increases the effectiveness of treatment  and redduces the number of recurrences. Hydropreparation of the mesh with an antibacterial agent and postoperative use of hyaluronidase intravaginally helps to reduce purulent-septic complications of surgery and improves the patients’quality of life

Investigation of two-photon 2s -> 1s decay in one-electron and one-muon ions

We have studied the radiative decay of the 2s state of one-electron and one-muon ions, where the two-photon mechanism plays an important role. Due to the nuclear size corrections the radiative decay of the 2s state in the electron and muon ions is qualitatively different. Based on the accurate relativistic calculation, we introduced a two-parameter approximation, which makes it possible to describe the two-photon angular-differential transition probability for the polarized emitted photons with high accuracy. The emission of photons with linear and circular polarizations was studied separately. We also investigated the transition probabilities for the polarized initial and final states. The investigation was performed for ions with atomic numbers 1 < Z < 120.Comment: 18 pages, 8 figure

The study of the «Self-concept» and volition qualities of adolescents

В статье представлены результаты исследования взаимосвязей и волевых качеств подростков.The article presents the results of a study of the relationships and volitional qualities of adolescents

АНАЛИЗИРУЮЩИЙ МАГНИТ ДЛЯ ТЕХНОЛОГИЧЕСКОГО УСКОРИТЕЛЯ ЭЛЕКТРОНОВ ЛУ-10М

Основной проблемой при использовании магнитов из редкоземельных материалов в ускорительных технологиях является изменение магнитных свойств материала под действием излучения. Особенно актуальна эта задача для мощных технологических ускорителей электронов с энергией до 10 МэВ. Для выбора наиболее стойкого материала были проведены исследования радиационной стойкости образцов магнитов из Sm2Co17 и Nd-Fe-B сплава. Постоянные магниты типа Sm2Co17 и Nd-Fe-B были изгтовлены методом порошковой технологи с использованием PLP процесса в производстве последних. Магнитные образцы подвергались прямому воздействию электронного пучка с энергией 10 МэВ и воздействию тормозного излучения этого пучка. Поглощённая доза от электронов для образцов составляла 16 Град (общий поток электронов, попавший на 1 см2 образца, был равен 1,4х1017) и 160 Град. Активность образцов после облучения изменилась в пределах допустимых норм. Этот факт существенно упрощает использование редкоземельных магнитных материалов в готовых изделиях ускорителей. В процессе облучения магниты охлаждались водой с температурой 38 °С для избежания перегрева. Для оценки изменения величины поля, создаваемого вокруг образца, использовался интеграл интерполированной нормальной к поверхности образца составляющей магнитного поля S по области интерполяции данных в относительных единицах. Для образцов из Nd-Fe-B сплава магнитный поток вокруг образца уменьшился и составил 0,92 и 0,717 от начального значения для указанных доз облучения. Магнитное поле вокруг образцов из Sm2Co17 сплава не изменилось в пределах точности измерений для тех же доз. На основе образцов из Sm2Co17 сплава размерами 30х24х12 мм было проведено моделирование и конструирование магнита для анализа пучка электронов технологического ускорителя на энергию до 10 МэВ. Наибольшее значение поля в медианной плоскости магнита равно 0,3110 Тл. Расстояние между полюсами магнита равно 25,25 мм. Эффективная длина магнита – 33,53 мм. Измеренные параметры поля магнита удовлетворяют заданным при разработке величинам. Магнит также может быть использован для настройки ускорителя в диапазоне энергий до 10 МэВ

ПАРЕНТЕРАЛЬНОЕ ПИТАНИЕ У ПАЦИЕНТОВ В КРИТИЧЕСКИХ СОСТОЯНИЯХ: ИСТОРИЯ СТАНОВЛЕНИЯ И РАЗВИТИЯ ПРОБЛЕМЫ

Parenteral nutrition in patients in critical conditions: the history of formation and development problem.Парентеральное питание у пациентов в критических состояниях: история становления и развития проблемы

Bovine Tuberculosis in a Nebraska Herd of Farmed Elk and Fallow Deer: A Failure of the Tuberculin Skin Test and Opportunities for Serodiagnosis

