Опыт хирургического лечения больных туберкулезом с поражением костей и суставов различной этиологии

Introduction. A decrease in the number of patients with tuberculosis of the bone system coincides with an increase in the number of indications and methods for operational treatment. The continuing development in skeletal tuberculosis surgery techniques determines the search for a material capable of replacing autologous bone. Therefore, the main purpose of this paper is to enhance the results of treatment of spinal caries to speed up treatment of tuberculous osteomyelitis by applying collagen material and to solve the issues of orthopedic alignment for TB patients.Materials and methods. Surgical treatment was carried out on 32 patients in 2016–2018. The patients were divided into several groups: 18 underwent transpedicular fixation of the spine, 2 had concomitant HIV-infection, 2 underwent necrectomy of vertebral bodies with anterior spondylodesis lift system, 1 underwent necrectomy of vertebral bodies with bone autoplasty and with plate fixation, 2 had cervical spine fixation, while 2 patients with pulmonary tuberculosis in the humerus traumatic fracture received intramedullary surgery.Results. 31 patients reported a positive dynamic following surgery, while a fatal outcome not connected with the surgery was experienced in one case. Complications included allergic reaction in one case, while three patients developed postoperative wound seroma (both patients having HIV infection). One patient reported pain in the lower extremities following TPF. 3 patients with osteitis underwent necrectomy and filling of cavities with collagen material. Wounds were healed by secondary healing, while no rejection of collagen material took place.Conclusions. Introduction of collagen material in osteitis treatment can speed up fistula healing. The research work demonstrated the possibility of providing trauma care to patients under the conditions of an antitubercular centre.Введение. На сегодняшний день имеются тенденции к уменьшению количества пациентов с туберкулезом костной системы и расширению показаний и способов их оперативного лечения. Развитие хирургии туберкулеза костей определяет «поиски нового материала, способного заменить аутокость». В этой связи основная цель данной работы: улучшить результаты лечения туберкулезного спондилита, ускорить излечение туберкулезных остеомиелитов применением коллагенового материала и решить проблемы ортопедического лечения больных туберкулезом.Материалы и методы. В 2016–2018 гг. хирургическое лечение проведено у 32 пациентов. Пациенты представляли несколько групп: 18 пациентам выполнена транспедикулярная фиксация позвоночника, у двоих сопутствующей патологией была ВИЧ-инфекция, 2 выполнена некрэктомия тел позвонков с передним спондилодезом лифт-системой, 1 пациенту — некрэктомия тел позвонков с аутопластикой костью и фиксацией пластиной, 2 пациентам — фиксация накостной пластиной шейного отдела позвоночника, 2 пациентам с туберкулезом легких при травматическом переломе плечевой кости установлена интрамедуллярная система.Результаты. После операции 31 пациент отмечал положительную динамику, летальный исход был в одном случае (не связан с операцией). Из осложнений наблюдались аллергическая реакция в одном случае, у трех пациентов — серома послеоперационной раны (у обоих пациентов с ВИЧ-инфекцией). Одна пациентка после ТПФ отметила появление болевого синдрома в нижних конечностях. 3 больным с оститами сделана некрэктомия, пломбировка полостей коллагеновым материалом. Заживление ран произошло через вторичное заживление, отторжения коллагенового материала не произошло.Заключение. Внедрение коллагенового материала в лечение оститов позволяет ускорить заживление свищей. Обоснована возможность оказания травматологической помощи больным в условиях противотуберкулезного учреждения

First-principles design and subsequent synthesis of a material to search for the permanent electric dipole moment of the electron

We describe the first-principles design and subsequent synthesis of a new material with the specific functionalities required for a solid-state-based search for the permanent electric dipole moment of the electron. We show computationally that perovskite-structure europium barium titanate should exhibit the required large and pressure-dependent ferroelectric polarization, local magnetic moments, and absence of magnetic ordering even at liquid helium temperature. Subsequent synthesis and characterization of Eu$_{0.5}$Ba$_{0.5}$TiO$_3$ ceramics confirm the predicted desirable properties.Comment: Nature Materials, in pres

Methods of reduction of technological losses of water in irrigation of agricultural crops in the Syr-Darya river basin

