Nevin Manimala

Wiad Lek. 2023;76(9):2103-2111. doi: 10.36740/WLek202309129.

ABSTRACT

OBJECTIVE: The aim: The article examines the peculiarities of the Ukrainian state policy in the field of digitalization, reveals the social challenges caused by this phenom¬enon, and outlines the ways to overcome them.

PATIENTS AND METHODS: Materials and Methods: The data collection was carried out using PubMed, Scopus, Google Scholar databases. Research papers were identified according to the search terms: “digitalization”, “digital transformations”, “Internet”, “digital services”, “smart city”, “smart urbanization”, “inclusion”, “social exclusion”, “community mental health”, “volunteering”, “social partnership”. The authors analyzed international and domestic official strategies, programs, and messages along with statistical data and social surveys conducted by foreign and Ukrainian institutions, public organizations, and analytical centers. The authors used the interdisciplinary approach along with the principles of objectivity, tolerance, and impartiality, and general scientific methods, such as induction, deduction, generalization, etc.

CONCLUSION: Conclusion: The rapid spread of digital technologies is associated with the growth of social cohesion, inclusion, solidarity, and the development of a healthy harmonious society that will provide all the conditions for a decent life for a human being and the comprehensive development of his/her abilities and talents. These hopes are not groundless, because digitalization is accompanied by a number of structural shifts in economics and public administration, which contribute to overcoming subjectivity in making management decisions and increasing the level of “intellectualization” of the environment. In addition, digitalization is becoming a significant driver of the sustainable growth in labor productivity, employment levels, personal and social well-being; and the spread of digital technologies provides an opportunity to overcome various social challenges. As the Ukrainian experience reveals, despite a number of positive shifts, digitalization can also give rise to destructive social trends, among which the digital gaps caused by the uneven access to digital technologies and services occupy a special place. People in the city outskirts, small towns, and especially in the remote rural areas often have extremely limited access to the Internet that significantly reduces their social opportunities. These problems became more acute after the full-scale invasion of the russian federation into Ukraine. The occupation of the part of Ukraine, hostilities, and missile attacks damaged the energy sector blocking telecommunication networks, which led to the social exclusion of a significant part of the population in some Ukrainian regions. The harsh living conditions during the war, the social exclusion as a result of the occupation, as well as the destruction of energy infrastructure and civilian objects fueled the activities of the Ministry of Digital Transformation of Ukraine. The proposed services and transformations provided social opportunities for a part of the population, while remaining unable to overcome social exclusion generated by the digital, social, or other gap. Volunteers and social activists usually help to bridge the gap and maintain mental health of the community, which has been suffering from the horrors of the war for more than a year. Their activities and public position lay the ground for the establishment of social partnership aimed at the harmonious development of every individual and the community as a whole.

PMID:37898951 | DOI:10.36740/WLek202309129

Wiad Lek. 2023;76(9):2047-2053. doi: 10.36740/WLek202309121.

ABSTRACT

OBJECTIVE: The aim is to study the dynamics of prostaglandins and cytokines in the blood and gingival fluid against the background of differential drug correction in patients with generalized periodontitis with different body reactivity.

PATIENTS AND METHODS: Materials and methods: 216 people aged 45 between 55 years with a diagnosis of generalized periodontitis of II, III degree of severity, chronic course were examined. Depending on the state of reactivity of the organism, the patients were divided into three groups: the first one consisted of people with normoreaction; the second group included patients with hyperreaction; the third group was made up of people with hyporeaction. The patients underwent patch surgery after the initial therapy. Initially, on the 1st, 2nd, 4th, 6th and 9th day after the operation, the content of prostaglandins (PG) E, E2, F2alpha and cytokines (IL-1β, IL-6, TNF, IL-4) in the blood and gingival fluid was performed. Patients with impaired body reactivity were treated with the proposed differential drug correction of cytokines and prostaglandins. Statistical processing of the obtained digital data was performed using the computer program Statistica 8.0.

