bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Abortion Accessibility and Its Effects: Assessing the Impact of the Dobbs Decision
Authors: Burkey Mark L. , Li Huan , Kelly Stephanie
Published: November 2023

Background: Previous research studies have used natural experiments to estimate the causal effects of changes in geographic accessibility to abortion clinics in the U.S. These effects include reductions in observed abortions, and births of so-called “marginal children” due to decreased access to abortion who may be raised in poor conditions. We measure changes in geographic accessibility to abortion procedures after the Dobbs decision repealed nationwide accessibility to abortion in the U.S., describe neighborhoods that are most affected, and use the results of previous studies to make estimates of the effects.
Methods: This paper measures road network distances and estimated travel times from each Census block group to the nearest abortion procedure provider before, and after the Dobbs decision when 21 states prohibited most abortion procedures ("Ban States"). These block groups comprise 236,883 neighborhoods of around 1,400 people each. Using the state of legislation changes at the end of 2022, we describe the socioeconomic characteristics of the neighborhoods most affected by the decision, and to forecast the changes in abortion rates and births in 2023.
Results: We find that the median distance to the nearest abortion provider nearly doubled to 24.68 miles, while the average distance for those in the 4th quartile increased from 82 to 364 miles. We estimate that more than 30,000 additional children will be born in 2023 due to the Dobbs decision. The neighborhoods that are the most affected by the Dobbs decision have high rates of families lacking in health insurance, education and internet connectivity, and high concentrations of people of color.
Conclusion: This study provides estimates of the changes in geographical accessibility to abortion clinics as a result of the Dobbs decision. The findings suggest that the impact extended beyond women in the 21 Ban States, affecting approximately 900,000 women in other states who will also experience reduced access to abortion services. The magnitude of the impacts and the demographic profile of those impacted will vary over time as states change their laws, but observing a snapshot of some of the impacts in 2023 is an important part of understanding this change in abortion policies.
Staphylococcus aureus pneumonia complicated with lower limb gangrene secondary to influenza A virus：a case report
Authors: Zhu Xiao-Ling , Zhang Juan , Zhang Dong-Ping , Wang Mao-Juan , Zhang Lian , Xie Hong
Published: November 2023

Background Millions of people worldwide die from lower respiratory tract infections every year, and a significant portion of these deaths can be attributed to seasonal influenza virus infections, due to the continuous emergence of new variants of influenza A virus (IAV) and secondary bacterialinfection with other viruses or bacteria. This report describes a female patient with IAV who secondary bacterial infection with Staphylococcus aureus and lower limb gangrene.
Case presentation The patient was a 39-year-old female who had persistent cough, sputum and tight breath for 2 days, worsening for 11+hours. She received VV-ECMO treatment for severe pneumonia. Her alveolar lavage fluid showed Staphylococcus aureus, Influenza A virus was positive for H3N2. After anti infection treatment, the patient's condition improved, and gangrene occurred in the lower limbs and amputation surgery was performed.
Conclusions Subsequent aureus infections after influenza can exacerbate respiratory failure in patients, leading to multiple organ dysfunction and even endangering patient safety. Early identification, identification of pathogens, and effective anti-infection treatment can improve prognosis.
The phthalocyanine derivative is less cytotoxic and does not impair in vitro wound healing compared to chlorhexidine
Authors: Santos Caique Andrade , Pessoa Adriano de Souza , Vilhena Fabiano Vieira , de Oliveira Rodrigo Cardoso , Santos Paulo Sérgio da Silva , Damante Carla Andreotti , Zangrando Mariana Schutzer Ragghianti
Published: November 2023

Objectives: To compare the cytotoxicity of different concentrations of a phthalocyanine (PHY) to chlorhexidine (CHX) and the influence of these compounds on fibroblast cell migration.
Methodology: Different concentrations of CHX and PHY (0.0075% to 0.12%) were evaluated using NIH 3T3 fibroblasts. Cell viability was assessed by the MTT and crystal violet (CV) assay; CHX and PHY (0.0075% and 0.12%) were also evaluated by in vitro wound healing assay.
Results: PHY was less cytotoxic compared to CHX, based on cell viability assays. PHY did not interfere with experimental healing, allowing cell migration similar to the positive control with both concentrations (PHY 0.0075% and 0.12%) and only 0.0075% CHX allowed cell migration. In a comparative analysis, PHY showed less cytotoxicity than CHX and PHY concentrations of 0.0075% and 0.015% was non-toxic even after 48 hours of contact with the cells.
Conclusion: This in vitroevaluation demonstrated that PHY was less cytotoxic to NIH 3T3 fibroblasts compared to CHX. Furthermore, the different concentrations of PHY did not interfere negatively in the healing of experimental wounds.
Clinical Relevance: Due to the observed clinical adverse effects and cytotoxicity, it becomes necessary to search for alternatives to CHX. Respecting the limitations of the current in vitro study, PHY showed satisfactory and promising results as a potential alternative to CHX.
Resected lung adenocarcinoma with lymph node metastasis: Is ground glass opacity component a prognostic factor?
Authors: Deng Chaoqiang , Jiang Chenyu , Ma Xiangyi , Fu Fangqiu , Wang Shengping , Li Yuan , Zhang Yang , Chen Haiquan
Published: November 2023

