Recent publications
Morton’s neuroma is one of the most common entrapment mononeuropathies of peripheral nerves. The main clinical manifestation is neuropathic pain syndrome in the foot. Currently, many methods of treatment are proposed. Despite the advantages of each method, the main disadvantages are low effectiveness, aggravation of symptoms due to scar-related complications, or relatively high incidence of complications following surgical invasion. Objective. To evaluate the effectiveness of percutaneous ultrasound-guided neurolysis with local administration of betamethasone in patients with Morton’s neuroma. Material and methods. The study included 14 female patients aged 24-56 years (mean 44.7±6.4). We analyzed VAS scores of pain syndrome (mean 7.1±1.1) and DN4 scores of neuropathic pain (mean 4.9±0.9). Ultrasound imaging was performed to estimate localization and volume of neuroma. Mean volume of neuroma was 226±142 mm3. Results. Mean follow-up was 12 months. In 12 out of 14 patients, there was a significant decrease in pain intensity to VAS score 1.1±0.6 and regression of neuropathic pain to DN4 score 0.5±0.5. In 2 cases, neuropathic pain recurred after 6 months with enlargement of neuromas (to 429 and 452 mm3). There were no complications in any patient. Conclusion. Percutaneous ultrasound-guided neurolysis of Morton’s neuroma with local administration of betamethasone is an effective and promising minimally invasive method. Selection criterion for this procedure may be small volume of neuroma. Further research is required to clarify the indications for this procedure.
According to the modern WHO classification, pituitary carcinomas (or metastatic neuroendocrine pituitary tumors) are pituitary tumors with confirmed craniospinal and/or distant metastases. The main goal of histological analysis of pituitary carcinomas is to confirm pituitary origin of metastases. Treatment usually includes surgery and radiotherapy, dopamine agonists in maximum possible doses in case of prolactin-secreting pituitary carcinomas and chemotherapy with preferable temozolomide. Objective. To present the results of diagnosis and treatment of two patients with prolactin-secreting pituitary carcinomas. Material and methods. The authors describe 2 patients with prolactin-secreting pituitary carcinomas arising from drug-resistant aggressive prolactinomas with histologically confirmed metastases. In both cases, combined treatment included surgery, radio- and chemotherapy (cabergoline and temozolomide). Results. A 47-year-old patient underwent surgery, radio- and dopamine agonist therapy with subsequent regression of tumor growth in the follow-up period. However, progressive increase in prolactin concentration necessitated PET/CT with detection of multiple metastases in bones and lymph nodes. Temozolomide therapy led to temporary shrinkage of metastatic foci with subsequent progression. The second case was characterized by multiple brain and spinal cord metastases in a 47-year-old woman. Resection of intracranial metastasis and temozolomide therapy stabilized the disease and normalized serum prolactin throughout 2-year follow-up with subsequent progression. Conclusion. Pituitary carcinoma is a rare tumor with unfavorable prognosis. Treatment is currently not standardized and determined by available world experience regarding various chemotherapeutic drugs. Temozolomide is the most effective drug. However, short-term remission is usually followed by subsequent disease progression in most cases.
According to the order of April 15, 1935, the opening of the Department of Neurosurgery, the first head of which was Nikolai N. Burdenko, laid the foundation for the development of neurosurgical activity and training of neurosurgical personnel in the USSR within the walls of the Russian Medical Academy of Medical Sciences (TsIUV). N.N. Burdenko was an outstanding Soviet surgeon, one of the founders of neurosurgery, academician of the Academy of Sciences of the USSR (1939) and the Academy of Medical Sciences of the USSR (1944-1946), Hero of Socialist Labor, honorary member of the British Royal Society of Surgeons and the Paris Academy of Surgery, Colonel General of Medical Service.
Objective. To analyze the incidence, clinical manifestations and treatment of post-pancreaticoduodenectomy hemorrhage in patients with pancreaticoduodenal tumors. Material and methods. There were 362 pancreaticoduodeneectomies for ductal adenocarcinoma of the pancreatic head and pancreatoduodenal tumors in 2016—2023. Post-pancreatectomy hemorrhage (PPH) occurred in 52 (14.4%) patients. Delayed post-pancreatectomy hemorrhage followed postoperative pancreatitis, pancreatic fistula or non-drained fluid collections. Bleeding was diagnosed considering clinical manifestations with verification through contrast-enhanced CT. Results. Emergency re-laparotomy was required in 15 (28.8%) patients with unstable hemodynamics; 9 (60%) people died. Thirty-seven patients with stable hemodynamics underwent emergency contrast-enhanced CT and subsequent endovascular hemostasis. Bleeding was stopped in 31 patients (89.2%). Endovascular hemostasis was ineffective in 1 patient who underwent re-laparotomy. We found no the cause of bleeding in 3 patients, and there was no hemorrhage recurrence. Six (18.7%) people died. The overall mortality among patients with PPH was 28.8% (15 out of 52 postoperative patients). Conclusion. PPH follows postoperative pancreatitis, pancreatic fistula or non-drained fluid collection. In case of stable hemodynamics, endovascular hemostasis is preferable for this complication.
