47 research outputs found
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ Π»Π΅Π΄ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΆΠ°ΡΠΈΡ Π½Π° ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠΈΠ΅ ΡΠΊΠΎΡΠΎΡΡΠΈ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ ΠΏΠΎΠ΄ Π»Π΅Π΄ΡΠ½ΡΠΌ ΠΏΠΎΠΊΡΠΎΠ²ΠΎΠΌ Π² Π±Π΅Π³ΡΡΠ΅ΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈΠ·Π³ΠΈΠ±Π½ΠΎ-Π³ΡΠ°Π²ΠΈΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π²ΠΎΠ»Π½Π΅ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΉ Π°ΠΌΠΏΠ»ΠΈΡΡΠ΄Ρ
ΠΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΌΠ½ΠΎΠ³ΠΈΡ
ΠΌΠ°ΡΡΡΠ°Π±ΠΎΠ² Ρ ΡΠΎΡΠ½ΠΎΡΡΡΡ Π΄ΠΎ Π²Π΅Π»ΠΈΡΠΈΠ½ ΡΡΠ΅ΡΡΠ΅Π³ΠΎ ΠΏΠΎΡΡΠ΄ΠΊΠ° ΠΌΠ°Π»ΠΎΡΡΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ Π°ΡΠΈΠΌΠΏΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ°Π·Π»ΠΎΠΆΠ΅Π½ΠΈΡ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠΈΠ΅ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠΈΠ΅ ΡΠΊΠΎΡΠΎΡΡΠΈ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ ΠΏΠΎΠ΄ ΠΏΠ»Π°Π²Π°ΡΡΠΈΠΌ Π»Π΅Π΄ΡΠ½ΡΠΌ ΠΏΠΎΠΊΡΠΎΠ²ΠΎΠΌ ΠΏΡΠΈ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠΈ ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠ²Π΅ΡΡ
Π½ΠΎΡΡΠ½ΠΎΠΉ ΠΈΠ·Π³ΠΈΠ±Π½ΠΎΠ³ΡΠ°Π²ΠΈΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π²ΠΎΠ»Π½Ρ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΉ Π°ΠΌΠΏΠ»ΠΈΡΡΠ΄Ρ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
Π»Π΅Π΄ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΆΠ°ΡΠΈΡ. Π Π°ΡΡΠΌΠΎΡΡΠ΅Π½Π° Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΉ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠΈΡ
ΡΠΊΠΎΡΠΎΡΡΠΈ Π²Π΄ΠΎΠ»Ρ ΠΏΡΠΎΡΠΈΠ»Ρ Π²ΠΎΠ»Π½Ρ ΠΎΡ Π²Π΅Π»ΠΈΡΠΈΠ½Ρ ΡΠΆΠΈΠΌΠ°ΡΡΠ΅Π³ΠΎ ΡΡΠΈΠ»ΠΈΡ ΠΈ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ Π½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ Π³Π°ΡΠΌΠΎΠ½ΠΈΠΊΠΈ. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠΆΠΈΠΌΠ°ΡΡΠ΅Π³ΠΎ ΡΡΠΈΠ»ΠΈΡ ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΠΈΡ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ Π°ΠΌΠΏΠ»ΠΈΡΡΠ΄Π½ΡΡ
Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠΈΡ
ΡΠΊΠΎΡΠΎΡΡΠΈ ΠΈ ΠΎΡΡΡΠ°Π²Π°Π½ΠΈΠ΅ ΡΠ°Π·Ρ ΠΊΠΎΠ»Π΅Π±Π°Π½ΠΈΠΉ.ΠΠ΅ΡΠΎΠ΄ΠΎΠΌ Π±Π°Π³Π°ΡΡΠΎΡ
ΠΌΠ°ΡΡΡΠ°Π±ΡΠ² Π· ΡΠΎΡΠ½ΡΡΡΡ Π΄ΠΎ Π²Π΅Π»ΠΈΡΠΈΠ½ ΡΡΠ΅ΡΡΠΎΠ³ΠΎ ΠΏΠΎΡΡΠ΄ΠΊΡ ΠΌΠ°Π»ΠΎΡΡΡ ΠΎΡΡΠΈΠΌΠ°Π½Ρ Π°ΡΠΈΠΌΠΏΡΠΎΡΠΈΡΠ½Ρ ΡΠΎΠ·ΠΊΠ»Π°Π΄Π°Π½Π½Ρ, ΡΠΊΡ Π²ΠΈΠ·Π½Π°ΡΠ°ΡΡΡ ΡΠΊΠ»Π°Π΄ΠΎΠ²Ρ ΡΠ²ΠΈΠ΄ΠΊΠΎΡΡΡ ΡΡΡ
Ρ ΡΡΠ΄ΠΈΠ½ΠΈ ΠΏΡΠ΄ ΠΏΠ»Π°Π²Π°ΡΡΠΈΠΌ Π»ΡΠΎΠ΄ΡΠ½ΠΈΠΌ ΠΏΠΎΠΊΡΠΈΠ²ΠΎΠΌ ΠΏΡΠΈ ΡΠΎΠ·ΠΏΠΎΠ²ΡΡΠ΄ΠΆΠ΅Π½Π½Ρ ΠΏΠ΅ΡΡΠΎΠ΄ΠΈΡΠ½ΠΎΡ ΠΏΠΎΠ²Π΅ΡΡ
Π½Π΅Π²ΠΎΡ Π·Π³ΠΈΠ½Π°Π»ΡΠ½ΠΎ-Π³ΡΠ°Π²ΡΡΠ°ΡΡΠΉΠ½ΠΎΡ Ρ
Π²ΠΈΠ»Ρ ΠΊΡΠ½ΡΠ΅Π²ΠΎΡ Π°ΠΌΠΏΠ»ΡΡΡΠ΄ΠΈ Π² ΡΠΌΠΎΠ²Π°Ρ
