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Обоснование. Истинные причины летальности и факторы риска при пневмонии, вызванной COVID-19, требуют детального анализа. Цель: уточнить факторы риска летального исхода при пневмонии, вызванной вирусом SARS-CoV-2. Материалы и методы. Обследовано 196 пациентов с пневмонией коронавирусной этиологии. Группу наблюдения составили 68 больных с летальным исходом, группу сравнения – 128 пациентов, выписанных с улучшением. Оценка значимости факторов риска летального исхода проводилась с помощью определения величины относительного риска и этиологической фракции. Результаты исследования подверглись статистической обработке с вычислением средних величин, ошибок средних величин, критерия достоверности показателей Стьюдента (t). Результаты. Вероятность летального исхода у пациентов с пневмонией, вызванной COVID-19, повышается при увеличении возраста пациентов, у проживающих в городе, при длительном сохранении лихорадочного синдрома, необходимости повторной госпитализации и перевода в реанимационное отделение, большом объеме поражения. Увеличивают риск летального исхода дыхательная недостаточность III степени, почечная недостаточность, плеврит, токсическое поражение печени, гематомы различной локализации. Усугубляют течение инфекции COVID-19 хроническая сердечная недостаточность, ишемическая болезнь сердца, сахарный диабет, хроническая обструктивная болезнь легких. Лабораторными предикторами неблагоприятного исхода являются цитопении (лимфопения, тромбоцитопения, анемия), значительное повышение СОЭ, СРБ, Д-димера. Заключение. Своевременное выявление и учет факторов риска летального исхода позволят корригировать объем лечебных мероприятий с целью улучшения прогноза для жизни пациентов с COVID-19-ассоциированной пневмонией.

Обоснование. Функциональные заболевания желудочно-кишечного тракта являются актуальной проблемой современной гастроэнтерологии в связи с ростом их частоты и значительным влиянием на качество жизни пациентов. В числе факторов, способствующих их манифестации, рассматриваются особенности образа жизни и питания. Однако, влияние нарушений пищевого поведения и распределения жировой ткани на выраженность гастроэнтерологической симптоматики у лиц с разным уровнем физической активности требует уточнения. Цель: уточнить влияние пищевого поведения, распределения жира и физической активности на симптомы функциональных гастроинтестинальных расстройств. Материалы и методы. Обследовано 60 человек без органических заболеваний желудочно-кишечного тракта в возрасте 22,7±0,19 года. Сформированы 2 группы по 30 человек: регулярно занимающиеся физическими упражнениями и не занимающиеся физическими упражнениями. Проведено анкетирование по опросникам GSRS, DEBQ, определены антропометрические данные. Статистическая обработка включала вычисление средних величин, их ошибок, t-критерий Стьюдента, критерий корреляции Пирсона, факторный анализ. Результаты. Регулярно занимающиеся физическими упражнениями имеют более низкие показатели количества подкожной и висцеральной жировой ткани, чем не занимающиеся. В группе физически активных выявлено наличие обратной зависимости между синдромом запоров и количеством висцерального жира. У не занимающихся физическими упражнениями обнаружена прямая зависимость между количеством висцерального жира и рефлюкс-синдромом, экстернальным типом пищевого поведения. В фактор «риск гастроэнтерологической патологии» вошли: общий балл по опроснику GSRS, эмоциогенный и экстернальный типы пищевого поведения, окружность бедер и соотношение объем талии/объем бедер. Заключение. Для минимизации симптомов функциональных гастроинтестинальных расстройств необходимо оптимальное количество висцерального жира, его уменьшение усугубляет синдром запоров, а увеличение – рефлюкс-синдром. Регулярные физические упражнения позволяют сбалансировать особенности пищевого поведения и оптимизировать количество жировой ткани в организме.

The solid-state dewetting phenomenon was used to obtain submicron- and micron-sized SiGe particle arrays by the Ge deposition on Si(100) substrates. Their transmission and reflection spectra were measured and numerically modeled by the FDTD method. They exhibit resonance effects in broad infrared spectral ranges, depending on the particle size. The broadband antireflection property is associated with wide particle size distributions and the influence of a high-index substrate. The results show that the dewetting phenomenon provides the natural formation of arrays of particles shaped as close to a sphere segment, and they turned out to be effective as antireflection coatings.

Primary hyperparathyroidism (PGPT) is an endocrine disease characterized by excessive secretion of parathyroid hormone (PTH) in upper — normal or elevated blood calcium levels due to primary parathyroid gland pathology (osch). Primary hyperparathyrosis, depending on the clinical manifestations, can occur in the normocalcemic, mild and manifest form. This article presents a clinical case of the development of the manifest form by the type of visceral disorders. Which appeared in the form of pathology of the gastrointestinal tract. This form of the disease is an indication for surgical treatment and further correction of calcium-phosphorus metabolism.

