Возможностим развития конкуренции на рынках теплоснабжения Донбасса

Проаналізовано стан ситем теплопостачання Донбасу, виявлено зниження виробництва та відпуску теплової енергії, що викликано появою конкурента — автономного опалення. Обгрунтовано причини протиріччя законодавства, що регулює діяльність у сфері комунального теплопостачання — природної монополії, в результаті чого порушені конституційні, цивільні, споживчі права людей. Розглянуто практику регулювання ринків теплопостачання в країнах з розвиненою ринковою економікою, і можливості застосування їх досвіду в Україні. Визначено роль держави, як найважливішого регулятора, який здійснює контроль за ринком теплопостачання, і є влавником стратегічно важливих підприємств сектора. Ключові слова: централізоване теплопостачання, природна монополія, автономне опалення, конкуренція, приватний капітал, державне регулювання.Проанализировано состояние ситем теплоснабжения Донбасса, выявлено снижение производства и отпуска тепловой энергии, что вызвано появлением конкурента — автономного отопления. Обоснованы причины протеворечивости законодательства регулирующего деятельность в сфере коммунального теплоснабжения — естественной монополии, в результате чего нарушены конституционные, гражданские, потребительские права людей. Рассмотрена практика регулирования рынков теплоснабжения в странах с развитой рыночной экономикой, и возможности применения их опыта в Украине. Определена роль государства, как важнейшего регулятора, осуществляющего контроль за рынком теплоснабжения, и собственика стратегически важных предприятий сектора. Ключевые слова: централизованное теплоснабжение, естественная монополия, автономное отопление, конкуренция, частный капитал, государственное регулирование.The state of Donbass Heating System Works, showed a reduction in production and supply of heat energy that is caused by the emergence of competitors — independent heating. Substantiated reasons imperfect legislation governing activities in the field of district heating — natural monopoly, resulting in a violation of the constitutional, civil, consumer rights of people. The practical management of district heating markets in countries with developed market economies, and the possibility of applying their experience in Ukraine. Defined the place of government as an important regulator, controlling the heating market, and the owners of strategically important enterprises in the sector. Key words: district heating, natural monopoly, independent heating, competition, private capital, government regulation

Optimisatoin tactics of disgnostic and treatment of women of reproductive age with dysplastic lesions of sguamosus cervical epitelium and hyperproliferative diseases of the uterus

Cervical cancer frequency ranks second in the structure of cancer among women. HPV is the only proven etiological factor of precancerous lesions and cervical cancer.Given the increasing frequency of adenomyosis and leiomyoma of the uterus and pathology of the cervical epithelium in women with unfulfilled reproductive function and the extension age limits of the reproductive period, organ-preserving methods of treatmentof these pathological conditions is a main priority in gynecology.The aim of this research was to develop approaches to the treatment of cervical pathology in women with hyperproliferative diseases of the uterus

Heart failure and the risk of stroke: the Rotterdam Study

Patients with heart failure used to have an increased risk of stroke, but this may have changed with current treatment regimens. We assessed the association between heart failure and the risk of stroke in a population-based cohort that was followed since 1990. The study uses the cohort of the Rotterdam Study and is based on 7,546 participants who at baseline (1990–1993) were aged 55 years or over and free from stroke. The associations between heart failure and risk of stroke were assessed using time-dependent Cox proportional hazards models, adjusted for cardiovascular risk factors (smoking, diabetes mellitus, BMI, ankle brachial index, blood pressure, atrial fibrillation, myocardial infarction and relevant medication). At baseline, 233 participants had heart failure. During an average follow-up time of 9.7 years, 1,014 persons developed heart failure, and 827 strokes (470 ischemic, 75 hemorrhagic, 282 unclassified) occurred. The risk of ischemic stroke was more than five-fold increased in the first month after diagnosis of heart failure (age and sex adjusted HR 5.79, 95% CI 2.15–15.62), but attenuated over time (age and sex adjusted HR 3.50 [95% CI 1.96–6.25] after 1–6 months and 0.83 [95% CI 0.53–1.29] after 0.5–6 years). Additional adjustment for cardiovascular risk factors only marginally attenuated these risks. In conclusion, the risk of ischemic stroke is strongly increased shortly after the diagnosis of heart failure but returns to normal within 6 months after onset of heart failure

Immigrant status and increased risk of heart failure: the role of hypertension and life-style risk factors

