222 research outputs found
Пролонгована місцева анестезія при інгвінальній герніопластиці
The aim of the work: to improve the results of surgical treatment of inguinal hernias by developing an effective and safe method of postoperative analgesia.
Materials and Methods. The article describes a new method of postoperative analgesia in patients who underwent Lichtenstein open alloplasty of inguinal hernia. The essence of the method is the input of catheter for prolonged injection of local anesthetic into the postoperative wound during surgery (before closing the wound) under direct visual control of the catheter for prolonged injection of local anesthetic into the postoperative wound area. Hernioplasty was performed under spinal anesthesia, in the postoperative period through a catheter was injected bolus of 0.25 % lidocaine. The technique was used in 11 patients.
Results and Discussion. In all cases, it was possible to abandon the use of narcotic analgesics and achieve good control of postoperative pain. In comparison with the traditional management of the postoperative period in patients with prolonged local anesthesia, motor activity was restored more quickly, the duration of hospitalization was reduced. There were no complications.Цель работы: улучшение результатов хирургического лечения паховых грыж путем разработки эффективного и безопасного метода послеоперационного обезболивания.
Материалы и методы. Приведено описание нового метода послеоперационного обезболивания у пациентов, перенесших открытую аллопластику паховой грыжи по Лихтенштейну. Суть метода заключается во введении во время операции (перед закрытием раны) под прямым визуальным контролем катетера для пролонгированного введения местного анестетика в область послеоперационной раны. Герниопластику выполняли в условиях спинальной анестезии, в послеоперационном периоде через катетер болюсно вводили 0,25 % раствор лидокаина. Методика применена у 11 пациентов.
Результаты исследований и их обсуждение. Во всех случаях удалось отказаться от применения наркотических анальгетиков и достичь хорошего контроля послеоперационной боли. По сравнению с традиционным ведением послеоперационного периода у пациентов с пролонгированной местной анестезией более быстро восстановилась двигательная активность, уменьшилась продолжительность госпитализации; осложнений не наблюдали.Мета роботи: поліпшення результатів хірургічного лікування пахових гриж шляхом розробки ефективного та безпечного методу післяопераційного знеболення.
Матеріали і методи. Наведено опис нового методу післяопераційного знеболення у пацієнтів, що перенесли відкриту алопластику пахової грижі за Ліхтенштейном. Суть методу полягає у введенні під час операції (перед закриттям рани) під прямим візуальним контролем катетера для пролонгованого введення місцевого анестетика в ділянку післяопераційної рани. Герніопластику виконували в умовах спінальної анестезії, у післяопераційному періоді через катетер болюсно вводили 0,25 % розчин лідокаїну. Методику застосовано у 11 пацієнтів.
Результати досліджень та їх обговорення. В усіх випадках вдалося відмовитись від застосування наркотичних анальгетиків та досягти гарного контролю післяопераційного болю. Порівняно з традиційним веденням післяопераційного періоду в пацієнтів із пролонгованою місцевою анестезією швидше відновилась рухова активність, зменшилась тривалість госпіталізації; ускладнень не спостерігали
Bulk Nanocrystalline Thermoelectrics Based on Bi-Sb-Te Solid Solution
A nanopowder from p-Bi-Sb-Te with particles ~ 10 nm were fabricated by the
ball milling using different technological modes. Cold and hot pressing at
different conditions and also SPS process were used for consolidation of the
powder into a bulk nanostructure and nanocomposites. The main factors allowing
slowing-down of the growth of nanograins as a result of recrystallization are
the reduction of the temperature and of the duration of the pressing, the
increase of the pressure, as well as addition of small value additives (like
MoS2, thermally expanded graphite or fullerenes). It was reached the
thermoelectric figure of merit ZT=1.22 (at 360 K) in the bulk nanostructure
Bi0,4Sb1,6Te3 fabricated by SPS method. Some mechanisms of the improvement of
the thermoelectric efficiency in bulk nanocrystalline semiconductors based on
