scholarly journals Adrenal adenomas: what to do with them? Review 2

2021 ◽  
Vol 17 (3) ◽  
pp. 241-249
Author(s):  
S. Rybakov
Keyword(s):  
Malignant Tumors ◽  
Optimal Operation ◽  
Gross Error ◽  
Wide Range ◽  
Morphological Diagnosis ◽  
The Subject ◽  
Definition Of ◽  
Significant Size ◽  
Initial Results

Adrenal incidentalomas (AI) are a collective, working category that contains a wide range of different forms of patho­logy of these glands. They differ in the original tissue structures from which they originate, in clinical and hormonal characte­ristics, in diagnostic and tactical approaches. Such a wide range of emergencies, which are hidden under the guise of accidentally detected AI, puts before the clinician the task of identifying them (establishing a clinical and, if possible, morphological diagnosis) with the definition of tactical approaches. Based on the analysis of these data, as well as numerous publications, their working classification is proposed. When deciding on surgical treatment, the surgeon must have a clinical diagnosis — what nosological form of adrenal pathology is to be operated on. Interventions with the diagnosis AI are unacceptable and are a gross error. The optimal operation for most such tumors is laparoscopic adrenalectomy with the tumor. Open operations are indicated for malignant tumors of significant size, especially with signs of invasion into surrounding structures. Given that most AI are benign formations, it is equally important to determine further tactics for them — the mode and duration of observation, the order and scope of control clinical and hormonal and imaging studies, the principles of evaluation of the results. Several guidelines indicate that in the presence of hormonally inactive adenomas, without signs of malignancy, less than 3–4 cm in size, no further observation is indicated. It is noted that in such tumors the tendency to growth, malignancy, emergence of hormonal activity is extremely seldom observed. In other cases, especially with the slightest doubt of the initial results, follow-up examinations are recommended after 3, 6, 12 months and then after 1–2 years, the maxi­mum period is set to five years. These parameters are the subject of discussion in various clinics.

Typologization of security regulation

2020 ◽  
pp. 20-27
Author(s):  
Denis Tikhomirov
Keyword(s):  
Social Relations ◽  
Scientific Literature ◽  
Legal Regulation ◽  
Procedural Understanding ◽  
Limited Ability ◽  
Methodological Basis ◽  
Wide Range ◽  
The Subject ◽  
Definition Of ◽  
Legal Understanding

The purpose of the article is to typologize terminological definitions of security, to find out the general, to identify the originality of their interpretations depending on the subject of legal regulation. The methodological basis of the study is the methods that made it possible to obtain valid conclusions, in particular, the method of comparison, through which it became possible to correlate different interpretations of the term "security"; method of hermeneutics, which allowed to elaborate texts of normative legal acts of Ukraine, method of typologization, which made it possible to create typologization groups of variants of understanding of the term "security". Scientific novelty. The article analyzes the understanding of the term "security" in various regulatory acts in force in Ukraine. Typological groups were understood to understand the term "security". Conclusions. The analysis of the legal material makes it possible to confirm that the issues of security are within the scope of both legislative regulation and various specialized by-laws. However, today there is no single conception on how to interpret security terminology. This is due both to the wide range of social relations that are the subject of legal regulation and to the relativity of the notion of security itself and the lack of coherence of views on its definition in legal acts and in the scientific literature. The multiplicity of definitions is explained by combinations of material and procedural understanding, static - dynamic, and conditioned by the peculiarities of a particular branch of legal regulation, limited ability to use methods of one or another branch, the inter-branch nature of some variations of security, etc. Separation, common and different in the definition of "security" can be used to further standardize, in fact, the regulatory legal understanding of security to more effectively implement the legal regulation of the security direction.

