33 research outputs found
ΠΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ΅Ρ Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ Π±ΡΠΎΠ½Ρ ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ°ΡΡΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ
The aim of this study was to define full cost of therapy of adult bronchial asthma (BA) taking into account BA spread in Lesnoy and to evaluate economical benefit of modern BA management using the cost-benefit and cost-effectiveness analyses.The investigation was performed in Lesnoy town of Sverdlovsk region having 46,500 adult residents and BA spread 5.7% (the patients' age was 18 to 74 yrs). Three hundred and fifty three BA patients were registered in 1999 and 636 were in 2002 when seeking the aid. A list of antiasthmatic medications was determined including domestic drugs: Benacort, Salben, Saltos, Salgim. Sixty four per cent of the BA patients registered received the basic therapy with the domestic medications. The clinical-and-economical investigation used methods detecting full cost of the disease and cost-benefit and cost-effectiveness analysis.The results allowed to define the full cost of BA in Lesnoy which was 625,672 USD, or 13 USD for every resident of the town and 237 USD for every BA patient annually. The structural analysis of the BA cost showed a prevalence of direct (59%) expenses compared with the indirect ones (41%). Among the direct expenses the inpatient treatment (63%) and medication (27%) costs predominated. Manufacture waste (45%) prevailed in the indirect expenses. This analysis demonstrated a significant decrease (in near 2 times) in the direct and indirect expenses resulted from application of the modern methods of the BA management with the domestic medications. An economic efficiency of the domestic drug Benacort was showed which decreased the cost-benefit ratio in 6 times.The application of the modern management of the registered BA patients diminished the cost-effectiveness ratio in more than 2 times.So, the clinical-and-economical study of the modern BA management efficiency under the local antiasthmatic programme analyzed the full cost of the disease, the cost-benefit and the cost-effectiveness ratio and allowed to determine the BA expenditure in Lesnoy; it showed the economical effect of the domestic antiasthmatic medications and of the new approach to the cost-effectiveness of the modern BA management.Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ β ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΠΏΠΎΠ»Π½ΡΡ ΡΡΠΎΠΈΠΌΠΎΡΡΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΡ (ΠΠ) Ρ Π²Π·ΡΠΎΡΠ»ΡΡ
Ρ ΡΡΠ΅ΡΠΎΠΌ Π΄Π°Π½Π½ΡΡ
ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ ΠΠ Π² ΠΠ΅ΡΠ½ΠΎΠΌ ΠΈ ΠΎΡΠ΅Π½ΠΈΡΡ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ Π°Π½Π°Π»ΠΈΠ·Π° Π·Π°ΡΡΠ°ΡΡ-ΠΏΠΎΠ»Π΅Π·Π½ΠΎΡΡΡ ΠΈ Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ.ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ Π² ΠΠ΅ΡΠ½ΠΎΠΌ Π‘Π²Π΅ΡΠ΄Π»ΠΎΠ²ΡΠΊΠΎΠΉ ΠΎΠ±Π». ΡΠΎ Π²Π·ΡΠΎΡΠ»ΡΠΌ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΠ΅ΠΌ 46 500 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ ΠΈ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡΡ ΠΠ (Π²ΠΎΠ·ΡΠ°ΡΡ Π±ΠΎΠ»ΡΠ½ΡΡ
18-74 Π³ΠΎΠ΄Π°) 5,7%. ΠΠΎ ΠΎΠ±ΡΠ°ΡΠ°Π΅ΠΌΠΎΡΡΠΈ Π±ΡΠ»ΠΎ Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ Π² 1 9 9 9 Π³ _ 3 5 3 ) Π² 2002 Π³. β 636 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ. ΠΡΠ» ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ ΠΏΠ΅ΡΠ΅ΡΠ΅Π½Ρ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ°ΡΡΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ
ΡΡΠ΅Π΄ΡΡΠ² Ρ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ²: Π±Π΅Π½Π°ΠΊΠΎΡΡ, ΡΠ°Π»ΡΠ±Π΅Π½, ΡΠ°Π»ΡΡΠΎΡ, ΡΠ°Π»ΡΠ³ΠΈΠΌ. 64% Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ ΠΏΠΎΠ»ΡΡΠ°Π»ΠΈ Π±Π°Π·ΠΈΡΠ½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ, ΠΎΡΠ½ΠΎΠ²Ρ ΠΊΠΎΡΠΎΡΠΎΠΉ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ. ΠΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΡΡ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΏΠΎΠ»Π½ΠΎΠΉ ΡΡΠΎΠΈΠΌΠΎΡΡΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, Π°Π½Π°Π»ΠΈΠ·Π° Π·Π°ΡΡΠ°ΡΡ-ΠΏΠΎΠ»Π΅Π·Π½ΠΎΡΡΡ ΠΈ Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ.ΠΠ½Π°Π»ΠΈΠ· ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΠΏΠΎΠ»Π½ΡΡ ΡΡΠΎΠΈΠΌΠΎΡΡΡ ΠΠ Π΄Π»Ρ ΠΠ΅ΡΠ½ΠΎΠ³ΠΎ, ΠΊΠΎΡΠΎΡΠ°Ρ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 625 672 Π΄ΠΎΠ»Π». Π ΠΏΠ΅ΡΠ΅ΡΡΠ΅ΡΠ΅ Π½Π° 1 ΠΆΠΈΡΠ΅Π»Ρ Π³ΠΎΡΠΎΠ΄Π° ΡΡΠΎΠΈΠΌΠΎΡΡΡ ΠΠ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 13 Π΄ΠΎΠ»Π»., Π° Π½Π° 1 Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ ΠΠ β 237 Π΄ΠΎΠ»Π». Π² Π³ΠΎΠ΄. ΠΠ½Π°Π»ΠΈΠ· ΡΡΡΡΠΊΡΡΡΡ ΡΡΠΎΠΈΠΌΠΎΡΡΠΈ ΠΠ ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°Π½ΠΈΠ΅ ΠΏΡΡΠΌΡΡ
(59%) Π·Π°ΡΡΠ°Ρ Π½Π°Π΄ Π½Π΅ΠΏΡΡΠΌΡΠΌΠΈ (41%). Π ΡΡΡΡΠΊΡΡΡΠ΅ ΠΏΡΡΠΌΡΡ
Π·Π°ΡΡΠ°Ρ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°ΡΡ Π·Π°ΡΡΠ°ΡΡ Π½Π° ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ (63%) ΠΈ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ (27%), Π² ΡΡΡΡΠΊΡΡΡΠ΅ Π½Π΅ΠΏΡΡΠΌΡΡ
β ΠΏΠΎΡΠ΅ΡΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° (45%). ΠΠ½Π°Π»ΠΈΠ· ΠΏΡΡΠΌΡΡ
ΠΈ Π½Π΅ΠΏΡΡΠΌΡΡ
Π·Π°ΡΡΠ°Ρ ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ ΠΈΡ
ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ (ΠΏΡΠΈΠΌΠ΅ΡΠ½ΠΎ Π² 2 ΡΠ°Π·Π°) Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ². ΠΠΎΠΊΠ°Π·Π°Π½Π° ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° βΠΠ΅Π½Π°ΠΊΠΎΡΡβ , Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ ΠΏΡΠΈΠ²Π΅Π»ΠΎ ΠΊ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ Π·Π°ΡΡΠ°ΡΡ-ΠΏΠΎΠ»Π΅Π·Π½ΠΎΡΡΡ Π² 6 ΡΠ°Π·.ΠΠ½Π΅Π΄ΡΠ΅Π½ΠΈΠ΅ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ Π³ΡΡΠΏΠΏΡ Π²ΡΠ΅Ρ
Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ ΠΏΡΠΈΠ²Π΅Π»ΠΎ ΠΊ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ Π² 2 ΡΠ°Π·Π°.ΠΠ»ΠΈΠ½ΠΈΠΊΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΠΉ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΡ Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ°ΡΡΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΏΠΎΠ»Π½ΠΎΠΉ ΡΡΠΎΠΈΠΌΠΎΡΡΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, Π°Π½Π°Π»ΠΈΠ·Π° Π·Π°ΡΡΠ°ΡΡ-ΠΏΠΎΠ»Π΅Π·Π½ΠΎΡΡΡ ΠΈ Π·Π°ΡΡΠ°ΡΡ-ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΡΠΎΠΈΠΌΠΎΡΡΡ ΠΠ Π΄Π»Ρ ΠΠ΅ΡΠ½ΠΎΠ³ΠΎ Π² ΠΏΠ΅ΡΠ΅ΡΡΠ΅ΡΠ΅ Π½Π° 1 ΠΆΠΈΡΠ΅Π»Ρ ΠΈ 1 Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ ΠΠ; ΠΏΠΎΠΊΠ°Π·Π°Π» ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠΎΡΠΈΠ²ΠΎΠ°ΡΡΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΈ Π½ΠΎΠ²ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ ΠΊ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π·Π°ΡΡΠ°ΡΠ½ΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠ
Food anaphylaxis in pediatric population of Ekaterinburg
Background: The number of patients suffering from food allergy is increasing worldwide and also in Russia. The growth rate certainly depends on the country region, natural landscape, ecology and cuisine features of the are
Food allergy to nuts and fruits in children with hay fever and oral allergy syndrome in the middle Urals
The aim of research is to study the frequency of true sensitization to nuts and fruits in children sensitized to Bet v 1 and having oral allergy syndrome (OAS) and hay fever
Prevalence of severe bronchial asthma phenotypes in the middle Urals
Background : to determine the prevalence of severe bronchial asthma in the Middle Urals and to phenotype patients with severe asthma for determination of the need of targeted therap
Polyvalent allergy in children with oral allergic syndrome living in the Ural region. Sensitization structure
This research was aimed at studying the sensitization spectrum in children with polyvalent allergies, from the perspective of determining their true responsiveness and cross-sensitization for further planning of preventive and therapeutic measures
The effectiveness of single inhaler triple therapy in patients with bronchial asthma in real clinical practice
Introduction. About 40% ofΒ patients with bronchial asthma on dual therapy with inhaled glucocorticosteroids and long-acting Ξ²2-agonists do not achieve asthma control.Aim. To evaluate theΒ efficacy ofΒ triple therapy (fluticasone furoate, umeclidinium bromide, vilanterol) inΒ a single inhaler inΒ patients with bronchial asthma inΒ real clinical practice.Material and methods. The study included 43Β patients with bronchial asthma from municipal outpatientsβ clinics inΒ Ekaterinburg and theΒ Sverdlovsk region. The