[Social networks as a space of communication on health issues].

Social media is bringing a new dimension to healthcare as it offers an environment through which the public, patients, and healthcare professionals can report health issues with the possibility of potentially improving health outcomes. Social networks are a powerful tool that ensures cooperation between users and is a mechanism of social interaction for a wide range of people. Although the use of social networks for communication in the field of health has a number of advantages, the exchange of information must be monitored for quality and reliability, as well as to preserve the confidentiality of users.

[POPULARIZATION OF TOURISM, HEALTHY LIFESTYLE, PHYSICAL AND SOCIAL ACTIVITY IN THE PROGRAMS OF ACTIVE LONGEVITY OF SENIOR CITIZENS].

The article presents data on sports, active forms of leisure, travel among elderly Russians. An important conclusion is made that health promotion by means of active recreation and sports among senior citizens in Russia is one of the directions of active longevity policy. An overview of charitable foundations for senior citizens of the Russian Federation and their activities in promoting an active lifestyle among elderly citizens is presented.

Patho-mechanical comparative morpho-characterization of contre-coup injuries of liver by cadaveric experimental simulation for medico-legal and forensic implications.

BACKGROUND: Liver is the most common organ to get injured in cases of blunt force trauma to the abdomen (BFTA). It is the 2nd commonest organ after brain to sustain injuries out of all the trauma related fatalities. However, the literature about contre-coup injuries to the liver due to BFTA is scarce in-spite of the high mortality rates seen out of injury to this particular organ. PURPOSE: The authors intended to systematize the characteristic morphogenesis of the contre-coup injuries of the liver on the basis of the patho-mechanics involved in various types of BFTA. METHODOLOGY: One hundred and sixty three cases of BFTA were identified, and interpretation was attempted for the contre-coup rupture of the liver seen in twenty out of all the trauma related fatalities that presented for post-mortem examination during the study period. However, the mechanics of the pattern of the rupture injuries to the liver were indiscernible. This motivated the authors to conduct the comparative characterization of injuries to the liver by experimental simulation of BFTA after necessary permission via inflicting pre-calculated forces on unclaimed cadavers. RESULTS: The patterns of contre-coup rupture/s of liver were established in all the twenty out of one sixty-three cases of BFTA. The rupture depicted patterns of injury in the situations of - 1) strong hits with a limited surface trauma, 2) very strong hits with a generalized surface trauma, 3) and collision with a solid surface resulting due to fall onto the side of the abdomen. The causative mechanism discerned was deformation of the liver, followed by its parenchymal rupture due to the shear and strain types of force/s consequent upon tissue compression. The minimum force and energy of impact required for the liver to rupture was estimated to be 2000 N and 141.5 J. CONCLUSION: This series of the simulation experiments revealed two variants of liver rupture in the contre-coup impact zone. The pattern of injury was maintained in cases, those studied at post-mortem examinations, but the relief ruptures were found to vary depending upon the overall mechanics of the traumatic forces involved in the simulation experiments performed on the cadavers. The anti-shock ruptures were formed during shock trauma, and shockproof ruptures were not seen in cases of underlying compressive forces. The morphogenetic characterization of the relief rupture surface of the liver was also delineated in relation to its surface orientation to the spine on the basis of the terms "large" and "very large" depicting the quantum of force/s delivered out of an impact or blow.

[Histological signs of thermal damaging by electricity]. / Gistologicheskie priznaki termicheskogo povrezhdayushchego deistviya elektricheskogo toka.

OBJECTIVE: Identification of histological signs of thermal damaging by electricity. It was studied the histological picture of the electrometric and changes in the epidermis and dermis in the area of exposure to a red-hot metal object. The same type of microscopic changes in the skin have been revealed: in the central zone of damage there were coagulation necrosis and homogenization, as well as the porous tissue structure formation; in the peripheral zone there were deformation of cells with their verticalization and the vortex figures formation. These histological signs are a manifestation of coagulation processes, hydrodynamic effects because of explosive boiling of interstitial fluid and tissue deformation that characterize the thermal damaging effect. The data obtained clarify the mechanism of the damaging effect of technical electricity on human tissue.

