Positive experience of introducing telemedicine technologies in the Ekaterinburg Clinical Perinatal Centre

Introduction A clinical and statistical analysis of the medical records of the first obstetric hospital of the Ekaterinburg Clinical Perinatal Centre (ECPC) was performed to assess the medical effectiveness of the integration of telemedicine technology (TMT) into the system of medical care in the case of threatened and preterm birth (PB). The aim of the work was to assess the medical effectiveness of integrating a range of telemedicine technologies into the system of medical care in the case of threatened and preterm birth as exemplified by the ECPC (First Obstetric Hospital). Materials and methods Preterm births between 22 and 36 weeks and 6 days of gestation were selected for the study. The number of PBs was 2,468 before the introduction of telemedicine technology and 2,112 after the introduction of telemedicine technology. The incidence of extremely low birth weight was analyzed to assess the impact of TMT implementation on neonatal outcomes. Criterion of Kolmogorov – Smirnov was applied to assess the normality of the distribution; to analyse the difference between groups – criterion of Kruskal – Wallis for K-independent samples. The arithmetic mean, standard error and standard deviation were calculated. Significance of differences between the averages was assessed using Student’s t-test. Results Before the introduction of TMT, no significant difference was found in the proportion of PB groups between different years and the structure of PP did not change according to gestational age. After the introduction of TMT there was also no significant difference in the pattern of PB. The proportion of extremely early PB before TMT implementation was significantly higher than after implementation. There was a significant decrease in the number of preterm infants with extremely low birth weight after implementation compared with the period before TMT. Discussion The use of automated systems implemented in the Sverdlovsk region, which are applications for mobile phones or personal computers, does not require the financial investment associated with the purchase of additional expensive equipment by pregnant women. Like the authors of earlier studies, we note a prolongation of gestational age and a reduction in the frequency of extremely low birth weight babies. Conclusion The incidence of extremely early PB decreased from 10.81 % to 7.13 % (p = 0.012) during 2016–2021, the incidence of late PB increased from 54.6 % to 60.1 % (p = 0.027) due to increasing gestational age. The number of babies born with extremely low birth weight decreased from 13.69 % to 8.36 % (p ≤ 0.001).Введение. Для оценки медицинской эффективности интеграции комплекса телемедицинских технологий (ТМТ) в систему медицинской помощи в случае угрозы и наступления преждевременных родов (ПР) проведен клинико-статистический анализ медицинской документации первого акушерского стационара Екатеринбургского клинического перинатального центра (ЕКПЦ). Цель работы – оценить медицинскую эффективность интеграции комплекса ТМТ в систему медицинской помощи в случае угрозы и наступления преждевременных родов на примере ЕКПЦ (первый акушерский стационар). Материалы и методы. Для исследования отобрана медицинская документация по родам, наступившим преждевременно в срок от 22 до 36 недель и 6 дней беременности. Количество ПР составило 2 468 в период до внедрения телемедицинских технологий и 2 112 после внедрения телемедицинских технологий. Для оценки влияния внедрения ТМТ на состояние новорожденных, проанализирована частота рождения детей с экстремально низкой массой тела. Для оценки нормальности распределения применен критерий Колмогорова – Смирнова, для анализа различия между группами – критерий Краскала – Уолиса для К-независимых выборок. Проведен расчет средней арифметической, стандартной ошибки и среднего стандартного отклонения. Значимость различий сравниваемых средних величин оценивали с помощью критерия Стьюдента. Результаты. До внедрения ТМТ при сравнении удельного веса групп ПР по годам достоверной разницы не обнаружено, структура ПР в зависимости от срока гестации не менялась. После внедрения ТМТ также нет достоверной разницы в структуре ПР. Удельный вес встречаемости экстремально ранних ПР до внедрения ТМТ достоверно выше, чем после внедрения. Достоверно имеется уменьшение числа недоношенных детей с экстремально низкой массой тела в период после внедрения по сравнению с периодом до внедрения ТМТ. Обсуждение. Использование внедренных в Свердловской области автоматизированных систем, являющихся приложениями для мобильного телефона или персонального компьютера, не требует финансовых вложений, связанных с приобретением беременными дополнительного дорогостоящего оборудования. Как и авторы ранних исследований, мы отмечает удлинение срока гестации и снижение частоты рождения детей с экстремально низкой массой тела. Заключение. За 2016–2021 гг. произошло уменьшение частоты экстремально ранних ПР с 10,81 % до 7,13 % (р = 0,012), рост за счет увеличения срока гестации числа поздних ПР с 54,6 % до 60,1 % (p = 0,027). Количество детей, рожденных с экстремально низкой массой тела, уменьшилось с 13,69 % до 8,36 % (р ≤ 0,001)

Comparative evaluation of the influence of no-till and traditional treatment on the biological activity of agricultural chernozem of the Stavropol region

