bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired Feedforward Control and Enhanced Feedback Control of Speech in Patients with Cerebellar Degeneration
Authors: Parrell Benjamin , Agnew Zarinah , Nagarajan Srikantan , Houde John , Ivry Richard B.
Published: August 2017

The cerebellum has been hypothesized to form a crucial part of the speech motor control network. Evidence for this comes from patients with cerebellar damage, who exhibit a variety of speech deficits, as well as imaging studies showing cerebellar activation during speech production in healthy individuals. To date, the precise role of the cerebellum in speech motor control remains unclear, as it has been implicated in both anticipatory (feedforward) and reactive (feedback) control. Here, we assess both anticipatory and reactive aspects of speech motor control, comparing the performance of patients with cerebellar degeneration and matched controls. Experiment 1 tested feedforward control by examining speech adaptation across trials in response to a consistent perturbation of auditory feedback. Experiment 2 tested feedback control, examining online corrections in response to inconsistent perturbations of auditory feedback. Both male and female patients and controls were tested. The patients were impaired in adapting their feedforward control system relative to controls, exhibiting an attenuated anticipatory response to the perturbation. In contrast, the patients produced even larger compensatory responses than controls, suggesting an increased reliance on sensory feedback to guide speech articulation in this population. Together, these results suggest that the cerebellum is crucial for maintaining accurate feedforward control of speech, but relatively uninvolved in feedback control.

SIGNIFICANCE STATEMENTSpeech motor control is a complex activity that is thought to rely on both predictive, feedforward control as well as reactive, feedback control. While the cerebellum has been shown to be part of the speech motor control network, its functional contribution to feedback and feedforward control remains controversial. Here, we use real-time auditory perturbations of speech to show that patients with cerebellar degeneration are impaired in adapting feedforward control of speech but retain the ability to make online feedback corrections; indeed, the patients show an increased sensitivity to feedback. These results indicate that the cerebellum forms a crucial part of the feedforward control system for speech but is not essential for online, feedback control.
Irony and Incomprehensibility: Beethoven's “Serioso” String Quartet in F Minor, Op. 95, and the Path to the Late Style
Authors: Bonds Mark Evan
Published: August 2017

Beethoven acknowledged the radical nature of his “Quartetto serioso” (1810) when he noted that it had been written for “a small circle of connoisseurs” and was “never to be performed in public.” The coda to the quartet's finale, with its sudden reversal of tone, has proven especially problematic, eliciting responses that include incomprehension (Marx) and outright dismissal (d'Indy). More recent accounts have pointed to irony as a strategy of negation, but Beethoven's contemporaries were inclined to embrace it as a constructive, liberating device. The Schlegel brothers, among others, championed it as the primary instrument of an epistemological framework that promoted the accommodation of multiple perspectives. The antifoundationalist nature of irony encourages a mode of understanding that precludes the possibility of any one “correct” perspective. Beethoven's use of “serioso” here and elsewhere, moreover, evokes a sense of the word that conveys pathos bordering on bathos. The “Quartetto serioso” is Beethoven's most extreme essay in irony, a device that would permeate his later works in more subtle but no less far-reaching ways. Opus 95 also reflects the growing prestige of artistic incomprehensibility, part of a broader shift from an aesthetics based on the principles of rhetoric, in which the artist bears the burden of intelligibility, to an aesthetics based on the principles of hermeneutics, in which the audience assumes responsibility for comprehending a given text. Beethoven's “late” works, often regarded as products of self-critique or turning inward, can thus be heard as part of a wider effort to engage audiences as active participants in a community dedicated to a dialectic of critique.
Intervención educativa en el alumnado con altas capacidades
Authors: Higueras-Rodríguez Lina
Published: August 2017

Este ensayo trata de dar una visión general de aspectos a considerar en la intervención educativa del alumnado con altas capacidades intelectuales. Por ello, trata sobre esta necesidad educativa, las características que presenta el alumnado y cómo se manifiestan. Además de dar un enfoque sobre la atención a la diversidad y la inclusión de este estudiantado dentro de clase y fuera de ella. Un aspecto significativo a resaltar es la importancia que tienen, tanto familias como docentes a la hora de atender las necesidades educativas que presentan estos niños y niñas.
Medicaid Managed Care Structures and Care Coordination
Authors: Gilchrist-Scott Douglas H. , Feinstein James A. , Agrawal Rishi
Published: August 2017

BACKGROUND:

Child enrollment in Medicaid managed care (MMC) has expanded dramatically, primarily through state mandates. Care coordination is a key metric in MMC evaluation because it drives much of the proposed cost savings and may be associated with improved health outcomes and utilization. We evaluated the relationships between enrollment in 2 MMC structures, primary care case management (PCCM) and health maintenance organization (HMO) and access to and receipt of care coordination by children.

METHODS:

Using data from the 2011/2012 National Survey of Children’s Health and the Medicaid Statistical Information System state data mart, we conducted a retrospective, cross-sectional analysis of the relationships between fee-for-service, PCCM or HMO enrollment, and access to and receipt of care coordination. State-level univariate analyses and individual and state multilevel multivariable analyses evaluated correlations between MMC enrollment and care coordination, controlling for demographic characteristics and state financing levels.

