Thermal imaging diagnostics in stomatology

Thermal imaging diagnostics (thermography) is a high-precision method that allows identifying a pathological process at the preclinical stage by infrared radiation. For the maxillofacial region, this method may be one of the methods for choosing an additional diagnostic of the patient. Thermography has a large number of positive characteristics: safety of manipulation for the patient and the doctor; high reliability (up to 80%); speed and simplicity of research; the opportunity at one doctor’s appointment to examine the entire maxillofacial region; the possibility of dynamic observation; low cost of research. The difficulty of using this method lies only in interpreting the results, since external factors (superficially located vessels, age of the patient, thickness of subcutaneous fat, fluctuations in ambient temperature) can produce artifacts on the thermograms. However, this complexity can be solved by working with thermal imagers of experienced employees.Тепловизионная диагностика (теплография) — это высокоточный метод, позволяющий выявить патологический процесс на доклинической стадии посредством инфракрасного излучения. Для челюстно-лицевой области данный метод может являться одним из методов выбора дополнительной диагностики пациента. Теплография обладает большим количеством положительных характеристик: безопасность проведения манипуляции для пациента и врача; высокая достоверность (до 80%); быстрота и простота исследования; возможность в рамках одного приема обследовать всю челюстно-лицевую область; возможность динамического наблюдения; небольшая стоимость исследования. Сложность использования данного метода заключается лишь в интерпретации результатов, поскольку внешние факторы (поверхностно расположенные сосуды, возраст пациента, толщина подкожно-жировой клетчатки, колебания температуры окружающей среды) могут давать артефакты на теплограммах. Однако данная сложность может быть решена путем работы с тепловизорами опытных сотрудников

Cutaneous lupus erythematosus after treatment with paclitaxel and bevacizumab for metastatic breast cancer: a case report

Abstract Introduction The monoclonal anti-vascular endothelial growth factor antibody bevacizumab is increasingly used in the treatment of several malignant tumors. The usual side effects of this drug are hypertension and proteinuria. Paclitaxel is widely used in the treatment of breast cancer and head and neck carcinomas. Neither of these two drugs typically causes skin disorders. Paclitaxel-related cutaneous lupus erythematosus has been described before, but in earlier cases patients had a history of autoimmune disease. Case presentation We report a case of a 65-year-old Caucasian woman who presented with cutaneous lupus erythematosus after receiving paclitaxel-bevacizumab combination treatment as first-line therapy for metastatic breast cancer. Her cutaneous symptoms and increased serum anti-SSA and anti-SSB antibodies disappeared shortly after the discontinuation of therapy. Conclusion We conclude that cutaneous lupus erythematosus can also be seen in patients without earlier anamnesis of autoimmune disorders and that, furthermore, bevacizumab might cause atypical cutaneous side effects.</p

Improving access to emergent spinal care through knowledge translation : an ethnographic study

Background: For patients and family members, access to timely specialty medical care for emergent spinal conditions is a significant stressor to an already serious condition. Timing to surgical care for emergent spinal conditions such as spinal trauma is an important predictor of outcome. However, few studies have explored ethnographically the views of surgeons and other key stakeholders on issues related to patient access and care for emergent spine conditions. The primary study objective was to determine the challenges to the provision of timely care as well as to identify areas of opportunities to enhance care delivery. Methods: An ethnographic study of key administrative and clinical care providers involved in the triage and care of patients referred through CritiCall Ontario was undertaken utilizing standard methods of qualitative inquiry. This comprised 21 interviews with people involved in varying capacities with the provision of emergent spinal care, as well as qualitative observations on an orthopaedic/neurosurgical ward, in operating theatres, and at CritiCall Ontario’s call centre. Results: Several themes were identified and organized into categories that range from inter-professional collaboration through to issues of hospital-level resources and the role of relationships between hospitals and external organizations at the provincial level. Underlying many of these issues is the nature of the medically complex emergent spine patient and the scientific evidentiary base upon which best practice care is delivered. Through the implementation of knowledge translation strategies facilitated from this research, a reduction of patient transfers out of province was observed in the one-year period following program implementation. Conclusions: Our findings suggest that competing priorities at both the hospital and provincial level create challenges in the delivery of spinal care. Key stakeholders recognized spinal care as aligning with multiple priorities such as emergent/critical care, medical through surgical, acute through rehabilitative, disease-based (i.e. trauma, cancer), and wait times initiatives. However, despite newly implemented strategies, there continues to be increasing trends over time in the number of spinal CritiCall Ontario referrals. This reinforces the need for ongoing inter-professional efforts in care delivery that take into account the institutional contexts that may constrain individual or team efforts

On the methodology for assessing the quality of telemedicine services in the doctor-doctor system

The objective was to develop a system of indicators of telemedicine services in the "doctor – doctor" system in order to improve the quality of the organization of remote interaction between medical organizations in providing medical care using telemedical technologies.Цель работы – разработать систему показателей телемедицинских услуг в системе «врач – врач» с целью повышения качества организации дистанционного взаимодействия между медицинскими организациями при оказании медицинской помощи с применением телемедицинских технологий

Solution Structure of the KIX Domain of CBP Bound to the Transactivation Domain of CREB: A Model for Activator:Coactivator Interactions

AbstractThe nuclear factor CREB activates transcription of target genes in part through direct interactions with the KIX domain of the coactivator CBP in a phosphorylation-dependent manner. The solution structure of the complex formed by the phosphorylated kinase-inducible domain (pKID) of CREB with KIX reveals that pKID undergoes a coil→helix folding transition upon binding to KIX, forming two α helices. The amphipathic helix αB of pKID interacts with a hydrophobic groove defined by helices α1 and α3 of KIX. The other pKID helix, αA, contacts a different face of the α3 helix. The phosphate group of the critical phosphoserine residue of pKID forms a hydrogen bond to the side chain of Tyr-658 of KIX. The structure provides a model for interactions between other transactivation domains and their targets