Peculiarities of online training in the discipline of “Clinical anatomy and operative surgery” for the students of Ivano-Frankivsk national medical university

Background. Since mid-March 2020, the entire medical community of Ukraine has faced a new problem - the lack of experience and technical support for giving online classes. Purpose: to analyze the features of online training in the discipline of "Clinical Anatomy and Operative Surgery" for the second-year students of the medical faculty in IFNMU. Results. We have identified the benefits of online training. Thus, being at home, students can acquire knowledge under the conditions of constant mastering of educational material, so their theoretical basis will be quite thorough; online training also gives an opportunity to study the material anywhere with Internet access. In quiet home conditions online training provides mastering modern information and communication technologies. However, there are also the disadvantages of online training: the inability to form a consistent view and master practical skills in the discipline on their own, due to lack of necessary instruments, phantoms, models, etc., so it is difficult to obtain thorough knowledge, sometimes because of low capacity of the electronic network. Conclusion. In online training of the medical students, we outlined the following peculiarities of giving classes: remoteness, flexibility, mass, practicality, usability, economy, parallelism and modularity.

Phenomenon of Demikhov. At N.V. Sklifosovsky Institute (1960–1986). V.P. Demikhov and world transplantology in 1968-1969

The article has reviewed the advances of Soviet and world Transplantology in the field of heart and other organ transplantation achieved by the end of the 1960s. It is shown that there were several groups of doctors and scientists who worked in the USSR dealing with the problem of experimental organ transplantation and trying to bring this experience into clinic. The group of surgeons and urologists (B.V. Petrovsky, Y.M. Lopukhin, etc.) from the Research Institute of Clinical and Experimental Surgery and the 2nd MOLGMI named after N.I. Pirogov, which had the greatest administrative resources and technical capabilities, was successfully implementing kidney transplantation into clinic. The staff of the Faculty Surgery Department (V.S. Savelyev and others) of the 2nd MOLGMI named after N.I. Pirogov developed experimental approaches to heart and liver transplantation. Surgeons from the Tuberculosis Research Institute (N.I. Gerasimenko and others) were dealing with in lung auto- and homotransplats in experiment. All those studies were conducted in close contact with the Department of Operative Surgery and Topographic Anatomy of the 2nd MOLGMI named after N.I. Pirogov (G.E. Ostroverkhov) and the Research Laboratory for Organ Transplantation established at that Department (Y.M. Lopukhin). The leading position in heart transplantation in the country belonged to the Vishnevsky Institute of Surgery (A.A. Vishnevsky, etc.). Surgeons of the MMA named after S.M. Kirov (I.S. Kolesnikov, etc.) rendered a great assistance to the Institute. Apart from these institutions, the Organ Transplantation Laboratory (headed by V.P. Demikhov) worked at N.V. Sklifosovsky Research Institute for Emergency Medicine; it had gained a huge experimental experience, but had very modest opportunities to purchase equipment and pharmaceuticals, to conduct laboratory and morphological studies, having practically no prospects for introducing the results of its research into clinic. Meanwhile, the world clinical Transplantation continued to develop successfully, which was reflected in the materials of the 2nd International Symposium on Heart Transplantation held in 1969 in Montreal (Canada).

Ultrasound examination of myometrial changes after conservative myomectomy, with the aim of predicting the course of pregnancy and choosing the optimal method of delivery

Introduction. The article provides a methodology for assessing and predicting complications during pregnancy for selectionof the optimal method of delivery.Goals and objectives. The work assessed the degree of myometrium changes, according to ultrasound studies, after using standard instrumentation and electrocoagulation, in order to predict the course of pregnancy and select the optimal method of delivery.Materials and methods. The details of the surgical anatomy, the plan of the surgeon’s action before the operation, formed according to the data of ultrasound diagnostics and operative surgery, were analyzed. Ultrasound was performed using GE Logiq S8 (USA) and Medisan Accuvix (South Korea) devices with 3,5 MHz convex transducers for transabdominal examination and with a frequency of 5 MHz for transvaginal examination.Research results. Laparoscopic myomectomy was performed in 18 women, 31 patients underwent laparotomic myomectomy, in 11 patients a combined operation technique was used: laparoscopy with minilaparotomy. According to our data, in half of the cases considered, the effects of interventions were absent or minimal. We assigned these results to group I (A — A1, A2, A3). In all other observations, cicatricial changes were revealed — group II (B, C, D, E). To predict the possible consequences, we proposed a point assessment of the ultrasound postoperative changes in the uterus, with the help of which it is possible to assess the degree of risk when planning pregnancy for each patient individually. Each group corresponds to a certain number of points.Conclusions. The presented division according to the degree of severity into groups can make it possible to individualize the approach to each patient and ensure the safest possible management of her during pregnancy and childbirth. This assessment can be used by ultrasound doctors and obstetricians-gynecologists of antenatal clinics and hospitals. The assessment presented by us at the moment is of a recommendatory nature.

