Academy Of Medical Sciences Research Articles

Лікування «нещасливої тріади» плечового суглоба

Актуальність. «Нещаслива тріада» плечового суглоба — це тяжка та доволі поширена травма (9–18 % серед усіх вивихів плеча). Під нею розуміють комбінацію вивиху плеча, масивного повношарового розриву ротаторної манжети та ушкодження аксилярного нерва або підключичних відділів плечового сплетення. Мета роботи: на основі аналізу результатів власних досліджень визначити оптимальну тактику обстеження та лікування хворих з «нещасливою тріадою» плечового суглоба. Матеріали та методи. У період з 2000 по 2016 рік у відділенні мікрохірургії та реконструктивної хірургії верхньої кінцівки ДУ «Інститут травматології та ортопедії НАМН України» було проліковано 120 пацієнтів з діагнозом травматичного вивиху плеча. Серед них у 25 (20,8 % від загальної кількості травматичних вивихів) пацієнтів була діагностована «нещаслива тріада» плеча. Усім пацієнтам проводились стандартне клінічне, рентгенологічне дослідження, електронейроміографія (ЕНМГ) та магнітно-резонансна томографія. Результати. Усі пацієнти з даною патологією потребують передопераційного ЕНМГ-дослідження, у випадку збереження провідності за аксилярним нервом більше 30 % на першому етапі лікування рекомендоване відновлення цілісності ротаторної манжети плеча з призначенням консервативного лікування нейропатії. У разі збереження провідності за аксилярним нервом менше 30 % першим етапом лікування варто проводити ревізію та відновлення цілісності аксилярного нерва. Обов’язкова фіксація плеча у вправленому положенні. Висновки. Аналізуючи віддалені результати лікування пацієнтів з «нещасливою тріадою» плечового суглоба, ми виявили залежність між тяжкістю травми та результатами лікування. Так, коли на передопераційній ЕНМГ визначались збереження провідності за аксилярним нервом та позитивна динаміка відновлення, результати лікування через 12 місяців були найкращі. Найгірші результати були у первісно найтяжчих пацієнтів — з підключичним ушко­дженням плечового сплетення.

The Academy of Medical Sciences An interview with Simon Denegri OBE

The Academy of Medical Sciences An interview with Simon Denegri OBE

Risk factors relate to the variability of health outcomes as well as the mean: A GAMLSS tutorial.

Risk factors or interventions may affect the variability as well as the mean of health outcomes. Understanding this can aid aetiological understanding and public health translation, in that interventions which shift the outcome mean and reduce variability are typically preferable to those which affect only the mean. However, most commonly used statistical tools do not test for differences in variability. Tools that do have few epidemiological applications to date, and fewer applications still have attempted to explain their resulting findings. We thus provide a tutorial for investigating this using GAMLSS (Generalised Additive Models for Location, Scale and Shape). The 1970 British birth cohort study was used, with body mass index (BMI; N = 6007) and mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale; N = 7104) measured in midlife (42-46 years) as outcomes. We used GAMLSS to investigate how multiple risk factors (sex, childhood social class, and midlife physical inactivity) related to differences in health outcome mean and variability. Risk factors were related to sizable differences in outcome variability-for example males had marginally higher mean BMI yet 28% lower variability; lower social class and physical inactivity were each associated with higher mean and higher variability (6.1% and 13.5% higher variability, respectively). For mental wellbeing, gender was not associated with the mean while males had lower variability (-3.9%); lower social class and physical inactivity were each associated with lower mean yet higher variability (7.2% and 10.9% higher variability, respectively). The results highlight how GAMLSS can be used to investigate how risk factors or interventions may influence the variability in health outcomes. This underutilised approach to the analysis of continuously distributed outcomes may have broader utility in epidemiologic, medical, and psychological sciences. A tutorial and replication syntax is provided online to facilitate this (https://osf.io/5tvz6/). DB is supported by the Economic and Social Research Council (grant number ES/M001660/1), The Academy of Medical Sciences / Wellcome Trust ("Springboard Health of the Public in 2040" award: HOP001/1025); DB and LW are supported by the Medical Research Council (MR/V002147/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Quality of life problems in children with juvenile idiopathic arthritis and its subtype associated with uveitis (literature review and own research)

