Correct Management Research Articles

Spine to pelvis “T-Construct” using magnetic controlled growing rods in non-walkers neuromuscular early-onset scoliosis: a preliminary study

BackgroundsMagnetic controlled growing rods (MCGRs) have been proven to be effective in controlling early onset neuromuscular scoliosis but no study has evaluated the combination with a sacro-bi-iliac construct. The aim of our study is to report surgical management of early onset non-walkers neuromuscular scoliosis correction using MCGRs associated with a sacro-bi-iliac “T-construct” and its mid-term outcomes. Our hypothesis was that this set-up provided well correction of the pelvic obliquity and that this correction was maintained over time. MethodsA retrospective single-center study was conducted including all consecutive neuromuscular early onset scoliosis who underwent spinopelvic fixation using “T-construct” with two MCGRS. Four millimeters lengthening was performed every 4 months during outpatient clinics sessions. All children had a low-dose biplanar stereoradiography in EOS-Chair at pre/postoperative phase, each outpatient clinic appointment and last follow-up. ResultsEighteen patients were included and 17 analyzed at the last follow-up. The mean age at surgery was 9.5 (range from 5 to 12 years), the mean follow-up was 4,7 years (range from 2.5 to 6.6 years) and 8 patients had a Risser stage above four. The global complication rate was 35% (N = 6/17 patients) including three medical and three mechanical complications related to “T-construct”, while the reoperation rate was 18% (N = 2 patients for wound debridement and one for iterative pelvic fixation). Cobb angle and pelvic obliquity were significantly improved by surgery (mean correction was 33.2 ° (55%) and 11 ° (77%) respectively; p < 0.001). At the last follow-up, we noted a loss of frontal Cobb angle correction (p < 0.01) whereas we did not observe any significant loss of pelvic obliquity (p > 0.9). ConclusionsAlthough the global complication rate was 35% (half of which are mechanical complications), the treatment combining pelvic T-construct and MCGRs provides satisfactory correction of pelvic obliquity correction, good maintenance in the medium term and may be a procedure to consider for the surgical treatment of early onset neuromuscular scoliosis. Level of evidenceIV; Retrospective cohort prognostic study

Biomechanical effect between conventional and 3-dimensional printed customized foot orthoses on medial longitudinal arch support and rearfoot angle in adults with flexible flatfeet.

Customized foot orthoses are used to treat flexible flatfoot regarding medial longitudinal arch (MLA) support, alignment correction, and pain management. Recently, 3-dimensional (3D) printing orthosis has become the focus of discussion regarding function and manufacturing. We aimed to investigate differences in biomechanical effects between flat insole (Flat), conventional foot orthosis (Cinsole), and 3D printed foot orthosis (3Dinsole) use on MLA support and rearfoot alignment during walking in adult flexible flatfeet. Twelve men with flexible flatfoot were recruited. Data were collected and analyzed using a Vicon motion capture system under 3 trial conditions: Flat and >1 month after using Cinsole and 3Dinsole. Repeated-measures analysis of variance with Bonferroni post hoc tests was used to compare kinematics variables, foot pain, and satisfaction. Dynamic navicular drop significantly reduced with the use of the Cinsole and 3Dinsole compared with Flat (P < 0.001; ηp2 = 0.65). The maximum rearfoot eversion angle with the use of the Cinsole and 3Dinsole significantly reduced from Flat (P < 0.001; ηp2 = 0.56). Foot pain score significantly decreased after using foot orthoses; satisfaction between Cinsole and 3Dinsole was not significantly different. Thus, Cinsole and 3Dinsole are effective alternative treatments of MLA support and rearfoot alignment in adults with flexible flatfoot. 3D printing is a future technology with potential to replace conventional production methods. However, material characteristics, design, and manufacturing process can affect treatment outcomes; hence, our results may not represent all variations of 3D printed foot orthoses.

