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This factor reflects formation of such thinking operations as cooperation, separation from general and possession of mathematical operations. As we know at the age of 11-12, a child's concrete thinking changes into abstract-logic thinking [1] and it helps them to solve the sums or tasks easily. There are a number of factors at the age of 10-12 in boys and girls that change their meaning. Positive ahanges have factors as: "E", "D", "F" and "Q".
We all know at that this very age children become special they differ from other children of other ages by their behavior. The age of 11-12 is considered as a critical age period [3].
Here, the development of a child makes rather a destructive work than constructive. Progressive development of personality of a child switches down and off and stops for some time in the period of crisis. At the early stage the all sides of the behaviour that differentiated the child from others fall and die [3].
Leadership that is peculiar to young age eats itself up and begins to search a new concrete form of activity. Here the hyper activity, overstrain, independence and less accomplishing are born.
By comparing the results that characterize age-sex modifications, we can see that boys are active not only in one group but also in another group. (factor "D"), stubborn (factor "F"),
and overstrained (factor "Q ), have the worst self control (factor "Q")
The factors found with the help of our investigations can be referred to specific peculiarities that differentiate boys from girls in age diapason of 7-12 years. But there are some characteristic differences in investigating factors in children of our region. So, age-sex differences by factors "H", "I", "Q", "G" are minimal. The factor "C" is rather decreased in girls of 11-12 years, they have great sense of obey. These differences by factors have rather a high level of trustworthy (P < 0.05-0.001).
So, the data taken by testing determine quality peculiarities of personality in children of 7-10 and 11-12 years. Peculiarities determined from the questionnaire of children's personality form unicum, action and feel of sorry for someone. It enables to speak about the wholeness of individuals.
Our investigations prove that the given method is unique as it gives information about the development of different personality sphere of younger school age.the results of investigations showed that this method reveals age peculiarities of individuals and posses differential abilities. It gives the opportunity to recommend this method for the usage.
References:
1. Arhipova I. A. Psychology of development. Children's psycho diagnostics. - M.: Science and techniques, 2009. - P. 288.
2. Stepanova M. I. Diagnostics of child's readiness for education at school//For nursery school trainers. - 2007. - № 12. - P. 12-15.
3. Berenzin F. B., Miroshnikov M. P., Rojanes R. V. Methods of multiple investigations ofpersonality. - M.: Medicine, 1976. - P. 176.
4. These and other requirements were taken into considerations while using the questionnaire of children's personality by R. Cattell (CPQ) among pupils of schools (7-12 years) ofAndizhan city.
Kurbanov Ravshanbek Davletovich, Mullabaeva Guzal Uchkunovna, Kilichev Anvar Akravovich, The Republican Specialized Center of Cardiology, Tashkent, Uzbekistan E-mail: Guzal-m@inbox.ru
Possibilities of prediction of recurrent myocardial infarction
Abstract: There 131 patients with Q-wave myocardial infarction were observed (mean age 51.9 ± 9.13 year). For all patients were prescribed beta-blockers, ACE inhibitors, statins, aspirin and if needful antiarrhythmics and aldosterone blockators. The observational time was 24 months. During this period recurrent myocardial infarction (RMI) observed in 39 (29.7 %) patients. Analysis of the data showed that of the estimated factors most important for prognosis of the RMI counts in acute early postinfarction angina pectoris, arterial hypertension, diabetes Mellitus, as well as the instrumental methods that reflect the functional state of the myocardium: LVMi, and ejection fraction. No less important was the thrombolysis in the first hours of admission, heart rate at rest, estimated at 10-14 days of the disease. In addition, we can not exclude the relationship of RMI and overweight.
Keywords: recurrent myocardial infarction, prognostic model, integrated indicator.