clinical-functional and clinical-economic efficiency ofΒ therapy was evaluated forΒ 6Β months before and after theΒ appointment ofΒ a triple combination (fluticasone furoate, umeclidinium bromide, vilanterol) inΒ a single inhalerResults and discussion. Of theΒ 43Β patients, 39Β patients were included inΒ the analysis. During 6Β months ofΒ triple therapy inΒ a single inhaler, theΒ mean ACT value increased from 13Β (Q1βQ3: 12β14) to 21Β points (Q1βQ3: 20β22) (pΒ < Β 0.001), theΒ proportion ofΒ patients with uncontrolled asthma decreased from 100% initially to 15.4% at 6Β months ofΒ therapy (p< 0.001). By theΒ 6th month ofΒ therapy, all patients refused to take systemic glucocorticosteroids (pΒ = 0.003), there was an increase inΒ FEV1Β from 73.0% (Q1βQ2: 70.0β75.0) to 82% (Q1βQ2: 80.0β86.5) (pΒ <Β 0.001). The number ofΒ ambulance calls (from 0.28Β Β±Β 0.46Β per 1Β patient at baseline) and hospitalizations (from 0.67Β Β±Β 0.84Β per 1Β patient at baseline) decreased to 0Β (pΒ ><Β 0.001) after 6Β months ofΒ treatment with theΒ study drug. Savings inΒ the management ofΒ 1Β patient forΒ 6Β months on aΒ triple therapy inΒ a single inhaler amounted to 10523Β rubles, and theΒ prevented economic damage forΒ 39Β patients forΒ 6Β months ofΒ therapy is 410418Β rubles. Conclusion. The triple therapy inΒ a single inhaler made it possible to improve asthma control and respiratory function, stop taking systemic glucocorticosteroids, reduce theΒ number ofΒ hospitalizations and emergency calls, while reducing direct costs per unit ofΒ efficiency.>< 0.001). The number ofΒ ambulance calls (from 0.28Β Β±Β 0.46Β per 1Β patient at baseline) and hospitalizations (from 0.67Β Β±Β 0.84Β per 1Β patient at baseline) decreased to 0Β (p< 0.001) after 6Β months ofΒ treatment with theΒ study drug. Savings inΒ the management ofΒ 1Β patient forΒ 6Β months on aΒ triple therapy inΒ a single inhaler amounted to 10523Β rubles, and theΒ prevented economic damage forΒ 39Β patients forΒ 6Β months ofΒ therapy is 410418Β rubles.Conclusion. The triple therapy inΒ a single inhaler made it possible to improve asthma control and respiratory function, stop taking systemic glucocorticosteroids, reduce theΒ number ofΒ hospitalizations and emergency calls, while reducing direct costs per unit ofΒ efficiency
Surprises of food anaphylaxis: a clinical case
Abstract. Anaphylaxis is a severe systemic hypersensitivity reaction that is characterized by rapid onset and life-threatening respiratory and blood circulation problems. We present to your attention a clinical case of the polyvalent allergy development in a three-year-old child with repeated episodes of food anaphylaxis. The child was born and he constantly lives in central Russia, but has a profile of sensitization unusual for a Ural resident. The clinical case is described in detail in order to