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BACKGROUND AND OBJECTIVE: Providing trauma services demands high personnel resources and structural costs. The goal of this study was to show if the assignment of trauma patients to a defined A or B resuscitation room treatment as a modified management concept is safe and feasible. MATERIAL AND METHODS: Between May 2020 and January 2021, all resuscitation room trauma patients were included in this single center prospective observational study. All patients admitted to the resuscitation room underwent a classification according to the German S3 guidelines grade of recommendation GoR A and GoR B in polytrauma and the status of the ABCDE sequence to an A and B resuscitation room. The classification was performed by the senior consultant on call via telephone after consultation and discussion of clinical findings. RESULTS: All 135 resuscitation room patients were included in the study of whom 42 trauma patients were assigned to the A resuscitation room (A-SR) and 93 were assigned to the B resuscitation room (B-SR). The comparison of the two groups showed that patients in the ASR group are more likely to be accompanied by a prehospital emergency physician (80.5%) than patients in the BSR group (55.5%). Patients in the BSR group showed a significantly higher Glasgow coma scale (GCS). Using the eFAST emergency ultrasound protocol, 2.4% of the ASR and 4.3% of the BSR patients had trauma-associated pathologies, 26% of the ASR and only 3.2% of the BSR patients had to be admitted to the ICU, 21.4% of the ASR and 1% of the BSR patients died within 30 days after trauma. The injury severity scores (ISS) of the ASR patients were significantly higher than in the BSR group (ISS 28.3 vs. 6.8). CONCLUSION: The study confirmed that the assignment by the emergency department consultant according to the German S3 guideline in combination with the ABCDE sequence into resuscitation room A or B treatment is feasible, does not compromise the quality of care and is efficient in the use of the personnel resources.
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Traumatismo Múltiplo , Segurança do Paciente , Humanos , Centros de Traumatologia , Serviço Hospitalar de Emergência , Traumatismo Múltiplo/terapia , HospitaisRESUMO
The work is based on the results of a microscopic examination of 46 men and 50 women who were examined at the medical center for the treatment of hair and skin in the period 2022-2023. Depending on the age of the subjects, they were divided into two groups. The first group included 52 people (25 men and 27 women) of young age (21-35 years old). The second group consisted of 44 people (21 men and 23 women) of senile age (75-86 years old). Hair sampling was performed in the temporal region of the head by combing out the hair that had already fallen out with a comb (they did not pull it out of the skin!). The sample of this study consisted of conditionally healthy individuals of the Slavic phenotype. The width of the hair follicle and the hair shaft were calculated. The results of this lifetime comparative analysis of the linear dimensions of the hair follicle and the hair shaft in the temporal region in persons of both sexes of young and old age allow us to expand the understanding of the features of their age-related changes, and further continue detailed study, since new knowledge is necessary for the development of modern methods for the prevention of age-associated pathologies of the scalp.
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Folículo Piloso , Cabelo , Masculino , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Folículo Piloso/patologia , Couro Cabeludo/patologia , Envelhecimento , MicroscopiaRESUMO
The paper is based on the results of a CT study of 71 women with normal pelvic dimensions without pelvic bone or pelvic organ pathology who underwent the study in 2022-2023. All subjects consented to the study, which was performed according to the indications. The CT study consisted of determining the width, height, and thickness of the pubic symphysis in 3D reconstruction mode. The subjects were divided into three groups according to the anatomical age classification. The first group consisted of 23 first-age adults (21-35 years old); the second group included 25 elderly people (56-74 years old); the third group consisted of 23 elderly people (75-88 years old). The results obtained are the basis for further research and can be used by doctors of such clinical specialties as sports medicine, traumatology, forensics, forensic medicine, obstetrics and many others.
