ESTIMATION OF RADIATION EXPOSURE TO THE ORAL MUCOSA DURING SUPERFICIAL RADIOTHERAPY OF CANCER OF THE LOWER LIP USING PERSONAL PROTECTIVE EQUIPMENT

The purpose of the study is to evaluate the effectiveness of the shielding of leaded rubber plates in superficial radiotherapy of lower lip cancer of stage I–II. Material and methods. A comparison was made of the timing and severity of oral mucosa and alveolar ridge damage in patients who used and did not use personal protective equipment. Experimental studies were carried out using a tissue-equivalent phantom and thermoluminescent detectors LiF activated by Mg and Ti. The summary doses received by the alveolar are calculated. Results and discussion. The total dose of X-ray radiation to the alveolar ridge in the absence of shielding is 64, 38 and 16 Gy for 1.0, 1.5 and 2.0 cm thick lip, respectively. The obtained values of the absorbed doses with personal protective equipment indicate a high shielding ability of the lead rubber used in the clinic. The use of shielding devices for superficial radiotherapy of lower lip cancer can improve the quality of life, reduces the duration and severity of radiation damage

Pulmonary Vascular Thrombosis in COVID-19: Clinical and Morphological Parallels

Aim. We aimed to study the histological and thrombotic changes in lung vessels in patients who died with COVID-19, to access the correlation between anticoagulation therapy (ACT) and thrombotic events (TE), treatment results, clinical and laboratory patients' characteristics.Material and Methods. We retrospectively analyzed treatment results of patients hospitalized with COVID-19 and lung vessel samples of the deceased patients. Dynamic changes and highest levels of D-dimer and fibrinogen were studied in its correlation with the disease severity according to SOFA score, computer tomographic (CT) results, lung, renal and hepatic dysfunction. The association between different doses of ACT and treatment results, laboratory indicators and thrombotic events was accessed. The histological lung vessels examination was performed using Martius Scarlet Blue (MSB)staining.Results. 313 patients were included in the study (61 patients died). The median age of hospitalized patients was 60 years (IQR 51-66 years). The frequency of the intravitallyconfirmed TE was 4,8%. The strong statistical association was revealed between D-dimer level and 3-4 points SOFA score, patients' mortality, oxygen support requirement, CT3-CT4 pneumonia, glomerular filtration rate and TE. There was no mortality in patients with D-dimer normal references, but in cases with three times elevation reached 13%, 48,5% - in cases with 3-6 times elevation and 64,6% - in cases with more than 6 times elevation. The strong statistical association was registered between fibrinogen and SOFA score, CT 3-4 pneumonia, patients' mortality. D-dimer and fibrinogen levels demonstrated weak correlation. There was no statistical correlation between prophylactic, intermediate and therapeutic ACT and D-dimer and fibrinogen levels, CT results, patients' mortality. MSBstaining was used in 36 deceased patients tissue samples. 1394 lung vessels were analyzed. Lung vessels thrombi persisted in samples of all 36 patients (100%). Vessels with the diameter 3,5-30 mm were thrombosed in 7%, with the diameter 0,034-0,84 mm - in 48%, with the diameter 0,85-3,4 mm - in 45%. The frequency of thrombi persisted 06 hours, 6-12 hours, 12-18hours, 18-24 hours and more than 24 hours was12%, 14%, 62%, 5% and 7% respectively.Conclusion. Thrombi of different ages from fresh to organized were observed in one third of lung vessels in all deceased patients. Lung vessels thrombosis plays an important role in pathogenesis and thanatogenesis of COVID-19. The D-dimer level correlates with lung, renal dysfunction, patients' mortality and doesn't show any correlation with ACT and can be accepted as a criterion of lung vessel thrombotic progression

When You have Lived in a Different Culture, Does Returning ‘Home’ not Feel like Home? Predictors of Psychological Readjustment to the Heritage Culture

Many repatriates find it challenging to readjust to their heritage culture after spending a significant period of time abroad. Research on predictors of readjustment, however, remains limited. The present study in particular investigated the identification of third culture individuals (TCIs) – that is, individuals who spent their formative years outside of their heritage culture - with an abstract, third culture. Our findings demonstrated that TCIs’ identification with the third culture was empirically distinct from that of the heritage and host cultures. The present study further examined whether several variables – sojourner type (TCI vs. non-TCI), perceived conflict between heritage and host culture, perceived cultural distance, and cultural identification with heritage and other cultures – predicted psychological readjustment (stress, anxiety, depression and overall psychological readjustment). The results showed that strong heritage culture identification was associated with better psychological readjustment, whereas cultural conflict was generally associated with poorer readjustment. Furthermore, sojourner type significantly moderated the latter association, such that cultural conflict predicted the stress aspect of psychological readjustment for non-TCIs, but not for TCIs. As the present investigation is the first study to empirically establish identification with a ‘third culture’ we discuss implications for the literature on third culture individuals and psychological adjustment upon re-entry