bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical antibiotics for the prevention and treatment of purulent-inflammatory processes of soft tissues and diabetic foot
Authors: S. D. Khimich  , O. V. Katelyan  , I. O. Malyshevsky  
Published: March 2020

The aim — on the basis of literature data and own observations, to determine the feasibility and advisability of the combined local antibacterial Baneocin (Sandoz GmbH, Austria) in the complex treatment of purulent‑inflammatory processes of soft tissues and diabetic foot.Materials and methods. In the period from 2013 to 2019, 572 patients with purulent‑inflammatory diseases of soft tissues and 120 patients with purulent‑necrotic complications of the diabetic foot were treated at the General Surgery Clinic. The diagnostic and treatment processes were carried out according to the protocols and, if necessary, were supplemented with surgical and conservative treatment methods. In the treatment of soft tissues purulent‑inflammatory processes, an integrated approach was used, which included surgical treatment, drainage of the abscess, local and general treatment, and correction of comorbid conditions. For topical use, various antiseptics were widely used as the first choice and antibiotics as a general‑purpose drug. Later local antibiotics began to be used, in particular, Baneocin (ointment and powder), which contains two antibiotics with a synergistic effect (bacitracin and neomycin).Results and discussion. Based on literature data and own observations, the authors concluded that it is possible to use topical antibiotics in the form of a powder (sometimes in the form of an ointment) for both outpatient and inpatient treatment. Baneocin is an effective local antimicrobial agent, which, along with traditional methods of treatment, can be used in the complex treatment of patients with purulent‑inflammatory diseases of the soft tissues and diabetic foot.Conclusions. The possibility and feasibility of the combined antibacterial drug Baneocin in the treatment of patients with purulent‑inflammatory processes at different stages of the wound process is shown. The presence of two forms (powder and ointment) of the drug is an additional advantage, which allows it to be used sequentially in the treatment of patients, as well as in combination with dressings. In patients with obesity, it is advisable to use the drug a few days before the operation to combat the reservoirs of infection.
Granulation tissue morphology of the laparotomic wound with different types of sutures
Authors: V. V. Vlasov  , I. K. Morar  , I. S. Davidenko  , V. Y. Bodyaka  , K. A. Pokhodun  
Published: March 2020

The aim — to study experimentally the granulation tissue morphological features of the laparotomy wound after suturing it by simple knots and continuous wrapping sutures.Materials and methods. The experiment was performed on 108 rats undergoing a median laparotomy. The first group of animals (54 rats) edges of the musculoaponeurotic layer of the anterior abdominal wall were connected by simple sutures and in the second group (54 rats) by continuous wrapping. A sampling of biological material was performed on the 1st, 7th and 14th days after surgery, by excision of the musculoaponeurotic layer of the anterior abdominal wall along with the skin.Results and discussion. On the 1st day of the study, in the first group, lymphoid cells and neutrophils statistically significantly prevailed in the granulation tissue, the difference between their number was statistically insignificant.The second group of animals is likely to have a higher percentage of lymphoid cells only. At the 7th and 14th days of observation, the percentage of fibroblasts in the granulation tissue of animals of both groups probably prevails. On the 1st day after surgery, fibrin is observed in both experimental groups of animals, in the form of a grid, and in the second experimental group, there are still hemorrhages. The morphology of the laparotomy wound granulation tissue for the 14th day of observation does not differ when applying a simple knot and continuous suture, except that the latter is likely to be dominated by the specific volume of collagen fibers.Conclusions. The use of continuous suture, unlike simple knots, on the 14th day after suturing of the laparotomy wound lead to a probable increase in the percentage of fibroblasts, a decrease in macrophages, as well as a predominance of the specific volume of collagen fibers, indicating a relatively rapid maturation of the tissue.
Application of video-assisted thoracic surgical interventions in the surgical treatment of pulmonary tuberculosis and pleura
Authors: M. S. Opanasenko  , O. V. Tereshkovich  , B. M. Konik  , V. I. Lysenko  , M. Yu. Shamrai  , S. M. Shalagai  , M. I. Kalinichenko  , L. I. Levanda  , S. M. Bilokon  , O. K. Obremskaya  , D. S. Tkach  
Published: March 2020

