Medicine Institute Research Articles

Development of technology for obtaining an extract of Ziziphus Jujuba Mill. Fruits

Introduction. In spite of many years of experience herbal medicines for the treatment of various diseases remain relevant and in demand due to the combination of effectiveness, safety and efficiency. In the production of herbal medicines extracts obtained from plant raw materials are used on the pharmaceutical substance. Complex processing of plant raw materials is one of the ways to achieve economic efficiency of production, which is an important aspect in the development of herbal preparations. The aim of the study: to develop the complex processing technology of Ziziphus Jujuba Mill fruits using the cascade extraction method in order to obtain a plant extract as a pharmaceutical substance. Material and methods. Ziziphus Jujuba Mill. fruits were collected between October and November 2022 in “Sila Dolmena”Ltd (Gelendzhik, Russian Federation). Extraction Ziziphus Jujuba Mill. fruits was carried out on the laboratory module of the Cascade type, using battery extractors and a rotary evaporator. The following were used as extractants: liquefied subcritical carbon dioxide, 70 and 40% ethyl alcohol and purification water, which are necessary for the extraction of both lipophilic and hydrophilic components. Results. A technology for complex processing of Ziziphus Jujuba Mill. fruits by the cascade extraction method has been developed. The essence of the technology is in the sequential extraction of fruits with various extractants. By doing so, four extracts were obtained and standardized with the aim to obtain the final polyextract of Ziziphus Jujuba Mill. fruits. The kinetics of plant biologically active substances extraction was studied. Subcritical carbon dioxide extraction was used to extract lipophilic components. Flavonoids were extracted with 70% ethyl alcohol, and triterpene saponins – with 40% ethyl alcohol. The polysaccharide complex was extracted with purified water. The content of biologically active substances in the extracts obtained using extractants with successively increasing polarity was studied. Conclusion. The complex processing technology allows extracting a wide range of biologically active substances from plant raw materials. The final polyextract permits to combine all biologically active components of the Ziziphus Jujuba Mill. fruits in one medicinal product in order to expand the spectrum of its pharmacological activity. The work was carried out in accordance with the topic of the research project FGUU-2022-0011 of the Federal State Budgetary Scientific Institution "All-Russian Research Institute of Medicinal and Aromatic Plants".

Investigation of thyroid tissue in berry ligament by dissecting 103 cadavers

ObjectıvesIn this study, we investigated the relationship between berry ligament and thyroid tissue through cadaver dissection.Methods103 randomly selected cases from routine autopsy cases performed at the Istanbul Forensic Medicine Institute between December 2013 and May 2014 were included in the study. Demographic data of the cases, length and berry ligament length average values, section positivity and section positivity rates by side were examined.ResultsThere was histological section positivity in 22 (21.4%) of the cases. Histological section positivity was on the right side in 2.9% of the patients, on the left in 2.9%, and on both sides in 1.3%. There was no significant (p˃0.05) correlation between age and length and berry length. There was a significant (p < 0.05) positive correlation between length and berry length. Length and berry length values of male and female patients did not differ significantly (p˃0.05).ConclusıonIt has been observed that the aim of leaving almost no thyroid tissue, which we think will be more important especially in total thyroidectomies performed due to thyroid cancer, will technically fail in approximately 21% of cases and some thyroid tissue will remain within the berry ligament.

Quantification of antibiotic usage against Streptococcus suis in weaner pigs in The Netherlands between 2017-2021