[General characteristics of morphometric and morphoscopic signs of liver rupture with different localizations]. / Obshchaia kharakteristika morfometricheskikh i morfoskopicheskikh priznakov razryvov pecheni razlichnoi lokalizatsii.

The aim of this study was to compare the morphoscopic and morphometric features of local and remote liver ruptures under various external influences. It was found that the local main ruptures were formed in the case of impact trauma more often in the right side of the liver on its diaphragmatic surface, in the anterior third of the organ. They were linear and located in the longitudinal direction. The size of the ruptures increased as the impact force increased. Local additional ruptures were associated with impact and compression trauma and were located only on the diaphragmatic surface of the liver, more often in the right half, in the middle third of the organ. These ruptures were linear, co-directional and small in size under various external influences. Central ruptures were formed by impact and compression trauma, were located more often in the middle third of the right side of the liver and were slit-shaped with a longitudinal direction. The size of central ruptures was associated with falls on the stomach and compression trauma. Peripheral ruptures were formed in the case of impact and compression trauma, were located more often in the right half of the liver on its diaphragmatic surface, mainly in the middle third of the organ and were linear with a slanting direction. The relative constancy of the average sizes of peripheral ruptures was noted. Anti-shock ruptures were observed resulting from shock trauma and were located more often in the right side of the liver, on its visceral surface, in the rear third of the organ. They were linear and curvilinear, and longitudinally and obliquely oriented. Ruptures were relatively constant in size with different types of impact.

[Morphogenesis of central and peripheral liver ruptures in blunt-force trauma]. / Morfogenez tsentral'nykh i perifericheskikh razryvov pecheni pri travme tupymi predmetami.

The purpose of this study was an in depth investigation of the morphogenesis of central and peripheral liver ruptures in blunt trauma and to obtain additional information about their forensic medical significance. It has been established that central and peripheral ruptures are formed by shocks caused by very high forces, as well as by frontal compression of the body as a result of general deformation of the organ and rupture of parenchyma from stretching and tissue shearing. The surface relief of central ruptures was found to be independent of the type of external influence and was determined by the size of the rupture. The peripheral part of such ruptures was characterized by a relatively homogeneous surface topography formed by shear ridges, while the central part was characterized by an inhomogeneous surface topography formed by tensile zones. The surface relief of peripheral ruptures also did not depend on the type of external influence. The surface was relatively homogeneous, with ridges along the edge of the rupture, shear ridges and stretch zones directed deep into the rupture and forming the rupture surface relief in the form of alternating elevations and depressions.

Composition of the Stabilizer and Conditions of Lyophilization for Preserving Infectious Activity of Influenza Virus.

For stabilization of vaccine preparations, they are lyophilized. The composition of the protective medium is an important parameter affecting the quality of the vaccine after drying. In view of the risk of spreading prion diseases, the use of media containing animal proteins is not recommended. In this study, protective media containing no animal proteins and lyophilization regimen were determined. The optimum lyophilization regimen consisted of three stages: freezing at -70°C, main stage at -35°C, and drying at 24°C. Protective medium containing 4% trehalose or protective medium with 10% sucrose and 5% soy peptone ensured highest stability of the lyophilized vaccine preparation in temperature range of 4-24°C. This can help to overcome possible break in the cold chain, which is important during transporting or storage of vaccine preparations.

[The peculiar morphological features of the surface relief of the major local ruptures of the liver in the case of a blunt injury]. / Morfologicheskie osobennosti rel'efa poverkhnosti mestnykh osnovnykh razryvov pecheni pri tupoi travme.