Purpose
Ground glass opacity (GGO)-featured lung adenocarcinoma generally has excellent prognosis, and rarely has lymph node metastasis. We aim to explore the prognostic impact of GGO component in node-positive lung adenocarcinomas.
Methods
A total of 669 patients with pathologic N1/N2 lung adenocarcinoma receiving R0 resection and systemic lymph node dissection from 2008 to 2015 were reviewed, including 635 solid and 34 part-solid lesions. Propensity score matching (PSM) was performed to compare survival outcomes of solid and part-solid lesions, in order to determine the prognostic value of GGO component. Cox proportional hazard model was performed to identify significant prognostic factors for resected node positive lung adenocarcinoma.
Results
About 5.1% (34 of 669) resected node-positive lung adenocarcinoma presented as part-solid nodules on CT images in this cohort. The median nodule size on CT of 34 part-solid lesions was 31mm (range: 15-68mm), median solid component size on CT was 24mm (range: 12-62mm), and median consolidation/tumor ratio was 0.8 (range: 0.64–0.95). After 1:4 PSM, 136 patients and 34 patients were matched from solid and part-solid groups. No significant difference in either RFS (P = 0.71) or OS (P = 0.82) were found between solid and part-solid groups. Multivariable Cox regression pN stage as the strongest prognostic factors for RFS and OS. GGO component was not an independent prognostic factor toward either RFS [P = 0.753, HR(95%CI) = 0.93(0.59–1.46)] or OS [P = 0.528, HR(95%CI) = 1.19(0.69–2.05)].
Conclusion
A minority of resected node-positive lung adenocarcinoma present as GGO component on CT. The presence of GGO component does not predict better prognosis in node-positive lung adenocarcinoma.
Transport and inhibition of the sphingosine-1-phosphate exporter SPNS2
Authors: Sauer David , Li Huanyu , Pike Ashley , Chang Yung-Ning , Prakaash Dheeraj , Gelova Zuzana , Stanka Josefina , Moreau Christophe , Scott Hannah , Wunder Frank , Wolf Gernot , Scacioc Andreea , McKinley Gavin , Batoulis Helena , Mukhopadhyay Shubhashish , Garofoli Andrea , Pinto-Fernandez Adan , Kessler Benedikt , Burgess-Brown Nicola , Štefanic Saša , Wiedmer Tabea , Dürr Katharina , Puetter Vera , Ehrmann Alexander , Khalid Syma , Ingles-Prieto Alvaro , Superti-Furga Giulio
Published: November 2023

Sphingosine-1-phosphate (S1P) is a signaling lysolipid critical to heart development, immunity, and hearing. Accordingly, mutations in the S1P transporter SPNS2 are associated with reduced white cell count and hearing defects. SPNS2 also exports the S1P-mimicking FTY720-P (Fingolimod) and thereby is central to the pharmacokinetics of this drug when treating multiple sclerosis. Here, we use a combination of cryo-electron microscopy, immunofluorescence, in vitro binding and in vivo S1P export assays, and molecular dynamic simulations to probe SPNS2’s substrate binding and transport. These results reveal the transporter’s binding mode to its native substrate S1P, the therapeutic FTY720-P, and the SPNS2-targeting inhibitor 33p. Further capturing an inward-facing apo state, our structures illuminate the protein’s mechanism for exchange between inward-facing and outward-facing conformations. Finally, using these structural, localization, and S1P transport results, we identify how pathogenic mutations ablate the protein’s export activity and thereby lead to hearing loss.
The Significance of Filling Ultrasonography for Preoperative Staging of Colon Cancer Diagnosis: A Prospective Study
Authors: Feng Yingkai , Zhao Junmei , Fa Xinyu , Sun Xuan
Published: November 2023

Purpose
To investigate the value of filling ultrasonography in the preoperative staging diagnosis of colon cancer.
Methods
This study was a prospective, single-center, observational study. We performed CT examination and filling ultrasonography in 118 patients diagnosed with colon cancer by preoperative pathologic biopsy and compared the accuracy of filling ultrasonography and CT examination and the combination of the two examinations in the diagnosis of preoperative staging of colon cancer, using postoperative pathologic findings as the gold standard.
Results
In 118 patients, the overall diagnostic compliance rate of ultrasonography for T stage of colon cancer was 69.5% (86/118), of which the diagnostic compliance rate for T1-T2 stage, 75% (63/84) for T3 stage, and 63.6% (14/22) for T4 stage. the overall diagnostic compliance rate for lymph node metastasis of colon cancer was 68.6% (81/118), of which the diagnostic compliance rate for N0 was 81.7% (49/60), N1 59.6% (28/47), and N2 36.4% (4/11).The total diagnostic compliance rate of CT for the T-stage of colon cancer was 55.9% (68/118), of which the diagnostic compliance rate for the T1-T2 stage was 33.3% (4/12), 52.38% (44/84) for T3 stage and 90.9% (20/22) for T4 stage; the total diagnostic compliance rate of CT for lymph node metastasis of colon cancer was 39.8% (47/118), of which the diagnostic compliance rate was 28.3% (17/60) for N0, 44.6% (21/47) for N1 and 81.8% (9/11) for N2. By ROC analysis, ultrasonography was superior to CT for the diagnosis of T-stage (0.438 vs 0.243, P < 0.05) and N-stage (0.480 vs 0.231, P < 0.005).
Conclusion
Filling Ultrasound is valuable in the diagnosis of tumor characterization, localization, and preoperative staging, and the combined diagnosis with CT significantly improves the accuracy of colon cancer diagnosis and makes up for the shortcomings of the examination.
Isolation of KH2PO4 from crude glycerol purified using Acromonia aculleata charcoal as adsorbent
Authors: Freitas Milton Souza , Godinho João Victor , Nelson David Lee , Wentz Alexandre P. , Neri Claudio Roberto , Zanatta Lucas D. , Pessoa Fernando L. P. , Barbosa Sandro L.
Published: November 2023

