Pneumonia in patients on the background of blood cancer.

Problematic issues of etiologic diagnosis and treatment of community-acquired and nosocomial pneumonia are being studied actively. At the same time specific features of pneumonia in patients with severe immune defects, against blood cancer including are studied insufficiently. By the result of microbiological examinations of 149 patients with pneumonia on the background of blood cancer, who have undergone treatment in hematological center of CE “Dnipropetrovsk local multi-field clinical hospital №4” in 2010-2012, bacterial causative agents were determined in 59,7% of accidents, among which gram-negative microorganisms made up 69,7%, gram-positive – 30,3%. In 63% of accidents the asso­ciations of causative agents were determined: the combination of fungal flora made up 58, 4% bacterial associations – 25, 8%. Invasive methods of research have demonstrated a considerably bigger informativeness in determination of possible etiological diagnosis of pneumonia. In determination of causative agent in fluid of brochoalveolar lavage the part of positive results made up 77,4% against 30,3% in examination of sputum

The forecast of lethal outcome in chronic leukemia patients with pneumonia

Цель исследования - создание математической модели прогноза летального исхода пневмонии у больных на фоне хронических лейкозов для определения и своевременной оптимизации лечения. Исследовано 323 больных с пневмониями, которые розвились на фоне хронических лейкозов. Все показатели, полученные в результате исследования, внесены в электронную базу данных формализованных историй болезней в виде таблицы «объект-признак», которую подвергали поэтапной многоплановой статистической обработке методами непараметрического дисперсионного анализа Краскела-Уоллиса, корреляционного анализа с расчетом коэффициента ранговой корреляции Спирмена, Roc-анализа. Статистически достоверным считалось значение уровня значимости p<0,05 (5%). Выявлено, что с летальным исходом больных различными формами пневмонии, которые развились на фоне хронических лейкозов ассоциированы показатели лейкоцитов, лимфоцитов, нейтрофилов, тромбоцитов, эритроцитов, гемоглобина и показатели иммунитета (B(CD19+), Т (СD4+), (СD4+/СD8+), IgG). В результате проведенного исследования создана математическая модель прогноза возникновения летального исхода пневмонии у больных на фоне хронических лейкозов: ПЛИ = exp(-0,073-0,994*(лейкоциты) + 4,842 * (Р. Aerogиnosa)) / [1 + exp (-0,073-0,994 * (лейкоциты) + 4,842 * (Р. aerogиnosa)]. Использование в клинической практике разработаной математической модели позволит определить место лечения больных пневмонией в сочетании с хроническим лейкозом, что позволит своевременно оптимизировать программу лечения. The aim of the study - to create a mathematical model for forecasting of poor pneumonia outcome in patients with chronic leukemia in order to optimize treatment. Study included 323 patients with pneumonia and chronic leukemia. All indicators obtained in the study were entered into electronic database of formalized medical histories like a table "object-feature". These results were subjected to stepwise multidimensional statistical processing using non-parametric dispersive analysis by Kruskal-Wallis, correlation analysis with Spearman's rank correlation coefficient, and ROC - analysis. The statistically significant level was p < 0,05 (5%). We determined that the forecast of pneumonia poor outcome in patients with chronic leukemia is associated with: leukocytes, lymphocytes, neutrophils, platelets, erythrocytes, hemoglobin and immunity: B (CD19+) (G/L), T (CD4+) (%), immunoregulatory index (CD4+/СD8+) and IgG (g/l). A mathematical model for predicting the pneumonia poor outcome in patients with chronic leukemia was created in our study: PPO=exp (-0.073-0.994*(leukocytes) + 4.842*(P.aeroginosa)) / [1 + exp (-0.073-0.994*(leukocytes) + 4.842*(R. aeroginosa)]. Using in clinical practice the proposed mathematical model of prediction pneumonia poor outcome in patients with chronic leukemia will allow determining the treatment place and timely optimizing the treatment program

