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

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.

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Current State of the Autoimmune Thyroiditis Problem

Health and Ecology Issues ◽

10.51523/2708-6011.2019-16-2-1 ◽

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.

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The role of the department of surgical diseases №2 in the formation of cardiovascular surgery service in the Republic of Tatarstan (to the 80th anniversary of the department)

Kazan medical journal ◽

10.17750/kmj2015-893 ◽

2015 ◽

Vol 96 (6) ◽

pp. 893-900

Author(s):

R K Dzhordzhikiya

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Cardiovascular Surgery ◽

Heart Valve Disease ◽

High Tech ◽

City Hospital ◽

Clinical Hospital ◽

Diagnostic Center ◽

The Republic

The main stages of development and formation of the cardiovascular surgery in the Republic of Tatarstan and the role of the department of surgical diseases №2, on the basis of which this branch of surgery engendered in the 60s of XX century, are represented. The first demonstrational cardiac surgeries (closed mitral commissurotomy) were performed in Kazan at the premises of the 3d city hospital by academician A.A. Vishnevsky in 1958. In 1963 the 6th city hospital became the main base of the department of surgical diseases №2 in Kazan, and the first cardiac surgery intervention was performed on April 15, 1963 on 26 years old patient with mitral stenosis of rheumatic etiology. In the 70s of XX century cardiac surgery service at the premises of 6th city clinical hospital got the status of Interregional cardiac surgery center. From the beginning of the 1990s, cardiopulmonary bypass surgery became leading in the department of cardiac surgery. In 1992 the cardiac surgery department of the 6th city clinical hospital was reorganized and became the Kazan Center of Cardiovascular Surgery with 75 beds, since 1995 bearing the name of professor N.P. Medvedev. In 2000 the department was headed by associate professor R.K. Dzhordzhikiya (doctoral thesis «Minimally invasive surgery of acquired heart valve disease», 2004). In 2005 more than 300 cardiopulmonary bypass surgeries has been performed in the clinic. In 2006 employees of the center in almost full strength moved to the Interregional clinical diagnostic center, the first cardiac surgery at the center was performed in September 2006. Annually the number of high-tech operations increases. At the same time scientific research work is carrying out. The generalizing research studing the results of the preservation of annulo-papillary continuity when replacing valve in the mitral position with mechanical prosthesis in patients with rheumatic disease conducted at the center was one of the first in Russia. The past 80 years of the history of the Department of Cardiovascular Surgery and the stable foundation laid by previous generations of researchers and clinicians, the glorious representatives of the Kazan school of cardiovascular surgery, serve as a guarantee of successive development of scientific and clinical work of the department and the whole cardiac surgery service in the Republic of Tatarstan.

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Surgery for Recurrent Pancreatic Cancer: Is It Effective?

Cancers ◽

10.3390/cancers11070991 ◽

2019 ◽

Vol 11 (7) ◽

pp. 991 ◽

Cited By ~ 7

Author(s):

Lucia Moletta ◽

Simone Serafini ◽

Michele Valmasoni ◽

Elisa Sefora Pierobon ◽

Alberto Ponzoni ◽

...

Keyword(s):

Pancreatic Cancer ◽

Pancreatic Adenocarcinoma ◽

Surgical Procedures ◽

Extensive Literature ◽

Disease Free Interval ◽

Number Of Patients ◽

Recurrent Pancreatic Cancer ◽

Primary Neoplasm ◽

Meta Analyses

Despite improvements to surgical procedures and novel combinations of drugs for adjuvant and neoadjuvant therapies for pancreatic adenocarcinoma, the recurrence rate after radical surgery is still high. Little is known about the role of surgery in the treatment of isolated recurrences of pancreatic cancer. The aim of this study was to review the current literature dealing with surgery for recurrent pancreatic cancer in order to examine its feasibility and effectiveness. An extensive literature review was conducted according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and 14 articles dealing with re-resections for recurrent pancreatic adenocarcinoma were analyzed, focusing on the characteristics of the primary neoplasm and its recurrence, the surgical procedures used, and patient outcomes. Data were retrieved on a total of 301 patients. The interval between surgery for primary pancreatic cancer and the detection of a recurrence ranged from 2 to 120 months. The recurrence was local or regional in 230 patients, and distant in 71. The median overall survival was 68.9 months (range 3–152) after resection of the primary tumor, and 26.0 months (range 0–112) after surgery for recurrent disease. The disease-free interval after the resection of recurrences was 14.2 months (range 4–29). Although data analysis was performed on a heterogeneous and limited number of patients, some of these may benefit from surgery for isolated recurrence of pancreatic adenocarcinoma. Further studies are needed to identify these cases.

