664 research outputs found
Evaluation of the effects of establishing of consalidated groups of taxpayers for Russian groups of companies
One of the most important decisions in the field of tax policy is the possibility of establishing consolidated groups of taxpayers. In this article we consider the ambiguity of influence of establishing such groups on the revenues of budgets of subjects of Russia. Besides we will find out the reasons of this influence
Die Entwicklung der humanistischen Dokumentarschrift: Ergebnisse eines Würzburger Forschungsprojekts
Zusammenhänge zwischen den Folgen beruflicher Belastung und Alexithymie bei Psychotherapeut:innen
Alexithymie, auch als Gefühlsblindheit bekannt, charakterisiert durch Schwierigkeiten, eigene Emotionen zu erkennen und zu beschreiben, stellt eine bedeutende Herausforderung in der Psychotherapie dar, sowohl für Patienten* als auch für Psychotherapeuten (Goerlich, 2018). Die vorliegende Studie untersucht die Zusammenhänge zwischen den Folgen beruflicher Belastung und der Ausprägung von Alexithymie bei Psychotherapeuten. Als Folgen beruflicher Belastung werden Burnout(BO), Compassion Fatigue (CF) und sekundäre Traumatisierung (ST) betrachtet. Die rekrutierte Stichprobe umfasst 211 Psychotherapeuten, approbiert, so wie in Ausbildung, im Alter von 24 bis 65 Jahren. Die Datenerhebung erfolgte online mittels standardisierter Fragebögen. Zur Messung der Alexithymie wurde der PAQ-6 Fragebogen verwendet, während BO und CF mithilfe des ProQOL-5-9-R erfasst wurden. ST wurde anhand des PDS-8-ST gemessen. Die Ergebnisse einer Spearman-Korrelation zeigen, dass BO (r = .32), CF (r = .25) und ST (r = .33) positiv mit Alexithymie korrelieren. Durch die hierarchischen Regressionsanalysen wird deutlich, dass in gemeinsamer Betrachtung von BO, CF und ST nur ST als Prädiktor einen signifikanten Anteil der Varianz in der Ausprägung der Alexithymie erklären kann. Bei separater Einführung der Folgen beruflicher Belastung als Prädiktoren zeigen alle einen signifikanten Einfluss, wobei ST mit einer Varianzerklärung von 18.3% (Änderungen R 2 = .183) den stärksten Effekt auf die Alexithymie-Ausprägung hat, gefolgt von BO und CF. Diese Befunde stützen anteilig bereits existierende Forschungsergebnisse und können als Ausgangspunkt für weitere Studien dienen, um die Zusammenhänge beruflicher Belastung und Alexithymie weiter zu erforschen. Dabei sollten die unterschiedlich signifikanten Ergebnisse miteinbezogen und die zugrundeliegenden Ursachen erforscht werden
Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome
Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in childhood and the reason for chronic renal replacement therapy. It leads to significant morbidity and mortality during the acute phase. In addition to acute morbidity and mortality, long-term renal and extrarenal complications can occur in a substantial number of children years after the acute episode of HUS. The most common infectious agents causing HUS are enterohemorrhagic Escherichia coli (EHEC)-producing Shiga toxin (and belonging to the serotype O157:H7) and several non-O157:H7 serotypes. D+ HUS is an acute disease characterized by prodromal diarrhea followed by acute renal failure. The classic clinical features of HUS include the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS mortality is reported to be between 3% and 5%, and death due to HUS is nearly always associated with severe extrarenal disease, including severe central nervous system (CNS) involvement. Approximately two thirds of children with HUS require dialysis therapy, and about one third have milder renal involvement without the need for dialysis therapy. General management of acute renal failure includes appropriate fluid and electrolyte management, antihypertensive therapy if necessary, and initiation of renal replacement therapy when appropriate. The prognosis of HUS depends on several contributing factors. In general “classic” HUS, induced by EHEC, has an overall better outcome. Totally different is the prognosis in patients with atypical and particularly recurrent HUS. However, patients with severe disease should be screened for genetic disorders of the complement system or other underlying diseases
Analysis of the classical, alternative, and MBL pathways of the complement system in juvenile idiopathic arthritis
Eculizumab as rescue therapy for atypical hemolytic uremic syndrome with normal platelet count
Item does not contain fulltextBACKGROUND: Atypical hemolytic uremic syndrome (aHUS) in childhood is a rare disease with frequent progression to end-stage renal disease and a high recurrence after kidney transplantation. Eculizumab, a humanized monoclonal antibody that binds to complement protein C5, may be beneficial in the treatment of aHUS. CASE-DIAGNOSIS/TREATMENT: A 6-year-old girl developed aHUS with only slightly elevated C3d (4.4%), no mutations in complement factors, and no antibodies against factor H. Plasma exchange treatment was successful initially, until aHUS recurred. After reinitiating plasma exchange, normalization of the platelet count and improvement of hemolysis occurred, but renal function worsened. Renal function then improved dramatically promptly after the switch to eculizumab. CONCLUSIONS: This case demonstrates that platelet count is not always a reliable marker for improvement of aHUS and that eculizumab can prevent dialysis in plasma-resistant aHUS patients.1 juli 201