According to the WHO in 2005 the incidence of acute myocardial infarction (MI) increased by 32.7 % compared with 1997 and amounted to 10.7 million people in the population over 50 years old (Cleland J. G., Coletta A. P. et al. 2005). The frequency of recurrent myocardial infarction (RMI) is 25-29 %. RMI seriously worsen the prognosis of disease, causing a cascade of complications (heart failure (HF), arrhythmias, decreased quality of life) as well as a significant effect on mortality [1]. Determination of prognosis of MI is a difficult task because it requires taking into account a large number of interrelated factors that are time-personal prognostic significance [2; 3]. Available in-currently on traditional approaches
to risk assessment are not always perfect, it made difficult adequate choice of tactics of treatment of this category of patients.
The purpose of research — an integrated assessment of the risk factors for RMS to enable already at 10-14 days of disease to predict its development during nearest 2 years.
Materials and Methods
We examined 131 male patients with primary Qwave MI, aged 30 to 69 years (51.9 ± 9.13 years).
The hospital phase of AMI treatment was carried out in accordance with the recommendations on the management of patients with MI with ST-segment elevation and included thrombolytic
Possibilities of prediction of recurrent myocardial infarction
therapy if indicated, early administration ofbeta-blockers, antiplatelet agents, anti-coagulants, nitrates, lipid-lowering drugs, ACE inhibitors, loop diuretics.
On 10-14 days in all patients with AMI were performed echocardiography, 24-hours ECG monitoring. To characterize premature ventricular contractile (PVCs) used classification of Lown (1971) and prognostic classification J. Bigger (1982). By-hour qualitative and quantitative assessment was performed correspondingly by PVCs gradations Lown-Wolf: 0-VE absent, 1 rare PVCs; 2 — frequent PVCs; 3 — polymorphic PVCs; 4A — paired PVCs; 4B — PVCs group; 5 — early PVCs. According to the classification J. Bigger after MI to potentially hazardous ventricular arrhythmias (PHVA) refers PVCs > 10 per hour, pair and group PVCs.
There were anterior and posterior localization of MI with the same frequency (59.4 % and 40.6 % respectively). MI without prior angina history occurs in 42 % of patients; 58 % had a long history of coronary artery disease. Arterial hypertension (AH) suffered 61.3 % of the patients, while only 5.8 % of them received regular antihypertensive therapy (beta blockers, ACE inhibitors less often), and were treated episodically.
The factors are likely important for the prediction of complications, initially considered: age, hypertension, diabetes mellitus (DM), the nature of the disease (with previous angina or without); localization, heart rate (HR), defined by echocardiography end-diastolic diameter (EDD), end systolic diameter (ESD) of the left ventricle, left ventricular mass (LVmass), indexed left ventricular mass (LVMi), left ventricular ejection fraction (LV EF), body mass index (BMI).
Follow-up of 2 years. For 2 years RMI observed in 39 (29.7 %) patients.
The formulation of predictive scale modification taken probabilistic Bayes — intensive method of valuation indicators [4] with the calculation of prediction index of the normalized intensity and integrated indicators. To compile predictive matrix were obtained comparable figures predicted the phenomenon of gradation of the most important factors. The importance of the factors and their grades were determined using relative risk (relative risk — RR), which is the product of normalized integrated indicator (NII) on the "weight" factor.
Results and Discussion
Currently, mortality and disability from complications ofMI are high, which makes the need to improve the prediction of its complications [5]. Today, there are high-tech methods ofprophylaxis, post-infarction complications whether installation cardioverter-defibrillator for the prevention of sudden death or revascularization to prevent RMI. However, taking into account the high-cost of these methods requires more objective and early risk stratification ofpatients with MI.
To assess the significance of the factors affecting the development of RMI developed scale prediction of risk factors.
As shown by previous studies with increasing age the risk of adverse outcomes in AMI increases [6]. Our findings are consistent with the opinion of other researchers.
Analysis of the data showed that of the estimated factors most important for prognosis of the RMI counts in acute early postinfarction angina pectoris (EPAP), AH, diabetes Mellitus, as well as the instrumental methods that reflect the functional state of the myocardium: LVMi, and ejection fraction. No less important was the thrombolysis in the first hours of admission, heart rate at rest, estimated at 10-14 days of the disease. In addition, we can not exclude the relationship of RMI and overweight. These findings are consistent with the opinion of other researchers too [7].
