Pub Date : 2022-12-15DOI: 10.22363/2313-0245-2022-26-3-243-258
N. Guseynov, M. H. Hammouri, A. Muraev, Sergey Y. Ivanov, E. A. Lukianova, Anna S. Klimenko, M. A. Noeerazlighi
Relevance. Cold vasodilation is a response to a decrease in local and general temperature. Dose-controlled hypothermia is a therapeutic method for treating various pathological processes. Materials and Methods. In our study, we analyzed various indicators of the general condition of the human body under the influence of local controlled hypothermia. The study involved 25 healthy volunteers from the age of 21 to 34, including 14 males and 11 females. The study was carried out at a constant temperature of 25 ºС, relative humidity of 30 ± 5%, and an atmospheric pressure of 765mm Hg in silence and moderate illumination. The instruments of these indicators were bio-impedancemetry, angioscanning, as well as general thermometry. We also performed local thermometry of the buccal mucosa to identify temperature correlations between local hypothermia and buccal mucosa temperature. Local сontrolled hypothermia of the face was carried out by applying an elastic mask to the subject’s face. The mask had a system of irrigation tubes connected to the «ViTherm» device, which cooled the liquid and maintained its circulation. Due to the circulation of the cooled liquid in the mask the face was cooled. The mask covered the parotid-chewing, buccal, zygomatic, and infraorbital regions on the right and left. LCG lasted 50 minutes, and the circulating fluid temperature was 18 ºС. Results and Discussion. The effect of local controlled hypothermia at 18-20 °C did not affect vital signs in healthy adults: active cell mass, electrical reactance, extracellular fluid, oxygen saturation, the duration of systole. pulse. general temperature. At the same time, a decrease in tissue hydration was recorded. The revealed physiological effect of local hypothermia justifies using this temperature regime to reduce postoperative edema. Conclusion. Due to the absence of negative effects of local controlled hypothermia on the vital signs of the human body, the development and application of this tool in clinical practice, including the dental surgeon. is relevant.
{"title":"Local hardware hypothermia influence on the physiological processes","authors":"N. Guseynov, M. H. Hammouri, A. Muraev, Sergey Y. Ivanov, E. A. Lukianova, Anna S. Klimenko, M. A. Noeerazlighi","doi":"10.22363/2313-0245-2022-26-3-243-258","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-3-243-258","url":null,"abstract":"Relevance. Cold vasodilation is a response to a decrease in local and general temperature. Dose-controlled hypothermia is a therapeutic method for treating various pathological processes. Materials and Methods. In our study, we analyzed various indicators of the general condition of the human body under the influence of local controlled hypothermia. The study involved 25 healthy volunteers from the age of 21 to 34, including 14 males and 11 females. The study was carried out at a constant temperature of 25 ºС, relative humidity of 30 ± 5%, and an atmospheric pressure of 765mm Hg in silence and moderate illumination. The instruments of these indicators were bio-impedancemetry, angioscanning, as well as general thermometry. We also performed local thermometry of the buccal mucosa to identify temperature correlations between local hypothermia and buccal mucosa temperature. Local сontrolled hypothermia of the face was carried out by applying an elastic mask to the subject’s face. The mask had a system of irrigation tubes connected to the «ViTherm» device, which cooled the liquid and maintained its circulation. Due to the circulation of the cooled liquid in the mask the face was cooled. The mask covered the parotid-chewing, buccal, zygomatic, and infraorbital regions on the right and left. LCG lasted 50 minutes, and the circulating fluid temperature was 18 ºС. Results and Discussion. The effect of local controlled hypothermia at 18-20 °C did not affect vital signs in healthy adults: active cell mass, electrical reactance, extracellular fluid, oxygen saturation, the duration of systole. pulse. general temperature. At the same time, a decrease in tissue hydration was recorded. The revealed physiological effect of local hypothermia justifies using this temperature regime to reduce postoperative edema. Conclusion. Due to the absence of negative effects of local controlled hypothermia on the vital signs of the human body, the development and application of this tool in clinical practice, including the dental surgeon. is relevant.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48249085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-15DOI: 10.22363/2313-0245-2022-26-3-259-273
K. Kemoklidze, N. A. Tyumina
Relevance. The concept of the tissue morpho-functional units (modules) of the adrenal medulla is currently not fully developed for adrenaline-storing (A-) cells and completely undeveloped for noradrenaline-storing (NA-) cells. Aim. Separately for A- and NA-cells, establish modules in adrenal medulla based on criteria developed by fundamental histology. Materials and Methods. The study used serial, semithin, and ultrathin sections of the adrenal glands, 7-9 µm thick, from 6 adult male Wistar rats (weight 335 ± 25 g). The sections were stained according to the Honoré method with additional staining with toluidine blue, which allows one to reliably distinguish between A and HA cells in the medulla. A cells are stained blue and HA cells are stained green. Light and electron microscopy was used to visualize serial, semithin, and ultrathin sections of the adrenal glands of adult male rats with A- and HA-cell differentiation. Results and Discussion. A-cells formed round clusters, in which they were located in one layer on the basement membrane. Their lateral sides closely adjoined each other, while the inner sides (the central part of the complexes) formed intercellular expansions, microprotrusions, and primary cilia. Less firmly pressed NA-cells formed polyhedral beams. Both types of cell complexes were associated with auxiliary components (stromal, nervous, circulatory, etc.). The central expansions of A-cell round clusters apparently to serve to retain some of the already produced adrenaline, which increases the readiness of the medulla to rapidly release large amounts of adrenaline in case of hyperacute stress. Accordingly, the adherence of A-cell complexes to a rounded shape is determined by the need to create such central isolated storage expansions. NA-cells are located more freely and do not form isolated intercellular expansions. This allows NA-cells to wedge between stably round A-cell complexes and form polyhedral beams as a result. Conclusion. It was found that the rat adrenal medulla contains two logically and morpho-functionally distinct types of specific modules. A-module are A-cells rounded cluster and NA-module is polyhedral NA-cells beam, both associated with auxiliary components.