In 2009, Mycobacterium bovis infection was detected in a herd of 60 elk (Cervus elaphus) and 50 fallow deer (Dama dama) in Nebraska, USA. Upon depopulation of the herd, the prevalence of bovine tuberculosis (TB) was estimated at ∼71–75%, based upon histopathology and culture results. Particularly with elk, gross lesions were often severe and extensive. One year ago, the majority of the elk had been tested for TB by single cervical test (SCT), and all were negative. After initial detection of a tuberculous elk in this herd, 42 of the 59 elk were tested by SCT. Of the 42 SCT-tested elk, 28 were TB-infected with only 3/28 reacting upon SCT. After SCT, serum samples were collected from the infected elk and fallow deer from this herd at necropsy and tested by three antibody detection methods including multiantigen print immunoassay, cervidTB STAT-PAK, and dual path platform VetTB (DPP). Serologic test sensitivity ranged from 79 to 97% depending on the test format and host species. Together, these findings demonstrate the opportunities for use of serodiagnosis in the rapid detection of TB in elk and fallow deer

Potential for rapid antibody detection to identify tuberculous cattle with non-reactive tuberculin skin test results

Abstract Background Bovine tuberculosis (TB) control programs generally rely on the tuberculin skin test (TST) for ante-mortem detection of Mycobacterium bovis-infected cattle. Results Present findings demonstrate that a rapid antibody test based on Dual-Path Platform (DPP®) technology, when applied 1-3 weeks after TST, detected 9 of 11 and 34 of 52 TST non-reactive yet M. bovis-infected cattle from the US and GB, respectively. The specificity of the assay ranged from 98.9% (n = 92, US) to 96.0% (n = 50, GB) with samples from TB-free herds. Multi-antigen print immunoassay (MAPIA) revealed the presence of antibodies to multiple antigens of M. bovis in sera from TST non-reactors diagnosed with TB. Conclusions Thus, use of serologic assays in series with TST can identify a significant number of TST non-reactive tuberculous cattle for more efficient removal from TB-affected herds

Progress in Development of Kharkov X-Ray Generator Nestor

The sources of the X-rays based on Compton scattering of intense Nd:YAG laser beam on electron beam circulating in a storage ring with beam energy 43-225 MeV is under construction in NSC KIPT. In the paper the progress in development and construction of Kharkov X-ray generator NESTOR is presented. The current status of the main facility system design and development are described. New scheme and main parameters of injection system are presented. The status of power supply system and control system is described. The facility is going to be in operation in the middle of 2007 and generated X-rays flux is expected to be of about 10{sup 13} phot/s

Oral vaccination with heat inactivated Mycobacterium bovis activates the complement system to protect against tuberculosis

Tuberculosis (TB) remains a pandemic affecting billions of people worldwide, thus stressing the need for new vaccines. Defining the correlates of vaccine protection is essential to achieve this goal. In this study, we used the wild boar model for mycobacterial infection and TB to characterize the protective mechanisms elicited by a new heat inactivated Mycobacterium bovis vaccine (IV). Oral vaccination with the IV resulted in significantly lower culture and lesion scores, particularly in the thorax, suggesting that the IV might provide a novel vaccine for TB control with special impact on the prevention of pulmonary disease, which is one of the limitations of current vaccines. Oral vaccination with the IV induced an adaptive antibody response and activation of the innate immune response including the complement component C3 and inflammasome. Mycobacterial DNA/RNA was not involved in inflammasome activation but increased C3 production by a still unknown mechanism. The results also suggested a protective mechanism mediated by the activation of IFN-γ producing CD8+ T cells by MHC I antigen presenting dendritic cells (DCs) in response to vaccination with the IV, without a clear role for Th1 CD4+ T cells. These results support a role for DCs in triggering the immune response to the IV through a mechanism similar to the phagocyte response to PAMPs with a central role for C3 in protection against mycobacterial infection. Higher C3 levels may allow increased opsonophagocytosis and effective bacterial clearance, while interfering with CR3-mediated opsonic and nonopsonic phagocytosis of mycobacteria, a process that could be enhanced by specific antibodies against mycobacterial proteins induced by vaccination with the IV. These results suggest that the IV acts through novel mechanisms to protect against TB in wild boar