Background. The problem of the quality of life (QoL) is relevant nowadays, especially for patients with chronic diseases, including juvenile idiopathic arthritis (JIA) and the subtype of JIA associated with uveitis (JIA-u). The purpose was to carry out a literature review on the QoL in children with JIA and JIA-u, with an analysis of existing tools, the possibility of their use in children, and to assess the QoL indicators of children with JIA, who were treated in a specialized department of the hospital. Materials and methods. The search was performed in the PubMed, Medline, and Google databases using the keywords: JIA, rheumatoid arthritis, uveitis, JIA-u, arthritis with uveitis, QoL, QoL in children. Inclusion criteria were as follows: publication after 2010, use of questionnaires to assess QoL, the sample of patients over 30 people. The type of instrument for assessing QoL, the sample nature, and the QoL indicators of patients were analyzed. The study was carried out at the premises of the State Institution “Institute for Children and Adolescents Health Care of the National Academy of Medical Sciences of Ukraine” and involved 41 children with JIA (22 with polyarticular, and 19 with oligoarticular variants): 25 girls and 16 boys aged 3–17 years with disease duration of 40.2 ± 6.2 months. Thirty-six of them received methotrexate, and 5 — sulfasalazine. The disease activity was assessed by the Juvenile Arthritis Disease Activity Score (JADAS27) and the functional state — by the Childhood Health Assessment Questionnaire (CHAQ). For quality of life assessment, the Pediatric Quality of Life InventoryTM validated for Ukraine was used. Results. The analysis included 73 foreign scientific papers from 2011 to 2021, among which 11 are fully devoted to the assessment of QoL in children with JIA, and 62 partially cover this topic in children and adults with arthritis. In Ukraine, these issues are not discussed enough (6 articles on the evaluation of QoL in children), the factors for its deterioration remain unclear. The level of activity according to JADAS27 in children in subgroups with both poly- and oligoarticular variants was high (11.20 ± 7.04 and 8.9 ± 4.2 points), and the functional state (on CHAQ) — 0.19 ± 0.17. In children with JIA, QoL indicators are reduced, especially on the scales of emotional and school functioning, and closely correlate with disease activity (r = 0.784, p < 0.05). Conclusions. The analysis of the conducted studies showed that decreased disease activity is not accompanied by the QoL indicators optimization, which remain reduced. Recently, the situation with the QoL assessment in domestic medicine has been improving, relevant questionnaires are being actively introduced. However, the ambiguity of the results in world medicine and the presence of a small number of works on this topic determine the urgency of the problem of QoL in children with JIA in Ukraine.

Cardiometabolic Disease Burden and Steroid Excretion in Benign Adrenal Tumors : A Cross-Sectional Multicenter Study.

