RESEARCH OF PROCESSES OF HEAT TRANSFER IN THE COOLING SYSTEM ELEMENTS REA, MADE ON THE BASIS OF MELTING HEAT ACCUMULATORS WITH ADDITIONAL LIQUID HEAT SINK

The paper considers the system of cooling elements REA with intermittent by heat, made on the basis of melting heat accumulators with additional liquid heat sink. The basic computational relations for theoretical studies. Presents the dependence of the length of stable work of the REA element in ensuring its temperature conditions of the investigated system

Predictors of rethrombosis and death in patients with COVID-19 after lower limb arterial thrombectomy for acute ischemia

Aim. To identify predictors of rethrombosis and death in patients with coronavirus disease (COVID-19) after thrombectomy for acute lower limb ischemia.Material and methods. For the period from April 2020 to January 2022, 189 pa tients with acute arterial lower limb thrombosis and acute lower limb ischemia were included in this study. In all cases, a positive polymerase chain reaction test for SARS-CoV-2 was obtained. According to chest multislice computed tomography, bilateral multisegmental pneumonia was identified as follows: 76 patients — grade 2 (25-50% of lung tissue involvement); 52 patients — grade 3 (50-75%); 61 patients — grade 4 (>75%). Breathing was carried out as follows: in 88 patients — spontaneous; in 42 — with oxygen administration by nasal cannula; 26 — non-invasive ventilation; 33 had artificial ventilation. All acute arterial thromboses developed within the hospital at 4,5±1,5 days after hospitalization. The time between the onset to diagnosis verification was 27,8±5,0 min. The revascularization strategy was established by a multidisciplinary team meeting. The interval between the development of acute ischemia symptoms and surgery was 45,9±6,3 minutes. Thrombectomy was performed according to the standard technique, under local and/or intravenous anesthesia, using 3F-7F Fogarty catheters.Results. Retrombosis developed in 80,4% of cases 6,4±5,1 hours after surgery. In 59,8% of cases, retrombectomy turned out to be ineffective and the patient underwent limb amputation. In 65,6% of patients, a death was established due to multiple organ dysfunction. Among them, limb amputation was performed in 103 patients. Binary logistic regression identified following predictors of retrombosis/ death: age over 70 years (odds ratio (OR), 30,73; 95% confidence interval (CI), 11,52-33,7), obesity (OR, 15,53; 95% CI, 6,41-78,19), diabetes (OR 14,21; 95% CI, 5,86-49,21), vasopressor support (OR 8,55; 95% CI, 4,94-17,93), mechanical ventilation (OR 7,39; 95% CI, 4,81-16,52).Conclusion. Predictors of retrombosis and death in patients with COVID-19 after lower limb arterial thrombectomy are age over 70 years, obesity, diabetes, vasopressor support, and mechanical ventilation

Coronavirus infection (COVID-19): ocular manifestations. clinical case

The article describes a clinical case of keratouveitis with hypertension in a patient with COVID-19 coronavirus infection.В статье рассмотрен клинический случай развития кератоувеита с гипертензией у пациента на фоне коронавирусной инфекцией COVID-1

Комплаентность и персистентность у пациентов с первичной открытоугольной глаукомой с позиции офтальмолога

