Оказание медицинской помощи пациентам с акне. Результаты экспертизы качества медицинской помощи

Goal. To obtain information on typical errors in medical aid rendered to acne patients in dermatovenerology dispensaries in St. Petersburg in order to develop measures to improve the quality of medical aid rendered to this group of patients. Materials and methods. The authors conducted a special expert examination of 55 patients with acne who received treatment at St. Petersburg dermatovenerology dispensaries in 2013. The quality of medical aid was assessed using the Automated Expert Examination Technique (hereinafter referred to as AEET). Major results. The percentage of cases when medical aid of due quality was rendered to acne patients was 49%. Treatment and diagnostics errors prevailed in the structure of errors in medical aid. Errors in treatment were mainly a wrong combination of drugs, simultaneous administration of external and systemic antibacterial drugs, delayed comedolytic therapy and pathogenically infeasible therapy. Errors in diagnostics included absence of indications of the form and/or severity of acne. The most important error in the collection of information was absence of gynecology examinations for women to determine whether peroral contraceptives were necessary including in case of the administration of isotretinoin. Conclusion. The similarity of errors in medical aid rendered for acne as well as high percentage of errors relating to medical aid rendered to patients demand the development of consistent measures to improve the quality of medical aid rendered to such patients and repeated expert examination using preliminary (prompt) control of the quality of medical aid.Цель. Получение информации о типичных ошибках оказания медицинской помощи пациентам с акне в кожно-венерологических диспансерах (КВД) Санкт-Петербурга для разработки мер, направленных на улучшение качества медицинской помощи (КМП) данной группе пациентов. Материал и методы. Проведена тематическая экспертиза КМП 55 наблюдений пациентов с акне, которые получали лечение в КВД Санкт-Петербурга в 2013 г. Изучение КМП проводилось с применением Автоматизированной технологии экспертизы КМП. Результаты. Доля случаев оказания медицинской помощи надлежащего качества пациентам с акне составляла 49%. В структуре ошибок оказания медицинской помощи преобладали ошибки лечения и диагноза. Ошибки лечения были представлены преимущественно неверным сочетанием препаратов, наиболее часто одномоментным назначением антибактериальных препаратов для наружного и системного применения, поздним назначением комедолитической терапии, а также применением патогенетически необоснованной терапии. Ошибками постановки диагноза считали отсутствие указаний на форму и/или степень тяжести акне, наиболее важными ошибками сбора информации - отсутствие обследования женщин у гинеколога для решения вопроса о необходимости применения комбинированных оральных контрацептивов, в том числе и при назначении изотретиноина. Заключение. Сходство характера ошибок медицинской помощи при акне, а также их высокий удельный вес при оказании медицинской помощи пациентам требуют разработки системных мероприятий по улучшению КМП этим больным и повторной экспертизы с применением индикаторов промежуточного (оперативного) контроля КМП

Measurement of CP asymmetries and branching fraction ratios of B− decays to two charm mesons

