bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flaps in the management of open tibial fractures
Authors: Karikalan T. 
Published: April 2019

<p class="abstract"><strong>Background:</strong> The prognosis in open fractures is primarily determined by the amount of soft tissue loss and the level of contamination. Severe open tibial fractures usually require combined orthoplastic approach in the management. Our aim is to study the effectiveness of soft tissue flaps in the management of type III B open tibial fractures.</p><p class="abstract"><strong>Methods:</strong> The study material consists of 20 cases of grade III B open tibial fractures admitted in our institution. Under anaesthesia, wound debridement was done and fracture stabilised with external fixator or IM nail depending upon the wound status. Patient underwent flap cover once the wound was fit. Periodic follow up was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> Nonunion occurred in one patient (5%). Chronic osteomyelitis developed in two patients (10%). Deep infection occurred in three cases (15%). There was no secondary amputation in our series. The average union time of fracture was 30.1 weeks. Lower third fractures and those patients with extensive soft tissue injury, delayed flap cover and flap failure had longer union time.</p><p class="abstract"><strong>Conclusions:</strong> Fasciocutaneous flap has definitive role in the management of type III B open tibial fractures with soft tissue loss.</p><p class="abstract"> </p>
Composition and Density of Fouling Organism on the Wood Harbour at Karang-Karangan, Bua District, Luwu Regency
Authors: P Elki Julianto , Litaay Magdalena , Priosambodo Dody 
Published: April 2019

The Research on Composition and Abundance of Biofouling Biota at Woodenpier at Karang-Karangan Beach Bua Sub-district of Luwu Regency was conducted from December 2016-June 2017. The purpose of this research is to know the types of macrobiofouling, and the abundance of macrobiofouling on the wooden pier on the Beach Coral-Karangan, Bua Sub-district, Luwu Regency. Sampling method using a quadrant plot and performed two data retrieves on the poles of wooden pier which were either exposed or unexpressed by water with 12 point stations. The results showed there were 8 species of 6 families: Saccostrea sp (ostreidae), Saccostrea cucullata (Ostreidae), Littoraria scabra (Littorinidae), Thais rufotincta (Muricidae), Septifer sp (Mytilidea), Cladophora glomerata (Cladophoraceae), Balanus sp (Balanidae), and Haemocinus sp (Planopilumnidae). Saccostrea sp has the highest average abundance ofmacrobiofouling on exposed wooden pier (223 ind/m 2). The lowest abundance of Thais rufotincta and Haemocinus sp (1 ind/m2), respectively.
Management of Bone Defects in Revision Total Knee Arthroplasty with Use of a Stepped, Porous-Coated Metaphyseal Sleeve
Authors: Angerame Marc R. , Jennings Jason M. , Holst David C. , Dennis Douglas A. 
Published: April 2019

Background:
Revision total knee arthroplasty is a costly operation associated with many challenges including bone loss in the distal end of the femur and proximal end of the tibia
1,2
. Reconstruction of bone defects remains a difficult problem that may require more extensive reconstruction techniques to restore mechanical stability and ensure long-term fixation. Use of porous-coated metaphyseal sleeves is a modern technique to address bone deficiency in revision total knee arthroplasty
3,4
. Midterm reports have shown excellent survivorship and osseointegration
5–7
.

Description:
The use of a porous-coated metaphyseal sleeve begins with intramedullary canal reaming to determine the diameter of the diaphyseal-engaging stem. Bone loss is assessed followed by broaching of the tibial and/or femoral metaphyses. Broaching continues until axial and rotational stability are achieved. The sleeve typically occupies most, if not all, of the proximal tibial and distal femoral cavitary osseous defects often encountered during revision total knee arthroplasty. However, a sleeve does not address all distal and posterior femoral condylar bone loss, for which augments are often required.

Alternatives:
Previously described methods to address various bone deficiencies include use of morselized or structural bone-grafting, reinforcing screws within cement, metal augments, and metaphyseal cone fixation
8–17
.