RESULTS:

In univariate and multilevel multivariable analyses, the PCCM penetration rate was significantly associated with increased access to care coordination (adjusted odds ratio: 1.23, P = .034) and receipt of care coordination (adjusted odds ratio: 1.37, P = .02). The HMO penetration rate was significantly associated with lower access to care coordination (adjusted odds ratio: 0.85, P = .05) and receipt of care coordination (adjusted odds ratio: 0.71, P < .001). Fee-for-service served as the referent.

CONCLUSIONS:

State utilization of MMC varied widely. These data suggest that care coordination may be more effective in PCCM than HMO structures. States should consider care coordination outcomes when structuring their Medicaid programs.
A Multidimenzionális Észlelt Társas Támogatás Kérdőív magyar nyelvű validálása
Authors: Papp-Zipernovszky Orsolya , Kékesi Márk Zoltán , Jámbori Szilvia
Published: August 2017

Elméleti háttér

A társas beágyazottság az optimális funkcionálás, a jóllét egyik komponense. Emellett hazai és nemzetközi eredmények szerint is a lelki és testi egészség megőrzésének kulcstényezője – elsősorban stresszhelyzetekben. A Multidimenzionális Észlelt Társas Támogatás Kérdőívet (Multidimensional Scale of Perceived Social Support; MSPSS) 1988-ban fejlesztették ki Zimet és munkatársai, és azóta több európai és ázsiai nyelvre is lefordították. A kérdőív pszichometriai jellemzői a legtöbb esetben kiválóak. Cél: Mivel magyar nyelven jelenleg egyetlen validált, a Caldwell-féle, társas támogatást mérő kérdőív érhető el, amelynek a kiértékelése nehezen számszerűsíthető, tanulmányunk célja, hogy bemutassuk a MSPSS kérdőív magyar nyelvű validálását felnőtt mintán (n = 1073; 72,9% nő).

Módszerek

A feltáró faktoranalízis mellett megerősítő eljárást is alkalmaztunk. A konvergens és divergens validitás vizsgálatára a következő mérőeszközöket használtuk fel: Társas Támogatás Erőssége Kérdőív, Caldwell-féle Társas Támogatás Kérdőív, Általános Énhatékonyság Skála, Big Five Kérdőív Extraverzió és Barátságosság skálái és a Családi Szocializáció Kérdőív.

Eredmények

A feltáró és megerősítő faktorelemzés eredményei alapján a végső kérdőívben 10 tétel maradt. Ebből 4 állítás a Család alfaktorához, 3 állítás a Barátok alfaktorához és 3 állítás a Jelentős mások alfaktorához tartozik. Az egyes faktorok belső megbízhatósága (Család: Cronbach-α = 0,91; Barátok: Cronbach-α = 0,93; Jelentős mások: Cronbach-α = 0,87) és az egész kérdőív reliabilitása (Cronbach-α = 0,91) megfelelőnek bizonyult. A kérdőív illeszkedési mutatói az elfogadható vagy a jó tartományba estek (CMIN/DF = 5,876; CFI = 0,974; RMSEA = 0,08; GFI = 0,949; TLI = 0,963).

Következtetések

Az MSPSS magyar változata egy érvényes és megbízható mérőeszköz, amely egyrészt mutat összefüggést más, széles körben használt sztenderd kérdőívekkel, másrészt van az észlelt társas támogatás pszichológiai kérdéskörének több olyan szelete, amelyet a korábbi eszközök nem fedtek le, így indokolt az új kérdőív bevezetése.
Salvage Therapy in Advanced Adult Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis of Randomized Trials
Authors: Comandone Alessandro , Petrelli Fausto , Boglione Antonella , Barni Sandro
Published: August 2017

Background

Prognosis for patients with metastatic soft tissue sarcomas (STS) is dismal, with median overall survival (OS) of 8–12 months. The role of second-line therapy has been inconsistently investigated over the last 20 years. This systematic review and meta-analysis was performed to assess the efficacy of salvage treatment in pretreated adult type STS, gastrointestinal stromal tumor (GIST) excluded.

Material and Methods

PubMed, Web of Science, SCOPUS, EMBASE, CINAHL, and The Cochrane Library were searched for randomized phase II/phase III trials exploring second- or beyond therapy lines in pretreated metastatic STS. Two independent investigators extracted data; the quality of eligible studies was resolved by consensus. Hazard ratio (HR) of death and progression (OS and progression-free survival [PFS]) and odds ratio (OR) for response rate (RR) were pooled in a fixed- or random-effects model according to heterogeneity. Study quality was assessed with the Cochrane's risk of bias tool, and publication bias with funnel plots.

Results

Overall, 10 randomized trials were selected. The pooled HR for death was 0.81 (95% confidence interval [CI] 0.73–0.9). Second-line therapy reduced the risk of progression by 49% (HR = 0.51, 95% CI 0.34–0.76). This translated into an absolute benefit in OS and PFS by 3.3 and 1.6 months, respectively. Finally, RR with new agents or chemotherapy doublets translated from 4.3% to 7.6% (OR = 1.78, 95% CI 1.22–2.50).

