Choice Of Tactic Research Articles

MODERN PSYCHOANTHROPOLOGICAL APPROACH IN THE STRUCTURE OF PSYCHIATRIC DIAGNOSIS, TREATMENT AND PSYCHOTHERAPY

During the period from 1987 to 2021 in the former USSR (Kazakhstan, Russia) and Israel over 3500 people were examined, the first group consisted of males with substance abuse and alcohol abuse in their diagnoses, both with the main diagnosis and in combination with comorbid pathology (1027). The second mixed group, consisted of men and women with only psychiatric diagnoses (1657 and 989), with schizophrenic spectrum disorders dominating among the diagnoses -70.7%. According to the constitutional type of skeletal structure, in the first group among the patients, asthenics accounted for 37%, and in the second group - 58.7%. Thus, asthenics proved to be the most vulnerable group with respect to the development of psychopathology, yielding only slightly to normosthenics in the first group (41% and 37%). An individual, in extreme conditions, which include stressful situations, frustrating circumstances and the disease itself, usually demonstrates basic priority behavioral tactics for resolving an unfavorable situation. The method of psycho-constitutional psychotherapy is based on an understanding of three characteristic basic behavioral tactics: "Patience" is the typical "freeze" behavioral tactic for hypersthenics, in other words, "wait it out. "Avoidance" is the "flight" behavioral tactic typical of asthenics, i.e., actively move away from the frustrating object or situation; "Persistence" is the normosthenic "fight" behavioral tactic, i.e., the maximum use of one's own volitional qualities to overcome the frustrating situation. The patient's ability to change and model the choice of a behavioral tactic by himself or herself considerably raises not only self-esteem, but also amplifies the psychotherapeutic effect. Regarding clinical practice of pharmacological treatment of psychiatric and drug addiction problems, certain regularities between the choice of a drug, it's possible side effects and the psychoconstitutional structure of the patient's personality have been found.

MODERN PSYCHOANTHROPOLOGICAL APPROACH IN THE STRUCTURE OF PSYCHIATRIC DIAGNOSIS, TREATMENT AND PSYCHOTHERAPY / СОВРЕМЕННЫЙ ПСИХОАНТРОПОЛОГИЧЕСКИЙ ПОДХОД В СТРУКТУРЕ ПСИХИАТРИЧЕСКОГО ДИАГНОЗА, ЛЕЧЕНИИ И ПСИХОТЕРАПИИ

During the period from 1987 to 2021 in the former USSR (Kazakhstan, Russia) and Israel over 3500 people were examined, the first group consisted of males with substance abuse and alcohol abuse in their diagnoses, both with the main diagnosis and in combination with comorbid pathology (1027). The second mixed group, consisted of men and women with only psychiatric diagnoses (1657 and 989), with schizophrenic spectrum disorders dominating among the diagnoses -70.7%. According to the constitutional type of skeletal structure, in the first group among the patients, asthenics accounted for 37%, and in the second group - 58.7%. Thus, asthenics proved to be the most vulnerable group with respect to the development of psychopathology, yielding only slightly to normosthenics in the first group (41% and 37%). An individual, in extreme conditions, which include stressful situations, frustrating circumstances and the disease itself, usually demonstrates basic priority behavioral tactics for resolving an unfavorable situation. The method of psycho-constitutional psychotherapy is based on an understanding of three characteristic basic behavioral tactics: "Patience" is the typical "freeze" behavioral tactic for hypersthenics, in other words, "wait it out. "Avoidance" is the "flight" behavioral tactic typical of asthenics, i.e., actively move away from the frustrating object or situation; "Persistence" is the normosthenic "fight" behavioral tactic, i.e., the maximum use of one's own volitional qualities to overcome the frustrating situation. The patient's ability to change and model the choice of a behavioral tactic by himself or herself considerably raises not only self-esteem, but also amplifies the psychotherapeutic effect. Regarding clinical practice of pharmacological treatment of psychiatric and drug addiction problems, certain regularities between the choice of a drug, it's possible side effects and the psychoconstitutional structure of the patient's personality have been found.