{"title":"Rat adrenal medulla modular organization","authors":"K. Kemoklidze, N. A. Tyumina","doi":"10.22363/2313-0245-2022-26-3-259-273","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-3-259-273","url":null,"abstract":"Relevance. The concept of the tissue morpho-functional units (modules) of the adrenal medulla is currently not fully developed for adrenaline-storing (A-) cells and completely undeveloped for noradrenaline-storing (NA-) cells. Aim. Separately for A- and NA-cells, establish modules in adrenal medulla based on criteria developed by fundamental histology. Materials and Methods. The study used serial, semithin, and ultrathin sections of the adrenal glands, 7-9 µm thick, from 6 adult male Wistar rats (weight 335 ± 25 g). The sections were stained according to the Honoré method with additional staining with toluidine blue, which allows one to reliably distinguish between A and HA cells in the medulla. A cells are stained blue and HA cells are stained green. Light and electron microscopy was used to visualize serial, semithin, and ultrathin sections of the adrenal glands of adult male rats with A- and HA-cell differentiation. Results and Discussion. A-cells formed round clusters, in which they were located in one layer on the basement membrane. Their lateral sides closely adjoined each other, while the inner sides (the central part of the complexes) formed intercellular expansions, microprotrusions, and primary cilia. Less firmly pressed NA-cells formed polyhedral beams. Both types of cell complexes were associated with auxiliary components (stromal, nervous, circulatory, etc.). The central expansions of A-cell round clusters apparently to serve to retain some of the already produced adrenaline, which increases the readiness of the medulla to rapidly release large amounts of adrenaline in case of hyperacute stress. Accordingly, the adherence of A-cell complexes to a rounded shape is determined by the need to create such central isolated storage expansions. NA-cells are located more freely and do not form isolated intercellular expansions. This allows NA-cells to wedge between stably round A-cell complexes and form polyhedral beams as a result. Conclusion. It was found that the rat adrenal medulla contains two logically and morpho-functionally distinct types of specific modules. A-module are A-cells rounded cluster and NA-module is polyhedral NA-cells beam, both associated with auxiliary components.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48892606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-15DOI: 10.22363/2313-0245-2022-26-3-325-337
R. B. Kondratyuk, I. S. Grekov, E. A. Seleznev
Relevance. Epithelial-mesenchymal transformation (EMT) largely determines the biological behavior and prognosis of cancers of various localizations. It is known that the determining role in the control and implementation of the transition of the epithelial phenotype to the mesenchymal belongs to the microenvironment. At the same time, the histochemical and microscopic characteristics of stromal elements remain unclear; therefore, the aim of our study was to establish the morphological features of the stroma that affect the development of EMT in lung cancer. Materials and Methods. We studied 32 cases of lung cancer with hematoxylin and eosin staining of sections, Alcian blue at pH 1.0 and 2.5, PAS reaction, as well as immunohistochemical studies with monoclonal antibodies to HMW, AE 1 / AE 3, cytokeratin 18, c-erb B 2, vimentin E-cadherin, alpha-smooth muscle actin, GFAP and chromogranin A, Ki-67. In 16 cases, there was widespread epithelial-mesenchymal transformation (EMT), in 14 cases - focal and in 2 cases EMT was absent. In half of the cases of widespread EMT, it was complete; among the cases of focal EMT, it was not complete. The transition from the epithelial to the mesenchymal phenotype was facilitated by the activation of the stroma, namely, the presence of myofibroblasts and alcianophilia of the extracellular matrix, inflammatory cell infiltration, expression of the epidermal growth factor receptor (c-erb B 2) in stromal cells, proliferation and neurogenic differentiation of stromal cells of stromal cells. Results and Discussion. The activated stroma correlates with the frequency of EMT. Thus, large areas of activated stroma with the presence of myofibroblasts and alcianophilia of the extracellular matrix are more common in cases of widespread EMT (14 out of 16-87.5 %) than in cases of focal EMT (4 out of 14-28.6 %). The differences are statistically significant, p 0.01. Inflammatory cell infiltration, which is the source of a signal for transformation, expression of the epidermal growth factor receptor (c-erb B 2) in stromal cells, proliferation, and neurogenic differentiation of stromal cells also correlated with the frequency of EMT. In all cases, the differences are statistically significant, p0.01. Conclusions. The data obtained indicate the undoubted influence of signals from the activated stroma on the development of epithelial-mesenchymal transformation of tumor cells.
