TENEKTEPLASE: NEW POSSIBILITIES FOR SYSTEMIC THROMBOLYTIC THERAPY OF ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION

Possibilities to use and advantages of a new tissue plasminogen activator (tenekteplase) in patients with acute coronary syndrome (ACS) with ST segment elevation are discussed. The main factor of tenekteplase successful implementation is the time. Comparative studies of tenekteplase and other tissue plasminogen activator are presented. Efficacy of thrombolytic therapy and percutaneous coronary interventions is compared. Data from multicenter randomized clinical trials about combined use of tenekteplase and enoxaparin and unfractionated heparin in the hospital is discussed. Data about safety of tenekteplase in treatment of ACS with ST segment elevation is given

Portable neutron/gamma scintillation detector for status monitoring of accelerator-driven neutron source IREN

Accelerator-driven system (ADS) facilities world-wide opens new opportunities for nuclear physics investigations, so that a high flux of neutrons through spallation reactions can be produced at these facilities. It is known that the measurement, continuous monitoring and optimization of the particle accelerator beam intensity are among the most important actions in the operation of such facilities. Considering this point of view, this paper presents a neutron/gamma counter based on a micropixel avalanche photodiode (MAPD) and a plastic scintillator that monitors the status of the accelerator-driven intense resonance neutron source (IREN) facility by measuring the neutron-gamma intensity in the target hall. The electronics of the modular neutron counter has been designed and developed, including a bias voltage source (up to 130 V), a preamplifier (36 gain) and discriminator (>10 mV) circuit. The last product of MAPD (operation voltage- 55 V, PDE- 33 %, total number of pixels- 136900) was used as a photon readout from a plastic scintillator. The sensitive area of MAPD was 3.7*3.7 mm2 and the size of the plastic scintillator 3.7*3.7*30 mm3. The measurement was carried out in the IREN target hall, where it was necessary to monitor not only high neutron fluxes, but also gamma quanta. The experimental results demonstrated a dependence between the count rate of the detector and the frequency of the accelerator, which ranges from 2 to 50 Hz.Comment: 8 pages, 7 figure

Автоматизованая система для измерения декремента электрокожного сопротивления человека

Показано, що вимірювання електрошкіряного опору (ЕШО) з використанням тестуючих сигналів є недостатньо точними У статті запропонована автоматизована система для вимірювання динаміки ЕШО без тестуючих сигналів, яка використовує радіотеплові сигнали біологічно активних точок (БАТ). На основі цих уявлень отримані математичні вирази для оцінки динаміки ЕШО. Автоматизована система з логарифмічним перетворювачем дозволяє оцінювати декремент електрошкіряного опору людини як його діагностичний показник. Розглянуто функціональна схема автоматизованої вимірювальної системи, принцип і алгоритм обробки сигналу. Показано, що даний спосіб та розроблена автоматизована система дозволяє підвищити точність і забезпечує повну безпеку електропунктурної діагностики.It is shown that the measurement electroscrap resistance (ESR) using test signals are not accurate enough In the article we propose an automated system to measure the dynamics of ESR without testing signals, which uses thermal signals of biologically active points (BAP). On the basis of these representations the mathematical expression for the dynamics of ESR. Automated system with logarithmic Converter allows to estimate the decrement electroscrap resistance as a diagnostic indicator. The functional diagram of the automated measuring system, the principle and algorithm of signal processing. It is shown that this method can improve the accuracy of an automated system for measuring the decrement ESR eschau at their own noise fluctuations human, which use the circuit compared with loharyfmatorom and built-in microcomputer CPU, which excludes the impact of volatility parameters of the circuit elements and the comparison of its own noise. The system provides eschau count decrement ESR in logarithmic units with large uneven resistance in acupuncture points and beyond, which significantly expands the dynamic range comparable resistance and provides visibility and comparability of diagnostic results.Показано, что измерение электрокожного сопротивления (ЭКС) с использованием тестових сигналов является недостаточно точным. В статье предложена автоматизированная система для измерения динамики ЭКС без тестовых сигналов, с использованием радиотепловых собственных злучений биологеских активных точок (БАТ). На основании этих представлений получены математические соотношения для оценки динамики ЭКС. Автоматизированная система с логарифмическим преобразователем позволяєт оценивать декремент электрокожного сопротивления человека в виде диагностического показателя. Рассмотрена функциональная схема автоматизированной измерительной системы, принцип и алгоритм обработки сигнала. Показано, что такой поход и разработанная автоматизированная система позволяют увеличить точность и обеспечивают полную безопасность электропунктурной диагностики