Dissociation of the results of caloric and video head impulse tests as a marker of Meniere's disease

The study of vestibular function in patients with Meniere's disease (MD) is an urgent task, since it influences the choice of treatment tactic. We evaluated the results of caloric and video head impulse (vHIT) tests in 76 patients who met the clinical criteria for significant Meniere's disease (AAO-HNS modified by the Barany Society, 2015). Dissociation of the results of caloric and vHIT tests is observed in the majority (74%) of patients with MD: at normal gain, according to vHIT data, hypofunction of peripheral vestibular structures is recorded according to the caloric test (KASL 47 ± 7.8%). In patients with MD, vestibular dysfunction is observed mainly at low frequencies (0.003 Hz), therefore vHIT, which allows assessing horizontal semicircular canal function at high frequencies (3-5 Hz), is not an optimal study for assessing the degree of vestibular dysfunction in patients with MD.

Current state of problem of disturbances of menstrual function at women with diffuse dysplasia of mammary glands

Diffuse benign dysplasia of the mammary glands is one of the frequent pathologies that practitioners almost daily encounter. Studying the mechanisms of development of pathological gynecological conditions, the researchers concluded that there is a pathogenetic connection between cyclic changes in the reproductive system and the physiological processes occurring in the mammary glands. This makes it possible to assume a high probability of occurrence of pathological changes in the mammary glands in various gynecological diseases, developing as a result of disorders of the hypothalamic-pituitary-ovarian system. The general inhibition and unity of the reaction of the reproductive organs to hormonal imbalance is the main prerequisite for the development of benign hyperplastic and the risk of malignant processes. The relevance of studying the reproductive health of patients with dyshormonal non-inflammatory pathology of the genital organs is due to the steady increase in the proportion of this pathology in recent years in the structure of gynecological morbidity, the rejuvenation of the patient population, and the lack of a single algorithm for rehabilitation measures. On the one hand, effective treatment reduces symptoms, guarantees quality of life, on the other hand, mastopathy is a risk factor for the development of a malignant tumor in the future. Therefore, timely correction of dysplasia can be considered as a variant of primary prevention of breast cancer. The choice of an adequate tactic to manage such patients from the existing variety of dosage forms is the key to the success of treatment.

Attentional Tendencies That Impact Emotion Regulation Success Within a Borderline Personality Disorder Framework

Emotion regulation difficulties are key to borderline personality disorder (BPD) symptomatology. Literature indicates that attentional distraction, particularly within an interpersonal context, is common in BPD. Conversely, reappraisal tactics are less prevalent. The goal of the current study was to examine whether this discrepancy is observed when individuals reporting varying levels of BPD tendencies are given the choice of a preferred emotion regulation tactic when confronted with BPD-relevant stressors. Attentional engagement patterns, affective responses, and strategy success were also examined. Participants (N = 103) reported BPD tendencies as assessed by the Personality Assessment Inventory and were instructed to choose either to "distract" or to "reappraise" in response to affective images. Results revealed more instances of failing to implement distraction among individuals with higher BPD tendencies, which was also reflected in greater fixation biases to distressing content within those images. Results are discussed in terms of the malleability of emotion regulation in BPD contexts.

The choice of tactic for surgical treatment of aortic arch hypoplasia with ventricular septal defect in infants