The aim — to present their own experience in the use of minimally invasive video‑assisted thoracic surgical interventions in patients with pulmonary tuberculosis and pleura from 2008 to 2019.Materials and methods. 169 different types of VATS surgical interventions for patients with a phthisiosurgical profile were performed in clinic for the period 2008 to 2019. Among the minimally invasive VATS surgical interventions were the following: atypical segmental resection — 28 (16.6 %) cases, typical segmentectomy — 48 (28.4 %), lobectomy — 48 (28.4 %), bilobectomy — 2 (1.2 %) patients. VATS pulmonectomy was performed in 4 (2.4 %) cases. Pleurectomy with lung decortication was performed in 35 (20.7 %) patients. In 4 (2.4 %) cases of VATS, surgical interventions were used in patients with complicated course of pulmonary TV, namely pneumothorax, in 1 (0.6 %) of the patient VATS coagulation was performed, and 3 (1.8 %)) patients underwent VATS thermo‑chemical pleurodesis. The distribution of the operated patients according to the form of the tuberculous process was as follows: tuberculoma — 72 (42.6 %) cases, caseoma — 4 (2.4 %), conglomerative tuberculoma — 11 (6.5 %), multiple tuberculomas — 8 (4.7 %), fibro‑cavernous tuberculosis — 18 (10.6 %), infiltrative tuberculosis with decay — 7 (4.1 %), solitary cavern — 4 (2.4 %), expressed post‑tuberculous changes — 6 (3.5 %), chronic tuberculous pleurisy of the 1st degree — 31 (18.3 %), chronic tuberculous pleurisy of the 2nd degree — 3 (1.8 %), chronic tuberculous pleural empyema without bronchial fistula — 1 (0.6 %), tubercle oh es difficult pneumothorax in 4 (2.4 %) patients.Results and discussion. The average duration of surgical interventions was: when performing VATS‑resection 75.1 ± 22.3 minutes, with VATS‑pleurectomy with decortication, lungs 144.1 ± 45.2 minutes. The average blood loss during VATS resection and during VATS pleurectomy with lung decortication reached 85.4 ± 1.6 and 192.4 ± 41.8 ml, respectively. Intraoperative complications were diagnosed in 5 (3 %) patients who received VATS resection interventions.Conclusions. The use of VATS surgical interventions as a method of treating patients with pulmonary tuberculosis and pleura is an effective, convenient and low‑traumatic method.
Liver echinococcosis: which treatment method to prefer?
Authors: O. M. Tyshchenko  , E. V. Mushenko  , R. M. Smachylo  , V. Ju. Brovkin  , O. V. Ivanenko  
Published: March 2020

The aim — to determine the role and effectiveness of various surgical treatment methods for liver echinococcosis, depending on the type of echinococcal cyst, its location and size.Materials and methods. A treatment results analysis of 56 patients with liver echinococcosis who were treated in the clinic from 2008 to 2018 was performed. There were 42.9 % of men and 57.1 % of women. The mean age of the patients was 48 ± 2.3 years. The standard examination algorithm included mandatory contrast enhanced CT and the detection of antibodies to echinococcus in blood serum in addition to routine laboratory and instrumental tests. CL type of cysts were detected in 3 patients (5.4 %), type CE1 in 27 patients (48.2 %), type CE2 in 10 cases (17.9 %), type CE3 in 12 cases (21.4 %), type CE4 — 5 — in 4 patients (7.2 %). Patients underwent various surgical interventions, depending on the type of echinococcal cyst. PAIR was used in 3 patients (5.4 %), PAIRD was used in 7 patients (12.5 %). Echinococcectomy was performed in 17 patients (30.4 %) The open approach was performed in 8 patients (14.3 %), and laparoscopic approach — in 9 cases (16.1 %). Pericystectomy was performed in 19 patients (33.8 %)/The open approach was used in 16 cases (28.4 %), and laparoscopic approach — in 3 cases (5.4 %). In another 10 cases (17.9 %), liver resections varying from segmentectomy to hemihepatectomy were performed.Results and discussion.Bile leakage via the drainages of the abdominal cavity was observed in 7 cases (12.5 %). Allergic reactions of varying severity were observed in 3 cases (5.6 %). The recurrence of decease was noted in 2 patients (4 %). There was no lethality in this group of patients.Conclusions. The absence of a unified surgical tactics for liver echinococcosis requires the use of an individualized approach. The choice of treatment method depends on the location and size of the cyst, the stage of parasite development. Postoperative therapy with albendazole (mebendazole) in the presence of a live parasite is required. In the presence of a non‑living parasite (cysts of type CE4 — CE5) it is advisable to use observant tactics.
Thoracoabdominal wounds diagnostic in the secondary medical care during the combined forces operation in the East of Ukraine
Authors: Ya. L. Zarutsky  , O. F. Savitsky  , Yu. M. Oliinyk  , V. S. Goncharuk  , A. Ye. Tkachenko  , P. P. Forostyanyi  , M. S. Vovk  
Published: March 2020

