An analysis is presented of solid cancer incidence during 11 years of follow-up (1991-2001) of Chernobyl emergency workers residing in Russia. The analysis is based on data from the cohort of male emergency workers from 6 regions in Russia including 55718 persons with documented external radiation doses in the range of 0.001-0.3 Gy who worked within the 30 -km zone in 1986-1987. The mean age at exposure for these persons was 34.8 years and the mean external radiation dose 0.13 Gy. In the cohort 1370 cases of solid cancer were diagnosed and 3 follow-up periods were considered: 1991-1995, 1996-2001 and 1991-2001. The second follow-up period was chosen to allow for a minimum latency period of 10 years being characteristic of solid cancers. For risk assessment two control groups have been introduced, the first 'external' one representing incidence rates for corresponding ages in Russia in general, the second 'internal' one consisting of emergency workers. The risk estimates were based on spontaneous incidence rates of solid cancer. The estimated standardized incidence ratio (SIR) is in good agreement (95% CI) with that of the control. The values of excess relative risk per unit dose (ERR/Gy) for solid malignant neoplasms have been estimated to be 0.33 (95% CI: -0.39, 1.22) (internal control) for the follow-up period 1991-2001 and 0.19 (95% CI: -0.66, 1.27) for 1996-2001.
Цель. Проведение анализа выживаемости после хирургических вмешательств и изучение факторов, ас-социированных со временем наступления летального исхода у больных с мультифокальным атеросклерозом (МФА) в различных возрастных группах.Материал и методы. Включено 764 последовательных больных в возрасте от 39 до 84 лет с МФА, которым выполнялось изолированное коронарное шунтирование (КШ), либо КШ в сочетании с одномоментными или этапными хирургическими вмешательствами на некоронарных сосудистых бассейнах. Выбор тактики лече-ния определялся мультидисциплинарным консилиумом. В зависимости от возраста пациентов сформирова-но 4 группы: 1-я группа -больные до 60 лет (n=338), 2-я группа -60-64 года (n=185), 3-я группа − 65-69 лет (n=137) и 4-я группа -больные 70 лет и старше (n=104).Результаты. Анализ госпитальной летальности после проведенной операции КШ не выявил значимой разницы между группами, несмотря на ее увеличение среди больных старше 65 лет (р=0,373). Подобная тен-денция наблюдалась и по отдаленным показателям смертности без статистической достоверности между группами. Анализ выживаемости выявил отсутствие различий между группами по времени до наступления летального исхода (р=0,205), доля выживших за указанный период наблюдения во всех группах составила более 75%. Регрессионная модель выживаемости Кокса показала, что со временем наступления летального исхода после реваскуляризирующих вмешательств были достоверно связаны женский пол (р=0,009), нали-чие сахарного диабета (р=0,003), перенесенное ОНМК (р=0,002), риск оперативного вмешательства по шкале EuroScore (р=0,011) и ФВЛЖ (р=0,008).Заключение. Пожилой возраст в сочетании с МФА является маркером повышенной смертности после ре-васкуляризирующих операций, тем не менее, у данной категории больных могут быть получены благоприят-ные показатели по отдаленной выживаемости после хирургических операций.Ключевые слова: пожилой возраст, коронарное шунтирование, мультифокальный атеросклероз, выжи-ваемость.The purpose: Conducting the analysis of survival after surgery and the study of factors associated with mortality in patients with multifocal atherosclerosis (MFA) in different age groups.Material and methods. It were included 764 consecutive patients aged 39 to 84 years with the MFA, who underwent isolated coronary artery bypass grafting (CABG) or CABG in combination with simultaneous or staged surgical interventions in the non-coronary vascular beds. The treatment procedure was determined by the heart
Aim. To study the influence of deproteinized dialysate from blood of milk-fed calves on the type of exudative discharge and dynamics of inflammatory reaction after hernia repair with plastics of the anterior abdominal wall with hernioendoprosthesis of polypropylene. Materials and Methods. The study involved 59 patients being on stationary treatment in the surgical department of Kursk Regional Clinical Hospital. Patients were hospitalized for the herniation of small or medium dimension. The patients were divided to two groups: the main (n=30) and control (n=29) groups. After endoprosthetics, the patients of the control group were given complex conservative treatment. The patients of the main group, besides standard treatment, were administered deproteinized dialysate from blood of milk-fed calves intravenously in drips 10 ml + 200 ml of 0.9% sodium chloride solution within 7 days. For cytological examination and determination of the type of cytograms, the traumatic discharge was