bluuebunny/crossref_metadata_2025 huggingface dataset:
Silicon nitride with titania, calcia and silica additives for orthopaedic applications
Authors: Guedes-Silva Cecilia , Rodas Andrea , Carvalho Flávio , Higa Olga , Ferreira Thiago
Published: March 2020

Titanium, silicon and calcium ions have demonstrated positive effects in bone
healing. Therefore, this paper investigates the densification, mechanical
properties and in vitro biological behaviour of TiO2, together with SiO2 and
CaO, on silicon nitride ceramics to be used in clinical applications. The
results revealed that the sintered samples reached high values of relative
density and fracture toughness, non-cytotoxicity as well as good ability to
promote cell proliferation and form a layer of carbonated hydroxyapatite on
their surfaces, after immersion in simulated body fluid. The sample with the
highest amount of TiO2 reached the highest value of relative density and the
best results of cell proliferation and fracture toughness, indicating the
great potential to be explored by in vivo experiments for later application
as intervertebral devices.
Effects of divalent dopants on the microstructure and conversion efficiency of Cr4+ ions in Cr,Me:YAG (Me - Ca, Mg, Ca/Mg) transparent ceramics
Authors: Chaika Mykhailo , Mancardi Giulia , Tomala Robert , Stek Wiesław , Vovk Oleh
Published: March 2020

The efficiency of Cr4+:YAG is directly proportional to the transparency and
concentration of Cr4+ which can be tuned by changing the divalent dopant.
The aim of this study was to investigate the influence of different kinds of
divalent dopants on the properties of Cr,Me:YAG (Me = Ca, Mg or Ca/Mg)
ceramics made by solidstate sintering in vacuum. Pure YAG phases with an
in-line transmittance of 80% at 1064 nm were prepared. It was revealed that
the Cr4+ concentration is directly proportional to the concentration of
divalent dopants and it does not depend on the type of dopant. Our
experiment proves that the efficiency of high optical quality Cr4+:YAG
ceramics prepared by sintering does not change when different kinds of
divalent additives are used.
An International Survey of Pediatric and Neonatal Clinician’s Vascular Access Practice: PediSIG Assessment of Vascular Access, Education, and Support (PAVES)
Authors: Hovda Davis Mary Beth , Takashima Mari , Girgenti Constance , Ullman Amanda J.
Published: March 2020

Highlights

Background: Despite evidence to support best practice in neonatal and pediatric venipuncture delivery and procedural support, there are inconsistencies in practice. To inform future research, education, and workforce innovation, the Association for Vascular Access Pediatric Special Interest Group (PediSIG) developed and undertook a survey to describe the current vascular access practice for clinicians caring for neonatal and pediatric patients.

Objective: Describe the current state of workforce models, training, and clinical practices surrounding pediatric and neonatal vascular access.

Design: Cross-sectional, electronic survey using convenience sampling.

Settings: International clinicians who provide vascular access (peripheral intravenous catheter insertion, venipuncture for blood sampling) for neonatal and pediatric patients.

Methods: An electronic survey was developed by the PediSIG. The survey covered workforce models, clinician training and competency, pain relief, procedural support, and device securement. The electronic survey was then distributed to the PediSIG membership and shared among several neonatal/pediatric email lists. Data were analyzed descriptively, with an exploration of association between clinical outcomes, workforce, and training. Results: There were 242 responses from 5 countries showing a wide variance of practice. Workforce models showed many different team names and responsibilities along with a variance of personnel and staffing hours. Clinician training was described as 4 hours or less by 44% (n = 69) of respondents. Less than half of the responses (47%; n = 99) reported having a formal procedure to escalate a patient to an expert care and not having a set number of max attempts before escalation. Only two-thirds (n = 115) of respondents said they had a standardized protocol for pain control and procedural support, with only 13% (n = 23) and 15% (n = 27), respectively, self-reporting that they always followed the protocol.

Conclusions: The respondents reported a wide variance in neonatal and pediatric vascular access procedures and the resources used to support this practice. Core standards need to be developed to help guide neonatal and pediatric clinicians and their institutions. The standards should encompass recommendations for workforce models, proper training, competency, insertion guidelines, pain control, procedural support, and access to vascular access specialists to provide the best care for every neonate and child.
Assessment of Peroxide in Saliva During and After At-home Bleaching With 10% Carbamide and Hydrogen Peroxide Gels: A Clinical Crossover Trial
Authors: Mailart MC , Sakassegawa PA , Torres CRG , Palo RM , Borges AB
Published: March 2020

Clinical Relevance

This study suggests that at-home bleaching systems are safe in relation to toxicity based on peroxide levels in saliva since the amount of peroxide potentially ingested is much lower than the estimated toxic dose.

Objectives:

This study evaluated the presence of peroxide in saliva using at-home bleaching systems containing hydrogen peroxide (HP) and carbamide peroxide (CP) with a prefilled tray (PT) or conventional tray (CT).