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LEGAL PROTECTION OF MIGRANT WORKERS AGAINST THREATS OF ABUSE DISCRIMINATION IN A DIPLOMATIC RELATIONSHIP PERSPECTIVE BETWEEN COUNTRIES

Lampung Journal of International Law ◽

10.25041/lajil.v3i2.2366 ◽

2021 ◽

Vol 3 (2) ◽

pp. 111-120

Author(s):

Yapiter Marpi

Keyword(s):

Migrant Workers ◽

Descriptive Analysis ◽

National Development ◽

Legal Protection ◽

Role Of The State ◽

Study Results ◽

Unilateral Termination ◽

The Republic ◽

Diplomatic Relationship

Manpower is the driving force of an activity that can determine the implementation of manpower through the available manpower, which is an integral part of national development based on Pancasila and the 1945 Constitution of the Republic of Indonesia. Problems that occur to Indonesian migrant workers abroad occur cases, abuse and discrimination occur, such as cases of sexual harassment, cases involving convictions of migrant workers, cases of unpaid wages, to cases of unilateral termination of employment. This research uses normative juridical research methods and is legally supported by socio descriptive analysis employing primary, secondary, and tertiary data. The purpose of this research is that the placement of Indonesian workers abroad is one of the State's efforts to realize the same rights and obligations for workers to improve their standard of living. The study results show that the protection of migrant workers needs to be affirmed with certainty against the regulation of Law Number 18 of 2017. The aim is to guarantee Indonesian Migrant Workers and their families in realizing guaranteed fulfillment of their rights in all activities before working, during work, and after working in legal, economic aspects, and social. The role of state diplomacy is needed in protecting and fulfilling the rights of migrant workers because this condition involves relations between countries, as people who have no choice of provider for life, workers. Therefore the role of the State must be very spearheading in providing legal protection to migrant workers because their status is minimal. The research analysis results to realize the implementation of international and national legal instruments from Indonesia need to be optimized through diplomacy from those with interest so that protection is said to be effective and optimal.

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Health Care Problems and Ensuring Sustainable Development among Employees

Kwartalnik Ekonomistów i Menedżerów ◽

10.33119/eeim.2020.57.4 ◽

2020 ◽

Vol 57 (3) ◽

Author(s):

Tomasz Rostkowski

Keyword(s):

Sustainable Development ◽

Healthcare System ◽

Healthcare Workers ◽

Scientific Information ◽

Healthcare Services ◽

The Republic ◽

Care Problems ◽

Diverse Data ◽

Medical Healthcare

The article offers a synthetic presentation of the results of analyses of diverse data resources and other scientific information concerning the healthcare in Poland. These studies were conducted in order to put forward positive changes that are not only to prevent the fall of the system, which is highly probable, but also to improve the availability of medical services and increase their quality. These studies are of major importance because the availability of medical (healthcare) services is largely determined by whether it is possible to implement the idea of sustainable development among employees, which indirectly determines the possibility of implementing sustainable development principles incorporated into legal circulation under one of the first articles of the Constitution of the Republic of Poland. The concept of sustainable development is not only one of the important reasons which call for modernisation of the functioning of the healthcare system, but also an idea which, once applied, may be helpful in solving healthcare problems. Considering the fact that the largest problem of this system in Poland lies in the shortage of employees, it becomes clear that by trying to ensure sustainable development of employees working in other industries, first, it is necessary to take care of their health, which must lead through sustainable development of healthcare workers. The aim of the article is to present the comprehensive nature of the idea of sustainable development of employees, the role of health protection in achieving a balance by employees, and to show the way to build integrated programmes to maintain the health of employees and their families against the background of the limitations of the Polish healthcare system.