Rationale:
Structural allografts or metal augments remain a suitable option for uncontained metaphyseal defects. Metaphyseal structural allografts may undergo stress-shielding, resorption, and late fracture. Metaphyseal sleeves offer long-term biologic fixation to host bone while creating a stable platform to receive a cemented femoral and/or tibial component
7
. This hybrid combination may provide mechanically protective properties to decrease the loads at the cement-bone interfaces and enhance loads to metaphyseal bone to ensure long-term implant fixation in the setting of substantial bone deficiencies
18–20
.
Ethnic aspects of hereditary breast cancer
Authors: Gervas P. A. , Molokov A. Yu. , Panpherova E. V. , Pisareva L. Ph. , Cherdyntseva N. V. 
Published: April 2019

This studyaimed to reveal the spectrum of BRca1 and BRca2 genes mutation in various ethnic groups of the Russian Federation. asystematic literature search includes data for the past 10 years and was conducted by using electronic databases of pubmed, eliBRaRY and ect.Material and methods.The review includes research data on the frequency of mutations of breast cancer-associated genes in various ethnic groups of the Russian Federation.Results.For «slavic» patients with a family history, the BRca1/2 mutation testing is the standard of care. in addition, the development of new antitumour drugs has resulted in improved survival rates. more than 1000 mutations of the BRca1 gene have been identified. Recent research is focused on the confirmation the beneficial effect of identified mutations. For the indigenous population (mongoloid ethnic groups), there are no standards for the treatment of inherited breast cancer. thus, the advances in molecular oncology for the treatment of hereditary breast cancer are not available for the indigenous population of the Russian Federation.Conclusion.In this context, the search for markers of early cancer detection and the development of criteria for therapy response are relevant for indigenous people. the development of new predictive and prognostic criteria of breast cancer among mongoloid ethnic groups with a family history will allow the innovative strategies for personalized molecular therapy to be developed.
Combined modality radiotherapy for high-risk prostate cancer. Analysis of treatment-Related complications
Authors: Makarova K. S. , Gumenetskaya Yu. V. , Biryukov V. A. , Obukhov A. A. , Strikanova I. A. , Dzhabrailova S. O. , Lepilina O. G. , Borysheva N. B. , Karyakin O. B. , Ivanov S. A. , Kaprin A. D. 
Published: April 2019

Purpose: to analyze toxicity of combined modality radiotherapy in high-risk prostate cancer patients.Material and methods. Short-term outcomes after combined modality radiotherapy were analyzed in 88 prostate cancer patients treated at clinic of the a.F. tsyb medical Radiological Research center between april 2016 and February 2018. the median follow-up time was 13 months (range, 3–23 months). the mean age of the patients was 64.8 years (range, 49–80 years). an initial psawas in the range of 3.5–114 ng/ml (mean 16.7 ng/ml). all patients were considered high-risk according to the d’amico classification. the patients were divided into two groups according to the sequence of combined modality radiotherapy. in group 1, the patients (n=45) received conformal EBRtto a total dose of 44–46 gy, and 2–3 weeks later, they underwent high–dose rate 192ir- brachytherapy (one single fraction of 15 gy) as a boost to EBRt. in group 2, the patients (n=43) were treated with interstitial brachytherapy followed by EBRtdelivering at total doses of 44–46 gy.Results. All patients eventually completed the combined modality radiotherapy course planned for them. acute, grade 1 genitourinary (gu) toxicities (Rtog/EoRtc) occurred in 29 (32.9 %) patients. acute gastrointestinal (gi) toxicity was grade 1 in 17 (19.3 %) and grade 2 in 2 (2.3 %) patients. late gutoxicity was grade 1 in 6 (6.8 %) and grade 2 in 3 (3.4 %) patients. an urethral stricture developed in 1 (1.1 %) patient. late gitoxicity was grade 1 in 8 (9.1 %) patients and grade 2 in 6 (6.8 %) patients.Conclusion. The preliminary results of this study suggest satisfactory tolerability of combined modality radiotherapy by prostate cancer patients. the level of acute toxicity and complications in critical organs is quite acceptable, which maintains high quality of life for patients and does not exceed the published data.
Distress andneoangiogenesis in ovarian cancer patients
Authors: Guens G. P. , Oleynikova I. N. , Sirota N. A. , Moiseeva N. I. , Shikina V. E. , Kirkin V. V. 
Published: April 2019