The aim — to determine the sequence and scope of diagnostic measures in patients with thoracoabdominal injuries upon admission to the stages of medical evacuation of the II level of medical support, depending on the severity of the injury.Materials and methods. A retrospective analysis of 123 victims with gunshot thoracoabdominal wounds received during the operation of the combined forces (anti‑terrorist operation) in the East of Ukraine was carried out. The victims were divided into two groups: the main (n = 71), in which the diagnostic tactics depended on the severity of the injury according to the anatomical‑functional AdTS scale, and the comparison (n = 52), in which the diagnostic tactics depended on an empirical assessment of the injury severity. Groups on average age and injury severity were comparable. Clinical diagnostic methods and X‑ray imaging for chest, abdomen, spine, pelvis, and damaged limbs, FAST protocol ultrasonography, thoracopuncture/thoracocentesis, laparocentesis with diagnostic peritoneal lavage were used.Results and discussion. The introduction of ultrasonography according to the FAST protocol into the preoperative diagnostic algorithm in patients with thoracoabdominal wounds made it possible to reduce the time of preoperative diagnosis (by 12.2 min), the number of unjustified laparotomy and with high sensitivity to diagnose markers of damage to the organs of the chest (98.4 %) and abdominal (93, 8 %) of the cavity.Conclusions. FAST protocol ultrasonography is a non‑invasive fast (3 — 4 min) method for the diagnosis of thoracic and abdominal components of trauma with a sensitivity of 93.8 and 98.4 %, respectively, for identifying markers of damage to internal organs. The use of the FAST protocol reduced the time of preoperative diagnosis in severe and extremely severe victims with thoracoabdominal wounds by 1.4 times. Differential diagnostic tactics, depending on the severity of the injury, combined with the use of the FAST protocol, reduced the number of diagnostic errors by 19.1 %.
Torsion of the greater omentum
Authors: T. V. Gorodova-Andreeva  , V. I. Liakhovskyi  , O. O. Kyzymenko  , A. V. Sydorenko  , V. M. Liakh  
Published: March 2020

The medical records of the patients hospitalized in the surgical department and urgently operated for an acute abdominal greater omentum torsion over the past 10 years were retrospectively analyzed. Only two cases that was happened over the past three years and was not related were detected. Both young patients were delivered urgently to the hospital on‑duty surgical department of the city with a clinic of acute abdominal surgical pathology. Both patients underwent the full range of necessary laboratory and instrumental examinations. Patients were repeatedly examined by the on‑duty team consisting of three surgeons with significantly experience. The similarity with the clinical picture of acute appendicitis determined next treatment tactics. The type‑specificity of these patients was determined by the fuzziness of appendicular symptoms during physical examination. The increase in some manifestations of clinical symptoms led to the preliminary diagnosis of acute appendicitis. Both patients were operated on urgently after preoperative preparation. In the operating room, with a thorough revision, the secondary torsion of the greater omentum is visualized. Photofixation and measurement of the resected sections of the omentum were taken. Surgical experience, physical and additional examination methods do not provide clear reliable information about the presence of torsion of the greater omentum. Ultrasound examination of torsion of the greater omentum makes it possible only to determine the «thickened appendix» or infiltration in the abdominal cavity, but it is difficult to determine its components and genesis. When the torsion of the greater omentum is determined, a revision of the abdominal organs should be carried out to exclude the surgical pathology of the appendix, small intestine, cecum and pelvic organs.
PENGARUH KESEIMBANGAN FOREMILK DAN HINDMILK DENGAN POLA DEFEKASI BAYI YANG MENDAPATKAN ASI EKSKLUSIF DI DESA SUKARENDE
Authors: Paninsari Debora , Nurhayati Latifah 
Published: March 2020