{"title":"Microenvironment influence on the development of epithelial-mesenchymal transformation in lung cancer","authors":"R. B. Kondratyuk, I. S. Grekov, E. A. Seleznev","doi":"10.22363/2313-0245-2022-26-3-325-337","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-3-325-337","url":null,"abstract":"Relevance. Epithelial-mesenchymal transformation (EMT) largely determines the biological behavior and prognosis of cancers of various localizations. It is known that the determining role in the control and implementation of the transition of the epithelial phenotype to the mesenchymal belongs to the microenvironment. At the same time, the histochemical and microscopic characteristics of stromal elements remain unclear; therefore, the aim of our study was to establish the morphological features of the stroma that affect the development of EMT in lung cancer. Materials and Methods. We studied 32 cases of lung cancer with hematoxylin and eosin staining of sections, Alcian blue at pH 1.0 and 2.5, PAS reaction, as well as immunohistochemical studies with monoclonal antibodies to HMW, AE 1 / AE 3, cytokeratin 18, c-erb B 2, vimentin E-cadherin, alpha-smooth muscle actin, GFAP and chromogranin A, Ki-67. In 16 cases, there was widespread epithelial-mesenchymal transformation (EMT), in 14 cases - focal and in 2 cases EMT was absent. In half of the cases of widespread EMT, it was complete; among the cases of focal EMT, it was not complete. The transition from the epithelial to the mesenchymal phenotype was facilitated by the activation of the stroma, namely, the presence of myofibroblasts and alcianophilia of the extracellular matrix, inflammatory cell infiltration, expression of the epidermal growth factor receptor (c-erb B 2) in stromal cells, proliferation and neurogenic differentiation of stromal cells of stromal cells. Results and Discussion. The activated stroma correlates with the frequency of EMT. Thus, large areas of activated stroma with the presence of myofibroblasts and alcianophilia of the extracellular matrix are more common in cases of widespread EMT (14 out of 16-87.5 %) than in cases of focal EMT (4 out of 14-28.6 %). The differences are statistically significant, p 0.01. Inflammatory cell infiltration, which is the source of a signal for transformation, expression of the epidermal growth factor receptor (c-erb B 2) in stromal cells, proliferation, and neurogenic differentiation of stromal cells also correlated with the frequency of EMT. In all cases, the differences are statistically significant, p0.01. Conclusions. The data obtained indicate the undoubted influence of signals from the activated stroma on the development of epithelial-mesenchymal transformation of tumor cells.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44432290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.22363/2313-0245-2022-26-1-68-77
AlenaYu. Yu. Karetnikova, U. A. Matvienko, Daria. A. Savinova, Elvira. A. Denikaeva, N. Durnova
Relevance. Treatment of cognitive impairment is a serious problem for modern medicine. Alzheimers disease and Parkinsons disease are chronic progressive neurodegenerative diseases and the most common cause of progressive dementia in the elderly. There is no effective therapy for these diseases, so it is necessary to search for integrated therapies, including herbal medicine. The aim was to study a short-term and long-term memory of rats in the test eight-arm radial maze under the influence of repeated administration of an aqueous extract of the herb Astragalus membranaceus (Fisch.) Bunge. Materials and Methods. The experiment was carried out on 18 non-linear rats, divided into 3 groups - control and 2 experimental. For 21 days, the animals received daily intragastric caffeine at a dose of 5 mg/kg, infusion an aqueous extract of Astragalus membranaceus (Fisch.) Bunge at a dose of 100 mg/kg. The control was injected with drinking water by weight. To study the cognitive functions of the maze, performing two series of tests - at 2-7 and 16-21. Results and Discussion. In the course of the study, it was found that when the animals were tested for 2-7 days, there were no significant changes between the groups. With an increase in the duration of administration of the test substances by the 16-21 days of the experiment, in the second test series, an increase in memory points was observed both in the second (caffeine, 5 mg/kg) and in the third ( Astragalus membranaceus (Fisch.) Bunge, 100 mg/kg) of the experimental groups. Conclusion. The introduction of caffeine at a dosage of 5 mg/kg influenced the activation of short-term and long-term memory with a duration of more than 17 days of administrationat the 2nd stage of testing. Astragalus membranaceus (Fisch.) Bunge (100 mg/kg) caused the activation of working and long-term spatial memory from the 16th day of the experimenton the 2nd series of tests.
