Russian Railways

BACKGROUND: Impaired blood supply to the bladder is considered a risk factor for urinary dysfunction, including in patients with benign prostatic hyperplasia. One of the possible causes of pelvic hemodynamic disturbances is hypertension. AIM: This study aimed to evaluate the impact of hypertension on the severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia. METHODS: This retrospective and prospective observational study included 6117 men aged 48 to 83 years (mean age: 59.57 ± 10.1 years) who underwent surgical treatment for benign prostatic hyperplasia; 5960 patients were included in the final analysis. Medical records were reviewed with assessment of International Prostate Symptom Score, ultrasonographic findings of the prostate and bladder, and the presence and characteristics of comorbid conditions. RESULTS: Hypertension was identified in 3052 (51.2%) patients, of whom only 1385 (45.4%) were aware of the diagnosis. Patients with benign prostatic hyperplasia and concomitant hypertension demonstrated greater severity of lower urinary tract symptoms, with significant differences observed not only in overall International Prostate Symptom Score but also separately for storage and voiding symptoms. The severity of urinary dysfunction, primarily storage symptoms, depended on the stage and duration of hypertension, as well as on pharmacological blood pressure control. The presence of hypertension influenced the likelihood of persistent urinary dysfunction after surgical treatment of benign prostatic hyperplasia. In the postoperative period, lower urinary tract symptoms were observed in 2078 (68.1%) of 3052 patients with hypertension, compared with only 577 (19.8%) of 2908 patients without hypertension. CONCLUSION: Hypertension is associated with increased severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia; the duration and stage of hypertension, as well as antihypertensive therapy, are of significance. Hypertension may be considered a risk factor for persistent lower urinary tract symptoms in the long-term postoperative period. Prior to deciding on surgical intervention for benign prostatic hyperplasia in patients with hypertension, adequate blood pressure control followed by reassessment of lower urinary tract symptom severity appears to be necessary.

BACKGROUND: Currently, the scientific data lack well-substantiated clinical and radiologic indications for the differentiated use of anterior cervical discectomy with two-level interbody fusion versus anterior cervical corpectomy with single-level transbody fusion in patients with two-level degenerative cervical spine disease. AIM: This work aimed to prospectively assess the long-term clinical outcomes of an algorithmic approach for the selection of anterior interbody cervical fusion versus anterior transbody cervical fusion in patients with two-level degenerative cervical spine disease. METHODS: The treatment of patients with two-segment degenerative cervical spine disease was compared between a prospective cohort (n = 97), operated according to a preoperative clinico-morphologic algorithm in neurosurgical departments in Irkutsk and Krasnoyarsk during 2021–2023, and a retrospective control group (n = 186), operated at the Irkutsk Neurosurgery Center in 2009–2020 using the same surgical techniques according to surgeon preference. RESULTS: After undergoing anterior interbody cervical fusion, the prospective group demonstrated significantly better trends in improvement as compared with the retrospective group, including neurologic function recovery (p 0.05), regression of pseudoradicular symptoms (p 0.05), improvement in cervical disability scale indices (p = 0.03) and modified Japanese Orthopaedic Association scores (p = 0.04), improvement in both physical (p = 0.01) and psychological (p = 0.01) SF-36 health components, and better MacNab scale outcomes (p = 0.006). After anterior transbody cervical fusion, the prospective group demonstrated significantly better trends in improvement than the retrospective group did, including neurologic function recovery (p 0.05), regression of pseudoradicular symptoms (p 0.05), improvement in cervical disability scale indices (p = 0.03) and modified Japanese Orthopaedic Association scores (p = 0.01), as well as better physical (p = 0.02) and psychological (p = 0.01) health components of the SF-36. Complication rates in the prospective subgroups were significantly lower than those in the retrospective subgroups. CONCLUSION: In two-level degenerative cervical spine disease, an algorithm-based anterior approach to the differentiated selection of anterior interbody versus anterior transbody cervical fusion led to a significant improvement in clinical outcomes and a reduction in postoperative complications at a minimum 2-year postoperative follow-up.

The brake equipment in a modern freight locomotive with an electric transmission incorporates an automatic straight brake for controlling the pneumatic brake equipment of the train and locomotive, a locomotive manual straight brake, and an electrodynamic rheostatic brake. The purpose of this paper is to conduct a comparative analysis of the efficiency of different types of diesel locomotive brakes during operation and to determine ways to improve them. Methods: A statistical analysis was conducted on data obtained from contemporary locomotive monitoring systems, focusing on the calculations of heating and wheel tread loosening during extended braking. Results: The analysis of data from remote monitoring of the power plant parameters for 2TE25KM diesel locomotives operating on the Oktyabrskaya, Moskovskaya and Severnaya railways demonstrate that over 83% of adjustment braking cycles are performed using the pneumatic brake shoes of both the train and locomotive. Notably, the locomotive’s auxiliary brake remains unengaged when automatic straight brakes are applied, resulting in the brake shoes and wheel treads of the diesel locomotives being primarily responsible for train braking. Furthermore, the rheostatic braking is used in less than 17% of braking cycles, even though it has the capacity to entirely replace the automatic straight brake and decrease reliance on the locomotive auxiliary brake by 60% at speeds exceeding 10 km/h. Practical significance: Enhancing the efficiency of rheostatic brake systems in diesel locomotives requires the optimization of the control system to uphold the established standards of brake management for locomotive crews during operation.

The main biometric characteristics reflecting changes in the psycho-emotional state of a user of an information system are examined. They are ranked using the pairwise comparison method, as a result of which voice and keystroke dynamics are identified as most suitable for further research. Criteria for the preliminary identification of potential internal information security violators based on changes in the considered biometric characteristics are defined. A convolutional neural network model is developed and tested to solve the stated problem.

The article is dedicated to the 100th anniversary of the famous Russian ophthalmologist Skald L. Shapovalov, his life path and main scientific achievements.

Introduction. The problem of endothelioprotection is currently highly relevant for critical care medicine. The effect of diabetic ketoacidosis on the state of endothelial glycocalyx has not been sufficiently studied. The effectiveness of infusion therapy in the treatment of diabetic ketoacidosis is determined by the functional state of the endothelium.The objective was to evaluate the effectiveness of meglumine sodium succinate used in the infusion therapy of diabetic ketoacidosis for correction of endothelial glycocalyx dysfunction Materials and methods. The prospective study included 50 patients with diabetic ketoacidosis, divided into 2 groups – the first, where 0.9% sodium chloride was used as an infusion solution, the second, where meglumine sodium succinate (Reamberin) was added to the infusion program at a daily dose of 10 ml /kg. Two control groups were also examined: 20 healthy volunteers and 20 people with diabetes mellitus without a history of critical complications. Their randomization was carried out using the blind envelope method. We studied the levels of syndecan-1 in blood plasma and the albumin-creatinine ratio of urine (hereinafter referred to as ACR) at baseline in all groups, as well as in the study groups (№ 1 and № 2) during intensive care.Results. Syndecan-1 and ACR levels were lowest in the group of healthy volunteers. In the group of people with diabetes mellitus without critical complications, the level of these markers was statistically significant higher than in healthy volunteers. The highest values of syndecan-1 and ACR markers were in the groups of patients with diabetic ketoacidosis, and at the initial time point, they were representative of each other in both groups. During the study, it was revealed that in the group with the inclusion of Reamberin (group No. 2), the levels of syndecan-1 and ACR were lower in dynamics than in the group using 0.9% sodium chloride exclusively (group No. 1). The maximum difference was reached by 48 hours of intensive care and was 19.3% for syndecan-1 and 17.5% for ACR.Conclusion. The use of polyionic crystalloid solution Reamberin as part of infusion therapy has a positive effect on the state of glycocalyx during intensive care, which reduces the severity of capillary leakage syndrome.