<p>Abstract</p> <p>Background</p> <p>Studies from Sweden have reported association between immigrant status and incidence of cardiovascular diseases. The nature of this relationship is unclear. We investigated the relationship between immigrant status and risk of heart failure (HF) hospitalization in a population-based cohort, and to what extent this is mediated by hypertension and life-style risk factors. We also explored whether immigrant status was related to case-fatality after HF.</p> <p>Methods</p> <p>26,559 subjects without history of myocardial infarction (MI), stroke or HF from the community-based Malmö Diet and Cancer (MDC) cohort underwent a baseline examination during 1991-1996. Incidence of HF hospitalizations was monitored during a mean follow-up of 15 years.</p> <p>Results</p> <p>3,129 (11.8%) subjects were born outside Sweden. During follow-up, 764 subjects were hospitalized with HF as primary diagnosis, of whom 166 had an MI before or concurrent with the HF. After adjustment for potential confounding factors, the hazard ratios (HR) for foreign-born were 1.37 (95% CI: 1.08-1.73, <it>p </it>= 0.009) compared to native Swedes, for HF without previous MI. The results were similar in a secondary analysis without censoring at incident MI. There was a significant interaction (<it>p </it>< 0.001) between immigrant status and waist circumference (WC), and the increased HF risk was limited to immigrants with high WC. Although not significant foreign-born tended to have lower one-month and one-year mortality after HF.</p> <p>Conclusions</p> <p>Immigrant status was associated with long-term risk of HF hospitalization, independently of hypertension and several life-style risk factors. A significant interaction between WC and immigrant status on incident HF was observed.</p

Functional polymorphisms in genes of the Angiotensin and Serotonin systems and risk of hypertrophic cardiomyopathy: AT1R as a potential modifier

<p>Abstract</p> <p>Background</p> <p>Angiotensin and serotonin have been identified as inducers of cardiac hypertrophy. DNA polymorphisms at the genes encoding components of the angiotensin and serotonin systems have been associated with the risk of developing cardiovascular diseases, including left ventricular hypertrophy (LVH).</p> <p>Methods</p> <p>We genotyped five polymorphisms of the <it>AGT</it>, <it>ACE</it>, <it>AT1R</it>, <it>5-HT2A</it>, and <it>5-HTT </it>genes in 245 patients with Hypertrophic Cardiomyopathy (HCM; 205 without an identified sarcomeric gene mutation), in 145 patients with LVH secondary to hypertension, and 300 healthy controls.</p> <p>Results</p> <p>We found a significantly higher frequency of <it>AT1R </it>1166 C carriers (CC+AC) among the HCM patients without sarcomeric mutations compared to controls (p = 0.015; OR = 1.56; 95%CI = 1.09-2.23). The <it>AT1R </it>1166 C was also more frequent among patients who had at least one affected relative, compared to sporadic cases. This allele was also associated with higher left ventricular wall thickness in both, HCM patients with and without sarcomeric mutations.</p> <p>Conclusions</p> <p>The 1166 C <it>AT1R </it>allele could be a risk factor for cardiac hypertrophy in patients without sarcomeric mutations. Other variants at the <it>AGT</it>, <it>ACE</it>, <it>5-HT2A </it>and <it>5-HTT </it>did not contribute to the risk of cardiac hypertrophy.</p

The Rotterdam Study: objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in the Netherlands. The study targets cardiovascular, neurological, ophthalmological and endocrine diseases. As of 2008 about 15,000 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in some 600 research articles and reports (see http://www.epib.nl/rotterdamstudy). This article gives the reasons for the study and its design. It also presents a summary of the major findings and an update of the objectives and methods

Granulomatous Reactivation during the Course of a Leprosy Infection: Reaction or Relapse

Leprosy is a serious infectious disease whose treatment still poses some challenges. Patients are usually treated with a combination of antimicrobial drugs called multidrug therapy. Although this treatment is effective against Mycobacterium leprae, the bacillus that causes leprosy, patients may develop severe inflammatory reactions during treatment. These reactions may be either attributed to an improvement in the immunological reactivity of the patient along with the treatment, or to relapse of the disease due to the proliferation of remaining bacilli. In certain patients these two conditions may be difficult to differentiate. The present study addresses the histopathology picture of and the M. leprae bacilli in sequential biopsies taken from lesions of patients who presented such reactions aiming to improve the differentiation of the two conditions. This is important because these reactions are one of the major causes of the disabilities of the patients with leprosy, and should be treated early and appropriately. Our results show that the histopathology picture alone is not sufficient, and that bacilli's counting is necessary