Features of the personality adaptability of medical students in different courses of study

The adaptability of personality of medical university students studying at different courses is investigated. Various approaches to the definition of the concept of personality adaptability are analysed, methods of its diagnosis are considered, the structure of the personal adaptability of medical students of all training courses is revealed. As a result of an empirical study it was revealed that the greatest deficiency in the structure of personality adaptability, characterized by a socio-oriented orientation, prevails in the first, second and fourth years. The adaptability of the personality of third-year students is in the zone of average values. Students of the fifth and sixth years of a medical university have the most harmoniously developed adaptability with the predominant characteristics of an autonomously oriented personality

Peculiarities of the structure of personality adaptability of medical students studying on a budget basis

The article is devoted to the study of the features of the personal adaptability structure of 1st year students of a medical university studying on a budgetary basis. The concept of the phenomenon of adaptability is given, various approaches to understanding the structural components of adaptability are analyzed. The study used the method of Kolpakova L.M., which reveals the adaptive attitude of the individual to difficult situations, and the method of Maklakov A.G., which diagnoses the adaptive abilities of the individual. Based on the results of the study, conclusions were drawn about the deficiency of the level of reflective-evaluative, cognitive-emotional components of adaptability and the general level of adaptive abilities of this group of students. The analysis of the behavioral component of adaptability demonstrates the opposite result of its parameters; based on the results of the analysis of the motivational-semantic component, average indicators for both of its parameters were revealed. It has been established that the majority of respondents have signs of character accentuations with a tendency to behavioral reactions of a neurotic type, low emotional stability and signs of a socio-oriented personality orientation

The cyclic stability of rubber-like behaviour in stress-induced martensite aged Ni49Fe18Ga27Co6 (at.%) single crystals

In present work, the cyclic stability of the rubber-like behaviour (RLB) was investigated in Ni49Fe18Ga27Co6 (at. %) single crystals. Crystals were aged in the martensite phase at 423 K for 1 h under a compressive stress of 450 MPa, applied along the [110]B2[100]L10-direction. The RLB was induced by a preliminary chemical stabilization of the oriented L10-martensite during stress-induced martensite aging (SIM-aging) and following the reversible reorientation of martensitic variants under a compressive stress applied along the [001]B2[001]L10-direction. The high cyclic stability of the RLB was obtained in 200 loading/unloading cycles, due to the low reorientation stresses of the L10-martensite variants (no higher than 140 MPa) and the high strength properties of the L10-martensite (~1.6 GPa). The irreversible strain after 200 cycles did not exceed 0.6%. An increase in the number of cycles did not lead to the effect of destabilization of the L10-martensite

Orientation dependence of superelasticity in quenched high-nickel Ti51.8Ni single crystals

The orientation dependence of the functional and mechanical properties of quenched Ti-51.8at.%Ni single crystals, undergoing a strain-glass transition upon cooling/heating was investigated. It was found that a compressive stress above 800 MPa leads to the B2-B190 martensitic transformation (MT), regardless of orientation. In the high-strength [0 0 1]-orientation, superelasticity (SE) was observed at 203–248 K, with a reversible strain of 2.3%. Degradation of SE at deforming stresses r > 1000 MPa was associated with the formation of {1 1 3}B2 twins during the reverse MT. In the low-strength 1 1 1-orientation, the formation of stress-induced B190 -martensite occurred simultaneously with the plastic deformation of the B2-phase (due to the formation of reorientation bands and dislocation slip) and a reversible strain was not observed

Integrated approach to radiodiagnosis of follicular thyroid neoplasia: a retrospective cohort trial