Streptococcus suis is an important pig pathogen that can cause severe disease in the post-weaning period. As there are no commercial vaccines available in the Netherlands, antibiotic treatment is often necessary to control disease. S. suis is regarded as one of the major causes of antibiotic prescription in weaned pigs, but scientific studies supporting this claim with quantitative data are lacking. The aim of this study was to obtain insight in, and to quantify usage of, antibiotics against S. suis in weaner pigs at sow farms in the Netherlands. Three sources of data were used, including 1) total antibiotic usage in weaner pigs in the Netherlands, as yearly reported by the Netherlands Veterinary Medicines Institute (SDa), and estimates from 2) pig veterinarians and 3) pig farmers on the relative amount of antibiotics prescribed against S. suis, via questionnaires. Information from the SDa on the total amount of antibiotic usage was combined with the estimates of the veterinarians to estimate the antibiotic usage against S. suis in weaner pigs. Our study shows that ~90% of the total amount of amoxicillin (AMOX) and ampicillin (AMPI) prescribed in weaner pigs is used for treatment of disease caused by S. suis (S. suis disease). Of all orally prescribed antibiotics against S. suis, AMOX comprises 85% of the total absolute usage expressed by the mean defined daily dosage per animal farm (3.2 – 5.4 mean DDDAF). Furthermore, veterinarians reported that at farms with structural S. suis disease problems second choice antibiotics (AMOX, AMPI) are more often prescribed than at farms with incidental S. suis disease. All together, we estimated that S. suis disease accounts for about 1/3rd of the total antibiotic usage in weaner pigs. This study is the first to quantify antibiotic usage against S. suis in weaner pigs and shows that S. suis is a hotspot of antibiotic usage. This underlines the severity and relevance of S. suis disease and the need for alternative control measures.

Changes in olfactory bulb volume and olfactory sulcus depth in COVID-19 infection: an autopsy study.

The pathophysiology of COVID-19 remains unclear. Olfactory dysfunction is one of the neurological symptoms of the disease. There is no evidence to evaluate whether there is a morphometric change in the olfactory pathways. This study aimed to examine the effect of COVID-19 on olfactory center sections through morphometric measurements obtained from autopsy cases. Our study was conducted on 63 autopsy cases (COVID-19 [n = 37], control (non-COVID) [n = 26]) between the ages of 18-80 years who came to Tokat Forensic Medicine Institute. The anatomical structures of the olfactory tracts were determined on the brains removed during routine autopsy. The dimensions of the structures belonging to the olfactory center sections were measured with a precision digital caliper, weights were measured with a precision digital scale, and volumes were measured with a 0.01cm³ graduated cylinder. The Archimedes principle method was used for volume calculations. In the autopsy cases examined, it was found that there was a significant decrease in bilateral olfactory bulb (OB) and olfactory tract (OT) volumes in COVID-19 group (p < 0.001). In addition, OB and OT weights were lighter in COVID-19 group on both sides (p < 0.001). The length, width and depth measurements of the examined anatomical structures were found to be shorter in COVID-19 group (p < 0.01). Autopsy findings showed damage in olfactory center sections in COVID-19 group. We believe that knowing the OB and OT morphology in particular will make significant contributions to both clinical approaches and future studies in the pathology of infectious diseases.

Retinal and choroidal microvascular assessment of children receiving recombinant growth hormone therapy

BackgroundThe purpose of this study is to evaluate the retinal and choroidal microvascular state in children with congenital isolated growth hormone deficiency (IGHD) and determine the effect of recombinant human growth hormone treatment on these structures compared with healthy controls.MethodsThe study included children with IGHD under recombinant human GH treatment as group one and another group of healthy controls. Both groups were examined using optical coherence tomography angiography (OCTA). Data concerning superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC), and retinal thickness were recorded.ResultsThe study included two equal groups of 30 individuals. Both groups had no statistically significant differences in age, gender, weight, or spherical equivalent. However, subjects of group II were taller than those of group I (p = 0.011). OCTA images of the SCP, DCP, and CC vessel density revealed statistically non-significant differences between the two groups.ConclusionChildren receiving recombinant growth hormone therapy showed no changes in the retinal and choroidal microvasculature or macular thickness.Trial registration number1094/03/2024 by Minia University Faculty of Medicine Institutional Review Board. Another registration number is UMIN000055654.

Knee joint mechanics during gait after anterior cruciate ligament reconstruction using a partial or full thickness quadriceps tendon autograft at 2 years after surgery.