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Children’s republican clinical hospital - a 40-year-long path in the history of pediatric healthcare in Tatarstan

Kazan medical journal ◽

10.17750/kmj2017-468 ◽

2017 ◽

Vol 98 (3) ◽

pp. 468-475

Author(s):

S A Valiullina ◽

L A Doronina

Keyword(s):

Hospital Staff ◽

High Tech ◽

Clinical Hospital ◽

Chief Physician ◽

History Of ◽

The Republic ◽

Pediatric Healthcare ◽

The City ◽

Modern Technologies

Children’s republican clinical hospital of the Republic of Tatarstan has undergone a forty-year-long path in its development. Today it is a modern medical institution uniting a high-tech hospital, an emergency hospital and an organizational and methodological center. It is also a coordinator of pediatric healthcare in Tatarstan. However, it all began with the Government’s decision to build a modern pediatric republican center on the outskirts of the city. The article describes in detail how the hospital was built, how surgical and pediatric services were created and developed, how the staff was trained, how modern technologies were introduced, how the hospital was modernized to solve strategic tasks, what role the Departments of pediatrics and pediatric surgery have played and still play. History is made by people, so the article contains the detailed description of formation of the hospital staff and reflects the role of its first Chief physician E.V. Karpukhin who took an active part in hospital’s construction, in creation of its services and headed this hospital for 33 years. The efforts of the large team have made the Children’s republican clinical hospital one of the best among children’s hospitals in Russia.

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Simulation Modeling and Practice of Inpatient Emergency Department in COVID-19 Pandemic

Disaster Medicine ◽

10.33266/2070-1004-2021-4-37-43 ◽

2021 ◽

pp. 37-43

Author(s):

V.M. Teplov ◽

◽

S.S. Aleksanin ◽

E.A. Tsebrovskaya ◽

A.A. Lebedeva ◽

...

Keyword(s):

Emergency Department ◽

Simulation Modeling ◽

Daily Basis ◽

Positive Role ◽

Number Of Patients ◽

Correct Calculation ◽

Coronavirus Infection ◽

Inpatient Department ◽

Hospital Center

The article presents the experience of using simulation modeling to optimize inpatient emergency department as an admission unit of a hospital — Center for treatment of patients with new coronavirus infection COVID-19. It was noted that the inpatient emergency department effectively performed the functions of the inpatient department of the Center for treatment of patients with new COVID-19 coronavirus infection for a total of more than 7 months. A correct calculation of staffing and a competent use of the department “zones” ensured efficient and rapid reception of patients during both “waves” of the pandemic. The model also proved positive role of such departments with a large number of patients in a multimillion metropolis needed to be hospitalized on a daily basis.

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Covid-19 in Estonia. Restrictions and population’s coping with them

Papers on Anthropology ◽

10.12697/poa.2020.29.2.01 ◽

2020 ◽

Vol 29 (2) ◽

pp. 7-21

Author(s):

Ene-Margit Tiit ◽

Marianna Makarova

Keyword(s):

Mechanical Ventilation ◽

Emergency Situation ◽

Background Information ◽

Hospital Treatment ◽

Health Board ◽

Virus Infections ◽

Number Of Patients ◽

The Republic ◽

The Government ◽

The One

The article is based on a selection of data commissioned by the Government Office of the Republic of Estonia and received during 10 weeks from weekly surveys (COVID-THEMATIC SURVEY) conducted by Turu-uuringute AS, a market research company. The study began on 17 March and lasted for 10 weeks to 21 May. On three days of every week, about 2,000 Estonian residents aged 15 and over were interviewed. The respondents were randomly selected and represented the entire population of Estonia in terms of gender, age, ethnicity and social affiliation. The time series on the assessment of virus infections, hospital and intensive care (mechanical ventilation) and COVID deaths, compiled on the basis of data published by the Health Board, was also used as background information. The first three rounds took place during the period of increasing morbidity, the following four rounds (4–7) during the study period when the morbidity situation remained more or less stable, and all the established restrictions also applied. The last stage, rounds 8–10, took place at a time when morbidity was declining and restrictions were gradually eased. The survey revealed that Estonia was not ready for the crisis – just like most of the world’s countries. The crisis tested, on the one hand, the government’s ability to make difficult decisions and make significant use of the brain potential of the country’s research community, and, on the other hand, the people’s reasonableness, stress tolerance and ability to comply with rather awkward restrictions. It follows from the present analysis that all the restrictions were opposed by those who did not believe in their appropriateness. However, compared to the total population, their number was small, and, therefore, the restrictions in Estonia were maintained without sanctions and no contradictions arose, let alone unrest. The open action of the Crisis Committee was very important: the number of new infections, the number of patients in need of hospital treatment and mechanical ventilation, as well as the number of deaths, were reported daily at both the government press conference and in the media. The survey showed that there were very few people in the country who thought they did not know everything they needed about the crisis. The fact that people remained rather cautious in their assessments even after the end of the emergency situation adds to the hope of coping with the virus in the future – should a second wave or any other threat come.