Background. An evidence-based diagnostic tactics for follicular thyroid gland neoplasia is lacking to date. First-line priority are radiography diagnostic techniques, which vary in capacities and therefore must be regulated in use.Objectives. An efficacy evaluation of multiparametric ultrasound (US), sonoelastography (SEG) and radionuclide scintigraphy (RS) in diagnosis of follicular thyroid neoplasms (FTN).Methods. Preoperative examination was interpreted in 222 FTN patients (86 with follicular thyroid adenoma, FTA, and 136 with follicular thyroid cancer, FTC) with subsequent surgery. A retrospective statistical data analysis was performed for B-mode US, colour Doppler imaging (CDI), power Doppler imaging (PDI), sonoelastography and Tc-99m pertechnetate scintigraphy.Results. Novel FTN descriptive evidence has been obtained. Particularly, an FTA vs. FTC trait comparison showed no reliable US marker of a node assignment to FTA or FTC. Trials of the national-manufactured TI-RADS system showed its good diagnostic potential: FTN sensitivity 89.55, specificity 77.58 and accuracy 83.52%. A SEG picture of FTN was typically motley-colour and mosaic. Young’s modulus in FTA was 27.5 ± 7.1 kPa, a higher stiffness (62.1 ± 12.1 kPa) in FTC indicated a higher likelihood of malignancy. Scintigraphy exhibited a modest capacity for FTN diagnosis (sensitivity 86.67, specificity 48.08 and accuracy 56.72%). AUC values (0.617) indicate its limited use for differential FTN diagnosis, mainly in hyperfunctioning nodules. Our experience elaborated an original algorithm for radiographic techniques application in FTN diagnosis.Conclusion. Several radiographic methods are warranted in suspected FTN. First-line is multiparametric US B-mode imaging to detect FTN priority markers and US symptom complexes. Sonoelastography is second-line in ambiguous cases to further clarify structure (stiffness) of the thyroid nodule examined. Unlike SEG, scintigraphy assesses the functional traits of thyroid nodule and so has limited indications, an important factor to consider in FTN

Infective endocarditis and COVID-19: the impact of SARS-CoV-2 infection on diagnostics, course, and prognosis

Aim. To study the impact of coronavirus disease 2019 (COVID-19) pandemic on hospitalization rates, diagnosis, and outcomes of infective endocarditis (IE) with a subanalysis of IE course in combination with COVID-19.Material and methods. This prospective cohort study included 168 patients with definite or probable IE (DUKE 2015) hospitalized in the V.V. Vinogradov City Clinical Hospital from July 2017 to July 2022. All patients underwent a conventional examination in accordance with current clinical guidelines. We studied clinical, paraclinical and etiological parameters, as well as outcomes.Two clinical observations of the combination of IE and COVID-19 are presented.Results. When assessing the local registry of patients with IE, a trend towards an increase in hospitalizations rate of IE in 2021-2022 was shown, with a decrease during the period of long-term lockdowns in Moscow and a subsequent surge after their cancellation. Patients with IE during the COVID-19 pandemic had a more favorable clinical profile, a 2-fold increase in IE diagnosis (due to late hospitalization), frequent detection of Staphylococcus aureus MSSA (32,6%), and frequent surgical treatment (up to 87,6% with a combination of IE and COVID-19), as well as high in-hospital mortality, but without a tendency to increase (30,4%). Clinical observations of IE and COVID-19 combination are presented, which demonstrates the contribution of COVID-19 as the only risk factor for native tricuspid valve IE in a patient without predisposing causes, as well as a factor in the unfavorable prognosis for native aortic valve IE after the addition of COVID-19, which led to lethal outcome.Conclusion. The present study demonstrates the profile of patients with IE and COVID-19 depending on the epidemiological situation of COVID-19 and the association with SARS-CoV-2 infection. The data obtained make it possible to discuss the potential relationship between COVID-19 and IE. The "endocarditis team" determines the timely implementation of surgery and the absence of an increase in inhospital mortality, regardless of the epidemiological situation

Combination approach to diagnosis and treatment of an elderly patient with chronic Ph-negative myeloproliferative neoplasm and concomitant surgical pathology. Clinical observation

Chronic myeloproliferative neoplasms (CMPN), Ph-negative, are of clonal nature, develop on the level of hematopoietic stem cell and are characterized by proliferation of one or more hematopoietic pathways. Currently, the group of Ph-negative CMPN includes essential thrombocythemia, primary myelofibrosis, polycythemia vera, myeloproliferative neoplasm unclassifiable.Identification of mutations in the Jak2 (V617F), CALR, and MPL genes extended understanding of biological features of Ph-negative CMPN and improved differential diagnosis of myeloid neoplasms. Nonetheless, clinical practice still encounters difficulties in clear separation between such disorders as primary myelofibrosis, early-stage and transformation of essential thrombocythemia into myelofibrosis with high thrombocytosis. Thrombocytosis is one of the main risk factors for thromboembolic complications, especially in elderly people.A clinical case of an elderly patient with fracture of the left femur developed in the context of Ph-negative CMPN (myelofibrosis) with high level of thrombocytosis is presented which in combination with enforced long-term immobilization and presence of additional risk created danger of thrombosis and hemorrhage during surgery and in the postoperative period