Background.Previous pre-clinical and clinical trials showed that distress experienced by cancer patients can activate the sympathetic nervous system, resulting in the elevation of the level of catecholamines in tumor tissue. catecholamines activate tumor neoangiogenesis via binding to the adrenergic receptors of tumor cells and cells of tumor microenvironment. Vascular endothelial growth factor a(VEgF a) plays a key role in tumor neoangiogenesis.Objective.To evaluate the correlation between serum VEgF alevel and distress in ovarian cancer patients.Material and methods.The prospective cross-sectional study included 100 patients with stage i–iV ovarian cancer. the median age of the patients was 56 ± 9,56 years. Enzym-linked immunosorbent assay was used for the assessment of serum VEgF alevel. distress thermometer (validated self-reported questionnaire) was used for distress diagnosis.Results.The median serum VEgF alevel was 325.77 pg/ml. aclinically significant distress was diagnosed in 54 % of patients. We found the correlation between the serum VEgF alevel and distress level in ovarian cancer patients (spearman’s rho=0.33; 95 % ci, 0.11–0.52; р< 0.004). We also found the correlation between the serum VEgR alevel and disease stage (rho=0.30; 95 % ci0.02–0.53; p<0.05). However, there was no correlation between distress and disease stage. the regression analysis method revealed that distress was an independent factor of serum VEgF aelevation in ovarian cancer patients (p<0.05).Conclusion.Assessment and early diagnosis of cancer-related distress was shown to be important for the appropriate management of ovarian cancer.
Immunoassayofantibodies to benzo[a]pyrene, estradiol and progesterone fordeterminationofpersonal lung cancer riskinmen
Authors: Glushkov A. N. , Polenok E. G. , Mun S. A. , Gordeeva L. A. , Kostyanko M. V. , Magarill Y. A. , Titov V. A. , Verzhbitskaya N. E. , Vafin I. A. 
Published: April 2019

A personalized lung cancer risk assessment is important for disease prevention.The aim of the studywas to estimate a significance of immunoanalysis of antibodies to benzo[a]pyrene, estradiol and progesterone for lung cancer risk prediction in men with respect to age and smoking.Material and methods. Serum antibodies to benzo[a]pyrene, estradiol and progesterone in the blood serum of 620 healthy men (279 smokers) and 827 lung cancer patients (627 smokers) were studied using semi-quantitative enzyme immunoassay.Results. The high lung cancer risk was observed in smokers aged over 55 years: oR=15.4 (11.5–20.8 95 % ci). the lung cancer risk in this group of patients was significantly lower when their levels of antibodies to benzo[a]pyrene and to estradiol were lower than those to progesterone: oR=3.2 (2.0–5.0). the lung cancer risk was higher when the personal levels of antibodies to benzo[a]pyrene and to estradiol were higher than the levels of antibodies to progesterone: oR=20.0 (10.5–38.1).Conclusion. The immunoassay of the blood serum antibodies specific to benzo[a]pyrene, estradiol and progesterone could be useful for determination of the lung cancer risk in men.
Methodological approaches to prevention of radiation-induced skin reactions in neutron-photon therapy for malignant neoplasms
Authors: Choynzonov E. L. , Lisin V. A. , Gribova Zh. A. , Velikaya V. V. , Startseva O. V. 
Published: April 2019

The goal of radiotherapy is to maximize the radiation dose to abnormal cancer cells while preventing damage to healthy tissue. in neutron therapy, the optimum regime of treatment is uncertain to date.The purpose of the study to develop a set of methodological approaches that ensure the permissible frequency and severity of radiation-induced reactions in cancer patients subjected to neutron and neutron-photon therapy (NFt) using u-120 cyclotron.Material and methods. We used the dependence of the relative biological effectiveness (RBE) of neutrons on the dose and time-dose-fractionation model (tdF). the interaction of neutrons with various types of tissues was analyzed, and the algorithm for summing neutron and photon doses in neutronphoton therapy was developed.Results. Clinical studies of neutron-photon therapy showed that the developed approaches can predict and prevent serious damage to normal tissue with a satisfactory accuracy. the role of all factors influencing the nature of radiation reactions was taken into account in the computer program, which allowed the main characteristics of the planned courses of neutron-photon therapy to be obtained.
Organization of medical care for children with cancer in the central federal district
Authors: Rykov M. Yu. 
Published: April 2019

