336 research outputs found
Detection of virial shocks in stacked Fermi-LAT clusters
In the hierarchical paradigm of structure formation, galaxy clusters are the
largest objects ever to virialize. They are thought to grow by accreting mass
through large scale, strong virial shocks. Such a collisionless shock is
expected to accelerate relativistic electrons, thus generating a spectrally
flat leptonic virial ring. However attempts to detect virial rings have all
failed, leaving the shock paradigm unconfirmed. Here we identify a virial
-ray signal by stacking Fermi-LAT data for 112 clusters, enhancing the
ring sensitivity by rescaling clusters to their virial radii and utilizing the
anticipated spectrum. In addition to a central unresolved, hard signal
(detected at the nominal confidence level), probably dominated by
active galactic nuclei, we identify () a bright, spectrally flat
-ray ring at the expected shock position. It corresponds to (with an uncertainty factor ) thermal energy deposition in
relativistic electrons over a Hubble time. This result validates the shock
paradigm, calibrates its parameters, and indicates that the cumulative emission
from such shocks significantly contributes to the diffuse extragalactic
-ray and radio backgrounds.Comment: Proceedings of the 7th International Fermi Symposium, Garmisch, Oct
15-20 201
The quality of women\u27s intelligence : female humanists in Renaissance Italy.
This thesis examines how the advent of humanism in Renaissance Italy impacted women, namely those who were raised within intellectual families and granted educational opportunities not before afforded to members of their sex. In quattrocento Italy, learned women began to circulate their writings and participate in the humanist milieu, and the intellectual lives and published works of these female humanists all in some manner contested Renaissance patriarchy and gender perceptions. As such, this thesis challenges the conception that the Renaissance further disenfranchised women and offers a framework for analyzing and appreciating the ways in which women participated in the academic dialogue of their time once past the age of sexual maturity. I argue that to fully analyze the myriad of ways in which learned adult women participated in humanism more narrowly, and in the Renaissance more broadly, their engagement with paternal figures, patrons, and patriarchal institutions must be appreciated on an individual basis. The investigation of Renaissance humanism and the educational opportunities the movement provided for women in Part I contextualizes the social and academic milieu of the four notable learned women presented in the microhistorical, biographical case studies. Furthermore, the case studies support my larger argument that a sexually mature female humanistβs public reception and career longevity were dependent upon her willingness to adhere to patriarchal ideology and conform to traditional prescriptions of femininity. This thesis, therefore, suggests that historians continue to ask how adult womenβs experiences were determined by their sexual maturity, marital choices, and relationship with paternal figures, and even more importantly, how adult women continued to meaningfully participate in society in spite of socially mandated limitations on their gender
Surgical treatment of spondylitis and diaphragm relaxation in patient less than 1 year old
Design
Case report.
Introduction
The combination of severe post-infectious kyphosis and diaphragm relaxation is extremely rare in patient early than 1 year old. Its no publications concerning their simultaneous surgical treatment.
Case description
7-Month-old girl had simultaneous spinal reconstruction with anterior and posterior instrumentation and plastic of diaphragm because of sequelae of non-granulenatous spondylitis complicated by severe kyphosis (54Β°) and diaphragm relaxation. Between 1.5 and 3 months of live she had several infections incl. pneumonia, enterocolitis, ENT infection. Anterior fusion was done by titanium mesh with auto-rib, posterior β by compressive rods based on low-profile hooks. The deformity was reduced till 20Β°. 2.5 years after initial surgery and 1 year after removal of posterior instrumentation the adequate level of diaphragm and minimal (4Β°) loss of kyphosis correction were identified.