Activated charcoal was prepared from Acrocomia aculeata (macaúba) endocarp by ZnCl2 activation. The charcoal was used for the adsorptive purification of pretreated crude glycerol (CG) and potassium dihydrogen phosphate (KH2PO4 or KDP) was formed by the addition of H3PO4 to the crude glycerol containing KOH, which was used as catalyst in the production of biodiesel and glycerol. The KH2PO4 was isolated and purified by recrystallization from aqueous solution. The KH2PO4 was characterized by X-Ray diffraction (XRD), thermal analysis (TGA/DTA) and spectrophotometry in the infrared region – FTIR. From 216.0 m of crude glycerol, 20.1038 g of purified KH2PO4 was obtained.
Impaired homeostasis of T follicular helper cells in elderly patients with COVID-19
Authors: Wang Yihan , Wang Qiu , He Furong , Qiao Nan , Li Xuejun , Wei Liqun , Sun Lingjin , Dai Weiqian , Li Ying , Pang Xueyang , Hu Jiayi , Huang Chuan , Yang Guangchen , Pang Chongjie , Hu Zhidong , Xing Man , Wan Chunxiao , Zhou Dongming
Published: November 2023

Background
In December 2022, the discontinuation of China’s dynamic zero policy resulted in a nationwide surge of Corona Virus Disease 2019 (COVID-19)-related cases and hospitalizations. We sought to probe the immune profile of the elderly with COVID-19 and explore the feasibility of a certain cell population as biomarker for risk stratification, which may provide foundation for the diagnosis and treatment of upcoming COVID-19 wave this winter. Our study recruited 57 elderly patients with acute COVID-19 and 27 convalescent donors. SARS-CoV-2-specific adaptive immunity including binding antibodies, neutralizing antibodies and T-cell responses were assessed across the COVID-19 severity spectrum.
Results
Patients with acute illness underwent impaired CD4+ T homeostasis, preferential loss of follicular helper T cell (Tfh) subsets including Tfh-em, Tfh-cm, Tfh1, Tfh2, Tfh17 and T follicular regulatory cells (TFR), which correlated with antibody production through different pathways, were observed. Severity of acute respiratory distress syndrome correlated with the degree of Tfh deficiency, which may act as biomarkers for risk stratification of elderly patients with COVID-19. Moreover, vaccination ameliorated Tfh and TFR deficiency and helped to promote NAb production.
Conclusion
The elderly had gone through severity-dependent CD4+-biased lymphopenia post SARS-CoV-2 infection, and vaccination contributed to ameliorate prognosis of them via alleviating the impairment degree of Tfh subsets.
Empowerment als Handlungskonzept der Medienpädagogik
Authors: Stix Daniela Cornelia
Published: November 2023

Es lässt sich feststellen, dass Modelle zu Medienkompetenzen und Medienbildung meist nur lokal begrenzt rezipiert werden. Der vorliegende Beitrag stellt deshalb insgesamt fünf Medienkompetenzmodelle aus Brasilien, Grossbritannien, Deutschland und den USA vergleichend vor. Den Modellen – das wird schnell deutlich – ist gemein, dass die Menschen befähigt werden sollen, sich Medien gemäss den eigenen Bedürfnissen sowie für kommunikative Prozesse, zunutze zu machen. Da die Befähigung in den verglichenen Modellen eine zentrale Rolle einnimmt, schien es naheliegend zu prüfen, inwiefern sich das Handlungskonzept des Empowerments auch für medienpädagogische Kontexte als Grundlage professionellen Handelns eignet.
Acute bronchitis: place, role and effectiveness of phytotherapy
Authors: Korkmazov M. Yu. , Kornova N. V. , Korkmazov E. V. , Korkmazov A. M.
Published: November 2023

Introduction. An urgent issue of modern medicine is still early diagnosis and treatment of virus-associated respiratory infections. In this context, infectious lesions of the tracheobronchial tree, associated with a high incidence and limited use of drug therapy, are of particular relevance. Analysis of individual mechanisms for the development of acute bronchitis will allow you to choose the addition of course treatment with herbal remedies with high efficiency and safety.

Aim. Based on the clinical and epidemiological analysis of the incidence of acute bronchitis and the study of the pathogenetic mechanisms of the development of the disease, to determine the effectiveness of the use of herbal preparations in the course of preventive treatment.

Materials and methods. An open, controlled, comparative clinical study was conducted on 63 patients with a diagnosis of acute bronchitis of viral etiology of preventive use in the complex therapy of a phytopreparation containing an extract of common ivy leaves and to evaluate its clinical efficacy and safety.