Benign adrenal tumors are commonly discovered on cross-sectional imaging. Mild autonomous cortisol secretion (MACS) is regularly diagnosed, but its effect on cardiometabolic disease in affected persons is ill defined. To determine cardiometabolic disease burden and steroid excretion in persons with benign adrenal tumors with and without MACS. Cross-sectional study. 14 endocrine secondary and tertiary care centers (recruitment from 2011 to 2016). 1305 prospectively recruited persons with benign adrenal tumors. Cortisol excess was defined by clinical assessment and the 1-mg overnight dexamethasone-suppression test (serum cortisol: <50 nmol/L, nonfunctioning adrenal tumor [NFAT]; 50 to 138 nmol/L, possible MACS [MACS-1]; >138 nmol/L and absence of typical clinical Cushing syndrome [CS] features, definitive MACS [MACS-2]). Net steroid production was assessed by multisteroid profiling of 24-hour urine by tandem mass spectrometry. Of the 1305 participants, 49.7% had NFAT (n= 649; 64.1% women), 34.6% had MACS-1 (n= 451; 67.2% women), 10.7% had MACS-2 (n= 140; 73.6% women), and 5.0% had CS (n= 65; 86.2% women). Prevalence and severity of hypertension were higher in MACS-2 and CS than NFAT (adjusted prevalence ratios [aPRs] for hypertension: MACS-2, 1.15 [95% CI, 1.04 to 1.27], and CS, 1.37 [CI, 1.16 to 1.62]; aPRs for use of ≥3 antihypertensives: MACS-2, 1.31 [CI, 1.02 to 1.68], and CS, 2.22 [CI, 1.62 to 3.05]). Type 2 diabetes was more prevalent in CS than NFAT (aPR, 1.62 [CI, 1.08 to 2.42]) and more likely to require insulin therapy for MACS-2 (aPR, 1.89 [CI, 1.01 to 3.52]) and CS (aPR, 3.06 [CI, 1.60 to 5.85]). Urinary multisteroid profiling revealed an increase in glucocorticoid excretion from NFAT over MACS-1 and MACS-2 to CS, whereas androgen excretion decreased. Cross-sectional design; possible selection bias. A cardiometabolic risk condition, MACS predominantly affects women and warrants regular assessment for hypertension and type 2 diabetes. Diabetes UK, the European Commission, U.K. Medical Research Council, the U.K. Academy of Medical Sciences, the Wellcome Trust, the U.K. National Institute for Health Research, the U.S. National Institutes of Health, the Claire Khan Trust Fund at University Hospitals Birmingham Charities, and the Mayo Clinic Foundation for Medical Education and Research.

NEUROSURGICAL TREATMENT OF INTRAMEDULLAR TUMOR OF CERVICAL LOCATION

Materials and methods. This report analyzes 47 patients who were operated on at Romodanov Neurosurgery Institute of the Academy of Medical Sciences of Ukraine in the period from 2010 to 2020 due to intramedullary tumors of the cervical spine. Results. All patients with intramedullary tumors of the cervical spine were operated. According to the volume of tumor removal, operations with total (17 observations), subtotal (14 observations), and partial (19 observations) removal were distinguished. The removal of at least 95% of the tumor volume was considered total, which was confirmed by examination of the operating field under a microscope at the end of the operation or by early postoperative MRI. Discussion. Total tumor removal is the gold standard in the surgical treatment of intramedullary spinal cord tumors. Ferrante L. et al reported that none of the patients who underwent total tumor resection had a recurrence, while 57.1% of patients with subtotal resection had a recurrence. The authors argue that the volume of the removed tumor is an important factor influencing the further prognosis. Total tumor resection can be recommended for most cases of intramedullary tumors of the cervical spinal cord. It is not possible to determine preoperatively whether total tumor removal is possible. Conclusions. Intramedullary tumors of the cervical spine can be completely removed. Surgery should be performed immediately after diagnosis without expecting an increase in neurological deficit.

Annals of National Academy of Medical Sciences (India): Goals

Annals of National Academy of Medical Sciences (India): Goals

К 100-ЛЕТИЮ СО ДНЯ РОЖДЕНИЯ Б. В. ДРИВОТИНОВА БОРИС ВЛАДИМИРОВИЧ ДРИВОТИНОВ: ВЫДАЮЩИЙСЯ УЧЕНЫЙ, ВРАЧ-НЕВРОЛОГ, ТАЛАНТЛИВЫЙ ПЕДАГОГ

The article is devoted to the outstanding scientist-neurologist, Doctor of medical sciences, honored doctor of the Republic of Belarus, honorary academician of the Belarusian Academy of Medical Sciences, Professor Boris Vladimirovich Drivotinov. The article presents the main stages of biography and scientific way of professor B.V. Drivotinov, his merits in the development of Belarusian scientific-pedagogical school and practical medicine are marked. B. V. Drivotinov was the founder of Belarusian scientific and pedagogical school of vertebrooneurology; he participated in the development of clinical classification of peripheral nervous system diseases. The scientist created a new direction in neurological science associated with the development and substantiation of autoimmune pathogenesis of spinal osteochondrosis and its clinical manifestations. For the first time, he applied computational cybernetic methods for early diagnosis, prediction of the severity of the course and outcome of neurological manifestations of spinal osteochondrosis and other diseases of the nervous system. Professor B.V. Drivotinov was a reformer and innovator in the field of neurological practice and education.