Merosin-deficient muscular dystrophy is a rare neuromuscular disease characterized by diffuse muscular and epileptic seizures. The disease is inherited in an autosomal recessive type and occurs as a result of biallelic variants in the LAMA2 gene. In this gene there are described all types of violations of the normal nucleotide sequence (single nucleotide variants, variations in the number of DNA copies) which can lead to difficulties in genetic search. The combination of phenotype features (hypomimia, elongated face, ophthalmoparesis, muscle hypotonia, and weakness, spinal rigidity, contractures of large joints), laboratory and instrumental research results (increased activity of creatinephosphokinase in the blood, leukopathy on brain MRI) will help you choose the right diagnostic search tactics. In this article, we present a clinical case of a patient with three identified variants in the LAMA2 gene: two point substitutions (c.4048C>T and c.4860+75G>C) and deletion of exons 2 and 3. The use of several methods of genetic testing (high-throughput sequencing, chromosomal microarray analysis, Sanger sequencing) allowed the establishing of the diagnosis, which subsequently led to successful prenatal diagnosis and the birth of healthy siblings.
BACKGROUND: Diabetes mellitus is a socially significant pathology, which is characterized by an epidemic spreading. The epidemiological profile of disability due to diabetes mellitus in the territories of the Russian Federation is the basis for multidisciplinary effective medical and social rehabilitation and prevention, taking into account regional differences in the prevalence of this socially significant pathology. An in-depth analysis of disability due to diabetes mellitus in the Republic of Dagestan has not been conducted. AIM: To analyze the dynamics and structure of the repeated disability of the adult population due to diabetes mellitus in the Republic of Dagestan. MATERIALS AND METHODS: Object of the study: a combination of people repeatedly recognized as disabled (RRD) due to diabetes mellitus in the Republic of Dagestan. The analysis was carried out on three main age groups of the adult population. Study design: epidemiological, retrospective, evaluative. Study period: 2014–2023. The data were extracted from statistical documents on the number of people repeatedly recognized as disabled due to diabetes mellitus, the structure of repeated disability by age was determined, the prevalence (level) of repeated disability due to this pathology was determined among the adult population, the number of people repeatedly recognized as disabled (PRD) was ranked by severity (by disability groups), and the indicators of repeated disability in the Republic of Dagestan were compared with similar indicators in the North Caucasus Federal District and the Russian Federation (RF). Sources of information: Form7-A (social security) of Rosstat “Information on the medical and social examination of persons aged 18years and older”. RESULTS: : The total number of RRD in 2014–2023 amounted to 15584people. Among all subjects of the Russian Federation in terms of prevalence of repeated disability due to DM among the adult population, the RD ranks 2nd (a total of 18ranking places allocated) with an intensive indicator of 5.8 per 10thousand adult population (in the RF— 2.4; in the North Caucasus Federal District — 3.9). It was revealed that the structure of repeated disability due to DM by age in the Republic of Dagestan was characterized by the prevalence of working-age disabled people (in general, older disabled people prevalence in the RF). RRD with the third disability group predominated (72.8%). CONCLUSION: Based on the studied indicators of repeated disability of the adult population due to diabetes mellitus, it is possible to judge the array of patients in the Republic of Dagestan, re-examined due to persistent dysfunctions and associated limitations of life activities caused by complications of this leading endocrine pathology. The presented database demonstrates the acuteness of the problem of prevalence of disabling complications of diabetes mellitus in the republic and has scientific and practical significance for conducting multidisciplinary medical and social rehabilitation of disabled people and preventing disability of the population.