Interaction, engagement, and perceived interactivity in single-handed interaction

2016 ◽  
Vol 26 (5) ◽  
pp. 1134-1157 ◽  
Author(s):  
Donghee Shin ◽  
Myunggoon Choi ◽  
Jang Hyun Kim ◽  
Jae-gil Lee
Keyword(s):  
Behavioral Intention ◽  
Interaction Techniques ◽  
Content Type ◽  
Thumb Movement ◽  
Wide Range ◽  
Mobile Industry ◽  
Perceived Interactivity ◽  
The Subject ◽  
Definition Of ◽  
Practical Implications

Purpose The purpose of this paper is to examine the effects of interaction techniques (e.g. swiping and tapping) and the range of thumb movement on interactivity, engagement, attitude, and behavioral intention in single-handed interaction with smartphones. Design/methodology/approach A 2×2 between-participant experiment (technological features: swiping and tapping×range of thumb movement: wide and narrow) was conducted to study the effects of interaction techniques and thumb movement ranges. Findings The results showed that the range of thumb movement had significant effects on perceived interactivity, engagement, attitude, and behavioral intention, whereas no effects were observed for interaction techniques. A narrow range of thumb movement had more influence on the interactivity outcomes in comparison to a wide range of thumb movement. Practical implications While the subject of actual and perceived interactivity has been discussed, the issue has not been applied to smartphone. Based on the research results, the mobile industry may come up with a design strategy that balances feature- and perception-based interactivity. Originality/value This study adopted the perspective of the hybrid definition of interactivity, which includes both actual and perceived interactivity. Interactivity effect outcomes mediated by perceived interactivity.

The Milan System for Reporting Salivary Gland Cytopathology: Assessment of Cytohistological Concordance and Risk of Malignancy

2020 ◽  
pp. 1-13
Author(s):  
Shilpy Jha ◽  
Suvradeep Mitra ◽  
Suvendu Purkait ◽  
Amit Kumar Adhya
Keyword(s):  
Salivary Gland ◽  
Predictive Value ◽  
Malignant Tumors ◽  
Minor Salivary Gland ◽  
Treatment Protocol ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Wide Range ◽  
Risk Of Malignancy

<b><i>Introduction:</i></b> The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was proposed by the American Society of Cytopathology and the International Academy of Cytology to bring uniformity in the reporting system and the treatment protocol. A wide range of risk of malignancy for each category has been reported by various authors by applying the system. <b><i>Aim:</i></b> We intend to study the cytohistological concordance and the ROM for each of the diagnostic categories of the Milan system. <b><i>Materials and Methods:</i></b> The study included 292 cases of fine-needle aspiration cytology (FNAC) of salivary gland lesions over a period of 3 years. The diagnosis of these cases was reclassified into the 6 categories of the Milan system. The cytohistological concordance and ROM for each category of the Milan system were calculated based on the clinical and histopathological follow-up. <b><i>Results:</i></b> The patients’ age ranged from 3 to 81 years with the mean of 42.65 ± 16.3 years. The cases included 189 (64.7%) parotid, 82 (28.1%) submandibular, and 21 (7.2%) cases of minor salivary gland swellings. Follow-up histopathological diagnosis for 102 cases was available. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated to be 64.28, 97.01, 90, 86.67, and 87.37%, respectively. After reclassification, the number of cases in each category was as follows: category I: 31 (10.62%), category II: 80 (27.4%), category III: 2 (0.68%), category IVA: 143 (48.97%), category IVB: 1 (0.34%), category V: 13 (4.45%), and category VI: 22 (7.53%). The calculated ROM was as follows: category I: 42.86%, category II: 26.67%, category III: 100% category IVA: 10.17%, category IVB: 0%, category V: 71.42%, category VI: 100%. <b><i>Conclusion:</i></b> FNAC is an excellent procedure to differentiate benign from malignant tumors, and MSRSGC is a useful system for risk assessment and deciding the further treatment protocol. Our findings also suggest that in addition to the surgical follow-up, inclusion of the clinical and radiological follow-up may be a better strategy for calculation of ROM, especially for categories I and II.

