Observation Of A High-energy Cosmic-ray Family Caused By A Centauro-type Nuclear Interaction In The Joint Emulsion Chamber Experiment At The Pamirs

An exotic cosmic-ray family event is observed in the large emulsion chamber exposed by the joint at the Pamirs (4360 m above sea level). The family is composed of 120γ-ray-induced showers and 37 hadron-induced showers with individual visible energy exceeding 1 TeV. The decisive feature of the event is the hadron dominance: ΣEγ, ΣE(γ) h, 〈Eγ, 〈E(γ) h〉, 〈Eγ·Rγ〉 and 〈E(γ)·Rh〉 being 298 TeV, 476 TeV, 2.5 TeV, 12.9 TeV, 28.6 GeV m and 173 GeV m, respectively. Most probably the event is due to a Centauro interaction, which occured in the atmosphere at ∼700 m above the chamber. The event will constitute the second beautiful candidate for a Centauro observed at the Pamirs. © 1987.1901-2226233Bayburina, (1981) Nucl. Phys. B, 191, p. 1Lattes, Fujimoto, Hasegawa, Hadronic interactions of high energy cosmic-ray observed by emulsion chambers (1980) Physics Reports, 65, p. 151(1984) Trudy FIAN, 154, p. 1Borisov, (1984) Proc. Intern. Symp. on Cosmic rays and particle physics, p. 3. , TokyoRen, (1985) 19th Intern. Cosmic ray Conf., 6, p. 317. , La JollaYamashita, (1985) 19th Intern. Cosmic ray Conf., 6, p. 364. , La JollaTamada, (1977) Nuovo Cimento, 41 B, p. 245T. Shibata et al., to be publishedHillas, (1979) 16th Intern. Cosmic ray Conf., 6, p. 13. , KyotoBattiston, Measurement of the proton-antiproton elastic and total cross section at a centre-of-mass energy of 540 GeV (1982) Physics Letters B, 117, p. 126UA5 Collab., G.J. Alner et al., preprint CERN-EP/85-62Taylor, (1976) Phys. Rev. D, 14, p. 1217Burnett, (1984) Proc. Intern. Symp. on Cosmic rays and particle physics, p. 468. , Toky

CAUSES OF KIDNEY TRANSPLANT DYSFUNCTION AND METHODS OF ITS CORRECTION

The severity of the ischemia-reperfusion injury, the prognosis of survival, and the duration of renal allograft functioning have significant value. The use of new non-invasive methods for diagnosis of renal allograft dysfunction and the complex use of various drugs to improve its function create the prerequisites for preventing ischemia-reperfusion injury

SCREENING OF CHRONIC KIDNEY DISEASE IN TAJIKISTAN RESIDENTS

Objective: Assessment of the prevalence causes and risk factors for the development of chronic kidney disease (CKD) in the Republic of Tajikistan Methods: Screening of CKD and risk factors for its development among 374 persons in the course of scheduled prophylactic examinations in the urban health centers of Dushanbe city in 2017. The age of residents ranged from 18 to 82 years, averaging 55.2±12.3 years. Of these, 201 (53.7%) were females, 173 (46.3%) were males. The average weight of the examined was 85.9±11.2 kg, height – 168.3±6.92 cm, and body mass index (BMI) – 30.4±3.75. CKD was established on the basis of albuminuria, a reduction in glomerular filtration rate (GFR) and the identification of risk factors. Results: Albuminuria was detected in 63 (16.8%) residents (29 men; 34 women), more often among the age group 45-74 years (46 cases), as well as among patients with the first (n=34) and the second (n=11) degrees of obesity. Increased creatinine level in venous blood was detected in 37 patients with albuminuria (average concentration 165.5±52.5 μmol/l), mainly among people aged 45-74 years (n=23). A decrease in GFR was detected in 18 (9.9% of the total number of the examined) men and 19 (9.9% of the total number of the examined) women. A population-based screening of CKD based on the results of albuminuria, endogenous creatinine, and GFR, and other risk factors allowed us to identify various stages of CKD out of 63 cases of the positive result of albuminuria in 37 cases, which was 9.9%. The first stage of CKD was in 8 (21.6%) patients, the second stage in 15 (40.5%) patients, the third stage in 12 (32.4%) cases, and the fourth stage in 2 (5.4%) cases. Depending on age, CKD prevailed among people aged 45-74 years (62.1%). In young people (18-44 years), it occurred in 9 (24.3%) cases, and in elderly patients (75-90 years) – in 5 (13.5%) cases. Depending on the gender of the surveyed, various stages of CKD occurred in 18 (48.6%) men and 19 (51.4%) women, the diagnosis of CKD among the general population in men was 10.9%, in women – 8.9%. Conclusion: The incidence of CKD among the general population was 9.9%. Diagnosis of CKD is based on the determination of GFR and the detection of albuminuria. For the early diagnosis of CKD and adequate treatment, an algorithm has been proposed that is acceptable both economically and in terms of use in daily clinical practice

