It is difficult to imagine that just a few decades ago, many homes did not have access to regular hot water, electricity and heating during the winter season. And failure to comply with sanitary standards due to ignorance or the inability to do this led to real epidemics.

And even now, having all the above-mentioned amenities, we don’t often think about how it all functions? How do such large flows of water, electricity, and natural gas find appropriate and regulated use?

Responsibilities of housing and communal services

Everything related to social infrastructure falls within the competence of housing and communal services. This sector of the economy regulates the full functioning of residential buildings and provides comfortable living conditions.

The voiced service and its divisions have long been known to many, because a similar hierarchy developed back in the days when Belarus was part of the Soviet Union. Now the entire range of services and responsibilities is concentrated within the Housing Repair and Maintenance Associations.

Separate activities are carried out by the Housing and Maintenance Service or the Housing and Maintenance Section (several housing and communal services united into one division), namely their responsibility is the maintenance of the housing stock and the maintenance of courtyard areas, which includes landscaping and cleaning.

The functions of ZhREO, ZhES and, in general, housing and communal services imply:

• Ensuring uninterrupted supply of electricity and natural gas; supply of hot water and thermal energy; energy saving - control over electricity consumption.
• Sewage work - wastewater disposal, laying and repairing water pipes; ensuring uninterrupted supply of water, including hot water.
• Accounting for the consumption of utility resources and housing and communal services.
• Ventilation and centralized air conditioning.
• Control of elevator facilities.
• Maintenance of low-current networks: television and telephone communications;
• Regular waste removal: monitoring the condition of garbage chutes; sorting, processing and disposal of household waste.
• Installation of lightning rods and grounding.
• Monitoring the fire protection system for buildings and structures and fire safety (fire escape, alarm, fire extinguishing equipment).
• Monitoring the condition of building structures.
• Major repairs and modernization of buildings.
• Sanitary and epidemiological treatment of common areas (including deratization and disinfestation). Improvement of local areas

Exactly fifty-nine mandatory procedures are included in the list of maintaining engineering systems in working order and thirty-nine in the list of maintaining structural elements in good condition. They are performed at varying frequencies, most as needed. Such important ones as checking the technical condition of the heating system , sewer system, electrical devices in public areas, foundation and basement walls - twice a year. A complete list can be obtained by calling your local ZhREO.

Housing and utilities services

Responsibilities for maintaining residential buildings and courtyard areas in accordance with established sanitary and technical standards include: maintenance of multi-apartment buildings, timely removal of garbage and its safe disposal, maintaining the operation of the elevator.

It is necessary to consider in more detail the activities of housing services in apartment buildings. The mandatory list includes:

• Cleaning of the first three floors once a day.
• Comprehensive cleaning and disinfection of all floors twice a week.
• Work to maintain cleanliness in the basement and technical floor once a month.
• Cleaning windows in the entrance every six months.
• Emptying trash containers once a day;
• Wet cleaning of the garbage disposal chamber once a week;
• Cleaning the garbage loading system in the garbage chute twice a month;
• Disinfect the garbage disposal once a month.

There are a number of additional opportunities that can be used thanks to the activities of housing departments. They are carried out only on the basis of the voluntary consent of the customer, after the conclusion of the contract. Installation and further maintenance of intercoms and video surveillance; organization of concierge work; rental and replacement of special stain-resistant carpets; landscaping and subsequent maintenance of the courtyard area - all this falls under the definition of additional services. No one has the right to charge you for them without concluding an agreement.

Calling an electrician, plumbing work and other paid assistance from housing and communal services

The most important advantage of municipal services is their fixed price, accessible to everyone. The following are carried out on a paid basis:

• Work of plumbers (replacement of toilets, bathtubs, gaskets and faucets; installation of meters; cleaning of sewers).
• Repair of windows and doors, their replacement.
• Wallpapering walls; painting walls, windows and doors.
• Electric installation work.

The full list is approved at various intervals, depending on the demand by the population. It usually contains about thirty-five positions. You can check with your local housing authority for more details.