Optimized refractive surgery in keratoconus

Purpose: The aim of the study is to compare the refractive results after simultaneous TransPRK and Cross-linking procedure for treatment of keratoconus with optimized and non-optimized customized ablation profiles; to introduce the concept of optimization in keratoconus and discuss its clinical significance; to find predictive factors for better refractive outcomes in simultaneous combined procedures and to propose therapeutic algorithm.Methods: Syrius schimpflug aberrometer (Schwind) was used to create non-optimized custom and optimized custom ablation profiles in keratoconic corneas. TransPRK ablation was performed with Schwind Amaris Eximer Laser (500 Hz). Cross-linking was done with Avedro cross-linking suit. Analysis of preoperative and postoperative refraction, visual acuity, keratometric and aberometric data was done for both groups. Correlative analysis of the preoperative and postoperative variables was done with Pierson statistical analysis.Results: 44 patients (70 eyes), age 19-67, 29 eyes with optimization, 41 eyes without optimization were followed for 18 months. A positive correlation was found between CCT and the amount of postoperative flattening in patients over 40 years of age. No correlation was found with Kavg.Conclusions: Long term results after simultaneous TransPRK + Cross linking show stability and safety. Optimization of refraction brings better refractive results compared to non-optimized procedure. It can be safely performed in thinner corneas and compensates for the hypermetropic shift generated by the cross-linking procedure

Football fans in the context of negative identity

The article deals with the issues, related to the existence of such a phenomenon of modern times as football fanaticism. The author analyzes the features of sports rooting, in general, and football fanaticism, in particular. The classification of football fans was proposed, and their main characteristics were described. Social markers, having an impact on the fan’s life and the existence of the fan group, were determined in the context of negative identity. The role of the phenomenon of football fanaticism in modern culture was considered in the articl

Disturbances of electron density in the high latitude upper (F-region) ionosphere induced by X-mode HF pump waves from EISCAT UHF radar observations

The paper presents experimental results concerning disturbances of electron density in the high latitude ionosphere F-region, induced by powerfulHF radio waves (pump waves) with extraordinary (X-mode) polarization. The experiments were carried out at the EISCAT/Heating facility at Tromsø, Norway. The EISCAT UHF incoherent scatter radar (ISR), running at 930 MHz, co-located with a heating facility, was used to detect the disturbances of electron density. In the course of the experiments, the X-mode HF pump waves radiated into the F-region towards the magnetic zenith at different pump frequencies and ratios of the pump frequency to the critical frequency of the F2 layer.The effective radiated power was ERP = 360–820 MW. An increase in electron densities was found in a wide altitude range, giving rise to field-aligned ducts with enhanced electron density. The features and behavior of the ducts were investigated. It was revealed that the ducts are formed under quiet background geophysical conditions in a wide altitude range up to the upper altitude limit of EISCAT ISR measurements, when the pump frequencies were both below and above the critical frequency of the F2 layer (fH ≤ foF2 or fH &gt; foF2). A plausible formation mechanism of the ducts is discussed.Представлены результаты экспериментальных исследований возмущений электронной концентрацииNe в высокоширотной F-области ионосферы, вызванные воздействием мощных КВ-радиоволн необыкновенной (Х-мода) поляризации. Эксперименты выполнялись на КВ нагревном стенде EISCAT/ Heating в г. Тромсё, Норвегия при эффективной мощности излучения 360–820 МВт. В качестве средства диагностики возмущений Ne использовался EISCAT радар некогерентного рассеяния радиоволн (НР) на частоте 930 МГц, пространственно совмещенный с КВ нагревным стендом. Обнаружено возрастание Ne в широком диапазоне высот, которое формирует каналы повышенной электронной плотности, вытянутые вдоль магнитного поля Земли. Исследованы характеристики и условия создания каналов. Обсуждается возможный механизм формирования каналов Ne при Х-нагреве высокоширотной F-области ионосферы

Rapid identification of Corynebacterium diphtheriae clonal group associated with diphtheria epidemic, Russian Federation.