Conclusion

Better survival is achieved in patients treated with salvage therapies (chemotherapy, as single or multiple agents or targeted biological agents). A 3-months gain in OS and an almost double RR is observed. Second lines also attained a reduction by 50% the risk of progression.

Implications for Practice

There is some evidence that salvage therapies after first-line failure are able to improve outcome in metastatic soft tissue sarcoma (STS). Trabectedin, gemcitabine-based therapy, and pazopanib are currently approved drugs used after conventional upfront treatment. This meta-analysis reviews the benefit of new agents used in randomized trials in comparison with no active treatments or older agents for recurrent/progressed STS. The results show that modern drugs confer a statistically significant 3-month benefit in terms of overall survival, and an increase in response rate. Despite a limited improvement in outcome, currently approved second-line therapy should be offered to patients with good performance status.
BREVIARIO CULTURAL: EVOLUCIÓN DEL CONCEPTO HISTORIA Y DE LA CONCEPCIÓN DEL SER HUMANO
Authors: Patiño Román Alejandro
Published: August 2017

La diversidad de las culturas corresponde a la complejidad de los sistemas que esa cultura genera en su interior. Esa abundancia es necesaria, ya que, la cultura debe dar respuesta a todo. En el orden de la vida y de la muerte. La filosofía de la historia toma en cuenta la diversidad de las civilizaciones en el tiempo y espacio en que se presentaron y los cambios que han sido claves para su trasformación.
THE WELL-BEING AT WORK AND RESILIENCE: A STUDY CORRELATION IN NURSING TECHNICIANS IN HOSPITAL
Authors: Dias Abreu Heide , Rodriguez Blanco Alberto José Manuel
Published: August 2017

This article analyzes resilience and well-being at work as important constructs in the discussion of health promotion. In the hypothesis that well-being correlates with resilience, they are analyzed in the context of positive psychology by dialoguing with social psychology. An exploratory method was used in a sample of 131 nursing technicians. The theoretical models used were the Inventory of Well-being at Work and the Resilience Scale for Adults. Results: Consistency was analyzed by composite reliability and Cronbach's alpha, convergent validity through the AVE. The KMO test verified if the factorial analysis model used was adequately adjusted to the data. Confirmatory factorial analysis was performed for validation and Spearman’s correlation to measure the relationships between variables. The correlation analysis indicated that there is a positive correlation between indices (r = 0.20, p = 0.096) and indicators of well-being and resilience. Concluding the greater the resilience is, the greater welfare at work is and vice versa.
DA SOCIEDADE DE CONSUMO AO SUJEITO CONSUMIDO
Authors: Leite Marco Correa
Published: August 2017

Este artigo pretende discutir as relações humanas na contemporaneidade pela ótica psicanalítica, bem como as perspectivas de subjetivação dos indivíduos contemporâneos. Articula-se a visão de mundo e de homem a partir da psicanálise com pensadores e teóricos da sociedade para chegar ao ponto de compreender alguns motivos pelos quais os seres humanos têm se relacionado com o outro como objeto de consumo - mercadoria, e não como objeto no sentido de troca afetiva, tal qual compreendemos os vínculos afetivos a partir da psicanálise freudiana.
Children’s health of Saint Petersburg
Authors: Orel Vasily I , Sereda Vasily M , Kim Andrey V , Sharafutdinova Lyubov’ L , Bezhenar Sergey I , Buldakova Tatyana I , Roslova Zinaida A , Orel Vyacheslav V , Gureva Natalya A
Published: August 2017

Now in the Russian Federation negative tendencies in the state of health of children in all age categories are observed: high incidence, growth of prevalence of chronic pathology, existence of morfo-functional deviations, deterioration in the main quality indicators of health of children. Studying of data on incidence, death rate, disability, physical development and a role of the factors determining them in separate age groupes holds a specific place in assessment of health of children. For receipt of objective assessment of the state of health of the children’s population it is necessary to analyze in interrelation statistics on different sources: database of compulsory health insurances funds, medical examinations of children, accounting and reporting documentation of the medical organizations, computer methods of inspection of the children’s population. Social and hygienic researches on this problem are of great importance for practical health care consisting in development of recommendations about decrease in indicators of incidence, disability and death rate of children, offers of new organizational forms of work of treatment and prevention facilities. We in article provided the analysis of the children of 0-17 years this about the state of health inclusive of St Petersburg for the period 2011-2015. The main demographic characteristics of the children’s population are studied, features of physical development of children of 0-17 years inclusive, incidences, including prevalence of chronic pathology and socially important diseases among the children’s contingent, disability are revealed.
Main pediatric urology Saint Petersburg, professor Igor Borisovich Osipov (70th anniversary)
Authors: Lebedev Dmitry A , Sosnin Evgeny V , Osipov Anton I , Lifanova Maria V , Sarychev Sergey A , Krasilnikov Dmitry E , Alekseeva Ludmila A
Published: August 2017