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Sínfise Pubiana , Humanos , Feminino , Idoso , Adulto , Idoso de 80 Anos ou mais , Sínfise Pubiana/diagnóstico por imagem , Sínfise Pubiana/cirurgia , Tomografia Computadorizada por Raios X/métodos , Pelve/diagnóstico por imagemRESUMO
The work is based on the results of a retrospective analysis of the medical records of 56 patients with traumatic brain injury complicated by acute subdural hematoma with a volume of 60-100 cm3. The patients were divided into 2 groups according to their age: the 1st group included 29 patients aged 22-29 years, the 2nd group consisted of 27 patients aged 61-69 years. The degree of impaired consciousness in the victims at admission to the clinic was evaluated on the Glasgow scale, the effectiveness of the treatment at discharge from the hospital was performed on the Rankin scale, assessing the degree of independence and disability. Elderly patients were found to have a more severe condition upon admission to the clinic. Upon discharge from the hospital, the assessment of the degree of independence and disability on the Rankin scale revealed a statistically significant predominance of scores in the group of elderly patients (p<0,01), which indicates less effective treatment in comparison with young patients. The results of this study can serve as a basis for the development of additional recommendations in outpatient practice for the care and care of patients in the older age group and a personalized approach to neurosurgical patients taking into account their age.
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Lesões Encefálicas Traumáticas , Hematoma Subdural Agudo , Idoso , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Escala de Coma de Glasgow , Hematoma Subdural/complicações , Hematoma Subdural/diagnóstico , Hematoma Subdural/terapia , Humanos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The results of histological, micrometric and immunohistochemical studies performed on sectional material of 69 men corpses aged from 21 to 29 years are presented. Two groups were identified: 42 deaths without drug addiction and 27 deaths from exposure to a toxic synthetic opioids drug, with the history their systematic use lasting from 16 months to 3 years. A comparative analysis of the morphological characteristics of cerebellar cortex tissues was carried out using staining with hematoxylin and eosin and according to the Nissl method (according to Snesarev). For immunohistochemical analysis of the samples, a panel of antibodies to the Vimentin protein was used. In each case, the distance between Purkinje cells was determined and the percentage of immunonegative Purkinje cells to Vimentin from their total number was calculated. In persons with a history of opioid dependence, signs of neurodegenerative changes in the cerebellar cortex were noted: deformation of the shape of Purkinje cells, morphological transformation of nuclei from karyopyknosis to karyorrhexis, and the appearance of fuzzy cell boundaries. There was no statistically significant difference in the distance between the Purkinje cells and their number in the opioid-dependent group and in the conditionally healthy group. An increase in the number of Purkinje cells immunopositive to the Vimentin protein was found in the group of deaths with opioid dependence. The results of assessing the cytoarchitectonics of the cerebellar cortex using an immunohistochemical method for studying Purkinje cells positively stained with antibodies to Vimentin can be used as additional criteria for forensic medical determination of the opioid dependence presence in the deceased.
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Córtex Cerebelar , Transtornos Relacionados ao Uso de Opioides , Idoso , Humanos , Masculino , Células de Purkinje , VimentinaRESUMO
The work is based on a morphological study of ampoules of the fallopian tubes of 130 young and senile women who gave birth. Macrometric, histological, immunohistochemical and micrometric methods of investigation were applied. The regularities of age-related morphological variability of the fallopian tube ampoule are revealed, which are manifested in a decrease in the parameters of their length, as well as external diameters in the middle of the ampoule and at the places of transition of the isthmus into the ampoule and ampoule into the funnel from young age to old age. Histoarchitectonics of ampoules of the fallopian tubes in women in old age is characterized by flattening of the epithelium of the mucous membrane, which forms an abundance of nearby thickened folds that form an uneven narrowing of the lumen of the ampoule. The thinning of the muscle membrane is determined with the growth of connective tissue instead of it and the accumulation of adipocytes in the subserose base. In old age, there is a more pronounced expression of vimentin, which can be traced not only in the endothelium and subendothelial layer of blood vessels, including capillaries, but also in individual fibroblasts. It was found that the features of the micrometric characteristics of the fallopian tube ampoules consist in a decrease in the inner perimeter of the epithelial lining and the lumen area, along with an increase in the area of their wall at the median cross-section in old age compared with young age.