{"title":"Astragalus membranaceus infusion effect on rats learningin the radial maze","authors":"AlenaYu. Yu. Karetnikova, U. A. Matvienko, Daria. A. Savinova, Elvira. A. Denikaeva, N. Durnova","doi":"10.22363/2313-0245-2022-26-1-68-77","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-1-68-77","url":null,"abstract":"Relevance. Treatment of cognitive impairment is a serious problem for modern medicine. Alzheimers disease and Parkinsons disease are chronic progressive neurodegenerative diseases and the most common cause of progressive dementia in the elderly. There is no effective therapy for these diseases, so it is necessary to search for integrated therapies, including herbal medicine. The aim was to study a short-term and long-term memory of rats in the test eight-arm radial maze under the influence of repeated administration of an aqueous extract of the herb Astragalus membranaceus (Fisch.) Bunge. Materials and Methods. The experiment was carried out on 18 non-linear rats, divided into 3 groups - control and 2 experimental. For 21 days, the animals received daily intragastric caffeine at a dose of 5 mg/kg, infusion an aqueous extract of Astragalus membranaceus (Fisch.) Bunge at a dose of 100 mg/kg. The control was injected with drinking water by weight. To study the cognitive functions of the maze, performing two series of tests - at 2-7 and 16-21. Results and Discussion. In the course of the study, it was found that when the animals were tested for 2-7 days, there were no significant changes between the groups. With an increase in the duration of administration of the test substances by the 16-21 days of the experiment, in the second test series, an increase in memory points was observed both in the second (caffeine, 5 mg/kg) and in the third ( Astragalus membranaceus (Fisch.) Bunge, 100 mg/kg) of the experimental groups. Conclusion. The introduction of caffeine at a dosage of 5 mg/kg influenced the activation of short-term and long-term memory with a duration of more than 17 days of administrationat the 2nd stage of testing. Astragalus membranaceus (Fisch.) Bunge (100 mg/kg) caused the activation of working and long-term spatial memory from the 16th day of the experimenton the 2nd series of tests.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46983579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.22363/2313-0245-2022-26-1-33-40
Nijat A. Guseynov, S. G. Ivashkevich, Evgeniy M. Boyko
Hypothermia or cold therapy is the local or systemic application of cold for therapeutic purposes. Local application of cold is used to control inflammation: pain and swelling, hematoma and trismus reduction. Despite the frequent use of cooling in prosthodontic rehabilitation and in physical therapy, as evidenced by many reports in the literature, there is scientific documentation that suggests disadvantages of using this treatment in maxillofacial surgery and oral surgery. Also the clinical studies that have been carried out in maxillofacial surgery and oral surgery have been conducted in an empirical manner, which casts doubt on the results. In view of this, it is relevant to study the mechanisms of microcirculatory preconditioning and hypothermia. This physiological process is so interesting for the development of medical devices of controlled hardware hypothermia to prevent inflammatory symptoms at the stage of rehabilitation by targeting the vascular and cellular component of the inflammatory process in different areas of the human body. To date, the use of local hardware controlled hypothermia in various pathological conditions in humans is a topical trend in medicine. Microcirculatory bloodstream is directly related to temperature factors. Although there are concepts of vascular spasm or dilatation in the microcirculatory bloodstream during systemic hypothermia, there are no reliable data on the cellular and vascular reactions during local hypothermia. In this paper, a search for fundamental and current scientific work on the topic of cellular and vascular changes under the influence of hypothermia was conducted. The search for data revealed that the mechanisms of intracellular hypothermia are of particular interest for the development of therapeutic treatments after surgical interventions in areas with extensive blood supply. With this in mind, it is relevant to investigate several areas: the role of endothelium, glycocalyx and blood cells in microcirculatory-mediated preconditioning and intracellular hypothermia, and in the molecular mechanism that regulates these processes, whether they occur in the same way in all tissues.