Results. Analysis of the literature showed a high incidence of acute bronchitis during the outbreak of acute respiratory viral infections, the variability of the clinical course and the need to use additional methods of treatment. An early positive trend was noted in people who, in addition to standard therapy, used a phytopreparation containing an extract of ordinary ivy leaves in comparison with preparations of the amino acid derivative of cysteine relief of all symptoms already on the 5th day. The drug was easily tolerated by patients; no side effects were observed.

Conclusions. Preventive use in the complex therapy of acute bronchitis, herbal preparations with mucolytic action, which facilitate sputum discharge, allows for a faster recovery.
Clinical manifestations of autoimmune rheumatic diseases in the larynx
Authors: Stepanova Ju. E. , Коren E. E
Published: November 2023

Introduction. Autoimmune rheumatic diseases are attributed to a systemic process that develops in many organs, including the larynx. Complaints of impaired vocal function in patients with this pathology require a thorough clinical and endoscopic analysis.

The purpose of the study. To determine the clinical-endoscopic changes of the larynx in patients with impaired vocal function in autoimmune rheumatic diseases..

Materials and methods. 31 (100%) patients aged 25 to 84 (41 ± 15) years with autoimmune rheumatic diseases applied to the phoniatric department of the St. Petersburg Research Institute of ENT. There were 3 men (10%), 28 women (90%). All patients complained of impaired vocal function, 5 of the examined (16%) were also concerned about breathing disorders during exercise or at rest.

Patients were grouped into three groups: systemic lupus erythematosus 4 (13%) people, systemic vasculitis 10 (32%) people, rheumatoid arthritis 17 (55%) people.

Videolaryngoscopy, videolaryngostroboscopy, autofluorescence endoscopy, NBI – endoscopy (according to indications) were used to make the diagnosis.

Results. The distribution of laryngeal pathology by nosological forms in patients with аutoimmune rheumatic diseases was as follows. The most numerous were groups with functional dysphonia of the hypotonic type 10 (32%) and bamboo nodules of 8 (26%) patients. Chronic laryngeal stenosis was diagnosed in 5 (16%), and chronic catarrhal laryngitis and soft nodules of the vocal folds in 3 (9.5%) people in each group (respectively). The smallest number of patients suffered from ulcerative necrotic changes of the larynx and pharynx – 2 (7%).

Conclusion. Thus, laryngeal changes in аutoimmune rheumatic diseases had both specific manifestations and non-specific ones. The latter include functional dysphonia of the hypotonic type, chronic catarrhal laryngitis, soft nodules of the vocal folds. Bamboo nodules of the vocal folds, ulcerative necrotic diseases, chronic laryngeal stenosis (infiltrative and scarring) were specific for patients with аutoimmune rheumatic diseases.
Combined therapy of broncho-obstructive pathology: two solutions to one problem
Authors: Vizel A. A. , Vizel I. Yu.
Published: November 2023

Chronic broncho-obstructive pulmonary diseases – bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) – are a serious clinical problem and an economic burden for practical healthcare. The purpose of the scientific review is to track the evolution of views on the use of bronchodilators and inhaled corticosteroids (ICS) in these diseases and to analyze modern approaches to treatment based on domestic and international guidelines. COPD treatment is aimed at two pathogenetic components – inflammation of the bronchi and the formation of emphysema. The basis of basic therapy remains the use of long-acting bronchodilators of two classes. Treatment of asthma is directed primarily at chronic inflammation of the airways using long-acting bronchodilators. The basis of basic therapy for asthma is the use of inhaled glucocorticosteroids. Currently, the same combinations of bronchodilators and ICS are recommended for both asthma and COPD. One direction is based on the use of ICS with formoterol, a 12-hour drug with a fast onset, in which the drug can be used on demand. The second direction is based on the constant use of ICS/LABA only on a regular basis, but with the ability to use bronchodilators on demand. In this case, ICS with high affinity are more often used. An important component of treatment is adherence to medical prescriptions and the availability of different types of drugs for patients in real clinical practice. At present, conditions have been created in Russia for the implementation of both the treatment of patients with asthma and the treatment of patients with COPD with frequent exacerbations and eosinophilia based on import substitution with modern drugs.
Experience of using omalizumab in patients with severe bronchial asthma
Authors: Bolotova E. V. , Dudnikova A. V. , Shulzhenko L. V.
Published: November 2023

Introduction. New insights into the complex pathophysiology of severe asthma (SA) have led to the development of personalized treatment strategies using genetically engineered drugs, which is based not only on disease severity, but also on specific patient characteristics and asthma endotypes.

Aim. Evaluation of the effectiveness of omalizumab in patients with severe bronchial asthma (SBA).

Materials and methods. A prospective observational study (12 months) with the participation of 39 patients with TB (20 women and 19 men, average age 47.7 ± 14.2 years) who were treated at the Ochapovsky Regional Clinic Hospital of Krasnodar Region. All patients included in the study were prescribed the drug omalizumab.

