Creation of a three-dimensional point cloud model of the residential complex "Ozera Jozefa"

Geodetic works were carried out at the address Hordynskykh 15а Street, in the city of Lviv. The residential complex "Ozera Jozefa" is an upscale, club-type building situated in a cozy green corner of Lviv, near the Piskovi Ozera Park. The building has 6 floors and an underground parking facility, accommodating only 20 apartments. The construction technology is based on monolithic-frame construction. The building is equipped with a modern ventilated facade system, the main advantage of which is the free circulation of air between the facing and the wall. This allows for the efficient removal of moisture and condensation from the facade structure. Additional insulation is provided by a layer of mineral wool. This system helps to retain heat in the rooms during winter and prevent wall overheating in the summer. Additionally, it offers high sound insulation. To develop the facade, windows, and door openings, it is necessary to create a point cloud 3D model of the structure

Analysis of the Health State of Children of the First Year of Life, Living in a Zone of Service of Branch «The Children’s Polyclinic №45» of Rostov-on-Don

Purpose: To study and analyze the state of health of the children of the first year of a life by means of screening and monitoring within the limits of realization of the National Project of «Health».Materials and Methods: Extracts from maternity hospitals, results neonatal screening, case history of the 1535 children living in a zone of service of branch MLPUZ «The Children’s Polyclinic №45» of Rostov-on-Don are analyzed.Results: The first group of health in the neonatal period consisted 5,5%. By the end of the year of supervision this parameter had grown up to 20,5 %. Despite the identified plural pathology physical and neuro-psychological development of the examined do not lag behind the average parameter in Russia.Summary: The important reasons of a unsatisfactory state of health of children of the first year recognize a social factor and low sanitary culture of parents

Clinical case of gusher-syndrome in surgery of a congenital isolated malformation of the middle ear

Gusher syndrome is a rather rare condition complicating surgical interventions on the stapes. It is characterized by profuse effusion of perilymphatic fluid from the vestibule into the lumen of the tympanic cavity during fenestration or removal of the foot plate of the stapes and rapid filling of the volume of the tympanic cavity and the external auditory canal with perilymph. This is due to increased pressure of perilymph fluid in the inner ear cavity in some developmental anomalies. Preoperative diagnosis of gusher syndrome can be difficult when the CT scan does not show any abnormalities in the anatomy of the inner ear canal and inner ear structures. The rarity of this phenomenon greatly complicates the procedure of its study, as well as the development of optimal schemes of therapeutic and diagnostic tactics in a real clinical situation. A clinical case of a combination of congenital isolated middle ear developmental anomaly and gusher syndrome is studied. A patient with suspected otosclerosis underwent stapedoplasty at Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech. During the operation, abundant perilymphorrhea "Gusher" symptom was obtained, as well as thickening of the stapes legs and thin tendon of the stirrup muscle were revealed. The postoperative diagnosis was changed from otosclerosis to congenital isolated anomaly of middle ear development (isolated ankylosis of the stapes), gusher syndrome. The tactics of management of a patient with otosclerosis and isolated middle ear anomaly are similar. CT of temporal bones and virtual CT endoscopy should become the standard of examination of patients before surgical treatment. The use of cartilage and supracartilage is a safe way to stop perilymphorrhea in patients with gusher syndrome

СОВРЕМЕННАЯ ЛУЧЕВАЯ ТЕРАПИЯ ЖЕЛУДКА

External beam radiation therapy (EBRT) is currently an important component of the treatment of gastric cancer (GC). In accordance with international and domestic recommendations, it can be used in the postoperative period, before the operation and as a sole option, with a curative and palliative purpose, usually in combination with chemotherapy. With the transition of RT to a new technological level, which involves the use of conformal, intensively modulated regimens, and image guidance the revision of indications for and doses of EBRT is required. The article discusses modern approaches to the determination of irradiated volumes in various clinical scenarios of current radiation therapy for GC and strategies aimed at reducing the dose in critical organs at risk and increasing the overall effectiveness of treatment.Дистанционная лучевая терапия (ЛТ) в настоящее время является важным компонентом лечения рака желудка (РЖ). В соответствии с международными и отечественными рекомендациями она может быть использована в послеоперационном периоде, перед операцией и самостоятельно, с лечебной и паллиативной целью, как правило, в сочетании с химиотерапией. В связи с переходом ЛТ на новый технологический уровень, предусматривающий использование конформных, интенсивно-модулированных режимов, требуется пересмотр показаний, доз и режимов дистанционного облучения. В статье рассмотрены современные подходы к определению облучаемых объемов при различных клинических сценариях современной ЛТ по поводу РЖ и обсуждены стратегии, направленные на снижение дозы в критических органах и повышение эффективности лечения

Влияние пандемии COVID-19 на показатели заболеваемости злокачественными опухолями, подлежащими скринингу в рамках диспансеризации (популяционное исследование)