Conclusions
The combination of spondylitis and diaphragm relaxation in early aged patient could be explained but it could not be confirmed as a sequelae of late-onset neonatal sepsis with a multi-focal lesions. The simultaneous surgery provided on the combined approaches (trans-thoracic and posterior) looks as optimal options in such combination of pathologies. In remains controversial how will the spine develop after so early reconstructive surgery, including in situ stable anterior fusion carried out by titanium mesh with auto-rib
Π₯ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠΉ Π²Π΅ΡΡΠ΅Π±ΡΠ°Π»ΡΠ½ΡΡ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠΉ ΠΏΡΠΈ ΡΠ΅ΠΏΡΠΈΡΠ΅ Π½ΠΎΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ (Π°Π½Π°Π»ΠΈΠ· ΡΠ΅ΡΠΈΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ)
Background. Neonatal sepsis presents one of the current issues in modern pediatrics. The orthopedic outcomes of such a state and the possibility of treatment, in particular by surgical spinal reconstruction, are rarely analyzed. Objective. To analyze pathology features and treatment outcomes in infants with vertebral complications resulted from neonatal sepsis.Material and Methods. The analysis of observation and treatment of 15 infants, who have undergone neonatal sepsis which led to vertebral lesion with subsequent gross kyphotic deformity formation, is presented.Results. Average age of infants was 2.5 months when spinal pathology was diagnosed. In 7 of the 15 observations, a local angular kyphosis was revealed when the acute phase of disease was already passed (βcuredβ). The thoracic vertebrae were most often affected, mainly Th 7-8 vertebral bodies. Average kyphosis was 53Β°. All infants were operated on during the period from 2006 to 2017. Each had two-stage spinal reconstruction including the anterior spinal fusion using a titanium mesh cage filled with bone autografts, or an autogenous bone graft only. At the second stage, the instrumental correction and fixation of the spine with a multi-support laminar structure were performed. Average age of patients at the time of surgery was 14 months. Average value of kyphosis correction was 27Β°. Further correction and anterior spinal fusion were achieved when performing the incorporation of a titanium mesh cage with bone autografts. The histological and bacteriological examination of the surgical material did not reveal any signs of infection or inflammation. Correction of deformity and restoration of the supporting strength of anterior vertebral column as a result of surgery were achieved in all cases. Various complications in the early and late followup period were reported in a total of 7 cases. Repeated interventions were required in two patients: in one case in the early period (dislocation of the structure supporting hook) and in one case in the long-term period (graft resorption and kyphotic deformity relapse).Conclusion. One of the complications of neonatal sepsis is severe multilevel thoracic spondylitis, the outcome of which is the formation of severe kyphosis against the background of subtotal bone vertebral destruction. The principal possibility of radical spine reconstruction in infants with achievement of good anatomical and functional results is shown.Β ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΡΠΉ ΡΠ΅ΠΏΡΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΈΠΈ. ΠΡΡΠΎΠΏΠ΅Π΄ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΡΡ
ΠΎΠ΄Ρ ΡΠ°ΠΊΠΈΡ
ΡΠΎΡΡΠΎΡΠ½ΠΈΠΉ ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ, Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ°, Π°Π½Π°Π»ΠΈΠ·ΠΈΡΡΡΡΡΡ ΠΊΡΠ°ΠΉΠ½Π΅ ΡΠ΅Π΄ΠΊΠΎ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ ΠΎΡΠ΅Π½ΠΊΠ° ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄Π΅ΡΠ΅ΠΉ Ρ Π²Π΅ΡΡΠ΅Π±ΡΠ°Π»ΡΠ½ΡΠΌΠΈ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΠΌΠΈ ΠΏΠ΅ΡΠ΅Π½Π΅ΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΠΏΡΠΈΡΠ° Π½ΠΎΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ 15 Π΄Π΅ΡΠ΅ΠΉ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΡΠ΅ΠΏΡΠΈΡ Π½ΠΎΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Ρ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΠΈ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠΈΠΌ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π³ΡΡΠ±ΠΎΠΉ ΠΊΠΈΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΡΠΎΡΡΠ°Π²ΠΈΠ» 2,5 ΠΌΠ΅Ρ. Π 7 ΠΈΠ· 15 Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ Π»ΠΎΠΊΠ°Π»ΡΠ½ΡΠΉ ΡΠ³Π»ΠΎΠ²ΠΎΠΉ ΠΊΠΈΡΠΎΠ· Π²ΡΡΠ²Π»Π΅Π½ ΠΏΠΎΡΠ»Π΅ ΠΊΡΠΏΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ ΠΏΠΎΡΠ°ΠΆΠ°Π»ΠΈΡΡ Π³ΡΡΠ΄Π½ΡΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΈ, ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ Π½Π° ΡΡΠΎΠ²Π½Π΅ Th7-8. Π‘ΡΠ΅Π΄Π½ΡΡ Π²Π΅Π»ΠΈΡΠΈΠ½Π° ΠΊΠΈΡΠΎΠ·Π° ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 53Β°. ΠΡΠ΅ Π΄Π΅ΡΠΈ ΠΎΠΏΠ΅ΡΠΈΡΠΎΠ²Π°Π½Ρ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 2006 ΠΏΠΎ2017 Π³. Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ ΡΠ°ΡΡΠΈΡΠ΅Π½Π½ΠΎΠΉ ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ΅ΡΠ΅Π΄Π½Π΅Π³ΠΎ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄Π΅Π·Π° ΡΠΈΡΠ°Π½ΠΎΠ²ΠΎΠΉ Π±Π»ΠΎΠΊ-ΡΠ΅ΡΠ΅ΡΠΊΠΎΠΉ Ρ Π°ΡΡΠΎΠΊΠΎΡΡΡΡ Π»ΠΈΠ±ΠΎ ΡΠΎΠ»ΡΠΊΠΎ Π°ΡΡΠΎΠΊΠΎΡΡΡΡ. ΠΡΠΎΡΡΠΌ ΡΡΠ°ΠΏΠΎΠΌ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈΡΡ Π·Π°Π΄Π½ΡΡ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½Π°Ρ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΡ ΠΈ ΡΠΈΠΊΡΠ°ΡΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΠΌΠ½ΠΎΠ³ΠΎΠΎΠΏΠΎΡΠ½ΠΎΠΉ Π»Π°ΠΌΠΈΠ½Π°ΡΠ½ΠΎΠΉ ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠ΅ΠΉ. Π‘ΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ» 14 ΠΌΠ΅Ρ. Π‘ΡΠ΅Π΄Π½ΡΡ Π²Π΅Π»ΠΈΡΠΈΠ½Π° ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ ΠΊΠΈΡΠΎΠ·Π° β 27Β°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ ΠΈ ΠΏΠ΅ΡΠ΅Π΄Π½Π΅Π³ΠΎ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΎΠ΄Π΅Π·Π° Π±ΡΠ»ΠΈ Π»ΡΡΡΠ΅ ΠΏΡΠΈ ΠΈΠΌΠΏΠ»Π°Π½ΡΠ°ΡΠΈΠΈ ΡΠΈΡΠ°Π½ΠΎΠ²ΠΎΠΉ Π±Π»ΠΎΠΊ-ΡΠ΅ΡΡΡΠΊΠΈ Ρ Π°ΡΡΠΎΠΊΠΎΡΡΡΡ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΠ΅ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈ Π±Π°ΠΊΡΠ΅ΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π° Π½ΠΈ Π² ΠΎΠ΄Π½ΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ Π½Π΅ Π²ΡΡΠ²ΠΈΠ»ΠΈ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΠΎ-Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ°. ΠΠΎΡΡΠ΅ΠΊΡΠΈΡ Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠ΅ ΠΎΠΏΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΠ΅ΡΠ΅Π΄Π½Π΅ΠΉ ΠΊΠΎΠ»ΠΎΠ½Π½Ρ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΠΏΡΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΡ Π²ΠΎ Π²ΡΠ΅Ρ
ΡΠ»ΡΡΠ°ΡΡ