Results. After 6 months of follow-up, there was an improvement in asthma control in the form of an increase in the average number of points according to the ACT questionnaire: 15.9 (1.19) vs 10.7 (3.19); a decrease in the proportion of patients with an ACT score of ≤ 19 points by 15.6% (from 32 patients to 27), a decrease in the proportion of patients with the result of the ACT is less than 15 points by 16%. Within 12 months from the start of treatment with omalizumab, there was a decrease in asthma exacerbations regardless of the initial level of IgE and eosinophils, a decrease in the number of days of disability by 68.9%, the number of emergency calls by 50%, outpatient visits to a pulmonologist by 65.2%, the number of hospitalizations by 63.6%, the number of days spent in hospital – by 49.2, there was a significant decrease in daily doses of IGCS, oral GCS, the total number of exacerbations, the average score on the ACT test in all patients (p = 0.01).

Conclusions. Use of the drug omalizumab in patients with SBA, in combination with a different spectrum of sensitization, it was possible to bring the treatment of such patients to a qualitatively new level, providing a pronounced clinical effect by minimizing symptoms, stopping exacerbations, and improving the quality of life. It is important to have a good safety and portability profile, as well as a convenient application mode.
Long-term results of treatment of patients with newly detected pulmonary tuberculosis
Authors: Pavlova M. V. , Lushina O. V. , Anisimova A. I. , Archakova L. I. , Yablonskiy P. K.
Published: November 2023

Introduction. The article is devoted to the effectiveness of the treatment of pulmonary tuberculosis with multiple (MDR) and broad drug resistance (XDR) M. tuberculosis (MBT) in patients after the end of the main course of treatment (intensive and continuation phase), which were observed with clinical cure in 3rd dispensary registration group.

Aim. To study the long-term results of treatment of newly diagnosed patients with pulmonary tuberculosis with MDR and XDR MBT with the determination of significant risk factors for relapse in a megalopolis.

Materials and methods. The main course of treatment was completed by 119 newly diagnosed patients with pulmonary tuberculosis with MDR or XDR TB for the period from 2013 to 2019, who were treated in anti-tuberculosis hospitals in St. Petersburg and outpatient in St. Petersburg Interdistrict Petrograd-Primorsky TB Dispensary No. 3. The patients were divided into two groups: the main group (MG) consisted of 40 people who received treatment regimens that included drugs (thioureidoiminomethylpyridinium perchlorate (perchlosone, bedaquiline, linezolid ), the control group (CG) – 79 people who received who received standard therapy, without the above drugs. The groups are comparable in clinical, radiological and bacteriological characteristics. The course of treatment was found effective in 86 (72.3%): in MG – in 34 (85.0%) people, in CG – in 52 (65.8%) people, p < 0.01. These 86 patients were transferred to the 3rd group of dispensary registration with a diagnosis of “clinical cure”.

Results. Adverse treatment outcomes were analyzed, including the causes of tuberculosis recurrence. The use of drugs (perchlosone, bedaquiline, linezolid) in the complex chemotherapy of tuberculosis with MDR and XDR MBT increases the effectiveness of treatment of patients and significantly less often they have a recurrence of pulmonary tuberculosis (12.5%), compared with the group without the use of these drugs (27.8%). The most significant risk factors for relapses of drug-resistant tuberculosis: the preservation of residual cavities in the absence of bacterial excretion at the end of the main c male gender, concomitant pathology (HIV infection), past incarceration, late detection of the disease and destructive forms of tuberculosis.

Conclusions. The main course of therapy was found to be effective in 86 (72.3%) in patients with MG – in 34 (85.0%) people, in CG – in 52 (65.8%) people, p < 0.01. All the patients who completed the course of therapy were transferred to the 3rd group of dispensary registration with a diagnosis of “clinical cure”. Relapses of the disease occurred much less frequently in patients receiving perchlozon, bedaquiline, linezolid in complex therapy compared with the control group.
Management peculiarities of patients with chronic tonsillitis in comorbid conditions
Authors: Vladimirova T. Yu. , Fatenkov O. V. , Sokolova S. Yu. , Martynova A. B.
Published: November 2023

Introduction. Chronic tonsillitis (CT) remains an urgent challenge in outpatient practice of not only otorhinolaryngologists, but also multi-discipline specialists – primary care physicians and general practitioners.

Aim. To study the effectiveness of Tonsilgon® N at the outpatient care stage in CT patients with and without comorbidities. Materials and methods. 62 patients (30 to 56 years of age, average age 43.8 ± 13.2 years) with compensated CT were treated. The patients were divided into two groups: Group 1 (n = 30) included patients with compensated CT, Group 2 (n = 32) – patients with compensated CT and comorbidities: diabetes mellitus was detected in 40.6%, autoimmune thyroiditis in 43.7%, psoriasis in 15.7% of examined patients.

Results and discussion. Evaluation of treatment outcomes using a 10-point visual analogue scale showed a significant (p < 0.05) health improvement in patients of both groups who received Tonsilgon® N. The examination showed a 1.8-fold decrease in the severity of the local symptom of CT – hyperemia and a roll-like thickening of the edges of the pillars of the fauces in patients of both groups by the 7th day of treatment. The trends of changes were characterized by uniformity, amounting to 0.09 ± 0.02 scores in Group 1 and 0.1 ± 0.02 scores in Group 2 (p < 0.05) by the 14th day of treatment. In CT patients without comorbidities, exacerbations that developed within 3 months were only observed in 6.6% of patients, and occurred in a mild form, which made it possible to abandon the use of antibacterials for systemic use; in Group 2 with comorbidities, they were more common and developed in 12.5% of patients.

