Man in the Arctic: Environmental Risks through the Prism of Politics, Economics and Literature

The Arctic is now beginning to occupy an increasingly significant place in scientific discussions, geopolitical discourse, and in the mass consciousness. The development of the Arctic poses geopolitical, economic, socio-cultural and environmental risks. The strategic presence of large numbers of people will put pressure on the fragile ecosystems of the region and lead to an environmental crisis in the region with global implications. Building a system of institutions based on the Arctic Council to address these challenges and to implement environmental special programs and environmental policies can help address the environmental issue. An important basis is the construction of a correct “image” of man in the Arctic at the state level. In Soviet times, the image of the Arctic symbolized courage, perseverance, heroism, but other important issues were raised in fiction: the conquest of the Arctic and its devastation, the studying of it and attempts to preserve it for future generations. Today, it is the human being in contact with the Arctic, in all its diversity of capabilities and aspirations, that becomes the most important aspect of the Arctic theme

The Fabrication of Alginate–Carboxymethyl Cellulose-Based Composites and Drug Release Profiles

Recently, hydrogels based on natural water-soluble polysaccharides have attracted more and more attention due to their favorable characteristics. The high water-holding capacity, lack of toxicity, and biodegradability of such hydrogels make it possible to develop new materials on their basis for biotechnological, biomedical, pharmacological, and medical purposes. Sodium alginate is a non-toxic natural polysaccharide found in marine algae. It is capable of forming solid gels under the action of polyvalent cations that cross-link polysaccharide chains. Alginate-based products are popular in many industries, including food processing, pharmaceutical, and biomedical applications. Cellulose is the most abundant, renewable, and natural polymer on Earth, and it is used for various industrial and biomedical applications. Carboxymethyl cellulose (CMC) is useful in pharmaceutical, food, and non-food industries such as tablets, ice cream, drinks, toothpaste, and detergents. In this review, various methods for the preparation of the compositions based on sodium alginate and CMC using different crosslinking agents have been collected for the first time. Additionally, the drug release profile from such polymer matrixes was analyzed

Intraoperative neuromonitoring in thyroid and parathyroid surgery: indications and method

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

Percutaneous larynx ultrasonography for evaluation of vocal cords mobility after thyroid and parathyroid operations

The amount of thyroid and parathyroid surgeries increases annually. Contemporary diagnostics of such a severe complication, as larynx paresis, remains nowadays actual. The main diagnostic procedure for larynx paresis is endoscopic laryngoscopy, though it has several disadvantages: this is an invasive procedure, causing discomfort to the patients, it requires local anesthesia, which may lead to allergy; some patients can’t endure this procedure because of the anatomical features. All these factors force to find out a similar and at the same time effective diagnostic procedure for revealing disturbances of vocal cords mobility. This work represents the experience of implementation of 1252 percutaneous ultrasound examination of the vocal cords. We showed the diagnostic efficiency and convenience of this method at the endocrine surgical department. Aim. To evaluate a possibility of percutaneous ultrasound examination for detection of vocal cords mobility after thyroid and parathyroid surgery comparing with the laryngoscopy. Materials and methods. The first stage of the work included 809 patients, who were subjected to percutaneous larynx ultrasound check-up. During the second stage 443 patients were examined before and after operative treatment by means of larynx ultrasound and endoscopic laryngoscopy. Results. It is possible to visualize vocal cords in 85.9% of patients: in case of female patients it is possible to visualize vocal cords in 90.6%, and in men in 27.9% (c2 = 183.6; p 0.001). The visualization of vocal cords is feasible in 97.4% of patients under 40 years and in 57.1% in patients over 80 years (c2 = 42.4; p 0.001). Diagnostic efficiency of ultrasound visualization of vocal cords abnormality appeared to be 91.4%.The sensitivity of the method reached 62.5%, specificity 95.3%. Diagnostic efficiency of ultrasound visualization of vocal cords paresis reached 97.7%. The increase of this index is caused by sensitivity growth, which was 88.2%. Specificity grew also upto 98.5%. Dependence of diagnostic efficiency of ultrasound examination of vocal cords abnormality and patients’ age was statistically significant (c2 = 6.3; p 0.05). Conclusions. Percutaneous ultrasound examination of vocal cords is effective and convenient method of control over larynx function in patients after thyroid and parathyroid surgery

Loss of signal during intraoperative neuromonitoring of laryngeal nerves as a predictor of postoperative larynx paresis: Analysis of 1065 consequetive thyroid and parathyroid operations. Surgeons' algorythm (tactics)

During thyroid and parathyroid operations performed with laryngeal nerves neuromonitoring, a segmental or global loss of signal may occur. The most frequent cause of loss of signal – is tension of thyroid gland tissue and at the same time tension of the laryngeal nerves. There is no consensus if this complication arises regarding surgeon’s actions. Aim. Evaluation of predictive value of loss of signal during IONM regarding larynx paresis in postoperative period, and algorithm suggestion in case of loss of signal develops. Materials and methods. 1065 patients were operated on thyroid and parathyroid glands with neuromonitoring of laryngeal nerves. Neuromonitore C2 (Inomed, Emmendingen, Germany) was used. We evaluated frequency of loss of signal, described types of loss of signal, showed sensitivity and specificity of loss of signal and development of postoperative larynx paresis. Results. Loss of signal developed in 32 (1,9%) patients. More frequently loss of signal was detected at left side (p=0,01, χ2 = 4,2 OR=2,9). Sensitivity (Se)  of loss of signal and postoperative larynx paresis development reached 59,2%, specificity – 99,7% (Sp), positive predicitive value (PPV) – 91,4%, negative predictive value (NPV) – 97,8%. There are no statistically reliable differences in recovery periods of larynx function depending on type of loss of signal (segmental or global) (p=0,5). Conclusions. In most cases loss of electromyographical signal indicates injury of laryngeal nerves during operation on thyroid and parathyroid glands. When there is loss of signal in case of bilateral thyroid gland disease it is reasonable to make a decision to stop operation to prevent development of bilateral larynx paresis