It has become 70 years since birth and 40 years of medical, scientific, pedagogical and social activity of Professor Igor B. Osipov, ScD, chief of urology chair of Federal State Budget Educational Institution of High Education Saint Petersburg State Pediatric Medical University and not established chief pediatric urologist of Saint Petersburg. Igor B. Osipov graduated from Crimea State Medical Institute. Since 1973 till 1977 he had worked as an urologist at Pediatric Hospital No 2 named after N. Krupskaya and later he became one of the best followers of Professor G.A. Bairov, corresponding member of USSR Academy of Science, and E.A. Ostropolskaya. In 1996 he brilliantly got the degree of ScD on the subject of surgical treatment of children with bladder extrophy and in 1997 he became professor of pediatric surgery chair. Igor B. Osipov is always finding time for every side of his polyhedral talent. He actively performs scientific work, pedagogical practice and newer gives short of his attention to any colleague, follower or a parent of sick child. Professor Osipov is an author of 280 scientific works and 11 patents. For many years he has been not established chief pediatric urologist-andrologist of Saint Petersburg applying all his forcers and abilities on improvement of management of pediatric urology service. For long years Professor Igor Osipov has been board member of Russian Urology Society. Since 1999 to 2010 he had been scientific work pro-rector of Pediatric University, successfully uniting leadership at scientific activity of University and urology chair. His human characteristics as kindness, philanthropy, tenderness, insistence and diligence, his working achievements lay at the base of his success and huge scientific, medical and organizer authority in Russia and abroad.
Neuropsychiatric development of children in the first 6 months of life born with fetus growth delay
Authors: Ivanov Dmitry O , Kozlova Lyudmila V , Derevtsov Vitaly V
Published: August 2017

Features of the neurological status and neuropsychiatric development (NPD) in children at the age of 6 month of life born with fetus growth delay (G 1) in comparison with children born without fetus growth delay (G 2) are revealed in the article. Attention group was composed of 13 (22.41%) of children G 1. NPD delay was reported in 15.69% of children in G 1 and in 20.51% of children in G 2 at the age of 3 month of life. Thus, 13.73% of G 1 children (17.59% of G 2 children) were included in the attention group while 1.96% of G 1 children (2.56% of G 2 children) composed the control group. By the end of the first six months of life proper NPD was observed in the same percentage of cases (33.33% in G 1). Lower harmonious development dominated in all cases, but non-harmonious NRD was observed in children of G 2 born with fetus growth delay. Attention group was composed of 58.82% of G 1 children, risk group – of 5.88% and dispensary group – of 1.96%. Changes in the following lines of development were registered: general movement, active speech, skills and social behavior.
Serological level of transforming growth factor-β as a predictive biomarker of aortic enlargement in patients with Marfan syndrome
Authors: Rudoy Andrey S , Uryvaev Alexey M
Published: August 2017

Marfan syndrome - an inherited, autosomal dominant disease with an expected rate of 3-5/10 000 or fraction of 20-25% of new mutations, accompanied by violation of the connective tissue that occurs as a result of gene mutations FBN1, coding for the synthesis of fibrillin-1, performing the most important role in the modulation physiological bioavailability TGF-β (transforming growth factor-β). Prediction of aortic rupture is based on the identification of risk factors: family history, the absolute size of the aortic root, the rate of expansion of the aorta, which are based on the results of the history and techniques of imaging ultrasound, CT, MRI. At the same time there is a chance of developing aortic rupture under normal aortic root size and the absence of any risk factors, as well as after the prophylactic prosthetic aortic root. This makes it necessary to search for alternative prognostic markers, threatening bundle and rupture of the aorta. Article verified the predictive role of TGF-β as a serological biomarker for assessing the extension of the aortic root in patients with Marfan syndrome (n = 23, F : M / 7 : 16; 33 ± 9.3 years). The article describes the patterns between TGF-β and the size and the reconstruction of the aneurysm of the thoracic aorta. It was found that elevated levels of serum TGF-β1 (49.1 ng/ml Vs 29.15 ng/ml in the control, p < 0.05) in patients with MS diagnosed with an extension of the aortic root (Z > 1.96) can serve as a serological marker to poor prognosis, accompanied by an increase in the size of the aortic root. In patients with normal-sized aorta, and after aortic reconstruction serum TGFβ1 not elevated. Serum TGFβ may be a promising target for therapeutic, diagnostic and prognostic tactics which are not based on imaging techniques.
Features of the dynamics of self-assessment of people with autism spectrum disorders in the rehabilitation process
Authors: Kosina Nataliia V , Vasilyeva Mariya A
Published: August 2017

