Diagnostic value of ultrasound in the evaluation of the echostructures of the nodular formation of the thyroid gland using the classification system TI-RADS

Objective. Estimation of the ultrasonographic criteria efficacy in accordance to the TI-RADS system while determining the morphological structures of nodal thyroid affections. Materials and methods. Results of ultrasonographic investigation in 546 patients, ageing 17 - 76 old and suffering thyroidal nodal affections, were analyzed. All the patients were divided into two groups. Into the firsr group  (the main) 427 (78.2%) patients were included, to whom ultrasonographic investigation was performed by a surgeon-endocrinologist. Into the second group (the control one) 119 (21.8%) patients were included, to whom ultrasonographic investigation was performed by a radiologist. Ultrasonographic criteria with nodal thyroidal affections were estimated in accordance to the TI-RADS scale, and the results of cytological investigations of the nodal affections - in accordance to criteria of the Bethesda system. The degree of the malignant nodal affections risk was determined, taking into account a quantity of intranodal echographic signs in accordance to the points gradation, using a Ti-RADS system. Results. In accordance to results of pathohistological investigations of the removed specimen a benign changes were revealed in 128 (76.6%) patients, and malignant - in 39 (23.4%). In structure of malignant affections papillary cancer was established in 23 patients, follicular - in 13, medullary - in 2, Hurtle-cellular - in 1 patient. In accordance to cytological investigations, conducted in 2014 - 2018 yrs., there was established, that in the first group a fine-needle biopsy was conducted in 211/427(49.4%) patients. Operative interventions were performed in 105 (24.6%) patients. In the second group a fine-needle biopsy was performed in 64/119 (53.8%) patients. Operative intervention was conducted in 62 (52.1%) patients. Conclusion. While conduction of ultrasonographic investigation by a surgeon-endocrinologist the rate of revealing of false-positive echographic signs have lowered in more than 2 times (1.4%), comparing with analogous index while conduction of the investigation by radiologist (3.1%). Application of a TI-RADS classification have permitted to reduce the rate of the fine-needle biopsy and doing of surgical interventions

Analysis of Structure Destroyed Metal after Diffusion Heat Treatment

It was accomplished research of the structure steel which carbonitriding and subsequent heat treatment was exposed for its cause's destruction to discover. For measure quality field of metal were used methods optical, appearing electronic microscopy and X-ray diffraction. Therefore one of the principal problems were research phase composition, grain and dislocation structure of a metal the gear teeth. Mechanism of rising hear cracks in the gear teeth on different stages her making and their trajectories of evolution were determined

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population