Clinical characteristics of patients with reproductive dysfunction and benign ovarian neoplasms

The study reports on the analysis of the anamnestic data of2044 women with reproductive disorders who underwent operative interventions for tumors and tumorlike masses of the ovaries during the period of 1989-1999 in the Research Center of Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences. A high incidence rate о f complicated anamnesis and the coexisting somatic and extragenital diseases was revealed. The data are presented concerning the status of menstrual and reproductive function of the patients examined.

Information message about the scientific-practical conference "New approaches to screening, diagnosis and treatment of ovarian tumors", Veliky Novgorod, May 17-18, 2001

From 17 to 18 May 2001, a scientific and practical conference "New approaches to screening, diagnosis and treatment of ovarian tumors" was held at the Novgorod Regional Oncological Dispensary.The conference was organized with the joint participation of the Ministry of Health of the Russian Federation, Research Institute of Oncology named after V.I. prof. N.N. Petrov, Novgorod Regional Oncological Dispensary, Moscow Oncological Institute. P.A. Herzen, Research Institute of Obstetrics and Gynecology, Russian Academy of Medical Sciences. BEFORE. Ott.For the first time in our country, a representative forum of specialists in the field of oncology, obstetrics and gynecology, endovideosurgery was held. More than 200 leading experts from St. Petersburg, Moscow, Veliky Novgorod, Rostov-on-Don, Minsk, Kiev took part in the conference. Following the results of the conference, the following resolution was adopted

Academician Evgeniy Nikolaevich Meshalkin (1916–1997) (on the 105th anniversary of his birth)

The outstanding cardiologist and cardiac surgeon Evgeny Nikolaevich Meshalkin was born on February 25, 1916 in the city of Yekaterinoslav, now Dnepropetrovsk. In 1918, the Meshalkin family moved to Rostov-on-Don, and in 1928 to Moscow, where Evgeny graduated from school in 1930, and then studied at the factory school at the Sickle and Hammer factory. In 1941, Evgeny Nikolaevich graduated from the 2nd Moscow Medical Institute and from August 1941 to May 1945 was a participant of the Great Patriotic War permanently in the field army. After demobilization from the army, E. N. Meshalkin worked from 1946 to 1956 at the department and at the clinic of Faculty Surgery of the 2nd Moscow State Medical Institute, headed by Academician of the USSR Academy of Medical Sciences A. N. Bakulev. In 1950, he defended his PhD thesis «Intubation anesthesia», and in 1953, his first monograph «Intubation anesthesia Technique» was published. Evgeny Nikolaevich is rightfully considered one of the founders of the Russian anesthesiology. In 1953, E. N. Meshalkin defended his doctoral dissertation «Probing and contrast study of the heart and major vessels». In conditions of moderate nonperfusion hypothermia, Yevgeny Nikolaevich successfully operated on complex heart defects, performed the insertion of mechanical prostheses for mitral and aortic insufficiency. From January 1956 to 1960, he was the head of the Department of Thoracic Surgery and Anesthesiology of the Central Institute of Advanced Medical Training (now the Russian Medical Academy of Postgraduate Education). E.N.Meshalkin owns 47 copyright certificates and patents, which are implemented not only in the Research Institute of Circulatory Pathology, but also in other cardiac surgery centers in Russia. Honorary citizen of Novosibirsk Evgeny Nikolaevich Meshalkin passed away on March 8, 1997 and was buried in Novosibirsk at the Southern Cemetery. In memory of the outstanding scientist, the Novosibirsk Research Institute of Circulatory Pathology was named after Academician E. N. Meshalkin.