This article is devoted to analysis of the dynamics of self-assessment of persons with autism spectrum disorders in the rehabilitation process. The findings suggest that in the process of rehabilitation in this group of satisfaction with life in general increases, self-assessment becomes more adequate and related primarily to the importance of social support, focusing on social interaction and the ability to properly understand their feelings. In the process of rehabilitation self-perception becomes more realistic, appears the striving for greater sensitivity, empathy and self-confidence. In the process of rehabilitation work activity, sociability and optimism, orientation to urgent incentives and external circumstances increases, the ability to describe and identify feelings improves, the feeling of loneliness reduces, stresses the importance of social activity and interaction with family and people around, awareness and understanding of life events. Also it should be noted that examinees begin to perceive themselves introversive, closed, selfish and hostile, however seek to become surer, independent, energetic, active and resolute. The rehabilitation process contributes to a realistic assessment of yourself, your future and interaction with the social environment. The results of the study confirm the high efficiency of psychological support and comprehensive rehabilitation measures for improving social adaptation in society of persons with autism spectrum disorders.
The status of autonomic nervous system and adaptation in infants with the different types of intrauterine growth restriction
Authors: Ivanov Dmitry O , Kozlova Lyudmila V , Derevtsov Vitaly V
Published: August 2017

The article presents the characteristics of the status of autonomic nervous system and adaptation in babies with the different types of intrauterine growth restriction (IUGR). In infants the presence of symmetrical IUGR in comparison to asymmetrical IUGR is related to higher frequency of first- and second-degree cerebral ishaemia at birth and autonomic dysfunction starting from the second six months of life. Thus, babies with symmetrical IUGR display: lower sympathetic nervous system activity and depletion of adaptation reserves at the age of two-three days; higher sympathetic activity and strain on adaptation, high frequency of asympathicotonic responsiveness of the autonomic nervous system at the age of one month; higher sympathetic activity and higher frequency of adaptation strain with the prevalence of adaptation failure at the age of three months; lower sympathetic activity and higher frequency of asympathicotonic autonomic responsiveness at the age of six months; higher sympathetic activity and strain on compensatory reserves, higher frequency of asympathicotonic autonomic responsiveness and adaptation dysfunction with the prevalence of unsatisfactory adaptation at the age of 12 months. The proven facts should lead neonatologists and pediatricians to specifically monitor infants having had intrauterine growth restriction in their past medical history, especially those who have suffered from symmetrical intrauterine growth restriction, and to take preventive measures against autonomic dysfunction in the first six months of life of such infants and curative measures starting with non-pharmacologic ones or with a sparing use of drugs in the second six months of life. At the same time, infants having had asymmetrical intrauterine growth restriction demand special attention during the neonatal period and at the age of twelve months.
The results of an evaluation of quality of care and life in children with epilepsy
Authors: Guzeva Oksana V , Guzeva Valentina I , Guzeva Victiria V , Ochrim Inna V , Maksimova Nadezhda E , Chokmosov Mikhail S , Shin Svetlana V
Published: August 2017

Epilepsy is characterized by a chronic course, repeated seizures and psychopathological disorders. The debut of epilepsy occurs mainly in childhood, and the frequency of the disease in the child and adolescent population is 0.5-0.75%. The interrelation of the forms of the disease with the perception of the child’s environment, the quality of his life, according to the literature, are not well studied. The establishment of this interrelation will help better understand of the psychology of sick child, improve quality of life, and its characteristics have to be considered in the prescribing the therapy. The aim of this study is to identify the impact of the form of epilepsy on the perception of the child or the parents of the treatment process, the conditions of stay in the medical institution, the assessment of quality of life. At the department of neurology, neurosurgery and medical genetics SPbSPMU examined 50 children with epilepsy, and conducted a survey of the children and their relatives. To children diagnosed symptomatic or cryptogenic epilepsy (the first group), to 14 children - idiopathic epilepsy (the second group). All patients were also tested, during which children and/or their parents were asked to answer 15 questions related to the finding on the treatment in the clinic. The studying of the significant differences in positive responses to each question in children groups I and II using the exact method of Fisher revealed significant differences in the answers to questions related to the conditions in hospitals, silence during examinations, and satisfaction with the continuance of waiting a doctor visit. Close relatives and children were given 10 questions regarding satisfaction with various aspects of life. A comparison of the number of positive ratings from relatives children’s group I and II using the exact method of Fisher showed that relatives of children of group II received for responding significantly greater number of good marks.
Choise of local antibacterial medications for prevention of sternal infection
Authors: Shihverdiev Nazim N , Khubulava Gennadiy G , Marchenko Sergey P , Suvorov Vitaliy V , Zaitsev Vladimir V , Averkin Igor I , Badurov Ruslan B
Published: August 2017

Infection of wounds in surgery is one of the most frequent complications in the postoperative period. The development of this complication increases the duration of hospitalization, resulting in higher treatment costs, as well as the impact to the level of hospital mortality. There are many methods are exist to avoid this complication, which are allow to decontamination of pathogenic and conditionally pathogenic microorganisms including applying antimicrobial agents prior to surgery. One such method is intravenous antibiotic shortly before surgery. But there is evidence in the literature of successful local antibiotics in neurosurgery, traumatology and orthopedics, operations on the thorax and abdominal organs, including for prevention of sternal infection. For this purpose most often used vancomycin and gentamicin. This is often a causative agent of wound infection, which is a gram-positive flora: Staphylococcus aureus and Staphylococcus epidermidis. To increase the effectiveness of preventive measures to reduce the incidence of sternal infection intraoperatively topically applied antibiotics in various forms when closing the wound. For parenteral administration of antibiotics effective therapeutic dose is often not achieved, because it depend on the time period since the introduction of the substance until the start of the operation [3]. Local application of antibiotics to a reduction of frequency wound infection, as concentration of a substance is directly dependent on the applied dose.
Infant mortality in Russian Federation and influence on its dynamic factors
Authors: Ivanov Dmitry O. , Oryol Vasily I. , Alexandrovich Yuri S. , Prometnoy Dmitriy V.
Published: August 2017

Minimizing infant mortality (IM) is the primary national objective of the Russian Federation.