Aim: to determine the optimal tactic for surgical correction of aortic arch hypoplasia and ventricular septal defect (VSD) in infants based on the comparison of immediate and follow-up outcomes of one- and two-stage repair.Materials and methods. Between 2011 to 2019, 138 patients under the age of one year underwent surgical repair of aortic arch hypoplasia with VSD in the leading Ukrainina cardiosurgical institutions – National M. Amosov Institute of Cardiovascular Surgery Affilated to National Academy of Medical Sciences of Ukraine and Center for Pediatric Cardiology and Cardiac Surgery. Patients were divided into two groups: group I involved 66 (47.8 %) patients who underwent one-stage repai of aortic arch hypoplasia and VSD, group II included 72 (52.2 %) patients with two-stage repair, consisting of aortic arch reconstruction and pulmonary banding at the first stage, and correction of VSD at the second stage.Results. The total hospital mortality was 3.6 % (n = 5). In group I, hospital mortality was 3.0 % (n = 2), in group II – 4.2 % (n = 3), but this difference is not statistically significant (P > 0.05). Follow-up was from 1 month to 11 years. Mortality rate over follow-up period was 0 %. Aortic arch restenosis developed in 16 (11.6 %) patients: 6 (9.1 %) patients in group I and 10 (13.9 %) patients in group II. There was no statistically significant difference in restenosis development between two groups. Compression of the trachea and left main bronchus developed in two patients of group II (2.8 %). There were no residual VSDs which would need repeated repair.Conclusions. Both one-stage and two-stage tactic for surgical treatment of aortic arch hypoplasia with VSD in infants is effective and safe showing good immediate and long-term follow-up results. The study indicates that one- stage correction is more acceptable in infants with hypoplasia of segment C or all aortic arch segments. Stage tactic can be used in hypoplasia of segments B and A.

ANALYSIS OF TREATMENT OUTCOMES IN TRAUMA PATIENTS IN POLYTRAUMA CENTER

Introduction. Severe trauma is one of the leading causes of disability and mortality in all age groups. Long bone fractures of lower extremities, in particular the femur, have increased risk of complications. The choice of surgical treatment tactic, timing and methods of fixing of long bone fractures of lower extremities in patients with severe associated trauma is relevant and controversial issue.Objective: to conduct a retrospective analysis of injury structure in polytrauma center and evaluate treatment outcomes in polytrauma patients with multiple long bone fractures of lower extremities, frequency of complications and mortality.Materials and methods: the retrospective study was conducted, included a group of patients had applied to the admission department of Kyiv City Clinical Hospital No17 during the period from January 2010 to December 2019.Results: the study included 54,613 patients at the first stage. 69.3% of patients were received outpatient care, 30.7% were hospitalized. Among all patients, 13.7% were diagnosed with polytrauma, of which 80.2% had chest injury, 78.4% had traumatic brain injury, and 71.1% had musculoskeletal injuries. In the structure of musculoskeletal system trauma the multiple bone fractures of lower extremities were in 16.7% of patients, among them long bone fractures were in 57.6%.The study included 220 patients at the second stage. The incidence of pulmonary embolism occurred in 4.1% of patients, fat embolism – 12.7%, nosocomial pneumonia was diagnosed in 38.2% of patients, acute respiratory distress syndrome (ARDS) – 16.8%. The incidence of sepsis, according to the criteria of definition «Sepsis II» was 30.9%, according to the criteria «Sepsis III» – 9.5%, multiple organ failure (MOF) – 18.6%.The duration of mechanical ventilation was 19.1±10.8 days. The length of stay in intensive care unit was 24.8±12.6 days and the hospital length of stay was 48.9±22.4 days. The mortality rate was 22.3%. Among the main causes of death – hemorrhagic shock (46.9%), MOF (34.7%), refractory septic shock 18.4%.Conclusions: the frequency of polytrauma was 13.7% in trauma structure and frequency of polytrauma with combined multiple long bone fractures of lower extremities – 0.5%. Most common localizations of injuries were chest trauma (78.6%), traumatic brain injury (73.6%), injuries of musculoskeletal system (71.1%). Multiple bone fractures of lower extremities were in 16.7% of patients in the structure of musculoskeletal system trauma, among them fractures of long bones were in 57.6% of patients.Ultrasound examination according to the protocol «Focused Assessment with Sonography for Trauma» (FAST) and whole body computed tomography were not performed after patient hospitalization in 100% of cases, as required by international protocols. The frequency of Early Total Care tactics application – 1.4% that was too low, the definitive osteosynthesis in some cases was performed unreasonably late, and 17.2% of primary and definitive cases and 23.9% of temporary stabilization of fractures were performed by conservative methods.The most common complications were pulmonary: nosocomial pneumonia, ARDS and fat embolism syndrome, and also sepsis and MOF.

