scholarly journals Current State of the Autoimmune Thyroiditis Problem

2019 ◽  
pp. 4-13
Author(s):  
V. A. Rozhko
Keyword(s):  
Thyroid Gland ◽  
Autoimmune Thyroiditis ◽  
Convincing Evidence ◽  
Current State ◽  
Number Of Patients ◽  
Increased Risk ◽  
Study Results ◽  
The Republic

The review provides up-to-date data on pathogenetic mechanisms, opportunities of diagnosis, and organizational and medical measures concerning autoimmune thyroiditis (AIT). AIT is a polyetiological disease which is mainly caused by environmental factors, genetic predisposition and disorder in immune regulation. Primary AIT incidence in the Republic of Belarus in 2017 is 58 cases per 100,000 population in the overall structure of the thyroid gland pathology, the AIT accounts for up to 40 %. The upward trend in the number of autoimmune diseases of the thyroid gland, including that in ecologically unfavorable regions, is explained not only by the true increase in the number of patients with AIT, the consequences of stress, but also by the overdiagnosis. There is contradictory data on the correlation of the level of iodine sufficiency of the population with the AIT development; there is no convincing evidence of the role of radiation factors in increasing the risk of AIT. The review analyzes the correlation of AIT with an imbalance in a number of microelements involved in the synthesis of thyroid hormones and affecting the iodine exchange. The article presents the study results that determined the nature of immune disorders in AIT and hypothyroidism in such forms as disorders of lymphocyte subpopulations, proinflammatory and anti-inflammatory cytokines, changes in the apoptosis mechanisms, which were proposed for use as predictors of the severity of thyroid immune inflammation and hypothyroidism. The criteria for selecting patients with an increased risk of developing AIT complications remain unclear, that necessitates the development and implementation of additional organizational and medical measures for following-up of such patients and assessing their quality of life.

scholarly journals The role of surgeons during the COVID-19 pandemic: The experience of the Surgery Clinic of the Clinical Hospital Center 'Zemun'

2021 ◽  
Vol 2 (3) ◽  
pp. 228-235
Author(s):  
Dragoš Stojanović ◽  
Nebojša Mitrović ◽  
Dejan Stevanović ◽  
Damir Jašarović ◽  
Srđan Milina ◽  
...  
Keyword(s):  
Healthcare System ◽  
Surgical Procedures ◽  
Vascular Diseases ◽  
Hospital Treatment ◽  
Clinical Hospital ◽  
Number Of Patients ◽  
Study Results ◽  
The Republic ◽  
Hospital Center

Introduction: In December 2019, the existence of a new type of disease, caused by SARS coronavirus 2 (SARS-CoV-2), was discovered in the city of Wuhan, the Republic of China. The disease itself is characterized by a large number of patients with moderate and severe clinical presentation, who require hospital treatment. The organization of the healthcare system of Serbia, during the aforementioned pandemic, has required the engagement of all doctors, regardless of their specialty, in the treatment of patients with COVID-19. Surgeons of all branches, from the Surgery Clinic of the Clinical Hospital Center Zemun, were directly engaged in the treatment of both primary manifestations of the virus and the numerous surgical complications arising in the wake of this disease, but also in the treatment of primary acute surgical diseases in COVID-19-positive patients. Aim: The aim of this paper is to present the functioning of the Surgery Clinic of CHC Zemun, in the conditions of the COVID-19 pandemic, as well as to present the types and results of surgical procedures performed in patients with the COVID-19 infection. Methods: This study was conceived as a retrospective study and was conducted in the period between February 2020 and April 2021, in patients who had undergone emergency surgery and in whom the COVID-19 infection had previously been verified. A total of 232 patients surgically treated at the level of the entire Surgery Clinic of the CHC Zemun participated in the study. Results: Chest drainage, due to the development of pneumothorax, accounted for a quarter of all surgical procedures performed, while, in 53.85% of cases, surgical treatment was undertaken due to acute abdomen of various etiology, and in 21.15% of cases, due to vascular diseases. Conclusion: The COVID-19 pandemic is, in itself, a major challenge for the entire healthcare system. The role of the surgeon is significant, both in organization and in direct treatment, which is additionally complicated by the uniqueness of the entire situation and the severity of the disease itself. In addition to their involvement in the treatment of the COVID-19 infection itself, surgeons were, in a large number of cases, engaged in their primary activity in health care, i.e., in the treatment of surgical diseases and complications of COVID-19, performing demanding surgical procedures in very difficult and unique conditions.