The objective of the present study was the comprehensive investigation of morphogenesis of the surface relief of the major local ruptures of the liver in the case of a blunt injury and the obtaining of an additional information on the possibility to use these data for the purposes of forensic medical expertise. We explored the reliefs of the major local ruptures of the liver in the cases of a single fatal blunt injury inflicted in a traffic accident, by kicking or a powerful stroke with the fist. In addition, the threshold hepatic lesions depending on their severity were determined experimentally. The model allowing to describe the qualitative relief alterations of the rupture surface associated with a blunt injury has been developed. The main elements of the surface relief of the major ruptures include avulsion and shear ridges, folds as well as 'extension zones'. Three types of possible rupture surface reliefs have been identified, viz. relatively uniform, stratified and fragmented non-uniform ones. Such reliefs are formed in the case of a threshold injury, powerful stroke with the leg or the fist, and road traffic accident, respectively. The location of the shear ridges at the ruptured surface makes it possible to determine the direction of growth of the local major rupture and of the stroke vector. The presence of multiple 'extension zones' at the surface of the local major rupture may serve as an indicator either of the influence of the unlimited traumatic surface or of the very strong stroke. The above features of the relief of the rupture surface provide the conditions for the application of the statistical approach to the elucidation of the mechanisms underlying the deformation and the destruction of the parenchymatous organs suffering a blunt injury.

[Forensic medical characteristic of hepatic rupture in the car driver resulting from the injury inflicted inside the passenger compartment].

The objective of the present work was to study morphological changes in the ruptured liver of the car drivers resulting from the injury inflicted inside the passenger compartment. Special attention was given to the number, localization, and shape of the ruptures as well as their size and direction. It was shown that the majority of the local ruptures were located in the anterior and the adjoining parts of the liver. They were rather deep and long, directed longitudinally, and had a linear, sometimes zig-zag or irregular stellar shape. The local additional ruptures were also found in the frontal part of the liver, they were shorter than and not as deep as the major ones. These oblique ruptures had an ark-like, angular, linear or zig-zag shape. Central ruptures of a slit-like shape were most often located close to the adjacent frontal part of the liver. Shock-proof ruptures were located in the posterior part of the liver. They were long, deep, and directed longitudinally, had either linear or zig-zag shape. The peripheral ruptures were located in the middle and posterior parts of the liver. They were long, rather narrow, and shallow; their distinctive features was the oblique direction, besides a curvilinear or zig-zag shape.

[Contribution of neuraminidase of influenza viruses to the sensitivity to the serum inhibitors and reassortment efficiency].

The live attenuated influenza vaccine (LAIV) consists of reassortant viruses with hemagglutinin (HA) and neuraminidase (NA) gene segments inherited from the circulating wild-type (WT) parental and the 6 internal protein-encoding gene segments from the cold-adapted attenuated master donor viruses (genome composition 6:2). In this study, we describe the obstacles to developing LAIV vaccine strains depending on the phenotypic peculiarities of the WT viruses used for reassortment. The genomic composition analysis of 849 reassortants revealed that over 80% of the reassortants based on the inhibitor-resistant WT viruses inherited WT NA as compared to 26% of reassortants based on the inhibitor-sensitive WT viruses. In addition, the highest percentage of the vaccine genotype reassortants was achieved when WT parental viruses were resistant to the non-specific serum inhibitors. We demonstrate that NA may play a role in the influenza virus sensitivity to the non-specific serum inhibitors. Replacing NA of the inhibitor-sensitive WT virus with the NA of the inhibitor-resistant master donor virus significantly decreased the sensitivity of the resulting reassortant virus to the non-specific inhibitors.

[The general and individual characteristics of the liver ruptures in the case of a blunt injury to the chest and abdomen].

The present study is based on the results of analysis of 150 cases of the fatal blunt injury to the chest and abdomen associated with liver rupture for the purpose of systematization of practical and experimental data concerning this issue. Special attention is given to the diagnostic signs of local major (primary) and additional (secondary) lesions localized at the sites of force application and their long-term consequences. The diagnostic forensic medical criteria are proposed allowing to characterize hepatic injuries depending on the mechanism and conditions of their infliction in different situations.

[The morphological characteristic of an experimental rupture of the liver for the simulation of the blunt abdominal injury].