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Epidemiological Situation on Tick-Borne Viral Encephalitis in the Russian Federation in 2019 and Forecast for 2020

Problems of Particularly Dangerous Infections ◽

10.21055/0370-1069-2020-1-33-42 ◽

2020 ◽

pp. 33-42 ◽

Cited By ~ 1

Author(s):

A. Ya. Nikitin ◽

E. I. Andaev ◽

E. V. Yatsmenko ◽

Yu. N. Trushina ◽

M. I. Tolmacheva ◽

...

Keyword(s):

Preventive Measures ◽

Constant Attention ◽

Process Dynamics ◽

Tick Borne Encephalitis ◽

Number Of Patients ◽

Study Results ◽

Federal Districts ◽

The Russian Federation ◽

Epidemiological Situation

Tick-borne encephalitis is a transmissible natural-focal disease which occurs in some countries across Europe and Asia. The observation of epidemic process dynamics of TBVE in Russia covers an 80-year long period and it’s the world longest. The existence of extensive records, various data from different geographic and administrative areas opens the way to interpretation of certain ecological and social factors and their role in the regional epidemiological situation. The targeted measures against TBVE are feasible only when the role of basic predictors of decreasing incidence is defined. Objective: analysis of TBVE incidence among the population and preventive measures in the Districts and constituent entities of Russia in 2019, forecast for 2020 based on the data collected in 2010–2019. The article shows a continued downward trend in TBVE incidence, noted in recent years. However, cases of infection were registered in 6 Federal Districts and 46 regions just like in the past. The number of patients amounted to 1559 (the incidence rate is 1.02 per 100000 people), of whom 23 have died. The rate of seeking medical care among those who were bitten by ticks increased. Specific preventive measures against TBVE haven’t significantly changed by volume and focus compared to the previous period. The scope of acaricide treatments has declined. The article also presents the data concerning TBVE carriers’ infection rate, and the laboratory study results in districts and regions across the country. It is recognized that the epidemiological situation on TBVE in Russia is still unfavorable. It requires the constant attention of health facilities and Rospotrebnadzor and management decisions aimed at further decrease in the incidence by improved prevention especially in the regions with high TBVE incidence.

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On improving medical care for patients with metastatic tumors of the central nervous system in the Republic of Tatarstan

Kazan medical journal ◽

10.17816/kmj2299 ◽

2012 ◽

Vol 93 (2) ◽

pp. 241-245 ◽

Cited By ~ 1

Author(s):

V I Danilov ◽

R Sh Khasanov ◽

A G Alekseev ◽

K T Shakirov ◽

A A Nasher

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Medical Care ◽

Metastatic Tumors ◽

Significant Discrepancy ◽

Metastatic Lesions ◽

Number Of Patients ◽

Study Results ◽

The Central Nervous System ◽

The Republic

Aim. To optimize medical care for patients with metastatic tumors of the central nervous system in the Republic of Tatarstan. Methods. The database of the Cancer Registry of the Republican Clinical Oncology Dispensary of the Ministry of Health Care of the Republic of Tatarstan and the case histories of patients treated in the neurosurgical departments for the period from 1998 to 2007 served as the material for this study. Results. Lung cancer, breast cancer, kidney cancer and melanoma were the most frequent types of cancers to metastasize to the central nervous system. There was a significant discrepancy between the predicted and the detected number of patients with metastatic lesions of the central nervous system. Studied was the quality of medical care provision to this category of patients. In the Republic of Tatarstan established is a modern instrumental base for the timely diagnosis of metastatic lesions of the central nervous system and their complex treatment in accordance with the current guidelines. However, the effectiveness of diagnostic and therapeutic measures still remains unsatisfactory. Conclusion. A set of measures for optimizing medical care for patients with metastatic tumors of the central nervous system has been developed in the Republic of Tatarstan.

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