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Tubas Uterinas , Mucosa , Epitélio , Feminino , HumanosRESUMO
The work is based on the results of an organometric study of the corpus callosum (callosometry) among 93 people (49 men and 44 women) using the method of magnetic resonance imaging. A comparative analysing of the length, height, thickness of the roller and the knee of the corpus callosum, the depth of its occurrence (front, top, back) was carried out. The regularities of age variability of organometric characteristics of the corpus callosum, manifested in a decrease in its linear dimensions among old people in comparison with young people and a decrease in the depth of its occurrence. The results of this morphological study can be as a basis for identifying individual patterns of age-related anatomy of the brain and have practical importance as indicators of the norm, which will use these data in diagnostic and therapeutic work.
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Corpo Caloso , Imageamento por Ressonância Magnética , Adolescente , Corpo Caloso/diagnóstico por imagem , Feminino , Humanos , Articulação do Joelho , Masculino , Projetos de PesquisaRESUMO
The work is based on the results of histological and immunohistochemical studies performed on the sectional material of 104 human corpses (59 men and 45 women) of young and old age. A comparative analysis of the morphological characteristics of the corpus callosum tissues using hematoxylin and eosin staining, the Nissl method (by Snesarev), by Van Gieson, by Spielmeyer, by Foot. An immunohistochemical study of the samples used a panel of antibodies to glial fibrillar acid protein (GFAP), the S-100 protein. It was found that by senile age, the tissue of the corpus callosum is characterized by the accumulation of glial macrophages. With age, there is a proliferation of GFAP-immunopositive astroglia. There is no dynamics of S-100 protein expression with age. Thus, the revealed regularity of age-related variability of the cytoarchitectonics of the corpus callosum is of interest in diagnostic and therapeutic work, and its morphological picture in old age can serve as an equivalent of the anatomical norm.
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Envelhecimento , Corpo Caloso , Astrócitos/metabolismo , Corpo Caloso/metabolismo , Feminino , Proteína Glial Fibrilar Ácida/metabolismo , Humanos , Masculino , Neuroglia/metabolismoRESUMO
We demonstrate that charge-density-wave devices with quasi-two-dimensional 1T-TaS2 channels show remarkable immunity to bombardment with 1.8 MeV protons to a fluence of at least 1014 H+cm-2. The current-voltage characteristics of these devices do not change as a result of proton irradiation, in striking contrast to most conventional semiconductor devices or other two-dimensional devices. Only negligible changes are found in the low-frequency noise spectra. The radiation immunity of these "all-metallic" charge-density-wave devices is attributed to the quasi-2D nature of the electron transport in the nanoscale-thickness channel, high concentration of charge carriers in the utilized charge-density-wave phases, and two-dimensional device design. Such devices, capable of operating over a wide temperature range, can constitute a crucial segment of future electronics for space, particle accelerator and other radiation environments.
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We describe a magnetic field sensor based on a spin wave interferometer. Its sensing element consists of a magnetic cross junction with four micro-antennas fabricated at the edges. Two of these antennas are used for spin wave excitation while two other antennas are used for detection of the inductive voltage produced by the interfering spin waves. Two waves propagating in the orthogonal arms of the cross may accumulate significantly different phase shifts depending on the magnitude and direction of the external magnetic field. This phenomenon is utilized for magnetic field sensing. The sensitivity attains its maximum under the destructive interference condition, where a small change in the external magnetic field results in a drastic increase of the inductive voltage, as well as in the change of the output phase. We report experimental data obtained for a micrometer scale Y3Fe2(FeO4)3 cross structure. The change of the inductive voltage near the destructive interference point exceeds 40 dB per 1 Oe. The phase of the output signal exhibits a π-phase shift within 1 Oe. The data are collected at room temperature. Taking into account the low thermal noise in ferrite structures, we estimate that the maximum sensitivity of the spin wave magnetometer may exceed attotesla.