Background. Planning the organization of medical care for children diagnosed with cancer as well as assessing the quality of care is based on the statistical data analysis.The purpose of the study was to analyze the main parameters characterizing medical care for children with cancer in the central Federal district.Material and methods. The reports of the executive authorities in the sphere of health protection of 18 subjects of the Russian Federation included into the central Federal district were analyzed for 2017.Results. The number of children aged 0–17 years was 6 824 049, the number of pediatric oncology departments was 9, the number of hospital beds for children with cancer was 464, the number of bed-days per year was 319.3. the number of physicians providing pediatric cancer care was 91, of them 64 (70.3 %) had a certificate of a pediatric oncologist. in 11 subjects of the Russian Federation, there were no departments of pediatric oncology, and in 1of them, there were no hospital beds for children with cancer. the number of patients newly diagnosed with cancer was 821. the number of patients who died of cancer was 156, of them 66 were diagnosed with cancer in 2017. the cancer incidence rate was 12 per 100,000 children aged 017 years; the mortality rate was 2.3 per 100,000 children aged 017 years. the one-year mortality rate was 8 %. the mean time taken to establish the diagnosis and the time interval between diagnosis and initiation of treatment was unknown, since the reports did not contain precise information. twelve (1.5 %) patients left the territory of the Russian Federation for receiving treatment outside the Russian Federation.Conclusion. The information provided in most reports was not statistically reliable. the cancer incidence rates were significantly lower than those in countries with high statistical reliability. For reliable estimation of the number of inpatient beds for children with cancer and the percentage of children referred for the treatment to the federal medical centers, it is necessary to implement a unified database for pediatric oncology in the Russian Federation.
Sentinel lymph node biopsy guided by indocyanine green dye in endometrial cancer patients: literature review and clinical experience
Authors: Kochatkov A. V. , Kharlov N. S. 
Published: April 2019

The purpose of the study was to assess the feasibility and safety of using the technique of intraoperative sentinel lymph node (slN) detection guided by indocyanine green dye in endometrial cancer patients.Material and methods. The study included 10 patients with stage i–ii/g1–2 endometrial cancer. the mean age of the patients was 66.2 years. laser-assisted indocyanine green (icg) fluorescent dye was used for slN mapping. icgwas injected into the uterine cervix immediately before surgery. the concentration used for icgwas 1.25 mg/ml (a 25 mg vial with icgpowder was diluted into 20 cc of aqueous sterile water. icgwas injected intracervically at 3 and 9 o’clock positions: 0.5 ml at 5 mm depth and 0.5 ml at 10 mm depth. the pinpoint endoscopic fluorescence imaging system (Novadaq, canada) was used for slN mapping.Results. SLNs were identified and removed in all patients. SLNs were located along the external iliac vessels in 6 patients and in the obturator fossa and in the hypogastric vessels in 4 patients. an additional para-aortic lymph node was visualized in one case. Both urgent and planned histological examinations showed no evidence of metastases in all patients. pelvic lymph node dissection was performed in 4 patients. combined pelvic and para-aortic lymph node dissection was performed in one case.Conclusion. Lymph node involvement is an important prognostic factor in deciding whether neoadjuvant chemotherapy is necessary for endometrial cancer patients. the technique of slN detection using indocyanine green dye appears promising in ensuring adequate intraoperative staging and optimization of the extent and duration of surgery. the use of this algorithm for the treatment of endometrial cancer will significantly reduce the risk of perioperative complications associated with lymphadenectomy, not negatively influencing the disease outcome.
Intraoperative neuromonitoring of pelvic autonomic nerves during surgigal treatment of colorectal cancer: a review of the literature and the initial experience of our clinic
Authors: Tsarkov P. V. , Kochetkov V. S. , Efetov S. K. , Kitsenko Yu. E. , Stamov V. I. 
Published: April 2019