{"title":"Physiological features of cells and microvasculature under the local hypothermia influence","authors":"Nijat A. Guseynov, S. G. Ivashkevich, Evgeniy M. Boyko","doi":"10.22363/2313-0245-2022-26-1-33-40","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-1-33-40","url":null,"abstract":"Hypothermia or cold therapy is the local or systemic application of cold for therapeutic purposes. Local application of cold is used to control inflammation: pain and swelling, hematoma and trismus reduction. Despite the frequent use of cooling in prosthodontic rehabilitation and in physical therapy, as evidenced by many reports in the literature, there is scientific documentation that suggests disadvantages of using this treatment in maxillofacial surgery and oral surgery. Also the clinical studies that have been carried out in maxillofacial surgery and oral surgery have been conducted in an empirical manner, which casts doubt on the results. In view of this, it is relevant to study the mechanisms of microcirculatory preconditioning and hypothermia. This physiological process is so interesting for the development of medical devices of controlled hardware hypothermia to prevent inflammatory symptoms at the stage of rehabilitation by targeting the vascular and cellular component of the inflammatory process in different areas of the human body. To date, the use of local hardware controlled hypothermia in various pathological conditions in humans is a topical trend in medicine. Microcirculatory bloodstream is directly related to temperature factors. Although there are concepts of vascular spasm or dilatation in the microcirculatory bloodstream during systemic hypothermia, there are no reliable data on the cellular and vascular reactions during local hypothermia. In this paper, a search for fundamental and current scientific work on the topic of cellular and vascular changes under the influence of hypothermia was conducted. The search for data revealed that the mechanisms of intracellular hypothermia are of particular interest for the development of therapeutic treatments after surgical interventions in areas with extensive blood supply. With this in mind, it is relevant to investigate several areas: the role of endothelium, glycocalyx and blood cells in microcirculatory-mediated preconditioning and intracellular hypothermia, and in the molecular mechanism that regulates these processes, whether they occur in the same way in all tissues.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43763037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.22363/2313-0245-2022-26-1-87-94
A. M. Lebedeva, Alexei V. Bereznikov, E. A. Berseneva, Yu O Onufriychuk, Sergei O. Shkitin, Nadezhda V. Makarets
Relevance. The development of medical science has made it easier for clinicians to diagnose specific diseases, often leading to the reduction of traditional diagnostic methods, including differential diagnosis. As a result, there is an increase in medical errors in diagnosis, the choice of treatment tactics, including in cases with the development of an unfavorable outcome. The aim of the study was to identify typical errors in the differential diagnosis of diseases in cases with a fatal outcome in the departments of both therapeutic and surgical profiles. Materials and Methods. At the first stage of the retrospective cohort study, fatal cases were analyzed for the correctness of the final post-mortem clinical diagnosis and the results of its comparison with the pathoanatomical diagnosis based on the results of the examination of the quality of medical care in compulsory health insurance. Errors in the formulation of the post-mortem clinical diagnosis were identified, and their causes were determined. At the second stage, the scenario method determines three variants of risk realization in the case of divergence of the final clinical and pathoanatomical diagnoses, with an assessment of the frequency of risk variants realization in the surgical and therapeutic profiles . Results and Discussion. When analyzing cases of fatal outcomes with a discrepancy between the final clinical and pathoanatomical diagnoses, the main errors in the formulation of the final clinical diagnosis were identified. In the first variant of risk realization, the reason for the discrepancy is the incorrect formulation of the final post-mortem diagnosis. In the case of the second scenario, violations relate to incorrect diagnostic tactics when a new disease or exacerbation of a chronic disease occurs. In the third scenario, violations are associated with incorrect differential diagnosis: the initial restriction of the range of nosologies for diagnostic search. Conclusion. Typical violations of diagnosis and differential diagnosis leading to a discrepancy between the final clinical and pathoanatomical diagnoses are identified. As part of the provision of medical care in surgical specialties, the second scenario is more often identified: incorrect diagnostic tactics when a new disease appears or a chronic disease worsens. When providing medical care in therapeutic specialties, violations are more often detected in the third scenario: incorrect differential diagnosis, initial restriction of the range of nosologies for diagnostic search. The second and third scenarios create legal risks for the doctor and the medical organization when evaluated by the relevant authorities.
{"title":"Diagnostics errors as the reasons for the discrepancy between clinicaland pathoanatomical diagnoses","authors":"A. M. Lebedeva, Alexei V. Bereznikov, E. A. Berseneva, Yu O Onufriychuk, Sergei O. Shkitin, Nadezhda V. Makarets","doi":"10.22363/2313-0245-2022-26-1-87-94","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-1-87-94","url":null,"abstract":"Relevance. The development of medical science has made it easier for clinicians to diagnose specific diseases, often leading to the reduction of traditional diagnostic methods, including differential diagnosis. As a result, there is an increase in medical errors in diagnosis, the choice of treatment tactics, including in cases with the development of an unfavorable outcome. The aim of the study was to identify typical errors in the differential diagnosis of diseases in cases with a fatal outcome in the departments of both therapeutic and surgical profiles. Materials and Methods. At the first stage of the retrospective cohort study, fatal cases were analyzed for the correctness of the final post-mortem clinical diagnosis and the results of its comparison with the pathoanatomical diagnosis based on the results of the examination of the quality of medical care in compulsory health insurance. Errors in the formulation of the post-mortem clinical diagnosis were identified, and their causes were determined. At the second stage, the scenario method determines three variants of risk realization in the case of divergence of the final clinical and pathoanatomical diagnoses, with an assessment of the frequency of risk variants realization in the surgical and therapeutic profiles . Results and Discussion. When analyzing cases of fatal outcomes with a discrepancy between the final clinical and pathoanatomical diagnoses, the main errors in the formulation of the final clinical diagnosis were identified. In the first variant of risk realization, the reason for the discrepancy is the incorrect formulation of the final post-mortem diagnosis. In the case of the second scenario, violations relate to incorrect diagnostic tactics when a new disease or exacerbation of a chronic disease occurs. In the third scenario, violations are associated with incorrect differential diagnosis: the initial restriction of the range of nosologies for diagnostic search. Conclusion. Typical violations of diagnosis and differential diagnosis leading to a discrepancy between the final clinical and pathoanatomical diagnoses are identified. As part of the provision of medical care in surgical specialties, the second scenario is more often identified: incorrect diagnostic tactics when a new disease appears or a chronic disease worsens. When providing medical care in therapeutic specialties, violations are more often detected in the third scenario: incorrect differential diagnosis, initial restriction of the range of nosologies for diagnostic search. The second and third scenarios create legal risks for the doctor and the medical organization when evaluated by the relevant authorities.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46574584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.22363/2313-0245-2022-26-1-61-67