Methodology of prenatal ultrasound examinations in congenital diaphragmatic hernia

Background. Congenital diaphragmatic hernia is a complex malformation with high anatomical and clinical variability. Prenatal ultrasound examinations allow one to assess the severity of pathological process in a particular case in order to determine the management of pregnancy, labor and neonatal period. However, the rarity of this pathology and some features of ultrasound imaging can lead to low informative value of the examination. Purpose – to present a detailed methodology of prenatal ultrasound examinations in fetal congenital diaphragmatic hernia, taking into account anatomical variants of pathology and features of US imaging at different terms of pregnancy, and to characterize the preconditions for diagnostic errors. Materials and methods. The data on prenatal ultrasound examinations of 265 high-risk pregnant women with fetal diaphragmatic hernia conducted during the period of 2007–2020 in the Department of Fetal Medicine of State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova of National Academy of Medical Sciences of Ukraine», were systemized. US examinations were performed on systems HDI 4000, ACCUVIX V20EX-EXP, ACCUVIX V10LV-EX. Isolated anomaly was detected in 192 (72.5 %) cases, associated congenital malformations in 65 (24.5 %), chromosomal pathology in 8 (3.0 %). Left-sided hernia was diagnosed in 85.7 % of cases (n = 227), right-sided – in 12.1% (n = 32), central in 1.1 % (n = 3), bilateral in 1.1 % (n = 3). Location of abdominal, retroperitoneal and thoracic organs was determined, as well as specifics of their US imaging in different terms of pregnancy. Results. Methodology of prenatal ultrasound examination of fetuses with congenital diaphragmatic hernia was developed taking into account the specifics of pathological anatomy and ultrasound imaging. Typical and rare variants of thoracic and abdominal organs’ localization in the standard cross section plane at the level of the four chambers of the heart were characterized, preconditions and variants of diagnostic errors were determined. The methods of correct measurement of the thorax, lungs, liver, and also methods of prognostic indices’ calculation for determining the degree of pulmonary hypoplasia and the degree of liver herniation were presented. Conclusions. Prenatal ultrasound semiotics of congenital diaphragmatic hernia is characterized by considerable variability, and contains significant risks of diagnostic errors. The presented methodology of unified ultrasound examinations allows for systematic assessment, which results in correct prenatal diagnosis, determination of the pathology severity, and prognosis – for the correct choice of pregnancy and labor management.

REPRODUCTIVE FUNCTION IN WOMEN WITH MENSTRUAL CYCLE DISORDER

Aim. The purpose of this paper is to study reproductive function in women with menstrual disorders.&#x0D; Material and Methods. We analyzed the data and results of medical and genetic counseling of 107 women with menstrual dysfunction who applied to the medical and genetic center of the State Institution "The Institute of Hereditary Pathology of the National Academy of Medical Sciences of Ukraine". When analyzing the obtained indicators, we compared them with similar parameters in the comparison group which consisted of 100 healthy women applying for family planning. In the course of the work the data of somatic, gynecological and reproductive anamnesis were studied. Statistical processing of the obtained results was performed using the application package "Statistica 7.0" and the standard package of Excel 2013 statistical analysis. Significance between different groups was investigated by Pearson's test c2. Differences were considered significant at a significance level of p &lt;0.05.&#x0D; Results and Discussion. Data and results of the medical and genetic counseling of 107 women with menstrual dysfunction (the main group) and 100 women without menstrual dysfunction (the control group) were analyzed. Data of somatic, gynecological and reproductive anamnesis were studied. Significant differences were found in the social status of women of two groups (р&lt;0,05): in the main group, there were 60 working women (56.1%) and 44 (41.1%) housewives. In the control group, there were 32 working women (32.0%) and 68 (68.0%) housewives respectively. The study of the features of menstrual function showed significant differences in the formation and duration of the menstrual cycle in women of both groups (p&lt;0.05). In women with menstrual dysfunction, there were disorders of reproductive history, most often due to miscarriages and stillbirths - 59 (55.1%) and infertility - 19 (17.7%). It was found that most patients in the main group had somatic diseases: 66 (61.7%) in the main group and 46 (46.0%) in the control group (р&lt;0.05). Complications of gynecological anamnesis were significantly more often observed in women of the main group - 85 (79.4%) than in women of the control group - 41 (41.0%) (р&lt;0.05).&#x0D; Conclusions. Analysis of the social status of women in both groups showed that the vast majority of women in the main group were employees compared to women in the control group: 60 (56.1%) and 44 (32.0%) against 32 (32%) and 44 (44, 0%) respectively (p &lt;0,05). Significant differences in menstrual function data in women of both groups were found. A considerable proportion of women in the main group - 52 (48.0%) noted the onset of menarche at the age of 15 years, and in most women of the control group - 91 (91.0%) it was observed at the age of 12-14 years, and only in 9 (9.0%) cases - at the age of 15 years (p &lt;0.05). There were significant differences in the duration of the menstrual cycle on all indicators in women of both groups. In 48 (44.9%) women of the main group, the duration of the menstrual cycle was 35-45 days, and in 12 (11.2%) - 45-90 days. In all women of the control group, this figure was 28-35 days (p &lt;0.05). Only in 66 (61.7%) patients of the main group, the cycle was established immediately, compared with 81 (81.0%) women in the control group (p &lt;0.05). Women in the main group were significantly more likely to have complications of reproductive history - 63 (58.9%): most often miscarriages and stillbirths - 59 (55.1%) and infertility - 19 (17.7%) (p &lt;0.05). 85 (79.4%) women of the main risk group had difficult gynecological history, compared to 41 (41.0%) in the control group and they were significantly more likely to suffer from infertility -19 (17.7%), p &lt;0.05).

