Сравнительная оценка эффективности и безопасности 12-часового и 21-часового протоколов введения ацетилцистеина при отравлении парацетамолом

Background. Acetylcysteine (ACC) is an effective antidote for paracetamol poisoning. There are various schemes for its application. At the same time, there is currently no information about the most priority of them in this pathology. Few studies indicate the effectiveness of the 12-hour protocol for ACC administration in paracetamol poisoning. However, there were not enough justifications for the introduction of a modified 12-hour scheme into world practice.The objective was to compare the effectiveness of the 12-hour and 21-hour protocols for the administration of acetylcysteine in paracetamol poisoning.Materials and methods. 43 patients with acute paracetamol poisoning were examined. The study group (prospective) consisted of 23 patients who underwent the 12-hour ACC protocol; the comparison group (retrospective) with the 21-hour ACC protocol included 20 patients. Groups were comparable. The endpoints were: ALT blood level, the frequency of allergic reactions, the duration of treatment in the ICU, the duration of stay in the hospital.Results. The 12-hour and 21-hour protocols for intravenous administration of ACC in case of paracetamol poisoning are equally effective in preventing liver damage, as evidenced by the results of the study: in both groups, when the antidote was started early (in the first 8 hours), there was no increase in ALT levels. The use of the 12-hour protocol for intravenous administration of ACC leads to a reduction in the duration of stay in the ICU by 1.5 times (p = 0.001), the duration of hospital treatment by 1.3 times (p = 0.052) compared to the 21-hour protocol. The frequency of allergic reactions during the 21-hour protocol of ACC administration was 10%; with the 12-hour ACC scheme, no allergic reactions were noted.Conclusions. The data obtained show that both protocols for the administration of ACC, when used early, are equally effective in preventing toxic liver damage, while the administration of ACC according to the 12-hour protocol leads to fewer adverse reactions, a reduction in the duration of stay in the ICU and the duration of hospitalization.Актуальность. Ацетилцистеин (АЦЦ) является эффективным антидотом при отравлении парацетамолом. Существуют различные схемы его применения – при этом в настоящее время отсутствуют сведения о наиболее приоритетной из них при данной патологии. Немногочисленные исследования указывают на эффективность 12-часового протокола введения АЦЦ при отравлениях парацетамолом. Однако для внедрения в мировую практику модифицированной 12-часовой схемы не хватило обоснований.Цель – сравнение эффективности применения 12-часового и 21-часового протоколов введения ацетилцистеина при отравлениях парацетамолом.Материалы и методы. Обследованы 43 пациента с острым отравлением парацетамолом. Исследуемую группу (проспективную) составили 23 больных, которым проводили 12-часовой протокол АЦЦ, в группу сравнения (ретроспективную) с использованием 21-часового протокола АЦЦ вошли 20 пациентов. Группы были сопоставимы. Конечными точками являлись: уровень АЛТ в крови, частота аллергических реакций, длительность лечения в реанимации, срок нахождения в стационаре.Результаты. 12-часовой и 21-часовой протоколы внутривенного введения АЦЦ при отравлении парацетамолом одинаково эффективны в отношении профилактики поражения печени, о чем свидетельствовали результаты исследования: в обеих группах при раннем начале введения антидота (в первые 8 часов) повышения уровня АЛТ не было отмечено. Применение 12-часового протокола внутривенного введения АЦЦ приводит к сокращению срока пребывания в реанимационном отделении в 1,5 раза (р = 0,001), длительности лечения в стационаре в 1,3 раза (р = 0,034) по сравнению 21-часовым протоколом. Частота возникновения аллергических реакций при проведении 21-часового протокола введения АЦЦ составляла 10%, при 12-часовой схеме АЦЦ аллергических реакций отмечено не было.Выводы. Полученные данные показывают, что оба протокола введения АЦЦ при раннем их применении одинаково эффективны в профилактике токсического поражения печени, при этом введение АЦЦ по 12-часовому протоколу приводит к меньшему числу нежелательных реакций, сокращению срока пребывания в реанимации и длительности госпитализации