Despite quadriceps weakness in individuals after quadriceps tendon anterior cruciate ligament reconstruction (QT-ACLR), and its association with knee joint mechanics, no studies have addressed gait mechanics in both partial-thickness (PT-Q) and full-thickness (FT-Q) options for QT-ACLR. To assess gait mechanics across a QT-ACLR cohort. We hypothesized that QT-ACLR would show changes in knee joint mechanics compared to control participants (CON) and nonoperated limbs. Additionally, we hypothesized that FT-Q operated limbs would show greater changes compared to PT-Q and CON. Retrospective cohort study. University-affiliated sports medicine institute. Sixteen patients who underwent QT-ACLR (7 FT-Q: Age (years) = 28.6 ± 7.3, post-op (months) = 23.5 ± 10.7, 9 PT-Q: Age = 25.2 ± 4.3, post-op = 24.4 ± 11.7) were recruited and compared to 11 CON (age = 23.4 ± 4.8). Participants underwent gait testing with force plate integrated motion capture. Mixed repeated-measures analyses of covariance, adjusted for gait speed, were used to determine significant main effects or interactions in peak knee flexion angle, sagittal knee range of motion, peak internal knee extension moment (KEM), and peak internal knee flexion moment. When measured an average of 2 years after surgery, no main effect for limb or limb by depth interaction were detected. A significant effect by group was observed for peak KEM (p = .03, η2 = .27) and peak knee flexion angle (p = .04, η2 = .24) in the loading response phase. FT-Q (p = .02) and PT-Q (p = .03) showed lower KEM compared to the CON group in both limbs. The FT-Q group showed lower peak knee flexion angle compared to the CON group (p = .01). Knee joint symmetry may be recovered 2 years following QT-ACLR, but lower KEM compared to CON for both graft options and lower peak knee flexion angle than CON for the FT-Q group may indicate a need for further investigation in QT-ACLR.

Evaluating the Impact of an Online Mindfulness Program on Healthcare Workers in Korean Medicine Institutions: A Two-Year Retrospective Study.

Background/Objectives: This retrospective study evaluated the effectiveness of a two-year online mindfulness program (five biweekly sessions) combined with a smartphone application for healthcare workers (HCWs) in Korean medicine (KM) institutions. Methods: Twenty-three participants, including KM University students, KM doctors, and nurses, completed a 9-week online mindfulness program in 2023 or 2024. The pre- and post-intervention surveys assessed subjective health status (SHS), knowledge of mind-body modalities (MBMs), hwa-byung (HB) symptoms, emotional labor (EL), burnout, and program satisfaction. Results: Participants showed significant improvements in SHS (p = 0.008) and MBM knowledge (p = 0.035). HB personality scores decreased significantly (p = 0.027), while the reduction in HB symptoms approached statistical significance (p = 0.052). The frequency of interactions among job-focused EL increased (p = 0.003). The subgroup analysis revealed significant reductions in HB personality traits (p = 0.017) and symptoms (p = 0.006) among practicing KM doctors and nurses. No significant changes were observed in burnout levels. Participants reported high satisfaction (median 8.00 [IQR 8.0-9.0]) and willingness to recommend the program (median 5.00 [IQR 4.0-5.0]). Conclusions: Analysis of the 2-year results suggests that the online mindfulness program effectively improved SHS, MBM knowledge, and HB-related symptoms among HCWs in KM institutions, particularly among practicing professionals. High satisfaction rates indicated the acceptability of the program. Future research should use larger sample sizes and randomized controlled designs to further validate these findings and explore long-term outcomes. This intervention shows promise as a tool to promote mental health in Korean healthcare settings.

Forensic issues in autoerotic deaths: A 44-year systematic review and a case series from the legal medicine institutes of Bologna and Milan, Italy.

Autoerotic deaths, defined as accidental fatalities occurring during solitary sexual activities, show complex forensic challenges due to their different mechanisms and variable death scene presentations. This study combines a systematic review of global literature spanning 44 years (from 1980 to 2024) with a detailed case series analysis from the Legal Medicine Institutes of Bologna and Milan, Italy, to provide comprehensive insights into this phenomenon.The systematic review identified 67 relevant reports from databases namely Scopus, Web of Science, and PubMed. In parallel, a case series of 7 autoerotic fatalities was analyzed, highlighting victims' demographics, causes of death, and associated factors.Findings from 101 cases of autoerotic deaths included in the systematic review indicate a predominant prevalence of asphyxial deaths, with hanging being the most common method, followed by intoxication. The study underscores significant gender disparities, with men comprising most cases (n = 91), spanning a broader age range (12-87 y.o.) compared to women (17-48 y.o.). The findings are fully consistent with the Italian case series presented here, in which all the subjects were men aged 18 to 72 years, and the cause of death was asphyxia in 6 cases.Toxicological analyses played a crucial role in elucidating the cause and manner of death in most cases, yet their utilization varies widely, impacting data reliability and evaluation of the cause of death. Notably, the evidence of volatile substances, especially inhalants, creates an emerging area of interest with potential epidemiological and preventive implications. The systematic analysis revealed substantial variability in death scene characteristics and forensic procedures, emphasizing the need for standardized investigative protocols.This study highlights the multifaceted nature of autoerotic deaths and the importance of a holistic forensic approach encompassing death scene investigation, autopsy, and toxicological analysis. By enhancing the understanding and awareness about this phenomenon, this research aims to inform evidence-based practices in forensics, mitigate diagnostic uncertainties, and facilitate preventive interventions.