PURPOSE: Determination of key factors of non-compliance for treatment and duration of recommendations accomplishment in accordance with doctor’s instructions and associated with time from therapy start to its discontinuation (persistence) in patients with glaucoma by assessment of personal opinion of ophthalmologists with different amount of experience.METHODS: 509 queries of medical professionals (631 doctors) from Russia and other 6 countries were included into the study. All doctors’ queries were grouped according to the duration of their work experience, place of work — depending on medical care type (ambulatory or inpatient) and by hospital propriety type (state or private). Data collection method: online survey. The significance of the 32 selected compliance factors was assessed by the ball system from 10 (maximum significant factor) to 1 (minimally significant factor). Analysis program Statistica 8.0 (StatSoft Inc., USA).RESULTS: Data analysis allowed determining medium terms for continued application of recommended therapy depending on patients group. Persistency of low-compliant patients was considered a period of continued following of recommendations from 15 up to 27.5 days per year, high-compliant — 180-300 days per year. Doctors’ opinion depended on time in professional and place of work. Study results allowed recognizing percent’s of “low-compliant”, “mediumcompliant” and “high-compliant” patients. Following patients compliance factors were assessed as well: factors directly associated with treatment, factors, associated with patient’s condition, factors of behavioral compliance and social compliance. Moreover, trial results displayed difference in opinion of medical specialists depending on the duration of their work experience, place of work and clinic type.CONCLUSION: Study groups divided by the amount of healthcare experience showed no difference in patients compliance apprehension. Percentage of low-compliant patients was 20 [10; 30] %; medium-compliant — 30 [20; 45] and high-compliant — 50 [30; 60]% in all groups. A longer duration of healthcare experience corresponded with higher persistence requirements. Low-compliant patients followed recommendations for up to 20 days per year [7; 60]; medium-compliant — for 90 [20; 200] and lowcompliant — 200 [40; 350]. Primary factors for non-compliancy in all groups were defined as follows: absence of motivation; complicated instillation regimen influencing daily activities; absence of contact with attending physician; low information level concerning condition; age; side effects; medication price; laziness; family history of glaucoma. Factors of behavioral compliance were considered the most important in all groups — 75%.ЦЕЛЬ. Определение ключевых факторов нарушения приверженности к лечению (комплаентности) и продолжительности в выполнении назначений по времени от начала терапии до ее прекращения (персистентности) у пациентов с глаукомой при изучении субъективного мнения врачей-офтальмологов с разным стажем и местом работы.МЕТОДЫ. В исследование были включены 509 анкет от 631 врача из России и 6 стран СНГ. Все анкеты врачей были разделены на группы в зависимости от их стажа и места работы, вида собственности лечебно-профилактического учреждения (государственной или частной) и формы оказания медицинской помощи (амбулаторной или стационарной). Метод сбора данных: онлайн-анкетирование. Значимость 32 отобранных факторов комплаентности оценивалась по балльной системе от 10 (максимально значимого фактора) до 1 (минимально значимого фактора). Программа анализа: Statistica 8.0 (StatSoft Inc., США).РЕЗУЛЬТАТЫ. Анализ данных позволил получить средние сроки непрерывного соблюдения назначенной терапии в зависимости от принадлежности участников анкетирования к той или иной группе. Персистентность (период непрерывного соблюдения рекомендаций) низкокомплаентных пациентов составила от 15 до 27,5 дней в году, высококомплаентных — от 180 до 300 дней в году. Мнение врачей зависело от стажа и места их работы. Выявлены доли «низкокомплаентных», «среднекомплаентных» и «высококомплаентных» пациентов. Проанализированы конкретные факторы приверженности пациентов к соблюдению рекомендаций, связанные непосредственно с лечением, состоянием пациента, особенности поведенческой и социальной комплаентности. Результаты исследования показали различия мнений практикующих врачей в зависимости от стажа, места работы и вида лечебного учреждения.ЗАКЛЮЧЕНИЕ. В анализируемых группах врачей, разделенных по стажу работы, разница в представлениях о комплаентности пациентов не выявлена. Доля «низкокомплаентных» пациентов составляет в среднем 20% [10; 30], «среднекомплаентных» — 30% [20; 45] и «высококомплаентных» — 50% [30; 60]. Чем больше стаж, тем более высокие требования предъявляются врачами к соблюдению рекомендаций. Предполагается, что «низкокомплаентные» пациенты соблюдают рекомендации в течение 20 [7; 60] дней в году, «среднекомплаентные» — 90 [20; 200], «высококомплаентные» — 200 [40; 350]. Ведущими факторами нарушения комплаентности во всех группах являются: отсутствие мотивации, сложный режим инстилляций, отсутствие контакта с врачом, низкая степень информированности о заболевании, возраст, забывчивость, наличие побочных эффектов, стоимость, лень, семейный анамнез глаукомы. На первом месте во всех группах отмечают факторы поведенческой комплаентности — до 75%

Ecological assessment of ancological morbidity of the population of the Kulinsky region of Daghestan republic

An ecological assessment of oncological morbidity of Kulinsky region population is given. There is investigated the consistence of heavy metals in soil, drinking water and flora. There’s revealed the arized concentrations of heavy metals in the soil and drinking water of the region