Non-cash subsidy

You can compensate for the costs of paying for housing and communal services if they exceed twenty percent of the total income of a family or an individual citizen. For rural residents, this figure will be fifteen percent.

Homeowners or tenants of public housing space can receive a subsidy if consumption volumes do not exceed established standards.

This type of government assistance will be denied to owners of several residential premises or shares in other apartments, landlords and owners of apartments in which a private enterprise is registered.

To apply for a subsidy, you must contact the executive committees or village councils at your place of residence.

Where to complain about housing and communal services in Belarus

If you want to clarify the list of services and current tariffs, or contact utility services for help, keep in mind that there is a general contact center at the short number 115, where you can find out all the missing information and leave a complaint.

There is a charge for calls to this phone number. In the website's information service directory you can find a toll-free contact number for your local office. But what to do if your complaints or requests remain unanswered?

If you are dissatisfied with the services, you should contact the service provider directly. If you are not satisfied with the temperature of the heating batteries, contact the representative office of Minsk Heating Networks. If you are not satisfied with the quality of sewer water or its periodic absence, contact the Minskvodokanal employees. You can always contact the Minsk Housing and Communal Services directly so that your requirements are heard and fulfilled in a timely manner.

Ventricular extrasystoles (VES) are extraordinary contractions of the heart that occur under the influence of premature impulses that originate from the intraventricular conduction system.
Under the influence of an impulse generated in the trunk of the His bundle, its branches, branching branches or Purkinje fibers, the myocardium of one of the ventricles contracts, and then the second ventricle without previous contraction of the atria. This explains the main electrocardiographic signs of PVCs: premature dilated and deformed ventricular complex and the absence of a normal P wave preceding it, indicating atrial contraction.

In this article, we will consider the causes of ventricular extrasystole, its symptoms and signs, and we will talk about the principles of diagnosis and treatment of this pathology.

Extrasystoles can appear in healthy people after taking stimulants (caffeine, nicotine, alcohol).

Ventricular extrasystole can be observed in healthy people, especially with (Holter-ECG). Functional PVCs are more common in people under 50 years of age. It can be triggered by physical or emotional fatigue, stress, hypothermia or overheating, acute infectious diseases, taking stimulants (caffeine, alcohol, tannin, nicotine) or certain medications.

Functional PVCs are often detected when the activity of the vagus nerve increases. In this case, they are accompanied by a rare pulse, increased salivation, cold wet extremities, and arterial hypotension.

Functional PVCs do not have a pathological course. When the provoking factors are eliminated, they most often go away on their own.

In other cases, ventricular extrasystole is caused by organic heart disease. For its occurrence, even against the background of heart disease, additional exposure to toxic, mechanical or autonomic factors is often required.

Often PVCs accompany chronic ischemic heart disease (). With daily ECG monitoring, they occur in almost 100% of such patients. Arterial hypertension, heart defects, heart failure and myocardial infarction are also often accompanied by ventricular extrasystole.

This symptom is observed in patients with chronic lung diseases, rheumatism. Extrasystole of reflex origin occurs, associated with diseases of the abdominal organs: cholecystitis, gastric and duodenal ulcers, pancreatitis, colitis.
Another common cause of ventricular extrasystole is a metabolic disorder in the myocardium, especially associated with the loss of potassium by cells. These diseases include pheochromocytoma (a hormone-producing tumor of the adrenal gland) and hyperthyroidism. PVCs can occur in the third trimester of pregnancy.

Drugs that can cause ventricular arrhythmias include primarily cardiac glycosides. They also occur when using sympathomimetics, tricyclic antidepressants, quinidine, and anesthetics.

Most often, PVCs are recorded in patients who have serious changes at rest: signs, myocardial ischemia, rhythm and conduction disturbances. The frequency of this symptom increases with age and is more common in men.

Clinical signs

With a certain degree of convention, we can talk about different symptoms for functional and “organic” PVCs. Extrasystoles in the absence of severe heart disease are usually single, but are poorly tolerated by patients. They may be accompanied by a feeling of freezing, interruptions in heart function, and isolated strong beats in the chest. These extrasystoles often appear at rest, in a lying position, or during emotional stress. Physical tension or even a simple transition from a horizontal to a vertical position leads to their disappearance. They often occur against the background of a rare pulse (bradycardia).