COGNITIVE DYSFUNCTIONS IN PATIENTS OF MIDDLE, ELDERLY AND OLD AGE IN THE LONG-TERM PERIOD AFTER CHOLECYSTECTOMY

Objective: To study the state of cognitive dysfunction in patients of middle, elderly and old age in the long-term period after cholecystectomy Methods: A study conducted on the state of cognitive dysfunctions in 306 patients with cholelithiasis, operated on at the City Clinical Emergency Hospital for the period 2012 to 2017. Long-term results studied at 12 and 24 months after cholecystectomy. Depending on age, the subjects divided into 3 groups: middle, elderly, and old (senile) age. The study included a standardized neurological examination on a brief scale of neuropsychological testing, «Examination of mental status» and a quantitative assessment of the «Drawing watches» test; cognitive impairment determined by the performance of attention «The arrangement of numbers according to the method of Wexler». In addition, the following tests conducted distribution and switching of attention according to Schulte; selectivity of attention by Munsterberg; Bourdon correction method and intellectual liability assessment Results: 26 (25.4%) middle-aged patients diagnosed with mild cognitive dysfunction. In 28 (27.4%) elderly patients, cognitive impairment characterized by the presence of a moderate degree of cognitive dysfunction. In 39 (38.2%) patients of senile age, cognitive impairment manifested by the inability to memorize new information, as well as to reproduce the information that was already available that however did not lead to social deadaptation. Conclusion: Operative-anesthetic trauma has a negative impact on the state of cognitive functions in elderly and senile patients with a non-burdened neuropsychiatric history in the late postoperative period after cholecystectomy. The prevalence of cognitive impairment in the late postoperative period after cholecystectomy diagnosed in 27.4% of elderly patients and in 38.2% of old patients. The clinical picture of late postoperative cognitive dysfunction in the patients observed and expressed in a decrease in mental performance, attention, memory, distribution and switching of attention, concentration rate and accuracy, and intellectual liability, which was the cause of their social discomfort and reducing the quality of life

A PILOT STUDY EXAMINING THE BODY COMPOSITION OF THE POPULATION OF THE REPUBLIC OF TAJIKISTAN USING BIOELECTRICAL IMPEDANCE ANALYSIS

Objective: Evaluation of a pilot study results examining bioelectrical impedance analysis (BIA) of body composition of the population of the Republic of Tajikistan. Methods: The body composition of 1304 individuals was studied using bioimpedance measurements. The study included 718 women (55.1%) and 586 men (44.9%) with an average age of 41.1±13.6 years. The following variables were measured: fat mass (FM, kg), percent body fat (PBF, %), fat-free mass (FFM, kg), body cell mass (BCM, %), percent body cell mass (PBCM, %), skeletal muscle mass (SMM, kg), percentage of SMM (PSMM, %), total body water (TBW, kg), extracellular fluid (ECF, kg), bone mineral content (BMC, kg), basal metabolic rate (BMR, kcal/day) and mass-specific metabolic rate (msBMR, kcal/m2 /day). In addition to examining patients, we determined their body mass index (BMI) and waist-to-hip ratio (WHR) using the Adolphe Quetelet formula Results: The average FM for all study subjects was 22.5±12.04 kg. Women displayed 24.2% more FM than men – 24.6±12.0 kg and 19.8±11.6 kg, respectively (p0.05). There were also no gender differences in BMC for men and women: the average was 2.1±0.2 and 2.1±0.2 kg, respectively (p>0.05). The results showed positive significant (p<0.05) linear relationships between BMI categories and WHR (r=0.182), FM (r=0.933), PBF (r=0.855), FFM (r=0.262), BCM (r=0.159), TBW (r=0.259), ECF (r=0.440), BMC (r=0.522), BMR (r=0.161), and negative linear relationship – with PBCM (r= -0.042), SMM (r= -0.121), PSMM (r= -0.605) and msBMR (r=-0.521). Conclusion: BIA is a highly effective method for assessing body composition, allowing for accurate determination of fat and lean mass, total body fluid, and basal metabolic rates. The differences in the above indicators varied based on gender, age, and body weight of the examined cohort. Using bioimpedance instead of anthropometry provides a more accurate assessment of obesit