Rapid response Task Force: addressing the detection of Aedes albopictus in Lisbon, Portugal

Abstract Issue The invasive Aedes albopictus mosquitoes are spreading in southern Europe and pose a heightened risk of mosquito-borne diseases, like Dengue and Chikungunya. On September 2023, A. albopictus was first identified in Lisbon through community-based surveillance and a multidisciplinary national Task Force (TF) was convened. Description of the problem The TF included experts in epidemiology, entomology, environmental health, laboratory diagnosis, prevention and control and communication. The objectives were to i) confirm A.albopictus presence in Lisbon and adjust the risk assessment, ii) raise awareness and prevent mosquitoes’ spread, iii) revise national guidelines on arboviruses surveillance and control. During September-December 2023, the National Network for Vectors Surveillance (REVIVE) and the Hygiene and Tropical Medicine Institute sampled mosquito-prone habitats within 2km-radius of the detection point using QGIS software. They used snowball sampling to identify any new foci. They placed ovitraps for ongoing surveillance and conducted morphological analysis and xenomonitoring for pathogen DNA and RNA detection at the national reference laboratory. Results By November 2023, A.albopictus was detected in two new foci. No mosquitoes tested positive for arboviruses, and no autochthonous cases of mosquito-borne diseases were identified. The TF developed national guidelines for vector prevention and control and awareness for arboviruses and trained municipality workers. To raise awareness, we communicated with experts and the public through existing channels and media. As of April 2024, no new foci have been detected. Lessons Community-based surveillance and REVIVE approach were crucial for invasive A.albopictus detection and monitoring in Lisbon. Rapid multidisciplinary TF coordination may have been key for timely vector control.

Hypertension prevalence among the male population aged 35-74 years in Novosibirsk

Aim. To study the prevalence and risk factors of hypertension (HTN), structure and effectiveness of treatment coverage, as well as disease control indicators among the male population aged 35-74 years in Novosibirsk.Material and methods. This cross-sectional study of the Novosibirsk population was conducted in 2021-2023 at the Research Institute for Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics according to the ESSE-RF3 study protocol. A total of 1200 people aged 35-74 years living in Novosibirsk were examined. The analysis included 600 men. The response rate exceeded 70%. HTN was considered detected in systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or in patients taking antihypertensive agents. Awareness was estimated as the proportion of individuals who had previously been informed by a physician about HTN. Treatment effectiveness was considered the proportion of individuals who achieved target BP values while taking antihypertensive therapy. Hypertension control was considered the proportion of individuals who achieved target values among all those examined with HTN. Statistical processing was performed using the SPSS software package (version 13.0). Associations were assessed using multiple logistic regression analysis. The critical significance level of the null hypothesis (p) was 0,05.Results. The medians of systolic and diastolic BP among men in No­vo­sibirsk were 136,0 [126,5; 149,5] and 89,0 [82,0; 95,5] mm Hg, respectively. The prevalence of HTN among men aged 35-74 in Novo­sibirsk was 68,9%, while 81,1% of men in Novosibirsk were aware of HTN. Among men with HTN, 54,7% take antihypertensive agents. The effectiveness of treatment among men in Novosibirsk is 32,3%, while 19,6% of men control the disease. The odds of hypertension occurrence in men with hypertriglyceridemia increased by 3,5 times, with abdominal obesity — by 2 times, with an positive family history for cardiovascular diseases — by 1,6 times, and with each year of life increased by 1,1 times.Conclusion. The prevalence of HTN among men in Novosibirsk is higher in comparison with the average Russian level. Significant risk factors for HTN include abdominal obesity, hypertriglyceridemia, and decreased physical activity. While awareness, treatment coverage, and HTN control among men aged 35-74 in Novosibirsk correspond to Russian trends, treatment effectiveness turned out to be slightly lower than in the Russian population.

