12 research outputs found

    Magnetoresistance Features at the Magnetic Field-Induced Phase Transition in FeRh Thin Films

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    The causes of the appearance of first-order magnetic phase transitions remain a mystery. FeRh alloy is a classical material where a first-order magnetic phase transition occurs. The authors of this article studied the phase transition from the antiferromagnetic state to the ferromagnetic state in FeRh alloy. Comparison of the magnetometry and transport properties results allowed us to determine a number of differences in the mechanisms of the phase evolution during magnetic field and temperature induced transition. This article notes the priority of the rearrangement of the micromagnetic structure of the ferromagnetic phase as a result of the induction of a phase transition by a magnetic field. The main feature of the magnetic field induced phase transition compared to the temperature induced one is the change in the micromagnetic structure of the ferromagnetic phase. The growth of a ferromagnetic phase with less scattering fields leads to asymmetric behavior when a phase transition is induced near the metastable state. We also focused on the importance of taking into account the effect of magnetostriction when analyzing the evolution of the phase transition, which leads to the irreversibility of the phase transition near a zero magnetic field

    ОСОБЕННОСТИ АНЕСТЕЗИОЛОГИЧЕСКОГО ПОСОБИЯ ПРИ ПРОВЕДЕНИИ ОПЕРАЦИЙ С НЕЙРОМОНИТОРИНГОМ ВОЗВРАТНЫХ ГОРТАННЫХ НЕРВОВ В ТИРЕОИДНОЙ ХИРУРГИИ

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    The literature review describes the specifics of anesthesia when performing surgeries on the thyroid and parathyroid glands with neuromonitoring of recurrent laryngeal nerves. This technique has been described, the rationale of its use and role of the anesthesiologist in the provision of full functioning of neuromonitoring have been investigated. The article describes the anesthesia techniques (choice of neuromuscular relaxant, hypnotic and analgesic agents), method of endotracheal tube insertion, electrode positioning, causes of potential failures and ways of their management. В обзоре литературы рассмотрены особенности анестезии при проведении операций на щитовидных и паращитовидных железах с использованием нейромониторинга возвратных гортанных нервов. Приведено описание метода, изучены актуальность его применения и роль анестезиолога в обеспечении полноценного функционирования нейромониторинга. Освещены методики анестезии (выбор миорелаксантов, гипнотиков и анальгетиков), техника установки эндотрахеальной трубки, позиционирования электрода, причины возможных неудач и способы их исправления.

    Reducing bureaucratic corruption: Interdisciplinary perspectives on what works

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    This article offers the first comprehensive review of the interdisciplinary state of knowledge regarding anti-corruption policies, with a particular focus on reducing corruption among civil servants. Drawing on the work of economists, political scientists, sociologists, and anthropologists, we examine seven policy categories: (1) rewards and penalties; (2) monitoring; (3) restructuring bureaucracies; (4) screening and recruiting; (5) anti-corruption agencies; (6) educational campaigns; and (7) international agreements. Notably, rigorous empirical evaluation is lacking for the majority of commonly prescribed anti-corruption policies. Nevertheless, we find growing evidence of the effectiveness of policies based on monitoring, including anti-corruption audits and e-governance. In addition, adequate civil service wages seem to be a necessary but insufficient condition for control of corruption. An emerging skepticism regarding the effectiveness of anti-corruption agencies also is apparent in the literature. We conclude with broader lessons drawn from our review, such as the recognition that when corruption is a systemic problem, it cannot be treated in the long term with individual-level solutions

    SPECIFIC FEATURES OF ANESTHETIC SUPPORT IN THYROID SURGERY WITH NEUROMONITORING OF RECURRENT LARYNGEAL NERVES

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    The literature review describes the specifics of anesthesia when performing surgeries on the thyroid and parathyroid glands with neuromonitoring of recurrent laryngeal nerves. This technique has been described, the rationale of its use and role of the anesthesiologist in the provision of full functioning of neuromonitoring have been investigated. The article describes the anesthesia techniques (choice of neuromuscular relaxant, hypnotic and analgesic agents), method of endotracheal tube insertion, electrode positioning, causes of potential failures and ways of their management

    Intraoperative neuromonitoring in thyroid and parathyroid surgery: indications and method

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    Intraoperative neuromonitoring finds widespread application in thyroid and parathyroid surgery, as a preventive method against laryngeal nerves injuries. Today it is possible to monitor the laryngeal nerve function in real time during an operation. In this article based on experience of 1065 thyroid and parathyroid operations with intraoperative neuromonitoring, we describe in details the procedure of intraoperative neuromonitoring of laryngeal nerves: features of anaesthesia, endotracheal tube position, algorythm of trouble shooting in case of loss of electromyographical sygnal. Besides that, there is an explanation of electromyographical indices, such as: signal amplitude, latency, threshold, LOS (loss of signal); there are main literature sources on this problem

    Minimally invasive surgery of primary hyperparathyroidism

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    Results of various surgical techniques application in primary hyperparathyroidism patients were studied. Bilateral neck exploration, unilateral neck exploration, selective parathyroidectomy (conventional and videoassisted) were used in 297 patients with primary hyperparathyroidism. Results of the study showed high efficacy of selective parathyroidectomy with some benefits in comparison with bilateral neck exploration (reduced postoperative pain, better cosmetic result, diminished hospital stay etc.)

