[State of occupational morbidity in Ulianovsk region (results of 20-year work of Regional Occupational pathology center)].

Analysis of occupational morbidity changes in Ulianovsk region over recent 20 years demonstrated that occupational center foundation in the region played a positive role in diagnosis and treatment, occupational fitness examinations for patients with occupational diseases.

Automated sorting of polymer flakes: fluorescence labeling and development of a measurement system prototype.

The extensive demand and use of plastics in modern life is associated with a significant economical impact and a serious ecological footprint. The production of plastics involves a high energy consumption and CO2 emission as well as the large need for (limited) fossil resources. Due to the high durability of plastics, large amounts of plastic garbage is mounting in overflowing landfills (plus 9.6 million tons in Europe in the year 2012) and plastic debris is floating in the world oceans or waste-to-energy combustion releases even more CO2 plus toxic substances (dioxins, heavy metals) to the atmosphere. The recycling of plastic products after their life cycle can obviously contribute a great deal to the reduction of the environmental and economical impacts. In order to produce high-quality recycling products, mono-fractional compositions of waste polymers are required. However, existing measurement technologies such as near infrared spectroscopy show limitations in the sorting of complex mixtures and different grades of polymers, especially when black plastics are involved. More recently invented technologies based on mid-infrared, Raman spectroscopy or laser-aided spectroscopy are still under development and expected to be rather expensive. A promising approach to put high sorting purities into practice is to label plastic resins with unique combinations of fluorescence markers (tracers). These are incorporated into virgin resins during the manufacturing process at the ppm (or sub ppm) concentration level, just large enough that the fluorescence emissions can be detected with sensitive instrumentation but neither affect the visual appearance nor the mechanical properties of the polymers. In this paper we present the prototype of a measurement and classification system that identifies polymer flakes (mill material of a few millimeters size) located on a conveyor belt in real time based on the emitted fluorescence of incorporated markers. Classification performance and throughput were experimentally quantified using 3 different types of polymers (Polyoxymethylene (POM), Polybutylenterephthalat (PBT) and Acrylonitrile Styrene Acrylate (ASA)) in colored and uncolored form. Overall, 12 classes of plastic flakes were investigated in this study, where 11 classes were labeled with unique binary combinations of 4 fluorescence markers and class 12 includes unlabeled plastic flakes of various colors. From approx. 68,000 investigated flakes it was found that the developed measurement prototype system achieves an average sensitivity (true positive rate) of 99.4% and a precision (positive predictive value) of 99.5%, while being able to handle up to approx. 1800 flakes per second.

[Comparison of the results of radical and palliative operations for gastric cancer complicated by an acute hemorrhage].

The results of treatment of 1125 patients, suffering gastric cancer, complicated by an acute hemorrhage, were analyzed. The treatment tactics was elaborated, which have included endoscopic hemostasis conduction in an active tumoral hemorrhage present as well as the measures, directed on prophylaxis of the hemorrhage recurrence, when the signs of the hemorrhage spontaneous arrest and stigmata are present, using miniinvasive methods of endosurgical hemostasis, according to established criteria of their efficacy, and further conduction of clinic-endoscopic monitoring. Introduction into clinical practice of the elaborated algorithm of the treatment tactics have permitted to increase the radical operations performance rate from 66.0 to 75.9%, to lower postoperative lethality index in 4.4 times, to reduce a palliative operations performance rate from 44.0 to 24.1% and to lower lethality after this kind of procedures from 20.3 to 12.8%.

[Clinical and epidemiologic features and risk factors of occupational pulmonary diseases related to dust].

The authors demonstrated that the recent years are marked by increase in occupational pulmonary diseases related to dust. These diseases formation is influenced by various occupational and non-occupational factors. Basis of preventive measures in dust-related industries should be formed by not only by technogenic issues, but medical events participated by the workers.

[Application of antiseptic dekasan in urgent abdominal surgery].

Experience in local application of antiseptic Dekasan in the complex treatment of abdominal infections of various origins are presented. The clinical and economic efficacy of the drug application is notice.

[Surgical treatment of Meckel diverticulum complicated by an acute hemorrhage].

Mekkel's diverticulum (MD)--is the inborn anomaly, caused by incomplete yolk duct development, it is present in near 2% of population and in 95% of observations lacks clinical manifestations. Symptoms of the disease manifest while complications occurrence only--in presence of peptic ulcer with possible hemorrhage and perforation occurrence, while ileus, diverticulitis, hernia, umbilicus fistula and tumor development. Eight patients, suffering MD, complicated by gastrointestinal hemorrhage, were treated during 1983-2006 yrs in Kyiv's city center for giving the aid to patients suffering gastrointestinal hemorrhage (GIH). These had constituted 6.6% of general quantity of adult patients, suffering rare causes of GIH occurrence, and 0.03% of all the patients, suffering GIH. For the diagnosis establishing in all the patients colonoscopy, barium enema and abdominal ultrasonography were applied. Definitive diagnosis was established only postoperatively. MD was extirpated in 5 patients, the wedge ileum resection with MD was accomplished in 1 patient and ileum resection with MD--in 2 patients. All the patients are alive.