Plasma therapy in atypical haemolytic uremic syndrome: lessons from a family with a factor H mutation
Whilst randomised control trials are undoubtedly the best way to demonstrate whether plasma exchange or infusion alone is the best first-line treatment for patients with atypical haemolytic uremic syndrome (aHUS), individual case reports can provide valuable information. To that effect, we have had the unique opportunity to follow over a 10-year period three sisters with aHUS associated with a factor H mutation (CFH). Two of the sisters are monozygotic twins. A similar natural evolution and response to treatment would be expected for the three patients, as they all presented with the same at-risk polymorphisms for CFH and CD46 and no identifiable mutation in either CD46 or CFI. Our report of different modalities of treatment of the initial episode and of three transplantations and relapses in the transplant in two of them, strongly suggest that intensive plasma exchange, both acutely and prophylactically, can maintain the long-term function of both native kidneys and allografts. In our experience, the success of plasma therapy is dependent on the use of plasma exchange as opposed to plasma infusion alone, the prolongation of daily plasma exchange after normalisation of haematological parameters followed by prophylactic plasma exchange, the use of prophylactic plasma exchange prior to transplantation and the use of prophylactic plasma exchange at least once a week posttransplant with immediate intensification of treatment if there are any signs of recurrence
Shiga Toxin-Mediated Hemolytic Uremic Syndrome: Time to Change the Diagnostic Paradigm?
Hemolytic uremic syndrome (HUS) is caused by enterohemorrhagic Escherichia coli (EHEC) which possess genes encoding Shiga toxin (stx), the major virulence factor, and adhesin intimin (eae). However, the frequency of stx-negative/eae-positive E. coli in stools of HUS patients and the clinical significance of such strains are unknown.Between 1996 and 2006, we sought stx-negative/eae-positive E. coli in stools of HUS patients using colony blot hybridization with the eae probe and compared the isolates to EHEC causing HUS. stx-negative/eae-positive E. coli were isolated as the only pathogens from stools of 43 (5.5%) of 787 HUS patients; additional 440 (55.9%) patients excreted EHEC. The majority (90.7%) of the stx-negative/eae-positive isolates belonged to serotypes O26:H11/NM (nonmotile), O103:H2/NM, O145:H28/NM, and O157:H7/NM, which were also the most frequent serotypes identified among EHEC. The stx-negative isolates shared non-stx virulence and fitness genes with EHEC of the corresponding serotypes and clustered with them into the same clonal complexes in multilocus sequence typing, demonstrating their close relatedness to EHEC.At the time of microbiological analysis, approximately 5% of HUS patients shed no longer the causative EHEC, but do excrete stx-negative derivatives of EHEC that lost stx during infection. In such patients, the EHEC etiology of HUS is missed using current methods detecting solely stx or Shiga toxin; this can hamper epidemiological investigations and lead to inappropriate clinical management. While maintaining the paradigm that HUS is triggered by Shiga toxin, our data demonstrate the necessity of considering genetic changes of the pathogen during infection to adapt appropriately diagnostic strategies
Электроснабжение Международного аэропорта Сабетты, ЯНАО
В процессе выполнения выпускной квалификационной работы была спроектирована система электроснабжения здания ангара и предприятия в целом. При расчете использовался метод коэффициента расчетной мощности и метод коэффициента мощности. Были рассмотрены вопросы ресурсоэффективности и социальной ответственности проектируемой системы.
Основные конструктивные, технологические и эксплуатационные характеристики: предприятие включает четырнадцать зданий 1 и 2 категорий, напряжение питающей линии -35 кВ, напряжение внутризаводской сети – 10 кВ, напряжение зданий – 0.4 кВIn the course of the final qualifying work, the power supply system of the hangar building and the enterprise as a whole was designed. In the calculation we used the method of ratio calculation method of power and power factor. The issues of resource efficiency and social responsibility of the designed system were considered.
The basic constructive, technological and operating characteristics: the company includes fourteen buildings 1 and 2 categories, the line voltage of -35 kV, the voltage of the in-plant network of 10 kV, voltage-buildings – 0.4 k
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