The inevitable outcome of skin injuries caused by a variety of external factors is the formation of a connective tissue scar. A scar can deform when exposed to stretching, pressure or repeat surgeries and undergo structural changes leading to its dehiscence. Scar dehiscence is a common problem seen in women with a past history of cesarean delivery. There have been comprehensive studies of uterine scars formed after the C-section, but the morphology of cutaneous C-section scars has not yet been investigated. The aim of this study was to look into the morphology of connective tissue scars in multiparas with a past history of cesarean delivery. Specimens of cutaneous scars were collected from 30 women after the C-section. Within one age group, fiber thickness was directly proportional to the number of previous deliveries. Comparison of different age groups with the same number of previous deliveries revealed the thinning of collagen fibers and the increased density of type III collagen fibers. The most pronounced changes were observed in women with a history of 3 or more deliveries. We hypothesize that a connective tissue scar undergoes structural transformation, becomes thinner, and its fibers dissociate due to repeated skin stretching, which might indirectly suggest the dehiscence of the postoperative scar.
The study of the features of the structure of the lower jaw with preserved and with various degrees of loss of dentition is relevant from the point of view of dental implantology. Materials and methods. A craniometric study of angular dimensions was carried out on 120 3D models of the mandibles of men and women of the age groups Maturus and Senilis, divided into 10 subgroups. The degree of influence of tooth loss on angular dimensions was assessed. Results. In groups with complete acquired adentia, there was a statistically significant decrease in the angles of inclination and protrusion of the chin in men and women from 6° to 14° (p < 0,05), while in other groups with partial adentia, no statistically significant differences were Conclusions. The anterior segment of the lower jaw body undergoes maximum restructuring, which is reflected in the reaction of angular dimensions to the complete loss of teethobserved. The angle of the lower jaw branch and the basal angle did not respond to tooth loss.
Значимость биоэлектрической активности головного мозга в оценке функционального состояния нервной системы при цереброваскулярных заболеваниях широко известна. В настоящей работе показана характеристика биоэлектрической активности головного мозга у больных, перенесших острое нарушение мозгового кровообращения. В данной статье приведены данные о том, что у больных в остром и раннем восстановительном периодах церебрального инсульта биоэлектрическая активность головного мозга характеризовалась, в основном, десинхронным и дезорганизованным типами электроэнцефалограммы. Вместе с тем, отмечались, выраженная дельта и тета активность, а также единичные острые волны, спайки, преимущественно в пораженном полушарии головного мозга, реже в контралатеральном полушарии, межполушарная асимметрия, повышение мощности спектров в сторону преобладания медленных волн. Показатели индекса когерентности по всем отведениям были снижены, что свидетельствует о нарушении функциональных межполушарных взаимосвязей. Более значительное повышение индекса когерентности в дельта и тета диапазонах у пациентов, перенесших геморрагический инсульт, может указывать на более грубые межполушарные нарушения, в сравнении с ишемическим инсультом. Результаты исследования относительной спектральной плотности мощности диапазонов показали, что при геморрагическом инсульте отмечена более высокая дельта и бета активность, а также более значительное снижение мощности альфа ритма, в сравнении с ишемическим инсультом. В тоже время, отмечается повышение интегрального индекса диапазона низкочастотной медленно-волновой активности, особенно выраженное у больных с геморрагическим инсультом р<0,05. The significance of bioelectric activity of the brain in assessing the functional state of the nervous system in cerebrovascular diseases is widely known. In this paper, the characteristics of the bioelectric activity of the brain in patients with acute cerebral circulatory disorders are shown. This article presents data that in patients with acute and early recovery periods of cerebral stroke , the bioelectric activity of the brain was characterized mainly by desynchronous and disorganized types of electroencephalogram. At the, same time, pronounced delta and theta activity was noted , as well as single acute waves, spikes, mainly in the affected hemisphere of the brain, less often in the contralateral hemisphere, interhemispheric asymmetry, increased spectral power in the direction of predominance of slow waves. The coherence index values for all leads were reduced, which indicates a violation of functional interhemispheric relationships. A more significant increase in the coherence index in the delta and theta ranges in patients who have had a hemorrhagic stroke may indicate more severe interhemispheric disorders compared to ischemic stroke. The results of the study of the relative spectral power density of the ranges showed, that in hemorrhagic stroke, there was a higher delta and beta activity, as well as a more significant decrease in the power of the alpha rhythm, in comparison with ischemic stroke. At the same time, there is an increase in the integral index of the range of low-frequency slow-wave activity, especially pronounced in patients with hemorrhagic stroke p < 0.05.