collected and analyzed using the method of M.F. Kamaev and M.A. Palthsev. Results. Cytomorphometric examination was conducted on the third, fifth and seventh day after endoprosthetics with the aim of studying dynamic changes. Determination of cell composition and also of its changes characteristic of each studied period, was necessary for obtaining further information characterizing inflammatory process in the region of placement of the endoprosthesis. After endoprosthetics in patients who were administered hemodialysate, the inflammatory reaction was less pronounced than in patients who did not receive the preparation. This was associated with a more dynamic change of stages of the inflammatory process. In patients of the main group who received deproteinized dialysate, regenerative type of inflammation first appeared on the fifth day and made 6.9%; by the seventh day the share of patients with the regenerative type rose to 17.5%, while in the patients of the control group no regeneration stage was observed in both periods. Conclusion. Analysis of the efficiency of influence of hemodialysate on the inflammatory reaction in plastics of the anterior abdominal wall with polypropylene endoprosthesis evidences faster course of all stages of inflammation and reduction of its intensity by 10%.
In patients with ventral hernias collagen type I/III ratio in skin is 2.54 times lower than in patients without hernias. Significant correlation of collagen types in skin and aponeurosis (r= +0.92) allows to predict the risk of postoperative ventral hernias on basis of skin fragment.
The paper presents labour supply scenarios in France, Germany, Italy and the United Kingdom for the years 2025 and 2050. These projections were based on the examination of the dynamics of the major contributing factors to the labour supply (LS), i.e. working-age population (WAP), labour force participation rate (LFPR), employment rate (ER) and labour utilisation (LU; defined as time worked per worker per year). The assumptions underlying the scenarios varied from plausible to 'best case scenario' to unrealistic. In France and in the United Kingdom, the demographic factors coupled with continuing immigration at the current levels will shape only a marginal decrease of the size of WAP. By contrast, the size of Germany's and Italy's WAP will shrink significantly by 2025 and, barring a tremendous surge in immigration, greatly by mid-century. In order to sustain the supply of labour, Italy has to eliminate unemployment. This assumes the sustainability of such factors as the recent increase in LFPR (especially of women) and relatively large immigration. By contrast, Germany has a large potential for increasing labour utilisation. Unless, however, immigration is increased dramatically, this will not suffice to balance the impact of the WAP decrease on LS. Within varying degrees, governments are able to affect the components of labour supply and capitalise on eventual synergies. The analysis relies on data from the United Nations Population Division, OECD, ILO and the European Union.
Introduction. At present, objective difficulties remain in the timely diagnosis and treatment of severe complications of acute odontogenic infection, including progressive odontogenic phlegmon, contact odontogenic mediastinitis, odontogenic sepsis. Goal. Develop an algorithm for diagnosis and treatment of severe inflammatory complications of acute odontogenic infection, taking into account the criteria of “Sepsis-3” and evaluate its effectiveness. Material and methods. To conduct a comparative evaluation of the results of the study, patients (311 people) were divided into 2 groups: a control group (247 people), in which diagnosis and treatment were performed using the criteria “Sepsis-1”, and the main group (64 people), diagnosis and treatment were performed with using the developed algorithm for diagnosis and treatment, which includes a number of additions to the criteria of “Sepsis-3” of the European Society of Critical States Medicine and the Society of Critical States Medicine (SCCM / ESICM). Results. Using the developed algorithm for diagnosis and treatment of patients with odontogenic inflammatory diseases of the maxillofacial area allows to significantly increase the efficiency of early diagnosis of purulent-inflammatory processes in the maxillofacial region (by 5.7%), to reduce the number of severe septic complications (by 6.6%). Discussion. The application of the criteria “Sepsis-3” is not an effective method of early diagnosis of odontogenic sepsis. The conclusion. The conducted study confirmed the effectiveness of the developed algorithm for diagnosis and treatment of severe inflammatory complications of acute odontogenic infection, taking into account the criteria of “Sepsis-3”.
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