Long-term outcomes of the repeated lumbar microdiscectomies using polyacrylamide hydrogel: clinico-radiological relevance

Background. Epidural fibrosis (EF) is one of the reasons of the failed back surgery syndrome manifesting in back pain and pain in extremities as well as other signs of the compression or irritation of the nerve structures. The numerous approaches to prevent EF have been elaborated. Nowadays, many years of experience in the usage of different barrier materials in microdiscectomy such as polyacrylamide hydrogel (PAH) have been accumulated. Nevertheless, the results of such treatment are rather controversial. The aim of the study was to assess the radiological data on the state of the backbone according to MRI findings and the clinical symptoms of the patients following the surgery as well as to determine the long-term strength of the interaction between the factors under study after the repeated lumbar microdiscectomies performed with intraoperative epidural PAH administration. Materials and methods. The results of the clinical and radiological assessment of 96 patients (mean age 45.7 years; 95 % CI [43.5; 47.9]; 59 males and 37 females) enrolled into the single-center prospective cohort study performed at the State Institution «Romodanov Neurosurgery Institute National Academy of Medical Sciences of Ukraine» have been presented. The patients were divided into two groups. The main group (MG) consisted of 35 (36.5 %) patients with recurrent intervertebtral disc (IVD) herniation to whom PAH was administered epidurally at the final step of the surgery comprising disc removal and decompression of the nervous structures with the aim of preventing cicatrical adhesive EF. In control group (61 patients, 63.5 %), barrier materials were not used. The primary end-points of the study were the long-term outcomes of the repeated lumbar microdiscectomies: EF rate at the postoperative site; the rate of the displacement of spinal root at the postoperative site; the rate of the repeated recurrent IVD herniation and de novo IVD herniation; the rate of the cases with the residual radicular pain localized in the area of the surgical intervention and the extent of the worsening of life quality in the treated patients. The secondary end-points of the study were the following: the analysis of the associations with delineation of the strength of such factorsaffecting the residual radicular pain as EF, the displacement of spinal root at the postoperative site, the repeated recurrent IVD herniation the repeated recurrent IVD herniation and de novo IVD herniation. Results. In 12 months following the surgical treatment, EF frequency was significantly lower in MG as compared with CG where PAH was not used (p = 0.02936). Nevertheless, the difference between groups was not significant when MRI findings of the displacement of spinal root at the postoperative site (р = 0.46759), the frequency of the repeated recurrent IVD herniation (p = 0.90904) and de novo IVD herniation (p = 0.60385) were compared. In study group, there were no association between MRI signs of postoperative EF, the displacement of spinal root or new recurrent IVD herniation on the one hand and the frequency of the radicular pain localized at the area of the surgical intervention on the other hand (p = 0.66482; p = 0.09515; p = 0.22857, respectively). In CG, the significant association between the displacement of spinal root at the postoperative site and the clinical symptoms above was revealed (p = 0.00222) with association coefficient φ = 0.41 indicating the moderate strength of this association. Conclusions. The data obtained generally suggest the reasonability of applying PAH manufactured in Ukraine as a barrier material at least for the treatment of the patients with recurrent IVD herniation representing the challenging category of spinal patients.