Strangulation

Detection of manual strangulation, choking and hanging, as well as the intensity of these actions, helps to clarify the course of events, to enforce the state's right to prosecute and ultimately to protect against further attacks. However, this is complicated by the scarcity of externally visible findings. The forensic examination of the head and neck after strangulation is carried out by means of external inspection to detect injuries and congestion above the strangulation level. Lesions below the surface of the skin, in particular of the subcutaneous fat tissue, the muscles or the laryngeal structures, usually escape the external inspection. Imaging techniques allow internal injuries to be recorded and objectified, which can be of considerable added value in the collection of evidence. Since criminal proceedings must meet the highest standards of security, high demands are placed on imaging and diagnosis. Imaging techniques are suitable for detecting and objectifying internal injuries after aperson has survived strangulation. However, their excellent reconstruction and visualization capabilities also make them avaluable addition to postmortem examinations. After reported and survived strangulation, choking or hanging, magnetic resonance imaging (MRI) of the soft tissues of the neck should be performed as soon as possible, and if cerebral damage is suspected, the skull should also be examined. If the event was not survived, whole-body computed tomography (CT) is now standard practice at many forensic medicine institutes.

EFFICACY OF INDUCTION CHEMOTHERAPY WITH PACLITAXEL AND CARBOPLATIN IN LOCALLY ADVANCED SQUAMOUS CELL CARCINOMA OF THE HYPOPHARYNX: A DESCRIPTIVE CASE SERIES

Introduction: Head and neck cancer including hypopharyngeal carcinoma is one of commonest malignancies in Pakistan. According to the Pakistan Medical Research Council (PMRC) reports, it was found to be the commonest malignancy in males and was second highest to breast cancer in females. The patients for the management of hypopharyngeal cancer present with locally advanced disease. Induction chemotherapy with paclitaxel and carboplatin is being used for few years but the results have not been documented yet. The aim of this study is to design a protocol in future with improved outcome and acceptable morbidity. Objective:To determine the efficacy of induction chemotherapy with paclitaxel &amp; carboplatin in locally advanced squamous cell carcinoma of hypopharynx in terms of frequency of complete and partial response. Settings:This study was conducted at Nuclear Medicine, Oncology and Radiotherapy Institute (NORI), Islamabad. Study Design: Descriptive case series. Duration of study: 6 months from 01/08/2017 to 31/01/2018 Material and methods:In this study a total of 59 patients were observed by using World Health Organization sample size calculator where confidence level: 95%, anticipated population proportion: 67%, relative precision: 12%. Moreover, nonprobability consecutive sampling technique was used for sample collection. Results:Mean age was 60 ± 11.87 years. 40(68%) patients were males while 19(32%) were females. 22(38%) patients had carcinoma of stage III, 32(54%) patients had carcinoma of stage IVA while 5(8%) patients had carcinoma of stage IVB. Moreover, induction chemotherapy was effective in 42(72%) patients and was not effective in 17(28%) patients. Conclusion:Our study concludes that induction chemotherapy with paclitaxel &amp; carboplatin was 72% effective in locally advanced squamous cell carcinoma of hypopharynx in terms of frequency of complete and partial response.

Integrative Korean medicine treatment for low back pain with radiculopathy caused by Bertolotti syndrome: A CARE-compliant article and retrospective review of medical records.

