Variation cardiointervalometry in evaluating the efficiency of medical and psychological rehabilitation measures of military services

BACKGROUND: Тhe main tasks of medical and psychological rehabilitation (MPR): accelerated restoration of the functional state and working capacity of military personnel; increase of reserve capabilities; reduction of the influence of risk factors for various diseases; secondary prevention of chronic diseases and prevention of chronization of acute processes; carrying out measures to eliminate and reduce psychopathological syndromes in order to achieve mental adaptation; restoration of professional health, correction of maladaptosis. AIMS: Is to study the informative value of variational cardiointervalometry (VCM) indicators in assessing the effectiveness of MPR of military personnel. MATERIAL AND METHODS: This study was conducted in the branch Clinical Sanatorium Volga of the Federal State Budgetary Institution Privolzhsky of the Ministry of Defense of the Russian Federation during the work of the psychotherapy room with the category of MPR for 12 months. In addition to the regulated volume of diagnostic studies, the Device for psychophysiological testing UPFT-1/30 Psychophysiologist (manufacturer of LLC NPKF Medikom MTD, Russia) was used. One of the research methods is the assessment of the functional state of the heart rhythm by the method of variational cardiointervalometry (VCM) at admission to MPR and before discharge (also referred to in the literature as heart rate variability, HRV). The study was conducted with 116 servicemen undergoing MPR for fatigue of 12 degrees for 10 days. Representatives of the Strategic Missile Forces (RVSN) ― 34 people; aerospace forces (VKS) ― 32 people; ground forces (SV) ― 50 people. The data is processed in StatSoft Statistica 10 Russian Portable 10.0.1011.0 x86. RESULTS: The average values for the entire group (116 servicemen): at admission and before discharge IN (stress index) increased statistically significantly from 284.5 to 359.7 cu; VLF-decreased from 21.1% to 16.0%; LF/HF (vagosympathetic interaction index) ― from 2.7 to 4.0 cu; Centralization index ― from 3.8 to 5.1 cu; PARS (indicator of adaptation of regulatory systems) ― from 4.6 to 5.3 cu. The result is a pronounced tension of regulatory systems, active mobilization of protective mechanisms, increased activity of the sympatho-adrenal system and the pituitary-adrenal system. CONCLUSION: VCM (HRV) is one of the practical informative methods. RVSN: an increase in the voltage of regulatory systems as a reaction to physical exertion, a post-loading energy-deficient state, the index of vagosympathetic interaction has shifted to the parameters of the norm.VCS: an increase in the voltage of regulatory systems, an increase in the activation of the sympathetic nervous system, an active mobilization of protective mechanisms. SV: a tendency to reduce the voltage of regulatory systems, a post-loading energy-deficient state, a balanced state of the autonomic nervous system (VNS). A delayed training effect is likely, changes occur in the late phases of recovery, after the end of the rehabilitation period.

Introducing a Novel, Broad Host Range Temperate Phage Family Infecting Rhizobium leguminosarum and Beyond

Temperate phages play important roles in bacterial communities but have been largely overlooked, particularly in non-pathogenic bacteria. In rhizobia the presence of temperate phages has the potential to have significant ecological impacts but few examples have been described. Here we characterize a novel group of 5 Rhizobium leguminosarum prophages, capable of sustaining infections across a broad host range within their host genus. Genome comparisons identified further putative prophages infecting multiple Rhizobium species isolated globally, revealing a wider family of 10 temperate phages including one previously described lytic phage, RHEph01, which appears to have lost the ability to form lysogens. Phylogenetic discordance between prophage and host phylogenies suggests a history of active mobilization between Rhizobium lineages. Genome comparisons revealed conservation of gene content and order, with the notable exception of an approximately 5 kb region of hypervariability, containing almost exclusively hypothetical genes. Additionally, several horizontally acquired genes are present across the group, including a putative antirepressor present only in the RHEph01 genome, which may explain its apparent inability to form lysogens. In summary, both phenotypic and genomic comparisons between members of this group of phages reveals a clade of viruses with a long history of mobilization within and between Rhizobium species.

Fine tuning of the side-to-side tenorrhaphy: A biomechanical study assessing different side-to-side suture techniques in a porcine tendon model

Recent studies conclude that a new technique for tendon transfers, the side-to-side tenorrhaphy by Fridén (FR) provides higher biomechanical stability than the established standard first described by Pulvertaft (PT). The aim of this study was to optimize side-to-side tenorrhaphies. We compared PT and FR tenorrhaphies as well as a potential improvement, termed Woven-Fridén tenorrhaphy (WF), with regard to biomechanical stability. Our results demonstrate superior biomechanical stability and lower bulk of FR and, in particular, WF over PT tenorrhaphies. The WF and FR technnique therefore seem to be a notable alternative to the established standard tenorrhaphy as they display lower bulk and higher stability, permitting successful immediate active mobilization after surgery.