scholarly journals Pulmonary hypertension in chronic lung disease and hypoxia

2019 ◽  
Vol 53 (1) ◽  
pp. 1801914 ◽  
Author(s):  
Steven D. Nathan ◽  
Joan A. Barbera ◽  
Sean P. Gaine ◽  
Sergio Harari ◽  
Fernando J. Martinez ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Current State ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Oxygen Requirements ◽  
Impaired Quality

Pulmonary hypertension (PH) frequently complicates the course of patients with various forms of chronic lung disease (CLD). CLD-associated PH (CLD-PH) is invariably associated with reduced functional ability, impaired quality of life, greater oxygen requirements and an increased risk of mortality. The aetiology of CLD-PH is complex and multifactorial, with differences in the pathogenic sequelae between the diverse forms of CLD. Haemodynamic evaluation of PH severity should be contextualised within the extent of the underlying lung disease, which is best gauged through a combination of physiological and imaging assessment. Who, when, if and how to screen for PH will be addressed in this article, as will the current state of knowledge with regard to the role of treatment with pulmonary vasoactive agents. Although such therapy cannot be endorsed given the current state of findings, future studies in this area are strongly encouraged.

scholarly journals Assessment of forecast parameters of the volume of investment in the fixed capital in the region

2020 ◽  
Vol 13 (4) ◽  
pp. 460-470
Author(s):  
M. M. Nizamutdinov ◽  
V. V. Oreshnikov
Keyword(s):  
Fixed Capital ◽  
Investment Activity ◽  
State Management ◽  
Current State ◽  
Republic Of Bashkortostan ◽  
Social And Economic Development ◽  
The Republic ◽  
The One

The authors study the problems of the quality of government agencies’ forecasts for social and economic development of the subjects of the Russian Federation. They point out that the volumes of investment in the fixed capital is one of the most important indicators by which it is possible to judge about the current state of economics as well as about the prospects for its development. On the one hand, the study is considered to be of extreme topicality due to the risks of development of negative process in investment activity in the country which are caused by global factors. On the other hand, it is necessary to point out that the role of forecasting as the element of regional development management is growing under the present conditions. The purpose of the study is to assess the quality of forecast for the volumes of investment in fixed capital and the indicators connected with it at the regional level. The approach suggested has been tested while analyzing the data on the Republic of Bashkortostan. To achieve the objective, the authors made statistical analysis for revealing contradictions in the indicators’ dynamics; examined the pace of growth of investment in current and comparable prices; made comparison with the region’s GRP dynamics, enterprises’ profit, parameters of development of construction industry; calculated the return of capital. They employed structural analysis method, dynamics’ analysis. Moreover, the authors estimated the conformity of the forecast with the strategic planning of regional and federal levels. They disclosed contradictions which decrease the quality of the forecast and dispute the effect of the measures taken in accordance with it. The scientific novelty of the approach suggested lies in implementation of complex view on assessment of quality of such documents by means of analyzing the conformity of dynamics for interrelated indicators. The results of the research can be used to discover the drawbacks in the existing forecast system. These drawbacks ought to be eliminated to raise the efficiency of the entire state management system.

Evolution of the public administration system. The Republic of Estonia

2020 ◽  
Vol 22 (4) ◽  
pp. 82-118
Author(s):  
YANA TOOM ◽  
◽  
VALENTINA V. KOMLEVA ◽  
Keyword(s):  
Public Administration ◽  
Administration System ◽  
The Public ◽  
Administrative Reforms ◽  
Social Sphere ◽  
External Threats ◽  
The Social ◽  
The Republic