The $CP$ asymmetries of seven $B^-$ decays to two charm mesons are measured using data corresponding to an integrated luminosity of $9\text{fb}^{-1}$ of proton-proton collisions collected by the LHCb experiment. Decays involving a $D^{*0}$ or $D^{*-}_s$ meson are analysed by reconstructing only the $D^0$ or $D^-_s$ decay products. This paper presents the first measurement of $\mathcal{A}^{CP}(B^- \rightarrow D^{*-}_s D^0)$ and $\mathcal{A}^{CP}(B^- \rightarrow D^{-}_s D^{*0})$, and the most precise measurement of the other five $CP$ asymmetries. There is no evidence of $CP$ violation in any of the analysed decays. Additionally, two ratios between branching fractions of selected decays are measured.The CP asymmetries of seven B$^{−}$ decays to two charm mesons are measured using data corresponding to an integrated luminosity of 9 fb$^{−1}$ of proton-proton collisions collected by the LHCb experiment. Decays involving a D$^{*0}$ or ${D}_s^{\ast -}$ meson are analysed by reconstructing only the D$^{0}$ or ${D}_s^{-}$ decay products. This paper presents the first measurement of $\mathcal{A} ^{CP}$(B$^{−}$→${D}_s^{\ast -}$D$^{0}$) and $\mathcal{A} ^{CP}$(B$^{−}$→${D}_s^{-}$D$^{∗0}$), and the most precise measurement of the other five CP asymmetries. There is no evidence of CP violation in any of the analysed decays. Additionally, two ratios between branching fractions of selected decays are measured.[graphic not available: see fulltext]The $CP$ asymmetries of seven $B^-$ decays to two charm mesons are measured using data corresponding to an integrated luminosity of $9\text{ fb}^{-1}$ of proton-proton collisions collected by the LHCb experiment. Decays involving a $D^{*0}$ or $D^{*-}_s$ meson are analysed by reconstructing only the $D^0$ or $D^-_s$ decay products. This paper presents the first measurement of $\mathcal{A}^{CP}(B^- \rightarrow D^{*-}_s D^0)$ and $\mathcal{A}^{CP}(B^- \rightarrow D^{-}_s D^{*0})$, and the most precise measurement of the other five $CP$ asymmetries. There is no evidence of $CP$ violation in any of the analysed decays. Additionally, two ratios between branching fractions of selected decays are measured

Helium identification with LHCb

The identification of helium nuclei at LHCb is achieved using a method based on measurements of ionisation losses in the silicon sensors and timing measurements in the Outer Tracker drift tubes. The background from photon conversions is reduced using the RICH detectors and an isolation requirement. The method is developed using pp collision data at √(s) = 13 TeV recorded by the LHCb experiment in the years 2016 to 2018, corresponding to an integrated luminosity of 5.5 fb-1. A total of around 105 helium and antihelium candidates are identified with negligible background contamination. The helium identification efficiency is estimated to be approximately 50% with a corresponding background rejection rate of up to O(10^12). These results demonstrate the feasibility of a rich programme of measurements of QCD and astrophysics interest involving light nuclei

Curvature-bias corrections using a pseudomass method

Momentum measurements for very high momentum charged particles, such as muons from electroweak vector boson decays, are particularly susceptible to charge-dependent curvature biases that arise from misalignments of tracking detectors. Low momentum charged particles used in alignment procedures have limited sensitivity to coherent displacements of such detectors, and therefore are unable to fully constrain these misalignments to the precision necessary for studies of electroweak physics. Additional approaches are therefore required to understand and correct for these effects. In this paper the curvature biases present at the LHCb detector are studied using the pseudomass method in proton-proton collision data recorded at centre of mass energy √(s)=13 TeV during 2016, 2017 and 2018. The biases are determined using Z→μ + μ - decays in intervals defined by the data-taking period, magnet polarity and muon direction. Correcting for these biases, which are typically at the 10-4 GeV-1 level, improves the Z→μ + μ - mass resolution by roughly 18% and eliminates several pathological trends in the kinematic-dependence of the mean dimuon invariant mass

A novel cascade Kröhnke condensation-an intramolecular nucleophilic cyclization approach toward annulated chromenes

A one-pot protocol toward previously unreported derivatives of chromeno[2′,2′:4,5]imidazo[2,1-a]isoquinoline via a cascade reaction of isoquinoline-derived immonium salts and α-hydroxy aromatic aldehydes is elaborated. © 2010 Elsevier Ltd. All rights reserved

