Disturbance of the muscoloskeletal system in juvenile ankylosing spondylitis and disease developed in the adulthood (involvement of spine and sacroiliac joints).

Background. Two forms of ankylosing spondylitis (AS) are distinguished: juvenile and adult, depending on debut age of the disease. The diagnosis of juvenile AS (JAS) is one of the most urgent problems in a pediatric rheumatology. The peculiarities of AS course that onsets in childhood and adulthood are manifested by differences in the nature of a spinal column disturbance. At the same time, the evolution of JAS in adulthood remains unexplored. The goals and objectives of research: to study clinical and X-ray symptoms of spondylopathy and sacroiliitis course, to assess their characteristics in the disease that onset in childhood and adulthood. Material and methods. 217 patients with AS (193 men and 24 women) with an average age of 38 years were examined. The fast-progressing course of the disease was detected in 21% of cases, moderate and high degree of activity – in 79% of cases, the ІІ-ІІІ stage in 82%, and polyarthritis – in 65%. JAS was detected in 16% of cases (all boys), among them the third stage occurred twice more likely than among the other patients. Results. The clinical and radiologic signs of spondylopathy and sacroiliitis are observed in 95% and 97% of the total number of AS cases, respectively, among all patients with JAS lumbago was detected 4,3 times more frequently, sciatic muscles hypotrophy – 7,8 times, "the string symptom" - 2,9 times", the calcification of the spinal cord - 2,3 times, whereas the prevalence of spinal column injury, the severity of cervico-spondylopathy and sacroiliitis among patients with the disease debut in the adulthood is significantly greater, and the involvement in the process of the lumbar and thoracic spine are detected correspondingly twice as often and by 19%, occurrence of dorsalgia is 4 times as often, the limitation of body lateral bendover by 59%, while there are ambiguous dispersion-correlation links with extraarticular (systemic) manifestations of the disease, and the high prevalence of a peripheral articular syndrome regarding spondylopathy in JAS is a negative prognosis sign, and for the remaining patients there are indices of the Lansbury index and the index of arthro­pathy progression. Conclusion: the onset of AS in adulthood is a risk factor for the severe course of spondylopathy

The Marketing Communications as a Component of the Enterprise’s Marketing Policy in the International Market

The article is aimed at researching the features of formation of marketing communications as a part of the enterprise’s marketing policy in the international market. The essence of the concept of «marketing communications», the main means of marketing influence of enterprise in the international market are defined. The advantages and disadvantages of means of influence of marketing communications in the international business are allocated. A comparative characterization of the models of estimating the efficiency of marketing communications as important components of the marketing policy of enterprise, which allow to define the level of success of promo-actions, is carried out. The advantages and disadvantages of each model are allocated, depending on the specifics of the enterprise’s activity and the methods of sales promotion that the enterprise uses in the international market. The model of formation of system of marketing communications as a component of marketing policy of enterprise having a multilevel character is proposed. The model allows, in connection with the system of marketing communications, to consider consumer needs of the target audience and to evaluate efficiency of realization of promo-actions in the international market

Features of detection of latent tuberculosis infection and tuberculosis in children from household contacts within a household (clinical case)

Aim: to demonstrate the features of detection and diagnosis of latent tuberculosis infection and pulmonary tuberculosis in children from household contacts based on own clinical observation. Materials and methods. A clinical case of own observation of pulmonary tuberculosis and latent tuberculosis infection in children from household contacts who were treated in the paediatric department of the clinical base of the Phthysiatry and Pulmonology Department of Zaporizhzhia State Medical and Pharmaceutical University on Public Non-Profit Enterprise of the “Zaporizhzhia Regional Clinical and Diagnostic Center of Phthysiatry and Pulmonology” of Zaporizhzhia Regional Council. Results. Children from household contacts were examined at ages: 8 months, 2, 3, 5 and 7 years, after their mother was diagnosed with tuberculosis (TB). All children showed an increase in tuberculin skin test, at the X-ray of the thoracic cavity organs (TCO) no changes were detected in any child. Taking into account the age of the children and their constant residence with the index patient, a decision was made to conduct an additional examination using CT scan of the TCO. Thus, three children were diagnosed with pulmonary tuberculosis – primary tuberculosis complex, and two were infected. After receiving the results of the culture test in the gastric lavage, the youngest child was found MBT, which was resistant to first-line drugs, namely isoniazid and rifampicin, which required a treatment regimen adjustment. It should be noted that the youngest girl, who was not vaccinated, had the most widespread process in the lungs compared to other children. Conclusions. Monitoring and screening of children who have been in contact with the index patient within the household maximises the detection of additional cases of latent tuberculosis infection and pulmonary TB. The most at-risk groups are those who not vaccinated with BCG vaccine and children under 5 years of age. Early detection and timely prescription of anti-TB therapy is the key not only to effective treatment, but also to preventing the transmission of TB infection