THE IMPACT OF ISLAMIC COUNSELING ON THE MENTAL HEALTH OF PRISONERS IN YOGYAKARTA CORRECTIONAL INSTITUTION

Prisoners’ mental health is an important issue in the correctional context. Various counseling methods have been used to improve the mental welfare of prisoners, one of which is Islamic counseling which is based on Islamic teachings. This research aims to examine the impact of Islamic counseling on the mental health of prisoners in the Yogyakarta Correctional Institution. This research uses a quantitative method with a quasi-experimental design. The research sample consisted of 60 randomly selected prisoners and was divided into two groups from the experimental group who received Islamic counseling and the control group who did not receive the intervention. Data were collected through a validated mental health questionnaire, and analyzed using t-test to determine whether there were differences before and after the intervention in the two groups. The results showed that there was a significant improvement in the mental health of prisoners who received Islamic counseling compared to the control group (p&lt;0.05). Islamic counseling was effective in reducing the levels of stress, anxiety, and depression among the inmates. Islamic counseling has a positive impact on the mental health of prisoners in Yogyakarta Correctional Institution. The results of this research provide practical implications for correctional institution managers in developing faith-based counseling programs to improve the mental welfare of prisoners.

Transforming the Judicial System: The Impact of Machine Learning on Legal Processes and Outcomes

This paper explores the transformative impact of Machine Learning (ML) on legal processes and outcomes within the judicial system, aiming to analyze current applications, evaluate benefits and challenges, and assess ethical and practical implications. A comprehensive methodology is employed, including a literature review of academic articles, industry reports, and legal documents, case studies of specific ML tools like Correctional Offender Management Profiling for Alternative Sanctions (COMPAS) and ROSS Intelligence, and interviews with legal professionals, data scientists, and ethicists. Key findings reveal that ML enhances efficiency, accuracy, and accessibility in legal processes, with applications in recidivism prediction, legal research, e-discovery, and online dispute resolution. For instance, tools such as COMPAS aid in predicting recidivism rates, while ROSS Intelligence and CaseText streamline legal research through Natural Language Processing (NLP). However, significant challenges arise, particularly concerning data privacy, algorithmic bias, and the ethical implications of automated decision-making, as evidenced by criticisms of the COMPAS system for potential racial bias. The research underscores the necessity of interdisciplinary collaboration between legal experts and data scientists to develop robust and legally sound ML tools. The implications of these findings are profound, calling for clear policies and regulations to ensure transparency and fairness, the development of ethical frameworks to address bias and privacy concerns, and the provision of education and training for legal professionals in data science and ML. The paper concludes that continuous research and refinement of algorithms are essential to address emerging challenges and expand the beneficial applications of ML in the legal field, contributing to a more efficient, equitable, and accessible judicial system.

Development and implementation of a self-directed violence prevention training program for correctional behavioral health providers: a clinical trial study protocol

BackgroundSelf-directed violence (SDV) comprises both suicide and self-injury and represents a pressing problem among incarcerated persons. Negative impacts of SDV in correctional settings also extend to behavioral health clinicians (BHCs) (e.g., job turnover). Correctional SDV risk assessment and management standards include staff training as part of the comprehensive approach. The Core Competency Model for Corrections (CCM-C) is a novel, evidence-informed training program for BHCs covering both clinician self-management and clinical care skills.MethodsThis pilot trial is a type 3 hybrid implementation–effectiveness approach. It will employ a wait-list control sequential cross-over design. Participants (N = 50–100) will be BHCs employed by the North Carolina Department of Adult Corrections. Following stratification for years of clinical experience, BHCs will be randomly assigned to (1) a training group that receives CCM-C immediately and (2) a wait-list control receiving CCM-C approximately 6 weeks later. Electronically administrated survey evaluation will occur across baseline and two follow-up (i.e., 2 weeks after each training session) time points.DiscussionThe primary outcome is feasibility assessed through collaboration with a Corrections Advisory Panel and feedback from BHCs. Secondary effectiveness outcomes that will be evaluated over time include SDV-related knowledge, attitudes, stigma, and intent to use training content. We will examine a tertiary outcome, namely compassion fatigue. Clinical trial limitations and impacts are discussed.Trial registrationClinicaltrials.gov, NCT06359574. This study was registered on 04/05/2024.