The efficacy and safety of tigecycline for the treatment of complicated intra-abdominal infections - the European experience.

The polymicrobial nature of complicated intra-abdominal infections makes these infections particularly challenging to treat. The initial selection of antimicrobial therapy is therefore extremely important. Inappropriate empiric antimicrobial therapy has been shown to delay clinical resolution, increase length of hospital stay, and increase the risk of mortality. In addition, the increasing frequency with which resistant isolates (e.g., extended spectrum beta-lactamases [ESBLs]) are recovered from patients mandates that empiric antimicrobial therapy covers these difficult-to-treat organisms. Here, we assessed the efficacy of a new antimicrobial agent, tigecycline. This is a combined analysis of data from the European sites that participated in two Phase III, double-blind trials to evaluate the efficacy and safety of tigecycline, versus that of imipenem/cilastatin, in adults with complicated intra-abdominal infections. Patients received either tigecycline (initial dose of 100 mg, followed by 50 mg intravenously every 12 hours) or imipenem/cilastatin (500/500 mg intravenously every 6 hours) for 5-14 days. The primary end point was the clinical response at the test-of-cure visit (12-44 days after therapy) in the co-primary microbiologically evaluable (ME) and microbiological modified intent-to-treat (m-mITT) populations. For the ME group, clinical cure rates at the test-of-cure visit were 92.4% (219/237) for tigecycline versus 88.8% (198/223) for imipenem/cilastatin (95% CI = -2.2, 9.4). Clinical cure rates for the mmITT populations were 87.3% (247/283) for tigecycline versus 83.5% (228/273) for imipenem/cilastatin (95% CI = -2.5, 10.0) at the test-of-cure visit. Pretherapy in vitro activity against baseline isolates for tigecycline and imipenem/cilastatin were also determined. The mean MIC(90) for tigecycline against the most commonly isolated aerobes and anaerobes was < or =2.0 microg/mL. No pretherapy isolates displayed resistance to tigecycline based on the breakpoints used. Bacterial susceptibilities to tigecycline appeared to be consistent with clinical responses. Most commonly reported treatment emergent adverse events for tigecycline and imipenem/cilastatin were nausea (14.7% and 11.8%, respectively, p = 0.267) and vomiting (10.7% and 7.3%, respectively p = 0.146). This combined analysis demonstrates that tigecycline is safe and effective for the treatment of complicated intra-abdominal infections, and reflects the findings of the global population.

[Peculiarities of microflora in an acute appendicitis and its impact on the postoperative purulent-inflammatory complications rate].

Bacteriological investigation of processus vermiformis contents was performed in 102 patients suffering an acute appendicitis (AA) and of abdominal cavity exudate--in 82 patients, operated for an AA. The microflora identification was done, as well as probable connection between microorganisms associations, the rate of the AA destructive forms revealing and postoperative purulent-inflammatory complications occurrence.

[Occupational morbidity in Ulianovsk region].

Retrospective analysis of occupational morbidity in Ulianovsk region proved a definite trend to increase in occupational diseases number. The authors necessitated creation of programs on occupational diseases prevention in the region.

[Blocking action of pyridoxal-5'-phosphate on nonadrenergic synaptic inhibition of human small intestine smooth muscle].

We investigated the inhibitory synaptic potentials (ISP) in isolated smooth muscle strips of the human duodenum circular layer from the ulcer adjacent region (I group) as well as ileum and distal part of small intestine, which were on a distance of some dozen centimeters from the place of disturbance under the different gastrointestinal diseases (II group). ISP amplitude was several times smaller in the muscle strips of the I group compare to the II group. It could depend on the alterations of smooth muscles cable properties, increase of connective tissue mass, changes in the intestinal nervous system and synaptic transmission in the region adjacent to duodenum ulcer. Pyridoxal-5'-phosphate effectively decreased amplitude and increased ISP latent period in the muscle strips from both groups. N(omega)-nitro-L-arginine, the blocker of NO-synthase did not affect pyridoxal-5'-phosphate activity in smooth muscles. Phosphate group was essential for realization of its influence on ISP in smooth muscles because pyridoxal did not influence both ISP amplitude and ISP latent period.