scholarly journals Antenatal hydronephrosis: a five-year retrospective study

2021 ◽  
Vol 35 (3) ◽  
Author(s):  
Maria Gaia ◽  
◽  
Mariana Capela ◽  
Margarida Peixoto ◽  
Joana Borges ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Kidney Injury ◽  
Risk Groups ◽  
Mean Value ◽  
Third Trimester ◽  
Antenatal Hydronephrosis ◽  
Male Predominance ◽  
Wide Range ◽  
Definition Of

Introduction: Antenatal hydronephrosis (ANH) is common in fetal ultrasounds. Though mostly transient, it can be associated with congenital abnormalities and kidney injury. The authors went to assess the evolution of children with ANH and identify risk groups. Methods: Retrospective cohort study of children with ANH from 2013‑2017. Renal pelvis anteroposterior diameter (APD) of 4 and 7mm or more in the second and third trimester, respectively, defined diagnosis of ANH. APD also defined severity stratification. The primary out‑ comes included occurrence of urinary tract infection (UTI) and congenital anomalies of the kidney and urinary tract (CAKUT). Results: We identified 198 cases, with male predominance (76.8%) and a 2.1% incidence. It resolved antenatally in 12.1%, with a lower mean value of APD in these cases (p=0.017), and persisted in 43.4%. CAKUT were found in 8.6% of the patients. At least 1 episode of UTI occurred in 9.1% of patients during follow‑up. The degree of ANH in the 3rd trimester was related to postnatal persistence and degree (p<0.001) and the postnatal degree was related to the occurrence of UTI (p=0.008). The 3rd trimester and postnatal degree were also associated to the presence of CAKUT (p=0.036; p=0.001), although not with vesicoureteral reflux (VUR). The persistence of ANH through the 2nd and 3rd trimester was related to postnatal persistence (p=0.002) and degree (p=0.007), and the presence of CAKUT excluding VUR (p=0.034). The optimal cut‑off for the APD in the 3rd trimester to predict the occurrence of negative outcomes (CAKUT and/or UTI), through a receiver operating characteristic (ROC) curve, was 8.225mm with 76% sensitivity and 59% specificity. Discussion: ANH is frequent and reflects a wide range of conditions, requiring follow‑up. Most cases resolve spontaneously and require no further intervention other than ultrasounds. 3rd trimester and postnatal degree are related to prognosis, allowing the definition of risk groups and the improvement of patient management.

scholarly journals Device for intervertebral assisted motion: technique and initial results

2007 ◽  
Vol 22 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Jean Taylor ◽  
Patrick Pupin ◽  
Stephane Delajoux ◽  
Sylvain Palmer
Keyword(s):  
Surgical Management ◽  
Chart Review ◽  
Anterior Column ◽  
Effective Alternative ◽  
Patient Questionnaire ◽  
Retrospective Evaluation ◽  
Functional Integrity ◽  
Wide Range ◽  
Initial Results

Object The DIAM is a polyester-encased silicone interspinous dynamic stabilization device that can unload the anterior column and reestablish the functional integrity of the posterior column. Methods The DIAM was implanted in 104 patients between May 1, 2001 and October 30, 2001. A retrospective evaluation was performed based on chart review and patient questionnaire at a median follow-up interval of 18.1 months. Results Conclusions The DIAM implant appears to be a useful and effective alternative in the surgical management of a wide range of lumbar disorders. Patient complications are few and satisfaction is high.

scholarly journals Bounds for tentacular Hamiltonians

2018 ◽  
Vol 12 (01) ◽  
pp. 209-265 ◽  
Author(s):  
Federica Pasquotto ◽  
Jagna Wiśniewska
Keyword(s):  
Floer Homology ◽  
Energy Levels ◽  
Symplectic Manifolds ◽  
Rabinowitz Floer Homology ◽  
The Subject ◽  
Definition Of