Organic PVCs are often multiple, but patients usually do not notice them. They appear during physical activity and go away with rest, in a lying position. In many cases, such PVCs are accompanied by rapid heartbeat (tachycardia).

Diagnostics

The main methods of instrumental diagnosis of ventricular extrasystole are ECG at rest and 24-hour Holter ECG monitoring.

Signs of PVC on ECG:

• premature dilated and deformed ventricular complex;
• discordance (multidirectionality) of the ST segment and T wave of the extrasystole and the main wave of the QRS complex;
• absence of a P wave in front of the VES;
• the presence of a complete compensatory pause (not always).

Interpolated PVCs are distinguished, in which the extrasystolic complex is inserted, as it were, between two normal contractions without a compensatory pause.

If PVCs come from the same pathological focus and have the same shape, they are called monomorphic. Polymorphic PVCs emanating from different ectopic foci have different shapes and different coupling intervals (the distance from the previous contraction to the R wave of the extrasystole). Polymorphic PVCs are associated with severe cardiac damage and a more serious prognosis.
Early PVCs (“R to T”) are classified into a separate group. The criterion for prematurity is the shortening of the interval between the end of the T wave of sinus contraction and the beginning of the extrasystole complex. There are also late PVCs that occur at the end of diastole, which may be preceded by a normal sinus P wave, superimposed on the beginning of the extrasystolic complex.

VES can be single, paired or group. Quite often they form episodes of allorhythmia: bigeminy, trigeminy, quadrigeminy. With bigeminy, a VES is recorded through every normal sinus complex; with trigeminy, a VES is recorded every third complex, and so on.

During daily ECG monitoring, the number and morphology of extrasystoles, their distribution during the day, and dependence on load, sleep, and medication are specified. This important information helps determine the prognosis, clarify the diagnosis and prescribe treatment.

The most dangerous in terms of prognosis are considered to be frequent, polymorphic and polytopic, paired and group VES, as well as early extrasystoles.

The differential diagnosis of ventricular extrasystoles is carried out with supraventricular extrasystoles, complete block of the bundle branches, and escaped ventricular contractions.

If ventricular extrasystole is detected, the patient should be examined by a cardiologist. Additionally, general and biochemical blood tests, an electrocardiographic test with dosed physical activity, and echocardiography may be prescribed.

Treatment

Treatment of ventricular extrasystole depends on its causes. With functional PVCs, it is recommended to normalize the daily routine, reduce the use of stimulants, and reduce emotional stress. A diet enriched with potassium or drugs containing this microelement (Panangin) is prescribed.
For rare extrasystoles, special antiarrhythmic treatment is not prescribed. Herbal sedatives (valerian, motherwort) are prescribed in combination with beta-blockers. In case of JS against the background of vagotonia, sympathomimetics and anticholinergic drugs, for example, Bellataminal, are effective.
If the extrasystoles are organic, treatment depends on the number of extrasystoles. If there are few of them, ethmosin, etacizin or allapinin can be used. The use of these drugs is limited due to the possibility of their arrhythmogenic effects.

If extrasystole occurs in the acute period of myocardial infarction, it can be stopped with lidocaine or trimecaine.

Cordarone (amiodarone) is currently considered the main drug for suppressing ventricular extrasystole. It is prescribed according to a scheme with a gradual reduction in dosage. When treating with cordarone, it is necessary to periodically monitor the function of the liver, thyroid gland, external respiration and the level of electrolytes in the blood, as well as undergo an examination by an ophthalmologist.

In some cases, persistent ventricular premature beats from a known ectopic focus are well treated with radiofrequency ablation surgery. During such an intervention, cells that produce pathological impulses are destroyed.

The presence of ventricular extrasystole, especially its severe forms, worsens the prognosis in people with organic heart disease. On the other hand, functional VES most often do not affect the quality of life and prognosis of patients.

