The specific features of the diagnosis and treatment of coronary heart disease in rheumatoid arthritis (Results of the authors’ studies)

Coronary heart disease (CHD) and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA). Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987). The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years). Results. The incidence of CHD in RA was as much as 45.9% (n = 118), including 52.5% (n = 62) for typical angina pectoris on exertion; 25.4% (n = 30) and 22.1% (n = 26) for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100) were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1), smoking (OR = 10.2), early menopause (OR = 3.6), decreased glomerular filtration rate (OR = 3.5), cardiovascular heredity (OR = 3.1), overweight (OR = 2.5), a heart rate of more than 70 beats/min (OR = 2.3), atherogenic dyslipidemia (OR = 2.3), hyperglycemia (OR = 2.1), and age (OR = 1.7). Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0), concomitant anemia as a common complication of RA (OR = 4.7), high DAS 28 scores (OR = 3.7), visual analog scale pain scores of > 50 mm (OR = 2.6), and RA duration of >10 years (OR = 2.2). Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent

Особенности диагностики и лечения ишемической болезни сердца при ревматоидном артрите (результаты собственных исследований)

Coronary heart disease (CHD) and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA). Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987). The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years). Results. The incidence of CHD in RA was as much as 45.9% (n = 118), including 52.5% (n = 62) for typical angina pectoris on exertion; 25.4% (n = 30) and 22.1% (n = 26) for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100) were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1), smoking (OR = 10.2), early menopause (OR = 3.6), decreased glomerular filtration rate (OR = 3.5), cardiovascular heredity (OR = 3.1), overweight (OR = 2.5), a heart rate of more than 70 beats/min (OR = 2.3), atherogenic dyslipidemia (OR = 2.3), hyperglycemia (OR = 2.1), and age (OR = 1.7). Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0), concomitant anemia as a common complication of RA (OR = 4.7), high DAS 28 scores (OR = 3.7), visual analog scale pain scores of > 50 mm (OR = 2.6), and RA duration of >10 years (OR = 2.2). Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent.В структуре причин преждевременной смертности при ревматоидном артрите (РА) ведущее место занимают ишемическая болезнь сердца (ИБС) и ее осложнения. Цель исследования — изучение частоты, структуры и особенностей течения ИБС у больных РА. Пациенты и методы. Проведено аналитическое одномоментное поперечное исследование 257 пациентов с РА (ARA, 1987). Средний возраст больных составил 55,4+11,6 года, продолжительность РА — 14,7(2; 20) года. Результаты исследования. Частота ИБС при РА достигала 45,9% (n=118), в том числе типичной стенокардии напряжения — 52,5% (n=62), безболевой ишемии и нарушений ритма — 25,4% (n=30) и 22,1% (n=26) соответственно. Отмечен высокий удельный вес вертеброгенных кардиалгий (48,8%; n=100) у предъявлявших жалобы на боли в области сердца. Выявлены традиционные факторы риска, такие как артериальная гипертензия (ОР — 12,1), курение (ОР — 10,2), ранняя менопауза (ОР — 3,6), снижение скорости клубочковой фильтрации (ОР — 3,5), наследственность по сердечно-сосудистым заболеваниям (ОР — 3,1), избыточная масса тела (ОР — 2,5), частота сердечных сокращений — более 70 уд/мин (ОР — 2,3), атерогенные дислипидемии (ОР — 2,3), гипергликемия (ОР — 2,1) и возраст (ОР — 1,7). Наряду с ними установлены предикторы ИБС, ассоциирующиеся с последствиями хронического воспаления — прием глюкокортикоидов (ОР — 5,0), сопутствующая анемия как частое осложнение РА (ОР — 4,7), высокая активность РА по DAS 28 (ОР — 3,7), ВАШ боли >50 мм (ОР — 2,6) и давность >10 лет (ОР — 2,2). Выводы. К особенностям течения ИБС при РА относится частое выявление нарушений ритма и безболевой ишемии. Наряду с традиционными факторами риска ИБС очевидно значение степени активности воспаления

The efficiency of use of energy saving technologies in construction

The article considers problems and prospects of development of energy saving technologies in construction. The possible directions of improving the construction of residential facilities with the aim of increasing their efficiency are considered, taking into account different technologies. The main emphasis is on the use of solar panels as one of the most effective ways of saving resources. The maximum level of heliotropia for the Central black earth region is determined. To increase the efficiency of the solar battery it is proposed to develop a rotary device that allows you to change the angle of the battery in the vertical and horizontal planes. The dynamics of rotation in the horizontal plane should depend on the time of day, in the horizontal – season. The article presents the problem of determining the speed of rotation of the solar battery in the direction of the solar azimuth and relative to the horizon during the day, allowing you to use a slewing device with maximum efficiency. Increase efficiency when using the rotary mechanism will reduce the number of solar batteries with the same capacity of electricity consumption. Also the problem of determining the optimal number of solar panels