demonstrate the stages of a childβs life, on which sensitization was likely to be first formed, and later the manifestation of clinical symptoms arose. Determination of the sensitization profile by means of the component allergy diagnostics methods (ISAC, ImmunoCAP) showed that the boy is sensitized to a large number of food allergens, including milk and egg proteins; storage proteins for peanuts, soy, hazelnuts and sesame; proteins related to the nsLTP-proteins. The obtained results made it possible to recognize and differentiate true IgE-mediated sensitization, to propose the optimal therapeutic tactics and to select an elimination diet. Application of molecular allergy diagnostic methods is useful in clinical practice in case of patients with multivalent sensitization and a history of severe allergic reactions.Π Π΅Π·ΡΠΌΠ΅. ΠΠ½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΡ β ΡΡΠΎ ΡΡΠΆΠ΅Π»Π°Ρ ΡΠΈΡΡΠ΅ΠΌΠ½Π°Ρ ΡΠ΅Π°ΠΊΡΠΈΡ Π³ΠΈΠΏΠ΅ΡΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ, ΠΊΠΎΡΠΎΡΠ°Ρ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ Π±ΡΡΡΡΡΠΌ Π½Π°ΡΠ°Π»ΠΎΠΌ ΠΈ ΠΆΠΈΠ·Π½Π΅ΡΠ³ΡΠΎΠΆΠ°ΡΡΠΈΠΌΠΈ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌΠΈ ΡΠΎ ΡΡΠΎΡΠΎΠ½Ρ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ ΠΈ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ. Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΉ ΡΡΠ°ΡΡΠ΅ ΠΎΠΏΠΈΡΠ°Π½ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ ΡΠ°Π·Π²ΠΈΡΠΈΡ Ρ ΡΡΠ΅Ρ
Π»Π΅ΡΠ½Π΅Π³ΠΎ ΡΠ΅Π±Π΅Π½ΠΊΠ° ΠΏΠΎΠ»ΠΈΠ²Π°Π»Π΅Π½ΡΠ½ΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ Ρ ΠΏΠΎΠ²ΡΠΎΡΠ½ΡΠΌΠΈ ΡΠΏΠΈΠ·ΠΎΠ΄Π°ΠΌΠΈ ΠΏΠΈΡΠ΅Π²ΠΎΠΉ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΠΈ, ΡΠΎΠ΄ΠΈΠ²ΡΠ΅Π³ΠΎΡΡ ΠΈ ΠΏΠΎΡΡΠΎΡΠ½Π½ΠΎ ΠΏΡΠΎΠΆΠΈΠ²Π°ΡΡΠ΅Π³ΠΎ Π² ΡΡΠ΅Π΄Π½Π΅ΠΉ ΠΏΠΎΠ»ΠΎΡΠ΅ Π ΠΎΡΡΠΈΠΈ, Π½ΠΎ ΠΈΠΌΠ΅ΡΡΠ΅Π³ΠΎ Π½Π΅ΠΎΠ±ΡΡΠ½ΡΠΉ Π΄Π»Ρ ΠΆΠΈΡΠ΅Π»Ρ Π£ΡΠ°Π»Π° ΠΏΡΠΎΡΠΈΠ»Ρ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ ΠΏΠΎΠ΄ΡΠΎΠ±Π½ΠΎ ΠΎΠΏΠΈΡΠ°Π½ Ρ ΡΠ΅Π»ΡΡ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°ΡΡ ΡΡΠ°ΠΏΡ ΠΆΠΈΠ·Π½ΠΈ ΡΠ΅Π±Π΅Π½ΠΊΠ°, Π½Π° ΠΊΠΎΡΠΎΡΡΡ
, Π²Π΅ΡΠΎΡΡΠ½ΠΎ, ΡΠ½Π°ΡΠ°Π»Π° ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π»Π°ΡΡ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ, Π° Π² Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅ΠΌ Π²ΠΎΠ·Π½ΠΈΠΊΠ°Π»Π° ΠΌΠ°Π½ΠΈΡΠ΅ΡΡΠ°ΡΠΈΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ². ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠΎΡΠΈΠ»Ρ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ½ΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΎΠ΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ (ISAC, ImmunoCAP) ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΎ, ΡΡΠΎ ΠΌΠ°Π»ΡΡΠΈΠΊ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½ ΠΊ Π±ΠΎΠ»ΡΡΠΎΠΌΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Ρ ΠΏΠΈΡΠ΅Π²ΡΡ
Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ², Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΊ ΠΌΠΎΠ»ΠΎΡΠ½ΡΠΌ ΠΈ ΡΠΈΡΠ½ΡΠΌ ΠΏΡΠΎΡΠ΅ΠΈΠ½Π°ΠΌ; Π±Π΅Π»ΠΊΠ°ΠΌ Ρ
ΡΠ°Π½Π΅Π½ΠΈΡ Π°ΡΠ°Ρ
ΠΈΡΠ°, ΡΠΎΠΈ, ΡΡΠ½Π΄ΡΠΊΠ° ΠΈ ΠΊΡΠ½ΠΆΡΡΠ°; ΠΏΡΠΎΡΠ΅ΠΈΠ½Π°ΠΌ, ΠΎΡΠ½ΠΎΡΡΡΠΈΠΌΡΡ ΠΊ nsLTP-Π±Π΅Π»ΠΊΠ°ΠΌ. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΈ ΡΠ°ΡΠΏΠΎΠ·Π½Π°ΡΡ ΠΈ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°ΡΡ ΠΈΡΡΠΈΠ½Π½ΡΡ IgE-ΠΎΠΏΠΎΡΡΠ΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ, ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠΈΡΡ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΡ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΡΡ ΡΠ°ΠΊΡΠΈΠΊΡ ΠΈ ΠΏΠΎΠ΄ΠΎΠ±ΡΠ°ΡΡ ΡΠ»ΠΈΠΌΠΈΠ½Π°ΡΠΈΠΎΠ½Π½ΡΡ Π΄ΠΈΠ΅ΡΡ. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΎΠ΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΎΠΊΠ°Π·ΡΠ²Π°Π΅ΡΡΡ ΠΏΠΎΠ»Π΅Π·Π½ΡΠΌ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ Π² ΡΠ»ΡΡΠ°Π΅ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΈΠΌΠ΅ΡΡΠΈΡ
ΠΏΠΎΠ»ΠΈΠ²Π°Π»Π΅Π½ΡΠ½ΡΡ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ ΠΈ ΡΡΡΠ°Π΄Π°ΡΡΠΈΡ
, ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π°Π½Π°ΠΌΠ½Π΅Π·Π°, ΡΡΠΆΠ΅Π»ΡΠΌΠΈ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΡΠ΅Π°ΠΊΡΠΈΡΠΌΠΈ
Food anaphylaxis in children
Food anaphylaxis is a severe life-threatening reaction to food. In recent years, there has been an increase in the number of such reactions. The ability to recognize the symptoms of food anaphylaxis surrounding a sick person by people is the key to a saved life. This article on the basis of modern data on epidemiology, etiology and pathogenesis of food anaphylaxis discusses the problems that are currently in the diagnosis and treatment of children with food anaphylaxis, suggests ways to solve themΠΠΈΡΠ΅Π²Π°Ρ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΡ β ΡΡΠΆΠ΅Π»Π°Ρ, ΠΆΠΈΠ·Π½Π΅ΡΠ³ΡΠΎΠΆΠ°ΡΡΠ°Ρ ΡΠ΅Π°ΠΊΡΠΈΡ, Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡΠ°Ρ Π½Π° ΠΏΡΠΎΠ΄ΡΠΊΡΡ ΠΏΠΈΡΠ°Π½ΠΈΡ. Π ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π³ΠΎΠ΄Ρ ΠΎΡΠΌΠ΅ΡΠ°Π΅ΡΡΡ ΡΠΎΡΡ ΡΠΈΡΠ»Π° ΠΏΠΎΠ΄ΠΎΠ±Π½ΡΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ Ρ Π΄Π΅ΡΠ΅ΠΉ ΡΠ°Π·Π½ΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°. ΠΠ°ΡΠ°ΡΡΡΡ ΡΠΌΠ΅Π½ΠΈΠ΅ ΡΠ°ΡΠΏΠΎΠ·Π½Π°ΡΡ ΡΠΈΠΌΠΏΡΠΎΠΌΡ ΠΏΠΈΡΠ΅Π²ΠΎΠΉ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΠΈ ΠΎΠΊΡΡΠΆΠ°ΡΡΠΈΠΌΠΈ Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π±Π΅Π½ΠΊΠ° Π»ΡΠ΄ΡΠΌΠΈ β Π·Π°Π»ΠΎΠ³ ΡΠΏΠ°ΡΠ΅Π½Π½ΠΎΠΉ ΠΆΠΈΠ·Π½ΠΈ. Π Π΄Π°Π½Π½ΠΎΠΉ ΡΡΠ°ΡΡΠ΅ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΏΠΎ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Ρ ΠΏΠΈΡΠ΅Π²ΠΎΠΉ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΠΈ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΡΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΈΠΌΠ΅ΡΡΡΡ Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΠΈΡΠ΅Π²ΠΎΠΉ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΠ΅ΠΉ, ΠΏΡΠ΅Π΄Π»Π°Π³Π°ΡΡΡΡ ΠΏΡΡΠΈ ΠΊ ΠΈΡ