Popliteal artery aneurysm in pediatric population: a review

Popliteal artery aneurysm is a dilation greater than 1.5 cm in the diameter of the popliteal artery. It is a rare condition in children, which is frequently associated with connective tissue disorders or traumatic events. Clinically, it can present as a pulsating mass in the popliteal region, accompanied by pain and thrills in symptomatic cases. Diagnosis is made using Doppler ultrasound, although advanced techniques such as angiography can be used for more detailed evaluation. Management varies depending on the size and symptoms, with open surgery being the preferred treatment for aneurysms larger than 2 cm, with endovascular options reserved for specific circumstances; however, they are not recommended in young patients due to the high risk of stent rupture. Complications include thrombosis, infection, and limb loss in cases of aneurysm rupture without any corrective management.

Algorithm for forming a set of indicators of international trade customs regulation effectiveness in the EAEU member states

The relevance of the study is due to the fact that international trade globalization and intensification increase competitiveness of not only domestic but also foreign producers, so the business sector expects to facilitate business conditions, simplify customs procedures, increase customs activities efficiency, and improve customs services provision. Goods transportation across the customs borders of countries around the world presents challenges in filling out documentation, transportation methods, information processing, and compliance with regulations that are not internationally harmonized. It leads to customs laws violations that must be detected during the customs control process. Consequently, customs regulation effectiveness will depend directly on the customs control results. The article presents a theoretical and methodological description of the procedure for assessing international trade customs regulation effectiveness in the EAEU member states, as well as a vector for developing a comprehensive set of performance indicators. The proposed assessment algorithm and the set of quantitative and qualitative indicators can be regarded as fundamental interrelated criteria that ensure improvement of efficiency of control over the customs authorities’ activities and corrective management decisions, if necessary. The application in customs practice of the proposed indicators for assessing international trade customs regulation effectiveness will contribute to customs policy effective implementation for the harmonious development of the EAEU member states’ economies, including Russia, in modern society and the basis of their sustainable political, economic and social development.

Segmentation of Thoracic Organs through Distributed Extraction of Visual Feature Patterns Utilizing Resio-Inception U-Net and Deep Cluster Recognition Techniques.

Segmentation of medical images plays a key role in the correct identification and management of different diseases. In this study, we present a new segmentation method that meets the difficulties posed by sophisticated organ shapes in computed tomography (CT) images, particularly targeting lung, breast, and gastric cancers. Our suggested methods, Resio-Inception U-Net and Deep Cluster Recognition (RIUDCR), use a Residual Inception Architecture, which combines the power of residual connections and inception blocks to achieve cutting-edge segmentation performance while reducing the risk of overfitting. We present mathematical equations and functions that describe the design, including the encoding and decoding steps within the UC-Net system. Furthermore, we provide strong testing results that show the effectiveness of our method. Through thorough testing on varied datasets, our method regularly beats current techniques, achieving amazing precision and stability in organ task segmentation. These results show the promise of our residual inception architecture in better medical picture analysis. In summary, our research not only shows a state-of-the-art segment methodology but also reinforces its usefulness through thorough testing. The inclusion of residual inception architecture in medical picture segmentation offers good possibilities for improving the identification and management of disease planning.

Environmental and behavioral variables associated with lower urinary tract diseases in domestic cats

Objectives: Feline lower urinary tract disease (LUTD) is a frequently seen disease with multiple etiologies. Since it is a complex condition, the aim of this study is to evaluate the factors that may affect the development of the disease.&#x0D; Materials and Methods: Demographic, clinical, behavioral and environmental parameters of 30 cats diagnosed with lower urinary tract disease and 15 aged-matched healthy cats presented to Ankara University Small Animal Hospital were evaluated. &#x0D; Results: In the diseased group, the male population was higher and the cats were overweight. The number of food, water and litter boxes and litter material were found to differ significantly between groups. Daily habits such as playing with a scratching board and self-grooming differed between the groups. Inappropriate behaviors observed by the owners of the cats in the first group were listed as urinating/defecating outside the litter box and showing aggression towards the owner, guests, and/or other animals. &#x0D; Conclusions: The results of this study show that the detailed evaluation and regulation of the daily needs of cats is important for the emergence or recurrence of the disease and therefore may contribute to the correct management of the treatment process in cats with lower urinary tract disease.