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We demonstrate that, in contrast to most two-dimensional materials, ultrathin flakes of InSe are stable under ambient conditions. Despite their ambient stability, InSe-based nanodevices show an environmental p-type doping, suppressed by capping InSe with hexagonal boron nitride. By means of transport experiments, density functional theory and vibrational spectroscopy, we attribute the p-type doping assumed by uncapped InSe under an ambient atmosphere to the decomposition of water at Se vacancies. We have estimated the site-dependent adsorption energy of O2, N2, H2O, CO and CO2 on InSe. A stable adsorption is found only for the case of H2O, with a charge transfer of only 0.01 electrons per water molecule.
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In this science work there were conducted such researches as organometric, histological, immunomorphologic and morphometric of cerebellar cortex of 219 corpses of people (108 man and 111 woman) of young and old age. A comparative analysis of the parameters of bulb-shaped neurons in these ages revealed decrease of their height and width. It is found that distance between interval nerve cell bodies of ganglionic layer increases with age that obviously associated with progressing disorganization and death of bulb-shaped neurons. It is marked an increment in the number of immunopositive for glial fibrillary acidic protein, protide S-100 and vimentin astrocytes in granular layer and molecular layer of cerebellar cortex, and decline in the number of immunopositive for neuron-specific enolase and immunonegative for protide S-100 and vimentin bulb-shaped neurons that can be regarded as manifestation of neurodegeneration. Using immunohistochemical methods in research allows approaching more differentially to the issues of morphological assessment cerebellar cortex of elderly people and gives an opportunity to receive more objective and full information of postnatal morphogenesis.
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Envelhecimento , Córtex Cerebelar , Neurônios/metabolismo , Células de Purkinje , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Envelhecimento/fisiologia , Autopsia , Córtex Cerebelar/metabolismo , Córtex Cerebelar/patologia , Feminino , Proteína Glial Fibrilar Ácida/metabolismo , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/metabolismo , Doenças Neurodegenerativas/patologia , Gravidez , Células de Purkinje/metabolismo , Células de Purkinje/patologia , Proteínas S100/metabolismo , Vimentina/metabolismoRESUMO
The science work is based on morphological research of cerebellums of 219 corpses of people (108 man and 111 woman) of young and old age. There were used such research methods as organometric, histological and morphometric. During study a comparative analysis of the mass, linear dimensions, thickness of cerebellar cortex of young and old age was conducted. The regularities of age variability of organometric characteristic of cerebellum were revealed and they are found in the reduction of mass and linear dimensions of the people of senile age in comparison with younger people. It was determined that thickness of molecular and granular layers of cerebellum was characterized by aging changing parameters. The results of the morphological study can serve as a basis for the identification of certain regularities of age anatomy of the cerebellum and have practical significance as indicators of the norm that allows using these data in diagnostic and therapeutic work.
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Envelhecimento , Cerebelo , Fatores Etários , Envelhecimento/patologia , Envelhecimento/fisiologia , Antropometria/métodos , Cerebelo/metabolismo , Cerebelo/patologia , Feminino , Humanos , Masculino , Tamanho do ÓrgãoRESUMO
Bulk 1T-TaSe2 exhibits unusually high charge density wave (CDW) transition temperatures of 600 and 473 K below which the material exists in the incommensurate (I-CDW) and the commensurate (C-CDW) charge-density-wave phases, respectively. The (13)(1/2) × (13)(1/2) C-CDW reconstruction of the lattice coincides with new Raman peaks resulting from zone-folding of phonon modes from middle regions of the original Brillouin zone back to Γ. The C-CDW transition temperatures as a function of film thickness are determined from the evolution of these new Raman peaks, and they are found to decrease from 473 to 413 K as the film thicknesses decrease from 150 to 35 nm. A comparison of the Raman data with ab initio calculations of both the normal and C-CDW phases gives a consistent picture of the zone-folding of the phonon modes following lattice reconstruction. The Raman peak at â¼154 cm(-1) originates from the zone-folded phonons in the C-CDW phase. In the I-CDW phase, the loss of translational symmetry coincides with a strong suppression and broadening of the Raman peaks. The observed change in the C-CDW transition temperature is consistent with total energy calculations of bulk and monolayer 1T-TaSe2.