. Π Π°Π·Π»ΠΈΡΠ½ΡΠ΅ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ Π² ΡΠ°Π½Π½Π΅ΠΌ ΠΈ ΠΏΠΎΠ·Π΄Π½Π΅ΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π°Ρ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΡΡΠΌΠΌΠ°ΡΠ½ΠΎ ΠΎΡΠΌΠ΅ΡΠ΅Π½Ρ Π² 7 ΡΠ»ΡΡΠ°ΡΡ
. ΠΠΎΠ²ΡΠΎΡΠ½ΡΠ΅ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ΠΏΠΎΡΡΠ΅Π±ΠΎΠ²Π°Π»ΠΈΡΡ Ρ Π΄Π²ΠΎΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²: Π² ΠΎΠ΄Π½ΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ Π² ΡΠ°Π½Π½Π΅ΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ (Π²ΡΠ²ΠΈΡ
ΠΎΠΏΠΎΡΠ½ΠΎΠ³ΠΎ ΠΊΡΡΠΊΠ° ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ) ΠΈ Π² ΠΎΠ΄Π½ΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ β Π² ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ (ΡΠ΅Π·ΠΎΡΠ±ΡΠΈΡ ΡΡΠ°Π½ΡΠΏΠ»Π°Π½ΡΠ°ΡΠ° ΠΈ ΡΠ΅ΡΠΈΠ΄ΠΈΠ² ΠΊΠΈΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΈ).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΄Π½ΠΎ ΠΈΠ· ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΡΠ΅ΠΏΡΠΈΡΠ° Π½ΠΎΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
β ΡΡΠΆΠ΅Π»ΡΠΉ ΠΌΠ½ΠΎΠ³ΠΎΡΡΠΎΠ²Π½Π΅Π²ΡΠΉ ΡΠΏΠΎΠ½Π΄ΠΈΠ»ΠΈΡ Π³ΡΡΠ΄Π½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ°, ΠΈΡΡ
ΠΎΠ΄ΠΎΠΌ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π³ΡΡΠ±ΠΎΠ³ΠΎ ΠΊΠΈΡΠΎΠ·Π° Π½Π° ΡΠΎΠ½Π΅ ΡΡΠ±ΡΠΎΡΠ°Π»ΡΠ½ΠΎΠΉ Π΄Π΅ΡΡΡΡΠΊΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ². ΠΠΎΠΊΠ°Π·Π°Π½Π° ΠΏΡΠΈΠ½ΡΠΈΠΏΠΈΠ°Π»ΡΠ½Π°Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ ΡΠ°Π½Π½Π΅Π³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Ρ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠ΅ΠΌ Ρ
ΠΎΡΠΎΡΠ΅Π³ΠΎ Π°Π½Π°ΡΠΎΠΌΠΎ-ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°.
ΠΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΡ Π³ΡΡΠ΄Π½ΡΡ ΠΈ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² ΠΈΠ· Π΄ΠΎΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΡΠΏΠ° Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ Ρ Π΄Π΅ΡΠ΅ΠΉ: ΡΠ΅Π·ΡΠ»ΡΡΠ°Ρ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
Background. The surgical treatment of congenital spinal deformity caused by hemivertebra is associated with high rate of complications. A research of a new surgery technique for operation time and blood loss decrease could potentially improve outcomes. The purpose β to evaluate the efficacy of ultrasonic bone scalpel in surgical treatment of pediatric congenital spinal deformities caused by monosegmental hemivertebra. Patients and Methods. Level of Evidence III. The study based on the data of 55 consecutively operated pediatric patients who underwent 59 posterior hemivertebra resection provided by ultrasonic bone scalpel from January 2015 to December 2019. The average age was 4 years and 4 months. 36 hemivertebra were located in thoracic spine and 23 were located in lumbar spine. Total duration of surgery, estimated blood loss (ml and % of circulated blood volume, CBV), complications rate and deformity correction were noted. The influence of posterior instrumentation length and patients age at time of surgery on evaluation parameters was analyzed. 