Comorbidity development in patients with severe brain injury resulting in chronic critical condition (Review)

Advances in intensive care have enabled patients to survive an acute critical condition, producing a growing population of patients in a chronic critical condition with long-term dependence on intensive care. These patients make up 5–10% of all patients with acute respiratory failure and require a disproportionate share of re-sources in the intensive care units, with an overall yearly survival rate of 40–50%. The aim of review is to identify the impact of comorbid complications on the course and outcome of patients with severe brain injury. Ninety-six sources were selected according to the data characterizing the clinical (syndromic) model of the patient with consciousness disorders after coma of different etiologies. This model takes into account the stages and phases of the syndrome as well as a number of comorbid conditions that determine the course and outcome of the disease. The list of sources includes papers addressing the issues of comorbidity in patients with brain injury and conditions such as strokes, consequences of severe brain injury and brain surgery. The sources reflecting the most significant mechanisms of consistent development of comorbidities were examined. These include metabolic disorders with subsequent protein and energy deficiency and comorbidities of the gastrointestinal tract. The role of microbiome in the development of comorbidity in patients in chronic critical condition was also identified. Conclusion. The comorbidity development starts from the moment of brain injury and extends until sustained stabilization or multi-organ failure and death. Timely detection and correction of comorbidities allows optimizing treatment and increasing efficiency of rehabilitation in patients with severe brain injury. © 2020, V.A. Negovsky Research Institute of General Reanimatology. All rights reserved

Towards smart electrolytic plasma technologies: An overview of methodological approaches to process modelling

This paper reviews the present understanding of electrolytic plasma processes (EPPs) and approaches to their modelling. Based on the EPP type, characteristics and classification, it presents a generalised phenomenological model as the most appropriate one from the process diagnostics and control point of view. The model describes the system ‘power supply–electrolyser–electrode surface’ as a system with lumped parameters characterising integral properties of the surface layer and integral parameters of the EPP. The complexity of EPPs does not allow the drawing of a set of differential equations describing the treatment, although a model can be formalised for a particular process as a black box regression. Evaluation of dynamic properties reveals the multiscale nature of electrolytic plasma processes, which can be described by three time constants separated by 2–3 orders of magnitude (minutes, seconds and milliseconds), corresponding to different groups of characteristics in the model. Further developments based on the phenomenological approach and providing deeper insights into EPPs are proposed using frequency response methodology and electromagnetic field modelling. Examples demonstrating the efficiency of the proposed approach are supplied for EPP modelling with static and dynamic neural networks, frequency response evaluations and electromagnetic field calculations

Иммунотерапия

Руководство написано ведущими иммунологами и врачами разных специализаций, применяющими иммунотерапию в своей практике. В книге рассмотрены принципы иммунотерапии, механизмы действия иммунотропных препаратов и их применение в клинической практике. Описаны иммуноглобулины, пептиды тимуса, цитокины, интерфероны и их индукторы, бактериальные иммуномодуляторы и другие группы препаратов иммунной направленности. Представлены схемы применения иммуномодуляторов и результаты лечения инфекционных заболеваний респираторного и желудочно-кишечного трактов, мочевыделительной и репродуктивной систем, кожи и ее придатков, гепатитов, герпесвирусных инфекций, эндокринных заболеваний, различных видов аллергии. Значительное место уделено иммунотерапии в онкологии. Издание предназначено для врачей различных специальностей: терапевтов, педиатров, хирургов, урологов, дерматологов, микологов, венерологов, онкологов, эндокринологов, инфекционистов, аллергологов-иммунологов