ИССЛЕДОВАНИЕ ВОЗДЕЙСТВИЯ ИОНИЗИРУЮЩЕГО ИЗЛУЧЕНИЯ НА ТКАНИ МЕТОДОМ ЛАЗЕРНОЙ ФЛУОРЕСЦЕНТНОЙ СПЕКТРОСКОПИИ IN VIVO

Background: Laser fluorescence spectroscopy (LFS) is widely used in various medical areas, oncology being the most known of them. In general, the LFS is used for in vivo diagnostics of tumors. Recent studies have shown that this method could be used for diagnostics of local inflammation, induced by thermal or mechanical injury. It is of interest if LFS could be used for assessment of soft biological tissue injury caused by radiation exposure. Aim: To study fluorescence of an exogenous photosensitizer and its changes over time in the radiation injury area by LFS method in vivo. Materials and methods: The experiment was done in 12 outbred SHK mice whose right hind limbs were irradiated using a gamma-therapy device ROKUS-AM (source, 60Co, at dose of 15 Gy). Before irradiation, the photosensitizer Photosens was administered to all animals intraperitoneally at dose of 2.5 mg/kg. For 21 days fluorescence was assessed in vivo with a laser diagnostic system LAKK-M in the “fluorescence” operation mode, with an excitation wavelength of 635 nm. At days 7 and 21, tissue samples from the irradiated areas of the model animals were studied histologically and differential blood cell counts were assessed simultaneously. Results: The LFS method showed an increase in the accumulation of the photosensitizer in the affected area, compared to an intact contralateral area, with higher signal intensity from the irradiated limb. The changes in the fluorescence signal from the affected over time had two characteristic peaks at days 3 and 14, probably reflecting the stage of local radiation injury. Conclusion: The use of LFS with an exogenous photosensitizer has a potential for a personalized assessment of radiation reactions in radiology.Актуальность. Лазерная флуоресцентная спектроскопия (ЛФС) широко используется в  различных медицинских направлениях, наиболее известное из которых  – онкология. В  основном ЛФС применяют для in vivo диагностики опухолей. Последние исследования показали, что ЛФС можно использовать для диагностики локального воспаления, инициированного термическим или механическим воздействием. Представляет интерес, возможно ли оценить методом ЛФС поражение мягких биологических тканей, вызванное лучевым воздействием. Цель  – исследование динамики флуоресценции экзогенного фотосенсибилизатора в  области лучевого поражения методом ЛФС in vivo. Материал и методы. В исследовании участвовали мыши линии SHK (n=12), правая задняя конечность которых подвергалась облучению на гамма-терапевтическом аппарате РОКУС-АМ (источник 60Co, доза 15 Гр). Перед облучением всем животным внутрибрюшинно был введен фотосенсибилизатор Фотосенс из расчета 2,5  мг/кг. Измерения флуоресценции проводили на комплексе многофункциональной лазер- ной диагностики «ЛАКК-М» в  течение 21  суток, длина волны возбуждения флуоресценции  – 635 нм. Параллельно на 7- и  21-е сутки проводили гистологическое исследование области лучевого поражения и  исследование лейкоцитарной формулы крови экспериментальных животных. Результаты. Метод ЛФС выявил увеличение накопления фотосенсибилизатора в области поражения по сравнению с интактной симметричной областью, что приводило к  повышению интенсивности сигнала флуоресценции в облученной конечности. Динамика сигнала флуоресценции пораженной области имеет два характерных максимума – на 3-и и 14-е сутки, что, возможно, отражает динамику развития локального лучевого поражения. Заключение. Применение метода ЛФС с использованием экзогенного фотосенсибилизатора имеет потенциал для персонализированной оценки лучевых реакций в радиологии.

The DNA of Bacteria of the World Ocean and the Earth in Cosmic Dust at the International Space Station

Cosmic dust samples from the surface of the illuminator of the International Space Station (ISS) were collected by a crew member during his spacewalk. The sampler with tampon in a vacuum container was delivered to the Earth. Washouts from the tampon's material and the tampon itself were analyzed for the presence of bacterial DNA by the method of nested PCR with primers specific to DNA of the genus Mycobacteria, DNA of the strains of capsular bacteria Bacillus, and DNA encoding 16S ribosomal RNA. The results of amplification followed by sequencing and phylogenetic analysis indicated the presence of the bacteria of the genus Mycobacteria and the extreme bacterium of the genus Delftia in the samples of cosmic dust. It was shown that the DNA sequence of one of the bacteria of the genus Mycobacteria was genetically similar to that previously observed in superficial micro layer at the Barents and Kara seas' coastal zones. The presence of the wild land and marine bacteria DNA on the ISS suggests their possible transfer from the stratosphere into the ionosphere with the ascending branch of the global electric circuit. Alternatively, the wild land and marine bacteria as well as the ISS bacteria may all have an ultimate space origin. © 2018 T. V. Grebennikova et al