The article studies the main stages and features of the evolution of the public administration system in the Republic of Estonia after 1992. This paper presents brief geographical and socio-economic characteristics that largely determine the development of the country’s public administration. The evolution of the institution of the presidency, executive, and legislative powers are considered. The role of parliament and mechanisms for coordinating the interests of different groups of the population for the development of the country is especially emphasized. The authors analyze the state and administrative reforms of recent years, which were aimed at improving the quality of services provided to the population, increasing the competitiveness of different parts of Estonia, as well as optimizing public spending and management structure. The introduction of digital technologies into the sphere of public administration, healthcare, education, and the social sphere is of a notable place. Such phenomena as e-residency, e-federation, and other digital projects are considered. The development of a digital system of interstate interaction between Estonia and Finland made it possible to create the world’s first e-federation, and the digitization of all strategically important information and its transfer to cloud storage speaks of the creation of the world’s first e-residency, a special residence of data outside the country’s borders to ensure digital continuity and statehood in the event of critical malfunctions or external threats.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals ТНЕ BASICS OF CLIМATOTHERAPY, А MODERN VIEW OF ТНЕ PROSPECTS FOR ITS DEVELOPMENT IN CRIMEA, ТНЕ ROLE OF ТНЕ RESTORATION OF ТНЕ EVPATORIA BIOCLIМATIC STATION AS ТНЕ CRIMEAN CENTER OF CLIМATOLOGY

2020 ◽  
Vol 26 (3) ◽  
pp. 78-82
Author(s):  
Т. F. Golubova ◽  
А. I. Kreslov
Keyword(s):  
Environmental Factors ◽  
Specific Resistance ◽  
The Body ◽  
Main Condition ◽  
Physiologically Based ◽  
Modern Methods ◽  
Meteorological Observations ◽  
The Republic

Climate is an active, powerful factor that can have a powerful therapeutic effect. Climatotherapy is prescribed for the purpose of General strengthening effects on the body, to stimulate its defenses, increase non-specific resistance, especially in chronic or sluggish pathological processes. The effect of climate therapy is manifested in the body's responses to environmental factors, the main condition of which is the use of physiologically based methods of dosing climate procedures. The bioclimatic station (BCS) of the resort of Yevpatoria carries out meteorological observations of medical orientation and their dosing. The creation of a modern center of climatotherapy, as a scientific-clinical Department of medical climatology on the basis of the BCS will allow to organize a single service on introduction of modern methods of climatotherapy in Evpatoria and the Republic of Crimea, improve the quality of the holiday of climateprotection and effectiveness of climatotherapy.

scholarly journals Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Maurizio Nordio ◽  
Sabrina Basciani
Keyword(s):  
Autoimmune Thyroiditis ◽  
Single Case ◽  
Elevated Serum ◽  
Thyroid Stimulating Hormone ◽  
Free Triiodothyronine ◽  
Hyperthyroid Patient ◽  
Normal Thyroid Function ◽  
Complete Restoration

Clinical evidences have highlighted the efficacy of myo-inositol and selenium in the treatment of autoimmune thyroiditis. Aim of this study was to further analyze the role of myo-inositol plus selenium (Myo-Ins-Se) in restoring a normal thyroid function of Hashimoto’s patients with subclinical hypothyroidism. Eighty-six patients with Hashimoto’s thyroiditis having thyroid-stimulating hormone (TSH) levels between 3 and 6 mIU/L, elevated serum antithyroid peroxidase (TPOAb) and/or antithyroglobulin (TgAb), and normal free thyroxine (fT4) and free triiodothyronine (fT3) levels were enrolled in the study: one hyperthyroid subject with TSH about 0.14 μU/ml was included in this trial as a single case. Patients were assigned to receive Myo-Ins-Se. TSH, TPOAb, and TgAb levels were significantly decreased in patients treated with combined Myo-Ins-Se after 6 months of treatment. In addition, a significant fT3and fT4increase, along with an amelioration of their quality of life, was observed. Remarkably, TSH values of the hyperthyroid patient increased from 0.14 μU/ml up to 1.02 μU/ml, showing a complete restoration of TSH values at a normal range. In conclusion, the administration of Myo-Ins-Se is significantly effective in decreasing TSH, TPOAb, and TgAb levels, as well as enhancing thyroid hormones and personal wellbeing, therefore restoring euthyroidism in patients diagnosed with autoimmune thyroiditis.

scholarly journals Emotions in leaders’ enactment of professional agency

2019 ◽  
Vol 31 (2) ◽  
pp. 143-165 ◽  
Author(s):  
Päivi Hökkä ◽  
Katja Vähäsantanen ◽  
Susanna Paloniemi ◽  
Sanna Herranen ◽  
Anneli Eteläpelto
Keyword(s):  
Qualitative Content Analysis ◽  
Leadership Coaching ◽  
Content Type ◽  
Current State ◽  
Before And After ◽  
State Of Affairs ◽  
Practical Implications ◽  
A Current