ΡΠ΅ΡΠ΅Π½ΠΈΡ
Nutritional anaphylaxis in preschool children as a risk factor for respiratory allergies development in the future
Aim: to study the sensitization spectrum using comprehensive allergological diagnosis in children with persistent food allergy, who had experienced anaphylaxis episodes. Patients and Methods: 14 children (11 (79%) boys and 3 (21%) girls) who experienced one or more food anaphylaxis episodes in early childhood and have persistent food allergy during the study (mean age β 6.8 years) underwent dynamic follow-up. The following allergic etiologies to severe life-threatening reactions were revealed: in 6 (43%) patients there were dairy products, in another 6 (43%) children β eggs, in 3 (21%) patients β kiwi, 2 (14%) patients had a reaction to fish, peanuts, sesame, and 1 (7%) β to walnuts and shrimps. All patients underwent a comprehensive allergological diagnosis, including the ImmunoCAP ISAC test. Results: during the study, all children (100%) were confirmed with the true food allergy causing the anaphylactic reactions in history and the remaining etiologies of persistent food allergy at the present time. Sensitization to the major specific components of inhaled allergens was detected in all 14 children (100%) who experienced the food anaphylaxis. The highest hypersensitivity was observed to birch (rBet v1) β from 0.3 to 100.0 ISU-E (79%), to cypress (nCup a1) β from 0.3 to 1.2 ISU-E (36%), to cats (rFel d1) β from 1.6 to 90.0 ISU-E (64%), and to dogs (rCan f1) β from 1.1 to 40.0 ISU-E (50%). None of the patients showed sensitization to house dust mite molecules. Conclusion: as a result of the study, the data were obtained on the sensitization formation to respiratory allergens in all children (100%) who experienced food anaphylaxis and who have persistent food allergy at the present time.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ Π²ΠΈΠ΄ΠΎΠ² ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΠ΅ΡΡΠΈΡΡΠΈΡΡΡΡΠ΅ΠΉ ΠΏΠΈΡΠ΅Π²ΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΈΠ΅ΠΉ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΡΠ°Π½Π΅Π΅ ΡΠΏΠΈΠ·ΠΎΠ΄Ρ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΠΈ, Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ Π°Π»Π»Π΅ΡΠ³ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: ΠΏΠΎΠ΄ Π΄ΠΈΠ½Π°ΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ΠΌ Π½Π°Ρ
ΠΎΠ΄ΠΈΠ»ΠΈΡΡ 14 Π΄Π΅ΡΠ΅ΠΉ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΠΎΠ΄ΠΈΠ½ ΠΈΠ»ΠΈ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ ΡΠΏΠΈΠ·ΠΎΠ΄ΠΎΠ² ΠΏΠΈΡΠ΅Π²ΠΎΠΉ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΠΈ Π² ΡΠ°Π½Π½Π΅ΠΌ Π΄Π΅ΡΡΠΊΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΈ ΠΈΠΌΠ΅ΡΡΠΈΡ