Aleksander S. Vafiev
Relevance. Currently, several groups of scientists are working on the implementation of low-frequency ultrasound in surgery of the retina and vitreous body. But there are not enough articles on the study of the functional activity of the retina when exposed to this type of energy. Electrophysiological research methods make it possible to analyze and evaluate the safety, effectiveness of surgical interventions, the effect of new drugs at the level of neurons and visual pathways. The electroretinography method makes it possible to record the bioelectrical activity of retinal neurons during light stimulation during dark and light adaptation. The aim of the study is to carry out a comparative analysis of the a- and b-wave indices of the rabbit electroretinogram after experimental removal of the vitreous body using low-frequency ultrasound and mechanical action. Materials and Methods. Experiments were carried out in two groups of Chinchilla rabbits (n = 40). In the experimental group, surgery to remove the vitreous body was performed using low-frequency ultrasound, in the control group a fragmentator with guillotine mechanism was used. Before and after the surgery (1, 7, 14, 30 days) an electroretinogram was recorded, the parameters of the amplitude and latency of the a- and b-waves were measured. Results and Discussion. In both groups, a sharp decrease in all parameters was observed on day 1. Later, on the 7th day, the dynamics of the latency of a- and b-waves slightly decreased than the preoperative values. On the 14th day after the exposure, the amplitude and peak latency of the a- and b-waves in both groups remained at the same level as on the 7th day. On the 30th day, the indicators increased, which indicates the restoration of the functions of photoreceptors and Mueller cells in both groups. There were no statistically significant differences between the study groups at all periods of the study. Conclusion. The use of low-frequency ultrasound for vitreous removal can be considered safe and has prospects for further development and application.
{"title":"The rabbits retina functional state after exposure to low-frequencyultrasound: electroretinogram indicators analysis","authors":"Aleksander S. Vafiev","doi":"10.22363/2313-0245-2022-26-1-61-67","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-1-61-67","url":null,"abstract":"Relevance. Currently, several groups of scientists are working on the implementation of low-frequency ultrasound in surgery of the retina and vitreous body. But there are not enough articles on the study of the functional activity of the retina when exposed to this type of energy. Electrophysiological research methods make it possible to analyze and evaluate the safety, effectiveness of surgical interventions, the effect of new drugs at the level of neurons and visual pathways. The electroretinography method makes it possible to record the bioelectrical activity of retinal neurons during light stimulation during dark and light adaptation. The aim of the study is to carry out a comparative analysis of the a- and b-wave indices of the rabbit electroretinogram after experimental removal of the vitreous body using low-frequency ultrasound and mechanical action. Materials and Methods. Experiments were carried out in two groups of Chinchilla rabbits (n = 40). In the experimental group, surgery to remove the vitreous body was performed using low-frequency ultrasound, in the control group a fragmentator with guillotine mechanism was used. Before and after the surgery (1, 7, 14, 30 days) an electroretinogram was recorded, the parameters of the amplitude and latency of the a- and b-waves were measured. Results and Discussion. In both groups, a sharp decrease in all parameters was observed on day 1. Later, on the 7th day, the dynamics of the latency of a- and b-waves slightly decreased than the preoperative values. On the 14th day after the exposure, the amplitude and peak latency of the a- and b-waves in both groups remained at the same level as on the 7th day. On the 30th day, the indicators increased, which indicates the restoration of the functions of photoreceptors and Mueller cells in both groups. There were no statistically significant differences between the study groups at all periods of the study. Conclusion. The use of low-frequency ultrasound for vitreous removal can be considered safe and has prospects for further development and application.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47578837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.22363/2313-0245-2022-26-1-78-86
Kalpana Katel
Relevance. Nursing process is a scientific method of organizing and providing nursing care. Due to imbalance of nurse patient ratio, application of nursing process in actual clinical setting is very limited which reduces the quality nursing care. Despite the importance of application of nursing process, there is no standard nursing process protocol available in the hospital where study was carried out. The governments set a standard nurse patient ratio in Nepal, UK and USA is 1:10, 1:8, and 1:5 respectively. However, global statistic has been revealed due to improper nurse patient ratio which cannot implement the nursing process for patient caring which are being for leading cause of mortality of patient in hospitals. Aim of the study. The study was conducted to assess the application of the nursing process among nurses working in teaching hospital. Additionally, this study explores the association between status of application of nursing process and selected variables. Materials and Methods. Based on a descriptive cross-sectional study design. A simple random sampling technique was applied for nurses working in tertiary hospital of Chitwan, Nepal. The data was collected using structured questionnaire among 182 nurses. The statistical analysis tool chi-square was used to find out the association and logistic bivariate to find out the odds ratio. Results and Discussion. The result indicates that only 23.1 % of nurses have moderate level of application of nursing process. Majority of nurses did not follow standard ways of nursing process. This study also explored the influencing variable for barriers related to nurses and profession. Age (p=0.001), professional qualification (p=0.001) and learning approach (p=0.022) were the significant influencing variable for barriers related to nurses whereas practical skill (p= 0.001), cooperation among nurses (p=0.008) and difficulty in diagnosis characteristic (p=0.010) were the barrier related to profession. Conclusion. It was concluded that the majority of nurses working in teaching hospital of Nepal did not follow the standard ways of nursing process so that barriers for the application of nursing process are identified. The overall ratio of nurses to patients in the teaching hospital is 1:16, that is in the lower range than the standards set by the government. Therefore, special attention must be paid to adherence to a standardized nursing process protocol for quality medical care.