APPLIANCE OF MODERN INFORMATIVE TECHNOLOGIES IN MEDICAL POSTGRADUATE EDUCATIONAL PROCESS

This paper work describes the methodically new informative technologies in the system of continuing medical education. Medical students are trained by means of the information computer technologies that should be adopted and applied in their future professional activity. Scientifically and methodically substantiated systems of basic education based on computer technologies are created, and access to the library, data of international research and achievements is simplified. The stability of the educational process is maintained by computer use in all subjects and disciplines of the educational process

PATHOMORPHOLOGICAL CHANGES IN THE THYROID GLAND IN TOXIC DIFFUSE GOITER

Objective: To study the main pathomorphological and morphometric structural rearrangements of thyroid tissue (TT) formations in toxic diffuse goiter (TDG). Methods: By the methods of anatomical preparation and histological sections, macro and microscopic structural features of the thyroid gland were studied in 22 patients with TDG; both sexes aged 36 to 60 years, operated in the Department of General Surgery, State Clinical Hospital № 5, named by Academician K.T. Tadjiev Results: An analysis of the degree of progression of pathomorphological changes in the tissue and the follicular structure of the thyroid gland revealed a dependence on the duration and severity of the disease. The results of a quantitative study showed that the average diameter of the follicles, as compared with the norm (70.8±1.19 μm), became larger (80.8±1.26 μm). The height of the follicular epithelium for this pathology was 15.16±0.22 μm, with a norm of 10.06±0.09 μm (p<0.01). This led to a change in the Brown index, i.e. the more this index was, the lower the functional activity of the organ. Conclusion: The characteristic morphological signs of thyroid disease in TDG are lymphoplasmacytic infiltration of the stroma of the gland, activation of folliculogenesis and hyperplasia of the thyroid epithelium, which can lead to the development of functional thyroid disorders

CLINICAL AND HEMODYNAMIC FACTORS AFFECTING THE INITIAL FUNCTION OF RENAL ALLOGRAFT

Objective: To establish predictors of optimal functioning of renal allograft (RAG) and reversibility of cardiovascular disorders when comparing functional-hemodynamic indicators in patients with terminal chronic renal failure (TCRF) before and after kidney transplantation (KT). Methods: In the prospective (14-18 weeks after KT) study included 71 patients between the ages of 17 and 63 years (average age 36.4±1.3) with TCRF, which was examined by the Scientific and Practical Center of Organs and Tissues Transplantation Results: Found that recipients with delayed and slow initial function (IF) of RAG was older, and the values of the comorbidities – significantly higher (р<0.05) than any recipients with immediate (excellent) IF. The positive dynamics of structural and functional indicators are well expressed in recipients with immediate (excellent) IF RAG, which when compared with the group of recipients with slow-motion IF RAG, significant both in reducing blood pressure levels, heart failure, and in structural indicators. In recipients with delayed IF RAG when compared with a group with excellent IF, the positive dynamics of the initial structural and functional shifts in all indicators was significantly lower (р<0.05). Conclusion: Delayed and slow-motion IF RAG is most commonly observed in older age groups (р<0.05), with a high comorbidity index and with the initial high severity of CHF (р<0.05). Positive dynamics of the initial cardiovascular shifts and the degree of decrease in the severity of CHF in recipients with excellent (immediate) IF RAG are significant (р<0.05) compared to recipients with slow-motion and delayed IF. The results allow considering the age of the initial severity of the CHF and the level of comorbidity of the recipients, as predictors of the initial function of the RAG and the reversibility of the original cardiovascular disorders

HE ROLE OF TELEMEDICINE IN TRAINING OF SCIENTIFIC-PEDAGOGICAL AND PROFESSIONAL MEDICAL STAFF

Nowadays, telemedicine services are widely used throughout the world. Various types of telemedicine services, such as the storage and transmission of real-time information, remote monitoring or self-control can be applied in the fields of education, health and management, disease screening and disaster risk management worldwide. Telemedicine can play a big role in conducting medical research, as well as in the field of training scientific personnel, allowing remotely collaborate with scientific and clinical institutions and gain access to expensive remote equipment. In this context, it is considered appropriate to develop and apply such innovative ideas as online computing models in telehealth applications; simplified software and hardware interfaces, programs for modelling; portable telepresence systems; artificial intelligence applications that are especially relevant in cases where simulated patients cannot replace real ones; and development of a large number of application simulators