TRENDS IN PREVALENCE OF ASTHMA IN CHILDREN BY THE EXAMPLE OF THE KYIV REGION OF UKRAINE

Asthma constitute a significant cause of morbidity worldwide and a considerable burden on the health and medical systems of both developed and emerging economies. The article presents the results of the study of the prevalence of asthma symptoms in children of different ages (from 0 to 18 years) in the Kyiv region of Ukraine. Quite high levels of “wheezing in the past 12 months” are noted: 6 mounth-5 years – 24,6%; 6-7 years – 18,7%; 13-14 years – 12,6%; 15-17 years -9,2%. But at the same time, the low level of asthma diagnosis remains an important problem in Ukraine. The levels of asthma symptoms, which may indicate a severe course of the disease, are also quite high. The article presents the results of similar studies in other countries for comparison.Asthma constitute a significant cause of morbidity worldwide and a considerable burden on the health and medical systems of both developed and emerging economies. The article presents the results of the study of the prevalence of asthma symptoms in children of different ages (from 0 to 18 years) in the Kyiv region of Ukraine. Quite high levels of “wheezing in the past 12 months” are noted: 6 mounth-5 years – 24,6%; 6-7 years – 18,7%; 13-14 years – 12,6%; 15-17 years -9,2%. But at the same time, the low level of asthma diagnosis remains an important problem in Ukraine. The levels of asthma symptoms, which may indicate a severe course of the disease, are also quite high. The article presents the results of similar studies in other countries for comparison

Ocean sound channel ray path perturbations from internal-wave shear and strain

Author Posting. © Acoustical Society of America, 2005. This article is posted here by permission of Acoustical Society of America for personal use, not for redistribution. The definitive version was published in Journal of the Acoustical Society of America 118 (2005): 2899-2903, doi:10.1121/1.2062127.The relative importance of internal-wave strain and internal-wave shear on perturbation of acoustic ray trajectories in the ocean is analyzed. Previous estimates based on the Garrett-Munk internal-wave spectral model are updated using data from recent field studies of internal waves. Estimates of the ratio of the rms shear effect to the rms strain effect based on data from the upper kilometer of ocean are as high as 0.25–0.4, exceeding the estimates of 0.08–0.17 stemming from the model. Increased strength of three phenomena that have shear to strain ratios higher than the internal-wave average can cause this effect. These are near-inertial waves, internal tides, and vortical modes.This work was funded by grants from the U.S. Office of Naval Research

The ultrasonically guided percutaneous nephrostomy by trocar – the indications and efficacy