1164 St Andrew’s COVID Surgery Safety (StACS) Study: Skin Cancer

Background Skin cancer represents the most common malignancy worldwide and it is imperative that we develop strategies to ensure safe and sustained delivery of cancer care which are resilient to the ongoing impact of COVID-19. Objective This study prospectively evaluates the COVID-19 related patient risk and skin cancer management at a single tertiary referral centre, which rapidly implemented national COVID-safety guidelines. Method A prospective cohort study was performed in all patients who underwent surgery for elective skin cancer service management, during the UK COVID-19 pandemic peak (April-May 2020). ‘Real-time’ 30-day hospital database deceased data were collected. Random selection was undertaken for patients who either underwent operative (surgery group) management or remained on the waiting list (control group); these groups were also prospectively followed-up within a controlled cohort study design and telephoned at the end of June 2020 for the control group or 30 days post-operatively. Results Of the 767 patients who had operations, there were no COVID-19 related deaths. Both the surgery (n = 384) and control (n = 100) groups were matched for age, sex, ethnicity, BMI, presence of comorbidities, smoking and positive COVID-19 contact. There were no differences in post-operative versus any symptom development (1.3%, 5/384 vs. 4%, 4/100, p = 0.093), or proportion of positive tests (8.6%, 33/384 vs. 8%, 8/100; p = 0.849), between the surgery and control groups. Conclusions These data support continued and safe service provision, and no increased risk to skin cancer patients who require surgical management, which is vital for continuation of cancer treatment in the context of a pandemic.

PECULIARITIES OF THE PRACTICAL SKILLS BY STUDENTS OF THE MEDICAL FACULTY IN THE STUDY OF CLINICAL ANATOMY AND OPERATIVE SURGERY

The article provides basic information about the peculiarities of the acquisition of practical skills by students of the medical faculty in the study of clinical anatomy and operative surgery.A pedagogical experiment was conducted in which 65 students took part, who were divided into two groups and studied clinical anatomy and operative surgery. The fi rst group, after getting acquainted with the theory of operative surgery, began to perform operations on animals. The second group, after studying the theory, trained in the gym and began operations on animals. It was found that students of the fi rst group made 27.5% of mistakes when performing operations and manipulations on animals, and the second group – 11.25%.The results of the study show that the most adequate and full-fl edged practical skills in operative surgery are students who study in stages with the acquisition of the required minimum of theoretical knowledge, with practical skills in the gym, with surgical interventions on experimental animals and detailed analysis of time of operations, complications, consequences at diff erent times of the postoperative period and surgical corrective actions to eliminate them.

Pyotr Alexandrovich HERZEN - the founder of oncology in the USSR, Honored Scientist of the RSFSR (to the 150th of birthday)