Comparative evaluation of empagliflozin, canagliflozin and sitagliptin cardioprotective properties in rats with experimental type 2 diabetes mellitus

Background: Myocardial infarction (MI) is one of the leading causes of mortality in patients with type 2 diabetes mellitus (DM), therefore it is essential to give preference to a glucose-lowering drug having optimal cardioprotective properties. A comparative study of the various sodium-glucose co-transporter inhibitors representatives’ protective effects in experimental MI was not carried out within the framework of one study.Aim: To evaluate the influence of empagliflozin (EMPA) and canagliflozin (CANA), in comparison with sitagliptin (SITA), on hemodynamic parameters and myocardial damage area in rats with diabetes type 2 model in experimental MI.Materials and methods: Type 2 DM was modelled in Wistar rats by means of 4-week high-fat diet followed by nicotinamide 230 mg/kg and streptozotocin 60 mg/kg administration. 4 weeks after DM induction the following groups were made: «DM+SITA» — treatment with SITA 50 mg/kg, «DM+EMPA» — treatment with EMPA 2 mg/kg, «DM+CANA» — treatment with CANA 25 mg/kg per os once daily for 8 weeks. Animals in «DM» group remained untreated for the following 8 weeks. Rats in control group were fed with standard chow. 16 weeks after the experiment beginning transient global myocardial ischemia was modelled in all rats. Hemodynamic parameters and myocardium necrosis area were evaluated.Results: The necrosis area was larger in «DM» group, than in control one (p=0.018). Infarction size in «DM+SITA» did not differ from that in «DM» group (62.92(41.29;75.84) and 57.26(45.51;70.08)%, р=0.554). Necrosis area in «DM+EMPA» and «DM+CANA» groups was smaller than in «DM» group (37.90(20.76;54.66)%, 46.15(29.77;50.55) vs 57.26(45.51;70.08)%, р=0.008 and р=0.009, respectively). Necrosis size did not differ between «DM+EMPA» and «DM+CANA» groups (p=0.630). Ischemic contracture in «DM+CANA» group was less prominent than under the use of all other glucose-lowering drugs. We observed increase of coronary blood flow in «DM+EMPA» group, in comparison with «DM», «DM+CANA» and «DM+SITA» groups.Conclusions: SITA does not have cardioprotective effect in ischemia-reperfusion injury in diabetic rats. EMPA and CANA have similarly prominent infarct-limiting properties. EMPA is able to increase coronary blood flow, whereas cardioprotective action of CANA is associated with ischemic contracture diminishing

Протектор микрографтов кожи в ожоговой ране: аллодерма или гидрогелевое покрытие?