{"title":"Nursing process application in Nepal teaching hospital","authors":"Kalpana Katel","doi":"10.22363/2313-0245-2022-26-1-78-86","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-1-78-86","url":null,"abstract":"Relevance. Nursing process is a scientific method of organizing and providing nursing care. Due to imbalance of nurse patient ratio, application of nursing process in actual clinical setting is very limited which reduces the quality nursing care. Despite the importance of application of nursing process, there is no standard nursing process protocol available in the hospital where study was carried out. The governments set a standard nurse patient ratio in Nepal, UK and USA is 1:10, 1:8, and 1:5 respectively. However, global statistic has been revealed due to improper nurse patient ratio which cannot implement the nursing process for patient caring which are being for leading cause of mortality of patient in hospitals. Aim of the study. The study was conducted to assess the application of the nursing process among nurses working in teaching hospital. Additionally, this study explores the association between status of application of nursing process and selected variables. Materials and Methods. Based on a descriptive cross-sectional study design. A simple random sampling technique was applied for nurses working in tertiary hospital of Chitwan, Nepal. The data was collected using structured questionnaire among 182 nurses. The statistical analysis tool chi-square was used to find out the association and logistic bivariate to find out the odds ratio. Results and Discussion. The result indicates that only 23.1 % of nurses have moderate level of application of nursing process. Majority of nurses did not follow standard ways of nursing process. This study also explored the influencing variable for barriers related to nurses and profession. Age (p=0.001), professional qualification (p=0.001) and learning approach (p=0.022) were the significant influencing variable for barriers related to nurses whereas practical skill (p= 0.001), cooperation among nurses (p=0.008) and difficulty in diagnosis characteristic (p=0.010) were the barrier related to profession. Conclusion. It was concluded that the majority of nurses working in teaching hospital of Nepal did not follow the standard ways of nursing process so that barriers for the application of nursing process are identified. The overall ratio of nurses to patients in the teaching hospital is 1:16, that is in the lower range than the standards set by the government. Therefore, special attention must be paid to adherence to a standardized nursing process protocol for quality medical care.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44721293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.22363/2313-0245-2022-26-1-102-107
Rohan Jahagirdar
Relevance. Depression has substantial effects on cancer patients quality of life. Estimates of its prevalence vary widely. Aim of the study was to evaluate the prevalence and severity of depression in cancer patients. Materials and Methods . All cancer patients admitted at tertiary care Dr. Vithalrao Vikhe Patil Foundations Medical College Hospital (Dahod, Gujarat, India) between December 2015 to December 2016 were included in this study. All subjects gave informed consent to participate in the investigation and personal data processing. Depression in cancer patients was screened using the Mini International Neuropsychiatric Interview (MINI) questionnaire and administered the Hamilton Depression Rating Scale for severity of depression. Results and Discussion. Out of 128 cancer patients screened, 44 (34 %) patients were identified to have depression using MINI. Among them mild to moderate depression was seen in 60.4 % depressed patients, and severe to very severe depression was present in 39.4 % patients. Further analysis showed that the marital status, monthly income and literacy had an impact on the level of depression. Conclusion . The psychological impact of cancer is considerable. The failure to detect and treat elevated levels of psychological distress might jeopardize the result of cancer therapies, decrease patients quality of life and increase health care cost. The lack of identifiable risk factors makes the task of diagnosing psychiatric conditions in cancer patients a difficult one. Early recognition of psychiatric distress for the identification of depression is an integral part in the comprehensive management of cancer patients.