Study of the Various Factors Involved in Monteggia Fractures Treated by Open Reduction and Internal Fixation in Government Medical College, Trichur

BACKGROUND The various factors involved in Monteggia fractures treated by open reduction and internal fixation (ORIF) were studied in patients presenting to Government Medical College, Trichur. Its distribution based on age, gender, and nature of trauma, were observed in the patients. METHODS This study was a prospective descriptive study, conducted in Department of Orthopaedics, Medical College, Thrissur from 1, January, 2016 to 1, July, 2017. Patients were assessed according to age, sex, side of injury, co-morbidities and final functional assessment was made according to Broberg and Morrey score. A total of 37 patients were observed. The patients were assessed, deemed fit for the study, and subjected to operation. Radial head reduction, fixation if needed, then ulna fracture was opened, reduced, and fixed with plate and screws. Postoperative plaster slab was applied, then converted to full above elbow cast, and retained for as long as needed. Post-operative mobilization was by home physiotherapy only. RESULTS Our study showed that open reduction and internal fixation of ulna outcome in Monteggia fractures leads to good elbow function and minimal loss of physical capacity. Immobilization of more than 2 months have very high chances of elbow stiffness. Early active mobilization after surgery is necessary for good functional outcome. Other than mild stiffness and loss of range of motion in some cases, very few other complications were found in our series. CONCLUSIONS Rigid internal fixation of ulna and early active mobilization is the key to achieve a good functional outcome and minimal loss of physical capacity in Monteggia fractures. Very few of the complications that were described in the literature were seen in the study. Even with restricted resources and minimal facilities, almost no permanent or debilitating morbidity or complications were seen in our series. Early active mobilization after surgery was the most important deciding factor for good functional outcome. Prolonged immobilization of more than one month consistently produces poor results. KEYWORDS Monteggia, Broberg and Morrey, Bado Classification, Internal Fixation, Ulna Fracture

Wide-Awake Approach for Flexor Digitorum Superficialis Tendon Transfer Followed by Early Active Mobilization

Background The standard clinical practice to treat closed ruptures of the flexor digitorum profundus (FDP) tendons includes free tendon grafting; however, it is not suitable when the muscle amplitude of the ruptured FDP is not sufficient. We report outcomes of six patients who underwent flexor digitorum superficialis (FDS) tendon transfer of the ring finger using the wide-awake approach to repair the closed rupture of the FDP tendon of the little finger in zone 3 or 4. Methods The patients were identified by reviewing our institutional billing records from January 2012 to October 2019 for the International Classification of Disease 10 code M66.3 that describes the diagnosis as “spontaneous rupture of flexor tendons.” Results The patients comprised two men and four women with an average age of 72.2 years (standard deviation [SD], 8.4 years). All patients were hospitalized after surgery to undergo early active mobilization. The average total active motion at the final evaluation was 201.8° (range: 85–248°). According to Strickland’s criteria, outcomes were excellent for two, good for three, and poor for one patient. No patients complained about the ring finger. Conclusion These results suggest that FDS tendon transfer is recommended when the muscle amplitude of the ruptured FDP is insufficient. We believe that the wide-awake approach and early active mobilization may contribute to satisfactory outcomes.

SOME PROPERTIES OF ZEOLITES FOR THE PRESERVATION OF BIOCENOSIS

According to the obtained results, five samples of native zeolite from a mining quarry, Drozhzhanovsky district, Republic of Tatarstan, Russia had neither pathogenic nor saprophytic fungi when plated on Saburo agar with dextrose. Zeolites prolongated the action of mineral fertilizers, increasing the effectiveness of the latter. The content of calcium in the chemical composition of the zeolite-containing rock created favorable conditions for improving the reaction of the soil environment, for the active mobilization of soil phosphates into accessible forms. Silicon which in the composition of zeolites, improved plants nutrition with phosphorus and potassium. Due to the safe and beneficial properties of zeolite, this agro mineral can be used to restore soil fertility. This research will be continued.

Available for plants phosphorus in the floodplain catenas of the Amur River

This work was carried out to study the content and distribution of available for plants phosphorus in different types of floodplain soils along five catenas located in the upper and the middle Amur. It was found that the available for plants phosphorus forms in the soils of floodplains are influenced by the following factors: the structure of the river system, the type of floodplain, the type of vegetation cover, and soil-forming processes. During the long-term transportation of alluvium along the river bed, its hydrogenic weathering occurs with the release of phosphorus into river waters. In the absence of tributaries serving as additional sources of alluvium, the phosphorus content decreases downstream. More intense floodplain and alluvial processes in small floodplains provide renewal of the soil profile and replenishment of phosphorus reserves. In the soils under the birch forest, there is a significant accumulation of phosphorus, in comparison with the soils under meadow vegetation. The development of gley processes leads to active mobilization of phosphorus, but the long-term exposure leads to the depletion of its total reserves. The illimerization processes, initiated and developing when the floodplain hydrological regime of alluvial soils is changed to another one, promote the migration of iron oxides and phosphorus, adsorbed by the former, beyond the soil profile. To summarize, the average content of available for plants phosphorus, depending on the type of soil, decreases downstream from 300–100 mg/kg in the upper Amur to 170–20 mg/kg in the middle Amur. Available for plants of phosphorus are best provided in primitive alluvial layered soils, while in residual floodplain brunezems the lowest content is recorded.