Применение импульсного тока для растворения жаропрочного сплава ЖС32-ВИ

Objectives. To identify the regularities of electrochemical processing of the heat-resistant GS32-VI alloy in a sulfuric acid electrolyte with a concentration of 100 g/dm3 under the action of a pulsed current in a pulsed mode.Methods. Using the electrochemical technological complex EHK-1012 (developed by IP Tetran) and a non-compensatory method of measuring potential, polarization and depolarization curves with a change in pulse duration and a pause between them were recorded. The current pulses had an amplitude ranging from 0 to 3.5 A (when recording the polarization and depolarization curves), pulse durations ranging from 200 to 1200 ms, and a pause (delay) between pulses ranging from 50 to 500 ms. There were no reverse current pulses.Results. The parameters of the current program that provide the maximum values of the alloy dissolution rate and current output were determined: with a current pulse amplitude of 2 A, a current pulse duration of 500 ms, and a pause duration between pulses of 250 ms, the maximum dissolution rate of the alloy is 0.048 g/h·cm2, while the current output for nickel is 61.6% with an anode area of 10 cm2. The basic technological scheme for processing the heat-resistant GS32-VI alloy, which includes anodic alloy dissolution in a pulsed mode, is proposed.Conclusions. Electrochemical dissolution of GS32-VI alloy under pulsed current action results in an optimal dissolution rate ratio of the alloy components, ensuring the production of a cathode precipitate with a total nickel and cobalt content of 97.5%.Цели. Выявить закономерности электрохимической переработки жаропрочного сплава ЖС32-ВИ, проводимой в импульсном режиме в сернокислом электролите с концентрацией 100 г/дм3 под действием импульсного тока.Методы. Снятие поляризационных и деполяризационных кривых с изменением длительности импульса и паузы между ними проводили с помощью электрохимического технологического комплекса ЭХК-1012 (разработан ООО ИП «Тетран»), использующего некомпенсационный способ измерения потенциала. Амплитуда импульсов тока находилась в диапазоне значений от 0 до 3.5 А (при снятии поляризационных и деполяризационных кривых), длительности импульсов изменялись от 200 до 1200 мс, пауза (задержка) между импульсами – от 50 до 500 мс, импульсы реверсивного тока отсутствовали.Результаты. Определены параметры токовой программы, обеспечивающие максимальные значения скорости растворения сплава и выхода по току. При амплитуде импульса тока 2 А, длительности импульса тока 500 мс и продолжительности паузы между импульсами 250 мс максимальная скорость растворения сплава 0.048 г/ч·см2, при этом выход по току для никеля равен 61.6% при площади анода 10 см2. Предложена принципиальная технологическая схема переработки жаропрочного сплава ЖС32-ВИ, включающая анодное растворение сплава в импульсном режиме.Выводы. Электрохимическое растворение сплава ЖС32-ВИ под действием импульсного тока способствует оптимальному соотношению скоростей растворения составляющих сплава, что обеспечивает получение катодного осадка с суммарным содержанием никеля и кобальта 97.5%

