Experimental justification for prompt neutralization of traumatic action of thermal exo- and endogenous damage factors (morphological features)

Objective: morphological substantiation of efficiency of prompt neutralization of traumatic action of exogenous and endogenous damage factors in burn injuries in experimental conditions. After simulating the burns on 60 rats, the traumatic hyperthermic damage factors in the main group were immediately neutralized by a gauze napkin soaked in water. Depending on its duration, the animals were divided into subgroups. Such applications were not performed on the control group. The study involved histological examination of tissues. Animals of the main groups had the presence of histologically confirmed skin appendages with a formed scar of connective tissue without signs of inflammation. In animals of the control group there were no skin appendages, which indicates a deeper thermal damage to tissues and the impossibility of self-epithelialization of wounds. These results confirm the importance and necessity of prompt neutralization of the traumatic effect of damage factors as the main elements of burn depth formation.

Application of Nano-Insulin Pump in Children with Diabetic Ketoacidosis

Type 1 diabetes is an insulin-dependent type of diabetes that is most common among children. Due to absolute deficiency of insulin in patients, diabetic ketoacidosis (DKA) can easily ensue. Insulin pump can simulate the physiological secretion of islet, but increases the risk of pain and infection in children due to its traumatic effect. This study aimed to analyze the application effect of nano-insulin pump in children with DKA. Children with DKA admitted to our hospital from May 2018 to May 2020 were included in this study and, according to the random number table method, they were divided into two groups, with each group containing 36 cases. The first group received traditional insulin pump infusion (IP), while the second group received nano-insulin pump infusion (NIP). It was found that the reduction of FBG and PBG in NIP group was greater than that in IP group. The recovery time of urine ketone, blood ketone, glucose, venous pH, and other clinical indicators in the NIP group were all lower than those in the IP group (P < 0.05). The length of hospital stay, insulin dosage, incidence of hypoglycemia, and infusion site infection rate in the NIP group were all lower than those in the IP group (P <0.05). The findings indicate that the application of nano-insulin pump in children with DKA had a significant effect and could quickly and obviously correct the levels of blood glucose and ketone body in children.

THE EXPERIENCE OF NOSE TAMPONS APPLICATION WITH PRESERVATION OF THE NASAL RESPIRATION FUNCTION

Nasal tampons should provide effective hemostasis while maintaining the function of nasal breathing, and not produce a traumatic effect on the mucous membrane of the nasal cavity. Within the frames of the research work in the Republican Scientific and Practical Center of Otorhinolaryngology, together with LLC «Advantmed», nasal tampons with preservation of the nasal breathing function of several sizes (14×64×7 mm and 19×84×7 mm) have been developed and manufactured. A registration certificate for a medical device has been received. Objectives. To evaluate the effectiveness of the use of nasal tampons while maintaining the nasal breathing function. In the course of the work, the time of stopping bleeding has been measured, patients have been surveyed concerning preservation of their nasal breathing function during tamponade of the nasal cavity, comfort of the tamponade of the nasal cavity using a 10-point visual analogue scale has been assessed by the patients, the degree of edema and hyperemia of the nasal mucosa has been determined, the presence of scabs and fibrin plaque during endoscopic examination of the nasal cavity using a 3-point visual analogue scale has also been determined. Results. Nasal tampons with preservation of the nasal breathing function have good hemostatic quality: the speed of stopping bleeding was 5±1 seconds compared to 9±1 seconds in case of glove-gauze tamponade (p<0.05). When questionnairing all patients (100%) during the period of using the developed medical device, the function of nasal breathing was determined as sufficient. Conclusions. Tamponade of the nasal cavity using nasal tampons while maintaining the nasal breathing function is better tolerated by patients than the glove-gauze one (the comfort of tamponade of the nasal cavity according to the visual analogue scale varied from 4 to 6 points (with an average value of 4.9±0.6 points) in comparison with 5-8 points (on an average 6.8±0.3 points), respectively (p<0.05)). It has a less pronounced traumatic effect on the mucous membrane of the nasal cavity compared to that of the glove-gauze tamponade.

Trauma Informed Care During a Global Pandemic: Synergies and multidisciplinary boundaries for working with childhood, adolescence, senility and disability

This article addresses the issue of a trauma informed approach from a multidisciplinary perspective and global and systemic taking charge. The work is defined in the current pandemic background, with particular reference to the most fragile persons, in every phase of existence, especially when the fragility is due to deficit and disability. The guiding principles of trauma-informed organisations consist in creating a safe and reliable environment, allowing peer support and self-help, implementing personal empowerment, voice and choice. The TI approach aims to reduce exposure to adversity by implementing collective capacities for support, assistance, education and guidance. Trauma informed approach is a border territory to Special Pedagogy: the second part of the work outlines the role of Special Pedagogy in trauma and the issues highlighted by the COVID 19 pandemic, with the possible collective traumatic effect it can cause. The importance of recognizing, evaluating and dealing with stress due to trauma is highlighted in promoting collaboration with families and social networking, shaping policies and cultures to manage emergencies in relation to everyone's needs, especially the most exposed people such as people with disabilities.