Background. During the COVID-19 pandemic, annual adult check-ups have been postponed, resulting in cancer screening disruption.The aim of the study was to evaluate changes in the incidence and stage distribution of malignancies included in the screening program during the COVID-19 pandemic using the Arkhangelsk Regional Cancer Registry (ARRC).Material and Methods. We assessed the changes of the incidence rates and stage distribution for the colon, rectum, lung, breast, cervix, uterine body, ovary, prostate and kidney cancers over the periods 2018–19 and 2020–21. Results. A total of 12354 cases with 9 cancers were selected: 6680 for the period 2018–19 and 5674 (-15.1 %) for the period 2020-21. The most significant decrease in crude and age-standardized incidence rates was registered in patients with lung (-18.0–18.1 %), rectum (-25.1–25.9 %) and cervix (-33.6–36.9 %) cancers, p<0.001. The decrease was not signifcant in patients with breast, uterine body, and kidney cancers. The proportion of patients with stage I decreased in lung cancer (-20.0 %, from 14.8 % to 11.8 %), rectum (-20.2 %, from 20.9 % to 16.7 %), and uterine cervix (-37.1 %, from 53.2 % to 33.5 %). In prostate and kidney cancers, the proportion of patients with stage I increased by 30 % (from 19.5 % to 25.4 %) and 17.6 % (from 45.9 % to 54.0 %), respectively. A signifcant reduction in the proportion of early stages during the COVID-19 pandemic was observed in lung and cervical cancer. Conclusion Postponed health checkups due to COVID-19 pandemic disruptions have led to substantial reductions in new cancers being diagnosed, mainly for cervical, lung, colon and rectal cancers. No signifcant changes were observed for other cancers. Further analysis of mortality and survival of cancer patients is required. Key words: health checkup, cancer screening, COVID-19 pandemic, cancer incidence, stage distribution>˂0.001. The decrease was not significant in patients with breast, uterine body, and kidney cancers. The proportion of patients with stage I decreased in lung cancer (-20.0 %, from 14.8 % to 11.8 %), rectum (-20.2 %, from 20.9 % to 16.7 %), and uterine cervix (-37.1 %, from 53.2 % to 33.5 %). In prostate and kidney cancers, the proportion of patients with stage I increased by 30 % (from 19.5 % to 25.4 %) and 17.6 % (from 45.9 % to 54.0 %), respectively. A significant reduction in the proportion of early stages during the COVID-19 pandemic was observed in lung and cervical cancer.Conclusion. Postponed health checkups due to COVID-19 pandemic disruptions have led to substantial reductions in new cancers being diagnosed, mainly for cervical, lung, colon and rectal cancers. No significant changes were observed for other cancers. Further analysis of mortality and survival of cancer patients is required. Актуальность. В период пандемии COVID-19 была приостановлена диспансеризация отдельных групп взрослого населения (ДОГВН), что могло привести к ухудшению скрининга ряда злокачественных новообразований (ЗНО).Цель исследования ‒ оценить изменения заболеваемости и стадийной структуры ЗНО, включенных в программу скрининга в рамках ДОГВН, во время пандемии COVID-19 по данным Архангельского областного канцер-регистра (АОКР).Материал и методы. Оценивали динамику показателей заболеваемости и распределения по стадии при индексных ЗНО (иЗНО) ободочной, прямой кишки, легкого, молочной железы, шейки, тела матки, яичников, предстательной железы и почки в периоды 2018–19 гг. и 2020–21 гг.Результаты. Всего отобрано 12354 случая заболевания при девяти иЗНО: в 2018–19 гг. выявлено 6680, в 2020–21 гг. – 5674 (-15,1 %). Наиболее выраженное снижение «грубых» и стандартизованных по возрасту показателей заболеваемости зарегистрировано при раке легкого (-18,0–18,1 %), прямой кишки (-25,1–25,9 %) и шейки матки (-33,6–36,9 %), различия статистически значимы (р<0,001). Снижение было статистически незначимым при раке молочной железы, тела матки, почки. Доля больных I стадии уменьшалась при раке легкого (на 20,0 %, с 14,8 до 11,8 %), прямой кишки (на 20,2 %, с 20,9 до 16,7 %), шейки матки (на 37,1 %, с 53,2 до 33,5 %). При раке предстательной железы и почки зарегистрировано увеличение доли I стадии на 30 % (с 19,5 до 25,4 %) и 17,6 % (с 45,9 до 54,0 %) соответственно. В возрастных группах скрининга в рамках ДОГВН значимое снижение доли ранних стадий в период пандемии COVID-19 наблюдали при раке легкого и шейки матки. Заключение. Ограничение ДОГВН в период пандемии привело к уменьшению числа выявленных иЗНО в основном за счет ранних стадий при раке шейки матки, легкого, ободочной и прямой кишки. При других иЗНО эти изменения были не столь явными. В дальнейшем требуется анализ смертности и выживаемости больных иЗНО. Ключевые слова: диспансеризация взрослого населения, скрининг рака, индексные злокачественные новообразования, пандемия COVID-19, заболеваемость, распределение по стадии.>˂ 0,001). Снижение было статистически незначимым при раке молочной железы, тела матки, почки. Доля больных I стадии уменьшалась при раке легкого (на 20,0 %, с 14,8 до 11,8 %), прямой кишки (на 20,2 %, с 20,9 до 16,7 %), шейки матки (на 37,1 %, с 53,2 до 33,5 %). При раке предстательной железы и почки зарегистрировано увеличение доли I стадии на 30 % (с 19,5 до 25,4 %) и 17,6 % (с 45,9 до 54,0 %) соответственно. В возрастных группах скрининга в рамках ДОГВН значимое снижение доли ранних стадий в период пандемии COVID-19 наблюдали при раке легкого и шейки матки.Заключение. Ограничение ДОГВН в период пандемии привело к уменьшению числа выявленных иЗНО в основном за счет ранних стадий при раке шейки матки, легкого, ободочной и прямой кишки. При других иЗНО эти изменения были не столь явными. В дальнейшем требуется анализ смертности и выживаемости больных иЗНО.