Pedographic assessment of the impact of off-the-shelf orthopedic shoes on the load distribution under the feet in patients with a high risk of developing diabetic foot syndrome

BACKGROUND: It is known that the so-called “rocker” outsole helps to reduce the load on the forefoot and toes. Such an outsole is available in ready-made orthopedic shoes of some Russian manufacturers, however, an objective assessment of their impact on the load distribution under the foot during walking has not been carried out.AIMS: To study the pressure distribution inside the off-the-shelf orthopedic shoes“Sursil-Ortho” in comparison with the load inside the shoes used by patients on a daily basis.METHODS: We studied 20 patients (40 feet) with a high risk of diabetic foot syndrome. According to clinical data, a risk regions were determined on the plantar surface of the feet. In-shoe pedography (pedar, novel,Germany) was performed in shoes usually worn by the patients, and in orthopedic shoes“Sursil-Orto”(Moscow). The maximum peak pressure (MPP) was calculated. Criterion of efficiency: MPP in the risk region<200 kPa or reducing it by 25% or more.RESULTS: There was a significant decrease of the median MPP in the forefoot and in the risk region. The percentage of feet with MPP >200 kPa in the risk region decreased from 58% to 30% (p=0,014), in any area of the forefoot — from 63% to 30% (p=0,04). The increase in MPP under the midfoot and hindfoot did not exceed +14% (ns). Tested footwear was effective in 71% of cases. Predictors of the insufficient effect were: higher initial MPP in the risk region, risk region on the hallux or in the lateral part of the forefoot.CONCLUSIONS: Shoes with a rigid rocker outsole significantly reduce the pressure under the forefoot and under the toes during walking. The degree of load reduction varies: the lateral part of the forefoot and 2-5 toes are most unloaded, and the hallux and medial forefoot are slightly less

Effectiveness of offloading interventions to heal foot ulcers in persons with diabetes: a systematic review

Background Offloading interventions are commonly used in clinical practice to heal foot ulcers. The aim of this updated systematic review is to investigate the effectiveness of offloading interventions to heal diabetic foot ulcers. Methods We updated our previous systematic review search of PubMed, EMBASE, and Cochrane databases to also include original studies published between July 29, 2014 and August 13, 2018 relating to four offloading intervention categories in populations with diabetic foot ulcers: (a) offloading devices, (b) footwear, (c) other offloading techniques, and (d) surgical offloading techniques. Outcomes included ulcer healing, plantar pressure, ambulatory activity, adherence, adverse events, patient‐reported measures, and cost‐effectiveness. Included controlled studies were assessed for methodological quality and had key data extracted into evidence and risk of bias tables. Included non‐controlled studies were summarised on a narrative basis. Results We identified 41 studies from our updated search for a total of 165 included studies. Six included studies were meta‐analyses, 26 randomised controlled trials (RCTs), 13 other controlled studies, and 120 non‐controlled studies. Five meta‐analyses and 12 RCTs provided high‐quality evidence for non‐removable knee‐high offloading devices being more effective than removable offloading devices and therapeutic footwear for healing plantar forefoot and midfoot ulcers. Total contact casts (TCCs) and non‐removable knee‐high walkers were shown to be equally effective. Moderate‐quality evidence exists for removable knee‐high and ankle‐high offloading devices being equally effective in healing, but knee‐high devices have a larger effect on reducing plantar pressure and ambulatory activity. Low‐quality evidence exists for the use of felted foam and surgical offloading to promote healing of plantar forefoot and midfoot ulcers. Very limited evidence exists for the efficacy of any offloading intervention for healing plantar heel ulcers, non‐plantar ulcers, and neuropathic ulcers with infection or ischemia. Conclusion Strong evidence supports the use of non‐removable knee‐high offloading devices (either TCC or non‐removable walker) as the first‐choice offloading intervention for healing plantar neuropathic forefoot and midfoot ulcers. Removable offloading devices, either knee‐high or ankle‐high, are preferred as second choice over other offloading interventions. The evidence bases to support any other offloading intervention is still weak and more high‐quality controlled studies are needed in these areas