The strength and the energy of a striking blow with a clenched fist may be as high as 300 kgf (3,000 H) and 824.4 J respectively. Pressing a human body against a hard surface leads to a deep chest deflection while the rupture of the liver is associated with a lower blow strength and energy (2,000 H and 141.5 J respectively). In such situations, the shockproof mechanisms of the injury prevail giving rise to antishock peripheral and central ruptures of the liver due to the general deformation and displacement of this organ in the direction of the blow. In the absence of barriers preventing the inertial movement of the body, even a strong strike (1950 H) with an energy of 202.5 J does not cause a damage to the liver; it occurs when the strike strength and energy amount to 2650 H and 260.1 J respectively. In such cases, the direct injury mechanism develops manifested in the formation of local liver injures. The results of the study suggest the possibility of the rupture of the liver inflicted by a clenched fist strike delivered to the abdomen.

[The morphological characteristic of hepatorrhesis in the subjects with the blunt abdominal injury].

We have elucidated certain consistent patterns of the development of hepatic lesions associated with blunt abdominal trauma including primary and secondary local and distant ruptures of the liver of different localization, e.g. in the direction of the injurious force (central and anti-shock) and apart from it (peripheral). A kick in the stomach causes local (primary and secondary) or distant ruptures of the liver. A strong impact gives rise to local secondary and distant ruptures. Compression of the body with massive objects is associated with local primary ruptures whereas falling down on the stomach results only in anti-shock ruptures. Local (primary and secondary) as well as distant (anti-shock and peripheral) ruptures of hepatic parenchyma have different morphological properties and surface relief which makes it possible to discriminate between them. The consistent patterns of hepatorrhesis provide a methodological basis for the explanation of the physical nature of liver deformation and destruction of its tissue after a blunt abdominal trauma.

[Characteristic of the hepatic tissue degradation processes underlying the development of its local and distant lesions].

The processes associated with liver disruption caused by a blunt abdominal injury have been investigated on a model of continuous media deformation. It was shown that local primary injuries to the liver result from stress-induced tissue stretching, compression, and shear in the longitudinal direction. They have a layered relief due to transverse fissures. The peripheral ruptures result from tissue extension under effect of overall liver deformation. They are not deep and have a uniform relief created by alternating low tubercles and superficial fissures oriented at the right angle to the surface. Antishock ruptures are the consequences of tissue extension or stretching/compression during local and overall deformation of the liver surface. They develop in the longitudinal direction, have a non-uniform relief created by alternating high prominences and numerous fissures differing in both the depth and the extension and oriented at the right angle to the liver surface. Central ruptures result from tissue stretching accompanying overall deformation of the organ. They are directed perpendicular to the direction of the surface force, have the longitudinal direction and non-uniform relief.

[Characteristics of duodenal ruptures depending on topographical and anatomical properties of this organ and circumstances of blunt abdominal trauma].

We have studied specific morphological properties of duodenal rupture depending on the topographic and anatomical features of this organ and circumstances of blunt abdominal trauma suffered in a car crash (with the victim found in the passenger compartment or involved in an automobile-pedestrian accident) and a railway crash (a train-pedestrian accident) or resulting from a blunt-force trauma, a fall from height, a fall on the stomach, and traumatic compression of the body. We took into consideration the anatomical peculiarities of the duodenal rupture, such as its circular, horseshoe, and loop-like shape. The study has demonstrated that the frequency of duodenal injury associated with a blunt abdominal trauma shows a stronger dependence on the topographical and anatomical peculiarities of duodenum than on the circumstances of the case. Specifically, the circular duodenum and especially its descending portion are more readily subjected to the damage than the organs of a different shape. The position of the break with respect to the duodenal axis is an important diagnostic signs allowing to clarify circumstances of the blunt injury. Transverse ruptures are typical of strong impacts associated with the short-term interaction between the damaging object and the affected part of the body whereas longitudinal ruptures more commonly occur as a result the long-term traumatic impact. Bile imbibition of paraduodenal and peripancreatic retroperitoneal adipose tissue may be used as an additional diagnostic sign of duodenal rupture.

[Peculiarity of reassortment of current wild type influenza viruses with master donor viruses for live influenza vaccine].

