Gold as a Tool for Hedging Financial Risks

The article discusses gold as a protective asset, which claims to be a high-efficiency tool for hedging financial risks. In the introductory part the general characteristics of hedging as a method of full or partial risk elimination is given, and the main known types of risk hedging typical for a financial asset portfolio holder are considered. Further, dynamics of the world prices for gold is analyzed in a historical retrospective, whereby the conclusion is drawn on a tendency of this asset to grow during the periods of financial instability, and also if new financial assets appear. In the final part of the article the assessment of gold as a tool for hedging financial risks is given

Острый респираторный дистресс-синдром при тяжелой черепно-мозговой травме

Objective: to study the development of acute respiratory distress syndrome (ARDS) in victims with isolated severe brain injury (SBI). Subject and methods. 171 studies were performed in 16 victims with SBI. Their general condition was rated as very critical. The patients were divided into three groups: 1) non-ARDS; 2) Stage 1 ARDS; and 3) Stage 2 ARDS. The indicators of Stages 1 and 2 were assessed in accordance with the classification proposed by V. V. Moroz and A. M. Golubev. Intracranial pressure (ICP), extravascular lung water index, pulmonary vascular permeability, central hemodynamics, oxygenation index, lung anastomosis, the X-ray pattern of the lung and brain (computed tomography), and its function were monitored. Results. The hemispheric cortical level of injury of the brain with function compensation of its stem was predominantly determined in the controls; subcompensation and decompensation were ascertained in the ARDS groups. According to the proposed classification, these patients developed Stages 1 and 2 ARDS. When ARDS developed, there were rises in the level of extravascular lung fluid and pulmonary vascular permeability, a reduction in the oxygenation index (it was 6—12 hours later as compared with them), increases in a lung shunt and ICP; X-ray study revealed bilateral infiltrates in the absence of heart failure in Stage 2 ARDS. The correlation was positive between ICP and extravascular lung water index, and lung vascular permeability index (r>0.4;p<0.05). Conclusion. The studies have indicated that the classification proposed by V. V. Moroz and A. M. Golubev enables an early diagnosis of ARDS. One of its causes is severe brainstem injury that results in increased extravascular fluid in the lung due to its enhanced vascular permeability. The ICP value is a determinant in the diagnosis of secondary brain injuries. Key words: acute respiratory distress syndrome, extravascu-lar lung fluid, pulmonary vascular permeability, brain injury, intracranial pressure.Цель исследования — изучить развитие острого респираторного дистресс-синдрома (ОРДС) у пострадавших с изолированной тяжелой черепно-мозговой травмой (ТЧМТ). Материал и методы. Проведено 171 исследование у 16 пациентов с ТЧМТ. Состояние — крайне тяжелое. Больные были разделены на группы: группа сравнения — отсутствие ОРДС, 2-я группа — ОРДС I и 3-я — ОРДС II стадии. Критерии I и II стадий ОРДС оценивали в соответствии с классификацией, предложенной Морозом В. В. и Голубевым А. М. Проводили мониторинг внутричерепного давления (ВЧД), содержание внесосудистой воды в легких, проницаемости сосудов легких, центральной гемодинамики, индекса оксигенации, легочного шунта, рентгенологической картины легких и головного мозга (компьютерная томография) и его функционального состояния. Результаты. В контрольной группе определяли преимущественно полушарно-корковый уровень повреждения головного мозга с компенсацией функций его ствола, в группах с ОРДС — субкомпенсацию и декомпенсацию. Согласно предложенной классификации, у этих пациентов развивался ОРДС I и II стадии. При развитии ОРДС отмечалось повышение содержания внесосудистой жидкости, проницаемости сосудов легких, снижение индекса оксигенации (он запаздывал на 6—12 часов в сравнении с ними), увеличение легочного шунта, ВЧД, рентгенологически при II стадии ОРДС определялись двусторонние инфильтраты при отсутствии сердечной недостаточности. Корреляция между ВЧД и ИВСВЛ, ВЧД и ИПЛС была положительной (г>0,4, при

Состояние центральной гемодинамики, внутричерепного и церебрального перфузионного давлений при острых нарушениях мозгового кровообращения