To determine the possible range of values taken on a range of risk factor summarized the minimum and maximum predictor coefficients for each factor. Calculations have shown that the range of risks is within 27.91-61.43. The possible range of risk (27.91-61.43) was divided into three levels: mild (27.91-39.09), moderate — (39.0950.26) and high — (50.26-61.43), the probability of the risk ofRMI. In individuals with high values of the integrated indicator of complex factors studied more likely the risk ofthe RMI and more prerequisites for inclusion in the group of poor prognosis. Ranking Factors was conducted taking into account the share etiologic factors (Table 1).
Table 1 - Distribution of risk factors in order of importance
Risk Factors RR EF, % Rank place
EPAP 3.77 73.47 1
AH 3.31 69.79 2
LVMi > 150 g/m 2 3.08 67.53 3
DM 2.93 65.87 4
BMI > 30.0 kg/m2 1.99 49.75 5
EF<50 % 1.93 48.19 6
HR at rest > 80 bpm 1.89 47.09 7
Thrombolysis, no 1.85 45.95 8
LVDD E/A > 1 1.75 42.86 9
LVmass > 200 g. 1.63 38.65 10
ESD > 3.5 sm. 1.54 35.06 11
SDNN > 100 s. 1.51 33.77 12
Age, > 45 year 1.38 27.54 13
HF FC IV 1.35 25.93 14
PVCs > 10/hour 1.26 20.63 15
polymorphic PVCs 1.19 15.97 16
HRVTi < 15 s. 1.18 15.25 17
EDD > 5.5 sm. 1.11 9.91 18
paired PVCs 1.09 8.26 19
Note: EF — etiological fraction; RR — relative risk.
These relative risk and etiological fraction of risk factors in the development of the RMI indicate that factors almost complete conditioning RMI not identified (Table 3).Very high induced diseases are associated, respectively, with EPAP (RR = 3.77; EF = 73.47 %), and GB (RR = 3.31; EF = 69.79 %).
The high degree of conditionality of an unfavorable outcome is observed at LVMi> 150 g/m2 (RR = 3.08; EF = 67.53 %) and diabetes (RR = 2.93; EF = 65.87 %).
Table 2. - The degree of conditionality of the RMI, depending on the relative risk etiologic fraction and the corresponding risk factors
Degree conditioning RR EF, % Factors
Almost full 5.0 < 81-100
Very high 3.2 - < 5.0 67-80 EPAP; AH;
High 2.0 - < 3.2 51-66 LVMi >150 g/m 2; DM;
Moderate 1.5 - < 2.0 33-50 BMI > 30.0kg/m2; EF < 50 %; resting HR> 80 bpm.; Thrombolysis (no); LVDD E/A> 1; LVmass > 200 g.; ESD > 3.5 sm.; SDNN < 100ms.;
Mild 1.0 - <1.5 Less than 33 age > 45 year; HF FC IV; PVCs > 10/hour; polymorphic PVCs; HRV Ti < 15 s.; EDD > 5.5 sm.; paired PVCs
The moderate degree of conditionality of an unfavorable outcome is observed at BMI > 30.0 kg/m2 (RR = 1.99; EF = 49.75 %); EF < 50 % (RR = 1.93; EF = 48.19 %); resting HR > 80 bpm (RR = 1.89; EF = 47.09 %); Thrombolysis (no) (RR = 1.85; EF = 45.95 %); LVDD E/A > 1; (RR = 1.75; EF = 42.86 %) LVmass > 200 g. (RR = 1.63; EF = 38.65 %); ESD > 3.5 sm.
(RR = 1.54; EF = 35.06 %); SDNN < 100 ms.; (RR = 1.51; EF = 33.77 %). Conclusion:
The most informative in terms of forecasting the development of RMI in patients with Q-MI, is the presence of EPAP, AH, left ventricular hypertrophy, the presence of diabetes and excess body weight.
References:
1. Belenkov Y. N., Mareev V. Y. Cardiovascular continuum//Journal of Heart Failure. - 2002. - Vol. 3, № 1(11). - P. 7-11.