Simulation of heat transfer with variable energy input of the contact drying process for the production of potato flakes

According to the data on the norms of consumption of plant products of the Research Institute of Nutrition of the Russian Academy of Medical Sciences, potatoes rank first with a norm of 120 kg per person per year. Much attention is paid to the processing of potatoes, which allows to extend their shelf life, reduce storage capacity and reduce transportation, since 1 kg of dry potato product is equivalent to 7-8 kg of fresh potatoes. Industrial processing of potatoes into dried mashed potatoes and flakes allows to reduce losses of potatoes during storage and transportation, it becomes possible to enrich products with vitamins and other useful components, its nutritional value is better preserved, conditions are created for the complex processing of raw materials with complete disposal of waste and creating stocks of products from potatoes on a case of crop failure. The methods and equipment used for processing lines for potato processing and the production of dried products are distinguished by low thermal efficiency and the degree of use of the potential of the heat carrier and high specific energy consumption per unit of dried product. One of the ways to reduce heat consumption and increase the energy efficiency of production in the processing of edible plant materials is the use of an oscillated heat and moisture supply, which ensures a high quality finished product with an increase in the degree of thermodynamic perfection of the energy technology system. The modeling of the heat transfer process for contact drying with variable energy supply during potato processing was carried out to optimize the production technology, determine the rational production parameters of the roller dryer and increase the energy efficiency of the technological line. On the basis of the obtained model of heat exchange with variable heat supply, the calculation of the contact drying process for a roller dryer in the production of dry potato flakes is carried out

P. K. Anokhin’s answer to E. A. Asratyan’s review of “Biology and neurophysiology of conditioned reflex” monograph. Echo of Pavlovian session

The article presents previously unpublished documents, comments, and materials that were directly related to significant events in the life and performance of a Russian scientist and academician P. K. Anokhin, such as the Lenin Prize award and the Pavlovian session. The text of P. K. Anokhins answer to the review of a corresponding member of the USSR Academy of Sciences E. A. Asratyan of P. K. Anokhins monograph Biology and Neurophysiology of Conditioned Reflex submitted to the competition for the Lenin Prize, was published. In 1972, P. K. Anokhin was awarded the Lenin Prize for the monograph Biology and Neurophysiology of Conditioned Reflex. P. K. Anokhin answered the accusatory statements of the reviewer concerning the danger of the functional system for the Pavlovian doctrine and the analytical nature of the scientific method of I. P. Pavlov and answered critical questions about the synthetic and systemic approach and the priority in the development of the theory of systems and feedback.&#x0D; The work presented literature facts that the statements and questions of Asratyan were consistent with his accusatory comments about P. K. Anokhin at the Pavlovian session the scientific session of the USSR Academy of Sciences and of the USSR Academy of Medical Sciences, dedicated to the physiological doctrine of academician I. P. Pavlov, which was held in Moscow in JulyAugust 1950. At the session, P. K. Anokhin was accused of revision of the ideological foundations of Pavlovs teachings and of detraction of the significance of Pavlovs theory of the higher nervous activity.&#x0D; After the Pavlovian session, P. K. Anokhin was dismissed from the post of the director of Institute of Physiology of the USSR Academy of Medical Sciences, dismissed from the Presidium of the USSR Academy of Medical Sciences, and appointed Professor of the Department of Physiology of Ryazan Medical Institute. Over the years, E. A. Asratyan persistently criticized P. K. Anokhin as the opponent of I. PPavlovs teaching and actively rejected the theory of functional systems.&#x0D; Conclusion: The presented documents have not lost their significance even now. These documents are important for understanding the ideological essence of the systemic approach and of the theory of functional systems and are interesting for the history of Russian physiological science and medicine.