RESULTS: Results: The proposed differential drug correction in patients with generalized periodontitis against the background of hyper- and hyporeactivity of the body brings the content of IL-1β, IL-6, TNF, IL-4 to that of normal body reactivity, which ultimately restores the disturbed balance of pro- and anti-inflammatory cytokines in the blood and gingival fluid. On the 9th day, the content of all proinflammatory cytokines in the main groups was normalized and was commensurate with that of the body’s normal response (p>0.05). Differential drug correction led to normalization of the prostaglandin balance index on day 9 after flap surgery (p>0.05), indicating the establishment of a normal balance of eicosanoids in the blood and approximating the values of pro- and anti-inflammatory fractions of prostaglandins to those of normal body reactivity.

CONCLUSION: Conclusion: Correction of altered parameters in patients with generalized periodontitis accompanied by impaired (hyper- and hypo-) reactivity of the body with bringing them to values that are typical for normoreactivity is considered to be a condition for optimizing mucosal wound healing after surgery and further stabilization of periodontal tissues.

PMID:37898943 | DOI:10.36740/WLek202309121

Wiad Lek. 2023;76(9):1992-1999. doi: 10.36740/WLek202309113.

ABSTRACT

OBJECTIVE: The aim: This study was conducted to compare the results of spider vein: sclerotherapy or radiofrequency thermocoagulation.

PATIENTS AND METHODS: Materials and methods: The study included 52 patients with spider veins, who were randomized into two treatment groups: sclerotherapy or radiofrequency thermocoagulation. Treatment outcomes were assessed using: a self-assessed questionnaire, CIVIQ 20 questionnaire, computer evaluation of images, registration relapses complications, negative manifestations, and intensity of the pain syndrome.

RESULTS: Results: Both methods showed a statistically significant difference in the quality of life indicators before and one month after treatment (p<0.001 for both groups). Radiofrequency thermocoagulation showed a greater impact on the patient’s quality of life (p = 0.003). The average length of spider veins in the treatment area decreased the most with radiofrequency thermocoagulation (by 92.1%), slightly less after sclerotherapy (by 73.4%) (p < 0,01).

CONCLUSION: Conclusions: Both treatments have shown good results for spider veins and were reasonably safe with few negative manifestations. Radiofrequency coagulation better eliminates small veins, less than 0.3 mm.

PMID:37898935 | DOI:10.36740/WLek202309113

Wiad Lek. 2023;76(9):1978-1983. doi: 10.36740/WLek202309111.

ABSTRACT

OBJECTIVE: The aim: To identify the main groups of expert defects that arise during the forensic assessment of changes detected during the examination of persons who died from a traumatic brain injury (TBI).

PATIENTS AND METHODS: Materials and methods: A total of 102 repeated commission forensic medical examinations with changed conclusions in corpses with TBI were analyzed. Data processing and analysis were conducted using statistical methods.

RESULTS: Results: The examined forensic medical assessments of TBI with changed conclusions in corpses were categorized into the following groups: defects in estab¬lishing the diagnosis of TBI – 17.65±7.4%; defects in establishing the mechanism of TBI – 35.3±9.3%; defects in establishing the duration of TBI – 39.22±9.5%: sober – 20±12.4%; with alcohol intoxication – 80±12.4%. A combination of defects was found in 7.83±5.2% of cases. Defects that directly affected the experts’ incorrect establishment of the diagnosis, mechanism, and duration of TBI were also identified.

CONCLUSION: Conclusions: The largest number of changed conclusions during the forensic medical examination of corpses in cases of TBI was due to the wrongly established duration of the trauma, accounting for 39.2±9.5%, with the vast majority of cases (80±12.4%) observed against the background of alcohol intoxication. The mechanism of trauma accounted for 35.3±9.3% of the changed conclusions. The main defects were incomplete collection of material for histological examination (90.2±5.8%) and incorrect interpretation of the results of histological examination (76.48±8.2%), along with the violation of the method of sectional examination (68.6±9.0%). Different groups of expert defects predominated in the cases with an incorrectly established diagnosis of TBI, duration of trauma, and mechanism.