Bertolotti syndrome (BS) is characterized by radiculopathy caused by structural anomalies. Despite the structural deformity, conservative treatment is predominantly recommended due to surgery-related complications. Because of the diagnosis complexity, the incidence and contributing factors of BS, remain controversial. We report the case of a patient with BS who was treated with integrative Korean medicine (IKM). Moreover, we evaluated the epidemiological characteristics of lumbosacral transitional vertebrae (LSTV) from medical records of patients diagnosed with LSTV at 4 different medical clinics of Korean medicine. A 33-year-old male patient with low back pain and severe radiculopathy was diagnosed with BS (Castellvi Type II) on magnetic resonance imaging at a local orthopedic clinic. Additionally, the medical records of patients with BS who had been treated with IKM in 4 different institutions of Korean medicine were analyzed, and the characteristics of patients suffering from BS were identified. The patient underwent IKM treatment for 40 days as an inpatient. The patient's condition was assessed using the Euroqol 5-dimension index and Oswestry Disability Index, and symptom severity was measured using the Numeric Rating Scale. IKM was effective in improving pain and functional disability without causing any adverse effects. In a retrospective review of medical records, the study identified symptom trends reported by patients with LSTV. IKM demonstrates potential efficacy in BS management, with notable trends in LSTV-related symptomatology warranting further investigation.

Beyond biomedical institutions: An ethnographic study of community science and the rise of alternative therapeutic imaginaries

This paper examines the project Open Insulin—a community-based initiative aimed at producing their own insulin in response to rising prices in the United States—as a lens to analyze the emergence of “alternative therapeutic imaginaries.” These imaginaries represent a particular form of social activity: a planning approach toward greater individualization, fragmentation, and corporatization of healthcare. Examples include health and biomedical practices undertaken by citizen scientists, do-it-yourself (DIY) patients, and others who resist or operate outside institutions of medicine. Drawing on ethnographic research, this study analyzes the construction of Open Insulin's health politics, which I argue is inspired by forms of direct social action. Unlike conventional activism approaches that tend to make claims on the state or others in power, direct social action involves direct intervention in segments of society. This paper explores how this approach is complicated by the regulatory economy and materiality of drug research, and the need for diverse expertise in the space of pharmaceuticals. I examine how project members grappled with these complications, surfacing competing perspectives for how to produce insulin safely and the role of industry experts and scientific institutions in this pursuit. I argue that Open Insulin's vision for community-produced and -owned medicines sheds light on growing mistrust of health institutions and diminishing public responsibility over healthcare provisions, leading to technolibertarian logics to address unmet healthcare needs, and potentially exacerbating health disparities by privileging those who can participate in such alternatives. This analysis contributes to broader debates on transformations in healthcare and social activism, highlighting the need for reorienting biomedical institutions toward public benefit.

O74 EPOXYEICOSATRIENOIC ACIDS ANALOGUE (EET-A) FOR THE TREATMENT OF CHEMOTHERAPY-INDUCED HEART FAILURE WITH NEPHROTIC SYNDROME

Background and Objective: Doxorubicin (DOXO) is still commonly used anthracycline for the treatment of many types of cancers, but its application is burdened with a high risk of cardiotoxicity. The exact mechanisms of DOXO cardiotoxicity are still under investigation. Currently it is believed that the formation of topoisomerase II beta complex with DOXO, together with increased levels of reactive oxygen species (ROS) leads to cardiotoxicity. However, many additional mechanisms can weaken the heart and contribute to HFrEF development. Few years ago, new hypothesis emerged linking the DOXO-cardiotoxicity with the diminished expression of CYP2J2, an isoform of cytochrome P450, which is responsible for epoxyeicosatrienoic acids (EETs) formation. EETs were shown to exhibit vasodilation, decrease inflammation and to promote sodium excretion. Cardiac CYP2J2 overexpression decreased the cardiac injury in DOXO-treated mice. Hence, we decided to test the effectiveness of the EETs analogue (EET-A) in a model of DOXO-induced HFrEF with nephrotic syndrome. Methods: DOXO was administered to male Ren-2 transgenic rats (TGR) via five intravenous injections (cumulative dose 10 mg/kg of body weight). The long-term survival (20 weeks) of rats treated with EET-A (10 mg/kg of body weight administered in drinking water) was compared to ACE inhibitor (ACEi). Cardiac function was evaluated by echocardiography, urine and blood were collected for analysis. Results: The treatment with EET-A did not improve survival and cardiac function measured by echocardiography, however there was a clear renoprotective effect observed. Albuminuria was significantly lower in the EET-A treated group, when compared to ACEi. Plasma albumin did not change after 4-week treatment with EET-A, whereas in both placebo and ACEi a significant decrease was recorded. Conclusions: Despite the lack of improvement of survival, the beneficial effect of EET-A on the kidneys supports its potential for nephrotic syndrome treatment. Supported by MH CZ - DRO (“Institute for Clinical and Experimental Medicine - IKEM, IN 00023001”)

