Aim. To analyze the results of thrombectomy in lower-extremity ischemia in patients with coronavirus disease 2019 (COVID-19) and respiratory failure of different severity.Material and methods. This retrospective, cohort, comparative study for the period from May 1, 2020 to March 1, 2022 included 305 patients with acute lower-extremity ischemia and COVID-19. Depending on the type of oxygen support, three groups of patients were formed: group 1 (n=168) — nasal oxygen insufflation; group 2 (n=92) — non-invasive ventilation (NIV); group 3 (n=45) — artificial ventilation (AV). Thrombectomy was carried out according to the standard technique using Fogarty catheters (3F-6F — depending on the vessel size). After the diagnosis was established before and after the start of surgical treatment, all patients received the following therapy: Unfractionated IV heparin infusion at an initial rate of 1000 U/r, adjusted to maintain the activated partial thromboplastin time at 2-3 times the normal value; 2. Oral acetylsalicylic acid 125 mg; 3. Analgesics.Results. Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5,3%, n=9; group 2: 72,8%, n=67; group 3: 100%, n=45; p<0,0001), retrombosis (group 1 : 18,4%, n=31; group 2: 69,5%, n=64; group 3: 91,1%, n=41; p<0,0001) and limb amputations (group 1: 9,5%, n=16; group 2: 56,5%, n=52; group 3: 91,1%, n=41; p<0,0001) was recorded in group 3 patients.Conclusion. In patients receiving mechanical ventilation, COVID-19 have more aggressive course, which is expressed in an increase in laboratory para- meters (C-reactive protein, ferritin, interleukin-6, D-dimer), the severity of pneumonia and location of thrombosis in the tibial arteries. Among patients with COVID-19 receiving mechanical ventilation, the greatest number of rethromboses (91,1%), limb amputations (91,1%), and deaths (100%) are noted, which suggests the expediency of abandoning open thrombectomy in favor of anticoagulant/antiplatelet therapy in this cohort of patients. The development of arterial thrombosis in patients with COVID-19 receiving mechanical ventilation is an indicator of a high risk of death. Open thrombectomy in combination with anticoagulant/antiplatelet therapy is most effective in patients on nasal oxygen insufflation or NIV.
Economic reforms and reforms in the educational sphere have contributed to the increase of the concern towards the efficiency of the activity of educational organizations and higher educational establishments, in particular. This deals with the increased competition in both international and national markets for educational services; the growth of informational openness of higher education establishments and the enhanced role of strategic planning. All these aspects are gradually leading to a new objective that faces higher education establishments, which is a necessity to demonstrate the efficiency of their education services and support it with definite indices. Under conditions of budgetary expenditures, the problem of financial sustainability and efficiency of higher education institutions is becoming urgent, being focused on searching for possibilities to develop education establishments. In this context, the most important issue deals with developing approaches for quantifying financial sustainability and identifying the directions and means of its rise. The article suggests the method for defining the financial sustainability of higher education institutions and discusses both the indices, applied for financial sustainability evaluation, and their threshold values.
Purpose Economic problems of the system of education were the object of interest of classics of economic science – A. Smith and A. Marshall – who viewed education as a source of public capital, and acquired skills and competences – as a part of national wealth. These ideas were further developed in the theory of human capital by T. Schultz, G.S. Becker, G. Psacharopoulos, P. Teixeira, and R. Solow. At that, specifics of modernization economic processes in the sphere of education, peculiarities of modern functional and financial state require conceptual consideration and provision of development of working mechanism of effectiveness of spending assets of endowment funds. The purpose of this paper is to determine the mechanism of effectiveness of spending assets of endowment funds on the basis of mathematical models. Design/methodology/approach The paper offers a mechanism of determination of effectiveness of spending of endowment funds. Findings Effectiveness of an endowment fund’s effectiveness depends on the results of fund-raising activities, supporting relations with donators, and financing of targeted programs and directions of activities. This information is key information during the determination of results of endowment fund’s activities for current and potential donators. That is why it should provide reports in the order of formation of endowment, received revenue from trust management, and direction of usage of revenues from endowment, for which a donator has given his assets, on a regular basis. Originality/value In the modern system of higher education, the issue of search for new sources of financing for the purpose of improvement of quality of education and educational process, growth of wages of academic staff, attraction of foreign lecturers and specialists with practical experience of work from various spheres of production, and increase of stipends of the best students remains actual. The paper offers a mechanism of determination of effectiveness of spending of endowment funds.
The paper discusses seasonal changes in the surface temperature of the Northern Hemisphere during various climatic periods - the first wave of global warming, the second wave of global warming, and stabilization. The statistical significance of the changes was estimated. The features of the activity of global climatic trends in the Southeast of the Russian Plain in an arid climate are studied. It is shown that climatic changes in the region have their own characteristics. The degree of climate continentality in different climatic periods is estimated. The change in the continentality degree was statistically significant at the transition from stabilization period to the second wave of global warming. It has been revealed that in the current climate changes in the Southeast of the Russian Plain the main factor in winter is advective, and in summer the main factor is transformational. Climatically meaningful conclusion about the role of transformation in possible further development of global warming is formulated, especially in continental types of climate.
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