Purpose Although there has been an increase in workplace studies on professional agency, few of these have examined the role of emotions in the enactment of agency at work. To date, professional agency has been mainly conceptualised as a goal-oriented, rational activity aimed at influencing a current state of affairs. Challenged by this, this study aims to elaborate the nature and quality of emotions and how they might be connected to the enactment of professional agency. Design/methodology/approach Data are collected in the context of a leadership coaching programme that aimed to promote the leaders’ professional agency over the course of a year. The participants (11 middle-management leaders working in university and hospital contexts) were interviewed before and after the programme, and the data were analysed using qualitative content analysis. Findings Findings showed that emotions played an important role in the leaders’ enactment of professional agency, as it pertained to their work and to their professional identity. The study suggests that enacting professional agency is by no means a matter of purely rational actions. Practical implications The study suggests that emotional agency can be learned and enhanced through group-based interventions reflecting on and processing one’s own professional roles and work. Originality/value As a theoretical conclusion, the study argues that professional agency should be reconceptualised in such a way as to acknowledge the importance of emotions (one’s own and those of one’s fellow workers) in practising agency within organisational contexts.

A Refresher on Herpes Zoster, Current Status on Vaccination, and the Role of the Dermatologist

2011 ◽  
Vol 15 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Lyn C. Guenther ◽  
Charles W. Lynde
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Herpes Zoster ◽  
Preventive Medicine ◽  
Primary Care Physicians ◽  
Current Status ◽  
Age Group ◽  
Increased Risk

Background: Herpes zoster (HZ) and postherpetic neuralgia (PHN) have a significant impact on quality of life. PHN is often chronic and difficult to treat. Dermatologists have always been involved in making the diagnosis of these conditions and, most recently, teaching the need for early antiviral therapy. Objective: With the introduction of a new vaccine, HZ and its difficult-to-treat complication PHN can be prevented or minimized. Preventive medicine is important and has been supported by dermatologists with sun safety programs. Patients receiving biologics are at increased risk of developing zoster. Conclusion: Dermatologists should embrace zoster vaccination and recommend routine vaccination of immunocompetent individuals > age 60 years, as well as patients of any age who are starting immunosuppressants, including biologics. Given that individuals over age 50 years are at risk for PHN and studies have shown that the vaccine's immunogenicity and safety are maintained in individuals age 50 to 59 years, vaccination in this age group may be considered. Some dermatologists may consider vaccinating their own patients, but most will likely recommend that vaccination be performed by their patients' primary care physicians.

The Role of Cervical Dysfunction in Migraine: A Systematic Review

Cephalalgia ◽  
2008 ◽  
Vol 28 (5) ◽  
pp. 474-483 ◽  
Author(s):  
BA Robertson ◽  
ME Morris
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Convincing Evidence ◽  
Cervical Region ◽  
Electronic Database ◽  
Review Of The Literature ◽  
Diverse Range ◽  
Assessment Procedures

This systematic review evaluates the strength of the evidence for the role of cervical musculoskeletal dysfunction in migraine. In this review, cervical musculoskeletal dysfunction will refer to the abnormal sensory afferentation from cervical region structures contained within the receptive field of the trigeminocervical nucleus. Electronic database searches using MEDLINE, PubMed and CINAHL were performed, and 17 studies investigating cervical musculoskeletal dysfunction in people with migraine were selected for review. The methodological quality of the included studies was assessed by two independent reviewers using a customized checklist. The review found that intersubject differences were inadequately reported and controlled, which resulted in grouping of participants with varying pathologies and symptoms. A diverse range of assessment procedures was used by the reviewed studies, which made comparison of their findings difficult. The assessment procedures were mainly used to quantify the degree of cervical musculoskeletal dysfunction, rather than to identify a cause and effect relationship between cervical structure and migrainous pain. Although animal study evidence proposes a role for cervical musculoskeletal dysfunction in migraine, this systematic review of the literature found that there is currently no convincing evidence to confirm this phenomenon in humans.

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