Catedra de Oncologie, Universitatea de Stat de Medicină și Farmacie ”Nicolae Testemițanu”, IMSP Institutul Oncologic, Chișinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Nefrostomia percutanată ecoghidată (NPC) este o procedură intervențională minim-invazivă utilizată pentru decompresia sistemului pielo-caliceal renal. În 1955, Goodwin, a publicat un raport care descrie această procedură. Uropatia obstructivă este o afecțiune întâlnită frecvent în tumorile organelor bazinului mic şi constituie aprox. 25% în structura maladiilor oncologice. NPC se poate efectua prin 2 metode: - clasică - prin trocar (unimomentană ) TrNPC Material şi metode: Lotul de studiu a constituit 50 pacienți, tratați în perioada 2016-2019 în departamentul de urologie a IMSP IO, cărora le-au fost aplicate 70 de TrNPC. Metoda a fost implimentată cu succes, iar materialul publicat este propria experiență. Rezultate: Instrumentarul utilizat: ecograful și sonda abdominală cu ghidaj, set de nefrostomie, trocar N9 Fr. Din lotul constituit, femei au fost - 37 (74%) și - 14 (28%) bărbați, vârsta medie fiind de 62 ani. Dintre aceștia, 28 (56%) – bolnavi la prima adresare, 22 (44%) – adresare repetată. Indicațiile pentru TrNPC: pacienții cu tumori avansate ale bazinului mic cu diferite grade de hidronefroză. TrNPC s-au instalat: pe stânga la 19 pacienți, pe dreapta 15, iar 18 pacienți bilateral. În dependență de stadiul tumoral: stadiul I - 2(4%), stadiul II – 3(6%), stadiul III-IV - 45 (90%). Pentru pacienții cu stadiile I – II de boală, indicațiile către TrNPC a servit: traumatismul iatrogen intraoperator sau strictura anastamozei uretero-intestinale postoperatorii. Complicații întâlnite: hemoragie difuză – 2(4%), dislocația drenului cu reinstalarea acestuia 3(6%). Concluzii: 1.TrNPC este o metoda unimomentană mult mai efectivă şi sigură în drenarea obstrucțiilor infra renale în compaţie cu NPC clasică. 2. Având complicații minime TrNPC poate fi efectuată în condiții de ambulatoriu.Background: Ultrasound-guided percutaneous nephrostomy (PNE) is a minimally invasive method used to decompress the renal pyelocalcal system. Goodwin in 1955 published a report describing this procedure. Obstructive uropathy is a common disease founded in pelvic organ tumors and constitutes - 25% of all oncological diseases. PNE can be performed by 2 methods: - classic (multiple maneuvers) - by trocar ( unimoment method ) Methods and materials: The study group consists of 50 patients treated during the 2016-2019 period in the urology department of the IMSP IO, 70 TrPNEs being applied. The method was successfully implemented and the material is own experience. Results: The used instruments: ultrasound scan, abdominal guided catheter, nephrostomy set, trocar N9 Fr. Of the patients group, women were - 37 (74%), men were - 14 (28%), the mean age was 62 years. From them 28 (56%) were first addressed patients and 22 (44%) were patients at secondary address. The TrPNEs indications were: advanced pelvic tumors with clinical manifested hidronefrose. Were performed TrPNE: on the left at 19 patients, on the right at 15 patients, bilateral at 18 patients. The tumor grade: I degree – 2 (4%), II degree – 3 (6%), III – IV degree – 45 (90%). For the I – II degree the TrPNEs indication was the iatrogenic trauma or the ureter-intestinal anastomose stricture. The procedural complications: diffuse haemorrhage – 2 (4%), PNE tube complications 3 (6%). Conclusions: 1.TrPNE it is a more effective and safely unimoment method used for the infrarenal obstructions then the classic method. 2. TrPNE has minimal complications, also it is possible to use the procedure in ambulatory conditions