ΠΏΠ΅ΡΡΠΈΡΡΠΈΡΡΡΡΡΡ ΠΏΠΈΡΠ΅Π²ΡΡ Π°Π»Π»Π΅ΡΠ³ΠΈΡ Π½Π° ΠΌΠΎΠΌΠ΅Π½Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: 11 (79%) ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ² ΠΈ 3 (21%) Π΄Π΅Π²ΠΎΡΠΊΠΈ, ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ β 6,8 Π³ΠΎΠ΄Π°. Π Π°Π½Π΅Π΅ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΡΡΠΆΠ΅Π»ΡΡ
, ΠΆΠΈΠ·Π½Π΅ΡΠ³ΡΠΎΠΆΠ°ΡΡΠΈΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ Ρ 6 (43%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±ΡΠ»ΠΈ ΠΌΠΎΠ»ΠΎΡΠ½ΡΠ΅ ΠΏΡΠΎΠ΄ΡΠΊΡΡ, Π΅ΡΠ΅ Ρ 6 (43%) β ΠΊΡΡΠΈΠ½ΠΎΠ΅ ΡΠΉΡΠΎ, Ρ 3 (21%) β ΠΊΠΈΠ²ΠΈ, ΠΏΠΎ 2 (14%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° ΡΡΠ΅Π°Π³ΠΈΡΠΎΠ²Π°Π»ΠΈ Π½Π° ΡΡΠ±Ρ, Π°ΡΠ°Ρ
ΠΈΡ, ΠΊΡΠ½ΠΆΡΡ ΠΈ ΠΏΠΎ 1 (7%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ β Π½Π° Π³ΡΠ΅ΡΠΊΠΈΠΉ ΠΎΡΠ΅Ρ
ΠΈ ΠΊΡΠ΅Π²Π΅ΡΠΊΠΈ. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ΅ Π°Π»Π»Π΅ΡΠ³ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, Π² Ρ. Ρ. ISAC-ΡΠ΅ΡΡ (ImmunoCAP). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: Π² Ρ
ΠΎΠ΄Π΅ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Ρ Π²ΡΠ΅Ρ
Π΄Π΅ΡΠ΅ΠΉ (100%) Π±ΡΠ»Π° ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π° ΠΈΡΡΠΈΠ½Π½Π°Ρ ΠΏΠΈΡΠ΅Π²Π°Ρ Π°Π»Π»Π΅ΡΠ³ΠΈΡ Π½Π° ΠΏΡΠΎΠ΄ΡΠΊΡΡ, Π²ΡΠ·ΡΠ²Π°Π²ΡΠΈΠ΅ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅Π°ΠΊΡΠΈΠΈ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅ ΠΈ ΠΎΡΡΠ°ΡΡΠΈΠ΅ΡΡ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΠΏΠ΅ΡΡΠΈΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΈΡΠ΅Π²ΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ. Π£ Π²ΡΠ΅Ρ
14 Π΄Π΅ΡΠ΅ΠΉ (100%), ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΠΏΠΈΡΠ΅Π²ΡΡ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΡ, Π±ΡΠ»Π° Π²ΡΡΠ²Π»Π΅Π½Π° ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ ΠΊ Π³Π»Π°Π²Π½ΡΠΌ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ°ΠΌ ΠΈΠ½Π³Π°Π»ΡΡΠΈΠΎΠ½Π½ΡΡ
Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ². ΠΠ°ΠΈΠ±ΠΎΠ»ΡΡΠ°Ρ Π³ΠΈΠΏΠ΅ΡΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΎΡΠΌΠ΅ΡΠ΅Π½Π° ΠΊ Π±Π΅ΡΠ΅Π·Π΅ (rBet v1) β ΠΎΡ 0,3 Π΄ΠΎ 100,0 ISU-E (79%), ΠΊ ΠΊΠΈΠΏΠ°ΡΠΈΡΡ (nCup a1) β ΠΎΡ 0,3 Π΄ΠΎ 1,2 ISU-E (36%), ΠΊ ΠΊΠΎΡΠΊΠ΅ (rFel d1) β ΠΎΡ 1,6 Π΄ΠΎ 90,0 ISU-E (64%) ΠΈ ΠΊ ΡΠΎΠ±Π°ΠΊΠ΅ (rCan f1) β ΠΎΡ 1,1 Π΄ΠΎ 40,0 ISU-E (50%). ΠΠΈ Ρ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΈΠ· ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π΅ Π±ΡΠ»ΠΎ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΠΊΠ»Π΅ΡΠ΅ΠΉ Π΄ΠΎΠΌΠ°ΡΠ½Π΅ΠΉ ΠΏΡΠ»ΠΈ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: Π½Π°ΠΌΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΠΊ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ Ρ Π²ΡΠ΅Ρ
(100%) Π΄Π΅ΡΠ΅ΠΉ, ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈΡ
ΠΏΠΈΡΠ΅Π²ΡΡ Π°Π½Π°ΡΠΈΠ»Π°ΠΊΡΠΈΡ Π² Π°Π½Π°ΠΌΠ½Π΅Π·Π΅ ΠΈ ΠΈΠΌΠ΅ΡΡΠΈΡ
ΠΏΠ΅ΡΡΠΈΡΡΠΈΡΡΡΡΡΡ ΠΏΠΈΡΠ΅Π²ΡΡ Π°Π»Π»Π΅ΡΠ³ΠΈΡ Π² Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