Features of civil liability for damage caused to the life or health of a citizen when providing him with medical services

The aim of the study - defined as the disclosure of the conditions of civil liability of medical organizations for harm caused to the patient's health when providing him with medical services.Цель исследования - раскрытие условий гражданско-правовой ответственности медицинских организаций за вред, причиненный здоровью пациента при оказании ему медицинской услуги

Features of the motivation and needs in people with computer game addiction

The article deals with the problem of the formation of computer game addiction in adolescents. The typical features of addicted people and the peculiarities of their motivation and needs are highlighted. The stages of the formation of game addiction are considered. The positive properties of computer games are also notedВ статье рассматривается проблема формирования компьютерно-игровой зависимости у подрастающего поколения. Выделены характерные признаки зависимых от компьютерных игр, особенности их мотивационно-потребностной сферы. Проанализированы этапы формирования игровой зависимости. Отмечены также положительные свойства компьютерных иг

Спектральная туссофоиобарография — метод оценки обратимости бронхиальной обструкции у больных бронхиальной астмой

The purpose of this study was to evaluate reversibility of the airway obstruction in asthma patients using a method of spectral tussophonobarography permitting to perform the frequency analysis of cough sounds. As a result the cough sound spectrum was divided into 3 phases: the 1st phase was due to quick opening of the larynx, the 2nd, more continuous phase was relevant to the air output out of the lungs, the 3rd, inconstant phase corresponded to the closure of the larynx at the end of the cough. The method showed significant changes of spectral and temporary parameters of the cough sounds before and after inhalation of a bronchodilator in asthma patients (common duration of cough, duration of each cough phase, frequency of maximal cough sound energy Fmax, frequency containing 50% of the cough sound energy F50%, q coefficient which is the ratio of total energy of low and middle frequencies to the energy of high frequencies). Thus, the spectral tussophonobarography is thought to be an objective method to evaluate the reversibility of the airway obstruction in asthma.Целью работы явилось изучение обратимости бронхиальной обструкции у больных бронхиальной астмой с помощью метода спектральной туссофонобарографии, позволяющего проводить временночастотный анализ звуков кашля. В результате анализа были выделены три фазы в спектре звука кашля: 1 -я фаза — быстрое открытие гортани, 2 -я фаза — выход воздуха из легких, 3-я (непостоянная) фаза — закрытие гортани в конце кашля. Метод позволил выявить существенные различия спектральновременных параметров звуков кашля у больных бронхиальной астмой в результате проведения теста с β2-агонистом короткого действия (общая продолжительность кашля, продолжительность каждой фазы кашля, Fmax — частота максимальной энергии звука, F50% — частота, содержащая 50% энергии звука кашля, коэффициент q — отношение суммарной энергии низких и средних частот к энергии высоких частот). Таким образом, спектральная туссофонобарография является объективным методом оценки обратимости бронхиальной обструкции

Клиническая оценка эффективности кашля у больных неспецифическими заболеваниями легких на основе туссографии и времени экспекторации

The article deals with the investigation of cough and mico-cilliary clearence in patients with nonspecific iung diseases (lobular pneumonia, lung abscess, intrinsic asthma). The aim of this study is to define quantitative criteria of cough efficacy which in terms give the integral characteristic of tracheobronchial clearence components. It is achieved by monitoring the time of inuline expectoration and registering of cough jolts with the help of tussograph IKT-1. In case of prolongation of inuline expectoration time using drug suppression of cough, the latter is regarded effective.

Сердечный индекс и вариация ударного объема на основе анализа времени транзита пульсовой волны в сравнении с производными анализа контура пульсовой волны после коронарной реваскуляризации на работающем сердце