ОДНОСТАДИЙНОЕ ПОЛУЧЕНИЕ НИКЕЛЕВОГО КОНЦЕНТРАТА ПРИ ПЕРЕРАБОТКЕ РЕНИЙСОДЕРЖАЩЕГО ЖАРОПРОЧНОГО СПЛАВА

The paper outlines the results of electrochemical processing of HAS32-VI heat-resistant alloy in nitric acid solutions. The main technological idea is based on running an electrochemical process at a controlled anodic potential value, thus providing for a preferential transition into nickel solution with nickel as basis metal, and synthesis of a cathodic product – metal nickel with purity of at least 95 %. Experiments in electrochemical dissolution of the said alloy were conducted using a nitric acid solution with concentration of 100 g/l at different values of anodic potential. It was determined that at Еa = 1,05 V cathodic product contains, %: Ni – 94,9, Re – 0,2, Co – 4,7, Cr – 0,1. The study determines that introduction of chloride ion (20 g/l) into the nitric acid electrolyte has no significant effect on the process parameters: the amount of nickel in anodic slime is reduced from 2,4 to 1,6 % with no significant increase of nickel content in the cathodic product. An exception is a considerable increase in the transition speed of rhenium into electrolyte: after a 10-hour process, rhenium concentration in a nitric acid electrolyte was 1,26 g/l; in a nitric acid electrolyte with addition of chloride ion – 8,90 g/l. The study demonstrates that the process of electrochemical dissolution of Re-containing heat-resistant nickel-based alloys at a controlled anodic potential Еa = 1,05 V in nitric acid electrolytes provides for a one-stage synthesis of nickel concentrate with a purity of not less than 95 % and allows to concentrate rhenium in anodic slime.Изложены результаты электрохимической переработки жаропрочного сплава ЖС32-ВИ в азотнокислых растворах. Главная технологическая идея состоит в проведении электрохимического процесса при контролируемом значении анодного потенциала, что обеспечивает преимущественный перевод в раствор никеля, являющегося основой сплава, и получение катодного продукта – металлического никеля чистотой не менее 95 %. Проведены эксперименты по электрохимическому растворению указанного сплава с использованием раствора азотной кислоты с концентрацией 100 г/л при различных значениях анодного потенциала. Определено, что при Еa = 1,05 В катодный продукт содержит, %: Ni – 94,9, Re – 0,2, Co – 4,7, Cr – 0,1. Установлено, что введение хлорид-иона (20 г/л) к азотнокислому электролиту не оказывает существенного влияния на показатели процесса: количество никеля в анодном шламе снижается с 2,4 до 1,6 %, значительного увеличения содержания никеля в катодном продукте не происходит. Исключение составляет значительное возрастание скорости перехода рения в электролит: после 10-часового технологического процесса концентрация рения в азотнокислом электролите составляет 1,26 г/л, в азотнокислом электролите с добавкой хлорид-иона – 8,90 г/л. Показано, что проведение процесса электрохимического растворения Re-содержащих жаропрочных сплавов на основе никеля при контролируемом анодном потенциале Еa = 1,05 В в азотнокислых электролитах обеспечивает получение никелевого концентрата чистотой не менее 95 % в одну стадию и позволяет сконцентрировать рений в анодном шламе

NERVOUS SYSTEM LESION IN ANKYLOSING SPONDYLITIS, IN THE DISEASE BEGINNING IN СHILDHOOD AND ADULTHOOD

The incidence of ankylosing spondylitis (AS) in population amounts to 0.3 %, which is significantly more likely to develop at the age of 20–30 years. There are two forms of AS – juvenile and adults, depending on the age of the disease debut. The problem of juvenile AS (JAS) diagnostics is one of the most relevant in pediatric rheumatology, and the evolution of this disease remains unexplored in adulthood. The aim of the study – to learn the frequency and nature of separate clinical signs of CNS and PNS lesions in patients with AS , and to evaluate their special features in the disease beginning in childhood and adulthood. Materials and Methods. 217 patients with AS (193 males and 24 females) with an average age of 38 years were examined. The rapidly progression course is detected in 21 % of patients, moderate and high activity rate – in 79 %, stage II–III – in 82 %, polyarthritis – in 65 %. JAS was noted in 16 % of cases (all boys), in which stage III took place twice as often than other patients. Results and Discussion. Changes in PNS are observed in 4.9 times more often among patients with JAS , and CNS is 2 times less often than in cases of the disease debut in adulthood, moreover among the patients of the 1st group, the severity of CNS disturbance is associated with the involvement of the cervical spine and the prevalence of spondylopathy, PNS is associated with the availability of tendovaginitis, arthritis of the "root joints" (shoulder, hip) and changes in the thoracic spine, while in the 2nd group it is associated with the parameters of the integral index of arthritis activity and the x-ray stage of the disease, with disturbance of "root" and sacroiliac joints, wherein the age of the disease onset affects the development of asthenic vegetative and corticonuclear syndrome, the emergence of radiculopathy, cervicocranialgia and metacarpal canal syndrome, and in the pathogenetic architectonics of the CNS pathology the level of immunoglobulin-A plays a greater role, and in PNS the serum interleukin 1-β contents, which, in addition, in cases of JAC determine the occurrence of cervicocranialgia, and in the remaining observations of AS – the Morton's metatarsalgia. Conclusions. AS with different age of the disease debut is a risk factor for the development of certain symptoms of the CNS and PNS disturbances, which in these groups have their pathogenetic features