PMID:37898933 | DOI:10.36740/WLek202309111

Wiad Lek. 2023;76(9):1930-1935. doi: 10.36740/WLek202309105.

ABSTRACT

OBJECTIVE: The aim: To determine the peculiarities of the antioxidant-prooxidant balance in the kidney of rats of different ages under conditions of experimental cranioskeletal trauma (CST).

PATIENTS AND METHODS: Materials and methods: The experiments involved 147 male white Wistar rats of different age groups. The first experimental group included immature animals aged 100-120 days. The second group included sexually mature animals aged 6-8 months. The third group included old animals aged 19-23 months. In all experimental groups, CST was modelled under thiopental-sodium anaesthesia. The control groups of rats was only injected with thiopental-sodium anaesthesia. The animals were withdrawn from the experiments under anaesthesia after 1, 3, 7, 14, 21 and 28 days by total bleeding from the heart. The content of reagents to thiobarbituric acid and catalase activity was determined in a 10 % kidney homogenate extract, and the antioxidant-prooxidant index (API) was calculated from the ratio of these two parameters.

RESULTS: Results: As a result of the application of CST in rats of different age groups, a decrease in the value of renal API was observed with a maximum in immature rats – after 7 days, in mature and old rats – after 14 days. By day 28, the index increased in all experimental groups, but did not reach the control level. The degree of decrease in renal API in old rats under the influence of CCT was significantly higher than in other experimental groups. In immature rats, the impairment of renal API after the application of CST was less, indicating higher reserve capacity of the renal antioxidant defence system in this age group of rats.

CONCLUSION: Conclusions: Simulation of CST in rats of different age groups is accompanied by a decrease in the value of API, which by day 28 does not reach the control level in any of the experimental groups. The degree of decrease in renal API value statistically significantly increases with increasing age of rats at all times of the post-traumatic period.

PMID:37898927 | DOI:10.36740/WLek202309105

Wiad Lek. 2023;76(9):1897-1905. doi: 10.36740/WLek202309101.

ABSTRACT

OBJECTIVE: The aim: Study of the dynamics of changes in the average values of the index of mucosal microcirculation after dental implantation with immediate intraoperative prosthetics.

PATIENTS AND METHODS: Materials and methods: In clinical conditions, 55 patients aged from 29 to 60 years with a diagnosis of partial absence of teeth requiring orthopedic treatment using implants on the lower jaw were treated and examined. In the course of the latest achievements, the following methods were used: clinical protocol of immediate implantation with Solidum and Simplex implants of the «ART IMPLANT» system on the lower jaw by the one-stage implantation method, with immediate intraoperative loading and the manufacture of a temporary non-removable dental prosthesis, determination of the microcirculation index in dynamics using the laser Doppler method flowmetry, statistical analysis.

RESULTS: Results: The obtained results indicate a pronounced reaction of microcirculation up to the 3rd day after surgery, an increase in blood perfusion of the mucous membrane by 2.7 times while maintaining vasomotor activity, which indicates adaptation to the injury and immediate loading of the denture in the postoperative period. 3 months after dental surgery and immediate intraoperative prosthetics, all indicators of microcirculation approach the initial values before surgery.

CONCLUSION: Conclusions: With the help of laser Doppler flowmetry, the fact of a sharp restoration of microcirculation after dental implantation surgery with immediate intraoperative prosthetics is confirmed.

PMID:37898923 | DOI:10.36740/WLek202309101

J Biomed Mater Res B Appl Biomater. 2023 Oct 29. doi: 10.1002/jbm.b.35329. Online ahead of print.