Conclusion. The high rate of successful treatment outcomes confirms the safety of the drug as an effective agent to relieve the severity of CT symptoms.
Mucoactive therapy in the treatment of sinusitis in patients with post-Covid syndrome
Authors: Ryazantsev S. V. , Balatskaya K. A.
Published: November 2023

Rhinosinusitis, as in the pre-ovoid era, are still the most common diseases in the practice of an otorhinolaryngologist. According to the results of the analysis of medical documentation conducted at the clinic of the St. Petersburg Scientific Research Institute of Ear, Throat, Nose and Speech, more and more patients associate the diseases of the nasopharyngeal space that have appeared in them and the increase in the number of exacerbations of existing chronic diseases of this area with a coronavirus infection. In this regard, we decided to consider approaches to the treatment of rhinosinusitis by summarizing the available data and considering individual clinical cases of patients with sinusitis and COVID-19. Antibiotic resistance associated with uncontrolled administration of antibacterial drugs when infected with SARS-CoV-2 has also become one of the frequent problems at present. Therefore, our article considers the most relevant method in this case, based on the use of phytotherapy. According to the literature, the most effective phytopreparations are preparations containing standardized myrtol, which reduces the viscosity of the mucus of the paranasal sinuses and nasal cavity, increases the frequency of beating of the cilia of the ciliated epithelium, thereby contributing to an increase in the speed of mucociliary transport. Standardized myrtol also has an anti-inflammatory effect by reducing the concentration of leukotrienes and prostaglandin, neutralizing free OH radicals, inhibiting oxidation processes myrtol reduces toxic effects on the nasal mucosa and paranasal sinuses, and also acts on pathogenic flora as a bacteriostatic drug. Clinical recommendations of the Ministry of Health of the Russian Federation from 2021 according to the treatment of acute sinusitis and the European recommendations of the European Position Paper on Rhinosinusitis and Nasal polyps (EPOS 2020), based on the data of controlled studies presented in them, the use of phytopreparations in the treatment of acute and chronic sinusitis is confirmed both in combination with antibacterial therapy and without antibacterial drugs in combination with irrigation therapy and the use of topical decongestants.
Evaluation of the efficacy and tolerability of the combination of lidocaine + phenazone in the local therapy of acute otitis media at the doperforative stage in adults
Authors: Svistushkin V. M. , Nikiforova G. N. , Zolotova A. V. , Shevchik E. A. , Nikiforova A. N. , Kochetkov P. A.
Published: November 2023

Introduction. Acute otitis media is a widespread multifactorial disease characterized by inflammatory changes in the mucosa of all parts of the middle ear. One of the most important tasks in the early stages of the disease is adequate anesthesia of patients. The article provides a retrospective assessment of the efficacy (speed of analgesia) and tolerability of topical use of Otipax® (lidocaine + phenazone) in adult patients with acute otitis media before perforation, the timing of its use is justified.

Aim. To assess the efficacy and tolerability of topical Otipax® in adult patients with pre-perforated acute otitis media prescribed by a physician in routine practice.

Materials and methods. Outpatient maps of 50 adult patients with acute otitis media were analyzed.

Results. In almost all 50 patients after the use of Otipax®, the analgesic effect occurred after 3 minutes. The analgesic effect remained on average for 35–40 minutes, then the pain gradually resumed, but in dynamics there was a decrease in its intensity. Hearing loss and ear congestion were initially noted in all patients, by the 3rd visit these complaints persisted, but their intensity was significantly lower, on the 10th day of observation there were no subjectively impaired hearing in any of the patients, which corresponded to acumetric and tuning fork data. The anti-inflammatory effect of Otipax® after a day provided a significant decrease in the intensity and area of hyperemia and infiltration of the eardrum. After 10 days, almost all patients had no otoscopic signs of otitis media. No adverse events were reported during the follow-up period.

Conclusions. The use of Otipax® (lidocaine + phenazone) ear drops complies with the clinical guidelines of the Ministry of Health of the Russian Federation in 2021 for the treatment of patients with acute otitis media before perforation, effectively and safely, is the method of choice for reducing ear pain in patients already at the primary appointment.
Complex treatment of destructive pulmonary tuberculosis using inhaled tauractant therapy
Authors: Tatarintseva M. P. , Batishcheva T. L. , Demidkov I. N. , Aroyan A. R. , Miletskiy A. V.
Published: November 2023

Introduction. Chemotherapy is the main component used in the treatment of tuberculosis. In addition to chemotherapy, pathogenetic treatment holds a special place in the complex treatment. The inhaled tauractant therapy restores phospholipid content on the surface of the alveolar epithelium, stimulates the involvement of additional lung parenchyma areas in breathing, facilitates elimination of toxic substances together with sputum from the alveolar space and protects the alveolar epithelium against injury caused by chemical and physical agents. Thereby it promotes acceleration of the lung parenchyma recovery processes.

Aim. To study the experience of using Surfactant-BL in patients with destructive pulmonary tuberculosis receiving a standard chemotherapy regimen, taking into account the drug susceptibility for Mycobacterium tuberculosis.

