Euroopa Südamerütmi Assotsiatsiooni praktilised juhised uute suukaudsete antikoagulantide kasutamise kohta kodade virvendusarütmiaga patsientidel

Uute suukaudsete antikoagulantide kasutamine laieneb järjest. Algul kasutati neid lühiajalises perioperatiivses tromboosiprofülaktikas, aga nüüd määratakse neid üha rohkem ka kestvaks kasutamiseks kodade virvendusarütmiaga patsientidel. Kuigi nende ravimite kasutamine on mitmes mõttes lihtsam varfariinravist, on ravi määramisel ja jälgimisel vaja siiski olla väga hoolikas, kuna ka neil ravimeil on kõrvaltoimete ohtu suurendavad koostoimed teiste ravimitega, samuti vähendavad elundipuudulikkused ka nende kasutamise ohutust. Et anda praktilist nõu olulisemates küsimustes, avaldas Euroopa Südamerütmi Assotsiatsioon (European Heart Rhythm Association, EHRA) 2013. aastal juhendmaterjali (1, 2), mille põhiseisukohti on allpool refereeritud.Eesti Arst 2013; 92(11):645–648’

Eesti perekondliku hüperkolesteroleemia käsitlusjuhend

Eesti Arst 2023; 102(4):237–24

Wintertime Greenhouse Gas Fluxes in Hemiboreal Drained Peatlands

Funding Information: Funding: This study was supported by the Estonian Research Council (IUT2-16 and PRG352); the EU through the European Regional Development Fund (Centre of Excellence EcolChange, Estonia) and by the Estonian State Forest Management Centre (projects LLOOM13056 “Carbon and nitrogen cycling in forests with altered water regime “, 2013–2016 and LLTOM17250 “Water level restoration in cut-away peatlands: development of integrated monitoring methods and monitoring”, 2017–2023).Peer reviewedPublisher PD

Soil sequences atlas. 2

TäistekstThis is the second book in the series of Soil Sequence Atlases. The first volume was published in 2014. Main pedogeographic features are presented in the form of sequences to give a comprehensive picture of soils - their genesis and correlations with the environment in typical landscapes of Central Europe from Estonia furthest north, through Latvia, Lithuania, Poland, Germany, Czechia, Slovakia and Hungary to the southernmost Slovenia. Soils of natural landscapes - loess and sand (continental dunes) - are presented, as well as those of plains of various origin, karst lands, low mountains, and anthropically modified soils. Each chapter presents soil profiles supplemented by landscape information and basic analytical data. Then, genetic interpretations of soil properties related to soil forming agents are given as schematic catenas. When one factor changes while the others are more or less stable, the soil sequence can be recognised. Depending on the dominant soil-forming factor affecting repeated soil patterns, different types can be distinguished. Chapters are arranged roughly in accordance with the main soil-forming process in sequences, and referring to the WRB key (peat formation, vertic and gleyic process, podzolisation, humus accumulation, clay illuviation), with one small exception - the Technosols have been placed at the end of book. The main objective of this book is to present the diversity of relations between soil and landscape, climate, hydrology and human relations, and to present interpretations reflecting the World Reference Base for Soil Resources (2015) classification with comments on the choice of qualifiers. Sixteen Reference Soil Groups are featured, and represented by 67 soil profiles. The secondary objective is pedological education. One of the aims of soil science education is to explain to students the relations between landscape and soil cover. The patterns of soil units within landscapes are to some extent predictable. The collected data is intended as a useful educational tool in teaching soil science, supporting understanding of the reasons for the variability of soil cover, and also as a WRB classification guideline. The Atlas was developed as part of the EU Erasmus+ FACES project (Freely Accessible Central European Soil). Marcin Šwitoniak, Przemyslaw Charzynsk

Maternal gluten, cereal, and dietary fiber intake during pregnancy and lactation and the risk of islet autoimmunity and type 1 diabetes in the child

Background & aims: Maternal gluten intake in relation to child's risk of type 1 diabetes has been studied in few prospective studies considering the diet during pregnancy but none during lactation. Our aim was to study whether gluten, cereals, or dietary fiber in maternal diet during pregnancy and lactation is associated with the risk of islet autoimmunity or type 1 diabetes in the offspring. Methods: We included 4943 children with genetic susceptibility to type 1 diabetes from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study, born between 1996 and 2004. Maternal intake of gluten, different types of cereals, and dietary fiber were derived from a semi-quantitative validated food frequency questionnaire covering the eighth month of pregnancy and the third month of lactation. Children were monitored for islet autoantibodies up to age of 15 years and type 1 diabetes until year 2017. Risk of islet autoimmunity and clinical type 1 diabetes were estimated using Cox regression model, adjusted for energy intake, child's sex, HLA genotype, and familial diabetes. Results: Altogether 312 children (6.4%) developed islet autoimmunity at median age of 3.5 (IQR 1.7, 6.6) years and 178 children (3.6%) developed type 1 diabetes at median age of 7.1 (IQR 4.3, 10.6) years. Gluten intake during pregnancy was not associated with islet autoimmunity (HR 0.96; 95% CI 0.68, 1.35), per 1 g/MJ increase in intake nor type 1 diabetes (HR 0.96; 95% CI 0.62, 1.50) in the offspring. Higher barley consumption during lactation was associated with increased risk of type 1 diabetes (HR 3.25; 95% CI 1.21, 8.70) per 1 g/MJ increase in intake. Maternal intake of other cereals or dietary fiber was not associated with the offspring outcomes. Conclusions: We observed no association between maternal intake of gluten, most consumed cereals, or dietary fiber during pregnancy or lactation and the risk of islet autoimmunity or type 1 diabetes in children from a high-risk population

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

PROPERTIES AND ENVIRONMENTAL IMPACT OF OIL SHALE ASH LANDFILLS; pp. 257–270

Estoniaâs basic power supply is covered mainly by oil shale-fired thermal power plants. The pulverized combustion (PC) and circulating fluidized bed combustion (CFBC) technologies are used. The power plant exploitation has revealed the emission of gaseous pollutants, as well as ash handling problems. The hydro ash removal is used at large power plants in Estonia. An overview of the formation and properties of oil shale ash is given. The polluting impact of ash in contact with water is analyzed. Taking into account precipitation and evaporation conditions the amount of water bound by ash as well as ash field water balance is given. The leaching behaviour of oil shale ash is analyzed. The analysis of the ash field structure shows that the degree of water penetration of the ash field body meets the requirements for hazardous waste landfills. The water permeability through dense layers ranges from 0.15 Ã 10â9 to 16.1 Ã 10â9 m/s