The first year of parenthood is considered to be a challenging period, associated with the transformation of family relations. The links between family relations and parenting are widely studied. However, in most research only a limited number of indicators is investigated, and there is a lack of data on the agreement between mothers' and fathers' evaluations of family relations. The aims of the present study were to explore (1) the structure and measurement invariance of marital relations and parenting constructs for mothers and fathers; (2) the associations among the measures of marital relations and parenting in mothers and fathers; (3) the agreement between mothers and fathers in their perception of marital relations, as well as cross‐parent cross‐measure associations of marital relations and self‐rated parenting; (4) average differences between the parents in their perception of marital relations and parenting. The data from 352 Russian‐speaking married couples participating in the Wave 3 of the Prospective Longitudinal Interdisciplinary Study (PLIS) were collected when the children were 9 months old. Seven measures of family relations (marital relations, grandparents' support) and nine measures of parenting were obtained. The statistical analyses included the exploratory factor analysis, assessment of measurement invariance, comparative and correlational analysis. The result showed that measures were organised into coherent factor‐based groupings: (1) marital relations, (2) support from grandparents, (3) childcare and affection, and (4) harsh parental discipline. Six of 12 measures showed partial scalar invariance between mothers and fathers. Moderate within‐measure correlations were observed between mothers' and fathers' assessments of family relations; and weak correlations—for parenting. Mother‐father cross‐measure correlations were moderate for family relations, but negligible for parenting. Small to moderate average differences between mothers and fathers were found for all measures. The results highlight the need to consider similarities and differences between mothers' and fathers' experiences in future research and practice.
Directions for an educational organization development meet the requirements of society to the effectiveness and quality of educational activities in high dynamics of external and internal environment. The article examines the potential of the process approach, which considers management as a continuous performance of certain interrelated activities complex and general management functions when developing a quality management system of an educational organization. In the submitted article the components of the educational activities process are defined, which are based on the quality standard of the final product. This article is intended for educators, researchers, heads of educational institutions, employers, customers of educational services, education management organizations employees.
Article aims to develop the structure and content of higher professional school lecturer education competence as a lecturer professionalism should be evaluated not only on the quality of the studies, but also for his participation in education activities in higher school. It is needed to rely on a stating that education competence is an integral feature of professional and educational activities aimed at the effectiveness of the educational process in higher professional school in developing its structure and content. In the structure of the lecturer education competence there are four components: humanologic, socio-pedagogical, organizational and methodical, professional personal. Their content is disclosed in knowledge, skills, abilities and personal qualities as necessary for the implementation of the education activities in higher professional school. The presented structure of high school lecturer education competence facilitates the efficient evaluation of the competences, the identification of the gaps in the competencies development levels and their correction with additional measures and means aimed to their effective formation.
The transition to federal public administration in the Russian education system is determined by the legislation and presupposes responsible participation and interaction in education management of all educational agents. In the presented article an analysis has been carried out on the status of one of the federal public administration factors—information transparency of vocational and higher educational institutions. The paper defines the information realm of educational institutions from the perspective of educational services customers; there have been set the priorities for action in the field of transition to federal public administration of educational institutions. This article is written for managers and employees of the education authorities, educational institutions, as well as for all professionals and individuals interested in developing the Russian education system.
The globalization of education triggers fair criticism of the university self-sufficiency in any country to train competent professionals, moreover, today the necessity to expand the students’ academic mobility is universally recognized. The article describes the basic methodological approaches to defining the essence of the concept of “academic mobility”. It explores the goal, objectives, functions of the students’ academic mobility in the context of international educational integration. This publication submits a classification of the forms of academic mobility of the higher education students on the following grounds: on the type of educational process, on the period of study in a foreign educational establishment, on the nature of the students’ involvement. The article can be useful to the academic staff of higher educational institutions, to the staff of the university centers of academic mobility as well as the employees of the university international departments in the development of international cooperation and academic mobility of the students.
Socio-educational support in the process of education modernization should exhibit humanitarian nature, flexibility, non-violent and “non-intrusive” character of the educational process that can directly relate to the needs and interests of its members. The heightening attention to every member of the educational process marks the idea of socio-educational support of the specialist’s professional development top-priority. In this regard we have identified and described the content of the socio-educational support of a future specialist professional development in higher school that involves creating favorable conditions for personal development, social self-determination and professional establishment of the subjects of education in particular organizational and pedagogical forms, as well as successful possessing necessary competencies in the process of teachers’ and students’ interaction. The submissions of the article can be valuable for the higher-education teaching personnel and advisors in the educational institutions of both higher and secondary professional education.
The relevance of the topic is determined by the search for the ways to improve one of the vital personality features, identity and civil identity as a driving motive in upbringing the younger generation. The aim of the paper is to reveal the content of the patriotic education model as a factor of forming civil identity of school and institute students being in multicultural education space and to define the organizing pedagogical conditions for its effective realization. The main approach to this problem research is competence approach which allows students to summon the acquired knowledge, skills, experience and ways of behavior in some definite situation or definite activity. The article may be useful for improvement the content and methods of educational work at educational institutes and the system of teachers’ professional development.