В остром и раннем восстановительном периодах церебрального инсульта взаимосвязь между биоэлектрической активностью головного мозга и клинической картиной заболевания представляют значительный научный и практический интерес. В данной статье, представлены результаты исследования клинико-неврологических и электроэнцефалографических показателей, в остром и раннем восстановительном периодах церебрального инсульта, 67 больных в возрасте от 43 до 78 лет. Показано, что у больных в остром и раннем восстановительном периодах церебрального инсульта на фоне двигательных и речевых расстройств, наблюдались легкие и умеренные когнитивные нарушения, а также тревожно-депрессивные проявления. Головная боль, соответствующая критериям головной боли напряжения отмечалась у 61,1% больных. Биоэлектрическая активность головного мозга характеризовалась выраженной дельта и тета активностью, а также единичными острыми волнами, спайками, преимущественно в пораженном полушарии головного мозга, межполушарной асимметрией, повышением мощности спектров в сторону преобладания медленных волн. Показатели индекса когерентности по всем отведениям были снижены, что свидетельствует о нарушении функциональных межполушарных взаимосвязей. Более значительное повышение индекса когерентности в дельта и тета диапазонах у пациентов, перенесших геморрагический инсульт, может указывать на более грубые межполушарные нарушения, в сравнении с ишемическим инсультом. In the acute and early recovery periods of cerebral stroke, the correlation between bioelectrical activity of the brain and the clinical picture of the disease is of considerable scientific and practical interest. This article presents the results of a study of clinical, neurological and electroencephalographic parameters, in the acute and early recovery periods of cerebral stroke, in 67 patients aged from 43 to 78. Mild and moderate cognitive impairment as well as anxiety and depressive manifestations were shown among patients in the acute and early recovery periods of cerebral stroke amid the motor and speech disorders. Headache meeting the criteria of tension headache was reported among 61,1% of patients. The bioelectrical activity of the brain was characterised by marked delta and theta activity as well as single sharp waves, commissures mainly in the affected cerebral hemisphere, interhemispheric asymmetry and by increase in the spectrum power towards the predominance of slow waves. The coherence index scores were decreased on all directions, indicating impaired functional interhemispheric connectivity. A greater increase in coherence index in the delta and theta bands among haemorrhagic stroke patients may indicate more severe interhemispheric disturbances compared to ischaemic stroke.
Objectives - to develop the main strategies of emergency medical care improvement for patients with acute coronary syndrome, in order to to reduce the morbidity and mortality in the population of a large industrial region. Material and methods. The study was conducted on the basis of the Moscow regional ambulance station. We used the content analysis, logical, system analysis, the method of mathematical statistics. Results. In the period 2017-2018, in the region's population, there is a tendency for decrease in the number of calls for ambulance teams caused by acute coronary syndrome. During the analyzed period, we noticed the reduction of the number of cases of pre-hospital thrombolytic therapy (by 17.5%). The response time to the patient's call not more than 20 minutes was observed in 92.9% of cases, the number of lethal outcomes in presence of the ambulance team decreased by 4. 6%. The results can be explained by the dynamic development of the infrastructure of cities and districts of the Moscow Region, by the improvement of road networks, by the complete renewal of the service's motor vehicle fleet, and by the opening of a number of new specialized medical institutions. A set of medical and organizational measures has been developed and put into practice in the ambulance service of the region, aimed at further improvement of the system of ambulance care for patients with acute coronary syndrome at the prehospital stage. Conclusion. The mortality reduction, preservation and improvement of public health can be achieved only through the comprehensive sustainable development of the region’s infrastructure, improvement of the organizational structure of the emergency medical service, mandatory use of algorithms and standards for the provision of medical care to patients at all stages.
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