Organ-preserving Operations on Uterus with Placenta Accreta: Clinical Experience

Introduction. The aim of our work was to improve surgical delivery procedures in patients with a true placenta accreta. Materials and methods . We analysed 17 childbirth histories of patients who underwent organ-preserving surgeries on uterus during placenta rotation in 2018-2019. The choice of an optimal tactic for managing patients in the department of pregnancy pathology at the BSMU clinic, as well as each case of the surgical treatment of placenta accrete, was carried out jointly with specialists from I.M. Sechenov First Moscow State Medical University. Results and discussion . All patients underwent surgery in a planned manner; their age and parity had no static differences (p > 0.1). The surgery performed according to the described technique did not lead to a significant increase in its duration. Additionally, the average blood loss of 2200 ml during surgery was not considered significant for this type of operations. We believe that these indicators will decrease with the accumulation of practical experience in performing such interventions. Conclusion. The applied method of surgical intervention using temporary occlusion of the common iliac arteries has shown a high efficiency and allowed the amount of intraoperative blood loss to be reduced. Despite performing a bottom incision on the uterus to remove the fetus and excise the area of placenta rotation, the examined patients did not experience significant complications both during the surgery and in the early and late postoperative period. The first results allow this technique to be recommended as a method of choice during placenta rotation The monitoring of patients will continue.

Experience of using herbal medicine sinupret for patients with chronic maxillary sinusitis during the post-surgery period

The choice of an optimal tactic for chronic rhinosinusitis treatment is a very topical issue in otorhinolaryngology. Several pieces of existing literature report a positive impact of a herbal-based remedy Sinupret for patients in the post-rhinosurgical period. Objectives of the study: The investigation of the effect of Sinupret on patients with chronic maxillary sinusitis in the early postoperative period.Materials and methods: 15 patients with chronic rhinosinusitis were examined. The age of patients ranged from 20 to 57 years. The examination of patients was carried out right before the surgery and three months after it. The examination also included general otorhinolaryngological examination, assessment of the overall severity of the disease on the VAS scale, endoscopy of the nasal mucosa, assessment of nasal breathing function based on the analysis of the main indicators of anterior active rhinomanometry and computed tomography of the paranasal sinuses. Two days before their surgery, each patient was prescribed to take two tablets of Sinupret 3 times a day up to 14 days.Results: By day 10 of the post-surgery period, all patients reported noteworthy improvement in nasal breathing, a significant decrease in nasal discharge and no discomfort in the projection of the paranasal sinuses. There was a substantial decrease in the severity of oedema, exudation and formation of crusts, fibrin in all examined patients with rhinoscopy. According to the anterior active rhinomanometry, a statistically significant increase in the total nasal flow and a decrease in nasal resistance to physiological values were established 3 months after surgery. Conclusion: This article presents the results of Sinupret usage in the combined therapy before and after surgical treatment of patients with chronic rhinosinusitis and abnormal development of nasal structures. The results of that 14-day treatment evidenced an acceleration of epithelialization and restoration of drainage; as well as an improvement of ventilation function of the nasal cavity and paranasal sinuses. In addition to that, the chosen treatment contributed to the reduction of the rehabilitation period and the absence of relapses of chronic maxillary sinusitis was observed.