Effect of hypothyroidism on short-term outcomes after autologous and implant-based breast reconstruction.

Hypothyroidism has high prevalence in elderly women, which overlaps with the patient population who opt for post-mastectomy breast reconstruction. While hypothyroidism was shown to impact outcomes in other surgeries, its effect on breast reconstruction has not been established. This study aimed to compare the short-term outcomes of patients with and without hypothyroidism who underwent autologous (ABR) and implant-based breast reconstruction (IBR), respectively. Patients having ABR or IBR were identified in the National Inpatient Sample from Q4 2015-2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients with and without hypothyroidism, adjusted for demographics, socioeconomic status, comorbidities, and hospital characteristics. There were 12,765 patients underwent ABR, where 1591 (12.46%) of them had hypothyroidism, while 17,670 patients had IBR with 1,984 (11.23%) having hypothyroidism. Hypothyroid patients had a higher risk of hemorrhage/hematoma (aOR = 1.254, 95 CI 1.079-1.457, p < 0.01) after ABR. However, there were no differences in terms of mortality and organ system complications, nor wound dehiscence, superficial/deep wound complications, seroma, flap revision, excessive scarring, venous thromboembolism, pulmonary embolism, vascular complications, infection, sepsis, transfer out, length of stay (LOS), nor hospital charge between patients with and without hypothyroidism after ABR. All postoperative outcomes were comparable between hypothyroid patients and controls after IBR. While breast reconstruction is generally safe for hypothyroid patients, preoperative screening for hypothyroidism may be beneficial for those undergoing ABR. In ABR, hypothyroidism correction and blood management may help prevent bleeding complications in hypothyroid patients. Future studies should explore the long-term prognosis of hypothyroid patients after breast reconstruction.

SCHWANNOMA OF THE HEAD AND NECK REGION: A CASE SERIES IN A TERTIARY HEALTH CENTRE IN WESTERN ODISHA

Objective: Schwannoma is a benign peripheral nerve sheath tumour. Previously referred to as Neurilemmomas. It is a slow-growing tumour. The commonest site is the limb with a predilection to the upper limb. But, it has a 25–48% predilection for nerves of the head and neck. In the oral cavity, the commonest site is said to be the tongue. Methods: We report three cases of histopathologically diagnosed Schwannoma at unusual sites. The first case was a 52 y old lady with a palpable, firm, painless swelling in the occipital region of the scalp of size 2.0 x 1.0 x 1.0 cm. The second case was a 29 y old woman with a painless scalp swelling of 1 cm by 1 cm. The third case was a 23 y old boy who presented with a slow-growing and painless pedunculated swelling in the posterior pharyngeal wall for a year. All cases showed classical histopathologic pictures on microscopy. Results: All the patients were evaluated pre-operatively and subjected to an excisional biopsy. The post-operative period was uneventful and everything went according to plan for a full year. Conclusion: Schwannomas exhibit a slow growth rate, are present in all age groups, and are not specific to one gender. Extremities are the most common locations to occur, but some rare sites like the scalp, oral cavity, retroperitoneum, and internal viscera also exist. Magnetic resonance imaging (MRI) is helpful in those lesions, providing useful information about the location and nature of the lesion, eliminating differential diagnosis, and thus providing correct management plans.

Prolactin effects on the pathogenesis of diabetes mellitus.

Prolactin (PRL) is a pituitary hormone promoting lactation in response to the suckling reflex. Beyond its well-known effects, novel tissue-specific and metabolic functions of PRL are emerging. To dissect PRL as a critical mediator of whole-body gluco-insulinemic sensitivity. PubMed-based search with the following terms 'prolactin', 'glucose metabolism', 'type 2 diabetes mellitus', 'type 1 diabetes mellitus', 'gestational diabetes mellitus' was performed. The identification of the PRL-glucose metabolism network poses the basis for unprecedented avenues of research in the pathogenesis of diabetes mellitus type 1 or 2, as well as of gestational diabetes. In this regard, it is of timely relevance to define properly the homeostatic PRL serum levels since glucose metabolism could be influenced by the circulating amount of the hormone. This review underscores the basic mechanisms of regulation of pancreatic β-cell functions by PRL and provides a revision of articles which have investigated the connection between PRL unbalancing and diabetes mellitus. Future studies are needed to elucidate the burden and the role of PRL in the regulation of glucose metabolism and determine the specific PRL threshold that may impact the management of diabetes. A careful evaluation and context-driven interpretation of PRL levels (e.g., pregnancy, PRL-secreting pituitary adenomas, drug-related hyper- and hypoprolactinemia) could be critical for the correct screening and management of glucometabolic disorders, such as type 1 or 2 as well as gestational diabetes mellitus.

