Аудит промышленной безопасности предприятия

В данное время, когда фактически нет города, где бы не работали предприятия, особый смысл имеет промышленная безопасность. С каждым годом увеличивается количество опасных объектов. Исходя из этого, проблема с безопасностью возведена в ранг основных ценностей на государственном уровне. Часто в промышленно развитых странах установлен жесткий контроль лицензирования ОПО, строительства, эксплуатации и т.д. Безопасность сооружений в этих странах контролируется государственными органами. Промышленная безопасность опасных объектов - это определенная защита общества и страны от различных техногенных катастроф и аварий. Для того, чтобы обеспечить безопасность, проводится комплекс мероприятий, которые ориентированы, прежде всего, на обеспечение безопасности технических объектов. Все организации, которые эксплуатируют опасный производственный объект, должны временами производить вышесказанные мероприятия. Это указано в Федеральном законе «О промышленной безопасности опасных производственных объектов» Цель работы: проверка соответствия установленным требованиям ПБ, подготовка рекомендаций по устранению выявленных нарушений в УНДиПР МЧС России по Томской области.At the moment, when there is virtually no city, where enterprises would not work, industrial safety has a special meaning. Every year the number of dangerous objects increases. Proceeding from this, the security problem is elevated to the rank of basic values at the state level. Often in industrialized countries, strict control of GCO licensing, construction, operation, etc. is established. The safety of facilities in these countries is controlled by government agencies.Industrial safety of hazardous facilities is a certain protection of society and the country from various man-made disasters and accidents. In order to ensure safety, a set of measures is carried out, which are focused, first of all, on ensuring the safety of technical facilities. All organizations that operate a hazardous production facility must at times produce the aforesaid activities. This is indicated in the Federal Law "On Industrial Safety of Hazardous Production Facilities" The purpose of the work: verification of compliance with the established requirements of the PB, the preparation of recommendations for the elimination of identified violations in the UNDiPR of EMERCOM of Russia for the Tomsk region

Temporary Filtering Bleb Failure Induced by Anterior Chamber Sulfur Hexafluoride Gas: A Complication after Descemet Membrane Endothelial Keratoplasty

Herein, we report two clinical cases with acute temporary filtering bleb obstruction by gas tamponade after Descemet membrane endothelial keratoplasty (DMEK) surgery and postoperative intraocular pressure (IOP) peaks. Both patients underwent uncomplicated DMEK surgery with 20% sulfur hexafluoride (SF6) anterior chamber tamponade and had previous trabeculectomy for glaucoma. Prior to surgery, both patients showed patent bleb function with low to normal IOP without antiglaucomatous medication. After uneventful DMEK surgery, both patients showed postoperative IOP peaks of up to 50 mm Hg despite patent inferior iridotomy and no sign of a pupillary block. In both cases, SF6 gas bubbles could be visualized obstructing the bleb. Both patients were treated with IOP-lowering agents topically as well as systemically. In addition, anterior chamber paracenteses were performed to reduce the SF6 volume within the anterior chamber. Under this treatment, IOP normalized within the first 18 h after surgery. We hypothesize that the SF6 gas tamponade from the anterior chamber migrates into the ostium and below the bleb, leading to an acute temporary insufficiency of bleb function and to a consecutive IOP peak after surgery. In contrast to a pupillary block, this mechanism cannot be antagonized by preoperative iridotomy and needs to be taken into account for every glaucoma patient with functional bleb undergoing DMEK surgery

Follow-up of the GHSG HD16 trial of PET-guided treatment in early-stage favorable Hodgkin lymphoma.