Surgical Anatomy and Intrapelvic Course of Obturator Nerve

Study ObjectiveThe aim of this study is to reveal the anatomy of the obturator nerve (ON) and its important relationship in pelvic surgery with the surrounding anatomical structures. DesignProspective observational study. InterventionsParameters from the left and right ON's to relevant anatomical landmarks were measured and statistical analysis was performed. SettingThe current study was planned in Department of Anatomy Ankara University School of Medicine and then conducted at the Forensic Medicine Institute, Ankara Group Presidency after receiving the approval of the Institute for Forensic Medicine. ParticipantsThe study was performed in 40 fresh or fresh-frozen and female cadavers bilaterally. Measurements and Main ResultsThe mean distances of the midpoint of the left ON to the highest point of the fundus of uterus and isthmus of the uterus, cervico-uterine junction, and highest point of the promontory were 55.1 ± 10.4, 52.9 ± 12.4, 54.8 ± 11.3, and 58.5 ± 15.2 mm, respectively, and 58.7 ± 8.1, 52.5 ± 13.1, 61.4 ± 17.8, and 62.2 ± 19.7 mm on the right side, respectively (p > .05 for all values). The mean distance between the nerve root of the left ON and highest point of the promontory was 59.1 ± 28.4 mm, it was 59.7 ± 26.2 mm on the right side (p > .05). There were significant positive correlations between the distance between the left and right anterior superior iliac spines and the distances between the midpoint of the ON to the isthmus of the uterus on both the left and right sides of the pelvis (r = 0.546, p = .019, r = 0.896, p < .001, respectively). ConclusionsIntraoperative ON injury in gynecological procedures is a complication that may be minimized with good anatomical knowledge. Careful dissection should be performed to decrease the ON injury. The safe surgical zone was established for pelvic procedures by creating a topographical map of the ON. This research may improve pelvic surgery precision, aiding the development of better treatments and reducing ON-related complications.

Two Decades of Fatal Workplace Accidents in Milan and Monza, Italy: Trends, Work Sectors, and Causes From Autoptic Data.

Work-related fatalities represent an important global public health threat, accounting for over 300,000 deaths annually. Despite preventive strategies, fatalities persist, necessitating comprehensive investigations. Autoptic investigations, when ordered, offer comprehensive data on fatal accidents, in particular with detailed information about the type of accident, lesions, and type of work, enabling a thorough analysis of various factors contributing to workplace deaths. This study investigates work-related fatalities in Milan and Monza Brianza, Lombardy, analyzing patterns, industries, and factors leading to death among workers. This retrospective study analyzed all fatal work accident data from the Autopsy Database of the Legal Medicine Institute of Milan from January 2000 to December 2022. We also estimated the risk of fatal accidents per 1.00.000 workers using ISTAT data for the different work sectors. Of the 17,841 violent deaths in Milan and Monza Brianza, 308 resulted from work-related accidents. The majority were male (95.1%). The secondary sector showed the higher estimated risk (27 /106 vs. 19/106 in primary and 2.3/106 in tertiary sector) accounted for 78.5% of fatalities, with specialized workers (35.1%) and construction workers (25%) being the most affected. Falls from above were the leading cause of death (36.7%). A decreasing trend in fatal accidents over the study period was observed, with July having the greatest frequency. The most common causes of death were polytrauma (36.4%) and head injuries (19.2%). Non-Italian workers constitute a noteworthy percentage of fatal cases (24%). The secondary sector has the most fatal accidents at work despite a decrease in accidents over the observed time period. There is a need for rigorous analysis and interventions, using forensic autopsy case data to help understand causes, and collaboration between institutions is encouraged to develop effective preventive policies.