Comparative assessment of primary and paraneoplastic gout in lung cancer

Abstract Introduction. Lung cancer (LС) is the most common cause of the so-called paraneoplastic syndrome (PNPS) development, caused by the complex immunoinflammatory, degenerative and vascular distant changes. The risk of LC development is increased in patients with gout which proves the connection between violations of purine metabolism and carcinogenesis. Paraneoplastic (neoplastic) gout is one of the relatively frequent manifestations of LC, but such a relationship of the diseases requires further study. The objective of the study: to compare the clinical and laboratory course of primary gout and disease in the LC patients compared with the tumor process clinical course in the other signs of PNPS presence and to identify risk factors. Materials and methods. 113 patients with gout (97 men and 16 women aged 33 to 79 years) were observed. They were divided into two groups: the first group consisted of 54 patients with primary gout and the second group consisted of 59 patients with paraneoplastic variant of LC. Whereas in the 1st group the ratio of men and women was 26:1, in the 2nd – only 3: 1, and the average age was 50 and 59 years, respectively. The clinical course of gout and tumor process in the 2nd (main) group was compared with that in 199 LC patients with PNPS (comparison group), which was diagnosed in 15.5 % of LC observations. Purine metabolism was assessed by blood levels of uric acid and oxypurinol, their renal clearance, serum activity of xanthine oxidase, xanthine deaminase, adenosine deaminase, and 5-nucleotidase. Results. Paraneoplastic (neoplastic) gout develops in 3.5 % of the LC patients and in 22.9 % of those with PNPS. It differs from the primary (idiopathic) gout by the greater frequency of the disease development in women, the hand joints involvement and the metabolic type of hyperuricemia, but less often observed urolithiasis, peripheral tophi, chronic form of arthritis and the absence of renal type of purine metabolism impairment. Patients with tumorous gout differ from other LC patients with PNPS by the absence of bilateral and median lobe localization of the lung process, but relatively frequent occurrence of Pancoast tumor, high levels of uric acid and xanthine oxidase in the blood. The development of paraneoplastic gout depends on the clinical course of the LC (tumor invasion into the thoracic wall and pericardium, the number of distant organs metastasis) and the power of chemotherapy, the use of alkylating antineoplastic agents and alkaloids. Treatment-associated myelodepression, radiation pneumofibrosis and acute thrombophlebitis development depends on paraneoplastic gout. The presence of gout does not worsen the survival of LC patients with PNPS. LC patients with hyperuricemia (> 420 μmol / l in men and > 360 μmol / L in women) should be prescribed with xanthine oxidase inhibitor - allopurinol in the complex of therapeutic measures. Conclusions. Paraneoplastic gout is a frequent PNPS manifestation in LC, its course has peculiarities compared with the primary gout and is closely related to the tumor process character and the power of chemotherapy, it can determine the complications development in the course of therapeutic interventions. The data presented in the study require further comparative analysis of the other signs of PNPS, comparison of tumor and idiopathic variants of the musculoskeletal system lesion, cutaneous vasculitis and autoimmune systemic syndromes, which might assist in developing of the additional prognostic criteria for the tumor process clinical course, increasing the efficiency of therapy and its control quality

ІНФОРМАЦІЙНА СИСТЕМА (ІС) ДЛЯ ОТРИМАННЯ ТА ОБРОБЛЕННЯ МІКРОСКОПІЧНИХ ЗОБРАЖЕНЬ ЦИРКУЛЮЮЧИХ ПУХЛИННИХ КЛІТИН (ЦПК)