Video course “Everyone can do an ECG”, lesson 4 - “Heart rhythm disturbances: sinus arrhythmias, extrasystole” (VES - from 20:14)

1. Independent parts of speech:

• nouns (see morphological norms of nouns);
• Verbs:
• • participles;
  • participles;
• adjectives;
• numerals;
• pronouns;
• adverbs;

2. Functional parts of speech:

• prepositions;
• unions;
• particles;

3. Interjections.

The following do not fall into any of the classifications (according to the morphological system) of the Russian language:

• the words yes and no, if they act as an independent sentence.
• introductory words: so, by the way, total, as a separate sentence, as well as a number of other words.

Morphological analysis of a noun

• initial form in the nominative case, singular (with the exception of nouns used only in the plural: scissors, etc.);
• proper or common noun;
• animate or inanimate;
• gender (m,f, avg.);
• number (singular, plural);
• declination;
• case;
• syntactic role in a sentence.

Plan for morphological analysis of a noun

"The baby drinks milk."

Baby (answers the question who?) – noun;

• initial form - baby;
• constant morphological features: animate, common noun, concrete, masculine, 1st declension;
• inconsistent morphological features: nominative case, singular;
• when parsing a sentence, it plays the role of subject.

Morphological analysis of the word “milk” (answers the question of whom? What?).

• initial form – milk;
• constant morphological characteristics of the word: neuter, inanimate, real, common noun, II declension;
• variable morphological features: accusative case, singular;
• direct object in the sentence.

Here is another example of how to make a morphological analysis of a noun, based on a literary source:

"Two ladies ran up to Luzhin and helped him get up. He began to knock the dust off his coat with his palm. (example from: “Luzhin’s Defense”, Vladimir Nabokov)."

Ladies (who?) - noun;

• initial form - queen;
• constant morphological features: common noun, animate, concrete, feminine, first declension;
• fickle morphological characteristics of the noun: singular, genitive case;
• syntactic role: part of the subject.

Luzhin (to whom?) - noun;

• initial form - Luzhin;
• faithful morphological characteristics of the word: proper name, animate, concrete, masculine, mixed declension;
• inconsistent morphological features of the noun: singular, dative case;

Palm (with what?) - noun;

• initial shape - palm;
• constant morphological features: feminine, inanimate, common noun, concrete, I declension;
• inconsistent morpho. signs: singular, instrumental case;
• syntactic role in context: addition.

Dust (what?) - noun;

• initial form - dust;
• main morphological features: common noun, material, feminine, singular, animate not characterized, III declension (noun with zero ending);
• fickle morphological characteristics of the word: accusative case;
• syntactic role: addition.

(c) Coat (Why?) - noun;

• the initial form is a coat;
• constant correct morphological characteristics of the word: inanimate, common noun, specific, neuter, indeclinable;
• morphological features are inconsistent: the number cannot be determined from the context, genitive case;
• syntactic role as a member of a sentence: addition.

Morphological analysis of the adjective

An adjective is a significant part of speech. Answers the questions Which? Which? Which? Which? and characterizes the characteristics or qualities of an object. Table of morphological features of an adjective name:

• initial form in the nominative case, singular, masculine;
• constant morphological features of adjectives:
• • rank according to the value:
  • • - quality (warm, silent);
    • - relative (yesterday, reading);
    • - possessive (hare, mother);
  • degree of comparison (for quality ones, for which this feature is constant);
  • full/short form (for quality ones, for which this sign is constant);
• inconsistent morphological features of the adjective:
• • qualitative adjectives vary according to the degree of comparison (in comparative degrees the simple form, in superlative degrees - complex): beautiful - more beautiful - the most beautiful;
  • full or short form (qualitative adjectives only);
  • gender marker (singular only);
  • number (agrees with the noun);
  • case (agrees with the noun);
• syntactic role in a sentence: an adjective can be a definition or part of a compound nominal predicate.

Plan for morphological analysis of the adjective

Example sentence:

The full moon rose over the city.