5-year (2015β2019) systematic literature review was performed for compare with obtain results. Results. Total operation time was 131 min Β± 33 min for thoracic spine and 165 min Β± 50 min for lumbar spine (p = 0,005). Estimated blood loss was 105 ml Β± 74 ml (Me 80 ml) for thoracic resection and 123 ml Β± 59 ml (Me 120 ml) β for lumbar (p = 0,178). The length of posterior instrumentation were not influence on operation time and total blood loss (p = 0,957; p = 0,967), patients age at time of surgery were not influence on operation time (p = 0,458), but correlate with total blood loss (p = 0,023). Intraoperative complications was not observed. Four cases of transpedicular screw malposition without neurological deficit were noted (type C acc. Gertzbein-Robbins). Conclusions. Posterior hemivertebra resection with ultrasonic bone scalpel is safe and effective procedure provides decrease of operation time and estimated blood loss.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. Π₯ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΉ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΡΠΎΠ½Π΅ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² ΡΠΎΠΏΡΡΠΆΠ΅Π½ΠΎ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΡΠΎΠ²Π½Π΅ΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. ΠΠΎΠΈΡΠΊ ΠΏΡΡΠ΅ΠΉ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΡΠ°Π²ΠΌΠ°ΡΠΈΡΠ½ΠΎΡΡΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΡΠ»ΡΡΡΠΈΡΡ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π¦Π΅Π»Ρ β ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ Π² Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΉ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΡΠΎΠ½Π΅ ΠΌΠΎΠ½ΠΎΡΠ΅Π³ΠΌΠ΅Π½ΡΠ°ΡΠ½ΡΡ
ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ². ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠΈΠ·Π°ΠΉΠ½ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΡΡΠ΅Ρ
ΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ΅ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅. ΠΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎ ΠΎΠΏΠ΅ΡΠΈΡΠΎΠ²Π°Π½Ρ 55 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 10 ΠΌΠ΅Ρ. Π΄ΠΎ 13 Π»Π΅Ρ (M = 4 Π³ΠΎΠ΄Π° 4 ΠΌΠ΅Ρ., Me β 3 Π³ΠΎΠ΄Π° 8 ΠΌΠ΅Ρ.), Π²ΡΠΏΠΎΠ»Π½Π΅Π½Ρ 59 ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² (Π³ΡΡΠ΄Π½ΡΡ
β 36, ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
β 23) Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ ΠΈΠ· ΠΎΠ΄Π½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΎΡΡΡΠΏΠ°. ΠΡΠ΅Π½ΠΈΠ²Π°Π΅ΠΌΡΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ: Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, ΠΎΠ±ΡΠ΅ΠΌ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (Π°Π±ΡΠΎΠ»ΡΡΠ½ΡΠΉ ΠΈ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ), ΡΠ°ΡΡΠΎΡΠ° ΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, Π²Π΅Π»ΠΈΡΠΈΠ½Π° ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ Π΅Π΅ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° Π² ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΎΠ±Π·ΠΎΡ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ (ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΏΠΎΠΈΡΠΊΠ° ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΠΉ 2015β2019 Π³Π³.) ΠΏΠΎ Π΄ΠΎΡΡΠ°Π»ΡΠ½ΡΠΌ ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΡΠΌ ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² Ρ Π΄Π΅ΡΠ΅ΠΉ, Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π½ΡΡ
Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΈΠΊΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π²ΡΡΠΎΠΊΠΎΡΠΊΠΎΡΠΎΡΡΠ½ΠΎΠ³ΠΎ Π±ΡΡΠ°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Π² ΡΠ΅ΡΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 131Β±33 ΠΌΠΈΠ½. Π΄Π»Ρ Π³ΡΡΠ΄Π½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ ΠΈ 165Β±50 ΠΌΠΈΠ½. Π΄Π»Ρ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