Objective: to study the central hemodynamics (CH) and intracranial and cerebral perfusion pressures (ICP and CPP) in acute cerebral circulatory disorders (ACCD) and their possible relationships for further development of intensive differential therapy for the detected disorders. Material and methods. Hemodynamic studies using the transpulmonary thermodilu-tion technique, measurements of ICP, calculations of CPP, and currently available X-ray studies were conducted in 18 patients on days 1, 3, 5, and 7 of ACCD. All the patients were found to have essential hypertension and coronary heart disease. Results. In the first 5 days of ACCD, there was a normodynamic type of circulation in hemorrhagic stroke (HS) and a hypodynamic type in ischemic stroke (IS). ICP remained at the baseline elevated level in the IS group and increased over time in the HS group. CPP was significantly unchanged. Myocardial dysfunction was detected when there was a significant preload caused by a high postload. In IS, an inverse correlation was found between ICP and global ejection fraction (GEF), cardiac performance index (CPI) and on day 7, the correlation was direct. In HS, ICP had a direct correlation with CPI and an inverse correlation with GEF. These changes during treatment failed to progress and were revealed in the presence of brain dislocation, as evidenced by spiral computed tomography. Conclusion. Thus, the pattern of CH disorders depends on the type of ACCD. In the first 5 days of ACCD, a hypokinetic circulatory type is registered in IS and a normokinetic type is in HS. Evolving dislocation of the brain with impaired function of its stem structures due to ICP elevation is one of the causes of central hemodynamic changes. The value of ICP in ACCD is a crucial indicator in the diagnosis of secondary brain damages and determines treatment policy. Key words: acute ischemic attack, intracranial pressure, cerebral perfusion pressure, central hemodynamics, myocardial depression.Цель исследования — изучить состояние центральной гемодинамики (ЦГД), внутричерепного (ВЧД) и церебрального перфузионного давления (ЦПД) при острых нарушениях мозгового кровообращения (ОНМК) и взаимоотношений между ними для дальнейшей разработки интенсивной дифференцированной терапии выявленных нарушений. Материал и методы. Исследование состояния ЦГД методом транспульмональной термодилюции, измерение ВЧД, расчет ЦПД и рентгенологические исследования проведены у 18-и больных в 1-е, 3-и, 5-е и 7-е сутки острого периода ОНМК. У всех пациентов выявляли гипертоническую болезнь и ишемическую болезнь сердца. Результаты. В первые 5 суток ОНМК при геморрагическом инсульте (ГИ) отмечался нормодинамический тип кровообращения, а при ишемическом инсульте (ИИ) — гиподинамический. ВЧД в группе с ИИ оставалось на исходно повышенном уровне, а при ГИ в динамике нарастало. ЦПД достоверно не изменялось. Дисфункция миокарда выявлялась при достаточной преднагрузке за счет высокой постнагрузки. При ИИ выявлялась обратная корреляция между ВЧД и глобальной фракцией изгнания (ГФИ), индексом функции сердца (ИФС), а с 7-х суток — прямая корреляция. При геморрагическом инсульте ВЧД имело прямую связь с ИФС и обратную с ГФИ. Эти изменения на фоне лечения не прогрессировали и выявлялись на фоне дислокации головного мозга, что подтверждалось данными спиральной компьютерной томографии. Заключение. Таким образом, характер нарушения ЦГД зависит от вида ОНМК. В первые 5 суток острого периода при ИИ регистрируется гипокинетический тип кровообращения, а при геморрагическом — нормокинетический. Одной из причин изменений центральной гемодинамики является развитие дислокации головного мозга с нарушением функции его стволовых структур вследствие нарастания внутричерепного давления. Величина ВЧД при остром нарушении мозгового кровообращения является определяющим показателем в диагностике вторичных повреждений головного мозга и определяет тактику лечения. Ключевые слова: острое нарушение мозгового кровообращения, внутричерепное давление, церебральное перфузионное давление, центральная гемодинамика, депрессия миокарда

Аденомы гипофиза и их структура в крупном промышленном центре (г. Новокузнецк)