Thermal decomposition of ammonium hexachloroosmate

Structural changes of (NH4)2[OsCl6] occurring during thermal decomposition in a reduction atmosphere have been studied in situ using combined energy-dispersive X-ray absorption spectroscopy (ED-XAFS) and powder X-ray diffraction (PXRD). According to PXRD, (NH4)2[OsCl6] transforms directly to metallic Os without the formation of any crystalline intermediates but through a plateau where no reactions occur. XANES and EXAFS data by means of Multivariate Curve Resolution (MCR) analysis show that thermal decomposition occurs with the formation of an amorphous intermediate {OsCl4}x with a possible polymeric structure. Being revealed for the first time the intermediate was subjected to determine the local atomic structure around osmium. The thermal decomposition of hexachloroosmate is much more complex and occurs within a minimum two-step process, which has never been observed before

Novel avian paramyxovirus isolated from gulls in Caspian seashore in Kazakhstan.

Three isolates APMV/gull/Kazakhstan/5976/2014, APMV/gull/Kazakhstan/ 5977/2014 and APMV/gull/Kazakhstan/5979/2014, were obtained from independent samples during annual surveillance for avian influenza and paramyxoviruses in wild birds from the Caspian Sea coast in Western Kazakhstan, and were initially identified as putative paramyxoviruses on the basis of electron microscopy. Hemagglutination Inhibition Assays with antisera to nine known APMV serotypes (APMV1-9) indicated no relation to any of them. Next generation sequencing of whole genome sequences indicated the three isolates were genetically identical, and had a nucleotide structure typical for all APMVs, consisting of six genes 3'-NP-P-M-F-HN-L-5'. Phylogenetic analyses, and assessment of amino acid identities, suggested the most closely related lineages to be APMV-2, 8, 10 and 15, but the novel isolate had less than 64% identity to them and all other known avian paramyxoviruses. This value was above levels considered to generally define other APMV serotypes. Estimates of the evolutionary divergence of the nucleotide sequences of the genomes of APMVs have shown that novel Kazakhstan APMV strain was closest to APMV-2, APMV-8, APMV-10 and APMV-15, with calculated distance values of 2.057, 2.058, 2.026 and 2.286 respectively, which is above values considered to differentiate other serotypes (observed minimum was 1.108 between APMV-1 and recently isolated APMV/UPO216/Korea). Together, the data suggest that isolate APMV/gull/Kazakhstan/5976/2014 and other two should be considered as the first representative of a novel APMV-20 group, and is the first time that avian paramyxoviruses have been found infecting members of the gull family, extending the known taxonomic host range

Thermal Decomposition of Co-Doped Calcium Tartrate and Use of the Products for Catalytic Chemical Vapor Deposition Synthesis of Carbon Nanotubes.

Thermal decomposition of Co-doped calcium tartrate in an inert atmosphere or air was studied using thermogravimetric analysis and X-ray absorption fine structure (XAFS) spectroscopy. It was shown that the powder substance containing 4 at.% of cobalt completely decomposes within 650-730 °C, depending on the environment, and the formation of Co clusters does not proceed before 470 °C. The products of decomposition were characterized by transmission electron microscopy, XAFS, and X-ray photoelectron spectroscopy. Surfaceoxidized Co metal nanoparticles as large as ∼5.6 ( 1.2 nm were found to form in an inert atmosphere, while the annealing in air led to a wide distribution of diameters of the nanoparticles, with the largest nanoparticles (30-50 nm) mainly present as a Co3O4 phase. It was found that the former nanoparticles catalyze the growth of CNTs from alcohol while a reducing atmosphere is required for activation of the latter nanoparticles. We propose the scheme of formation of CaO-supported catalyst from Co-doped tartrate, depending on the thermal decomposition conditions

Changes in daily temperature and precipitation extremes in central and south Asia

Changes in indices of climate extremes are studied on the basis of daily series of temperature and precipitation observations from 116 meteorological stations in central and south Asia. Averaged over all stations, the indices of temperature extremes indicate warming of both the cold tail and the warm tail of the distributions of daily minimum and maximum temperature between 1961 and 2000. For precipitation, most regional indices of wet extremes show little change in this period as a result of low spatial trend coherence with mixed positive and negative station trends. Relative to the changes in the total amounts, there is a slight indication of disproportionate changes in the precipitation extremes. Stations with near-complete data for the longer period of 1901-2000 suggest that the recent trends in extremes of minimum temperature are consistent with long-term trends, whereas the recent trends in extremes of maximum temperature are part of multidecadal climate variability