The live attenuated influenza vaccine (LAIV) currently licensed in Russia consists of the reassortant viruses with hemagglutinin (HA) and neuraminidase (NA) gene segments from the circulating wild-type viruses and the six internal protein-encoding gene segments from cold-adapted master donor viruses (MDV) A/Leningrad/134/17/57 (H2N2) or B/USSR/60/69. Presently, only classical reassortment technique is approved for the generation of Russian LAIV strains. In this work, we describe the obstacles to the development of LAIV 6:2 vaccine strains depending on the phenotypic properties of the wild-type viruses used for reassortment. It was demonstrated that the highest percentage of 6:2 vaccine reassortants could be achieved when wild-type parental viruses were resistant to non-specific gamma-inhibitors. It was shown that it was impossible to generate 6:2 vaccine reassortants possessing six internal genes of the AILeningrad113417/57 (H2N2) master donor virus and avian HA and NA genes from H5N1-PR8 viruses using classical reassortment technique. It was suggested that strong constellation effects between the gene segments of the parental viruses could affect the virus gene reassortment. A strong interaction between the genome segments encoding neuraminidase of avian origin and PB2 gene of PR8 virus was observed. When the PB2 gene was inherited from cold-adapted master donor virus, the neuraminidase was also found to be of MDV origin.

[The mechanisms of formation of liver injuries associated with the blunt abdominal trauma].

The mechanisms of liver damage associated with the blunt abdominal trauma are considered based on the analysis of the literature publications. The general characteristic of these mechanisms and the processes underlying the development of liver injuries is presented. It is argued that the mechanisms underlying the formation of damages to the liver differ depending on the form of the traumatic impact, the injurious factor, and the processes leading to the destruction of the hepatic tissue. The main forms of traumatic impact in the case of a blunt abdominal trauma include the strike (blow), pressure, and concussion of the organ while the major traumatic factors are deformation, displacement, and "shock-resistant effects". The mechanisms underlying tissue destruction are compression and stretching. These two mechanisms are responsible for the formation of different variants of liver destruction. The results of the study suggest the necessity of the search for other mechanisms of degradation of the hepatic tissue following a blunt abdominal trauma for the improvement of forensic medical diagnostics of its cause and the underlying mechanism.

[Forensic medical estimation of gunshot fractures of the flat bones].

The principal characteristics of the investigations into the mechanisms of gunshot injuries are considered. The general and peculiar features of gunshot fractures and the pathological processes underlying them are discussed. The theory of bullet impact effect put forward by the Russian surgeons in the late XIXth century is verified. The explanation is proposed for the physical nature of direct and side impacts and the phenomenon of a temporary oscillating cavity from the standpoint of the theory of bullet impact effect. The new forensic medical criteria for the gunshot origin of an injury have been developed that allow the gunshot distance and the geometric characteristics of the bullet to be determined. A methodological basis for the determination of the long-range gunshot distance has been created. The results of the present study may be of interest for criminal lawyers and military specialists.

[The forensic medical classification of damages to the liver in the case of a blunt abdominal injury].

The present work had the objective to evaluate the existing classifications of damages to the liver associated with a blunt abdominal injury. An original forensic medical classification of hepatic lesions has been developed taking into consideration both localization and mechanisms of blunt abdominal injuries. It is proposed that such injuries should be categorized into three groups: local primary injuries developing as a result of abdominal wall deformation at the site of the application of the traumatic force; local secondary injuries developing in conjunction with the primary ones at the site of the application of the traumatic impact from the fractured costal fragments resulting from chest deformation; late post-traumatic injuries developing simultaneously with the local ones both in the direction of the traumatic force and far away from its application site as a result of the general deformation, displacement, and concussion of the organ. The scope of classifications overviewed in this paper provide a basis for the transition to the next stage of systematization, namely the estimation of morphological features of hepatic injuries depending on the form of blunt abdominal injuries, i.e. blow, compression, etc.

[The methodological basis for the expert assessment of unfavourable outcomes of the treatment].

Procedures of forensic medical examination are considered with special reference to the cases of unfavourable outcomes of the treatment and methodological basis of their expert assessment. The step-by-step analysis of the doctor's actions is proposed for their objective evaluation. The objective opinion of the expert commission should be based on the medical criteria for the doctor's actions.