Introduction. Urogenital and anorectal functional disturbances associated with the pelvic autonomic nerve damage are common complications of rectal cancer surgery. the search for methods of intraoperative identification of the autonomic nerve plexus is currently one of the key tasks in modern surgery of rectal cancer. the purpose of our study is to evaluate the role of intraoperative neuromonitoring in rectal cancer surgery.Material and methods. In 2017 we performed intraoperative neuromonitoring during rectal cancer surgery in two cases. the superior hypogastric plexus and the inferior hypogastric plexus were identified and the pelvic autonomic nerve was preserved in both patients. urogenital and anorectal functional outcomes were assessed in the postoperative period.Results. Satisfactory functional outcomes in the late postoperative period and at the 12-month follow-up suggest that intraoperative neuromonitoring may be useful in identification and prevention of the pelvic autonomic nerve damage in patients with rectal cancer.Conclusion. This method would be difficult to use routinely for intraoperative identification of the autonomic nerve plexus but could be especially useful for the study of pelvic physiology. With further development, the method of intraoperative neuromonitoring could help discover a technique that will improve the surgical treatment of rectal cancer. Further research using intraoperative neuromonitoring is needed to more precisely determine its value in the preservation of urinary, anorectal and sexual function.
Legal support of palliative care for cancer patients
Authors: Chernus N. Yu. , Sidorov S. V. , Babayants E. V. , Krasilnikov S. E. 
Published: April 2019

Background. According to the novel approach to the treatment of patients as persons, the phenomenon of palliation distinguishes modern medicine from the traditional medical paternalism. it means that medical science and practice go beyond physical health, when treatment methods aimed to improving the quality of patient’ life are widely used. man as a phenomenon of culture becomes something much more than his physical body.The purpose of the study was to analyze the palliative care legislation.Results. The palliative care was shown not to be a type of medical care, but it refers to the terms used in clinical practice to determine the purposes of specialized treatment aimed at not curing the disease, but rather extending life and controlling symptoms. conclusion. it is necessary to include patients’ relatives and friends to the number of people in need of medical care. The development of the federal state educational standard of higher education in the specialty of a palliative care physician is also of great importance.
Polymorphism of Folate metabolism genes and risk of lung cancer
Authors: Bakanova M. L. , Minina V. I. , Savchenko Ya. A. , Glushkov A. N. 
Published: April 2019

Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality worldwide. Folate metabolism plays an important role in carcinogenesis through its involvement in the process of dNamethylation and repair.The aim of our studywas to evaluate the relationship between MTHFR С677Т (rs1801133), MTR A2756G (rs1805087), MTRR А66G (rs1801394) gene polymorphisms and lung cancer risk.Material and methods.Asystematic literature search was conducted in the electronic databases pubmed, elibrary.ru in the time period between 2003 and 2018.Results.The MTHFR C677Tand MTRR А66G gene polymorphisms were found to be significantly associated with lung cancer. No significant association between the MTR A2756Gpolymorphism and lung cancer risk was found. the variant alleles of MTR 2756A > Gand MTRR 66A > Gpolymorphisms may have a joint effect on lung cancer risk. anumber of factors, such as nationality, smoking, gender, and an accurate diagnosis can influence the results of studies on the role of genes involved in folate cycle in patients with lung cancer.Conclusion.Future studies are needed to consider gene-gene and gene-environment interactions in lung cancer. Further investigations on MTHFR С677Т (rs1801133), MTR A2756G (rs1805087), MTRR А66G (rs1801394) polymorphisms and lung cancer susceptibility may provide a theoretical basis for lung cancer prevention.
Bariery i ograniczenia w refleksyjnym rozwoju nauczycieli wczesnej edukacji
Authors: Muchacka Bożena , Czaja-Chudyba Iwona 
Published: April 2019

Idea refleksyjnego rozwoju nauczycieli od lat jest ważnym zagadnieniem w edukacji, hasło to jednak pozostaje w przestrzeni życzeń i postulatów. Badacze najczęściej nie zagłębiają się w przyczyny uporczywego trwania nauczycieli na bezpiecznych pozycjach bezrefleksyjnego, instrumentalno-technicznego sposobu doświadczania rzeczywistości. Dlatego celem artykułu będzie analiza podmiotowych i zewnętrznych ograniczeń procesu refleksyjnego w rozwoju nauczycieli wczesnej edukacji. Przedstawiona klasyfikacja ograniczeń obejmować będzie bariery podmiotowe (poznawcze, emocjonalno-motywacyjne i osobowościowe) oraz (związane z czynnikami zewnętrznymi) bariery kulturowe, polityczne, środowiskowe i łączące się ze specyfiką procesu edukacji. Należy podkreślić, iż uświadomienie czynników hamujących lub ograniczających refleksyjny rozwój zawodowy może przyczynić się do lepszego zrozumienia sytuacji nauczycieli wczesnej edukacji, gdyż jest on jedną z bardziej optymalnych form współuczestniczenia w ponowoczesności.