Using the method of inoculation on elective nutrient media, the abundance and activity of taxonomic (bacteria, actinomycetes, micromycetes) and functional (nitrogen fixers, ammonifiers, denitrifiers of amylolytic, cellulolytic) groups of microorganisms in agrochernozems of the Stavropol region under the influence of various tillage systems – direct seeding (no-till) and moldboard plowing with the turnover of soil horizon (traditional treatment). Analyzes were carried out for such crops as winter wheat, corn, sunflower and soybean with/without application of mineral fertilizers. Traditional tillage for the majority of crops leads to increased activity of aerobic ammonifiers, cellulolytics, denitrifiers, actinomycetes and micromycetes. No-till technology, in its turn, increases the intensity of anaerobic cellulolytics and nitrogen fixers, aerobic diazotrophs and amylolytics activity. The most responsive crop, under which the biological activity of almost all groups of microorganisms increased in the no-till variant, was corn, while winter wheat contributed to the increase in the number of microorganisms in the moldboard plowing variant. The use of mineral fertilizers provoked the growth of soil biological activity under sunflower sown directly in the soil, while conventional tillage resulted in higher soil biological activity without application of mineral fertilizers

Криомассаж грудной клетки и сильвинитовая спелеотерапия в комплексной медицинской реабилитации больных бронхиальной астмой

Summary. The study was conducted to evaluate therapeutic and preventive effect of chest cryomassage and sylvinite speleotherapy in addition to the standard drug therapy in patients with mild to moderate persistent partially controlled bronchial asthma. Effects of a comprehensive rehabilitation programme were confirmed by a distinct reduction in eosinophilic and neutrophilic inflammation, significant improvements in systemic immunity, lung function, cardiorespitatory hemodynamics, exercise tolerance, and psychological adaptation.Резюме. Изучено лечебно-профилактическое действие криомассажа грудной клетки и сильвинитовой спелеотерапии на фоне стандартного медикаментозного лечения у больных легкой и среднетяжелой персистирующей бронхиальной астмой с частично контролируемым течением. Отчетливый регресс эозинофильного и нейтрофильного воспаления, выраженное улучшение показателей системного иммунитета, внешнего дыхания, легочной кардиогемодинамики, физической толерантности, психологической адаптации позволил констатировать преимущество комплексного применения реабилитационных методов

Study of the epidermis ablation effect on the efficiency of optical clearing of skin in vivo

We present the results of a comparative analysis of optical immersion clearing of skin in laboratory animals in vivo with and without preliminary ablation of epidermis. Laser ablation is implemented using a setup based on a pulsed erbium laser (λ = 2940 nm). The size of the damaged region amounted to 6 × 6 mm, the depth being smaller than 50 μm. As an optical clearing agent (OCA), use is made of polyethylene glycol (PEG-300). Based on optical coherence tomography, we use the single scattering model to estimate the scattering coefficient in the process of optical clearing in 2 regions at depths of 50−170 μm and 150−400 μm. The results show that skin surface ablation leads to the local oedema of the affected region that increases the scattering coefficient. However, the intense evaporation of water from the ablation zone facilitates the optical clearing at the expense of tissue dehydration, particularly in the upper layers. The assessment of the optical clearing efficiency shows that the efficiency exceeding 30% can be achieved at a depth from 50 to 170 μm in 120 min after ablation, as well as after the same ablation with subsequent application of PEG-300, which increases the efficiency of the immersion method by almost 1.8 times. At a depth from 150 to 400 μm, dehydration of upper layers cannot completely compensate for an increase in light scattering by dermis after epidermis ablation. The additional effect of OCA enhances the optical clearing of skin at the expense of improving the refractive index matching between dermis components, but the maximal efficiency of optical clearing in 120 min does not exceed 6%

Study of the epidermis ablation effect on the efficiency of optical clearing of skin in vivo

We present the results of a comparative analysis of optical immersion clearing of skin in laboratory animals in vivo with and without preliminary ablation of epidermis. Laser ablation is implemented using a setup based on a pulsed erbium laser (λ = 2940 nm). The size of the damaged region amounted to 6 × 6 mm, the depth being smaller than 50 μm. As an optical clearing agent (OCA), use is made of polyethylene glycol (PEG-300). Based on optical coherence tomography, we use the single scattering model to estimate the scattering coefficient in the process of optical clearing in 2 regions at depths of 50−170 μm and 150−400 μm. The results show that skin surface ablation leads to the local oedema of the affected region that increases the scattering coefficient. However, the intense evaporation of water from the ablation zone facilitates the optical clearing at the expense of tissue dehydration, particularly in the upper layers. The assessment of the optical clearing efficiency shows that the efficiency exceeding 30% can be achieved at a depth from 50 to 170 μm in 120 min after ablation, as well as after the same ablation with subsequent application of PEG-300, which increases the efficiency of the immersion method by almost 1.8 times. At a depth from 150 to 400 μm, dehydration of upper layers cannot completely compensate for an increase in light scattering by dermis after epidermis ablation. The additional effect of OCA enhances the optical clearing of skin at the expense of improving the refractive index matching between dermis components, but the maximal efficiency of optical clearing in 120 min does not exceed 6%

PATIENT WITH PRIMARY PULMONARY HYPERTENSION – WHO HE IS AND HOW TO HELP HIM?

Differential diagnostic search in patients with pulmonary hypertension is always difficult clinical problem. This article describes the clinical case of treating patient with high risk primary pulmonary hypertension.</p