ANALYSIS OF CLINICAL CASES АНТИ-VEGF TREATMENT OF MASSIVE SUBRETINAL HEMORRHAGES COMPLICATING WET AGE-RELATED MACULAR DEGENERATION

Purpose. Analysis of clinical cases of anti-VEGF therapy (ranibizumab) in the treatment of wet age-related macular degeneration (AMD) complicated by massive subretinal hemorrhages of various sizes.Material and methods. A retrospective analysis of the results of treatment was performed in 18 patients with wet AMD complicated by massive subretinal hemorrhages, who received as a treatment three monthly intravitreal ranibizumab injections. The first group (10 eyes) included patients with hemorrhages ranging from 1.5 to 3 disc diameters (DD), the second group (8 eyes) – patients with subretinal hemorrhage area of up to 1.5 DD. The age of patients varied from 65 to 83 years. The study was conducted using visometry, ophthalmoscopy of the damaged eye and of the fellow eye, as well as a monthly photo-registration of fundus and the OCT of macular area. The examinations were carried out before the treatment and 1 month after each ranibizumab IVI conducted by the standard technology in a sterile operating room.Results. After 3 monthly ranibizumab IVI in 8 patients of the second group the ophthalmoscopy showed a complete resorption of subretinal blood already after the 2nd ranibizumab IVI. According to the OCT a normalization of anatomy in the macular area was noted. Visometry results and patients subjectively reported a gradual improvement in visual acuity in the course of treatment, in some cases up to a full recovery by the end of the third month of therapy. A pigment epithelial tear, passing through the foveal zone, was detected in the treatment process associated with resorption of submacular clumps in 9 of 10 patients of the first group with areas of subretinal hemorrhages more than 1.5 DD. A complete attachment and a recovery profile of the foveal zone were not observed in any patients even after the full course of anti-VEGF therapy. A total hemophthalmus developed in one eye in the postinjection period that required the vitrectomy surgery. The visual acuity in patients of the first group decreased from 0.3 to0.15 in the anti-VEGF therapy in the majority of cases. At the same time all patients reported a subjective improvement in the quality of vision – a reduction of the size and intensity of the central scotoma darkening due to a resorption of subretinal blood in the central area of the retina.Conclusion. The therapy with intravitreal injections of ranibizumab is indicated and effective in patients with hemorrhages more than 1.5 DD. anti-VEGF therapy leads to an improvement in the life quality of patients and facilitates their adaptation to a visual impairment, due to a total or partial resorption of subretinal blood and a reduction in the area and intensity of the central scotoma

Кореляційний радіодальномір

In work widely known methods of range measuring are short characterized. The basic attention is given features of signal processing in a correlation method of range measuring. The signal with angular modulation with one-voice-frequency fluctuation is used as a probing signal. The absence of Doppler effect on the formation of the correlation integral, the frequency instability of the transmitter, the phase change on reflection from the target is presented. It is noticed that the result of signal processing in the range measuring instrument is reduced to formation on an exit one-voice-frequency harmonious fluctuation equal to modulating frequency that provides high characteristics of a radio range finder.В работе кратко характеризуются широко известные методы измерения дальности. Основное внимание уделено особенностям обработки сигнала в корреляционном методе измерения дальности. В качестве зондирующего сигнала используется сигнал с угловой модуляцией с однотональным колебанием. Показано отсутствие влияния доплеровского сдвига частоты на формирование корреляционного интеграла, нестабильности частоты передатчика, изменения фазы при отражении от цели. Отмечается, что результат обработки сигнала в измерителе дальности сводится к формированию на выходе однотонального гармонического колебания равного модулирующей частоте, что обеспечивает высокие характеристики радиодальномераВ роботі стисло характеризуються широко відомі методи вимірювання дальності. Головна увага приділяється особливостям оброблення сигналу в кореляційному методі вимірювання дальності. В якості зондуючого сигналу використовується сигнал з кутовою модуляцією з однотональним коливанням. Показана відсутність впливу доплерівського зсуву частоти на формування кореляційного інтеграла, нестабільність частоти передавача, змінення фази при відбитті його від цілі. Відмічається, що результат оброблення сигналу у вимірювачі дальності зводиться до формування на виході однотональ-ного гармонічного коливання рівного частоті модуляції, що забезпечує високі характеристики радіодальномір

