BackgroundTransarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis.MethodsPreventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group). The comparison group consisted of similar patients who only underwent endoscopic haemostasis, without preventive TAE (PE− group). The technical success of preventive TAE, the completeness of haemostasis, the incidence of rebleeding and the need for surgical intervention and the main outcomes were compared between the groups.ResultsThe PE+ group consisted of 25 patients, and the PE− group of 50 patients, similar in age (median age 66 vs. 63 years), gender and comorbid conditions. The ulcer size at endoscopy was not significantly different (median of 152 mm vs. 127 mm). The most frequent were Forest II type ulcers, 44% in both groups. The distribution of the Forest grade was even. The median haemoglobin on admission was 8, 2 g/dl vs. 8,7 g/dl, p = 0,482, erythrocyte count was 2,7 × 1012/L vs. 2,9 × 1012/L, p = 0,727. The shock index and Rockall scores were similar, as well as and transfusion – on average, four units of packed red blood cells for the majority of patients in both groups, however, significantly more fresh frozen plasma was transfused in the PE− group, p = 0,013. The rebleeding rate was similar, while surgical treatment was needed notably more often in the PE- group, 8% vs. 35% accordingly, p = 0,012. The median ICU stay was 3 days, hospital stay – 6 days vs. 9 days, p = 0.079. The overall mortality reached 20%; in the PE+ group it was 4%, not reaching a statistically significant difference.ConclusionPreventive TAE is a feasible, safe and effective minimally invasive type of haemostasis decreasing the risk of repeated bleeding and preparing the patient for the definitive surgical intervention when indicated.
The training of modern specialists in the field of philology, and in particular the formation of their communicative competence, is a very complex and time-consuming process, which depends on a variety of objective and subjective factors. In this study, we used the business game method to increase the level of environmental education and communicative competence of students of philology. Environmental education provides an opportunity to create the necessary conditions for the sustainable development of the economy and society. In most industrialized countries, there are trends towards saving the natural resources consumed, and waste recycling is also used to reuse the useful resources contained in them. In our opinion, sustainable socio-economic development should provide for the preservation of the fauna and flora, the fertility of the land, as well as the cleanliness of the air space for future generations. We believe that this requires the availability of high-quality environmental education among specialists in various areas of human activity. The results of the business game showed an increase in students ’ communicative competence, as well as an increase in environmental education and the desire to protect the environment.
Стаття присвячена проблемі оцінювання рівня економічної безпеки підприємства. Досліджено особливості оцінювання рівне економічної безпеки, розроблено методику оцінювання рівня економічної безпеки. Розкрито основи формування системи оціноч них показників на підприємстві, представлено алгоритм оцінки рівня економічної безпеки на підприємстві. Узагальнення результатів оцінювання економічної безпеки підприємства за двома етапами здійснюється шляхом визначення зон економічної безпеки підприємства. Ключові слова: економічна безпека, підприємство, методика оцінювання, інтегральний показник, показники прибутку.
В статті визначено стратегічні пріоритети розвитку вітчизняних підприємств, до яких віднесено реіндустріалізацію, забезпечення конкурентоспроможності, екологізацію, диверсифікацію, навчання. В якості інструмента реалізації стратегічних пріоритетів розвитку запропоновано обрати розробку та реалізацію стратегії кластеризації. Досліджено поняття територіальновиробничі об'єднання, кластери та визначено, що оптимальною формою організації виробництва в умовах реіндустріалізації є промислово-територіальні кластери. Представлена загальна структура промислово-технологічного кластеру, визначено особливе положення ремонтних, енергомонтажних підприємств. Ключові слова: промислові підприємства, реіндустріалізація, стратегічні пріоритети, кластеризація, промислово-територальні комплекси.
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