68 research outputs found

    Osteoconductive properties of carbon fibre implants used in surgery of spine injuries and disorders (case report)

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    Purpose To assess osteoconductive properties of carbon fibre implants used in surgery of spine injuries and disorders. Materials and methods Two clinical cases from a multicentre prospective study on nanostructured carbon fibrous implants applied for a variety of spinal pathology are presented. Results The usage of highly porous carbon fibre implant resulted in bone and carbon fusion in the clinical instances whereas implants with a residual porosity of 7–12 % showed no fusion between bone and carbon. The patients had satisfactory clinical condition and quality of life. Discussion Carbon fibrous implant characteristics are close to those of bone tissue, being inert and osteoconductive along with high mechanical strength that ensure bone and carbon fibrous fusion with highly porous implan

    Аневризмы системы воротной вены: значение лучевых методов в диагностике и лечении (обзор литературы)

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    Portal venous system aneurysms - is the term used for the description of aneurysms of portal vein, mesenterica superior and inferior veins, splenic vein and confluence of splenic and mesenterica superior veins. Portal venous system aneurysms consider as rather rare nosological form with various pathogenesis, clinical manifestations or lack of those. Their prevalence varies according to literature depending on the used diagnostics methods (0.6-4.3 for 1000 patients). Since 1953 to today in the analysis of the PubMed, Scopus and eLibrary databases about 480 cases of portal venous system aneurysms are revealed. Aneurysms are localized in extra hepatic part of portal vein most often. They can be isolated and be combined with other pathology. The accompanying pathology are cirrhosis and portal hypertension more often. The clinical picture can be absent or have nonspecific symptoms. Ultrasonography is a preferable method at primary inspection by the patient with suspicion on existence of portal venous system aneurysms. At some disputable or difficult cases, and also in the presence of complications and associated diseases of hepatopancreatobiliary area, performance of MSCT and/or MRI is expedient. Waiting tactics of treatment is the main in the absence of clinic and complications, and also at the small sizes of aneurysm. Dynamic ultrasonography is an effective method of supervision over a condition of aneurysm. Symptomatic aneurysm of portal venous system and progressive rapid growth of aneurysm are indications for surgery. The most widespread complications are thrombosis of a cavity of aneurysm and a gap.Аневризмы вен портальной (воротной) системы - это термин, используемый для описания аневризм воротной вены, верхней и нижней брыжеечных вен, селезеночной вены, зоны конфлюенса селезеночной и верхней брыжеечной вен. Аневризмы вен портальной системы считают достаточно редкой нозологической формой с различным патогенезом, клиническими проявлениями или отсутствием таковых. Их распространенность варьирует, по данным литературы, в зависимости от используемых методов диагностики (0,6-4,3 на 1000 пациентов). Начиная с 1953 г на сегодняшний день при анализе баз данных PubMed, Scopus и eLibrary выявлено около 480 наблюдений в аневризм вен воротной системы. Наиболее часто аневризмы локализуются во внепеченочной части воротной вены. Они могут быть изолированными и сочетаться с другой патологией. Чаще всего сопутствующей патологией является цирроз печени и портальная гипертензия. Клиническая картина может отсутствовать или иметь неспецифические симптомы. УЗИ является предпочтительным методом при первичном обследовании пациентом с подозрением на наличие аневризмы вен портальной системы. При каких-то спорных или сложных случаях, а также при наличии осложнений и сопутствующих заболеваний органов гепатопанкреатобилиарной зоны целесообразно выполнение МСКТ и/или МРТ Выжидательная тактика лечения является основной при отсутствии клинической картины и осложнений, а также при небольших размерах аневризмы. Динамическое УЗИ является эффективным методом при наблюдении за состоянием аневризмы. Симптоматическая аневризма воротной вены и прогрессивный быстрый рост аневризмы являются показаниями к оперативному лечению. Наиболее распространенными осложнениями являются тромбоз полости аневризмы и разрыв

    Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

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    Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

    Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

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    Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

    O niezawodności systemów działających w środowisku losowym

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    Markov reliability model of a system, operating in random environment is introduced and investigated. The model is described by multidimensional Markov process with block-wise infinitesimal matrix. Algorithms for calculation of time dependent and steady state probabilities as well as Quality of Service (QoS) characteristics of the system based on this special form of infinitesimal matrix are given. Hybrid system of information transmission as an example of such approach is studied.W artykule przedstawiono i zbadano model Markowa niezawodności systemu działającego w środowisku losowym. Model jest opisany przez wielowymiarowy proces Markowa z infinitezymalnym generatorem o strukturze blokowej. Na podstawie tej szczególnej postaci macierzy podane są algorytmy obliczania czasowo zależnych i stacjonarnych prawdopodobieństw oraz charakterystyk jakości usług (QoS) systemu. Jako przykład takiego podejścia przebadany został hybrydowy system transmisji informacji
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