Postoperative Cardiac Ischemic Complications in Lung Cancer Patients

Background. Perioperative myocardial ischemia often complicates extracardiac surgery. The problems of its prediction, diagnostics, treatment and prevention are not solved. Frequency, structure and clinical features of cardiac ischemic complications of surgical treatment of lung cancer are not well understood.The aim of the study was to investigate the frequency of postoperative myocardial infarction and myocardial ischemia in the surgical treatment of patients with non-small cell lung cancer.Methods. The frequency (%) of myocardial infarction (MI) with and without ST segment elevation of electrocardiogram, acute myocardial ischemia in a complete sample of cancer patients (n = 2051) who underwent treatment for non-small cell lung cancer for the last 10 years was calculated. By comparing the relative indicators and calculating the Odds Ratio (OR), we studied the relationship between the cardiac ischemic events with age, type of surgery, prevalence and localization of the tumour. The clinical manifestations and pathomorphology of postoperative myocardial infarction were analysed.Results. Cardiac ischemic complications of thoracotomy for lung cancer occurred in 2.73 % (95% CI 1.98–3.48) cases. Myocardial infarction with ST segment elevation was recorded in 1.07 % (95% CI 0.58–1.57) patients, MI without ST segment elevation – in 0.54 % (95% CI 0.17–0.9), myocardial ischemia – in 1.12 % (95% CI 0.62–1.63). An increase in the frequency of ischemic events after pneumonectomy was observed compared with lobectomy (OR 6.5, 95% CI 3.5–12.2) and after right-sided pneumonectomy compared with left-sided one (OR 3.2, 95% CI 1.6–6.3), and also the age over 70. Hospital mortality from MI was 39.3 %. According to autopsies of patients who died of МI, coronary atherothrombosis was detected in 2 of 22 cases.Conclusion. In the surgical treatment of non-small cell lung cancer, cardiac ischemic events develop in 2.73 % of patients. The greatest risk is associated with right-sided pneumonectomy

Analysis of self-assessment of practical skills on parodontology of graduates of UGMU

The article presents data from the analysis of the self-assessment of knowledge and skills of graduate dentists, which gives a vector for the development of work programs in the “Parodontology” discipline, indicates to students the need for a more detailed consideration of certain topics.В статье приведены данные анализа самооценки знаний и умений выпускников-стоматологов, что дает вектор развития рабочих программ дисциплины «Пародонтология», указывает студентам необходимость более детального рассмотрения определенных тем

The development of quality assessment systems the development of competencies in the study of periodontics at the department of therapeutic dentistry propedeutics of dental diseases USMU is conducted

The article presents the analysis of the existing system of assessing the quality of development of competencies of graduates in the study of periodontics and teaching methods of this section at the Department of therapeutic dentistry and propaedeutics of dental diseases of USMU.В статье приведены данные анализа существующей системы оценки качества освоения компетенций выпускниками при изучении пародонтологии и методики преподавания данного раздела на кафедре терапевтической стоматологии и пропедевтики стоматологических заболеваний УГМУ

Postoperative myocardial infarction in lung cancer patients with: incidence rate, clinical features, prognostic factors

