The study of the prognostic value scales of assessing the risk of adverse coronary events in patients with acute coronary syndrome without ST-segment elevation in combination with comorbid conditions

Objective: to identify the most prognostically significant scale risk assessment of patients with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2, chronic renal failure, multifo-cal coronarocardiosclerosis, dyscirculatory encephalopathy. Material and methods. 260 patients with acute coronary syndrome without ST-segment elevation were divided into 4 groups according to the presence of severe concomitant diseases: patients with diabetes mellitus type 2 (71 people), chronic renal failure (49), multifocal lesions of the coronary arteries (76) and patients with dyscirculatory encephalopathy of grade 2-3, including ischemic stroke (64). All patients were stratified by major scales risk: TIMI, GRACE, PURSUIT. The development of negative coronary events was assessed in hospital and during the year after discharge. On the basis of the results, all scales were studied using the criterion of Mann-Whitney and identified the most predictably significant groups of patients with specific comorbid conditions. Results. It is revealed that the significance of the scales TIMI and GRACE in the study of distant forecast (up to 6 months) is the most reliable with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2. For the patients with combination with chronic renal insufficiency the best prognostic significance was obtained by the GRACE scale in the study of hospital risk and forecast up to 6 months. TIMI and GRACE scales in the study of hospital risk and forecast up to 6 months had the greatest prognostic significance for the patients with acute coronary syndrome without ST-segment elevation on the background of multifocal lesions of the coronary arteries. For the patients with dyscirculatory encephalopathy of the 2nd and 3rd grades, the greatest prognostic significance was obtained by stratification of risk on PURSUIT and GRACE scales in the study of hospital risk and forecast up to 6 months. Conclusion. The results demonstrate the necessity of a differentiated approach to the risk stratification of patients with acute coronary syndrome without ST-segment elevation depending on the grade of a severe comorbid disease

Remediation strategies for contaminated territories resulting from Chernobyl accident Final report

The present report realizes a settlement specific approach to derive remediation strategies and generalizes the results to the whole affected area. The ultimate aim of the study is to prepare possible investment projects on remediation activities in the contaminated territories. Its current aim was to identify the areas and the remedial actions that should be primarily supported and their corresponding cost. The present report starts with an outline of the methodology of deriving remediation strategies, a description of data for 70 representative settlements and of parameters of the remedial actions considered, and a classification of the contaminated territory according to radiological criteria. After summarising aspects of the contamination situation and applications of remedial actions in the past, dose calculations and derived remediation strategies for the representative settlements are described. These are generalized to the total contaminated territory. Within the contaminated territory private produce is of main importance for the radionuclide intake. At the end of the report, radiological aspects of the produce of collective farms are described. (orig.)SIGLEAvailable from TIB Hannover: RO 2674(02/01) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekCommission of the European Communities, Brussels (Belgium). Directorate General for Environment, Nuclear Safety and Civil ProtectionDEGerman