Irrigation water management techniques for cotton production in the Syr Dara river basin are described. Alternate furrow methods and other water saving technologies enable reduction in water demands. Extension workers ensured successful promulgation of these techniques in drought years

Operative Therapy Practices in Tubercular Patients with Bone and Joint Effects of Different Etiologies

Introduction. A decrease in the number of patients with tuberculosis of the bone system coincides with an increase in the number of indications and methods for operational treatment. The continuing development in skeletal tuberculosis surgery techniques determines the search for a material capable of replacing autologous bone. Therefore, the main purpose of this paper is to enhance the results of treatment of spinal caries to speed up treatment of tuberculous osteomyelitis by applying collagen material and to solve the issues of orthopedic alignment for TB patients.Materials and methods. Surgical treatment was carried out on 32 patients in 2016–2018. The patients were divided into several groups: 18 underwent transpedicular fixation of the spine, 2 had concomitant HIV-infection, 2 underwent necrectomy of vertebral bodies with anterior spondylodesis lift system, 1 underwent necrectomy of vertebral bodies with bone autoplasty and with plate fixation, 2 had cervical spine fixation, while 2 patients with pulmonary tuberculosis in the humerus traumatic fracture received intramedullary surgery.Results. 31 patients reported a positive dynamic following surgery, while a fatal outcome not connected with the surgery was experienced in one case. Complications included allergic reaction in one case, while three patients developed postoperative wound seroma (both patients having HIV infection). One patient reported pain in the lower extremities following TPF. 3 patients with osteitis underwent necrectomy and filling of cavities with collagen material. Wounds were healed by secondary healing, while no rejection of collagen material took place.Conclusions. Introduction of collagen material in osteitis treatment can speed up fistula healing. The research work demonstrated the possibility of providing trauma care to patients under the conditions of an antitubercular centre

Enhancing the productivity of high-magnesium soil and water resources in Central Asia through the application of phosphogypsum

Recent evidences from some irrigated areas worldwide, such as Central Asia, suggest that water used for irrigation contains magnesium (Mg2?) at levels higher than calcium (Ca2?). Excess levels of Mg2? in irrigation water and/or in soil, in combination with sodium (Na2?) or alone, result in soil degradation because of Mg2? effects on the soil's physical properties. More than 30 per cent of irrigated lands in Southern Kazakhstan having excess levels of Mg2? are characterized by low infiltration rates and hydraulic conductivities. The consequence has been a gradual decline in the yield of cotton (Gossypium hirsutum L.), which is commonly grown in the region. These soils require adequate quantities of Ca2? to mitigate the effects of excess Mg2?. As a source of Ca2?, phosphogypsum?a byproduct of the phosphorous fertilizer industry?is available in some parts of Central Asia. In participation with the local farming community, we carried out a 4-year field experiment in Southern Kazakhstan to evaluate the effects of soil application of phosphogypsum?0, 4_5, and 8_0 metric ton per hectare (t ha_1)?on chemical changes in a soil containing excess levels of Mg2?, and on cotton yield and economics. The canal water had Mg2? to Ca2? ratio ranging from 1_30 to 1_66 during irrigation period. The application of phosphogypsum increased Ca2? concentration in the soil and triggered the replacement of excess Mg2? from the cation exchange complex. After harvesting the first crop, there was 18 per cent decrease in exchangeable magnesium percentage (EMP) of the surface 0_2m soil over the pre- experiment EMP level in the plots where phosphogypsum was applied at 4_5 t ha_1, and a 31 per cent decrease in EMP in plots treated with phosphogypsum at 8 t ha_1. Additional beneficial effect of the amendment was an increase in the soil phosphorus content. The 4-year average cotton yields were 2_6 t ha_1 with 8 t ha_1 phosphogypsum, 2_4 t ha_1 with 4_5 t ha_1 phosphogypsum, and 1_4 t ha_1 with the control. Since the amendment was applied once at the beginning, exchangeable Mg2? levels tended to increase 4 years after its application, particularly in the treatment with 4_5 tha_1 phosphogypsum. Thus, there would be a need for phosphogypsum application to such soils after every 4-5 years to optimize the ionic balance and sustain higher levels of cotton production. The economic benefits from the phosphogypsum treatments were almost twice those from the control