Mathematical simulation of heat transfer at deciduous tree ignition by cloud-to-ground lightning discharge

Numerical research results of deciduous tree ignition by cloud-to-ground lightning discharge are presented. The problem is solved in one-dimensional statement in cylindrical system of coordinates. The typical range of influence parameters of positive and negative cloud-to-ground lightning discharges is considered. Ignition conditions for deciduous tree are established

Expression, purification and crystallization of a thermostable short-chain alcohol dehydrogenase from the archaeon Thermococcus sibiricus

The expression, purification and crystallization of a thermostable short-chain alcohol dehydrogenase from the archaeon T. sibiricus is reported

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings.EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.Paroxysmal Cerebral Disorder

Afatinib vs Placebo as Adjuvant Therapy After Chemoradiotherapy in Squamous Cell Carcinoma of the Head and Neck: A Randomized Clinical Trial

ImportanceLocoregionally advanced head and neck squamous cell cancer (HNSCC) is treated curatively; however, risk of recurrence remains high among some patients. The ERBB family blocker afatinib has shown efficacy in recurrent or metastatic HNSCC. ObjectiveTo assess whether afatinib therapy after definitive chemoradiotherapy (CRT) improves disease-free survival (DFS) in patients with HNSCC. Design, Setting, and ParticipantsThis multicenter, phase 3, double-blind randomized clinical trial (LUX-Head & Neck 2) studied 617 patients from November 2, 2011, to July 4, 2016. Patients who had complete response after CRT, comprising radiotherapy with cisplatin or carboplatin, with or without resection of residual disease, for locoregionally advanced high- or intermediate-risk HNSCC of the oral cavity, hypopharynx, larynx, or oropharynx were included in the study. Data analysis was of the intention-to-treat population. InterventionsPatients were randomized (2:1) to treatment with afatinib (40 mg/d) or placebo, stratified by nodal status (N0-2a or N2b-3) and Eastern Cooperative Oncology Group performance status (0 or 1). Treatment continued for 18 months or until disease recurrence, unacceptable adverse events, or patient withdrawal. Main Outcomes and MeasuresThe primary end point was DFS, defined as time from the date of randomization to the date of tumor recurrence or secondary primary tumor or death from any cause. Secondary end points were DFS at 2 years, overall survival (defined as time from the date of randomization to death), and health-related quality of life. ResultsA total of 617 patients were studied (mean [SD] age, 58 [8.4] years; 528 male [85.6%]). Recruitment was stopped after a preplanned interim futility analysis on July 4, 2016, on recommendation from an independent data monitoring committee. Treatment was discontinued. Median DFS was 43.4 months (95% CI, 37.4 months to not estimable) in the afatinib group and not estimable (95% CI, 40.1 months to not estimable) in the placebo group (hazard ratio, 1.13; 95% CI, 0.81-1.57; stratified log-rank test P=.48). The most common grade 3 and 4 drug-related adverse effects were acneiform rash (61 [14.8%] of 411 patients in the afatinib group vs 1 [0.5%] of 206 patients in the placebo group), stomatitis (55 [13.4%] in the afatinib group vs 1 [0.5%] in the placebo group), and diarrhea (32 [7.8%] in the afatinib group vs 1 [0.5%] in the placebo group). Conclusions and RelevanceThis study's findings indicate that treatment with afatinib after CRT did not improve DFS and was associated with more adverse events than placebo in patients with primary, unresected, clinically high- to intermediate-risk HNSCC. The use of adjuvant afatinib after CRT is not recommended. Trial RegistrationClinicalTrials.gov identifier: NCT01345669Experimentele farmacotherapi