Risk Factors of Patient-Related Safety Events during Active Mobilization for Intubated Patients in Intensive Care Units—A Multi-Center Retrospective Observational Study

The aim of this study is to clarify the incidence and risk factors of patient-related safety events (PSE) in situations limited to intubated patients in which active mobilization, such as sitting on the edge of the bed/standing/walking, was carried out. A multi-center retrospective observational study was conducted at nine hospitals between January 2017 and March 2018. The safety profiles and PSE of 87 patients were analyzed. PSE occurred in 10 out of 87 patients (11.5%) and 13 out of 198 sessions (6.6%). The types of PSE that occurred were hypotension (8, 62%), heart rate instability (3, 23%), and desaturation (2, 15%). Circulation-related events occurred in 85% of overall cases. No accidents, such as line/tube removal or falls, were observed. The highest incidence of PSE was observed during the mobilization level of standing (8 out of 39 sessions, 20.5%). The occurrence of PSE correlated with the highest activity level under logistic regression analysis. Close vigilance is required for intubated patients during active mobilization in the standing position with regard to circulatory dynamics.

Seasonal dynamics of lead content in sod-podzolic soil in dependence of mineral fertilizer application

Influence of prolonged use of increasing doses of mineral fertilizers (NPK by 0-30-60-90-120-150 kg of active matter/ha) on contents and dynamics of acid-soluble and mobile compounds of lead in an arable layer of the sod-podsolic soil was studied during the growing season of 2016. It has been established that prolonged application of fertilizers significantly increases the content of mobile forms of the element in the soil at application of NPK in dozes of 30 and 150 kg of active matter / ha as compared to the control (average values are 0.57, 0.51, and 0.33, respectively). However, even prolonged application of large doses of mineral fertilizers does not lead to a significant increase in lead content in the arable horizons of the soil. Acid-soluble lead compounds range from 2.46 (N0P0K0) to 5.33 mg/kg (N150P150K150); the content of mobile lead compounds from 0.08 to 1.31 mg/kg of soil, respectively, at maximum acceptable concentration of 6.0 mg/kg. The content of acid-soluble and mobile lead compounds in arable horizons of sod-podzolic soil had a reliable dynamics during the growing season on all variants of the experiment. An increase in the content and acid-soluble and mobile compounds is usually observed in the first half of the growing season (end of May - beginning of June), which is probably due to the active mobilization of lead from slow-moving compounds as a result of the activation of microbiological activity under a favorable hydrothermal regime. In the same period, the portion of mobile fractions of lead to acid-soluble fractions increases. Application of increasing doses of fertilizers (30, 60, 90, 120 and 150 kg/ha of active matter) does not always show a reliable increase in the content of the element in the corresponding variant, which is obviously due to the influence of unaccounted factors. A clearer content dynamics is characteristic of mobile lead compounds.

Functional outcome of zone 5 to zone 8 extensor tendon injuries of hand managed with early active mobilization following repair using a static splint: an observational study

<p class="abstract"><strong>Background:</strong> Injuries to extensor tendons of the hand are underrepresented in the literature compared to flexor tendons. The concept of early mobilization following extensor tendon repair emerged as previous strategies of static immobilization lead to frequent adhesions and poor outcome. In our study we assessed the functional outcome of early active mobilization after extensor tendon repair using a static splint. </p><p class="abstract"><strong>Methods:</strong> In this observational study 42 patients with 48 extensor tendon severances of the hand from zone 5 to 8 were selected. Following repair, early active mobilization with a static splint was done and the functional outcomes were assessed using the Dargan criteria. <strong></strong></p><p class="abstract"><strong>Results:</strong> After mobilizing for 4 weeks, out of total 48 patients, 18 (43%) had good outcomes, 19 (45%) had fair and 5 patients (12%) had poor outcome. After 6 weeks 14 patients (33.3%) had excellent, 20 patients (48%) had good and 6 patients (14%) had fair outcomes whereas only one patient (2.4%) had poor outcome. This result was statistically significant with a p value of 0.000.</p><p class="abstract"><strong>Conclusions:</strong> Early active mobilization following extensor tendon repair from zone 5 to 8 prevents adhesion around the repair site, leads to better post-operative outcome and faster recovery. Using a static splint along with a patient friendly, easily comprehensible rehabilitation protocol offers results comparable to the use of dynamic splints and requires fewer post-operative follow ups. The static splints being cheap, easy to construct are financially beneficial to the patients. </p>