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We have investigated thermal conductivity of graphene laminate films deposited on polyethylene terephthalate substrates. Two types of graphene laminate were studied, as deposited and compressed, in order to determine the physical parameters affecting the heat conduction the most. The measurements were performed using the optothermal Raman technique and a set of suspended samples with the graphene laminate thickness from 9 to 44 µm. The thermal conductivity of graphene laminate was found to be in the range from 40 to 90 W/mK at room temperature. It was found unexpectedly that the average size and the alignment of graphene flakes are more important parameters defining the heat conduction than the mass density of the graphene laminate. The thermal conductivity scales up linearly with the average graphene flake size in both uncompressed and compressed laminates. The compressed laminates have higher thermal conductivity for the same average flake size owing to better flake alignment. Coating plastic materials with thin graphene laminate films that have up to 600× higher thermal conductivity than plastics may have important practical implications.
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We fabricated a large number of single and bilayer graphene transistors and carried out a systematic experimental study of their low-frequency noise characteristics. Special attention was given to determining the dominant noise sources in these devices and the effect of aging on the current-voltage and noise characteristics. The analysis of the noise spectral density dependence on the area of graphene channel showed that the dominant contributions to the low-frequency electronic noise come from the graphene layer itself rather than from the contacts. Aging of graphene transistors due to exposure to ambient conditions for over a month resulted in substantially increased noise, attributed to the decreasing mobility of graphene and increasing contact resistance. The noise spectral density in both single and bilayer graphene transistors either increased with deviation from the charge neutrality point or depended weakly on the gate bias. This observation confirms that the low-frequency noise characteristics of graphene transistors are qualitatively different from those of conventional silicon metal-oxide-semiconductor field-effect transistors.
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We investigated the temperature dependence of the frequency of G peak in the Raman spectra of graphene on Si/SiO2 substrates. The micro-Raman spectroscopy was carried out under the 488 nm laser excitation over the temperature range from -190 to +100 degrees C. The extracted value of the temperature coefficient of G mode of graphene is chi = -0.016 cm-1/ degrees C for the single layer and chi = -0.015 cm-1/ degrees C for the bilayer. The obtained results shed light on the anharmonic properties of graphene.
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Carbono/química , Cristalização/métodos , Nanoestruturas/química , Nanoestruturas/ultraestrutura , Nanotecnologia/métodos , Análise Espectral Raman/métodos , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Tamanho da Partícula , Propriedades de Superfície , TemperaturaAssuntos
Analgésicos não Narcóticos/uso terapêutico , Analgésicos/uso terapêutico , Expectorantes/uso terapêutico , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Descongestionantes Nasais/uso terapêutico , Doenças dos Seios Paranasais/terapia , Humanos , Doenças dos Seios Paranasais/tratamento farmacológico , Irrigação TerapêuticaRESUMO
A retrospective study of adequacy of outpatient treatment for acute otitis media made analysis of 275 case histories of acute otitis media and 271 case histories of acute sinusitis. It was revealed that choice of antibacterial drugs was sometimes made without analysis of most possible pathogens, doses and regimens of pharmacotherapy are often not strictly adhered. The analysis of adequacy of the treatment of acute bacterial sinusitis and otitis in Moscow and 8 cities of Russia is also presented.
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Assistência Ambulatorial/métodos , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Otite Média/tratamento farmacológico , Avaliação de Resultados em Cuidados de Saúde , Sinusite/tratamento farmacológico , Doença Aguda , Infecções Bacterianas/microbiologia , Humanos , Sinusite/microbiologiaRESUMO
In this article there is data which shows the results of Ulyanovsk area country side older persons complex medical tests. 345 of 60-85 years old patients were tested (204 males, 141 females). Result--there are no healthy people in the tested group. In average each old patient has 4.3 diseases--in 3.1 times more than adults do. The most of the sicknesses are the case rates of the blood-transporting, eyes and ears ones and bone-muscle system. The level of a medical care tolerance war analyzed by 172 old patients application checking. Result is a high tolerance of a medical care. So, it's nessesary to improve a specialized geriatric services.