SUSTAINABLE ACTIONS AND WASTE MANAGEMENT IN DENTISTRY

Purpose: Examine the social and economic functions of companies and their actions, mainly regarding the protection and use of natural resources, minerals and the disposal of contaminated materials.&#x0D; Theoretical Framework: The government created regulations that thoroughly describe the management, classification and importance of implementing a Health Service Waste Management Plan in all health institutions.&#x0D; Design/Methodology/Approach: It is an exploratory case study, which compared the disposal of Health Service Waste in two dental clinics.&#x0D; Findings: The clinics' Health Service Waste Management Plan aims to minimize the production of waste, treat it and send it safely to its final destination, which prevents and controls occupational, public health and environmental risks environment.&#x0D; Research, Practical &amp; Social Implications: We suggest that knowledge of the standards and monitoring of their compliance, together with the education and training of professionals who deal directly or indirectly with Health Service Waste, to create awareness and change habits.&#x0D; Originality/Value: Taking measures based on saving resources, preserving the environment, ethics and responsibility can guarantee a healthier future for future generations, where dental professionals learn about the correct management of waste and their participation in maintenance the environmental integrity of the planet.

ПРОЯВЛЕНИЕ ГИПЕРКОАГУЛЯЦИОННОГО СИНДРОМА У ПАЦИЕНТКИ С МНОЖЕСТВЕННОЙ МИОМОЙ МАТКИ БОЛЬШИХ РАЗМЕРОВ

When analyzing the features of the manifestation of hypercoagulation syndrome in a patient with multiple large uterine fibroids, it was revealed that in this clinical case the patient had one of the variants of the syndrome Gardner, which can be confirmed by the fact that the patient’s history revealed the presence of osteoma of the clavicle and radius, a gastric polyp, which required surgical interventions. In addition, multiple uterine fibroids, reaching large sizes in combination with the hyperplastic process of the endometrium, can also be manifestations of hyperplastic syndrome in this clinical case. The presence of hyperplastic syndrome could lead the patient to an undiagnosed state of hypercoagulation, the so-called hypercoagulation syndrome, which, even with minimal blood loss, turned into a deficiency of blood coagulation factors. As a result of this pathology, despite observing the correct technique for performing the operation, intra-abdominal bleeding occurred in the early postoperative period, due to a deficiency of blood coagulation factors. The complication was diagnosed in a timely manner, the correct management tactics were chosen, consisting of both surgical hemostasis and correction of blood coagulation factors, which contributed to the rapid relief of this complication and the timely discharge of the patient. In addition, a careful analysis of this clinical case revealed that the patient had one of the variants of Gardner's syndrome. Despite the benign course of this disease, the patient was given recommendations for further management tactics, including mandatory observation by a gastroenterologist, fibrogastrodudenoscopy and colonoscopy over time for the timely detection of polyps.

A novel risk assessment tool for postoperative delirium in vascular surgery: The stress model (Siena posTopeRative dElirium in vaScular Surgery).