We used 199 Corynebacterium diphtheriae isolated from 1995 to 1997 in Russia to evaluate the ability of random amplified polymorphic DNA (RAPD) to identify the unique clonal group that emerged there in 1990. Our data show that RAPD can reliably, reproducibly, and rapidly screen a large number of strains to identify the epidemic clonal group

FEATURES OF GENOTYPiNG VARIABILITY OF STRAINS OF BORDETELLA PERTUSSIS ALLOCATED FROM PATIENTS WITH WHOOPING COUGH IN RUSSIA

On the basis of studying of features of structure of 7 genes determining major factors of pathogenicity of the causative agent of whooping cough - ptxA, ptxB, ptxC, ptxD, ptxE, ptxP and prn, features of genotyping variability of strains of B.pertussis allocated from patients with whooping cough in Russia are shown. Dynamics of formation of population of strains of the causative agent of whooping cough is tracked and is established that population of strains of B.pertussis is formed by clonal expansion of strains with, new genetic structure of major factors of pathogenicity - pertussis toxin and. pertactin. The structure of population of strains of B.pertussis causing a disease by whooping cough, at the present stage of epidemic process of a pertussis infection - domination. of strains with new «non-vaccine» alleles genes - ptxA1 (97,7 %), ptxC2 (87,4 %), prn2 (89,5 %) and. ptxP3 (93,3 %), in 2,2 % cases with ptxB2 allele and. in 1,3 % cases with. prn9 allele circulate

Criteria of vital activity lesions as a methodological basis for determining disability.

Evaluation of the functional state of the patient is the basis for recognizing him persistently incapacitated. The reform in the field of medicine in our country entrusts the function of the initial selection of such patients to general practitioners and primary care physicians. In 2001, the working group of the World Health Organization approved the International Classification of Functioning, Disability and Health. There are 7 basic parameters for detailing the functioning of a person: the ability to self-service, to move, to work, to orientate, to control own behavior, to learn, to communicate. The ability to self-service characterizes a person's capability to provide own physiological needs, to adhere to own hygiene and to perform daily activities. A person with a preserved capacity for self-service does not depend on other people.The ability to move allows the person to move in space independently: to walk, to run, to overpass the obstacles, to use public transport. If this criterion is limited, the person needs more time to overcome the distance or uses the additional support or needs help from outside. The ability to orient allows the person to analyze the surrounding world with the help of eyes and ears.The ability to communicate provides an opportunity to establish contacts and maintain relationships with other people. For communication spoken, written and non-verbal speech is used. The ability to control one's own behavior consists in the awareness of one's own personality and one's own place in the world, limited by certain norms and rules of behavior. The ability to learn allows the person to perceive, comprehend, accumulate and reproduce the information. Due to this,the person can accumulate knowledge and skills. Ability to work allows the person to perform work according to the level of one’s own education. The definition of criteria for disability and the degree of their severity requires a certain level of medical training for general practitioners and primary care physicians

SPECIFIC TRAITS OF TICK-BORNE ENCEPHALITIS IN ZABAYKALSKY KRAI

We conducted regionalization of Zabaykalsky Krai by the quantity of epidemic manifestations of tick-borne viral encephalitis over a period of 10years. The most adverse territories in the context of tick-borne viral encephalitis were determined. Maximum duration of seasonal incidence rate was 112 days -from the end of April to the mid-August. The categories of population included in infection contamination risk group were revealed. The researches promote forehanded development of the complex of preventive measures aimed at the decrease of tick- borne viral encephalitis incidence rate in Zabaykalsky Krai

The impact of visual functions on athletes’ results and methods of their improvements

Regardless of the sport, maintaining and improvement of visual functions in athletes act an important role in achieving personal records.In this article, the interrelationships between sports results and the state of visual functions were determined, as well as devices and methods were analyzed, thanks to which it is possible to improve functions of the visual analyzer