Materials and methods. A study was conducted involving 10 patients with destructive pulmonary tuberculosis who were diagnosed with it for the first time in their lives. They received treatment in Respiratory Tuberculosis Patients Department No. 4 of the Budgetary Healthcare Institution of Omsk Region – Clinical TB Dispensary in 2022–2023.

Results. Tauractant showed a pronounced positive effect on the destructive tuberculosis process in patients who already received a standard chemotherapy regimen. Inhaled therapy promoted acceleration of the cavity closure.

Conclusion. The addition of inhaled tauractant therapy to the standard chemotherapy regimen in patients with multidrug resistance (MDR) and pre-extensively drug-resistant (pre-XDR) respiratory TB significantly accelerated the TB cavity closure. The severity of intoxication and respiratory syndrome decreased in terms of clinical symptoms (relief of shortness of breath and cough). Spirography showed an increase in major indices of the pulmonary function test monitored at 2and 4-month follow-up.
The role of peak inspiratory flow in the selection of inhalation therapy in patients with chronic obstructive pulmonary disease
Authors: Trushenko N. V. , Lavginova B. B. , Obukhova N. E. , Brynza K. A. , Nuralieva G. S. , Nekludova G. V. , Avdeeva A. I. , Avdeev S. N.
Published: November 2023

Pharmacotherapy for chronic obstructive pulmonary disease (COPD) primarily relies on inhalation therapy. The choice of an appropriate inhalation device is of particular importance as it impacts the frequency of device use errors, patient adherence to treatment, and overall treatment effectiveness. Peak inspiratory flow (PIF) represents the maximum air flow rate generated by a patient during inhalation and is measured in liters per minute. Dry powder inhalers (DPIs) possess internal device resistance that patients must overcome to activate the device. Measuring PIF is an integral component of optimizing COPD therapy when utilizing dry powder inhalers (DPIs). For most DPIs, an optimal PIF value is considered to be no less than 60 L/min, while with a PIF of less than 30 L/min, the medication can’t reach the lower airways. At the same time, the clinical effectiveness of the use of DPI at values of PIF from 30 L/min to 60 L/min may be insufficient, therefore, it is necessary to take into account the value of PIF for the selection of basic COPD therapy. Given the lack of portable fluometers among doctors in real clinical practice, it is important to identify risk factors for suboptimal PIF in patients with COPD. Patients with emphysema, pulmonary hyperinflation, elderly, female, short height, obesity and comorbidity are at risk for insufficient PIF value for further effective use of DPI.This review provides essential information about the role of inspiratory flow for the effective use of DPIs, presents methods for its measurement, discusses predictors of suboptimal PIF, and offers recommendations for selecting inhalation devices for COPD patients based on PIF values.
Geography of patients in the federal ENT hospital before and after the COVID-19 pandemic: changing spatial patterns and characteristics
Authors: Korneenkov A. A. , Ovchinnikov P. A. , Vyazemskaya E. E. , Medvedeva A. Yu. , Yanov Yu. K.
Published: November 2023

Introduction. During the COVID-19 pandemic, access to elective specialized healthcare has decreased significantly. In addition to economic, social, cultural, organizational and language factors, access to healthcare also includes geographic factors. In our country, geographical barriers are an important negative factor hampering access to healthcare for patients living far from regional and federal centres.

Aim. This analysis provides an indirect view of the change in the availability of specialized medical otorhinolaryngological care. Describe the procedure for conducting a spatial analysis of the geographic accessibility of medical care.

Materials and methods. The study analyzed changes in the spatial characteristics of the place of residence of patients admitted for inpatient treatment at the St Petersburg Research Institute of Ear, Nose and Speech Throat before and after the onset of the COVID-19 pandemic. The study materials used anonymized data of 32,304 patients who were treated in a 24-hour hospital at the St Petersburg Research Institute of Ear, Nose and Throat and Speech from January 2016 to December 2022. Descriptive statistics, spatial statistics, non-parametric methods for testing hypotheses (Wilcoxon criterion for independent samples), odds ratio for binary factors and outcomes processed in the R software environment, built on the basis of OpenStreetMap cartography with QGIS geocoding, were used as research methods.

Results and discussion. In the study, geographic patterns of places of residence (locations) of inpatients before and after COVID-19 were obtained, and a visual assessment of their changes was made. The distances between the place of residence of patients and the place of provision of ENT care were calculated, and hypotheses were tested on the equality of the average geographical distance to the places of residence of patients before and after the pandemic. A count of patients and areas of zones of nuclear assessment of the probability density of patient locations in the country before and after the pandemic was made. The design of the study was an observational analytical retrospective study of the spatial characteristics of inpatients, in which the event of the onset of the COVID-19 pandemic acted as a factor.