The article is devoted to the study of the process of interaction of the rotary ripper’s working bodies with the soil. The classification of rotary machines and implements according to the energy transmitted to the working body and the location of the rotation axis is outlined. The article notes that the main characteristics of the rotor work body motion are the trajectory type, the magnitude and direction of velocity of its most characteristic point, and in some cases, the magnitude and direction of acceleration. The article presents the results of theoretical research in the field of kinematics of interaction of rotary working tools with the soil. The design of the rotary ripper is presented and the description of the trajectory of its working bodies is made, the value of movement of the scraper plate in the contact area with the soil is established. We analyzed the segment of the path from the beginning of contact with the soil (the beginning of dragging the surface layer of soil) and the end of contact (the end of dragging the surface layer of soil), on the line of which weed combing, loosening and destruction of soil crust occurs.

Aim. To demonstrate difficulties in diagnosing multiple myeloma at the out-patient stage on the example of a clinical case.Materials and methods. The course of establishing a diagnosis in a 58-year-old patient complaining of pain in the hip joint was analysed on the basis of the patient’s medical records both at the out-patient and in-patient stages.Results. A case of multiple myeloma occurring under the guise of common degenerative-dystrophic diseases is presented. An oncological diagnosis was suspected due to the patient’s complains of persistent pain, which was poorly relieved by non-steroidal anti-inflammatory pain agents, and progressive changes in the general blood test (acceleration of ESR to 40 mm/h, and then to 50 mm/h; reduction of hemoglobin from 145 g/l to 134 g/l). The diagnostic search started with an ultrasound examination of the abdominal cavity and pelvic organs, which revealed both an extensive formation in the pelvis in the right iliac region and the lymphadenopathy of the inguinal lymph nodes. Subsequently, spiral computed tomography of the abdominal cavity and the pelvis was conducted. In all bones at the study level, multiple spherical solid formations with uneven contours causing destruction of bone tissue were detected, allowing myeloma to be suspected. The patient was referred to the Republican Clinical Oncology Dispensary, where a percutaneous biopsy of the retroperitoneal neoplasm, as well as morphological and immunohistochemical studies, were carried out. As a result, the following diagnosis was established: multiple stage IIIA myeloma, first detected, with damage to the thoracic, lumbosacral spine, ribs, pelvic, and thigh bones. The patient was hospitalised in the Hematology Department of the First Republican Clinical Hospital, where he underwent chemotherapy according to the VCD scheme (bortezomib, dexamethasone, cyclophosphomide), and was discharged with improvement.Conclusion. The diagnosis of multiple myeloma is a challenging task for a primary care physician due to the diversity of the clinical picture and the lack of clinical suspicion. At the same time, timely diagnosis of the disease at the out-patient stage can significantly increase the effectiveness of treatment and, therefore, improve the prognosis. Thus, more attention should be paid to the differential diagnosis of degenerative diseases of the musculoskeletal system and multiple myeloma.

Aim. Diabetes mellitus (DM) is known to be a risk factor in adverse outcomes and complications in many infectious diseases. In the combination of hemorrhagic fever with renal syndrome (HFRS) and DM there are mutually exclusive pathogenetic States - hyperosmolarity, characteristic of DM is layered on the reduction of osmotic blood pressure in HFRS. Under these conditions, the effect of one disease (DM) on the clinical manifestations of another (HFRS) is not obvious. The aim of the work is to find out the clinical features during hfps in patients with DM. Materials and methods. The study is based on the results of the retrospective studies "case - control" - studied the information contained in medical records of patient (form 003/u), who suffered HFRS in 2006-2018. The Selection of cards produced randomly. In the end, there were formed two groups: the first - 981 patient who suffered HFRS and had no signs of diabetes; the second, 33 patients who suffered HFRS on the background of previously existing (28 people), or the first identified (5) diabetes. Results. With a combination of HFRS and DM, a mild course of the disease is 2.5 times more common, there are no severe forms. Among this group of patients, complications are almost 10 times less common, less likely to develop infectious - toxic shock, acute kidney damage (class F by RIFLE), pulmonary edema. The combination of DM and HFRS is manifested by less high and prolonged fever, less high levels of urea and creatinine in the blood. Conclusion. HFRS in combination with DM is easier, apparently, high osmolarity of the blood is a stabilizing factor during the disease.