Development of mechanisms for innovative projects management based on their identification and results forecast in the risk environment

The article presents the essential characteristics of innovative projects and classifies them by grade of novelty and types of innovative products to be created. The classification features allow us to identify the categories of tangible innovative products and innovative technologies. The article contains the main challenges in evaluating, forecasting and managing innovative projects in the risk environment. An innovative project is considered as a complex of possible implementations, i.e. as a random function. The investors’ goal is to determine the most likely outcome of project implementation for making further decisions

Modeling optimal solutions with the use of heat technologies based on graph theory

The article describes the types of energy efficient technologies focused on energy saving. The presented technologies have significantly improved performance, while the disadvantage is high cost, which is the main factor preventing the introduction of energy saving technologies in construction. In this regard, solve the problem of optimizing the choice of the possible heat saving technologies of construction enterprises based on their financial and production capabilities based on graph theory. As a result, identify the technology yielding the greatest effect at minimum cost. The decision process is formalized as a graphical structure. In this case, the problem of finding the optimal solutions solved in graph theory. Graphical modeling of the structure of relations allows to visualize and organize variants of the consistent use of energy-saving technologies construction companies. On the basis of the construction of adjacency matrices organization of construction production is planned based on the use of energy-saving technologies determines the best combination of the ability of the construction company and the effectiveness to the execution of the technology

Model of investment appraisal of high-rise construction with account of cost of land resources

The article considers problems and potential of high-rise construction as a global urbanization. The results of theoretical and practical studies on the appraisal of investments in high-rise construction are provided. High-rise construction has a number of apparent upsides in modern terms of development of megapolises and primarily it is economically efficient. Amid serious lack of construction sites, skyscrapers successfully deal with the need of manufacturing, office and living premises. Nevertheless, there are plenty issues, which are related with high-rise construction, and only thorough scrutiny of them allow to estimate the real economic efficiency of this branch. The article focuses on the question of economic efficiency of high-rise construction. The suggested model allows adjusting the parameters of a facility under construction, setting the tone for market value as well as the coefficient for appreciation of the construction net cost, that depends on the number of storey’s, in the form of function or discrete values

Risk-based management of an investment project that contemplates reproduction of real estate

Making investments into projects that contemplate reconstruction and renovation of residential housing is always accompanied by particular risks. Risky investments are highly profitable while low-risk investments have a low profit margin. The task of an investor is reduced to identification of the most desirable "risk income" in the course of the due diligence of a specific investment project. The authors present a formal approach to the management of a real estate investment project with account for the risks that may arise in the course of its development and implementation. We consider passive and proactive types of investment control. The problem of proactive management represents projecting potential investment project development patterns, ongoing monitoring of the market situation, involvement of profit generating assets, disposal of low-profit assets. The passive type of management involves compilation of a well-balanced mix of investment operations that contemplates a pre-set level of risk (for example, through reasonable diversifi cation) within an extensive period of time. Particular attention is driven to the optimal choice of an investment project based on the rate of return and risks. The profitability represents an average value, while the risk is identified by using the method of dispersion. Optimization of investment projects is performed on the basis of the profi tability-to-risk ratio. The main feature of this method is that the limits of an admissible risk aren't specified there, and the extent of risk correlates with the amount of potential revenues to be generated. Thus, we believe that it is possible to derive an obvious decision-making formula on the basis of certain assumptions

Innovative technologies in construction and Building Information Modeling

The paper presents the results of research in the field of the use of innovative technologies in the design of buildings. The modern technologies of information modeling, in particular, BIM, which makes it possible to represent the building not only in three-dimensional space, but also allows designing it in the dynamic system « design - construction – operation » are considered. The experience of using BIM technologies is based on identifying errors at the initial design stage and the possibility of their elimination at the same stage. The development of mechanisms for detecting design errors and defects formed the basis of the task set in the work. A model for signaling about the detection of defects has been developed, and the problem of stochastic modeling of the qualitative parameters of the designed object has been solved

Innovation and certification as the basis for the development of energy-efficient construction

Within the framework of the concept of sustainable development, issues of energy efficiency, environmental safety, minimization of anthropogenic impact on the environment are of particular relevance. In construction, these theses are projected onto the segment of energy-efficient, “green” construction. Nowadays, the development of energy-efficient construction in Russia is progressing at a slow pace, and this is primarily due to the lack of an integrated energy management system, environmental certification of construction products, and institutional features of the real estate market. The authors systematized the methods of improving energy efficiency and greening of construction regarding the types of real estate, analyzed the main global and Russian environmental certification systems in construction, identified the features, advantages and disadvantages of each system, substantiated the need to ensure the generally accepted Russian certification system. The problem of enhancing energy-efficient construction is also interconnected with the need to increase the level of innovation in construction, which is substantiated by the authors in the paper. The authors substantiated the need to change the criteria for monitoring investment projects, taking into account the optimization of energy efficiency and environmental performance of real estate