Aim: This study aimed to analyze IM indicators in the Russian Federation and identify factors that influence the dynamics of IM. The level of leading regional indicators of socioeconomic development and provision by doctors and hospital beds in the Russian Federation was studied and compared with the similar factors in foreign countries.

Materials: Official and operative reports of Rosstat for 2011-2016 were assessed.

Results. The coefficient of IM was 6.0 per 1000 live births in the Russian Federation, and varied from 4.8-9.2 in federal districts. The indicator increased in 2012 in connection with the transition to a new system of newborn registration. The indicator witnessed a permanent decline in 2016 and revealed a negative correlation between the regional bulk products and the coefficient of IM and a positive correlation with the overall IM. However, the relationship among the indicators of IM and the size of the region, the number of highways, the number of patients per one hospital bed or assigned to one doctor could not be established.

Conclusion. In the Russian Federation, IM is higher than that indeveloped countries; has permanent tendency to decline; correlates with regional bulk products; does not depend on transport availability, provision with doctors, and hospital beds; and is determined by the organization and the quality of medical care.
Characteristics of acute period of traumatic brain injury in children with hemophilia
Authors: Guzeva Valentina I , Ochrim Inna V , Maksimova Nadezhda E , Guzeva Oksana V , Guzeva Victoria V , Abramova Natalia N , Rodionov Jurii V
Published: August 2017

The clinical picture of traumatic brain injury (TBI) in children is characterized by pronounced polymorphism. To clarify the severity of TBI and the localization of the pathological process, use computed tomography (CT) or magnetic resonance imaging (MRI) of the brain.

The aim of the work was to justify the need for neuroimaging to all children with hemophilia with TBI and to determine the correlation between the severity of clinical manifestations and neuroimaging data. The article describes the clinical case of a favorable outcome of an TBI in a toddler child with hemophilia A. The case is of interest to physicians of various specialties and demonstrates the features of the clinical course of acute TBI with hemophilia. The diagnostic process for TBI was based on complaints, clinical and neuroimaging data. Complaints and the circumstances of the injury are known from the mother's words in connection with the early age of the child and the absence of a formed speech. Methods of investigation: collection of complaints and anamnesis of the disease, neurological examinations, laboratory and instrumental data, including neuroimaging data. It is known that the boy fell off the couch, hit the back of the head, did not lose consciousness, there was no vomiting. A day after receiving the injury, there was an increase in cerebral neurological symptoms. Clinically, hematoma is suspected. On the CT of the brain, epidural hematoma was determined. Thus, the presented clinical case illustrates that even a minor head injury in patients with hemophilia can lead to severe consequences. Neuroimaging of the brain with TBI is indicated for all children with hemophilia, regardless of the severity of clinical manifestations.
The auditory function of infants with congenital heart diseases
Authors: Nnomzo’o Alice , Pavlov Pavel V , Garbaruk Ekaterina S , Gorkina Oksana C , Olina Olga S
Published: August 2017

Congenital heart disease (CHD) is 1/3 of all congenital malformations and one of the main causes of infant mortality. Hearing loss may be part of syndromes associated with CHD, or the hearing pathology can be a consequence of the various stages of rehabilitation of underlying pathology. Currently, there isn’t any data on the systematic study of hearing impairment in children with congenital cardiac pathologies. Three hundred and six patients aged 2 days to 8.5 months were examined: 96 patients were included in the main group with CHD, and 300 children without CHD made up a comparison group. All children underwent newborn hearing screening. Infants with suspected hearing pathology were tested with a comprehensive audiological examination. In the CHD group hearing impairment was detected in 29% of children, including sensorineural hearing loss (SNHL) in 12%. And in the comparison group, 3.6% of infants had a hearing loss, SNHL was defined in 1%. Analysis of the data revealed the most significant risk factors for hearing impairments in children with CHD and it had showed the difference in the structure of the risk factors between the both groups. In the study group was registered a case of auditory neuropathy spectrum disorders. This case illustrated the importance of conducting hearing screening by means of click-evoked auditory brainstem responses and not only of registration of otoacoustic emissions. One child with CHD was found to have delayed SNHL, which requires long-term monitoring of hearing in children with cardiopathology.
Possibilities of topical treatment of inflammatory diseases of vulva and vagina in girls
Authors: Mironova Anna V , Chernichenko Ivan I
Published: August 2017