The retroperitoneal sarcomas – the experience of single centre

Catedra de Oncologie, Universitatea de Stat de Medicină și Farmacie ”Nicolae Testemițanu”, IMSP Institutul Oncologic, Chișinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Sarcoamele retroperitoneale (SRP) constituie un grup heterogenic de tumori maligne. Criteriile comune ale acestor tumori sunt: regiunea anatomică în care se dezvoltă; proveniența mezenchimală; clinică silențioasă; rata înaltă a recurenței. RPS constituie 1/3 dintre toate tumorile retroperitoneumului și constituie aproximativ 15% dintre toate sarcoamele țesuturilor moi. Succesul tratamentului constă în diagnosticul precoce și radicalitatea actului chirurgical. Material și metode: lotul de studiu a fost constituit din 217 pacienți ai serviciului Gastrologie a IMSP IO, Chișinău, între anii 2005- 2019. Materialul histologic a fost examinat de un expert morfopatolog, Rezultate: Pentru diagnostic au fost utilizate USG, CT, MRI și examinarea histologică a materialului histologic obținut prin biopsie sau înlăturarea tumorii în întregime. Din totalul de 217 pacienți cu TRP, în 82 cazuri (36 bărbați și 46 femei, vârsta medie constituind 54,52 ani) au fost determinate una din formele histologice de SRP ceea ce a constituit 37,20%. Formele histologice identificate: liposarcom -23 cazuri (28,04%), leiomiosarcom – 20 cazuri (24,39%), histiocitom fibros malign 16 cazuri (19,51%), fibrosarcom – 6 cazuri (7,31%), angiosarcom 4 cazuri (4,87%), hemangiopericitom - 3 cazuri (3,65%), sarcom nediferențiat - 10 cazuri (12,19%). Tratamentul chirurgical radiacal a fost posibil de efectuat în 70 cazuri (85,36%), într-un caz s-a efectuat intervenție chirurgicală citoreductivă (1,21%), și în 10 cazuri (12,19%) s-a efectuat laparotomie de diagnostic. Pentru asigurarea radicalității în 27 cazuri (32,92%) s-a efectuat excizia ”en bloc”: în 17 cazuri (24,28%) cu un organ, în 8 cazuri (9,75 %) – 2 organe și într-un caz (1,42%) – 3 organe. Cele mai sacrificate organe au fost: rinichi – 10 cazuri (14,28%), colon - 6 cazuri (8,57%), intestin subțire - 6 cazuri (8,57%), splină - 4 cazuri (4,87%), glanda suprarenală - 2 cazuri (2,85%), pancreas - 2 cazuri (2,43%), stomac - 1 caz (1,42%). Rata recurențelor a constituit 25,61%. Concluzii: Sarcoamele retroperitoneale constituie cea mai întânită entitate nozologică dintre TRP în corpul uman, se caracterizează prin heterogenitate morfologică și are un tablou clinic nespecific. Deseori, asigurarea radicalități tratamentului chirurgical este necesară sacrificarea unui organ adiacent ca rinichi, colon, intestin subțire, splină.Background: Retroperitoneal sarcomas (RPS) represent a heterogenic group of malignant tumors. The common criteria of this group are: the common anatomical base; the mesenchymal origin of the tumor; the silent clinical manifestation; the high frequency of recurrence. RPS constitutes one-third of the malignant tumors occurring in retroperitoneum and accounting for approximately 15% of the soft tissue sarcomas of the human body. The success of treatment depends on early diagnosis and radical surgery. Methods and materials: the study group consists of 217 patients with primitive retroperitoneal tumors (PRT), reviewed by an expert pathologist, during the period 2005-2019 from the Gastrology clinic of IMSP IO Chisinău. Results: For diagnostic purpose following investigations were applied: USG, CT, MRI and histological exam of biopsy specimen of removed tumor. From the group of 217 patients with PRT we identified one of the histological forms of sarcoma in 82 cases (37,20%; 36 men and 46 women, average age 54,52 years). Identified histological forms are: liposarcoma - 23 cases (28,04%), leiomyosarcoma – 20 cases (24,39%), malign fibrous histiocytoma - 16 cases (19,51%), fibrosarcoma – 6 cases (7,31%), angiosarcoma - 4 cases (4,87%), hemangiopericytoma - 3 cases (3,65%), unclassified sarcoma - 10 cases ( 12,19%). Radical surgical treatment was performed in 70 cases (85,36%), in one case was performed cytoreductive surgery (1,21%), and in 10 cases (12,19%) was performed laparotomy of evaluation. To ensure the radicality in 27 cases (32,92%) was performed excision ”en bloc”: in 17 cases (24,28%) one organ, 8 cases (9,75 %) – 2 organs and 1 case (1,42%) – 3 organs. Slaughtered organs were: kidney – 10 cases (14,28%), colon - 6 cases (8,57%), small intestine - 6 cases (8,57%), spleen - 4 cases (4,87%), adrenal gland - 2 cases (2,85%), pancreas - 2 case (2,43%), stomach - 1 case (1,42%). The rate of recidivism recorded is 25,61%. Conclusion: The retroperitoneal sarcoma is the most common primitive retroperitoneal tumor in human body, that is characterized by morphological heterogeneity and it has an unspecific clinical manifestation. Often to ensure the radicality of surgery, it is necessary to sacrifice some adjacent organs (kidney, colon, small intestine, spleen)

Classification of newborn EEG maturity with Bayesian averaging over decision trees

EEG experts can assess a newborn’s brain maturity by visual analysis of age-related patterns in sleep EEG. It is highly desirable to make the results of assessment most accurate and reliable. However, the expert analysis is limited in capability to provide the estimate of uncertainty in assessments. Bayesian inference has been shown providing the most accurate estimates of uncertainty by using Markov Chain Monte Carlo (MCMC) integration over the posterior distribution. The use of MCMC enables to approximate the desired distribution by sampling the areas of interests in which the density of distribution is high. In practice, the posterior distribution can be multimodal, and so that the existing MCMC techniques cannot provide the proportional sampling from the areas of interest. The lack of prior information makes MCMC integration more difficult when a model parameter space is large and cannot be explored in detail within a reasonable time. In particular, the lack of information about EEG feature importance can affect the results of Bayesian assessment of EEG maturity. In this paper we explore how the posterior information about EEG feature importance can be used to reduce a negative influence of disproportional sampling on the results of Bayesian assessment. We found that the MCMC integration tends to oversample the areas in which a model parameter space includes one or more features, the importance of which counted in terms of their posterior use is low. Using this finding, we proposed to cure the results of MCMC integration and then described the results of testing the proposed method on a set of sleep EEG recordings