Laparoscopic retropubic colpopexy in the treatment of stress incontinence

The results of treating urinary stress incontinence in women with the help of some combined methods are demonstrated. Original methods laparoscopic retropubic colpopexy by lateral approach, MESH-vaginopexy, laparoscopic retropubic colpopexy are analyzed considering the type of urinary incontinence to substantiate pathogenetically the prophylaxis of stress incontinence recurrence.

MODELOS DE PREDICCIÓN PARA EL SECTOR TURÍSTICO ANDALUZ MEDIANTE MÉTODOS ESTADÍSTICOS AVANZADOS

En el trabajo se modeliza la serie temporal “turistas que visitan Andalucía”, variable que presenta una fuerte componente estacional. Se plantea y analiza la capacidad predictiva de tres modelos diferentes, aplicando distintas metodologías de modelización (Box-Jenkins, Holt-Winters y métodos combinados). Se comparan los resultados obtenidos de las predicciones con los valores reales de la serie de turismo, valorándose la buena capacidad predictiva de las tres metodologías empleadas. Se comprueba que el procedimiento clásico de Holt-Winters es el que ofrece mejores resultados predictivos. In the work, the time series "tourists were visiting Andalusia" is modeled, a variable that has a strong seasonal component. The forecasting capacity of three different models is considered and analyzed, applying different modeling methodologies (Box-Jenkins, Holt-Winters and combined methods). The results obtained from the predictions are compared with the real values of the tourism series, assessing the good forecasting capacity of the three methodologies used. It is verified that the classic Holt-Winters procedure is the one that offers the best predictive results.

APPLICATION OF COMBINED TECHNOLOGY FOR RENOVATION AND INCREASED RESOURCE DETAILS OF MEANS OF TRANSPORT

It presents various combinations of primary hardfacing technology for the renovation and improvement of the resource details of ship machinery. Currently, promising are integrated or combined methods hard facing (hybrid technology) coating in conjunction with the modification, the application of multi-layer, multi-functional coatings; development of integrated multioperational technologies. In all conditions, increasing scarcity of expensive alloying materials included in the composition of steels requiring high strength properties of the complex, are promising hybrid technology peening (restore) the surfaces of mild steel Combinations of various primary technologies of application of multipurpose coverings for restoration and increase of a resource of details of knots and units of vehicles are presented. Currently promising are combined methods of application of multifunctional coatings (integrated, hybrid technologies), methods of coating in combination with methods of modification, application of multilayer, multifunctional coatings; development of combined (integrated, hybrid) multioperational technologies. In the conditions of growing shortage of expensive alloying materials which are a part of the steels demanding a high complex of properties of durability, the combined methods of restoration of surfaces are perspective.At present, a methodology for the synthesis of combined multi-operational technologies has not been developed. An empirical-intuitive approach prevails in the combination of multifunctional coating restoration methods. The optimal choice of restoration methods and their sequence is determined by the increase of hardness, complex of mechanical properties, wear resistance, as well as the roughness of the restored surface and the accuracy of the dimensions of the restored part. In the first-best case of combined (hybrid) methods of recovery, the criterion of choice is the comparison of costs and increase the set of mechanical properties of the recoverable parts of components and units of vehicles [13-14]. Each method of recovery has its niche of optimal conditions of use, including even the technological traditions that have developed in a particular enterprise. The decisive factor in the choice of primary methods of applying multifunctional coatings in the combined restoration process is the presence of certain types of equipment at the enterprise and the ability to integrate them intoa single technological cycle. In order to restore vehicle parts with multifunctional coatings with high adhesion strength, hardness and wear resistance, we have proposed a combined (integrated) technology that includes electric arc spraying, electrospark doping and pulsed ion nitriding.

Intravenous and combined methods of treatment of articular rheumatism

In recent years, we have used the following methods in the treatment of articular rheumatism: 1) intravenous infusion of the so-called Attritin 16% salicylic sodium solution + 4% coffeini n.- salic solution. 2) Intramuscular injections of milk in combination with intravenous infusions of Attritin'a. 3) Intravenous infusion of opsonized salicylic sodium and 4) Natr. salic, ex 10-12.0-200.0 per os - 4-6 tablespoons per day in combination with subcutaneous injections of autologous blood.

X-ray checks of NG tube position: a case for guided tube placement

Objectives: Checking nasogastric (NG) tube position by X-ray is too late to prevent 1.5% of blind tube placements entering the lung and results in delays to feeding and drugs. We audit the safety of the tube position and delay incurred by X-ray. Methods: From Radiology reports, we determined whether tube position was safe for feeding, factors associated with an X-ray request and the time delay from X-ray request to that report. For tubes misplaced into the lung, the distance from the carina to tube tip was measured and compared with that from published records of guided tube placement. Results: From 1 July 2019 to 30 June 2020, 1934 X-rays were done to check NG tube position in 891 patients. Gastric placement was confirmed in 85% but, because of tube proximity to the oesophagus, only 73% were deemed safe to feed. The 2.2% of tubes reported to be in the lung were a median of 18 cm beyond the carina compared to 12 cm and 0 cm for electromagnetic and direct vision methods of guided placement. X-ray checks delayed feed and drug treatment by >2 h in 51% of placements and 33% of patients required >3 X-rays during their enteral episode. Conclusion: X-ray checks are common and detect a high percentage of unsafe tube placements, leading to repeated X-ray and delayed delivery of drugs and nutrition. Interpretation can be difficult even when following standard national criteria and post-placement X-ray cannot prevent deep lung placement. Guided or combined methods of confirming tube placement should be investigated. Advances in knowledge: Reports included 27.5% of placements as unsafe, 2.2% in the lung at a median depth of 18 cm beyond the carina and too late to prevent 7 pneumothoraces. X-rays were repeated >3 times in 33% of patients over their enteral course and we are associated with clinically significant delays to drug treatment (and nutrition) in 51%; combined methods of tube confirmation or guided placement may be safer and more efficient.