The primary analysis of the GHSG HD16 trial indicated a significant loss of tumor control with PET-guided omission of radiotherapy (RT) in patients with early-stage favorable Hodgkin lymphoma (HL). This analysis reports long-term outcomes. Overall, 1150 patients aged 18-75 years with newly diagnosed early-stage favorable HL were randomized between standard combined-modality treatment (CMT) (2x ABVD followed by PET/CT [PET-2] and 20 Gy involved-field RT) and PET-2-guided treatment omitting RT in case of PET-2 negativity (Deauville score [DS] < 3). The study aimed at excluding inferiority of PET-2-guided treatment and assessing the prognostic impact of PET-2 in patients receiving CMT. At a median follow-up of 64 months, PET-2-negative patients had a 5-year progression-free survival (PFS) of 94.2% after CMT (n = 328) and 86.7% after ABVD alone (n = 300; HR = 2.05 [1.20-3.51]; p = 0.0072). 5-year OS was 98.3% and 98.8%, respectively (p = 0.14); 4/12 documented deaths were caused by second primary malignancies and only one by HL. Among patients assigned to CMT, 5-year PFS was better in PET-2-negative (n = 353; 94.0%) than in PET-2-positive patients (n = 340; 90.3%; p = 0.012). The difference was more pronounced when using DS4 as cut-off (DS 1-3: n = 571; 94.0% vs. DS ≥ 4: n = 122; 83.6%; p < 0.0001). Taken together, CMT should be considered standard treatment for early-stage favorable HL irrespective of the PET-2-result

Optical Coherence Tomography in Parkinsonian Syndromes

BACKGROUND/OBJECTIVE: Parkinson's disease (PD) and the atypical parkinsonian syndromes multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are movement disorders associated with degeneration of the central nervous system. Degeneration of the retina has not been systematically compared in these diseases. METHODS: This cross-sectional study used spectral-domain optical coherence tomography with manual segmentation to measure the peripapillar nerve fiber layer, the macular thickness, and the thickness of all retinal layers in foveal scans of 40 patients with PD, 19 with MSA, 10 with CBS, 15 with PSP, and 35 age- and sex-matched controls. RESULTS: The mean paramacular thickness and volume were reduced in PSP while the mean RNFL did not differ significantly between groups. In PSP patients, the complex of retinal ganglion cell- and inner plexiform layer and the outer nuclear layer was reduced. In PD, the inner nuclear layer was thicker than in controls, MSA and PSP. Using the ratio between the outer nuclear layer and the outer plexiform layer with a cut-off at 3.1 and the additional constraint that the inner nuclear layer be under 46 µm, we were able to differentiate PSP from PD in our patient sample with a sensitivity of 96% and a specificity of 70%. CONCLUSION: Different parkinsonian syndromes are associated with distinct changes in retinal morphology. These findings may serve to facilitate the differential diagnosis of parkinsonian syndromes and give insight into the degenerative processes of patients with atypical parkinsonian syndromes

Cionni capsular tension ring implantation in Marfan's syndrome

Progress is being made in dealing with Marfan's syndrome, but careful surgical planning decisions are still necessar

Surgical Options in Glaucoma Management

During the last few years, there has been a considerable capacity of innovations in glaucoma surgery owing to new micro-stents increasing the aqueous outflow via transscleral routes, via the trabecular meshwork or the suprachoroidal space. These interventions can be easily performed in combination with small-incision cataract surgery. Even the well-known filtering procedures, trabeculectomy and drainage device surgery, formerly perceived as being outdated, reachieve better reputation owing to refinements in surgical technique and improved surgical experience. Although enthusiasm is understandable, considering the technical advances, we must wait for clinical long-term results and compare the new procedures with the established ones

Surgical Options in Glaucoma Management

During the last few years, there has been a considerable capacity of innovations in glaucoma surgery owing to new micro-stents increasing the aqueous outflow via transscleral routes, via the trabecular meshwork or the suprachoroidal space. These interventions can be easily performed in combination with small-incision cataract surgery. Even the well-known filtering procedures, trabeculectomy and drainage device surgery, formerly perceived as being outdated, reachieve better reputation owing to refinements in surgical technique and improved surgical experience. Although enthusiasm is understandable, considering the technical advances, we must wait for clinical long-term results and compare the new procedures with the established ones