Postoperative delirium (POD) is a common complication with a high health-related impact. The creation of a model (Siena posTopeRative dElirium in vaScular Surgery) to identify high-risk patients with consecutive prompt diagnosis and correct management. This is an observational retrospective study to evaluate POD incidence in patients who underwent elective vascular surgery procedures between 2018 and 2020. POD was detected using CAM and defined as the onset of an acute confusional state, clinically manifesting as a disturbed state of consciousness, cognitive dysfunction, or alteration in perception and behavior. The total population was divided in the development and validation subsamples. Multivariable logistic regression analysis was performed, identifying variables related to the occurrence of POD. An additive score was created and the STRESS score was internally validated using the Validation subgroup. A total of 1067 patients were enrolled. POD occurred in 111 cases (10.4%). Multivariable logistic regression analysis for POD occurrence revealed as significant predictors: age>75 years, CKD, dyslipidaemia, psychiatric disease, CAD, hospitalization in the previous month, preoperative NLR >3.59, preoperative Hb < 12g/dl, preoperative Barthel score <75, major amputation, CLTI revascularization, general anesthesia, and postoperative urinary catheter. These variables were used to create the STRESS score. The model was applied to both development and validation subgroups; AUC was respectively 0.7079 (p < .0001) and 0.7270 (p < .0001). The STRESS score has a good predictive potentiality for POD occurrence in elective vascular surgery procedures. However, implementation and external validation are needed to be correctly used in everyday clinical practice.

Corrosion Risk for Process Safety in the Chemical Industry

The aim of this work is to analyze how corrosion risk management influences process safety. Both issues occupy an important niche in the chemical industry. Corrosion risk management includes identifying, analyzing, assessing, and managing corrosion hazards. Process safety is a discipline that focuses on preventing fires, explosions, and accidental releases at chemical process facilities. Corrosion can cause all these detrimental events. &#x0D; There is much literature about both topics, corrosion risk, and process safety, separately, but there are nearly no research works concerning intersection and influence.&#x0D; The level of corrosion failure and its consequences, defining corrosion risk, may be different: the leak of crude oil, natural gas, water, liquid and gaseous hazardous chemicals, fire, explosion, damages, deterioration of the environment, injuries, and death of people and animals. Due to the biological and psychological properties of human nature, we are unlikely to exclude human mistakes.&#x0D; We should pay significant attention to education, dissemination of information, knowledge transfer, collaboration, and communication. Correct corrosion risk management gives rise to the improvement of process safety at stages of design, fabrication, implementation, erection, service, and maintenance of equipment and constructions in the chemical industry.&#x0D; For this realization, specific corrosion mitigation strategies and technologies are described. They are successfully implemented in the chemical industry. It shows how corrosion management and process safety management can be better integrated into practice.&#x0D; The future consideration of the prognosis of corrosion risk with process safety is connected with corrosion modeling. Limitations and challenges of such a forecast are discussed too.&#x0D; Special educational and training programs are developed to help engineers, scientists, professionals, students, and managers learn about corrosion science and engineering

Use of Abzolem ® in Pressure Injuries: Experience of an Exploratory Study

Introduction: Pressure injuries represent a significant and prevalent public health problem in bedridden and institutionalized patients. The correct management of pressure injuries is essential for preventing complications, enhancing patient well-being, and reducing the overall burden on healthcare systems. It underscores the importance of a holistic and patient-centered approach to wound care. Preventive measures and the action of a multidisciplinary team are essential to the correct treatment of pressure injuries. There are multiple active dressings and topical solutions to treat and protect the wounds, among them the hyperoxygenated fatty acids, such as Abzolem®. Objective: Evaluate and verify the effectiveness and safety of the use of Abzolem® in the treatment of patients with pressure injuries grade I and II. Materials and methods: an exploratory study was carried out on 6 patients residing in a long-term establishment in Santiago of Chile with grade I and II pressure injuries in which Abzolem® was used for twice-daily dressings. Results: The use of Abzolem® led to a significant improvement in grade I pressure injuries in 10 ± 3 days and grade II pressure injuries in 15 ± 3 days, without related adverse events and with good tolerance by patients. Conclusion: The use of hyperoxygenated fatty acids, such as Abzolem® corresponds to a safe therapeutic alternative, easy to apply, and effective in the treatment of grade I and II pressure injuries.

