RESUMO
In Naberezhnye Chelny, a number of structural and technological reformations of service of emergency medical care was implemented in 2009-2012. The reformation manifested in organization of unified emergency center of medical care of patients with acute coronary syndrome; joining up of cardiological departments of two hospitals; organization of X-ray surgical department; enhancement of logistics of admission department and interaction with emergency medical care; optimization of mode of medical care rendering at pre-hospital and hospital stages. The implemented reforms permitted increasing accessibility and timeliness of reperfusion therapy under acute coronary syndrome; to implement transcutaneous coronary interventions into practice and increase their number annually; to decrease "door-balloon" index up to 30-40%. As a result, lethality of acute myocardium infarction decreased from 12 to 3 to 5.8% in 2010-2014.
Assuntos
Síndrome Coronariana Aguda , Prestação Integrada de Cuidados de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/normas , Departamentos Hospitalares/métodos , Hospitalização/estatística & dados numéricos , Síndrome Coronariana Aguda/epidemiologia , Síndrome Coronariana Aguda/terapia , Humanos , Melhoria de Qualidade , Federação Russa/epidemiologiaRESUMO
A solid complex of C60 with gamma-cyclodextrin (gamma-CyD) was examined with NMR spectroscopic methods in order to understand the dynamics of C60, and the interaction between C60 and gamma-CyD. A 13C solid-state cross-polarization magic angle spinning (CP/MAS) NMR spectra shows C60 resonance at 142.6 ppm. This provides the evidence of interaction between 13C spins in C60 and 1H spins in the gamma-CyD host. Ambient temperature experiments on the 13C CP/MAS NMR, with varying contact time, shows that the water associated with gamma-CyDs plays an important role in the nuclear relaxation processes. The dynamics of C60 in gamma-CyD was investigated using temperature and field-dependent 13C spin-lattice relaxation time measurements. The influence of water on the dynamics of C60 was less significant below 250 K.