(p = 0,005). ΠΠ±ΡΠ΅ΠΌ Π°Π±ΡΠΎΠ»ΡΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ: 105Β±74 ΠΌΠ» (Me 80 ΠΌΠ») Π΄Π»Ρ Π³ΡΡΠ΄Π½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ ΠΈ 123Β±59 ΠΌΠ» (Me 120 ΠΌΠ») Π΄Π»Ρ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
(p = 0,178). ΠΠ±ΡΠ΅ΠΌ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ: 6,8Β±3,1% ΠΎΡ ΠΠ¦Π Π΄Π»Ρ Π³ΡΡΠ΄Π½ΡΡ
ΠΈ 11,5Β±5,5% ΠΎΡ ΠΠ¦Π Π΄Π»Ρ ΠΏΠΎΡΡΠ½ΠΈΡΠ½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΠΉ (p = 0,002). ΠΡΠΎΡΡΠΆΠ΅Π½Π½ΠΎΡΡΡ Π·Π°Π΄Π½Π΅ΠΉ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΈΠΊΡΠ°ΡΠΈΠΈ Π½Π΅ ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΈ ΠΎΠ±ΡΠ΅ΠΌ Π°Π±ΡΠΎΠ»ΡΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (p = 0,957; p = 0,967). ΠΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ Π½Π΅ ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ (p = 0,458), ΠΏΡΠΈ ΡΡΠΎΠΌ Π²Π»ΠΈΡΠ΅Ρ Π½Π° ΠΎΠ±ΡΠ΅ΠΌ Π°Π±ΡΠΎΠ»ΡΡΠ½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ (p = 0,023). ΠΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ, Π·Π° ΠΈΡΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ΠΌ 4 ΡΠ»ΡΡΠ°Π΅Π² ΠΌΠ°Π»ΡΠΏΠΎΠ·ΠΈΡΠΈΠΈ Π’ΠΠ€, Π½Π΅ ΠΏΠΎΡΡΠ΅Π±ΠΎΠ²Π°Π²ΡΠΈΡ
ΡΠ΅Π²ΠΈΠ·ΠΈΠΈ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΡΠ½ΠΎΠ³ΠΎ ΡΠΊΠ°Π»ΡΠΏΠ΅Π»Ρ ΠΏΡΠΈ Π΄ΠΎΡΡΠ°Π»ΡΠ½ΡΡ
ΡΠΊΡΡΠΈΡΠΏΠ°ΡΠΈΡΡ
ΠΏΠΎΠ»ΡΠΏΠΎΠ·Π²ΠΎΠ½ΠΊΠΎΠ² Ρ Π΄Π΅ΡΠ΅ΠΉ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, ΡΠ½ΠΈΠΆΠ°Π΅Ρ Π΅Π΅ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΡ
Calculation of nuclear magnetic shielding constants using variation-perturbation method with moderate size basis sets
Within a framework of variation-perturbation formalism of Karplus-Kolker, an algorithm and a program for the nuclear magnetic shielding calculations with ground-state wave functions were developed. The calculations of nuclear magnetic shielding Ο in some diatomic molecules and also in methane, water and CH3F molecules with 6-311G ab initio wave functions were carried out. The results were compared with the experimental data and the results obtained by other theoretical methods. This method can be considered as an alternative approach for the calculations of the magnetic anisotropic effects on chemical shifts and can be used for predicting the tendencies in magnetic shielding alteration due to the different fragments in a big molecular systems. Β© 2001 Elsevier Science B.V. All rights reserved
MANAGEMENT OF INTENSIVE THERAPY OF GENERAL PERITONITIS IN CHILDREN
In the presented work the results of treatment of 161 children at the age from
Quantum-Chemical Model for Description of Solvation Effect in Proton-Transfer Reactions. Prediction of Gas-Phase Acidities of Organic Compounds
Electrostatic solvation effects in proton-transfer reactions were described in terms of the AM1 and MNDO energies of electrostatic interaction between a unit positive charge with organic anions. These values were then used to estimate the gas-phase acidities of organic compounds from the ionic acidities in dimethyl sulfoxide. For 35 CH, NH, OH, and SH acids, the difference between the calculated and experimental gas-phase acidities does not exceed 15 kJ/mol (standard deviation 8.3 kJ/mol)
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