Full (what?) – adjective;

• initial form – full;
• constant morphological features of the adjective: qualitative, full form;
• inconsistent morphological characteristics: in a positive (zero) degree of comparison, feminine (consistent with the noun), nominative case;
• according to syntactic analysis - a minor member of the sentence, serves as a definition.

Here is another whole literary passage and morphological analysis of the adjective, using examples:

The girl was beautiful: slender, thin, blue eyes, like two amazing sapphires, looking into your soul.

Beautiful (what?) - adjective;

• initial form - beautiful (in this meaning);
• constant morphological norms: qualitative, brief;
• inconstant signs: positive degree of comparison, singular, feminine;

Slender (what?) - adjective;

• initial form - slender;
• constant morphological characteristics: qualitative, complete;
• inconsistent morphological characteristics of the word: full, positive degree of comparison, singular, feminine, nominative case;
• syntactic role in a sentence: part of the predicate.

Thin (what?) - adjective;

• initial form - thin;
• morphological constant characteristics: qualitative, complete;
• inconsistent morphological characteristics of the adjective: positive degree of comparison, singular, feminine, nominative case;
• syntactic role: part of the predicate.

Blue (what?) - adjective;

• initial form - blue;
• table of constant morphological features of the adjective name: qualitative;
• inconsistent morphological characteristics: full, positive degree of comparison, plural, nominative case;
• syntactic role: definition.

Amazing (what?) - adjective;

• initial form - amazing;
• constant characteristics of morphology: relative, expressive;
• inconsistent morphological features: plural, genitive case;
• syntactic role in a sentence: part of the circumstance.

Morphological features of the verb

According to the morphology of the Russian language, a verb is an independent part of speech. It can denote an action (to walk), a property (to limp), an attitude (to be equal), a state (to rejoice), a sign (to turn white, to show off) of an object. Verbs answer the question what to do? what to do? what is he doing? what did you do? or what will it do? Different groups of verbal word forms have heterogeneous morphological characteristics and grammatical features.

Morphological forms of verbs:

• the initial form of the verb is the infinitive. It is also called the indefinite or unchangeable form of the verb. There are no variable morphological features;
• conjugated (personal and impersonal) forms;
• inconjugated forms: participles and participles.

Morphological analysis of the verb

• initial form - infinitive;
• constant morphological features of the verb:
• • transitivity:
  • • transitive (used with accusative case nouns without a preposition);
    • intransitive (not used with a noun in the accusative case without a preposition);
  • repayment:
  • • returnable (there is -sya, -sya);
    • irrevocable (no -sya, -sya);
  • • imperfect (what to do?);
    • perfect (what to do?);
  • conjugation:
  • • I conjugation (do-eat, do-e, do-eat, do-e, do-ut/ut);
    • II conjugation (sto-ish, sto-it, sto-im, sto-ite, sto-yat/at);
    • mixed verbs (want, run);
• inconsistent morphological features of the verb:
• • mood:
  • • indicative: what did you do? What did you do? what is he doing? what will he do?;
    • conditional: what would you do? what would you do?;
    • imperative: do!;
  • time (in the indicative mood: past/present/future);
  • person (in the present/future tense, indicative and imperative: 1st person: I/we, 2nd person: you/you, 3rd person: he/they);
  • gender (past tense, singular, indicative and conditional);
  • number;
• syntactic role in a sentence. The infinitive can be any part of the sentence:
• • predicate: To be a holiday today;
  • subject: Learning is always useful;
  • addition: All the guests asked her to dance;
  • definition: He had an irresistible desire to eat;
  • circumstance: I went out for a walk.

Morphological analysis of verb example

To understand the scheme, let’s conduct a written analysis of the morphology of the verb using the example of a sentence:

God somehow sent a piece of cheese to the crow... (fable, I. Krylov)

Sent (what did you do?) - part of speech verb;

• initial form - send;
• constant morphological features: perfective aspect, transitional, 1st conjugation;
• inconsistent morphological characteristics of the verb: indicative mood, past tense, masculine, singular;

The following online example of morphological analysis of a verb in a sentence:

What silence, listen.