The article presents the structure and implementation of an information system for obtaining and processing microscopic images of the CPC. It is determined that identification of CPC is a complex task, which is practically inaccessible to clinical doctors due to the absence of relevant medical protocols and technological standards for the detection of CPC. The methods of isolation of the CPC are given, and the seven: the technology of separation by morphological features, the method of dividing by density gradient, using centrifugation and subsequent allocation by the OncoQuick technology of the CPC, immune-magnetic methods in which tumor cells interact with antibodies against the markers of CPP with conjugated magnetic particles, after which the cancer cells can be obtained by means of a magnetic field, and their disadvantages. The information system for obtaining and analyzing microscopic images of the CPK, which consists of 4 subsystems: venous blood filtration is developed. Receiving and preprocessing images of the CPC; the formation of images of the CPC and the "intellectual" image processing of the CPC, which, together with the patient's venous blood filtration subsystem, is the basic structural element of information technology for the determination of circulating tumor cells in human blood. The peculiarity of the developed system is the introduction into its structure of the subsystem of "intellectual" image processing of the CPC, which serves as a subsystem of maintaining decision-making and provides almost 100% conformity of the diagnosis to the actual situation, eliminating ambiguity in its interpretation. The problem solving was found, namely, the application of the information system proposed by the authors for the receipt and processing of microscopic images of the MIC for early diagnosis of oncology diseases.В статье приведена структура и реализацию информационной системы для получения и обработки микроскопических изображений ЦОК. Определено, что идентификация ЦОК является сложной задачей, которая практически недоступна клиническим врачам за причины отсутствия соответствующих медицинских протоколов и технологических стандартов выявления ЦОК. Приведены методы выделения ЦОК, а семе: технологии разделения по морфологическим признакам, метод разделения по градиенту плотности с использованием центрифугирования и последующего выделения технологии OncoQuick ЦОК, имуномагнитные методы, в которых опухолевые клетки взаимодействуют с антителами против маркеров ЦОК с конъюгированными магнитными частицами, после чего раковые клетки можно получить с помощью магнитного поля, и их недостатки. Разработана информационная система для получения и анализа микроскопических изображений ЦОК, состоит из 4-х подсистем: фильтрации венозной крови получения и предварительной обработки изображений ЦОК; формирования изображений ЦОК и «интеллектуальной» обработки изображений ЦОК, вместе с подсистемой фильтрации венозной крови пациента представляет собой базовый структурный элемент информационной технологии для определения циркулирующих опухолевых клеток в крови человека. Особенностью разработанной системы является введение в ее структуру подсистемы «интеллектуальной» обработки изображений ЦОК, выполняет функции подсистемы поддержания принятия решений и обеспечивает практически 100% соответствие поставленного диагноза реальной ситуации, исключив неоднозначность в его интерпретации. Найдено решение проблемы, а именно применение предложенной авторами информационной системы для получения и обработки микроскопических изображений ЦОК для ранней диагностики онкологических заболеваний.У статті наведено структуру та реалізацію інформаційної системи для отримання та оброблення мікроскопічних зображень ЦПК. Визначено, що ідентифікація ЦПК є складною задачею, яка практично недоступна клінічним лікарям за причини відсутності відповідних медичних протоколів і технологічних стандартів виявлення ЦПК. Наведено методи виділення ЦПК, а семе: технології поділу за морфологічними ознаками, метод поділу за градієнтом щільності, з використанням центрифугування і подальшого виділення технологією OncoQuick ЦПК, імуномагнітні методи, в яких пухлинні клітини взаємодіють з антитілами проти маркерів ЦПК з кон'югованими магнітними частинками, після чого ракові клітини можна отримати за допомогою магнітного поля, та їх недоліки. Розроблено інформаційну систему для отримання та аналізу мікроскопічних зображень ЦПК, яка складається з 4-х підсистем: фільтрації венозної крові; отримання і попередньої обробки зображень ЦПК; формування зображень ЦПК та «інтелектуальної» обробки зображень ЦПК, яка разом з підсистемою фільтрації венозної крові пацієнта представляє собою базовий структурний елемент інформаційної технології для визначення циркулюючих пухлинних клітин в крові людини. Особливістю розробленої системи є введення до її структури підсистеми «інтелектуальної» обробки зображень ЦПК, яка виконує функції підсистеми підтримання прийняття рішень і забезпечує практично 100% відповідність поставленого діагнозу реальній ситуації, виключивши неоднозначність в його інтерпретації. Знайдено вирішення проблеми, а саме застосування запропонованої авторами інформаційної системи для отримання та оброблення мікроскопічних зображень ЦПК для ранньої діагностики онкологічних захворювань

Электрохимическое оборудование нового поколения: возможности и перспективы использования

The article presents new generation of the electrochemical equipment realizing technologies with controllable potential. The basic differences and advantages of electrochemical complex before the existing equipment are given. Examples of application electrochemical complex in technology of rare and platinum metals are given.В статье представлены основные предпосылки для создания нового поколения электрохимического оборудования, реализующего технологии с контролируемым потенциалом, приведены основные отличия и преимущества перед существующим оборудованием. Даны примеры, иллюстри- рующие возможности применения электрохимического комплекса в техно- логии редких и платиновых металлов