Основні віхи розвитку української гірничої термінології

Ідеться про розвиток термінології й номенклатури гірничої справи, зокрема частково шахтобудування, яка активно розвивалася впродовж 20–З0-х рр. ХХ ст. Наголошено на спірних моментах в історії становлення цієї лексичної групи. Зроблено висновок про те, що нині гірнича термінологія української мови практично повністю унормована завдяки ретельній праці лексикографів та фахівців-гірників.The paper examines the ways mining terminology and nomenclature was developed. Special attention is drawn to the period of the 20th – 30th of the 20th century, when the term system was formed. The research focuses on disputable moments in the history of lexical group development; it concludes that mining terminology is normalized in the present-day Ukrainian language thanks to the careful work of lexicographers and mining specialist

Incidence, risk factors and outcomes of new-onset atrial fibrillation in patients with sepsis: a systematic review.

IntroductionCritically ill patients with sepsis are prone to develop cardiac dysrhythmias, most commonly atrial fibrillation (AF). Systemic inflammation, circulating stress hormones, autonomic dysfunction, and volume shifts are all possible triggers for AF in this setting. We conducted a systematic review to describe the incidence, risk factors and outcomes of new-onset AF in patients with sepsis.MethodsMEDLINE, EMBASE and Web Of Science were searched for studies reporting the incidence of new-onset AF, atrial flutter or supraventricular tachycardia in patients with sepsis admitted to an intensive care unit, excluding studies that primarily focused on postcardiotomy patients. Studies were assessed for methodological quality using the GRADE system. Risk factors were considered to have a high level of evidence if they were reported in ¿2 studies using multivariable analyses at a P-value <0.05. Subsequently, the strength of association was classified as strong, moderate or weak, based on the reported odds ratios.ResultsEleven studies were included. Overall quality was low to moderate. The weighted mean incidence of new-onset AF was 8% (range 0 to 14%), 10% (4 to 23%) and 23% (6 to 46%) in critically ill patients with sepsis, severe sepsis and septic shock, respectively. Independent risk factors with a high level of evidence included advanced age (weak strength of association), white race (moderate association), presence of a respiratory tract infection (weak association), organ failure (moderate association), and pulmonary artery catheter use (moderate association). Protective factors were a history of diabetes mellitus (weak association) and the presence of a urinary tract infection (weak association). New-onset AF was associated with increased short-term mortality in five studies (crude relative effect estimates ranging from 1.96 to 3.32; adjusted effects 1.07 to 3.28). Three studies reported a significantly increased length of stay in the ICU (weighted mean difference 9 days, range 5 to 13 days), whereas an increased risk of ischemic stroke was reported in the single study that looked at this outcome.ConclusionsNew-onset AF is a common consequence of sepsis and is independently associated with poor outcome. Early risk stratification of patients may allow for pharmacological interventions to prevent this complication

Short-course adjunctive gentamicin as empirical therapy in patients with severe sepsis and septic shock : a prospective observational cohort study

Background.: Meta-analyses failed to demonstrate clinical benefits of beta lactam plus aminoglycoside combination therapy, compared to beta lactam monotherapy, in patients with sepsis. However, few data exist on the effects of short-course adjunctive aminoglycoside therapy in sepsis patients with organ failure or shock. Methods.: We prospectively enrolled consecutive patients with severe sepsis or septic shock in two intensive care units in the Netherlands from 2011 to 2015. Local antibiotic protocols recommended empiric gentamicin add-on therapy in only one of the units. We used logistic regression analyses to determine the association between gentamicin use and the number of days alive and free of renal failure, shock, and death, all on day 14. Results.: Of 648 patients enrolled, 245 received gentamicin (222 of 309 (72%) in hospital A and 23 of 339 (7%) in hospital B) for a median duration of 2 (IQR 1-3) days. The adjusted odds ratios associated with gentamicin use were 1.39 (95%CI 1.00-1.94) for renal failure, 1.34 (95%CI 0.96-1.86) for shock duration and 1.41 (95%CI 0.94-2.12) for day-14 mortality. Based on in vitro susceptibilities, inappropriate (initial) Gram-negative coverage was given in 9 of 245 (4%) and 18 of 403 (4%) patients treated and not treated with gentamicin, respectively (p=0.62). Conclusion.: Short-course empirical gentamicin use in patients with severe sepsis or septic shock was associated with an increased incidence of acute kidney injury, but not with faster reversal of shock or improved survival in a setting with low prevalence of antimicrobial resistance

Short-course adjunctive gentamicin as empirical therapy in patients with severe sepsis and septic shock : a prospective observational cohort study