ABSTRACT

We engineered an in vitro model of bioartificial 3D bone organoid consistent with an anatomical and vascular microenvironment common to mammalian flat and short bones. To achieve this, we chose the decellularized-decalcified matrix of the adult male rat scapula, implemented with the reconstruction of its intrinsic vessels, obtained through an original intravascular perfusion with polylevolactic (PLLA), followed by coating of the PLLA-fabricated vascularization with rat tail collagen. As a result, the 3D bone and vascular geometry of the native bone cortical and cancellous compartments was reproduced, and the rat tail collagen-PLLA biomaterial could in vitro act as a surrogate of the perivascular extracellular matrix (ECM) around the wall of the biomaterial-reconstituted cancellous vessels. As a proof-of-concept of cell compatibility and site-dependent osteoinductive properties of this bioartificial 3D construct, we show that it in vitro leads to a time-dependent microtopographic positioning of rat mesenchymal stromal cells (MSCs), initiating an osteogenic fate in relation to the bone compartment. In addition, coating of PLLA-reconstructed vessels with rat tail collagen favored perivascular attachment and survival of MSC-like cells (mouse embryonic fibroblasts), confirming its potentiality as a perivascular stroma for triggering competence of seeded MSCs. Finally, in vivo radiographic topography of bone lesions in the human jaw and foot tarsus of subjects with primary osteoporosis revealed selective bone cortical versus cancellous involvement, suggesting usefulness of a human 3D bone organoid engineered with the same principles of our rat organoid, to in vitro investigate compartment-dependent activities of human MSC in flat and short bones under experimental osteoporotic challenge. We conclude that our 3D bioartificial construct offers a reliable replica of flat and short bones microanatomy, and promises to help in building a compartment-dependent mechanistic perspective of bone remodeling, including the microtopographic dysregulation of osteoporosis.

PMID:37898921 | DOI:10.1002/jbm.b.35329

Trends Psychiatry Psychother. 2023 Oct 29. doi: 10.47626/2237-6089-2023-0622. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the growing recognition of gaming disorder as a mental disorder, there is still debate about how it should be best screened for. This is especially relevant in countries where prevalence studies that could support evidence-based policymaking are still to be conducted. This study aims to evaluate the psychometric properties of the Brazilian Portuguese version of the Ten-Item Internet Gaming Disorder Test (IGDT-10) and to explore its association with functional impairment.

METHODS: An online convenience sample of 805 Brazilian adults who reported playing games completed the adapted version of IGDT-10 and World Health Organization Disability Assessment Schedule 2.0, as well as the Problematic Internet Use Questionnaire, the Center for Epidemiologic Studies-Depression Scale, the Rosenberg Self Esteem Scale and socio-demographic questions.

RESULTS: The Brazilian Portuguese version of IGDT-10 demonstrated a unidimensional structure in both confirmatory and exploratory factor analysis, with satisfactory internal consistency and adequate temporal stability. Participants who scored five or more on IGDT-10 presented higher levels of functional impairment compared to those who scored positive for four symptoms or less. The difference between the two groups was statistically significant and showed a moderate effect size. Network analysis showed a direct connection between IGDT-10 and functional impairment, and identified “negative consequences” as the most relevant item connecting these variables.

CONCLUSION: The IGDT-10 is a brief, easy-to-understand, valid, and reliable instrument, proving to be a suitable candidate for screening gaming disorder in future epidemiological studies.

PMID:37898905 | DOI:10.47626/2237-6089-2023-0622

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Sep;31(5):1028-1034. doi: 10.32687/0869-866X-2023-31-5-1028-1034.