This paper represents a first step toward the extension of the definition of Rabinowitz Floer homology to non-compact energy hypersurfaces in exact symplectic manifolds. More concretely, we study under which conditions it is possible to establish [Formula: see text]-bounds for the Floer trajectories of a Hamiltonian with non-compact energy levels. Moreover, we introduce a class of Hamiltonians, called tentacular Hamiltonians which satisfy the conditions: how to define Rabinowitz Floer homology for these examples will be the subject of a follow-up paper.

scholarly journals “Alle Hilfsmittel an der Hand”: note sulle prime fotografie collezionate da Aby Warburg

2020 ◽  
Vol 5 (10) ◽  
pp. 122-139
Author(s):  
Katia Mazzucco
Keyword(s):  
20Th Century ◽  
Art History ◽  
Research Tool ◽  
Theoretical Position ◽  
Wide Range ◽  
The Subject ◽  
Methodological Approaches ◽  
Definition Of ◽  
Aby Warburg ◽  
Made In

There is no evidence of a consistent theoretical position of Aby Warburg regarding photography, but his scattered notes on the subject allow for a deductive evaluation. The considerable use of photographs that he made in his work suggests a wide range of methodological approaches, with significant implications for the disciplinary and methodological definition of art history and the development of photographic documentation at the turn of the 20th century. This essay provides examples of Warburg’s early attention to photography, both as a research tool and a required piece of equipment for any research institute.

scholarly journals Serous borderline ovarian tumors: modern possibilities of ultrasound diagnostics in monitoring the course of the disease after organ-preserving operations

2021 ◽  
Vol 23 (1) ◽  
pp. 106-111
Author(s):  
Irina I. Davydova ◽  
Marina A. Chekalova ◽  
Apollon I. Karseladze ◽  
Viktor V. Kuznetsov ◽  
Liudmila A. Meshcheriakova ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Optimal Operation ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Computer Assisted ◽  
Malignant Neoplasms ◽  
Ultrasound Method ◽  
Borderline Ovarian Tumors ◽  
Ultrasound Diagnostics ◽  
Wide Range

Relevance. Borderline ovarian tumors (BOT) occur mainly in women of reproductive age and account for 20% of all neoplasms of the female genital organs. Currently, there is an increase in the incidence of ВОТ. One of the reasons for the increase in morbidity is the improvement of knowledge and experience in relation to the morphological diagnosis of tumors of low malignancy potential. Nevertheless, the results of a preliminary instrumental assessment of the nature of the disease and the final diagnosis formed by histological examination are not always satisfactory, since borderline tumors are a thin layer that occupies an intermediate position between benign and malignant tumors. And, in spite of the fact that ВОТ is an independent nosological form in the histological classification, nevertheless, they have signs of both benign and malignant neoplasms. In this regard, the complexity of both instrumental and morphological diagnostics of ВOT becomes understandable, and, therefore, difficulties arise in determining the tactics of treatment, choosing the optimal operation, and the need for drug therapy. All these issues are directly related to the patients quality of life, and, most importantly, to survival. Because an incorrectly established diagnosis entails incorrect treatment and unsatisfactory results. Thus, the study of the peculiarities of ВOT diagnostics is extremely important. The ultrasound computed tomography method is simple, relatively cheap and affordable. Considering that almost all patients with ovarian neoplasms undergo this type of examination, it is extremely important and interesting to assess the role of the ultrasound method in the diagnosis of ВОТ. Moreover, at present more and more gynecological oncologists are resorting to organ-preserving surgical interventions for ВOТ. Therefore, it is especially important to study the possibility of ultrasound diagnostics in monitoring the course of the disease after breast-conserving operations, identifying recurrences of the disease in the ovary, differentiating recurrence and cystic formations of the ovaries. Aim. To determine the effectiveness of computer-assisted ultrasound diagnostics in monitoring the course of BOT after breast-conserving operations. Materials and methods. At Blokhin National Medical Research Center of Oncology carried out a retrospective and prospective analysis of 405 patients with serous BOT for the period 19702013. The age of the patients varied in a wide range, the minimum was 15, the maximum was 78 years, the median corresponded to 38 years. Before the start of treatment, the patients underwent an ultrasound examination (ultrasound) of the abdominal organs, the pelvic organs and the retroperitoneal space. The studies were carried out on expert ultrasonic systems Siemens ACUSON S2000, Hitachi ARIETTA V70 and Philips EPIQ 5. Results. We studied the capabilities of the ultrasound method for diagnosing serous BOT based on the analysis of morpho-ultrasound comparisons in patients after conservative and ultra-conservative operations. Conclusion. It has been established that ultrasound diagnostics is of decisive importance both in the initial diagnosis and in the dynamic observation of patients with conservative and ultra-conservative surgery for serous BOT. Echography makes it possible to diagnose a tumor in the ovary in 83.3% of cases and to reject the diagnosis in 86.7% of cases.