Aim. To study the incidence, clinical features and predictors of postoperative myocardial infarction (MI) after lung cancer surgery.Material and methods. The retrospective analysis included 2051 patients (1373 males and 678 females, mean age, 65,5 [62-69] years), who underwent thoracotomy for non-small cell lung cancer. At the first stage, the incidence rate of postoperative MI (%) was calculated with 95% confidential interval (CI) in relation to sex, age and extent of surgery. At the second stage, the case-control study was carried out in groups with MI revealed on the first stage (n=33) and without MI (n=130), formed by individual criteria-based matching. A comparative intergroup analysis was performed and prognostic value of 60 clinical perioperative indicators was assessed by odds ratio (OR). The features associated with MI in the univariateregression model were introduced into multivariate stepwise logistic regression. Independent MI predictors was revealed.Results. The postoperative IM incidence rate amounted to 1,61 [0,67-1,76]%. MI was more frequently diagnosed in men than women (0,29%), and after pneumonectomy (3,92%) compared with less operative extent (0,37%). MI was associated with comorbidities, smoking intensity, right pneumonectomy, preoperative increase in white blood cells, neutrophils and monocytes, blood loss volume, surgery duration, postoperative heart rate, preoperative decrease in serum total protein, postoperative haemoglobin, haematocrit, red blood cells decrease, and intraoperative blood pressure (BP). By means of multivariate logistic regression, the following factors with most accurate MI prediction were established: postoperative heart rate (OR, 4,06 [95% CI 1,58-10,43]), Sokolow-Lyon index (OR, 1,54 [95% CI 1,14-2,07]), ACS-NSQIP value for cardiac complications (OR, 3,86 [95% CI 1,36-10,92]), preoperative serum total protein (OR, 0,17 [95% CI 0,040,71]) and white blood cells (CR 1,54 [95% CI 1,03-2,31]), minimal intraoperative systolic BP (OR, 0,35 [95% CI 0,15-0,83]).Conclusion. Postoperative MI incidence in lung cancer patients accounts for 1,61%. Following independent predictors for postoperative MI were established: Sokolow-Lyon index, preoperative serum total protein and leukocytes levels, ACS-NSQIP value, minimal intraoperative systolic BP and postoperative heart rate

Synthesis, Structure, and Properties of EuLnCuSe₃ (Ln = Nd, Sm, Gd, Er)

EuLnCuSe3 (Ln = Nd, Sm, Gd, Er), due to their complex composition, should be considered new materials with the ability to purposefully change the properties. Samples of the EuLnCuSe3 were prepared using Cu, rare earth metal, Se (99.99%) by the ampoule method. The samples were obtained by the crystallization from a melt and annealed at temperatures 1073 and 1273 K. The EuErCuSe3 crystal structure was established using the single-crystal particle. EuErCuSe3 crystallizes in the orthorhombic system, space group Cmcm, KCuZrS3 structure type, with cell parameters a = 4.0555 (3), b = 13.3570 (9), and c = 10.4602 (7) Å, V = 566.62 (6) Å3. In structure EuErCuSe3, erbium ions are coordinated by selenium ions in the octahedral polyhedron, copper ions are in the tetrahedral coordination, europium ions are between copper and erbium polyhedra layers and are coordinated by selenium ions as two-cap trigonal prisms. The optical band gap is 1.79 eV. At 4.7 K, a transition from the ferrimagnetic state to the paramagnetic state was detected in EuErCuSe3. At 85 and 293 K, the compound is in a paramagnetic state. According to XRPD data, EuLnCuSe3 (Ln = Nd, Sm, Gd) compounds have a Pnma orthorhombic space group of the Eu2CuS3 structure type. For EuSmCuSe3, a = 10.75704 (15) Å, b = 4.11120 (5) Å, c = 13.37778 (22) Å. In the series of EuLnCuSe3 compounds, the optical band gap increases 1.58 eV (Nd), 1.58 eV (Sm), 1.72 eV (Gd), 1.79 eV (Er), the microhardness of the 205 (Nd), 210 (Sm), 225 (Gd) 235 ± 4 HV (Er) phases increases, and the thermal stability of the phases increases significantly. According to the measurement data of differential scanning calorimetry, the EuNdCuSe3 decomposes, according to the solid-phase reaction T = 1296 K, ΔH = 8.2 ± 0.8 kJ/mol. EuSmCuSe3 melts incongruently T = 1449 K, ΔH = 18.8 ± 1.9 kJ/mol. For the EuGdCuSe3, two (Tα↔β = 1494 K, ΔHα↔β = 14.8 kJ/mol, Tβ↔γ = 1530 K, ΔHβ↔γ = 4.8 kJ/mol) and for EuErCuSe3 three polymorphic transitions (Tα↔β = 1561 K, ΔHα↔β = 30.3 kJ/mol, Tβ↔γ = 1579 K, ΔHβ↔γ = 4.4 kJ/mol, and Tγ↔δ = 1600 K, ΔHγ↔δ = 10.1 kJ/mol). The compounds melt incongruently at the temperature of 1588 K, ΔHmelt = 17.9 ± 1.8 kJ/mol and 1664 K, ΔHmelt = 25.6 ± 2.5 kJ/mol, respectively. Incongruent melting of the phases proceeds with the formation of a solid solution of EuSe and a liquid phase