In 1992 Kemerovo region in the Russian Federation was first admitted as the area with an extraordinary ecological situation. Living in Kuzbass is factor of risk of forming of different endocrine diseases, deterioration of reproductive health, high quantities of individual and population risks of oncologist pathology, high levels of invalidism of population at able-to-work age because of environment pollution and harmful work conditions. The present study includes 299 sick people with confirmed diagnosis of adenomas of pituitary in the endocrine department of the town hospital № 1 for the period from 1995 to 2007 that is complete selection. Adenomas of pituitary are more often detected at people at active able- to-work age. Adenomas of pituitary are more often diagnosed at women 87,0%. The overwhelming majority of adenomas of pituitary (74,0%) is detected at the age of 20—50. Because of this disease 99 people (33,1%) have different degree of loss of their working ability. In the structure of adenomas prolactinomas dominate (53,5%), on the frequency of meeting hormonally inactive adenomas are on the second place (32,1%), somatotrophinomas are rarely met (in 11,7%) and the rarest ones at the population on Novokuznetsk are corticotrophinomas (in 2,7%). On dimensions of adenomas of pituitary microadenomas predominate — at 68,0% sick people. The relation microadenomas to macroadenomas is 17 : 22 at men and 187 : 73 at women.Еще в 1992 г. впервые в Российской Федерации Кемеровская область была признана регионом с чрезвычайной экологической ситуацией. Проживание в Кузбассе является фактором риска формирования различных эндокринологических и нейроэндокринологических заболеваний, ухудшения репродуктивного здоровья, высоких величин индивидуальных и популяционных рисков онкологической заболеваемости в связи с загрязнением окружающей среды и вредными условиями труда. В исследование включены 299 больных с подтвержденным диагнозом аденомы гипофиза (АГ) за период с 1995 по 2007 г., что является сплошной выборкой. Наиболее часто АГ определялась у лиц трудоспособного возраста и у женщин (87,0%). Подавляющее большинство АГ (74,0%) установлено в возрасте от 20 до 50 лет. По данному заболеванию 99 (33,11%) человек имели разную степень утраты трудоспособности. В структуре аденом доминировали пролактиномы (53,5%), на втором месте гормонально неактивные аденомы (32,1%), соматотропиномы встречались реже, в 11,7%, и самыми редкими у населения г. Новокузнецка являлись кортикотропиномы — 2,7%. По размерам среди АГ преобладали микроаденомы — у 68,0% больных. Отношение микроаденом и макроаденом составило у мужчин 17 : 22, у женщин 187 : 73

Pituitary adenomas and their structure in a large industrial center (Novokuznetsk)

In 1992 Kemerovo region in the Russian Federation was first admitted as the area with an extraordinary ecological situation. Living in Kuzbass is factor of risk of forming of different endocrine diseases, deterioration of reproductive health, high quantities of individual and population risks of oncologist pathology, high levels of invalidism of population at able-to-work age because of environment pollution and harmful work conditions. The present study includes 299 sick people with confirmed diagnosis of adenomas of pituitary in the endocrine department of the town hospital № 1 for the period from 1995 to 2007 that is complete selection. Adenomas of pituitary are more often detected at people at active able- to-work age. Adenomas of pituitary are more often diagnosed at women 87,0%. The overwhelming majority of adenomas of pituitary (74,0%) is detected at the age of 20—50. Because of this disease 99 people (33,1%) have different degree of loss of their working ability. In the structure of adenomas prolactinomas dominate (53,5%), on the frequency of meeting hormonally inactive adenomas are on the second place (32,1%), somatotrophinomas are rarely met (in 11,7%) and the rarest ones at the population on Novokuznetsk are corticotrophinomas (in 2,7%). On dimensions of adenomas of pituitary microadenomas predominate — at 68,0% sick people. The relation microadenomas to macroadenomas is 17 : 22 at men and 187 : 73 at women

Erythron Changes in Miners with a Different Length of Underground Work

Objective: to investigate the erythron and hematological reactions in miners in relation to the length of underground work. Subjects and methods. A prospective study of peripheral blood red cell parameters was conducted in 482 miners with an underground work length of as long as 40 years, who were divided into 3 length groups. Age subgroups were identified from the length groups to define the significance of age-related changes. A control group comprised 30 apparently healthy volunteers who did not work under harmful working conditions. Results and discussion. The miners were found to have the following statistically significant changes in red blood cell parameters in relation to the underground work length: elevated levels of red blood cells and hemoglobin as their adaptation to chronic hypoxia and intoxication in the first 10 years of underground work, which were more pronounced in young people (aged less than 29 years), this results from the accelerated release of red blood cells from the bone marrow into the bloodstream. Thereafter, there is a satisfactory adaptation or resistance phase that makes itself evident in the stabilization of erythron parameters. This process is accompanied by the change in the morphophysiological parameters of red blood cells themselves, which may present as increases in average hemoglobin concentration in the red blood cells and in their average hemoglobin volume. The alteration of cell volume is associated with the longer maturation of red blood cells and their increased hemoglobin volume. Conclusion. Our investigation has established that that the miners with an underground work length of less than 10 years, exposed to intermittent hypoxia and intoxicated with coal-ore dust, show a compensatory rise in red blood cells and hemoglobin levels; those with a length of 10 years or more had exhausted adaptive resources, as shown by the downward trend for red blood cells and hemoglobin, which is compensated for by increases in the volume of red blood cells and their hemoglobin concentration. Keywords: hypoxia, red blood cells ta^gbWn general adaptation syndrome