Порушення менструальної функції у жінок із дифузною дисплазією грудних залоз

Diffuse benign dysplasia of the mammary glands is one of the frequent pathologies that practitioners almost daily encounter. Studying the mechanisms of development of pathological gynecological conditions, the researchers concluded that there is a pathogenetic connection between cyclic changes in the reproductive system and the physiological processes occurring in the mammary glands. This makes it possible to assume a high probability of occurrence of pathological changes in the mammary glands in various gynecological diseases, developing as a result of disorders of the hypothalamic-pituitary-ovarian system. The general inhibition and unity of the reaction of the reproductive organs to hormonal imbalance is the main prerequisite for the development of benign hyperplastic and the risk of malignant processes. The relevance of studying the reproductive health of patients with dyshormonal non-inflammatory pathology of the genital organs is due to the steady increase in the proportion of this pathology in recent years in the structure of gynecological morbidity, the rejuvenation of the patient population, and the lack of a single algorithm for rehabilitation measures. On the one hand, effective treatment reduces symptoms, guarantees quality of life, on the other hand, mastopathy is a risk factor for the development of a malignant tumor in the future. Therefore, timely correction of dysplasia can be considered as a variant of primary prevention of breast cancer. The choice of an adequate tactic to manage such patients from the existing variety of dosage forms is the key to the success of treatment. Key words: mammary glands, uterine myoma, dyshormonal breast diseases, mastopathy, diffuse dysplasia, fibro-cystic disease, progestogens, phytotherapy, transdermal progestogens.

INFLUENCE LEVEL OF EXPRESSION OF SEX HORMONES RECEPTORS ON THE EFFECTIVENESS OF HORMONAL TREATMENT OF ENDOMETRIAL HYPERPLASIA WITHOUT ATYPIA

It is now believed that the leading role in the development of EH belongs to excessive estrogen stimulation, combined with a lack of progesterone effects. However, not only the concentration of hormones in the blood and tissues determines the degree of their effect on cells, but in the first place the cell’s response depends on the expression of the receptors to them.Materials and methods. A prospective immunohistochemical study of expression of estrogen receptors and progesterone in 45 women of reproductive age with histologically confirmed endometrial hyperplasia without atypia in specimens of uterine cavity scars was performed. All women received micronized progesterone therapy in continuous mode for 6 months, followed by morphohistological examination of endometrial scabies. By the level of expression of progesterone receptors, all women were divided into two groups: low and high expression of receptors.Results of the research and their discussion. The obtained data showed that in all groups of women with hyperplasia, high expression of estrogen receptors was observed. In the group of women with high expression of progesterone receptors, after treatment, in all cases normalization of the trophic endometrium, which is characteristic of the phase of the menstrual cycle, was observed in all cases. In the group of women with low expression of progesterone receptors, a 13.2% progression was observed, 57.8% had re-diagnosed hyperplasia without atypia, and 29% normalized the histological picture.Conclusions. The level of expression of progesterone receptors should be taken into account in the appointment of hormonal therapy and the choice of therapeutic tactics in patients with EH without atypia. Low expression of progesterone receptors in the endometrium leads to a reduction in the effect of treatment with progestogens and requires the choice of another treatment tactic.

Terrorist Group Types and Tactic Choice

ABSTRACTUsing a new dataset, this study examines the role of ideology on specific operational decisions within terrorist groups, namely choice of tactic. Five groups are considered: nationalist/separatist, left wing, right wing, and environmental groups. This study posits that ideology is a driving force for tactic choice, while resources mitigate these decisions. It also considers the role of time, namely Rapaport's waves of terrorism, and the role of the Internet on group decision making. Results indicate that group types are distinct in terms of their tactic choices, conveying the importance of introducing ideology as context when examining terrorist group behavior.

Effect of fisher’s soak tactic on catch pattern in the Danish gillnet plaice fishery

Soak duration in the gillnet fisheries can vary from a few hours to several days. The industry reports a variation of soak tactics between target species, but also between seasons for the same species. These are determined by the robustness of the target species and the catch of unwanted species. Different soak tactics were compared to estimate the role that the choice of a soak tactic plays in the catch efficiency of both target and unwanted species. In the Danish summer gillnet fishery targeting plaice (Pleuronectes platessa), nets are deployed approximately 12h (h) during day. Unwanted species are common dab (Limanda limanda) and edible crab (Cancer pagurus). The commercially used 12h deployment during day was compared to 12h deployment during night and 24h deployment. On average, there were about 1.5 more catches of commercial size plaice (above 27cm), and 2 and 4 times less catches of the unwanted dab and edible crab, respectively, for 12h at day compared to the other soak tactics (12h at night or 24h). Gillnetters participating in the coastal summer fishery for plaice follow the theoretical optimal soak tactic. The commercially used 12h deployment during day maximises the catch of commercial sized plaice and limits handling time by catching less unwanted dab and crabs.