Background.: Meta-analyses failed to demonstrate clinical benefits of beta lactam plus aminoglycoside combination therapy, compared to beta lactam monotherapy, in patients with sepsis. However, few data exist on the effects of short-course adjunctive aminoglycoside therapy in sepsis patients with organ failure or shock. Methods.: We prospectively enrolled consecutive patients with severe sepsis or septic shock in two intensive care units in the Netherlands from 2011 to 2015. Local antibiotic protocols recommended empiric gentamicin add-on therapy in only one of the units. We used logistic regression analyses to determine the association between gentamicin use and the number of days alive and free of renal failure, shock, and death, all on day 14. Results.: Of 648 patients enrolled, 245 received gentamicin (222 of 309 (72%) in hospital A and 23 of 339 (7%) in hospital B) for a median duration of 2 (IQR 1-3) days. The adjusted odds ratios associated with gentamicin use were 1.39 (95%CI 1.00-1.94) for renal failure, 1.34 (95%CI 0.96-1.86) for shock duration and 1.41 (95%CI 0.94-2.12) for day-14 mortality. Based on in vitro susceptibilities, inappropriate (initial) Gram-negative coverage was given in 9 of 245 (4%) and 18 of 403 (4%) patients treated and not treated with gentamicin, respectively (p=0.62). Conclusion.: Short-course empirical gentamicin use in patients with severe sepsis or septic shock was associated with an increased incidence of acute kidney injury, but not with faster reversal of shock or improved survival in a setting with low prevalence of antimicrobial resistance

Electronic implementation of a novel surveillance paradigm for ventilator-associated events. Feasibility and validation

Accurate surveillance of ventilator-associated pneumonia (VAP) is hampered by subjective diagnostic criteria. A novel surveillance paradigm for ventilator-associated events (VAEs) was introduced. To determine the validity of surveillance using the new VAE algorithm. Prospective cohort study in two Dutch academic medical centers (2011-2012). VAE surveillance was electronically implemented and included assessment of (infection-related) ventilator-associated conditions (VAC, IVAC) and VAP. Concordance with ongoing prospective VAP surveillance was assessed, along with clinical diagnoses underlying VAEs and associated mortality of all conditions. Consequences of minor differences in electronic VAE implementation were evaluated. The study included 2,080 patients with 2,296 admissions. Incidences of VAC, IVAC, VAE-VAP, and VAP according to prospective surveillance were 10.0, 4.2, 3.2, and 8.0 per 1000 ventilation days, respectively. The VAE algorithm detected at most 32% of the patients with VAP identified by prospective surveillance. VAC signals were most often caused by volume overload and infections, but not necessarily VAP. Subdistribution hazards for mortality were 3.9 (95% confidence interval, 2.9-5.3) for VAC, 2.5 (1.5-4.1) for IVAC, 2.0 (1.1-3.6) for VAE-VAP, and 7.2 (5.1-10.3) for VAP identified by prospective surveillance. In sensitivity analyses, mortality estimates varied considerably after minor differences in electronic algorithm implementation. Concordance between the novel VAE algorithm and VAP was poor. Incidence and associated mortality of VAE were susceptible to small differences in electronic implementation. More studies are needed to characterize the clinical entities underlying VAE and to ensure comparability of rates from different institution

Critical care management of severe sepsis and septic shock: a cost-analysis

Background Sepsis treatment has been associated with high costs. Furthermore, both the incidence of sepsis and the severity of illness at presentation appear to be increasing. We estimated healthcare costs related to the treatment of patients with sepsis in the intensive care unit (ICU) and aimed to explain variability in costs between individuals. Methods We performed a prospective cohort study in patients presenting with severe sepsis or septic shock to the ICUs of two tertiary centres in the Netherlands. Resource use was valued using a bottom-up micro-costing approach. Multivariable regression analysis was used to study variability in costs. Results Overall, 651 patients were included, of which 294 presented with septic shock. Mean costs were €2250 (95% CI €2235-€2266) per day and €29,102 (95% CI €26,598-€31,690) per ICU admission. Of the total expenditure, 74% was related to accommodation, personnel, and disposables, 12% to diagnostic procedures, and 14% to therapeutic interventions. Patients with septic shock had higher costs compared with patients with severe sepsis (additional costs: €69 (95% CI €37-€100) per day, and €8355 (95% CI €3400-€13,367) per admission). Site of infection, causative organism, presence of shock, and immunodeficiency were independently associated with costs, but explained only 11% of the total variance. Conclusion Mean costs of sepsis care in the ICU were almost €30,000 per case. As costs were poorly predictable, opportunities for cost savings based on patient profiling upon admission are limited