    Fine Needle Aspiration Biopsy of Thyroid Nodules: Diagnostic Value, Technical Aspects, Analysis of Results

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    The goal of the study was to determine diagnostic value of fine needle aspiration biopsy (FNAB) in detection of malignant thyroid tumors based on retrospective analyses of 40696 FNAB of patients with thyroid nodules. Results. Comparison of the results of FNAB with postoperative histological examination data from 3004 patients revealed that the rate of false positive cytopathological results was 1.2% and the rate of false negative results was 1.8%. The sensitivity reached 99.67%. The specificity of FNAB when taking into account follicular lesions dropped to 16.29%, while leaving follicular lesions - 94.29%. Cytological results of 49609 FNAB of patients with thyroid nodules according to Bethesda system were arranged as follows: noninformative results - 8%, benign nodules - 81.9% (colloid nodules - 71.6%, autoimmune thyroiditis - 10.2%, subacute thyroiditis and others - 0.02%), follicular lesions - 7.2% (follicular neoplasm - 7.1%, follicular lesion of indeterminate value - 0.1%), suspicious for malignancy - 0.02%, malignant tumor - 3%, among the latter papillary carcinoma - 93%. Malignant tumors, according to postoperative histological examination, were detected among the group with cytological diagnosis “follicular neoplasm” in 16.3% of cases. After performing FNAB of regional lymph nodes with suspicious ultrasound signs the metastases of papillary carcinoma were revealed in 24.6% of cases. Application of FNAB in clinical practice at our Center to all patients with thyroid nodules of 1 cm in size and larger resulted in increment of thyroid operations for oncological indications from 12.5% in 2004 to 53% in 2012. Conclusion. FNAB under ultrasound control is the most informative differential method for thyroid diseases, permitting to reveal primary and metastatic thyroid lesions. FNAB allow to evade nonobligatory diagnostic operations in many patients

    Modified quick parathyroid hormone test in surgery of primary hyperparathyroidism

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    Aim. The aim of the current study was the improvement of intraoperative quick parathyroid hormone (PTH) test, enabling to receive the results in a shorter period of time and to reduce the cost of the test, comparing with the existing methods. Methods. 404 consecutive patients with primary hyperparathyroidism (PHPT) were included in the study. All patients were subjected to selective parathyroidectomy – by traditional or videoassisted technique. We performed two parathyroid tests – traditional and modified – in each patient. Blood was taken a) before skin incision, b) before cutting the parathyroid adenoma vessels and c) in 10 minutes after cutting the parathyroid adenoma vessels. We used immunochemiluminescent analyzer DiaSorin Liaison. Modified test for parathyroid hormone differed in the duration of reagents incubation – two times shorter than in traditional method, resulting in immune reaction break before plateau occurrence. The statistical analysis of the results was performed using Microsoft Excel 2010. Results. With 50% cut-off level for PTH level fall (between the maximal level – before operation or before cutting parathyroid adenoma vessels – and the level in 10 minutes after cutting the adenoma vessels), the sensitivity, specificity, positive predictive value and negative predictive value for modified test reached 92.73%, 60.00%, 97.81% and 30.00%, accordingly, comparing with 95.84%, 55.00%, 97.62% and 40.74% for conventional method. Cut-off level change to 40% improved the results of modified test application, and increased its sensitivity and negative predictive value (97.14%; 50.00%; 97.40%; 47.62%). Conclusions. 2 times reduction of incubation time with cut-off level change to 40% allowed to cut the duration of intraoperative test for parathyroid hormone by half, and to improve diagnostic accuracy of the test, and at the same time to preserve low cost of the test

    Is it advisable to perform preoperativelaryngoscopy in all patients due to undergo the thyroid and parathyroid surgery?Analysis of 5172 preoperative laryngoscopies

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    Given the yearly growth of thyroid and parathyroid surgery, diagnosis of such serious complications as paresis of the larynx is still relevant today. Endoscopic laryngoscopy is the main method of controlling laryngeal function. The timely detection of violations of this function in the postoperative period allows for patients to be sent to specialists quickly for treatment. Nonetheless, the role of laryngoscopies in the preoperative period has not been precisely recognized. The main contentious issue has become the need to perform preoperative laryngoscopies on all patients due to undergo operations on the thyroid or parathyroid glands.For this paper, we analyzed 5172 consecutive endoscopic laryngoscopies. The role of preoperative laryngoscopy when planning surgery on the thyroid or parathyroid glands was determined. Aim: to evaluate the feasibility of performing routine laryngoscopies on patients due to undergo surgery for diseases of the thyroid and parathyroid glands. Materials and Methods.  This paper presents an analysis of the results of preoperative laryngoscopy on 5172 patients who underwent surgical procedures on the thyroid and parathyroid glands. Results.  Preoperative one-sided paresis of the larynx was detected in 12 (0.23%) of the 5172 patients. Patients did not exhibit bilateral paresis of the larynx. Conclusions.  Preoperative paresis of the larynx is rare, and performing routine endoscopic laryngoscopies on all patients due to undergo thyroid or parathyroid gland operations is not appropriate
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