The Testimonios of System-Impacted Daughters of Color on Healing from Parental Incarceration

1 in every 25 children in the United States currently has a parent incarcerated in jail or prison. Black and Latinx children make up the majority of this population, as their parents are overrepresented in local jails and state and federal prisons. Parental incarceration affects a child’s behavior, emotional and mental health, social interaction, and financial stability. Daughters of incarcerated parents are particularly affected. This research investigates testimonios (testimonies), a narrative form of counter-storytelling, as a tool to address the traumatic effect of parental incarceration on female children of color. Testimonios give a person agency and allow them to share their unique and nuanced experiences in detail. In-depth interviews demonstrated that testimonios can be an effective healing tool for women who have been impacted by parental incarceration and can improve social service organizations directed towards families affected by incarceration. Testimonios provided space in which daughters of incarcerated parents were able to express their emotions and make sense of their experiences. The interviews also revealed shared themes in the experiences of multiple interviewees.

Experimental substantiation of hyperthermic exogenous and endogenous factors prompt neutralization in burn injuries

Background: High mortality and disability of patients with critical and supercritical burns, long-term treatment, unsatisfactory aesthetic and functional results lead to the search for ways to provide assistance aimed at counteracting the formation of a mass of necrotic tissue, which is crucial for life or death of the victim. Material and methods: The experimental study was performed on 60 sexually mature Wistar rats, which were on a regular diet and weighed 150-160 g. The experimental animals were divided into the main and control groups and were used to simulate burns with boiling water of IIb degree. Results: The traumatic effect of hyperthermic exogenous and endogenous damage factors of the animals in the main group were immediately neutralized by a gauze napkin soaked in water at a temperature of 18-20 ° C immediately after the simulation of burns, the duration of which became the criterion for dividing them into subgroups. In animals of subgroup 1 the time of application of a wet wipe to the burn area was 1 min., in the 2nd subgroup it was 5 min., 3rd subgroup – 10 min., 4th subgroup – 15 min., 5th subgroup – 20 min. The application napkin was changed when it was heated to 34 °C. Such applications were not performed to the animals of the control group. Conclusions: The conclusion was made on the necessity of prompt neutralization of traumatic action of hyperthermic exogenous and endogenous damage factors as the main elements of burn wound depth. For a broader understanding of action mechanisms of the suggested technology of self-help and mutual first aid as well as the nature of the impact of neutralization directly on the tissues, it is advisable to supplement the research with morphological methods

STALKER HARASSMENT; CASE REPORT

Stalking is defined as the act of determining the person as a target and following and communicating with the person repeatedly without his/her consent, creating concern for her safety. Compared to forensic medicine applications, it’s a group that is relatively common in the field of psychiatry, and reporting the results of forensic medical evaluation is rarely done in this respect. The case applied to the clinic with the allegation of mobbing, and besides it’s a rare case in forensic medicine practice due to the characteristics of the event she experienced, it was aimed to discuss the evaluation to be made in such cases in terms of stalking. The 33-year-old female case, working in a company as senior manager, stated that she didn’t accept the proposal of a male employee in another city and in the same position as her, to be her girlfriend and she was verbally threatened by this person afterwards, wandered around her workplace and home and followed her for a long time. In her mental evaluation; It was found that the person was subjected to psychological violence and stalking harassment; the verbal threats and behaviors of the aggressor had a traumatic effect on her mental health for a long time and the action she was exposed to permanently deteriorated the mental health of the person. Stalking is addressed in different areas within the framework of mobbing or violence against women. Considering that in cases of stalking harassment, which doesn’t have a specific legal provision, it may result in the most severe form of violence against women due to its consequences, besides studies on prevention and legal regulation, as highlighted in the case presented, the identification of trauma and forensic medical documentation and also the need for psychiatric follow-up and support in terms of treatment should be considered.

The effect of surgical complications on ENT trainees

Background The ‘second victim phenomenon’ is a term attributed to the traumatic effect a medical error can have on healthcare professionals. Patient safety incidents have been shown to occur in as many as one in seven patients in hospital. These incidents cause significant, potentially devastating, trauma to patients and their relatives, and can have deep and long-lasting effects on the health professionals involved. These incidents can have a negative impact on doctors’ emotional wellbeing; their professional practice in relation to this impact has not been extensively investigated in surgical trainees. Method A survey of UK otolaryngology trainees was conducted to investigate the effects of complications and medical errors on trainees, and examine how these are discussed within departments. Results and conclusion The findings suggest that further training is required and would be warmly received by otolaryngology trainees as part of higher surgical training.

COMPLEX FORENSIC MEDICAL EVALUATION OF THE TRAUMATIC BRAIN INJURY: CASE OF PRACTICE

The problem of studying the mechanisms of the occurrence of traumatic brain injury remains a very urgent issue for forensic medicine. The high incidence and high mortality rate of head injuries underlines its importance to experts. The article presents a case from the practice of a forensic medical examination of a traumatic brain injury. This case is indicative, since it clearly demonstrates the difficulties that forensic doctors face when examining craniocerebral injuries, when determining the mechanism of damage and the severity of bodily injuries. In this case, there is damage to the head and a concussion. The cited several conclusions of the experts of the bureau of forensic medical examination and the commission examination of the Main Bureau of Forensic Medical Examination of the Ministry of Health of Ukraine regarding the forensic medical assessment in the case of traumatic brain injury with damage to the head. When conducting an investigative experiment, it was determined that the simultaneous occurrence of an abrasion and a concussion of the brain with one traumatic effect in the glabellar region is unlikely. After all, a concussion of the brain and abrasions in the glabellar area were formed by different mechanisms. The results of this assessment of the characteristics of traumatic brain injury can be useful for preventing difficulties in establishing the mechanism of damage in further expert practice.