BixSb2-xTe3 are studied theoretically. The reduction of nanograin size can lead
to improvement of the thermoelectric figure of merit. The theoretical
dependence of the electric and heat conductivities and the thermoelectric power
as the function of nanograins size in BixSb2-xTe3 bulk nanostructure are quite
accurately correlates with the experimental data.Comment: 35 pages, 24 figures, 4 tables, 52 reference
Photometric observations of the supernova 2009nr
We present the results of our UBVRI CCD photometry for the second brightest
supernova of 2009, SN 2009nr, discovered during a sky survey with the
telescopes of the MASTER robotic network. Its light and color curves and
bolometric light curves have been constructed. The light-curve parameters and
the maximum luminosity have been determined. SN 2009nr is shown to be similar
in light-curve shape and maximum luminosity to SN 1991T, which is the prototype
of the class of supernovae Ia with an enhanced luminosity. SN 2009nr exploded
far from the center of the spiral galaxy UGC 8255 and most likely belongs to
its old halo population. We hypothesize that this explosion is a consequence of
the merger of white dwarfs
Optical polarization observations with the MASTER robotic net
We present results of optical polarization observations performed with the
MASTER robotic net for three types of objects: gamma-ray bursts, supernovae,
and blazars. For the Swift gamma-ray bursts GRB100906A, GRB110422A, GRB121011A,
polarization observations were obtained during very early stages of optical
emission. For GRB100906A it was the first prompt optical polarization
observation in the world. Photometry in polarizers is presented for Type Ia
Supernova 2012bh during 20 days, starting on March 27, 2012. We find that the
linear polarization of SN 2012bh at the early stage of the envelope expansion
was less than 3%. Polarization measurements for the blazars OC 457, 3C 454.3,
QSO B1215+303, 87GB 165943.2+395846 at single nights are presented. We infer
the degree of the linear polarization and polarization angle. The blazars OC
457 and 3C 454.3 were observed during their periods of activity. The results
show that MASTER is able to measure substantially polarized light; at the same
time it is not suitable for determining weak polarization (less than 5%) of dim
objects (fainter than 16). Polarimetric observations of the optical
emission from gamma-ray bursts and supernovae are necessary to investigate the
nature of these transient objects.Comment: 31 pages, 12 figures, 4 tables; Exposure times in Table 2 have been
correcte
Combined Surgical Tactics with Step-up Approach in the Treatment of Infected Acute Pancreatitis
Objective. To evaluate the results of treatment using minimally invasive interventions and open necrectomy in patients with infected acute pancreatitis.
Materials and methods. A retrospective cohort two-centered analysis was performed in 211 patients with infected acute pancreatitis who divided into two groups: the first included 101 patients, in the treatment of which used open surgery; the second included 110 patients, in the treatment of which used treatment tactic step-up approach.
Results. In the first group used open necrosectomy with drainage for postoperative lavage (75 patients, 74.3%), including open packing with planned re-laparotomy (8 patients, 7.9%), and omentobursostomy for necrosectomy after surgery (18 patients, 17.8%). Postoperative complications occurred in 58 (57.4%), after the surgery 34 (33.7%) patients was died: 30 had a thirty-day mortality, and 4 had a ninety-day mortality. In the second group group, 72 (65.5%) patients were treated by percutaneous catheter drainage, 6 (5.5%) by video-assisted retroperitoneal debridement and drainage, 5 (4.5%) by through the wall of the stomach or duodenum in the infected pseudocyst and open necrosectomy was performed on 27 (24.5%) patients. Postoperative complications occurred in 37 (33.6%) patients, after the surgery 19 (17.3%) was died: 15 had a thirty -day mortality and 4 had a ninety-day mortality. In the regression analysis, only the presence of multiple organ dysfunction before (AUC = 0.867) and after surgery (AUC = 0.930) significantly affected postoperative mortality, but the effect of the prevalence of pancreatic necrosis (AUC = 0.693) on mortality was limited. Differences were likely between groups (χ2=7.282, p=0.026).