[Prognosis of disability after performance of operation for complicated gastroduodenal ulcer].

Quality of life of a patient constitutes integrated index of the treatment efficacy. One of parts of the "quality of life" term is a restriction of vital activities - disability. It is for the first time, when the prognostication system was proposed for the risk estimation of disability occurrence in patients, operated on for complicated gastroduodenal ulcer, which was elaborated on background of the step by step discriminant analysis. Application of prognostication system, in particular, its simplified variant, permits to apply it widely for choosing of optimal operative treatment method, which prophylaxes the risk of disability occurrence.

[Application of anticoagulants in patients after operations for gastro-intestinal bleeding].

Our clinical experience witness the necessity of administration of direct anticoagulants in prophylactic dosage to patients, operated on for gastro-intestinal bleeding. The most effective and secure is preparation of the low molecular weight fractionized heparins group--Fraxparin. The summarized data concerning group of patients, in whom Fraxyparin was applied, witness the absence of unfavourable peak of effect after the preparation injection, gradual action and holding on of the interinjection time plato, the absence of significant additive noncontrollable action of Fraxparin after each subsequent injection made.

[Application of synthetic analogue of somatostatin--octrestatin in the treatment of gastroduodenal erosions and acute ulcers complicated by hemorrhage].

Retrospective analysis of diagnostic and curative processes in Kyiv's city centre of delivering the aid in gastrointestinal hemorrhage for 1131 patients in 1999--2003 yrs period was done. The classification of gastroduodenal erosions and an acute ulcers, complicated by hemorrhage, oriented on etiological factor involved, was proposed. Depending on etiological feature present, there were determined characteristic signs of mucosal affections, their localization and the hemorrhage severity. There was proved the expediency of introduction of the treatment results control, based on investigation of dehydrogenases activity, the intracellular glycogen content and the state of the lipids peroxidal oxidation. Clinical efficacy of synthetic analogue of somatostatin Octrestatin was studied in the treatment of gastroduodenal erosions and an acute ulcers in 26 patients. Application of Octrestatin have promoted the lipids metabolism normalization and acceleration of the mucosal ulcers healing by 2-3 days.

[Comparative evaluation of remote results of surgical treatment of complicated gastroduodenal ulcer]. / Porivnial'na otsinka viddalenykh rezul'tativ khirurhichnoho likuvannia uskladnenoï hastroduodenal'noï vyrazky.

Results of operative treatment of 1588 patients with complicated gastroduodenal ulcer in immediate and of 667--in late postoperative period were analyzed. Best results were obtained after performance of organ preserving operations in combination with proper full complex medical rehabilitation of operated patients.

[Ways for improvement of medical, occupational, and social rehabilitation of patients operated for complicated gastroduodenal ulcer]. / Shliakhy pokrashchannia medychnoï, profesiinoï ta sotsial'noï reabilitatsiï khvorykh, operovanykh z pryvodu uskladnenoï hastroduodenal'noï vyrazky.

Based on the analysis of the early post-operative period in 1588 patients and long-term results in 667 patients having been operated for complicated gastroduodenal ulcers, algorithms are submitted of medical, occupational, and social rehabilitation, which fact permitted improving results of surgical treatment. The proposed rehabilitation project envisages staging and continuity of measures aimed to restore the patients' capacity for work and their social status.

[Complex rehabilitation of patients operated on for complicated peptic ulcer]. / Kompleksna reabilitatsiia khvorykh, operovanykh z pryvodu uskladnenoï vyrazkovoï khvoroby.

Results are submitted of sanatorium-and-health resort treatment of 104 patients operated on with the aid of the organ-sparing and resection techniques for complicated forms of gastroduodenal ulcers. An algorithm of therapeutic measures taking account of sanatorium-and-health resort treatment has been worked out. It allows to lessen considerably the postoperative complications, to shorten duration of temporary disability, to reduce permanent disability after resection of the stomach 3-fold.

[Effectiveness of the use of solcoseryl after surgery of acute hemorrhage in gastroduodenal ulcer]. / Effektivnost' primeneniia solkoserila posle operatsii po povodu ostrogo krovotecheniia iz gastroduodenal'noi iazvy.

The experience of solcoseryl application in 70 patients, operated on for an acute hemorrhage from gastroduodenal ulcer, was summarized. The preparation was injected intravenously in the dose of 10 ml in 5% solution of glucose every other day during 6 days and then in the dose of 5 ml intramuscularly during 4-5 days. High efficacy of solcoseryl, manifesting by more earlier elimination of pain and oedema, healing of mucosa by first intention, shortening of the treatment duration in stationary by 3-5 days, was established.