Эпидемиологические факторы прогноза выживаемости больных раком тела матки: популяционный анализ

Cancer of the corpus uteri (CCU) is one of the most common gynecological malignancies in high- and middleincome countries. The objective of the study was to evaluate the factors predicting survival in CCU patients over the period 2000-2021 using the data of population-based cancer registry of the Arkhangelsk region. Material and Methods. Cancer-specific survival (CSS) of patients with CCU for the period 2000-21 was evaluated using life tables and Kaplan-Mayer methods with a log-rank test. The Cox proportional hazards regression model was used to assess the effect of prognostic factors on survival time. Results. A total of 3272 cases were selected for the analysis. The 5-year survival rates improved from 70.6 % in 2000-04 to 75.6 % in 2015-19. In stage I, II, III, and IV CUN, the 5-year survival rates were 90.8 % (95 % CI 89.3-92.0 %), 71.1 (95 % CI 66.3-75.4 %), 46.7 (95 % CI 41.4-51.8 %), and 3.9 (95 % CI 1.5-7.5 %), respectively; p<0.001. In the multivariate regression model, for stage II, III, and IV CCU, the hazard ratios for death from cancer were respectively 2.69 (2.14-3.39), 5.73 (4.66-7.03), and 20.26 (16.13-25.44) compared to stage I. The risk of death from CCU was 2.0-2.7 times higher in patients with aggressive histological subtypes and sarcomas compared to that in patients with endometrioid adenocarcinoma; 2.0-2.8 times higher in patients older than 60 years compared to younger patients, and 1.3 times higher in rural patients compared to urban patients (p<0.05). There was no increase in the risk of death from CCU over the period of COVID-19 pandemic. Conclusion. In this population-based study, we have found that the survival of patients with CCU is significantly affected by age and place of residence, which may indicate a limited access of some patients to effective treatment and requires further analysis. No increased risk of death from CCU during the COVID-19 pandemic was found.Актуальность. Злокачественные новообразования тела матки (ЗНО ТМ) лидируют среди гинекологических опухолей в России и мире. Цель исследования - оценить факторы прогноза выживаемости при ЗНО ТМ в период с 2000 по 2021 г. по данным популяционного канцер-регистра Архангельской области (АОКР). Материал и методы. Опухолеспецифическую выживаемость (ОСВ) больных ЗНО ТМ, зарегистрированных в АОКР за период 2000-21 гг., оценивали актуарным методом и методом Каплана-Майера с лог-ранговым критерием. Прогностическое значение популяционных факторов определяли с помощью регрессии Кокса; включение в модель прогностических факторов осуществляли форсированным способом. Результаты. Для анализа отобрано 3272 случая. Показатели 5-летней выживаемости улучшались с 70,6 % в 2000-04 гг. до 75,6 % в 2015-19 гг. При I, II, III, IV стадиях ЗНО ТМ 5-летняя выживаемость составила 90,8 (95 % ДИ 89,3-92,0 %), 71,1 (95 % ДИ 66,3-75,4 %), 46,7 (95 % ДИ 41,4-51,8 %), 3,9 % (95 % ДИ 1,5-7,5 %), p<0,001. В множественной регрессионной модели при II, III, IV стадиях отношение рисков смерти по сравнению с I стадией составило 2,69 (2,14-3,39), 5,73 (4,66-7,03), 20,26 (16,13-25,44) соответственно. Риск смерти от ЗНО ТМ в 2,0-2,7 раза был выше при агрессивных гистологических подтипах и саркомах по сравнению с эндометриоидной аденокарциномой, в 2-2,8 раза выше у больных старше 60 лет по сравнению с более молодыми пациентками, у больных, проживающих в сельской местности, - в 1,3 раза выше по сравнению с больными из городов (р<0,05). Заключение. Установлено, что на выживаемость пациенток с ЗНО ТМ, помимо клинических факторов, значимо влияют возраст и место проживания, что может свидетельствовать об ограниченном доступе части больных к эффективному лечению и требует дальнейшего изучения. Риск смерти от ЗНО ТМ в период пандемии COVID-19 не повышался

Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe