Search

The aim of the article is to raise the issue, the essence of which is to find educational, theoretical and methodological approaches to the formation of knowledge, practical and professional skills regarding ethical norms and principles used in communication with the patient, colleagues, medical personnel and to train a highly qualified modern specialist in the field of medicine. The article demonstrates peculiarities of medical ethics and deontology, as well as the principles that doctors should obey and follow in their professional activities in order to become highly qualified professionals. There were also considered the pedagogical approaches respecting moral culture of young doctors over the process of study in a higher medical institution. Universal human values should be the highest priority for a modern doctor, therefore, by making a decision, one must be guided by concepts of a moral and ethical nature. Medical ethics is the theoretical basis of medical deontology. Deontology is also an essential and integral component of a medical activity. Very important aspect in the practical activity of a doctor is the issue of the law and morality in respect between a doctor and a patient. The teacher should introduce to the interns not only practical skills, but also inspire them to become a comprehensively educated, harmoniously developed personality with a high level of universal values. The attention of young specialists at practical classes is given to the rules of ethics and deontology, mutual respect, the cultivation of civility and compassion for patients, the readiness to come to the rescue and provide the patient with high-standards of medical care that meets the principles of humanity and professional canon. They also are taught to bear moral responsibility for the patient, colleagues and society. Formation of psycho-emotional stability, a humane attitude towards patients, sympathy, mercy, compassion, kindness, endurance, a sense of a high level of responsibility are considered as being necessary in the educational process. The staff of a higher medical institution help in formation of the patient’s trust in future doctors by using knowledge on medical ethics and deontology regarding the relationship between a doctor and a patient. The teacher explains to the patient the need to involve interns in the treatment process in order to transfer gained experience. Pursuing the goal of improving medical skills, interns conduct discussions with experienced doctors on more complex situations, clinical debriefings, as well as participating at clinical conferences. Doctor interns learn how to use a differentiated and individual approach to each patient. Preservation of medical confidentiality remains as one of the main ethical and moral principle in medical practice. Obeying the principles of medical ethics and deontology is essential for the formation of a doctor’s personality and for development of the desire to meet the standards of a highly qualified specialist. The main moral task of the doctor is responsibility for the patients and their health.The role of medical ethics and deontology is often underestimated in the process of professional training of future doctors and does not always occupy a leading place in the curriculum. However, current requirements for the quality of medical services demand from future doctors to be competent in medical ethics and deontology, as the latter contributes to the transformation of medical students into highly qualified specialists.

The article demonstrates the specifics of the management regarding independent extracurricular work of doctors-interns within the institution of higher medical education. It also provides the basic ideas, experience, conditions for the organization of extracurricular activities as well as giving the directions for participation in scientific and practical work to achieve their self-realization. One of the most actual issues facing the modern education system is the improvement of the specialist training. Professional postgraduate training at the level of higher medical institutions are appropriate to the peculiarities of their medical activities. The adaption of an individual-oriented approach to the training of doctor-interns is considered as being relevant in the field of Dentistry. Practically-orientated training as individual extracurricular work with the application and assimilation of existing and new knowledge at the Postgraduate Dentistry Department of IFNMU provides the formation of professional competencies, helps to improve the quality of training of future doctors, who will be able to apply the acquired knowledge, skills and abilities in practice. The aim of practical orientated work is to provide training how to work with modern information technology, to learn how to administer a patient treatment based on evidence-based medicine and individual clinical experience, motivate them to continuous professional improvement throughout the period of medical practice. Involvement of doctors-interns in scientific practice-oriented work at the department is established according to the interests and capabilities of doctors-interns. The modern equipment at the Department and the latest technologies enable interns to expand and improve their knowledge, develop the ability to think clinically and facilitate their further professional adaptation. Practically-oriented work is vital in the professional development of young specialists, has a positive impact on medical training of doctors-interns and mastering by them dental care at the level of world standards.

Here we will briefly describe the commissioning of the Double ElectroStatic Ion Ring ExpEriment (DESIREE) facility at Stockholm University, Sweden. This device uses purely electrostatic focussing and deflection elements and allows ion beams of opposite charge to be confined under extreme high vacuum and cryogenic conditions in separate “rings” and then merged over a common straight section. This apparatus allows for studies of interactions between cations and anions at very low and well-defined centre-of-mass energies (down to a few meV) and at very low internal temperatures (down to a few K).

Varicocele is a venous anomaly characterized by the enlargement of the plexus of veins in the testicle. In pediatric cases, indications for surgical intervention in varicocele include palpable dilatation of the enlargement of the plexus veins, intermittent pain in the ipsilateral testicle, and a 20% reduction in size of the ipsilateral testicle compared to the contralateral healthy one. The limitations of evaluating these criteria and the need to assess semen parameters prompt clinicians to explore new diagnostic methods for timely surgical interventions in adolescents. One such promising study involves Near-infrared reflectance spectroscopy (NIRS) in the Near-infrared range. The aim of the research is to evaluate the diagnostic capabilities of NIRS in children with varicocele to determine the indications for surgical intervention. The study included 65 boys aged 11 to 17 years with left-sided grade III varicocele (main group) and 29 healthy boys as a control group. Monitoring of regional oxygen saturation (rSO2) of testicular tissues was conducted using optical spectroscopy. NIRS examination of testicular tissues in both study and control groups showed statistically homogeneous data for regional oxygen saturation in the healthy (right) testicle. However, the NIRS study revealed significantly lower oxygen saturation (rSO2) in the testicular tissue of the left testicle in patients with varicocele compared to the control group. The diagnostic significance of the difference in bilateral NIRS monitoring Δ rSO2 >13% reliably characterized the presence of testicular hypotrophy by more than 20% compared to the healthy contralateral side (AUC=0.64, 95% CI (0.505-0.775), sensitivity – 79%, specificity – 50%, p=0.042). Δ rSO2 >11% values indicated disturbances in spermogram related to oxidative stress (AUC=0.702, 95% DI (0.51-0.88), sensitivity – 82%, specificity – 61%, p=0.031). Therefore, NIRS study data have potential valuable information for the diagnosis and selection of treatment for varicocele in children. The research utilizing Near-infrared Reflectance Spectroscopy revealed a significant potential of this method for diagnosing and assessing the impact of varicocele on the microcirculation of testicular tissue in children. The diagnostic significance of the difference in bilateral monitoring using this non-invasive technique in determining the state of testicles and the possibility of addressing the question of the necessity of surgical intervention is established. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea (OSA) exacerbates Parkinson's disease (PD) manifestations including cognitive dysfunction. Both OSA and PD have been associated with inflammation. Brain-derived neurotrophic factor (BDNF) has been implicated in cognitive function. We aimed to investigate inflammatory cytokines and BDNF in relation to OSA and PD symptoms.Methods: In a prospective observational study, patients with PD underwent overnight polysomnography. Morning serum levels of interleukin (IL)-1β, IL-6, IL-8, TNFα, and BDNF were quantified at baseline (n = 64) and 6 months (n = 38). Outcomes included non-motor and motor standard scores; Montreal Cognitive Assessment (MoCA); and Epworth Sleepiness scale (ESS). Associations were assessed using linear regression, adjusting for age, sex and body mass index.Results: At baseline, IL-6 was associated with the Apnea-Hypopnea Index (β = 0.013, p = 0.03), and the Oxygen Desaturation Index (β = 0.028, p = 0.002). No other associations between cytokines and sleep parameters were found. Motor dysfunction was associated with IL-6 (β = 0.03, p = 0.001). ESS was associated non-significantly with IL-6 (β = 0.04, p = 0.07) and BDNF (β = 555, p = 0.06). At follow-up, change in IL-6 was associated with change in non-motor (β = 0.08, p = 0.007), and motor (β = 0.03, p = 0.001) symptoms. Change in BDNF was associated with change in ESS (β = 1450, p = 0.02).Interpretation: We found an association between IL-6 levels and both OSA severity and PD motor dysfunction. At follow-up, increasing IL-6 correlated with deterioration of motor and non-motor PD symptoms. Increasing BDNF correlated with increasing sleepiness. Further work with a larger sample size is needed, but our results support the hypothesis that OSA-related inflammation plays a role in PD manifestations and progression. [ABSTRACT FROM AUTHOR]

Tunability in the concentration and average dimensions of self-forming semiconductor quantum dots (QDs) was accomplished. Three of the methods used were variations with temperature, group V partial pressure and with substrate miscut angle. Thermally activated group III adatom mobilities were observed to induce larger diameters and lower concentrations with increasing deposition temperatures.

The stoichiometry, crystallinity, defect concentration and excess lattice location in GaAs layers grown by low temperature molecular beam epitaxy were investigated using ion beam techniques. The results showed that when the growth temperature was lowered, the excess As concentration in the layers increased. Arsenic atoms coalesced into precipitates after annealing at tempereatures higher than 400 degrees celsius. The unannealed layers grown at 200 degrees celsius exhibited good crystalline quality.

In this work, we present measurements of the dynamics of photoexcited carriers in GaInN/GaN quantum wells (QWs) grown on ammonothermal GaN, especially thermalization and recombination rates. Emission properties were measured by time-resolved photoluminescence (PL) and electroluminescence spectroscopy. Due to the use of high quality homoepitaxial material, we were able to obtain very valuable data on carrier thermalization. The temperature dependence of the QW energy observed in PL shows characteristic S-shape with a step of about 10 meV. Such a behavior (related to thermalization and localization at potential fluctuations) is often reported for QWs; but in our samples, the effect is smaller than in heteroepitaxial InGaN/GaN QWs due to lower potential fluctuation in our material. Absorption properties were studied by photocurrent spectroscopy measurements. A comparison of emission and absorption spectra revealed a shift in energy of about 60 meV. Contrary to PL, the QW energy observed in absorption decreases monotonically with temperature, which can be described by a Bose-like dependence E(T) = E(0) - λ/(exp(θ/T) - 1), with parameters λ = (0.11 ± 0.01) eV, θ = (355 ± 20) K, or by a Varshni dependence with coefficients α = (10 ± 3) × 10-4 eV/K and β = (1500 ± 500) K. Taking into account absorption and emission, the fluctuation amplitude (according to Eliseev theory) was σ = 14 meV. The time resolved PL revealed that in a short period (<1 ns) after excitation, the PL peaks were broadened because of the thermal distribution of carriers. We interpreted this distribution in terms of quasi-temperature (Tq) of the carriers. The initial Tq was of the order of 500 K. The thermalization led to a fast decrease of Tq. The obtained cooling time in the QW was τC = 0.3 ns, which was faster than the observed recombination time τR = 2.2 ns (at 4 K). [ABSTRACT FROM AUTHOR]

The observation of the local vibrational stretching mode of the manganese-hydrogen complex in GaP by infrared spectroscopy is reported. It is shown that when manganese is in the impurity regime, the complex only forms in very small concentrations in samples in which the Fermi level is about 0.3 eV above the valence band maximum. The reasons for this behavior are analyzed. It is argued that in GaMnP alloys, the formation of manganese-hydrogen complexes is more likely than in the impurity regime, but a full passivation of the manganese by hydrogen is not possible. However, the fraction of passivated manganese can impede ferromagnetism. [ABSTRACT FROM AUTHOR]

We report an investigation into the dissociative recombination of the azide radical cation, N3+. The reaction rate constant has been measured to be 6.47×10-7 cm3 s-1 at room temperature. This value is smaller than those reported earlier for the ion-electron neutralization of N3+ at nitrogen atmospheric pressure. A strong propensity to dissociate through the N2+N channel has been observed. [ABSTRACT FROM AUTHOR]

Self-organized Ga(Mn)As nanoclusters, embedded in GaAs, were formed during post-growth thermal annealing of Ga1-xMnxAs layers. Structural and magnetic properties of such composites were systematically studied as a function of the annealing temperature. Small (∼3 nm) Mn-rich zinc-blende Mn(Ga)As clusters, coherent with the GaAs matrix, were formed at the annealing temperature of 500 °C. An increase of the annealing temperature of up to 600 °C led to the creation of 10–20 nm large NiAs-type hexagonal MnAs nanocrystals. Magnetization measurements showed that the MnAs nanoprecipitates were superparamagnetic, with a distribution of blocking temperatures that depended on the MnAs cluster size. Some intermediate paramagnetic clusters (structurally disordered clusters) were also observed. [ABSTRACT FROM AUTHOR]

Dimethyl disulfide (DMDS) and N-methylacetamide are two first choice model systems that represent the disulfide bridge bonding and the peptide bonding in proteins. These molecules are therefore suitable for investigation of the mechanisms involved when proteins fragment under electron capture dissociation (ECD). The dissociative recombination cross sections for both protonated DMDS and protonated N-methylacetamide were determined at electron energies ranging from 0.001 to 0.3 eV. Also, the branching ratios at 0 eV center-of-mass collision energy were determined. The present results give support for the indirect mechanism of ECD, where free hydrogen atoms produced in the initial fragmentation step induce further decomposition. We suggest that both indirect and direct dissociations play a role in ECD. © 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

We report the results of optical absorption measurements on Ga1-xMnxAs layers grown by low-temperature molecular beam epitaxy. In the paramagnetic layers grown at very low temperatures (below 250 °C) the experiments reveal an absorption band at 1.2 eV arising from the presence of neutral arsenic antisites, AsGa. From the magnitude of the absorption we determine the concentration of AsGa to be between 4×1019 and 8×1019 cm-3 in these paramagnetic samples. These values are typical for GaAs specimens grown below 250 °C. Extrapolating the AsGa concentration from low-temperature-grown GaAs to Ga1-xMnxAs, we determine the concentration of this defect in ferromagnetic Ga1-xMnxAs layers grown at temperatures above 250 °C as 1×1019 down to 1×1018 cm-3. We conclude that the compensating role of arsenic antisites in Ga1-xMnxAs becomes gradually less important with increasing growth temperature. © 2004 American Institute of Physics. [ABSTRACT FROM AUTHOR]

The results of optical absorption measurements on Ga(sub 1-x)Mn(sub x)As layers grown by low-temperature molecules beam epitaxy is reported. With increasing temperature, the compensating role of arsenic antisites in Ga(sub 1-x)Mn(sub x)As becomes less important.

Ferromagnetic behavior of GaN doped with Mn (Ga(sub 1-z)Mn(sub z)N) grown by the ammonothermal and chemical transport methods, in terms of a second phase (ferromagnetic one ) produced during the growth process, is discussed. Ferromagnetic behavior of (Ga,Mn)N is due to different Mn(sub x)N(sub y) phases, is suggested.

Summary: Background: Bullous pemphigoid (BP) is a distressing autoimmune bullous disease strongly associated with severe pruritus; however, data concerning pruritus in BP are still scarce. No clinical research evaluating the effect of BP on sleep quality has been conducted. Aim: To evaluate the intensity of pruritus measured by nocturnal wrist movements (NWMs) and the sleep quality in patients with BP using actigraphy in comparison with nonpruritic healthy controls (HCs) with subsequent correlations with an itch visual analogue scale (VAS) as a subjective measure, disease severity [Bullous Pemphigoid Disease Area Index (BPDAI), urticaria/erythema, erosions/blisters] and serum total IgE level. Methods: In total, 31 patients with newly diagnosed BP (mean ± SD age 75.4 ± 12.3 years) and 40 nonpruritic HCs (age 73.5 ± 11.7 years) were recruited. All participants wore a sleep monitor (ActiSleep+) on the dominant wrist. Results: For patients with BP, median VAS score was 5.5 and median BPDAI was 43 (urticaria/erythema BPDAI was 16, erosions/blisters BPDAI was 29). Scratching, defined as bouts of NWMs, was significantly (P < 0.001) more intensive in patients with BP than in controls. Characteristic of BP was that scratching bouts corresponded with the slowest wrist movements. There were no correlations with VAS, BPDAI or total IgE level. Compared with HCs, patients with BP presented significant (P < 0.001) sleep disturbances, as determined by sleep efficiency, waking after sleep onset and average duration of awakening, and these were strongly correlated with urticaria/erythema BPDAI. Conclusion: Nocturnal wrist movements measured by actigraphy are more intensive in patients with BP than in nonpruritic HCs, and characteristically slow movements. Actigraphy method showed very low sleep quality in patients with BP, thus severity of BP has a negative impact on sleep. [ABSTRACT FROM AUTHOR]

Presents a study which examined the stoichiometry, crystallinity, defect concentration, and excess arsenic lattice location in gallium arsenide (GaAs) layers grown by molecular beam epitaxy (MBE) using ion beam techniques. Experimental procedures; Results and discussion.

We present selected semiconductor (inorganic and organic) structures for which non-radiative recombination of excess charge carriers is very high, luminescence suppressed and its lifetime substantially shortened. Processes competitive with radiative energy emission are discussed. The importance of Shockley-Read-Hall recombination in materials with high impurity or defect concentration, applied in ultrafast devices, is shown. Also, charge transfer process in solar cells is discussed in the context of luminescence quenching of individual components of an active layer. A part of the shown research was a subject of our common work with Prof. Arūnas Krotkus during the period from 1994 till 2006. [ABSTRACT FROM AUTHOR]

Product branching ratios and thermal rate coefficients for the dissociative recombination of CO2+ have been measured in the cryogenic ion source ring ion storage ring. The rate constants were found to be 4.2×10-7(Te/300)-0.75 cm3 s-1. The 300-K result is in agreement with previous flowing afterglow values and is somewhat smaller than a recent determination made at the Aarhas storage ring in Denmark (ASTRID) storage ring. The electron temperature dependence is, however, in good agreement with the ASTRID result of T-0.8. The present results show that only CO plus O are formed, other product branching ratios are zero within experimental error. This is in contradiction to the ASTRID results which show that 9% of the reactivity goes to C+O2. The new results show that the C+O2 channel does not need to be included in the models of the ionospheres of Venus and Mars. [ABSTRACT FROM AUTHOR]

Objective Acute dystonia in children is distressing, painful and can progress to life-threatening status dystonicus. Typical management involves benzodiazepines which can result in respiratory depression requiring PICU admission. Clonidine is less respiratory-depressant, and by facilitating sleep, switches dystonia off. It can also be administered via enteral, continuous intravenous infusion, and transdermal slow release routes. We describe the dose range and safety profile of clonidine management in a case-series of children with severe acute exacerbation of dystonia in a tertiary hospital setting. Methods The management of 5 children (3 female, age range 8–14 years) suffering from an acute exacerbation of secondary dystonia requiring hospital admission at the Evelina London Children's Hospital was reviewed. The average and maximum dose of clonidine in mcg/kg/h and routes of administration were recorded for each day of hospital admission. Co-administration of any other medical treatments for dystonia and their route of administration were also recorded. Cardiovascular and respiratory clinical status were measured by recording the daily mean and maximum Paediatric Early Warning Scores (PEWS). Results Clonidine was administered via enteral, intravenous, and transdermal routes at a median dose of 2.5 mcg/kg/h (range 0.1–9 mcg/kg/h). Administration of high dose clonidine was associated with decreased use of benzodiazepines, morphine, and propofol: avoiding invasive respiratory support for ¾ cases during admission. Clonidine doses via all routes of administration did not correlate with poorer PEWS scores (p = 0.839). Both high dose intravenous and transdermal clonidine where found to be effective. Conclusions High dose clonidine administered via different routes can be used in the acute management of severe exacerbations of dystonia. Its use in our cohort was not associated with significant cardio-respiratory depression even at doses as high as 9 mcg/kg/h. [ABSTRACT FROM AUTHOR]

Objective To evaluate the safety, efficacy and effective dosage of clonidine in the outpatient (OP) management of secondary dystonia. Methods A retrospective analysis of children and young people (CAYP) prescribed clonidine in an OP clinic between January 2011 and November 2013 for dystonia management. Of 224 children receiving clonidine, 149/224 did not have a movement disorder and 12/224 had no data leaving 63 movement disorder cases, 15/63 managed as in-patients, 15/48 suffered from tics leaving 33/63 for OP evaluation. Clonidine effectiveness was assessed by ‘yes/no’ criteria in improving 5 areas: seating, sleep, pain, tone and involuntary movements. Results 2/33 motor cases had insufficient data; 7/33 had concurrent therapy leaving 24/33 for analysis. Improvement in at least one area was reported by 20/24 (83%) CAYP: Improved seating tolerance 14/24, and sleep 15/24; reduced pain 15/24; improved tone 16/24 and involuntary movements 17/24. Starting doses ranged from 1 mcg/kg OD to 2 mcg/kg TDS with optimum doses reached on average at 9.5 months follow-up. Maximum dose reached was 75 mcg/kg/day given in 8 divided doses. Average maximum daily dose was 20 mcg/kg/day. The commonest frequency of administration was 8 hourly. Side effects were reported in 11/24 CAYP and discontinued in 1/24 for lack of clinical effectiveness, 1/24 for side effects and 4/24 due to both lack of effectiveness and side effects. Conclusion Clonidine was effective in secondary dystonia management in 83% of cases. A starting dose of 1 mcg/kg TDS was well tolerated and safely escalated. Prospective objective evaluation is now required to confirm the efficacy of clonidine. [ABSTRACT FROM AUTHOR]