Mothers who exclusively breastfed their babies from 2011-2015 tended to increase. However, in breastfeeding there are still many maternal understandings that are lacking about foremilk and hindmilk. Foremilk and hindmilk are related to the duration of the baby breastfeeding, if the baby has not been obtained in a balanced manner can cause problems in the pattern of defecation of infants especially those aged 1-6 months. The purpose of study was to determine the effect of foremilk and hindmilk balance with defecation patterns of infants who received exclusive. The study design was cross sectional, with total sample 30 mothers who had infants aged 1-6 months and exclusively. The results showed the majority (96.7%) frequency of defecation of infants 1-8 times, consistency of soft stool (96.7%) and yellow stool (93.3%). Out of 30 respondents 53.33% of mothers had a balance of foremilk and hindmilk while breastfeeding and 86.66% of infants had normal defecation patterns. Chi-square test results did not influence the balance of foremilk and hindmilk with the pattern of defecation Â with 30 respondents surveyed. This shows that the balance of foremilk and hindmilk has not affected the pattern of infant defecation including frequency, consistency and color of feces.
A Questão da Comunicação
Authors: Marcondes Filho Ciro 
Published: March 2020

As discussões sobre Epistemologia da Comunicação, realizadas em diversos espaços, parecem ter uma vitalidade renovada nos estudos da área, seja propondo questões ou delineando respostas para perguntas recorrentes: o que é comunicação? O que nos caracteriza como área? Qual é nosso objeto de estudos? O que nos aproxima e nos separa de outros campos do saber? Pela originalidade das propostas, algumas pesquisadoras e pesquisadores podem ser destacados dentre outros, Lucrécia D´Alessio Ferrara, Ciro Marcondes Filho, José Luiz Braga e Norval Baitello Junior. Neste dossiê, discutem a comunicação para além das mídias, como fenômeno de muitas dimensões e um número proporcional de indagações. Palavras-chave: Comunicação. Epistemologia. Linguagem.
Traumatismo cervical por arma de fuego en pediatría: apropósito de un caso
Authors: Teme Lichi Claudia , Gómez Natalia , Matsumura Kichiro , Cabral Guido , Jara José 
Published: March 2020

Introducción: Las lesiones cervicales por arma de fuego en pediatría tienen baja incidencia, aproximadamente a 5 a 10%, con una mortalidad de 0 a 11%. Objetivo: describir un caso de politraumatismo por arma de fuego, su manejo multidisciplinario y las consecuencias de la imprudencia a la exposición de niños a las mismas. Caso Clínico: paciente de sexo masculino, de 13 años de edad, con traumatismo de cara, cuello y tórax por herida accidental por arma de fuego (escopeta) con diagnósticos: Trauma Facial: fractura de maxilar superior e inferior; Trauma de cuello: lesión en cuerpo vertebral C4/C7 con perdigones incrustados; Trauma de tórax: contusión pulmonar derecha; Trauma de partes Blandas: con perdigones incrustados en celular subcutáneo. Ingresa al hospital de Trauma en choque hipovolémico presentando casi inmediatamente paro cardiorespiratorio, respondiendo a reanimación cardiopulmonar avanzada. TAC de cráneo al ingreso normal; al 8vo día se evidencia esquirla en sistema venoso de la base; TAC de cuello: se evidencia desplazamiento de tráquea y aire peri tráquea; AgioTAC: pseudoaneurisma en carótida interna izquierda. Fibrobroncospcopía: contusiones a nivel de tráquea; EDA: esófago y estómago con erosiones cubiertas por fibrina sin evidencia de fístula o perforación de víscera hueca. Tratamiento: en Asistencia Mecánica Respiratoria (ARM) por 10 días; inotrópicos por 72 hs, se realiza reparación de arteria carótida interna; colocación de arco de Erich por cirujanos maxilofaciales. Alta a sala de pediatría con buena evolución.
Conflicto de interés: Los autores declaran no poseer conflicto de interés
Recibido: 25/01/2019 Aceptado: 19/02/2020
A system divided: the state of neurosurgical training in modern-day Vietnam
Authors: Jean Walter C. , Huynh Trong , Pham Tuan A. , Ngo Hung M. , Syed Hasan R. , Felbaum Daniel R. 
Published: March 2020