Aim. The present article studies the effect of balneotherapy with Uvinskaya mineral water on the microbial spectrum of urine in patients with type 2 diabetes.Materials and methods. The study was carried out at the Endocrinology Department of the First Republican Clinical Hospital (Izhevsk). A total of 56 patients with type 2 diabetes participated in the study, which involved collecting medical history and complaint data of patients along with performing general and system-based examination, urinalysis, urine culture prior to and following the course of therapy, as well as kidney ultrasound aimed at excluding the presence of calculi. Urine cultures (morning sample) were plated onto 5% blood agar, as well as Endo’s medium for detecting bacteria from the Enterobacteriaceae family using the Gould method. Urine cultures were incubated for 24, 72 and 144 hours at a temperature of 37 °C. The significance of differences was determined using the t-test for independent and paired samples.Results. Changes in urinalysis were observed in all examined patients, which included changes characteristic of urinary tract infections: a large number of bacteria per field of view; a large amount of mucus; the presence of leukocytes in urine; alkaline pH shift; as well as disorders typical of diabetes mellitus (glycosuria, proteinuria). E. coli predominated in urine cultures. Following a 30-day therapy with Uvinskaya mineral water, the number of bacteria and leukocytes, as well as the amount of mucus, detected in the urine reduced significantly, which indicates urinary tract sanation. Positive dynamics among patients who underwent balneotherapy treatment is confirmed by the Student’s t-test (p < 0.05). In addition, no urinary sanation was observed in the group of patients who did not receive balneotherapy.Conclusion. Drawing on the study results, the authors recommend using Uvinskaya natural mineral water in the combined treatment of patients with type 2 diabetes for urinary tract rehabilitation.

An efficient and easy approach to the synthesis of novel racemic planar-chiral 3,4-dihydroferroceno[c]pyridines and 1H-ferroceno[c]pyrroles via the intramolecular Ritter reaction of 2-ferrocenyl-3,3-dimethylbutan-2-ol with nitriles and thiocyanates in the presence of MeSO3H was developed. Aromatic and aliphatic nitriles, phenylacetonitriles, and β-oxonitriles produced exclusively 3,4-dihydroferroceno[c]pyridines. The condensation of 2-ferrocenyl-3,3-dimethylbutan-2-ol with various thiocyanates, including alkyl thiocyanates, benzyl thiocyanate, and ethyl 2-thiocyanatoacetate, yielded not only 3,4-dihydroferroceno[c]pyridines but also 1H-ferroceno[c]pyrroles. The selectivity of these reactions depended on the temperature and the order of addition. The size of substituents at the α-position to the sulfur atom of thiocyanates also had a significant effect on the distribution of products.

The development of antireflection coatings is crucially important to improve the performance of various photonic devices, for example, to increase the efficiency of harmonic generators based on high-refractive index crystals with significant Fresnel losses. A promising technique for the reducing of radiation reflection is to change the refractive index by fabrication of antireflection microstructures (ARM) on the surface. This paper presents the results of ARM direct writing on the surfaces of a nonlinear GaSe crystal (of ε modification, according to Raman and photoluminescence spectroscopy data) using fs laser radiation and a multiples approach. An increase in transmission from 65% to 80% for an ARM fabricated on one side of the crystal and up to 94% for ARMs fabricated on both sides is demonstrated. The increase in transmission with the increasing pulse energy, as well as with an increase in the number of pulses used for the formation of a single crater, is shown. The experimental results of ARM transmission of GaSe are in qualitative agreement with the simulation results based on the measured profiles and morphology of the ARM structures.

Nanoscale enzymes anchored to surfaces act as chemical pumps by converting chemical energy released from enzymatic reactions into spontaneous fluid flow that propels entrained nano‐ and microparticles. Enzymatic pumps are biocompatible, highly selective, and display unique substrate specificity. Utilizing these pumps to trigger self‐propelled motion on the macroscale has, however, constituted a significant challenge and thus prevented their adaptation in macroscopic fluidic devices and soft robotics. Using experiments and simulations, we herein show that enzymatic pumps can drive centimeter‐scale polymer sheets along directed linear paths and rotational trajectories. In these studies, the sheets are confined to the air/water interface. With the addition of appropriate substrate, the asymmetric enzymatic coating on the sheets induces chemically driven, buoyancy flows that controllably propel the sheet's motion on the air/water interface. The directionality and speed of the motion can be tailored by changing the pattern of the enzymatic coating, type of enzyme, and nature and concentration of the substrate. This work highlights the utility of biocompatible enzymes for generating motion in macroscale fluidic devices and robotics and indicates their potential utility for in vivo applications. [ABSTRACT FROM AUTHOR]

Let {Zn, n ≥ 0} be a branching process in an independent and identically distributed (i.i.d.) random environment and {Sn, n≥ 1} be the associated random walk with steps ξi. Under the Cramßr condition on ξ1 and moment assumptions on a number of descendants of one particle, we know the asymptotics of the large deviation probabilities P(lnZn > x), where x/n > µ*. Here, µ* is a parameter depending on the process type. We study the asymptotic behavior of the process trajectory under the condition of a large deviation event. In particular, we obtain a conditional functional limit theorem for the trajectory of (Z[nt], t ∈ [0, 1]) given ln Zn > x. This result is obtained in a more general model of linear recurrence sequence Yn+1 = AnYn + Bn, n ≥ 0, where {Ai} is a sequence of i.i.d. random variables, Y0, Bi, i ≥ 0, are possibly dependent and have different distributions, and we need only some moment assumptions on them. [ABSTRACT FROM AUTHOR]