Intrathoracic (mediastinal) goiter. A clinical case

Using a clinical case as the example the article sheds light on the issues of diagnosis and surgical treatment of intrathoracic goiter. A comprehensive approach to the problem which allows the most radical implementation of surgical treatment and involves thoracic and endocrine surgeons is taken into consideration. The intrathoracic goiter, which constitutes 16-37% of all cases of mediastinal tumors, can be removed by thoracic surgeons with the neck part of the thyroid gland left without surgical attention, which leads to reoperations. At the same time the intrathoracic part of the thyroid gland, occurring in 0.1-0.5% of cases among all the operated goiters, remains unnoticed by endocrine surgeons. In our case the diagnosis of intrathoracic goiter was proved in 56-year-old woman by the multispiral CT after the separated node of thyroid tissue was suspected by ultrasound examination and palpation. It was decided to carry out a joint operation. Under the conditions of the thoracic center the patient underwent cervicotomy, right-sided mid thoracotomy and extrafascial thyroidectomy. The neck part of the thyroid gland was removed with extrafascial standard exposure according to Kocher. The thoracic part was removed with thoracotomy exposure. If the multinodular goiter is localized in posterior mediastinum the transverse size of aperture should be considered for the choice of surgery tactic: in cases the latter is

Вiomechanical rationale for the choice of surgical tactic for treatment of distal femur fractures consolidation disturbances

Objective: to study stress-strain distribution in osteosynthesis model with non-union of distal femoral fracture and to define the most effective ways of injury fixation. Methods: finite ele­ment model of distal femur with different length are created, which is determined by distance (3 and 10 cm) from the top edge to the fracture line of lateral condyle. To fix the fracture used: blocked intramedullary rod, LCP-plate and 95° bladed plate. The area of contact between the fragments was 50 %. To load the appropriate models applied in the natural two-limb standing and flexion of knee joint with rotatory displacement. Results: it is revealed that for all model rotary load is critical in terms of stress in bone tissue, locking elements and structures in general and displacement of fragments of bones. In a case of fracture localization in the epiphyseal part of the femur, safer fixation of short distal fragment provides LCP-plate, so it should be used in such cases. Given the non-union location in the distal diaphy­ses of the femur bone stress are smallest and largest system sta­bility «bone – fixation device» to load strains provides model with blocked intramedullar nail. Therefore, for fixation of frac­ture consolidation problems in the distal femur blocked nail is recommend. Conclusions:the obtained results allow to jus­tify the method of surgical treatment of patients with impaired consolidation of the distal femur fracture, ie. to select fixation device depending on the injury level and the length of distal fragment.

On fitness and partial migration in a large herbivore – migratory moose have higher reproductive performance than residents

Partially migratory populations comprise both resident and migratory individuals. These tactics may coexist if their demographic contribution to future generations (i.e. fitness) are equal or vary temporally with environmental conditions, or if individuals switch between being migrant and resident. Alternatively, the choice of movement tactic can be based on individual attributes such as age, competitive ability or personality. In the latter cases, the two tactics are not expected to have similar average fitness. In this study, we examined the effect of movement tactic on reproductive performance and survival of 82 GPS‐marked female moose and their offspring in a partial migratory population in central Norway. The results indicated higher growth in the migrating part of the population because migrating females produced more twins than resident females. We found no differences in pregnancy rates or survival of adults or their offspring, indicating a net fitness benefit of being migrant. We found the average shoulder height of residents to be slightly lower than of migrants, but doubt that this affected their migration ability. A more likely explanation is that migratory females are both more fecund and grow bigger because of better conditions in their summer ranges. This may be a temporal phenomenon if the fitness differences between migratory and resident moose vary according to environmental fluctuations.