The current report is the first of its kind in describing the neurosurgical training in modern-day Vietnam. Starting with in-depth face-to-face interviews, followed by electronically distributed questionnaires, a detailed picture of the training systems emerged.Neurosurgical training in Vietnam is multifaceted and dichotomous. The country of nearly 100 million people currently has only one neurosurgery-specific residency program, at the University of Medicine and Pharmacy at Ho Chi Minh City (UMPHCMC). This program lasts for 3 years, and Westerners might recognize many similarities to programs native to their countries. A similar training program exists in the north, at the Hanoi Medical University, but at this institution, trainees focus on neurosurgery only in the final year of their 3-year training. Neurosurgical training that resembles the program in Hanoi permeates the rest of the country, and the goal for all of the programs is to rapidly produce surgeons who can be dispersed throughout the country to treat patients requiring urgent neurosurgical procedures who are medically unsuitable for transfer to large urban centers and multispecialty hospitals. For the privilege of practicing elective neurosurgery, trainees around the country are required to acquire further training in Ho Chi Minh City or Hanoi or during fellowships abroad.A clear description of the neurosurgical training systems in Vietnam is hard to achieve, as there exist many diverse pathways and no standard definition of the endpoint for training. Unification and a clearer certification standard will likely help to elevate the standards of training and the state of neurosurgical practice in Vietnam.
Trends in United States neurosurgery residency education and training over the last decade (2009–2019)
Authors: Yaeger Kurt A. , Munich Stephan A. , Byrne Richard W. , Germano Isabelle M. 
Published: March 2020

OBJECTIVEPostgraduate training in medicine has been under scrutiny in the last 10 years, with a focus on improving residents’ education. The aim of this study was to quantify trends in neurosurgery residency (NSR) training and education over the last 10 years.METHODSThe authors assessed Accreditation Council for Graduate Medical Education (ACGME), National Resident Matching Program, and American Board of Neurological Surgeons records and searched PubMed to collate 2009–2019 data. Analyzed trends included residents’ demographic data, programs’ characteristics, graduation and attrition rates, match data, resident case logs, and qualitative educational curriculum changes.RESULTSSignificant increases in residents’ demographic data (p < 0.05) included the number of female residents (from 12.7% to 17.6%) and the absolute number of residents (from 1112 to 1462). Age (mean 28.8 years), ethnicity, and number of residents per program (mean 13 residents per program) were unchanged. There were 16 new ACGME NSR programs, with currently 115 programs nationwide. The number of applicants per year (324 applicants per year) and the matching rate (mean 64%) remained stable. The mean attrition rate of 2.6% (range 2%–4%) was higher than the mean 2.1% ACGME attrition rate, a rate that decreased from 3% in 2009 to 1.6% in 2019. Education curriculum changes aimed at the standardization of training across the US included residents’ boot camp (2009), the Milestones project (2012), and mandatory 7-year training initiated in 2013. An increase in endovascular, functional, trauma, and spine resident caseload was noted. The number of yearly publications about US NSR education has significantly increased (p < 0.05).CONCLUSIONSNSR education has received greater attention over the last decade in the US. Standardization of training has been implemented. A steady number of students remain interested in neurosurgery, with an increased number of women entering the field. Attention to wellness, in addition to high-quality education, should be further assessed as a factor to improve the overall NSR training and retention rate.