Conclusion. In general, after the resumption of planned inpatient otorhinolaryngological care, its availability, which can indirectly be assessed using a spatial statistical analysis of the places of residence of patients of a federal budgetary institution, has not changed.
Omalizumab: a quarter of a century in the fight against T2-inflammatory diseases of upper and lower respiratory tract
Authors: Naumova V. V. , Beltyukov E. K. , Kiseleva D. V. , Shtanova A. A. , Stepina D. A.
Published: November 2023

T2 inflammation underlies diseases such as bronchial asthma, allergic rhinitis and chronic rhinosinusitis with nasal polyps. These diseases often have a severe course and often accompany each other, which leads to a significant decrease in the quality of life of patients. Studying the mechanisms of inflammation at the molecular level has made it possible to develop immunobiological drugs aimed at different stages of pathogenesis. One of the targets of immunobiological therapy for T2 inflammation, which can be affected by monoclonal antibodies, is immunoglobulin E. The purpose of the scientific review is to summarize the data accumulated over the past 25 years from randomized clinical trials and studies of real clinical practice on the effectiveness and safety of the original anti-IgE drug – “omalizumab”, including in comorbid patients. Clinical trials have shown that the use of omalizumab in patients with severe bronchial asthma reduces the frequency of exacerbations and severe exacerbations of asthma, reduces the number of hospitalizations and emergency room visits due to asthma exacerbations, reduces oral and inhaled glucocorticosteroids doses, improves respiratory function and improves quality of life. Omalizumab reduces the severity of nasal and ocular symptoms and reduces the need for antihistamines in patients with severe allergic rhinitis. Omalizumab effectiveness in patients with chronic rhinosinusitis with nasal polyps is manifested by decrease in nasal symptoms (nasal congestion, rhinorrhea), improvement in the sense of smell, decrease in polyps size, and the need for systemic glucocorticosteroids and surgical interventions. Omalizumab showed good tolerability and safety profile comparable to placebo in both clinical trials and routine practice.
Multi-spectral remote sensing for current irrigated area mapping of the Rift Valley Lakes Basin in Ethiopia
Authors: Mohammed Mulugeta , Birhanu Belete , Abegaz Fentaw
Published: November 2023

The study was conducted in the Rift Valley Basin in 2020–2022, with the objective of evaluating the newly developed techniques for irrigated area mapping of spatially large areas and assessing the current irrigated area in the basin. Methods used for irrigated area mapping are imagery analysis using the NDVI and EVI methods and land use classification. All results were verified with ground-truthing data using the sample locations selected. A 10 m × 10 m spatial resolution image derived from the European Space Agency Sentinel-2 satellite was used to create a time series spanning 2020, 2021, and 2022. Irrigated area maps from all three techniques were obtained and evaluated. Metric indicators were used to evaluate the performance of the irrigated area mapping techniques, the mean overall accuracy was 0.82, with a kappa coefficient of 0.76 and an F1-score of 0.86 with the highest and lowest overall accuracy observed in 2020 (0.86) and 2022 (0.76), respectively. Coefficient of determination was used to quantify the correlation of geospatial information and the multispectral remote sensing data analysis results maps agreed with irrigated area mapping with respect to ground truthing with R2 mean value of 0.87 which suggests a strong agreement.
Initial Assessment Form of Medical Record Document: Is It Important to Complete?
Authors: Zhafira Anisah Kesuma  , Nuthea Merry , Hariyanti Tita
Published: November 2023

Medical record document completeness is crucial because it serves as a means of communication, quality evaluation, payment, and legal protection. A preliminary study showed that none of the initial assessment forms in the outpatient unit of Puri Bunda Mother and Child Hospital were filled completely. This study aimed to explore the causes of incomplete initial assessment forms to avoid lawsuits against the hospital. The method used was qualitative research with a case study approach. Data were collected using triangulation, which included in-depth interviews with 15 participants, flow observations, and document studies on 150 medical record files. Data were analyzed using thematic analysis. The document study found none of the medical records with a complete initial assessment form (0%). A total of 141 documents (94%) were not filled at all, and only 9 (6%) of the initial assessment forms were filled in certain fields. The flow observation disclosed that file availability was one of the contributing problems to the completeness of filling. Seven reasons for incomplete initial medical assessment documents were categorized into individual internal and external factors. The internal factors include the lack of awareness of doctors and feeling a high workload, and the external factors include the absence of communication between management and doctors, unavailability of work procedures, the absence of a reward and punishment system, the format and availability of initial assessment forms, and individual culture.
Student’s knowledge of the mbkm program in the culinary education study program
Authors: Ekawatiningsih Prihastuti , Firdausa Ambar Rizqi , Mulyatiningsih Endang , Palupi Sri
Published: November 2023

The implementation of MBKM Program at the level of Study Program is expected to provide a good atmosphere for the development of student attention and talent. Students can hone their skills in learning situations that are innovative, flexible, based on student curiosity and interest. This study aims to see the student’s knowledge or understanding of the MBKM Program in the Culinary Education Study Program. The research was conducted using an online survey method. The subject of this research is the MBKM Program which includes: (1) MBKM Program, (2) Student Exchange activities, (3) Teaching Assistance activities, (4) Internship activities, and (5) Entrepreneurship Practice activities. This study involved 131 student respondents in the Culinary Education Study Program. Data was collected online with an answer scale of 1-5 to describe the level of student knowledge ranging from poor to very good. The survey results show that (1) the level of understanding of students in the MBKM program in general is in the good category, (2) the level of knowledge of Student Exchange activities and Teaching Assistance activities in the sufficient category, (3) the level of understanding of Internship activities and Entrepreneurship Practices in the good category, however, students experience misconceptions of understanding with similar regular activities that have been organized by the study program on a regular basis.