The purpose of this article is aimed at studying the problem of increasing the formation of students’ diagnostic skills in the course of training at a university. The presented article demonstrates a technique for diagnosing the level of professional and cultural competences formation on the basis of students’ effectiveness in quasi professional environment. The basis of the presented work is formed by the ideas of the competence approach, their qualitative tools, expert assessment of the educational activities of university students. The article describes a method of assessing competences, criteria? and levels of formation and methods of their estimation, allowing a diagnostics of educational activities. This article is intended for teachers, researchers, educational institutions heads who deal with the diagnostics of educational activities.
University management is currently supported by information system providing storage and data structuring of information required. Managing the development and improvement of the educational process quality requires creation of a monitoring system covering all of its objects and various measurement tools, which monitors the set of all features. The paper presents the components of pedagogical management, considers indicators of pedagogical processes and methods of evaluation, which define the basis for monitoring the educational processes at the University. Also the structure of a software module is shown, that works on the principle of the expert system and identifies problem characteristics of the educational activity. The results of the experimental work show the effectiveness of the presented software, that supports management decision-making of university departments’ leadership and faculty.
Extraskeletal chondromas are rare benign neoplasms comprising mature hyaline cartilage. A distinctive feature of these tumors is that they develop in soft tissues away from bone and cartilage. Extraskeletal chondromas account for 1.5% of benign soft tissue tumors. They occur predominantly at 30-60, in males, and in the hand or foot. In only 4% of cases, the tumor is located not on the extremities. Patients predominantly complain of increased mass, rarely on pain or a pulling sensation. The literature on the chondromas of the anterior abdominal wall is scarce. We present a rare case of a large extraskeletal left inguinal chondroma in a 71-year-old patient. The mass was over 6 cm large, and this is the only case of inguinal chondroma described in the literature. The mass was resected with surrounding tissues (a surgical margin of 1 cm) under combined endotracheal anesthesia and the histology confirmed the tumor to be a chondroma.
p>The results of a study of psychological well-being and educational outcomes of first-year students depending on their university admission strategy – based on the results of the Unified State Examinations, winners and prize-winners of school Olympic competitions, within the framework of targeted recruitment, after graduating from secondary vocational education institutions, or combined data from the Unified State Examinations and additional entrance examinations organized by universities were presented. The focus of the research is on the indicators of well-being, subjective happiness, and anxiety of first-year students and the results of their first examination session. The study involved 4,920 first-year students from 19 universities of the Russian Federation (57.5% girls; the average age was 18.6 years, standard deviation 1.6). It is shown that first-year students with different university admission strategies differ in their level of well-being, subjective happiness and anxiety, demonstrating unique combinations of the severity of these traits. At the same time, personal anxiety varies to the greatest extent among first-year students depending on the strategy of admission to the university. The choice of admission strategy turns out to be interconnected with the educational outcomes of the student in the first academic year, and the unique combination of the expression of signs of psychological well-being in groups of students with different admission strategies can strengthen or weaken this relationship. The obtained data on the group uniqueness of the manifestation of signs of psychological state depending on the admission strategy can become a scientific basis for organizing psychological support of higher education.</p
At the end of XX - XXI century globalization processes taking place in various fields of economy, science, culture and other spheres of human activity also affected the system of education. In the era of globalization one of the important components of higher education is the academic mobility of students, which is recognized and accepted by both universities and employers. In the article the concept of academic mobility of students in the narrow and broad senses of the word, the principles of organization of academic mobility of higher educational institutions students are revealed. It presents and justifies the structural components of academic mobility, the main stages of the implementation of students’ academic mobility and identifies a phased activity of all entities in educational process during the implementation of these stages. The article is addressed to higher educational institutions teachers, representatives of universities’ international departments and centers of academic mobility in higher education institutions aimed at the development of high school students’ academic mobility.
The relevance of the article is determined by the necessity of theoretical concepts’ and practical experience’s rethinking how to change the functioning of socio-economic processes and systems in the conditions of technological mode, the cycle of development, evaluation of current reforms’ changing. In this regard, the purpose of this article is aimed at socio-economic systems’ strategic development management improving when it is necessary to clarify the types of structural changes, to envisage various scenarios of events’ development, to determine the possibility of sustainable development achieving. The basis of the presented paper is the ideas of the infological approach and the principles of continuous improvement of all processes in the system. The presented article shows the structural model of information provision providing for the selection of significant information content for the development management implementation. The article presents the author's system of information sources’ ranking on quality criteria, providing a formalization and standardization of strategic planning source data. This article is intended for business leaders, educational organizations, top-managers, researchers and those who are focused on the development of socio-economic systems.
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