Pyotr Alexandrovich was born in 1871 in Florence in the family of Professor A. A. Herzen of the University of Lausanne. In 1896, he studied at the medical faculty of the University of Lausanne and began working at the Caesar Roux Clinic. In 1997, Pyotr Alexandrovich received a Doctor of Medicine degree and, fulfilling his grandfather's will, left for Russia. In 1898, P. A. Herzen received a Russian diploma of a doctor with honors. Then Pyotr Alexandrovich worked as an external doctor until 1900, and then until 1920, with breaks for service in the army as a military surgeon he was a resident of the surgical department of the Old Catherine Hospital in Moscow. During the Russian-Japanese War, Pyotr Alexandrovich was a surgeon on the Manchurian front, a surgeon in the active army during the First World War, and a consultant at the 151st military hospital during the Civil War. In 1909, he defended his dissertation for the degree of Doctor of Medicine in Russia. In 1917, he became the head of the Department of Operative Surgery, in 1921-General Surgery of the 1st Moscow State University. The clinical base of the department was the Institute for the Treatment of Tumors (now the P. A. Herzen Moscow Research Oncological Institute), the director of which was P. A. Herzen from 1922 to 1934. In 1926, he was first elected chairman of the Surgical Society of Moscow, and in 1929 the XXI Congress of Russian Surgeons. In 1934, Pyotr Alexandrovich became the head of the Department of Hospital Surgery of the 1st Moscow Medical Institute and in the same year he was awarded the honorary title of Honored Scientist of the RSFSR, and in 1939 he was elected a corresponding member of the USSR Academy of Sciences. He created the world's first pre-thoracic artificial esophagus (1907), was the first in the USSR to perform thoracoscopy for chronic pleural empyema (1925), suturing of a heart wound (1904), liver resection, developed a number of original operations: intra-abdominal fixation of the rectum when it falls out; application of cholecystoenteroanastomosis (1901), cholecystectomy, trans-vesical prostatectomy (1906); omentorenopexy of the lower pole of the kidney (1913); operations for anterior cerebral, inguinal and femoral hernias; developed the principles of surgical treatment of traumatic aneurysms. He also made a significant contribution to solving the problems of vascular surgery, oncology, urology, cardiac surgery, etc. He published 84 scientific papers, including 5 monographs. P. A. Herzen created the largest school of Soviet surgeons, oncologists. He was an honorary member of the French Academy of Surgery, the International Society of Surgeons, chairman of the surgical societies of the RSFSR and the USSR (1926-1928; 1935-1936), the XXI and XXIV All-Union Congresses of Surgeons (1929, 1938). P. A. Herzen was awarded two Orders of the Red Banner of Labor, medals, including "For the Defense of Moscow". P. A. Herzen died in January 1947 and was buried in Moscow. The Moscow Research Oncological Institute, the periodical " Oncology. The journal named after P. A. Herzen". A memorial plaque in his honor is installed in the First Moscow State Medical University named after I. M. Sechenov. His name is given to surgical operations used for anterior craniocerebral and femoral hernias, hydronephrosis, cryptorchidism, the creation of an artificial esophagus from the small intestine, esophagoejunostomy after removal of the stomach, and others.

Case of a double upper hollow ox (vena cаѵаsuperior duplex)

Working for the last year at the Institute of Operative Surgery and Topographic Anatomy under prof. P. M. Krasin, on one old, already shriveled corpse of a man of about 45 who died from an unknown cause, I noticed an unusual arrangement of large vessels of the mediastinum.

The legacy of Saint Luke (Valentin Felixovich Voyno-Yasenetsky) to medical sciences

Saint Luke, Archbishop of Simferopol and Crimea (1877‒1961), was born Valentin Felixovich Voyno-Yasenetsky in Kerch, Crimea. He served as an outstanding physician and Academic Professor of Topographic Anatomy and Operative Surgery at Medical School of Tashkent University. He worked extensively on the fields of surgery, regional anesthesia, pyogenic infections, ophthalmology, neurosurgery, oncology, orthopedics, otorhinolaryngology, gynecology, urology, and dentistry, often under difficult circumstances. He performed a wide variety of operations, from minor outpatient procedures to extremely complicated ones, followed by extensive inpatient management and treatment of ailing individuals. He published numerous research articles and books. His most acclaimed monograph entitled “Essays on the surgery of pyogenic infections” (“Sketches of purulent surgery”), focused on the broad field of surgery with special reference to the pyogenic infections and served as a reference tool and guide book for the next generations of physicians. The Stalin Prize was the highest professional honor awarded to Valentin Felixovich Voyno-Yasenetsky by the Soviet state in recognition of his contribution to science. Voyno-Yasenetsky was a blessed physician who had a major influence on both patients and colleagues, due to his fundamental ethical principles and values based on Christian beliefs. His life and scientific work have been an example of the practical unity of scientific truth and religious faith. He was ordained to the diaconate and priesthood, until he elevated to the ranks of Bishop and Archbishop. He was arrested and subsequently exiled for his religious beliefs and his glorification by the Orthodox Church as Saint Luke was held in Russia in 2000, as a recognition of God’s holiness manifesting in his life. Saint Luke received an honorable place in the history of Medicine and the Eastern Orthodox Church. The present study aims to highlight key elements of his life and his scientific contributions.