Vulvitis and vaginitis in girls are the most frequent reason for contacting a pediatric gynecologist. The article considers options for local treatment with various forms of inflammation of the vulva and vagina. In recent years, there has been an increase in this pathology. The maximum number of appeals is observed at 1 year of age and at the age of 3-7 years. The formation of the inflammatory process in the vagina is caused by the state of the endocrine and immune systems, as well as a number of anatomical and physiological features of the structure of the external sexual organs. An important role in the development of vulvovaginitis and vulvitis is played by extragenital pathology. The development of the secondary inflammatory process in the vagina provokes such diseases as urinary tract infection, dysbacteriosis, atopic dermatitis, noopharyngeal diseases, frequent colds, transient immunodeficiency states, childhood infections. The clinical manifestations of vulva-guinitis and vulvitis are similar and depend on the severity of the process, the type of exciter. In acute nonspecific vulvovaginitis, a vivid clinical picture is typical. This discharge from the genital tract, hyperemia and swelling of the vulva, discomfort, burning with urination. The diagnosis of the disease is based on the details of complaints, clinical picture, laboratory and instrumental diagnostic methods. In the treatment of non-specific vulvovaginitis, girls rarely resort to the use of systemic antibacterial drugs. Preference is given to topical preparations. The advantage of local treatment is a minimal risk of adverse reactions, simplicity and ease of use, in the absence of contraindications (except for individual intolerance of the drug), as well as in the possibility of use in extragenital pathology.
A Percepção de Cirurgiões sobre o Cuidado em Estomias
Authors: Moraes Juliano Teixeira , Silva Alexandre Ernesto , Silva Marlene Das Dores Medeiros , Guimarães Raquel Oliveira , Ferraz Guilherme Barbosa
Published: August 2017

A assistência a pessoas com estomias exige reflexão sobre os aspectos de reabilitação, significando um grande desafio para o profissional de saúde. A pesquisa teve por objetivo descrever a percepção de médicos cirurgiões sobre a assistência à saúde das pessoas com estomias, em um hospital de grande porte, referência para uma região de saúde de Minas Gerais. Utilizou-se questionário semiestruturado que buscou captar a percepção destes profissionais em relação ao atendimento a estas pessoas no hospital. Foi realizada a análise de conteúdo, que se dividiu em três etapas: pré-análise; exploração do material e criação das categorias; interpretação dos dados e discussão. Foram entrevistados sete médicos cirurgiões. Da exploração do material coletado emergiram três categorias temáticas: necessidade de orientação multidisciplinar à pessoa com estomia; atuação na confecção de estomia; acompanhamento pós-operatório e orientações; e deficiência na aquisição de conhecimento sobre estomias durante a formação médica. Este estudo mostrou que os médicos cirurgiões têm atuado como integrantes da equipe multidisciplinar de atendimento às pessoas com estomias. No entanto, ainda se percebe uma deficiência na aquisição de conhecimentos sobre estomias durante a graduação.Palavras-chave: Estomia. Cirurgiões. Assistência Médica.AbstractAssistance to people with stomies requires a reflection on the rehabilitation aspects, meaning a great challenge for the health professional. This article aimed to describe the medical surgeons’ perception about the people’s health care with stomies in a large hospital reference for a health region from Minas Gerais. This is a descriptive qualitative research. A semi-structured questionnaire was used that sought to capture the perception of these professionals regarding the care given to these people in the hospital. Content analysis was performed, which was divided into three stages: pre-analysis; Exploitation of material and categories creation; Data interpretation and discussion. Seven medical surgeons were interviewed. From the exploration of the material collected, three thematic categories emerged: the need for multidisciplinary guidance to the person with the stoma; Performance in the manufacture of the ostomy and postoperative follow-up and guidelines; and deficiency in acquiring knowledge about ostomies during medical training. This study showed that medical surgeons have acted as members of the multidisciplinary team of caregivers with ostomies. However, a deficiency in the acquisition of knowledge about ostomies during under graduation is still noticed.Keywords: Ostomy. Surgeons. Medical Assistance
O Brincar na Percepção de Enfermeiros em um Hospital Pediátrico do Maranhão
Authors: Fernandes Maria Neyrian de Fatima , Chaves Flávia Loiola , Nunes Jacqueline Targino , Costa Ana Cristina Pereira de Jesus
Published: August 2017

Objetivou-se compreender a percepção do enfermeiro em relação ao brincar durante a assistência pediátrica em um hospital do Maranhão. Estudo exploratório-descritivo, de abordagem qualitativa envolvendo doze profissionais. A coleta de dados se realizou em agosto de 2013 em um hospital pediátrico do interior do Maranhão, Brasil. Utilizou-se um roteiro de entrevista semiestruturado composto por cinco questões relacionadas ao brincar. Os dados coletados foram tratados de acordo com a Análise de conteúdo de Bardin. Foram abordadas as seguintes categorias: “o brincar e a comunicação”, “o brincar e o tratamento” e “o brincar e a infraestrutura necessária”. A partir dos resultados se percebeu que os enfermeiros reconhecem a importância do brincar durante o internamento pediátrico, mas não o utilizam como elemento importante no plano de cuidados.Palavras-chave: Ludoterapia. Cuidado da Criança. Enfermagem Pediátrica.AbstractIt was aimed to evaluate the nurses’ perception when it comes to the playing in the pediatric care implementation in a hospital in Maranhão. It is a descriptive and exploratory study with a qualitative approach carried out with 12 professionals. Data collection took place in August 2013 in a hospital in Maranhão state in Brazil. A semi-structured interview was used with five questions about the playing. The data were processed by content analysis according to the model of Bardin. From the results, the following categories were identified: “playing and communication”, “playing and treatment” and “playing and the infrastructure required”. From the results it was noticed that nurses recognize the importance of playing during the pediatric hospitalization, but they do not use it as an important element of the care planning process.Keywords: Playing Therapy. Child Care. Pediatric Nursing.
Impact of post appendectomy pain
Authors: Lamture Yashwant R. , Gajbhiye Varsha P. , Shinde R. K. , Kiran Kher
Published: August 2017