Vaginal foreign bodies in pediatric population - presentation, diagnostic challenges, and role of vaginoscopy: A case series

Background: Vaginal foreign bodies (VFBs) in the pediatric population pose diagnostic and management challenges. This is due to the usual difficulty in obtaining an appropriate history, difficulty in conducting a vaginal examination, and the fallibility of conventional imaging modalities in picking most of the vaginal foreign bodies. In prepubertal who present with abnormal vaginal discharge or vaginal bleeding, the diagnosis of a vaginal foreign body should be considered, and appropriate care should be provided. Vaginoscopy is an excellent diagnostic and therapeutic modality for these cases. Case series: Between 2018 and 2023, 6 children aged between 3 and 6 years underwent vaginoscopy at our institution, having presented with diverse vaginal symptoms. The mean age was 4.5 years. Three presented with vaginal bleeding, two had recurrent vaginal discharge, and one had a history of trauma to the genitalia. There were no cases suspicious of sexual abuse. All except two had a normal external genital examination, with one having a small excoriation on the labia and the other having superficial perineal injuries due to trauma. All six cases had intact hymens. Vaginoscopy was performed using a 4-mm scope. Vaginal foreign bodies of varying size and consistency were retrieved from three patients. One patient had inflammatory changes on the proximal anterior vaginal wall. Two had normal findings. All 6 children tolerated the procedure well, with an excellent response to treatment. Conclusion: Correct diagnosis and management of pediatric vaginal foreign bodies is challenging compared with the adult population. A high index of suspicion is necessary for any young girl presenting with vaginal bleeding or abnormal vaginal discharge. Vaginoscopy is a safe and efficient diagnostic and therapeutic procedure for vaginal foreign bodies in the pediatric population.

Методика дослідження та прогнозування виробничого потенціалу автотранспортного підприємства

Essence and importance of diagnostics of condition of a motor vehicle enterprise were discussed in the article. The existing potential that a company should use to choose its own strategic development was analyzed.&#x0D; It was outlined that organizational and economic mechanism of stable development of a motor vehicle enterprise is based on system of assessing stability of a enterprise in a conditions of an unstable external environment of operation. The basic components of sustainability of a motor vehicle enterprise were identified and analyzed, in particular: the safety of operations, the presence of competitive advantages and the quality of the provision of transport services. Analysis of impact of macroenvironmental factors on the operation of the selected transport enterprise was carried out. At the same time, the manifestations of the influence of specific factors and the nature of the influence of the factors were indicated. Evaluation of the degree of influence of factors on the selected enterprise is carried out by experts on a rating scale.It was determined that political, scientific and technical factors have the greatest positive influence on the enterprise. Economic, legal and natural factors exert the most negative influence.&#x0D; The article stated that competitiveness of a motor vehicle enterprise is a decisive factor determining a stability of enterprise's functioning.Directions of the system for ensuring high competitiveness of a transport enterprise were proposed. The key aspects of ensuring a sustainable development of an enterprise, on the basis of which it is possible to evaluate a competitiveness of an enterprise using the grapho-analytical method, were proposed. A graph-analytical model of the potential of the selected enterprise was built with a reflection of resource, investment, marketing, organizational, innovation and production potentials. The conclusion about incomplete use of all types of potential was made on the basis of the carried out assessment of potential of a motor transport enterprise. Unused potential is a reserve for increasing the company's competitiveness in future periods. The «hexagon of potential» of the selected enterprise was characterized by correct form and balanced management.

Particulars of sinogenic orbital complications in children

Sinogenic orbital complications in children are relatively rare but critical conditions that require accurate diagnosis and timely appropriate treatment to prevent severe sequelae. This article concentrates on clinical, diagnostic, and therapeutic specifics of sinogenic orbital complications in children. The work is based on aliterature review (PubMed, Google Scholar) and own experience as well as data from the authors' own pediatric population. In children, sinogenic orbital complications are usually secondary due to acute bacterial sinusitis. Correct distinction between pre- and postseptal cellulitis is of utmost importance for correct diagnostic and therapeutic management in order to prevent long-term sequelae. Preseptal cellulitis can be treated conservatively. If there are signs of postseptal involvement, prompt cross sectional imaging will be required. Depending on the severity of the postseptal involvement, surgical treatment may be necessary. Recent literature debates three main issues: 1)developing models for different combinations of symptoms that reliably distinguish between pre- and postseptal cellulitis; 2)selection of appropriate cross-sectional imaging (MRI vs. CT); and 3)indications for surgery. All three issues will be discussed in detail in this article.