{"title":"Depression prevalence in cancer patients: a cross sectional study","authors":"Rohan Jahagirdar","doi":"10.22363/2313-0245-2022-26-1-102-107","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-1-102-107","url":null,"abstract":"Relevance. Depression has substantial effects on cancer patients quality of life. Estimates of its prevalence vary widely. Aim of the study was to evaluate the prevalence and severity of depression in cancer patients. Materials and Methods . All cancer patients admitted at tertiary care Dr. Vithalrao Vikhe Patil Foundations Medical College Hospital (Dahod, Gujarat, India) between December 2015 to December 2016 were included in this study. All subjects gave informed consent to participate in the investigation and personal data processing. Depression in cancer patients was screened using the Mini International Neuropsychiatric Interview (MINI) questionnaire and administered the Hamilton Depression Rating Scale for severity of depression. Results and Discussion. Out of 128 cancer patients screened, 44 (34 %) patients were identified to have depression using MINI. Among them mild to moderate depression was seen in 60.4 % depressed patients, and severe to very severe depression was present in 39.4 % patients. Further analysis showed that the marital status, monthly income and literacy had an impact on the level of depression. Conclusion . The psychological impact of cancer is considerable. The failure to detect and treat elevated levels of psychological distress might jeopardize the result of cancer therapies, decrease patients quality of life and increase health care cost. The lack of identifiable risk factors makes the task of diagnosing psychiatric conditions in cancer patients a difficult one. Early recognition of psychiatric distress for the identification of depression is an integral part in the comprehensive management of cancer patients.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42442959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.22363/2313-0245-2022-26-1-95-101
G. Roitberg, Zh. V. Dorosh, T. Tarasova, I. Saushev, E. Tyurina, Irina V. Shuligina
Relevance. In majority of men, varicose veins of the testicle - varicocele - does not cause discomfort and is asymptomatic, and scrotal pain only bothers 10 % of patients. In 2/3 of cases, varicocele is a clinical finding. In this case, varicocele is the most common cause of male infertility. Aim of the study. Recovery of the reproductive potential of patients with varicocele. Materials and Methods. In 219 patients with varicocele, weve carried an ejaculate study out (WHO, 2010) 3, 6, 12 months after surgical treatment of varicocele. We considered the reproductive function restored by normozoospermia in the ejaculate and the onset of pregnancy in the spouse during the follow - up period of 12 months. Results and Discussion. The 2/3 men of the 219 patients with varicocele had ejaculate abnormalities. The age of patients who were diagnosed with pathospermia was 31+11 years. 66 (39.5 %) patients with varicocele had spermatozoa with reduced mobility. After surgical treatment (varicocelectomy according to Marmara), normozoospermia was present almost in every second man. Nevertheless, the number of pregnancies in a married couple was higher than 6 months after varicocelectomy - 24(32.8 %). The surgical method of treatment of varicocele allows to restore the reproductive function of a man in 30 %. In our study, normozoospermia after varicocelectomy was recorded in almost every second patient. Ultrasound changes in the testicle with varicocele are an unfavorable prognosis for the restoration of male fertility. Conclusion. Surgical treatment of varicocele can recover the reproductive potential of almost every second man of reproductive age. Moreover, a greater number of pregnancies six months right after the operation were registered in spouses.
{"title":"Reproductive potential repair in men with varicocele","authors":"G. Roitberg, Zh. V. Dorosh, T. Tarasova, I. Saushev, E. Tyurina, Irina V. Shuligina","doi":"10.22363/2313-0245-2022-26-1-95-101","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-1-95-101","url":null,"abstract":"Relevance. In majority of men, varicose veins of the testicle - varicocele - does not cause discomfort and is asymptomatic, and scrotal pain only bothers 10 % of patients. In 2/3 of cases, varicocele is a clinical finding. In this case, varicocele is the most common cause of male infertility. Aim of the study. Recovery of the reproductive potential of patients with varicocele. Materials and Methods. In 219 patients with varicocele, weve carried an ejaculate study out (WHO, 2010) 3, 6, 12 months after surgical treatment of varicocele. We considered the reproductive function restored by normozoospermia in the ejaculate and the onset of pregnancy in the spouse during the follow - up period of 12 months. Results and Discussion. The 2/3 men of the 219 patients with varicocele had ejaculate abnormalities. The age of patients who were diagnosed with pathospermia was 31+11 years. 66 (39.5 %) patients with varicocele had spermatozoa with reduced mobility. After surgical treatment (varicocelectomy according to Marmara), normozoospermia was present almost in every second man. Nevertheless, the number of pregnancies in a married couple was higher than 6 months after varicocelectomy - 24(32.8 %). The surgical method of treatment of varicocele allows to restore the reproductive function of a man in 30 %. In our study, normozoospermia after varicocelectomy was recorded in almost every second patient. Ultrasound changes in the testicle with varicocele are an unfavorable prognosis for the restoration of male fertility. Conclusion. Surgical treatment of varicocele can recover the reproductive potential of almost every second man of reproductive age. Moreover, a greater number of pregnancies six months right after the operation were registered in spouses.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43316280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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