To evaluate the effectiveness of modern methods for preventing damage to recurrent laryngeal nerve in thyroid surgery. Full-text prospective comparative studies were reviewed in the PubMed Central databases, bibliographic database of the Russian Science Citation Index and Cochrane library database. Heterogeneity was assessed using forest plots, tau2 and I2 statistics. Meta-analysis of pooled risk of recurrent laryngeal nerve injuries revealed significantly lower pooled estimate of the incidence of recurrent laryngeal nerve injuries in groups of intraoperative neuromonitoring (z=-2.04, p=0.0409). Heterogeneity among studies was not significant (I2=28%, p=0.25). Meta-analysis of pooled risk of damage to recurrent laryngeal nerve in case of prevention by precise dissection using ultrasound and electric cauterization found no significant differences in both groups (z= -0.19, p=0.8806). Heterogeneity among studies was moderate (I2=60%, p=0.11). There were no significant publication biases. Intraoperative neuromonitoring and precise dissection of recurrent laryngeal nerve using ultrasound and electric cauterization reduce surgery time. Intraoperative neuromonitoring is advisable as an optional procedure for prevention of damage to recurrent laryngeal nerve.

The article describes reasons for transition of small shipments from railway transport to automobile one and studies proposals to return highly-profitable shot lots back to the railway transport. Today we can observe a rise in the volume of shot lots and joint goods that are delivered by automobile transport. The authors analyzed global experience of transporting shot lots in mid-ton containers. Analysis of market of joint goods transporters showed that serious impact for choosing forwarder is exercised by speed of delivery. Study of existing technologies of goods transportation by speedy cargo trains was carried out, which showed the necessity to choose for shot lots transportation such technology, which could allow railway transport to compete with automobile one not only at long distances but at short legs as well. The authors proposed to use new intermodal transport cargo units: 5- and 10- foot mid-ton module and 10-and 20-foot pick-up body to transport shot lots. Issues of tariffing goods transportation in new intermodal transport units were analyzed and the use of through tariff rate was grounded.

Introduction. The modern world is characterized by global changes in technology, social structure, the mental sphere of children and features of their behavior are also subject to change. There is a change in the fine tuning of mental cognitive processes. The number of children and adolescents with signs of attention deficit and hyperactivity has increased. The development of children with peculiarities is directly related to parental upbringing and relationships in the family. In preschool age parental relations become a determining factor for building the child’s relations in the future, they determine the success of his social life. The study considered the peculiarities of parents’ attitudes towards a child with attention deficit hyperactivity disorder and attitudes towards family life.Objective. To analyze the specificity of relationships in families with ADHD children and aspects of child development with disabilities.Materials and Methods. Identification of preschoolers with ADHD was carried out through the study of anamnestic data, neurological diagnoses and expert evaluations. The following psychodiagnostic tools were used during the study: Toulouse-Pieron test; Unified questionnaire for parents and teachers by A. B. Filippova; PARI technique (E. S. Schaefer, R. K. Bell adapted by T. V. Nescheret); Projective technique “Family Drawing”.Results. The study involved 66 families raising children with ADHD and children without neurological diagnoses, aged 6–7 years. In families of children with ADHD compared to families raising children with normal development, there are differences in the categories of “custody” and “parental dominance”, the role of the mother “on top” prevails. There is a specificity in attitudes to the family role, father’s indifference and tendency to conflicts are common. The revealed tendencies can become an independent reason for secondary neurotization of both the mother of a child with disabilities and the child himself.Discussion. The results of the study can become the basis for psychological help to both children with disabilities and their parents. They can be applied in diagnosing dysfunctional families and taken into account when diagnosing children with symptoms of attention deficit and hyperactivity disorder due to the fact that the results of improper upbringing can cause symptoms of a child’s behavior disorder.