ABSTRACT

Nigeria, with its low routine immunization coverage and wild poliovirus reservoir, significantly contributes to overall regional burden of vaccine-preventable diseases. Since introduction of the EPI in 1974 (which later became the National Program of Immunization), Nigeria’s immunization program suffered from declining coverage. The poor quality of immunization affects service utilization, even where they are provided for free, just as immunization services are. The quality assessment will provide both notion of degree of satisfaction of clients with services and framework for revision of program priorities, strategies and components Purpose of the study is to evaluate quality of immunization services provided to children in primary health centers in Oron, Akwa Ibom State, Nigeria. The study targets to identify strengths and weaknesses of immunization services, to evaluate level of compliance with national and international standards of immunization and to develop corresponding recommendations. The study seeks to contribute to body of knowledge about quality of children immunization services in Nigeria, particularly in context of primary health centers. The study may help to improve delivery of immunization services in the region and to ensure that more children will be vaccinated and protected against vaccine-preventable diseases. The cross-sectional descriptive study of quality of immunization services in primary health centers was carried on in Akwa Ibom State, Nigeria. The variables as indicators such as physical environment, resource availability, client satisfaction etc. were utilized and included into questionnaire. The study covered 402 caregivers and 152 medical workers in 12 primary health centers. The client questionnaire, facility staff questionnaire, facility checklist, personal observation,focus group discussion guide and client flow chart were applied. The results demonstrated that quality of immunization services was poor. The caregivers were dissatisfied both with reception by providers and too long waiting time. The attitude of health care providers was also mentioned as cause of dissatisfaction. This study demonstrated that community health extension workers constituted majority (39.4%) of immunization service providers. Out of 152 health care providers that participated in the study, 92 (60.9%) had attended in-service training on immunization within previous two years. The comparison of staff categories with attendance at in-service training established statistically significant difference (p=0.0072), suggesting that whether one attended in-service training or not depended on category of staff one belongs to. Of all staff, 112 workers (73.3%) knew proper vaccine storage temperature while 40 (26.7%) did not. The health care providers who do not know proper vaccine storage temperature may administer vaccines with compromised potency. Most of health care providers (149 or 98.0%) were aware that clients have particular rights that in overall is referred as client rights. Only by knowing rights of clients providers would be expected to respect these rights. The client right with which most of providers were agreed was right to information (105 or 70.2%). While right with which most providers were disagree (52 or 34.0%)) was right to choice of where and when access immunization services. The study conducted thorough quality assessment of children imunization services in primary health centers in Oron, Akwa Ibom State, Nigeria. The results revealed both strengths and weaknesses in delivery of immunization services to children in the region. While there were areas of average performance due to experienced and trained health care workers, there were also areas of concern with inadequate cold chain storage and insufficient record-keeping practices. The study recommends to improve quality of immunization services in the region, including strengthening cold chain system, ensuring adequate record-keeping practices and implementing regular training and supervision of medical workers. These measures are crucial to ensure that more children are vaccinated and protected against vaccine-preventable diseases. The results of the study contribute to body of knowledge on quality of children immunization services in Nigeria and emphasize importance to continue efforts improving delivery of immunization services to children. There is hope that proposed recommendations will become a basis for policy decisions making and ultimately will result in better health outcomes for children in Oron, Akwa Ibom State and beyond.

PMID:37898895 | DOI:10.32687/0869-866X-2023-31-5-1028-1034

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Sep;31(5):1021-1027. doi: 10.32687/0869-866X-2023-31-5-1021-1027.

ABSTRACT

The choice of specialty by graduate of medical university can be promoted by particular social, demographic and personal characteristics. Purpose of the study is to investigate demographic, social and personal characteristics of students in residency on specialty “General Medical Practice” in the Russian Federation. The sociological, statistical and analytical methods are applied. The sampling for survey consisted of 81 respondents. The specialty “General Medical Practice” is chosen mainly by women residing in city, non-married and without children. They are not characterized by participation in public life and they are characterized by the presence of hobbies (hobbies). The choice is conditioned by multidisciplinary nature of medical care and scope of professional horizons. They are attracted by treatment work and are less interested in pedagogy and science. In perspective, 80% of female respondents are going to get another specialty. More than 70% of respondents plan to work in out-patient conditions and predominantly in state sector of health care. For women, main goals of further professional training are improvement in main and adjoining specialties and career promotion. And in educational program, internal diseases are of greatest interest. The preferred forms of training are internships and e-learning. The main direction of improving educational process is increasing of scope of practical training. The comparative analysis of study results with data of previous publications was implemented. The factors influencing commitment to specialty are revealed. The proposals increasing attractiveness of general medical practice for graduates of medical universities and keeping in specialty after residency are formulated.

PMID:37898894 | DOI:10.32687/0869-866X-2023-31-5-1021-1027