X-RAY SPECTRAL ANALYSIS OF CAPSULES OF FOREIGN BODIES OF SOFT TISSUES OF GUNSHOT ORIGIN IN DYNAMICS

The aim of the research is to determine and analyze the X-ray spectral composition of capsules around foreign bodies (CT) of soft tissues of fire origin.&#x0D; Materials and methods. As a material for X-ray spectrometric examination, soft tissues were removed, surgically removed together with an encapsulated foreign body of gunshot origin in 36 wounded in the period from 2 months to 23 years after the wound, who were treated at the Military Medical Clinical Center of the Northern Region of Ukraine. and in the State Institution «IZNH them. V.T. Zaitseva National Academy of Medical Sciences of Ukraine».&#x0D; Research results and their discussion. According to the results of X-ray diffraction analysis, the largest changes in trace elements were found, which show that heavy metals in the soft tissues of the body are broken down at the latest, but they can be identified most resistant to protective chemical processes: copper, zinc, lead (first group), which only 10 and 24 months after injury change their concentration twice. Conclusions. The data of X-ray spectral analysis in combination with morphological studies substantiate the expediency of removing CT of soft tissues of fire-fighting origin together with the capsule.

Prognostic evaluation models for primary thyroid lymphoma, based on the SEER database and an external validation cohort

PurposePrimary thyroid lymphoma (PTL) is a rare malignancy, and the literature is limited to small case series and case reports. This study aimed to assess the epidemiologic characteristics, survival, and prognostic factors of patients with PTL.MethodsWe analyzed 2215 PTL patients from the Surveillance, Epidemiology, and End Results database medical records, between 1983 and 2015, as the training cohort. We enrolled 105 patients from the Cancer Hospital, Chinese Academy of Medical Sciences, for the external validation cohort. The nomograms for predicting the 1-, 5-, and 10-year overall survival (OS) and lymphoma-specific survival (LSS) were constructed.ResultsPTL incidence steadily increased from 1977 to 1994, with an annual percentage change of 3.2% (95% confidence interval [CI]: 1.2–5.2, P < 0.05). The 1-, 5-, and 10-year OS and LSS rates were 84.66%, 71.61%, and 55.95%; and 90.5%, 85.7%, and 82.2%, respectively. Multivariate Cox regression analysis revealed that shorter OS association with age ≥ 60 years (hazard ratio [HR], 3.94; 95% CI 3.31–4.69; P < 0.001), unmarried status (HR, 1.55; 95% CI 1.37–1.75; P < 0.001), Ann Arbor stage III-IV (HR, 1.55; 95% CI 1.37–1.75; P = 0.020), diffuse large B-cell lymphoma (HR, 2.60; 95% CI 1.15–5.87; P = 0.022), and T cell non–Hodgkin lymphoma (HR, 3.53; 95% CI 1.12–11.10; P = 0.031). In the multivariate competing-risk analyzes, age, stages III-IV, year of diagnosis, surgery, radiation, chemotherapy, and histology were strongly predictive of PTL-specific risk of death. To estimate the 1-, 5-, and 10-year LSS and OS rates, respectively, nomograms were built. In the validation cohort, the results also confirmed the utility.ConclusionsThis study presents the first prognostic model with an external validation that could help clinicians identify patients with high-risk PTL to improve their prognosis.

Vladimir Filippovich Zelenin — the founder of clinical electrocardiography (to the 140th anniversary of the scientist)

Тhe article presents the facts of life and career of an outstanding Russian cardiologist, a talented organizer of medical science, a well-known public figure, a wonderful clinician and teacher, academician of the USSR Academy of medical Sciences, honored scientist of the Russian Soviet Federated Socialist Republic, Professor Vladimir Filippovich Zelenin.

Konstantin Mikhailovich Lisitsyn — an outstanding military field surgeon (to the 100th anniversary of the birth)

The article presents the facts of life and career of a prominent domestic field surgeon, a talented organizer, a well-known public figure, an excellent teacher, a remarkable surgical clinician, a corresponding member of the Russian Academy of Medical Sciences, laureate of the USSR State Prize, professor, lieutenant general of the medical service Konstantin Mikhailovich Lisitsyn.