Π»ΡΠΎΠ΄ΡΠ½ΠΎΠ³ΠΎ ΡΡΠΈΡΠ½Π΅Π½Π½Ρ. Π ΠΎΠ·Π³Π»ΡΠ½ΡΡΠΎ Π·Π°Π»Π΅ΠΆΠ½ΡΡΡΡ ΡΠΎΠ·ΠΏΠΎΠ΄ΡΠ»ΡΠ² ΡΠΊΠ»Π°Π΄ΠΎΠ²ΠΈΡ
ΡΠ²ΠΈΠ΄ΠΊΠΎΡΡΡ Π²Π·Π΄ΠΎΠ²ΠΆ ΠΏΡΠΎΡΡΠ»Ρ Ρ
Π²ΠΈΠ»Ρ Π²ΡΠ΄ Π²Π΅Π»ΠΈΡΠΈΠ½ΠΈ ΡΡΠΈΡΠΊΠ°ΡΡΠΎΠ³ΠΎ Π·ΡΡΠΈΠ»Π»Ρ ΡΠ° Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ ΠΏΠΎΡΠ°ΡΠΊΠΎΠ²ΠΎΡ Π³Π°ΡΠΌΠΎΠ½ΡΠΊΠΈ. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΠΎ ΡΠ· Π·Π±ΡΠ»ΡΡΠ΅Π½Π½ΡΠΌ ΡΡΠΈΡΠΊΠ°ΡΡΠΎΠ³ΠΎ Π·ΡΡΠΈΠ»Π»Ρ Π²ΡΠ΄Π±ΡΠ²Π°ΡΡΡΡΡ Π·ΠΌΠ΅Π½ΡΠ΅Π½Π½Ρ Π°ΠΌΠΏΠ»ΡΡΡΠ΄Π½ΠΈΡ
Π·Π½Π°ΡΠ΅Π½Ρ ΡΠΊΠ»Π°Π΄ΠΎΠ²ΠΈΡ
ΡΠ²ΠΈΠ΄ΠΊΠΎΡΡΡ ΡΠ° Π²ΡΠ΄ΡΡΠ°Π²Π°Π½Π½Ρ ΡΠ°Π·ΠΈ ΠΊΠΎΠ»ΠΈΠ²Π°Π½Ρ.Using the method of multiple scales, the asymptotic expansions are obtained up to the values of the third order. The expansions condition the components of fluid movement velocity under floating ice cover at propagation of periodic surface flexural-gravity wave of finite amplitude in the condition of ice compression. Dependence of distribution of velocity components along the wave profile upon the compressive force value and the initial harmonic characteristics is considered. It is shown that rise of compressive force is accompanied by decrease of amplitude values of velocity components and lag of oscillationsβ phase
Threat of an influenza pandemic: family physicians in the front line
<p>Abstract</p> <p>Background</p> <p>The chance of an influenza pandemic is real and clinicians should keep themselves informed about the rationale and science behind preventive and therapeutic principles relating to an (impending) influenza pandemic.</p> <p>Discussion</p> <p>Vaccination is considered the best prevention in case of a pandemic threat and first choice to contain the impact of a pandemic. Pending the availability of an effective pandemic vaccine, antivirals are likely the only effective agents for prevention and treatment. When an influenza pandemic is impending, all interventions aim to prevent people becoming infected and to suppress replication and transmission of the virus as much as possible. Antivirals will be prescribed to patients with laboratory confirmed pre-pandemic influenza as well as to their contacts (post-exposure prophylaxis) which may delay development of or even prevent a pandemic. During a manifest influenza pandemic, however, there is large-scale spreading of the influenza virus. Therefore, preventive use of antivirals is less efficient to prevent transmission. Delaying the pandemic is then important in order to prevent exhausting public health resources and disruption of society. Thus, during a manifest pandemic everyone with influenza symptoms should receive antivirals as quickly as possible, regardless of virological confirmation. To ensure optimal effectiveness of antivirals and to minimize development of drug resistant viral strains, the use of antivirals for annual influenza should be restrictive. The crucial position of family physicians during an (impending) influenza pandemic necessitates the development of primary health care guidelines on this topic for all countries.