The objective was to validate cardiac index (CI) and stroke volume variation (SVV) measured by pulse wave transit time (PWTT) technology  using estimated continuous cardiac output (esCCO) technique, with pulse contour analysis (PCA) after off-pump coronary artery bypass grafting  (OPCAB)Materials and methods. The study involved 21 patients after elective OPCAB. In all patients, CI and SVV were measured with both esCCO technique  (CIesCCO and esSVV) and PCA (CIPCA and SVVPCA). The agreement between methods was analyzed using correlation analysis and Bland-Altman  analysis. In addition, the trending ability of esCCO technique to control changes in CI during dynamic tests was investigated.  Results. During the study, 178 pairs for CI and 174 pairs for SVV were collected. The mean bias between CIesCCO and CIPCA was 0.06 L·min–1 m–2 with limits of agreement of ± 0.92 L·min–1 m–2 and a percentage error of 35.3%. The concordance rate of CIesCCO was 70%. The mean bias between  esSVV and SVVPCA achieved – 6.1% with limits of agreement of ± 15.5% and percentage error of 137%.Conclusions. The coherence of CIesCCO and esSVV based on PWTT in comparison with PCA is not appropriate. Further development of this  monitoring algorithm may be required for more correct measurement of cardiac output and fluid responsiveness  Цель – провести валидацию сердечного индекса (СИ) и вариации ударного объема (ВУО), измеренных с помощью метода анализа  времени транзита пульсовой волны (ВТПВ) с использованием технологии estimated continuous cardiac output (esCCO), с показателями, полученными на основе анализа контура пульсовой волны (АКПВ), после аортокоронарного шунтирования на работающем  сердце (АКШ).Материалы и методы. В исследование был включен 21 пациент после планового АКШ. Всем пациентам была выполнена оценка СИ и ВУО  как с помощью технологии ВТПВ (СИВТПВ и ВУОВТПВ), так и на основе АКПВ (СИАКПВ и ВУОАКПВ). Согласованность между методами была  оценена с помощью корреляционного анализа и анализа Бланда – Альтмана. Кроме того, была произведена оценка способности технологии  esCCO контролировать изменения СИ на фоне динамических тестов.Результаты. В ходе исследования было получено 178 пар данных для СИ и 174 пары данных для ВУО. Средняя разница между СИВТПВ  и СИАКПВ составила 0,06 л∙мин–1∙м–2 с границей согласованности ± 0,92 л∙мин–1∙м–2 и процентной ошибкой 35,3%. Показатель конкордантности  для СИВТПВ составил 70%. Средняя разница между ВУОВТПВ и ВУОАКПВ достигла 6,1% с пределом согласованности ± 15,5% и процентной  ошибкой 137%. Заключение. Показатели СИ и ВУО, полученные с помощью анализа ВТПВ, обладают недостаточной согласованностью в сравнении c  АКПВ. Необходимо дальнейшее совершенствование данного алгоритма мониторинга для более точной оценки сердечного выброса и восприимчивости к инфузионной нагрузке.

Effects of alpha fetoprotein on escape of Bel 7402 cells from attack of lymphocytes

BACKGROUND: Involvement of AFP against apoptosis of tumor cell has been implicated in its evasion of immune surveillance. However, the molecular events of immune escape mechanisms are still unknown. The major observations reported here relate to a possible mechanism by which heptoloma Bel 7402 cells escape immune surveillance in vitro. METHODS: Western blotting and a well-characterized cofocal scanning image were performed to analyze the expression of Fas/FasL and caspase-3 in co-cultured Bel 7402 and Jurkat cells. RESULTS: After co-culture with Jurkat cells, up-regulated Fas and reduced FasL expression could be observed. Treatment with AFP could remarkably inhibit the elevated Fas and, whereas, induce the FasL expression in co-cultured Bel 7402 cells. Cells co-culture could induce the expression of caspase-3 in both cells line. The elevated caspase-3 in Bel 7402 cells was abolished following the treatment of AFP. The expression of caspase-3 was elevated in co-cultured Jurkat cells treated with AFP. No detectable change on the expression of survivin was examined in both cells line. Monoclonal antibody against AFP treatment alone did not obviously influence the growth of cells, as well as the expression of Fas/FasL and caspase-3. However, the effect of AFP could be blocked by antibody. CONCLUSIONS: our results provide evidence that AFP could promote the escape of liver cancer cells from immune surveillance through blocking the caspase signal pathway of tumor cells and triggering the Fas/FasL interaction between tumor cells and lymphocytes

The Apoptosome: Emerging Insights and New Potential Targets for Drug Design

Apoptosis plays a crucial role in tissue homeostasis, development and many diseases. The relevance of Apaf1, the molecular core of apoptosome, has been underlined in mitochondria-dependent apoptosis, which according to a growing body of evidence, is involved in various pathologies where the equilibrium of life-and-death is dysregulated, such as heart attack, stroke, liver failure, cancer and autoimmune diseases. Consequently, great interest has emerged in devising therapeutic strategies for regulating the key molecules involved in the life-and-death decision. Here we review recent progress in apoptosis-based pharmacological therapies and, in particular, we point out a possible role of the apoptosome as an emerging and promising pharmacological target

Risk factors of atherosclerosis and clinical and morphological comparisons in systemic vasculitides

Objective: to study the incidence rates of angina, myocardial infarction (MI), stroke, and the frequency of endovascular interventions in patients with systemic vasculitides, and the incidence rate of atherosclerosis according to autopsy data. Subjects and methods. Three hundred and twenty-one patients with systemic vasculitides: Wegener's granulomatosis (n = 138), Takayasu's arteritis (n = 79), polyarteritis nodosum (n = 55), and Churg-Strauss syndrome (n = 49) were examined; 55 autopsies were analyzed in patients with the above diseases. Results. Fifty-one (15.6%) of the 321 patients were diagnosed as having cardiovascular diseases (CVD): angina pectoris (7.1%) and MI (3.1%) and endovascular interventions (0.9%). The risk of cardiovascular events was found to be associated with traditional risk factors, such as male gender and age. Arterial hypertension, hypercholesterolaemia, and increased serum creatinine were more frequently detected in the CVD group that showed no significant differences from the non-CVD group. According to autopsy results, atherosclerosis was identified in the patients with Wegener's granulomatosis (52%), Takayasu's arteritis (50%), polyarteritis nodosum (52.6%), and Churg-Strauss syndrome (57.1%). Conclusion. CVD and atherosclerosis are common in systemic vasculitides, which requires the traditional risk factors of atherosclerosis to be actively corrected