AIM OF STUDY Was to compare the dynamics of engraftment of skin micrographs in a burn wound when using protectors from an allodermal graft and from a hydrogel coating.MATERIAL AND METHODS The experimental study was conducted on 18 rats with a scab formed 3 days after modeling a deep burn with an area of 20% of the body surface. Partial fascial necrectomy was performed: two rounded sections of the sling with a diameter of 25 mm were excised. 6 automicrographs of skin 4x4 mm, 0.3 mm thick, were applied to each surface freed from the scab. In each animal, micrographs on one of the wounds were covered with a hydrogel protector, on the other with an allodermotransplant from another animal of the group. A secondary aseptic dressing was applied to the protectors. On the 5th and 20th days after the operation, the state of micrographs was studied: blood circulation — according to laser Doppler flowmetry, microstructure in vivo — using optical coherence tomography, microstructure ex vivo — according to histological examination of biopsies.ReSUlTS Differences in the rate of restoration of blood circulation of micrographs in the early stages of the postoperative period were found. In the first 5 days, the perfusion of micrographs under an allodermal protector exceeded the indicator in micrographs under a hydrogel coating by 44 [21; 51] % (p=0.031) due to the contribution of endothelial and neurogenic mechanisms of blood flow modulation. Starting from day 10, the differences in perfusion were levelled, but there were signs of more active endothelial regulation of blood flow under the skin (p=0.028). Histologically, the appearance of full-blooded capillaries was revealed earlier in micrographs under the alloderm than when using a hydrogel protector. By 20 days, under the condition of regular change of hydrogel coatings, the area of wound healing under the studied coatings did not significantly differ. However, the structure of the integumentary tissue under the alloderm according to the optical coherence tomography data was closer to normal skin than when using a hydrogel protector.CONClUSIONS From the point of view of the physiology of the wound process, alloderm is the preferred option of an autograft protector in comparison with a hydrogel coating, which is probably due to the paracrine biological activity of the alloderm. However, hydrogel coatings can provide a comparable level of efficiency, provided they are regularly changed and, potentially, given the properties of cytokine activity.ЦЕЛЬ ИССЛЕДОВАНИЯ Сравнить динамику приживления микрографтов кожи в ожоговой ране при использовании протекторов из аллодермального трансплантата и из гидрогелевого покрытия.МАТЕРИАЛ И МЕТОДЫ Экспериментальное исследование проведено на 18 крысах, имеющих струп, сформировавшийся через 3 суток после моделирования глубокого ожога площадью 20% поверхности тела. Выполнялась частичная фасциальная некрэктомия: иссечение двух округлых участков струпа диаметром по 25 мм. На каждую поверхность, освобожденную от струпа, наносились 6 ауто­микрографтов кожи 4х4 мм толщиной 0,3 мм. У каждого животного микрографты на одной из ран закрывались гидрогелевым протектором, на другой — аллодермотрансплантатом от другого животного группы. На протекторы накладывалась вторичная асептическая повязка. На 5-е и на 20-е сутки после операции исследовалось состояние микрографтов: кровообращение — по данным лазерной допплеровской флоуметрии, микроструктура in vivo — с помощью оптической когерентной томографии, микроструктура ex vivo — по данным гистологического исследования биоптатов.РЕЗУЛЬТАТЫ Обнаружены различия в скорости восстановления кровообращения аутомикрографтов на ранних этапах послеоперационного периода. В первые 5 суток перфузия микрографтов под аллодермальным протектором превысила показатель в микрографтах под гидрогелевым покрытием на 44 [21; 51] % (р=0,031) за счет вклада эндотелиального и нейрогенного механизмов модуляции кровотока. Начиная с 10-х суток различия в перфузии нивелировались, однако сохранялись признаки более активной эндотелиальной модуляции кровотока под аллокожей (p=0,028). Гисто­логически в микрографтах под аллокожей выявлено более раннее появление полнокровных капилляров, чем при использовании гидрогелевого протектора. К 20-м суткам, при условии регулярной смены гидрогелевых покрытий, площадь заживления ран под исследуемыми покрытиями значимо не различалась. Однако структура покровной ткани под аллодермой, по данным оптической когерентной томографии, была ближе к нормальной коже, чем при использовании гидрогелевого протектора.ЗАКЛЮЧЕНИЕ С точки зрения физиологии раневого процесса аллокожа является предпочтительным вариантом протектора аутотрансплантата в сравнении с гидрогелевым покрытием, что, вероятно, обусловлено паракринной биологической активностью аллодермы.Однако гидрогелевые покрытия могут обеспечить сопоставимый уровень эффективности при условии их регулярной смены и, потенциально, придания им свойств цитокиновой активности

Recurrent, low-frequency coding variants contributing to colorectal cancer in the Swedish population

<div><p>Genome-wide association studies (GWAS) have identified dozens of common genetic variants associated with risk of colorectal cancer (CRC). However, the majority of CRC heritability remains unclear. In order to discover low-frequency, high-risk CRC susceptibility variants in Swedish population, we genotyped 1 515 CRC patients enriched for familial cases, and 12 108 controls. Case/control association analysis suggested eight novel variants associated with CRC risk (OR 2.0–17.6, p-value < 2.0E-07), comprised of seven coding variants in genes <i>RAB11FIP5</i>, <i>POTEA</i>, <i>COL27A1</i>, <i>MUC5B</i>, <i>PSMA8</i>, <i>MYH7B</i>, and <i>PABPC1L</i> as well as one variant downstream of <i>NEU1</i> gene. We also confirmed 27 out of 30 risk variants previously reported from GWAS in CRC with a mixed European population background. This study identified rare, coding sequence variants associated with CRC risk through analysis in a relatively homogeneous population. The segregation data suggest a complex mode of inheritance in seemingly dominant pedigrees.</p></div