</p> <p>Summary</p> <p>Family physicians will play a key role in assessing and treating victims of a new influenza virus, and in reassuring the worried well. We outline various possible interventions in the event of an impending and a manifest influenza pandemic, such as non-medial measures, prescription of antivirals, and vaccination, and emphasize the need for pandemic influenza preparedness.</p
The PINE study: rationale and design of a randomised comparison of epidural injection of local anaesthetics and steroids versus care-as-usual to prevent postherpetic neuralgia in the elderly [ISRCTN32866390]
BACKGROUND: Postherpetic neuralgia (PHN) is by far the most common complication of herpes zoster (HZ) and one of the most intractable pain disorders. Since PHN is seen most often in the elderly, the number of patients with this disorder is expected to increase in our ageing society. PHN may last for months to years and has a high impact on the quality of life. The results of PHN treatment are rather disappointing. Epidural injection of local anaesthetics and steroids in the acute phase of HZ is a promising therapy for the prevention of PHN. Since randomised trials on the effectiveness of this intervention are lacking, the PINE (Prevention by epidural Injection of postherpetic Neuralgia in the Elderly) study was set up. The PINE study compares the effectiveness and cost-effectiveness of a single epidural injection of local anaesthetics and steroids during the acute phase of HZ with that of care-as-usual (i.e. antivirals and analgesics) in preventing PHN in elderly patients. METHODS / DESIGN: The PINE study is an open, multicenter clinical trial in which 550 elderly (age β₯ 50 yr.) patients who consult their general practitioner in the acute phase of HZ (rash < 7 days) are randomised to one of the treatment groups. The primary clinical endpoint is the presence of HZ-related pain one month after the onset of the rash. Secondary endpoints include duration and severity of pain, re-interventions aiming to treat the existing pain, side effects, quality of life, and cost-effectiveness. CONCLUSION: The PINE study is aimed to quantify the (cost-) effectiveness of a single epidural injection during the acute phase of HZ on the prevention of PHN