Listen (what do you do?) - verb;

• initial form - listen;
• morphological constant features: perfective aspect, intransitive, reflexive, 1st conjugation;
• inconsistent morphological characteristics of the word: imperative mood, plural, 2nd person;
• syntactic role in a sentence: predicate.

Plan for morphological analysis of verbs online for free, based on an example from a whole paragraph:

He needs to be warned.

No need, let him know next time how to break the rules.

What are the rules?

Wait, I'll tell you later. Has entered! (“Golden Calf”, I. Ilf)

Caution (what to do?) - verb;

• initial form - warn;
• morphological features of the verb are constant: perfective, transitive, irrevocative, 1st conjugation;
• inconsistent morphology of part of speech: infinitive;
• syntactic function in a sentence: part of the predicate.

Let him know (what is he doing?) - verb part of speech;

• initial form - know;
• inconsistent verb morphology: imperative, singular, 3rd person;
• syntactic role in a sentence: predicate.

Violate (what to do?) - the word is a verb;

• initial form - violate;
• constant morphological features: imperfect form, irrevocable, transitional, 1st conjugation;
• inconstant features of the verb: infinitive (initial form);
• syntactic role in context: part of the predicate.

Wait (what will you do?) - part of speech verb;

• initial form - wait;
• constant morphological features: perfective aspect, irrevocable, transitional, 1st conjugation;
• inconsistent morphological characteristics of the verb: imperative mood, plural, 2nd person;
• syntactic role in a sentence: predicate.

Entered (what did you do?) - verb;

• initial form - enter;
• constant morphological features: perfective aspect, irreversible, intransitive, 1st conjugation;
• inconsistent morphological characteristics of the verb: past tense, indicative mood, singular, masculine;
• syntactic role in a sentence: predicate.

If ventricular extrasystoles (VES) occur due to anxiety, stress, alcohol or caffeine intake (cola drinks, coffee, tea, nasal drops), they may disappear after eliminating the provoking factors and calming the patient. Antiarrhythmic treatment should be prescribed only in cases where the patient does not tolerate the symptoms of PVCs, but special attention is required to the safety of therapy. If treatment is necessary, beta blockers should be tried in all cases where there are no contraindications.

If continuous 24-hour ECG recording reveals a positive correlation between heart rate and the occurrence of PVCs, this indicates a high likelihood of a beneficial effect (3-blockers. However, this study is not specific enough to refuse to try to treat those patients with these drugs , in which such a correlation is not found. The next in descending order of preference would be mexiletine and disopyramide, quinidine, procainamide and amiodarone are very toxic with long-term use and are usually unsuitable for use. Class 1c drugs (flecainide, encainide) are very effective in suppressing PVCs, but have been shown to worsen the survival of post-MI patients in whom PVCs are usually asymptomatic. The role of these drugs in the treatment of patients with symptomatic PVCs is currently being tested.

There is no convincing evidence that PVCs (of any frequency) in patients without heart disease can have prognostic value. However, VES are prognostically significant if they complicate aortic valve stenosis, heart failure, or the course of the post-infarction period. The prognostic value of PVCs depends on their frequency, and in the post-infarction period, more than 10/hour is taken as the threshold value; It is likely that a similar threshold could be adopted for other situations. Despite this, no positive results from suppression of the VES were identified. Among post-MI patients receiving antiarrhythmic drugs, mortality was usually higher than in the group of patients taking placebo (especially for class 1c drugs - encainide and flecainide).

In post-infarction patients at high risk (judging by the high frequency of PVCs), a change in prognosis can be achieved not by prescribing class I antiarrhythmic drugs, but by using beta blockers or operations that restore coronary blood flow (angioplasty, coronary bypass surgery, etc.).

Some types of PVCs developing in the acute stage of MI were considered as precursors of VF. However, PVCs of the R-on-T type, observed almost exclusively in the first 6 hours of MI, are a temporary phenomenon, and neither by mechanism nor prognostically are they related to VF. Therefore, there is no basis for selective treatment of PVCs in the early stage of MI.

Ed. N. Alipov

"Prognosis and treatment of ventricular extrasystoles" - article from the section