Conclusion. The surgical treatment should be initiated with a minimally invasive procedures and combination these operations with open surgery was able to reduce complications and mortality in the patients with infected acute pancreatitis
Клинико-морфологическое наблюдение сочетанного туберкулезного и цитомегаловирусного поражения легких при ВИЧ-инфекции
Clinical and morphological observation of co-morbid pulmonary tuberculosis and cytomegalovirus lung injury in HIV-infected patients.Клинико-морфологическое наблюдение сочетанного туберкулезного и цитомегаловирусного поражения легких при ВИЧ-инфекции
ДЕЗАКТИВАЦИЯ НАСЕЛЕННЫХ ПУНКТОВ БРЯНСКОЙ ОБЛАСТИ ПОСЛЕ АВАРИИ НА ЧЕРНОБЫЛЬСКОЙ АЭС
The paper presents at first time in Russian the experience of decontamination of settlements located in the ‘Strict control area’ of the Bryansk region. Large scale decontamination campaign was implemented in summer 1989 by Russian Civil Defence forces jointly with the experts of the Institute of Radiation Hygiene. Radiological criteria for decontamination are presented and external dosimetry of the public considered. Recommendations for decontamination of settlements were developed based on modeling and experiments. During five months, 93 settlements with population of 90 this. were decontaminated. Repeated radiation measurements next year and afterwards proved that there was no radioactive re-contamination of the treated areas. Effectiveness of decontamination was estimated by modeling and by individual TLD measurements conducted before and after decontamination. The results of two methods agreed well and the average effectiveness was estimated as 20%. The collective effective dose averted by the decontamination works in 1989 was estimated as 350 man-Sv.В статье впервые на русском языке описан опыт кампании дезактивации населенных пунктов Зоны жесткого контроля Брянской области, которая была проведена летом 1989 г. силами Гражданской обороны РСФСР совместно с сотрудниками НИИ радиационной гигиены. Приведены радиологические критерии для проведения дезактивации, рассмотрены дозиметрические аспекты внешнего облучения жителей. На основе расчетного моделирования и экспериментальных работ обоснованы рекомендации по дезактивации населенных пунктов. За 5 месяцев были дезактивированы 93 населенных пункта с на-селением около 90 тыс. человек. Повторные измерения через год и позднее показали отсутствие вторичного переноса радионуклидов на дезактивированные участки. Эффективность дезактивации оценили модельным расчетом и путем ТЛД-измерений дозы у жителей до и после дезактивации. Результаты двух оценок согласуются и составляют в среднем 20%. Коллективная эффективная доза, предотвращенная в результате дезактивации 1989 г., оценена в 350 чел.-Зв
Морфологические особенности пневмоцистной пневмонии при ВИЧ-инфекции
Summary. In our study, pneumonia caused by Pneumocystis comprised 7.1 % of all autopsies of patients died from HIVassociated infections and was the forth cause of death following tuberculosis (35.6 %), bacterial pneumonia (16.5 %), and infectious endocarditis (10.8 %). Acute stage was more frequent (73.1 %); cavitary pneumonia was diagnosed in 7.7 % autopsies, generalized Pneumocystis infection was found in 3.8 % of cases. In 7.7 % of cases, the course of Pneumocystis pneumonia was complicated by diffuse alveolar damage. Advanced stages of Pneumocystis pneumonia should be differentiated from organizing bacterial pneumonia, pulmonary tuberculosis, and cytomegalovirus infection. In died HIVinfected patients with com bined pulmonary infection, Pneumocystis was found in 27.6 % of cases. Advanced stages of pneumonia caused by Pneumocystis and combined pul monary infection are difficult for morphological diagnosis and require a complex of modern investigations.Резюме. Пневмоцистная пневмония (ПЦП) составила 7,1 % от количества всех вскрытий умерших от ВИЧассоциированных инфекций и занимает в структуре смертности 4е место после туберкулеза (35,6 %), бактериальной пневмонии (16,5 %), инфекционного эндокардита (10,8 %). Превалировала отечная стадия ПЦП (73,1 %), в 7,7 % аутопсий констатирована кавернозная форма заболевания, в 3,8 % – генерализованный пневмоцистоз. В 7,7 % течение ПЦП осложнилось развитием диффузного альвеолярного повреждения. На поздних стадиях ПЦП необходимо морфологически дифференцировать с организацией при бактериальной пневмонии, туберкулезе, цитомегаловирусной инфекции. В 27,6 % случаев сочетанного инфекционного поражения легких у умерших от ВИЧинфекции в составе ассоциации обнаруживалась ПЦП. Случаи поздней стадии ПЦП и сочетанного поражения легких сложны для морфологической верификации, что требует использования комплекса современных исследований
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