Roadside Medicine Assessment Approaches

Diabetes mellitus (DM) is an important risk factor in the long-term outcomes of surgical revascularization. However, few studies have focused on patients with ischemic heart failure (IHF) and DM, and the results are controversial. This study aimed to evaluate the effect of DM on the long-term outcomes of IHF patients undergoing coronary artery bypass grafting (CABG).
In this propensity-matched study, data of IHF patients who underwent CABG in our hospital from January 2007 to December 2017 were analyzed. With a mean 73-month follow-up time, the patients were divided into two groups according to whether they had DM. The primary endpoint was all-cause death, and the secondary endpoint was a composite of all-cause death, stroke, recurrent myocardial infarction, and revascularization.
There was no significant difference in all-cause mortality between the two groups (5.8% vs. 4.1%, P = 0.216). https://www.selleckchem.com/products/Temsirolimus.html The incidence of main adverse cardiovascular and cerebrovascular events (MACCE) in the secondary endpoint was significantly higher in the DM group than that in the non-DM group (10.4% vs. 8.1%, P = 0.023).
DM can negatively affect the long-term outcomes of IHF patients undergoing CABG by significantly increasing the overall incidence of MACCE, though the long-term survival does not show a significant difference between the DM and non-DM patients.
DM can negatively affect the long-term outcomes of IHF patients undergoing CABG by significantly increasing the overall incidence of MACCE, though the long-term survival does not show a significant difference between the DM and non-DM patients.In this article there is a clinical case of occlusion trauma of implant-supported metal-ceramic crown for prosthetics of central incisor. Its uniqueness is the possibility to save dental implant after acute occlusion impact, which was strong enough to break ceramic facing of fixed denture, but not able to destroy bone and implant components. The occlusion force located at the incisal edge of the crown induced a reverse torque to the implant and did not result in its failure or bone resorption. In a year after repeated fixed prosthetics, the results of clinical examination proved absence of any problem with osseointegration. Literature analysis lets us to suggest, that the phenomenon was caused by protective action of cortical bone around of dental implant. Besides, in the case of natural tooth, the bone is suddenly compressed against the conical root; it transfers occlusal breaking to the supporting periodontal ligament. A dental implant has no periodontal ligament but can have a rough surface that may preclude implant failure.The aim was to analyze the contemporary scientific literature on Devic's opticomyelitis and to present a case report from our clinical practice. Based on the patient's complaints, case history and features of clinical course, objective neurological status, clinical laboratory and additional examination methods, characteristic MR-patterns, consultations of related specialists and differential diagnostics, we made the clinical diagnosis according to ICD-10 G36.0 Devic's opticomyelitis, exacerbation, with a sustained bilateral lesion of the optic nerves in the form of retrobulbar neuritis with the development of partial atrophy of the optic nerves in both eyes, spinal cord lesions with common cystic, cicatrical and atrophic alterations at C1-Th8 level with moderate lower paraparesis, expressed by sensory ataxia, sensory disturbances by the descending conductive type from Th10, impaired function of pelvic organs by the type of acute urinary retention, asthenic and neurotic syndrome. Widespread cases of demyelinating pathology in medical practice and complexity of differential diagnostics determine the need for a specific diagnostic algorithm. This algorithm should consider anamnestic data along with the course of the disease, clinical, laboratory and instrumental examination, including neuroimaging, analysis of CSF for oligoclonal bands, analysis for IgG antibodies to AQP4, which will allow to carry out diagnostics and to decide on tactics for further management of patients of this cohort. Further research is needed to conduct additional studies for optimization of tactics for dynamics monitoring and improvement of diagnostic, treatment and rehabilitation measures in patients with Devic's opticomyelitis, including appropriate immunological control, given the complexity of differential diagnostics and the affinity of this pathology to multiple sclerosis.
The aim Was to analyze the scientific and pedagogical heritage of N.I. Pirogov through the prism of his outstanding polymathic abilities.
Materials and methods The authors examined the scientific and pedagogical heritage of N.I. Pirogov using the method of historiographical analysis, as well as the methods of synthesis and generalization. The study relies on research publications devoted to N.I. Pirogov's biography, as well as his epistolary and autobiographical works.
Conclusions The scientific novelty of the research is that the biography of N. Pirogov is represented with refinements and additions based on his latest work "From the Diary of an Old Doctor". The authors analyzed the epistolary heritage of N. Pirogov, which served as a valuable biographical source. Given the anthropocentrism of the current stage of the existence of society and European civilization, the authors sought to "revive" the biography of N. Pirogov. In this regard, considerable attention is paid to his personal life. As a result, the article considers this outstanding personality in a new perspective, presenting the main stages of his scientific and medical activity.
Conclusions The scientific novelty of the research is that the biography of N. Pirogov is represented with refinements and additions based on his latest work "From the Diary of an Old Doctor". The authors analyzed the epistolary heritage of N. Pirogov, which served as a valuable biographical source. Given the anthropocentrism of the current stage of the existence of society and European civilization, the authors sought to "revive" the biography of N. Pirogov. In this regard, considerable attention is paid to his personal life. As a result, the article considers this outstanding personality in a new perspective, presenting the main stages of his scientific and medical activity.