2. Ginzburg M. L., Martsevich S. Y., Kutishenko N. P., Deev A. D., Fokin A. V., Diniels E. V. The study of factors affecting the long-term prognosis of patients with myocardial infarction. Russian National Congress of Cardiologists - 2011. When 1-position of the journal "Cardiovascular therapy and prevention". - 2011. - 10(6): 75.
3. Greenfield P. Major risk factors as antecedents of fatal and nonfatal coronary heart disease/P. Greenfield, M. D. Knoll, J. Stam-ler//JAMA. - 2003. - Vol. 290, № 7. - P. 891-897.
4. Sheehan E. N. Methods for forecasting and modeling in socio-sanitary research. - M., 1986. - 207s.
5. Wood D. European recommendation on coronary prevention: implication for secondary preventions and rehabilitation/D. Wood// 7th World Congress of Card. Rehabilit. - Manyla, 2006. - P. 24-35.
6. Nikishin A. G., Kurbanov R. D., Pirnazarov M. M. Time of hospitalization and outcome of acute myocardial infarction in elderly patients in the Central Asian region//Cardiovascular therapy and prevention. - 2012. - T. 11, № 2. - P. 53-56.
7. Martsevich S., Kutishenko N., Ginzburg M., Deev A., Drozdova L. Influence of prehospi-tal and in-hospital cardiovascular therapy use on short-term and long-term prognosis in patients with acute myocardial infarction//Eur J Preventive Cardiology. - April 2013. -20 (Suppl 1), 84. - P. 482.
Murodov Alijon Salimovich, Teshaev Oktyabr Ruhullaevich,
Ruziev Umid Sanokulovich, Tashkent Medical Academy, Uzbekistan E-mail: saodat@mail.ru
Effect of photodynamic therapy and CO2 laser in the microbial landscape of purulent wounds in the experiment
Abstract:
Objective: To evaluate the antimicrobial effect of photodynamic complex and CO2 laser in the treatment of purulent
wounds in the experiment.
Materials and methods. purulent wound model reproduced in 80 male rats by MP Thick (2002) with some modification. Animals from the third day were divided into 4 groups: 1) 20 rats with physiological regeneration; 2) 20 rats with standard therapy, and 3) 20 rats PDT; 4) rats 20 inclusion complex treatment with conventional methods, the CO2 laser (JZ- 3A) 3 times daily until the wound cleansing from necrotic raids and PDT. Microbiological studies conducted by the conventional method at the 1st, 3rd, 7th and 10th day of the experiment.
Results. The discharge from the festering wounds were sown mainly St. Aureus; Proteusmirabilis and E. Colli, polyresistance possess antibiotic. If a high level of contamination of tissue wounds (1 x 10 6-9 CFU/g) was determined prior to treatment the animals of all groups, the carrying out of the integrated laser and PDT contamination was 10 2-10 5 cfu/g for 3-7 hours, and the final deadline for all groups It noted a progressive decrease in the level of microbial contamination, especially with PDT and CO2 laser is below the critical value.
Conclusions: Photodynamic therapy in a CO2 laser complex has a strong antimicrobial activity in the treatment of purulent wounds.
Keywords: purulent wounds, microbial contamination, laser, photodynamic therapy.
Modern wound infection manifesting in various forms 35-45 % of the patients surgical hospitals, the problem is not only the clinical but also general biological [1; 5; 7]. Increasing the number of purulent diseases and postoperative complications, a higher incidence of infection and generalization ofvarious types of toxic and allergic reactions, an unsolved problem of purulent infection in surgery. The steady increase in the number of microorganisms that are resistant to commonly used antibiotics, stimulates both the development
and implementation of the health practice of new antibacterial drugs and the improvement of surgical techniques of the local treatment of purulent wounds, including the impact of physical methods [3; 4; 6]. To resolve this issue in recent years successfully used laser photodynamic therapy (PDT) [6; 10; 13]. PDT has recently attracted attention of researchers because of its high efficiency. An-two antimicrobial photodynamic therapy characterized by a wide specter actions and, unlike antibiotics, practically complete absence