Background: Appendectomy is one of the commonest abdominal operation performed during emergency hours for acute appendicitis. Acute appendicitis is the common pathology in right lower abdomen. Postoperative complications following appendicectomies are not uncommon and reflect the degree of peritonitis that was present at the time of operation. Intra operative spillage and intercurrent diseases that may predispose to the complication. But all patients are not relieved of their symptoms following surgery. Few patients continue to visit surgical OPD for continuous pain in right iliac fossa even after appendectomy had been performed. So, we design proforma to find out exact cause of pain. This study is a sincere effort on our part to solve secrets of post appendectomy pain.Methods: Evaluation of patient who continue to visit even after removal of appendix for pain in right iliac fossa. It was tried to establish correlation between relief of pain and histopathology report of appendix to justify the appendicectomies. These patients investigated to find out underlying organic cause. Functional patients were subjected for psychological evaluation.Results: In present study from June 2006 to August 2008 we enrolled around 30 patients with complaints of pain in right iliac fossa even after appendectomy. 60% were female and 40% were male in a present study. Out of 30 cases 24 patient means 80%, were in the age group of 20 to 40 years. We found one patient means 3.33% with clinical diagnosis of stump appendicitis on radiological (barium meal follows through) examination was confirmed who responded to conservative line of treatment. All patients presented with pain in right iliac fossa symptom was the criteria for selection of patients. Exception of single patient of stump appendicitis rest were having other treatable causes.Conclusions: Out of 30 patients only one patient was having actual stump appendicitis. It is not correct to say that post appendectomy pain is a complication of surgical procedure, as multiple treatable causes were found in 29 patients. Study demonstrated that most of these patients really had organic disease. Only two patients were simple victims of psychosomatic pain. This study enlightened nicely regarding various delayed complications of appendectomy.
Complications of laparoscopic cholecystectomy: an analysis of 1,695 laparoscopic operations
Authors: Jatothu Dasharadha , Sade Rajkumar , Sade Kirthana , Taruni . , Pyadala Nagababu
Published: August 2017

Background: Laparoscopic cholecystectomy (LCs) is the gold standard method to treat gallstone disease. But there are some complications which occur frequently as compared to open cholecystectomy.Methods: The prospective study was conducted in the Department of Surgery, Kamineni Institute of Medical Sciences, Telengana during the period of 2 years; March 2015 to February 2017. A total of 1,695 laparoscopic cholecystectomy cases were included in this study. Several treatment options such as, conservative treatment, minimally invasive treatment and open surgery was performed based on the severity of the disease.Results: Majority of patients were female (83.9%) and most common age group affected was above 40 years. Intra-operative and post-operative complication occurred in 4.5% and 1.9% patients respectively. Majority complications were treated by conservative treatment and minimally invasive treatment. So, in conclusion, we can use conservative and minimally invasive treatment to manage the complications from laparoscopic cholecystectomy.Conclusions: Conservative treatment options and minimally invasive treatment was more efficient to overcome the post-operative complication of laparoscopic cholecystectomy.
Max appendicitis score: a new diagnostic score for diagnosing acute appendicitis
Authors: Jyoti Vidur , Kumar Akhilesh , Yadav Preeti , Kapoor Vaibhav
Published: August 2017

Background: Scoring systems are valuable and valid for discriminating between acute appendicitis and nonspecific abdominal pain. Alvarado scoring is classical and different modifications of Alvarado score have been introduced but none is ideal and negative appendicectomy rate is still high. The aim of the study is to design a more reliable scoring system which is cost effective, simple, easy to learn, high accuracy, which can be applied by any doctor at any health care facility.Methods: Retrospective study of 160 patients hospitalized with abdominal pain suggestive of acute appendicitis and subsequently operated over a period of 5 year from January 2012 to January 2017 at Max Super Speciality Hospital, Gurgaon.Results: In the present study based on six clinically most significant variables, a diagnostic accuracy of 96.25% was achieved while the same was 85% for classical Alvardo Score. This significantly increased the diagnostic accuracy and lowered the negative appendicectomy rate.Conclusions: Max Appendicitis Score is perfect scoring system for diagnosing appendicitis, it can be specially very handy in peripheral health centers where radiological facilities are sparse.