scholarly journals Judicial construction and technical expertise as a means of protecting the interests of participants of building process

2018 ◽  
Vol 170 ◽  
pp. 01009
Author(s):  
Andrey Butyrin ◽  
Ekaterina Stativa
Keyword(s):  
Public Relations ◽  
Legal Regulation ◽  
Technical Condition ◽  
Causal Connection ◽  
Technical Expertise ◽  
Building Process ◽  
Wide Range ◽  
The Subject ◽  
Definition Of ◽  
Judicial Expertise

The paper defines the significance of judicial construction and technical expertise as a means of protecting the rights and interests of participants of building process when considering and resolving economic and industrial disputes, significant number of which is based on the imperfect legal regulation of public relations of this activity. Noting the insufficient knowledge of the judicial community about the informational potential of this kind of judicial expertise, the authors presented a wide range of types of studies conducted by the building expert in practice. The presented list includes the following types of studies of the object of judicial construction and technical expertise: establishment of its existence; location; technical condition; its properties; qualitative and quantitative characteristics; cost; an object's belonging to a particular class, sort, kind, type, group; establishment of the conformity of its characteristics to a certain standard, rule or regulation. Consideration is also made of studies that have been conducted in judicial and investigation expert practice aimed at establishing the presence and types of causal connection between events that have been the subject of criminal investigation and (or) judicial proceeding, as well as establishing the object’s existence by its representation, belonging of a part of the object to the whole, definition of a unified source of origin (manufacturer) of several objects of judicial construction and technical expertise.

scholarly journals The Role of the Endocrinologist in the Gender Adequacy Process and the Barriers for Adequate Transgender Health Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A796-A796
Author(s):  
Alexandra Saliba
Keyword(s):  
Health Care ◽  
Professional Training ◽  
Federal District ◽  
Specific Knowledge ◽  
Transgender People ◽  
Transgender Health ◽  
Wide Range ◽  
The Subject

Abstract The transgender universe comprises a wide range of individuals who do not identify with the gender role related to their birth sex, presenting distinct gender identities that transcend the binary concept of female and male. The follow-up of this population requires specific knowledge and training for its demands and peculiarities. Hormone therapy is a key point in the process of gender adequacy, and despite the increase in demand for specialized health services, there are still many barriers to full and free of prejudice health care. This is a descriptive and exploratory study about the characteristics of the professional training of the doctors involved in transgender health care, in particular the endocrinologist, and to enable an overview of the doctor-patient relationship and medical follow-up in the context of transsexuality in the Federal District. For this purpose, questionnaires were used for physicians: endocrinologists, family and community physicians, urologists, and psychiatrists; and transgender people residents of the Federal District. This study shows that most of the professionals involved in the process of gender adequacy, in particular the endocrinologist, do not present confidence or knowledge to accomplish it, and prejudice is still presented in a striking way in health care. In Federal District, services are not adequately structured for the care of this population, both from the perspective of doctors and transgender people. Moreover, in this sample, it was observed that the higher degree of specific knowledge in the subject increases the sensation of confidence of the professional to treat transgender people but does not correlate with the prejudice.

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