“A doctor and teacher from God and from birth”. To the 100th anniversary from the birth of Tatiana Igorevna Zavadskaya

«Each of us has a Master. The first teacher to teach us how to read and write, add numbers and solve problems. The school teachers who taught us to love the Motherland and life, make friends and cherish beauty. Life teachers who taught us the lessons of love and hate, good and evil. Apart from the number of teachers who gave us general knowledge of life, there are People who taught us the great art of healing, who gave us professional foundations, who revealed to us the secret mysteries of healing. Each of us will name dozens of such Teachers, who have invested reasonable and light in us, who have given us a piece of their soul. But among them there is the very main Teacher who was able to consider in you only the visible sprouts of knowledge, the inclinations of a future doctor, the ability to master the profession. The very main Teacher who gave you all his knowledge and experience, taught you the art of healing, which became the basis of your profession, the meaning of your whole life. Tatiana Igorevna Zavadskaya was such a teacher», — recalled one of her many students, Yuri Ivanovich Zudbinov.The article is dedicated to the 100th anniversary of the birth of Zavadskaya T.I. - Associate Professor of the Hospital Therapy Department of the Rostov State Medical Institute, an experienced clinician, an enthusiastic scientist, a talented teacher and an outstanding personality.

632 Analysing Laser Doppler Images - A Modified Approach to the Assessment of Burn Depth

Aim To establish a method of quantifiably determining burn depth from Laser Doppler (LD) images of burns. Method NICE advises for LD scanning to be utilised for the assessment of intermediate depth burns, where there is doubt about burn depth following experienced clinician examination. However, these scan images do not provide a quantifiable measure of burn depth. LD determines burn perfusion, with deeper burns appear blue, and superficial burns appearing red. We retrospectively studied LD images from 110 patients over the course of 2019. Using Adobe Photoshop, Histogram software, we highlighted the burns using the selection tool, and determined the proportion of the burn that was deep/poorly perfused. We then correlated these results with time till recovery. Results Burns with a poorly perfused region of larger than 20%, had a proportional increase in time till full recovery. This proportional increase was also reflected in burns with a 30% and 40% poor perfusion. Burns with less than 20% of poor perfusion were found to recover at the same rate as superficial burns. This novel method for the measurement of burn depth will allow for the examining plastic surgeon to make a decision on treatment based on concrete and quantifiable burn depth data. Conclusions We have demonstrated the initial validity of a novel method for the quantifiable measurement of burn depth. Further study is required, to establish the validity of this novel approach to the quantifiable detection of burn depth.

Systemic disorders reflected in the hand

Clinical examination of the hand can reveal a broader diagnosis with manifestations of many systemic conditions evident to the experienced clinician. The features of these conditions are discussed in this chapter.

Early identification of postpartum depression using demographic, clinical, and digital phenotyping

Postpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention. Combinations of anamnestic, clinical, and remote assessments were evaluated for an early and accurate identification of PPD and AD. Two cohorts of mothers giving birth were included in the study (N = 308 and N = 193). At baseline, participants underwent a detailed sociodemographic-anamnestic and clinical interview. Remote assessments were collected over 12 weeks comprising mood and stress levels as well as depression and attachment scores. At 12 weeks postpartum, an experienced clinician assigned the participants to three distinct groups: women with PPD, women with AD, and healthy controls (HC). Combinations of these assessments were assessed for an early an accurate detection of PPD and AD in the first cohort and, after pre-registration, validated in a prospective second cohort. Combinations of postnatal depression, attachment (for AD) and mood scores at week 3 achieved balanced accuracies of 93 and 79% for differentiation of PPD and AD from HC in the validation cohort and balanced accuracies of 87 and 91% in the first cohort. Differentiation between AD and PPD, with a balanced accuracy of 73% was possible at week 6 based on mood levels only with a balanced accuracy of 73% in the validation cohort and a balanced accuracy of 76% in the first cohort. Combinations of in clinic and remote self-assessments allow for early and accurate detection of PPD and AD as early as three weeks postpartum, enabling early intervention to the benefit of both mothers and children.

Sonoelastography in the diagnosis of thyroid focal lesions

The occurrence of focal lesions in the thyroid gland affects up to 65% of the general population, and an important element of diagnostics is the most precise possible distinction between benign and malignant lesions. Despite advanced knowledge and developed algorithms, in some cases the decision to proceed further may cause problems even for an experienced clinician. A promising tool in estimating oncological risk is sonoelastography. This article aims to approximate and organize knowledge in this field in relation to focal lesions of the thyroid gland and to encourage the implementation of the method in everyday practice.

Haematology

This chapter summarizes the key aspects of paediatric haematology. It is a big subject. Despite having detailed texts to hand, sometimes interpreting and evaluating the significance of certain blood results can be challenging for even the most experienced clinician. In this regard, one should have a low threshold for discussing the results (and further investigations, if needed) with a friendly haematologist and consult local guidelines.

Assessment Across the Life Span: The Clinical Swallow Evaluation

Purpose This clinical focus article considers the roles of the clinical swallow examination (CSE) as a clinically meaningful assessment method used in both adult and pediatric populations. Method This clinical focus article explores the utility of the CSE across the life span. Specifically, components, reliability, standardized assessments, and limitations of the CSE within the adult and pediatric populations are highlighted. Conclusions The CSE remains a crucial assessment tool for the speech-language pathologist. The experienced clinician can make important judgments regarding patient safety and function. If the CSE is conducted mindfully and methodically, findings can help chart the course of care for individuals needing additional assessment and possibly intervention.

Early identification of postpartum depression using demographic, clinical, and digital phenotyping

BackgroundPostpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention.AimsTo evaluate combinations of anamnestic, clinical and remote assessments for an early and accurate identification of PPD and AD.MethodTwo cohorts of mothers giving birth were included in the study (N=308 and N=193). At baseline, participants underwent a detailed anamnestic and clinical interview. Remote assessments were collected over twelve weeks comprising mood and stress levels as well as depression and attachment scores. At twelve weeks postpartum, an experienced clinician assigned the participants to three distinct groups: women with PPD, women with AD, and healthy controls (HC). Combinations of these assessments were assessed for an early an accurate detection of PPD and AD in the first cohort and, after pre-registration, prospectively validated in the second cohort.ResultsCombinations of postnatal depression, attachment (for AD) and mood scores at week 3 achieved balanced accuracies of 93% and 79% for differentiation of PPD and AD from HC in the prospective validation cohort. Differentiation between AD and PPD, with a balanced accuracy of 73 % was possible at week 6 based on mood levels only.ConclusionsCombinations of in clinic and remote self-assessments allowed for early and accurate detection of PPD and AD as early as three weeks postpartum, enabling early intervention to the benefit of both mothers and children.

Induction

Anaesthetic induction in children can be challenging even for the most experienced clinician. The anaesthetist’s approach must vary depending on the age group. Communication is paramount, since parents are frequently present at induction and are often stressed; the clinician must ensure the parent knows what is expected of them and what will happen at induction. Induction becomes even more challenging with the uncooperative child, and a well-thought-out plan is essential. Anaesthetic induction is performed either by an inhalational or an intravenous route; this chapter provides the reader with some simple top tips to provide a smooth induction process for child and parent. After induction, managing the airway is the priority; this chapter discusses both basic and advanced airway skills. In addition, the issue of administering a standard rapid sequence induction is discussed.

The Influence of Implant Shape on Primary Stability of Implants With a Thread Cutting and Forming Design: An Ex Vivo Study

The design of an implant has a great effect on primary stability. The purpose of this study was to determine the differences in primary stability between straight and tapered Neoss ProActive implants in type I and type III bones using resonance frequency analysis (RFA) and electronic percussive testing (EPT) methods. Fresh cow vertebrae and pelvis were used as models of type III and type i bone, respectively. Implants of 2 different designs—straight and tapered Neoss ProActive implants with a thread cutting and forming (TCF) design, both 3.5-mm wide and 11-mm long—were placed in both types of bone (n = 60). The primary stability of all implants was measured by an experienced clinician blinded to the study protocol using the EPT and RFA devices. No statistically significant difference was found between the implant stability quotients and the percussive test values of straight and tapered implants in either bone type. Within the limitations of this ex vivo study, it may be concluded that the shape of an implant with a TCF design does not affect primary stability.