Construction of TCM Institution Image: A Corpus-Based Comparative Critical Discourse Study of Chinese and Western Mainstream Media Reports

This study conducts a corpus-assisted comparative analysis of the media images of Traditional Chinese Medicine (TCM) institutions in Chinese and Western media contexts. Applying Fairclough’s three-dimensional critical discourse analysis (CDA) model alongside the TCM Social Image Evaluation Index System, this study explores media image construction and ideological factors shaping the perception of TCM institutions globally through an analysis of linguistic features in keywords, evaluative collocates and modal verbs. It’s found that Chinese media present TCM institutions in a positive light, depicting them as multifaceted organizations with a rich cultural legacy and robust capabilities in medical and scientific research. They showcase TCM institutions as cooperative, promising in integration with modern healthcare, efficient, rapid, flexible, innovative, and imbued with humanitarian values especially during the COVID-19 epidemic. Western media, however, adopt a more cautious stance. They tend to frame TCM institutions as providers of alternative medicine and temporary solutions, with a focus on health preservation, leisure and overall well-being. Concerns have also been raised about the potential illicit activities associated with some massage schools. These disparities in presenting TCM institutions reflect cultural, political and audience demand differences between China and the West. The results of this study contribute to a deeper understanding of the media portrayal of TCM institutions, provide insights into the challenges facing the global recognition and acceptance of TCM institutions, and suggest strategies for Chinese media, TCM practitioners, and policymakers to enhance their international image.

Protocol for a randomised trial of a self-directed digital pain management intervention (Empowered Relief) tailored to adults with chronic pain and prescription opioid misuse/disorder: the MOBILE Relief study

IntroductionChronic pain increases the risk of prescription opioid misuse or opioid use disorder (OUD). Non-pharmacological treatments are needed to dually address pain and opioid risks. The purpose of the Mobile...

Biochemical indicators, quality and safety of domestic and wild pig slaughter products

Animal husbandry is one of the important branches of agricultural production, which plays an important role in the formation of food security of Ukraine and providing the population with important types of food. The correct methodical approach to the inspection of organs and tissues of slaughtered animals allows to avoid errors in the diagnosis of various diseases, in the sanitary assessment of slaughter products, to prevent meat losses and the release of food products that are dangerous for humans. Analyzing the requirements of the modern market and the priority directions for the development of trade relations between the countries of the European Union for our country, it should be noted that the responsibility for the export and import of products of animal origin and the control of the production of high-quality and safe products is entrusted to the specialist of the state veterinary service. Organoleptic analysis of slaughter products is an important component of inspection. In addition, it should be noted that determining the degree of freshness of meat for a long time was carried out only with the help of the organoleptic method. It has been proven that organoleptic indicators provide comprehensive information for determining the good quality of meat. The quality of meat or its nutritional value refers to the chemical composition of the fleshy part, which includes muscle, fat and connective tissue. The chemical composition, energy value, digestibility, taste, culinary and other properties of meat depend on the ratio of these tissues. The quality of meat is influenced by the breed of animals, sex, age, fatness, the nature of fattening, conditions of transportation and pre-slaughter aging, methods of stunning, degree of exsanguination, etc. The article presents materials related to the inspection of animal slaughter products in the Zhytomyr region (agro-food market in the city of Olevsk). The study was carried out as part of the research work of the department of normal and pathological morphology, hygiene and expertise “Monitoring the content of toxic substances in drinking water, feed and their impact on the body of cattle and the quality and safety of products”, state registration number – 0120U101318. The purpose of the study is to inspect the slaughter products of domestic and wild pigs in the agro-food market of the Zhytomyr region. The task of the work was to determine the organoleptic, physico-chemical and microbiological indicators of slaughter products of domestic and wild pigs. The testing laboratory of veterinary and sanitary examination in the market carries out significant work on the inspection of animal slaughter products, which ensures the release of good-quality products for the population. As a result of the inspection of the slaughter products of domestic and wild pigs, it was established that all meat samples according to organoleptic parameters corresponded to the parameters of fresh high-quality meat, the reaction to peroxidase was positive, the pH of the meat ranged from 5.9 to 6.1. No trichinella was detected during trichinoscopy of pork samples. Veterinary and sanitary examination of livestock products on the markets is carried out only by veterinary medicine specialists of state laboratories or other state institutions of veterinary medicine. The laboratory carries out mandatory quality and safety control of all controlled products sold, including food products of animal origin intended for human consumption. In this regard, it is important to carry out inspection, sanitary evaluation of slaughter products of slaughter animals and determination of morphological characteristics of meat of domestic and wild pigs.