Surgical treatment of low grade spondylolisthesis: the modern state of the problem

The paper presents a literature review on contemporary problems of surgical treatment of low grade spondylolisthesis. The results of various surgical techniques including modern minimally invasive methods of treatment are provided. The importance of selecting a method of surgical intervention depending on the type of spondylolisthesis, sacro-pelvic balance, and global sagittal balance is indicated, as well as their influence on the quality of life of patients. Complications and causes of pseudoarthrosis development depending on different methods of interbody fusion are discussed. The choice of optimal treatment tactic is the main problem in surgery of low grade spondylolisthesis.

Managerial tactics for communicating negative performance feedback

Purpose – Delivering negative feedback to employees is highly problematic for managers. Negative feedback is important in generating improvements in employee performance, but likely to generate adverse employee reactions. However, if managers do not address poor performance, good performers may become demoralized or exit the organization. The purpose of this paper is to investigate how managers communicate negative feedback and the factors that drive their choice of tactic. Design/methodology/approach – The authors use interview data from practicing line managers with experience in delivering negative feedback to learn whether their tactic choices are consistent with Implicit (“best practice”) or Contingency (“best fit”) theory. Findings – The authors identify five negative feedback tactics: evidence, emotive and communication tactics are foundation tactics while evidence + communication and evidence + emotive tactics are bundles of the foundation tactics. Managers apply a “best fit” approach from a set of “best practice” negative feedback options. The choice of negative feedback tactic is driven by the manager’s assessment of the “best fit” with the employee’s personality. Research limitations/implications – Most of the managers believed that their negative feedback tactic had been effective. Future researchers should investigate which negative feedback tactics employees regard as most effective. Practical implications – A best fit approach to the delivery of negative feedback requires organizations to give managers discretion in the delivery of negative feedback. Managers may mis-assess fit which can undermine the effectiveness of the appraisal process. Originality/value – The authors focus on how negative feedback is communicated by managers. Existing research focusses on reactions to negative feedback without taking into account how it is delivered.

Role of definition of clonogenic activity of stromal bone marrow stem cells in patients with aseptic necrosis of the femoral head

A problem of choice of medical tactic for patients with avascular necrosis of the femoral head (ANFH) is extremely topical. It is very important to focus ones main efforts on either organ salvage surgical interventions or on improvement of a technique for total hip replacement. Largely as a solution to this problem designation of regenerative potential of bone tissue by culturing fibroblast colony-forming units (CFU-F) can help. Objective: To obtain data for the development of a differentiated approach to the treatment strategy by examining the clonogenic activity of stem bone marrow stromal cells in patients with ANFH. Methods: As a material for this study were samples of cancellous bone of the femoral head in 26 patients with ANFH at different stages of the disease. There were grown 36 cultures of stromal fibroblasts. We have estimated such parameters as total number of nucleated cells, the number of stem stromal cells - colony-forming units of fibroblast in the bone marrow of 1 cm3 and the effectiveness of their cloning among 105 nucleated cells. Results: It was found that as the disease progresses the ability to stem bone marrow stromal cells to ensure the reduction reactions in bone tissue loose quite rapidly. According to the results of the research the most significant negative effect on the proliferation and differentiation of stem bone marrow stromal cells of the proximal femur in patients with ANFH are such factors as alcohol abuse and exposure to toxic compounds. Conclusions: ANFH is one of the most critical diseases of the hip joint pathology in terms of oppression of the potential ability of bone remodeling and restoration. The regenerative potential of bone in patients with ANFH is significantly higher in the early stages of the disease.

SIGNIFICANCE OF СD4+ Т-LYMPHOCYTE POPULATIONS MONITORING FOR DIAGNOSING AND FORECASTING OF ORGANISM REACTION ON TRANSPLANT

In this review article the necessity of adaptation and introduction into clinical practice of simultaneous monitoring of immune blood cells and cytokines in patients with grafted organs for a choice of individual tactic of immuno- suppressive therapy, determination of its ef fi ciency and forecasting is proved. It is emphasized, that with the spe- cial attention it ought to concern to characteristic of CD4 + T-lymphocytes and to de fi nition of an interrelation of their separate populations in peripheral blood (Treg, Th17, Tact memory cells – CD4+CD25 hi CD127 hi CD45RO) since they are the basic participants of immune system reaction on grafts.