Distribution of Infectious Diseases Significant for Sanitary Protection of the Territory of the Russian Federation in the WHO European Region

The review presents generalized epidemiological data and the situation on infectious diseases requiring measures for the sanitary protection of the territory of the Russian Federation in the countries of the European Region of the World Health Organization (WHO). The epidemiological analysis was carried out using data from the official websites and periodicals of WHO, the WHO European Office, the ministries of health of countries, the European Center for Disease Prevention and Control, other international organizations, as well as materials from publicly available publications. The review summarizes and systematizes data on the incidence and territorial distribution of diseases in each specific country from the standpoint of possible risks for people visiting it. The presented data on infectious diseases make it possible to navigate through issues related to the risk of contracting infectious diseases, to determine the factors and seasonality of an increased risk of infection, and to predict the possibility of importing diseases into the Russian Federation

Concerning Two-Level Structure of Potential Epidemic Hazard of the Mass Events with International Participation

The paper discusses epidemiological environment of particular countries and parts of the world viewed as potential platforms for mass events with international participation. It is established that the most unfavorable in this respect are Asian countries, primarily South-Eastern Asia ones, and African ones, from where the majority of well-known pandemics and epidemics have originated. Specified are the factors which are significant for spread of infectious diseases that can trigger emergency situation of sanitary epidemiological character of international concern. They are tourism and migration, trade and economic affairs, natural and anthropogenic disasters. The concept - “potential epidemic hazard of mass events with international participation” - is defined. It is demonstrated that its structure comprises two levels: the natural background of endemic and imported as related to mass event region epidemiological hazards, and epidemiological hazards imposed by the event itself. Outlined is a step-by-step algorithm for assessment of “potential epidemic hazard” of mass events with international participation allowing for adjustment of measures for the provision of sanitary and epidemiological welfare of the population

Dissemination of Infectious Diseases Significant for the Sanitary Protection of the Territory of the Russian Federation in East-Mediterranean Region

Objective of the study is to generalize epidemiological data and assess the situation in the countries of East-Mediterranean region on infectious diseases that require the measures on sanitary protection of the territory of the Russian Federation, CIS member-states, and Eurasian Economic Union. Materials and methods. Epidemiological analysis was carried out using the data of official websites and periodical publications of WHO, WHO East-Mediterranean Office, National Health Ministries, Center for Disease Control and Prevention, other international organizations and open-access literature sources. Results and conclusions. Systematized and summarized have been the data on morbidity rates and spatial dissemination of diseases in each particular country from the point of view of possible risks to visiting them individuals. The data presented on the infectious diseases allow for addressing the issues associated with the risk of infection; identification of the factors and terms of high risk of infection; for forecasting the probability of disease importation into the Russian Federation. The information may prove to be useful for quantitative and qualitative evaluation of potential epidemic hazard in the course of sanitary-epidemiological welfare provision under international mass events

Improvement of the Preventive Measures for Managing Universiade-2013 Held in Kazan, Based on Comprehensive Evaluation of Epidemiological Risks as Regards Natural-Focal Infectious Diseases

Presented is the methodology for comprehensive evaluation of epidemiological risks (spatial and temporal characteristics, risk factors and cohorts) associated with natural-focal infectious diseases that pose a threat to sanitary-epidemiological welfare of the population within the frames of Universiade-2013. The event has been characterized from the viewpoint of mass gathering taking into consideration the complex of related threats to sanitary-epidemiological welfare of the population. Analyzed has been regional epidemiological situation on the currently important infections, whereas natural-focal infections have been assessed in reference to epidemiological risk. Based on the comprehensive evaluation with GIS software application differentiated have been the territories against the level of potential epidemiological hazard, put forward has been methodological approach to non-specific prophylaxis of natural-focal infectious diseases. Discussed have been the fundamentals of the approach, herewith it has been demonstrated that justified selection of internal threat and identification of spatial risk factors, as well as nature, scope and timing of the preventive measures ensure provision of favorable epidemiological situation as seen in the case of Universiade-2013