Methods and Materials:

Participants received bleaching treatments after the sequence randomization (n=10): PT-HP/OpalescenceGo10%; CT-HP/WhiteClass10%; and CT-CP/OpalescencePF10%. Saliva was collected at the following times: baseline; at 1, 5, 15, and 30 minutes after administration; and at 3, 5, and 8 minutes after the tray was removed. Colorimetric analysis using analytic spectrophotometry was performed. The salivary flow (SF) was monitored during use of trays. Data about peroxide concentration (PC) were submitted to repeated-measures analysis of variance and Tukey tests (5%), and toxic dose was calculated based on body weight. The relation between SF and PC was verified with the Pearson correlation test.

Results:

There was a significant difference for bleaching (p=0.0001) and time (p=0.0003) but not for interaction (p=0.3121). PC was lower for CT-CP in relation to PT-HP and CT-HP. After tray removal, expectoration, of the remaining gel, and mouth rinsing, no peroxide was detected in saliva. Correlation between SF and PC was considered weak (r=0.3379). The overall mean SF was 50.44% during tray use. In general, PC in saliva was 68.72% lower than the estimated toxic dose (0.26 mg/kg/day) considering all the bleaching systems.

Conclusions:

Higher peroxide levels were detected in saliva with 10% HP gels. Nevertheless, they were below estimated toxic dose and were considered safe in relation to toxicity.
Rolling Resistance Evaluation of Winter Tires on In-Service Road Surfaces
Authors: Vieira Tiago , Sandberg Ulf , Erlingsson Sigurdur
Published: March 2020

Rolling resistance, the energy dissipated due to the rolling movement of a pneumatic tire over a surface, is a relevant factor that should be considered when aiming at a more energy efficient road infrastructure as well as for reducing CO2 emissions. The energy dissipation, as a result mainly of hysteretic losses, is dependent on the tire, the road surface, and the operating temperature, among other factors. In this study, 50 different tires of five different types—all-season tires, summer tires, winter tires without studs, winter tires with studs, and winter tires with hard particles—were evaluated with respect to rolling resistance on two different road surfaces, at three different test speeds and different states of tire wear. In addition to the full-scale field tests, a drum facility was used to evaluate rolling resistance of the same tires in a more controlled environment. This resulted in more than 500 measurements that were analyzed in this paper. Previously, no data regarding rolling resistance of studded winter tires had been published, and there have been very few studies comparing measurements on drums with measurements on road pavements. In the field, rolling resistance was significantly depending on tire type, and many tested tires performed differently on the two surfaces. No significant correlation was found between labeled tire values and rolling resistance measured on roads, or between rolling resistance measured on roads and on a drum facility. Better correlations were found between labeled tire values and our own drum results. This calls for a review of the relevance of the energy labeling procedure.
PENINGKATAN NILAI EKONOMIS LIMBAH PRODUKSI JAMUR MERANG MENJADI BRIKET SEBAGAI SUMBER ENERGI ALTERNATIF DI DESA BAYUR KECAMATAN RAJABASA
Authors: Darni Yuli , Utami Herti , Darmansyah Darmansyah , Lismeri Lia , Haerudin Nandi
Published: March 2020

The paddy straw mushroom  is one type of  mushrooms that begin to be developed in the village of Bayur. They cultivate the paddy straw mushroom because the commodity, can make a lot of money in the market,  the maintenance are relatively easy and cheap with the price quite beneficial. For the media paddy straw mushroom used the empty bunches of oil palm which it was the utilization of waste from palm oil plantations. After several harvests, the paddy straw mushroom replaced with new media. Of the empty bunches of oil palm used, the rest of the media mushroom that become waste that accumulates and difficult to decomposed because of the cellulose and lignin of the empty bunches of oil palm. Increasingly the waste will pollute and containing bacterium of disease. The problems faced by partner is related to the aspects of the provision of energy and management waste processing the rest of the production of mushroom. To overcome the problems, the team  provide training  the procedure of making briquette and design an instrument print of  briquette from the rest of the media of mushroom. This instrument give an advantages for both in the independence of energy and the utilization of the waste production .

The method of PKM activity involved the partners (the farmers)  in the overall of activities. The outer of this main activity are the instrument print of briquette and to increase the ability and knowledge the partner. The product development briquettes can be used own and sold commercially. With this training, the ability of the partner of the making  product briquettes can reduce production cost and to raise the income of partner.

Keywords: efficient technology; print of briquettes; waste; media the paddy straw mushroom
PELATIHAN PEMBUATAN OBAT KUMUR (MOUTHWASH) KAYU MANIS (Cinnamomum burmanii) DAN DAUN SIRIH (Piper betle L.) BAGI KELOMPOK KADER POSYANDU DESA HAJIMENA
Authors: Gunawan Indra , Ardini Dias , Makdalena Makdalena
Published: March 2020

Upaya peningkatan kesehatan yang ditujukan kepada Masyarakat di Desa Hajimena dilakukan mengikuti kebijakan pemerintah Kabupaten Lampung Selatan dan Provinsi Lampung dengan berbagai program peningkatan upaya kesehatan sunalah satu adalah kesehatan gigi dan mulut. Kegiatan pengabdian kepada masyarakat yang dilakukan Tim Dosen Program Studi DIII Farmasi  melalui skema Program Kemitraan Masyarakat (PKM) telah memberikan kontribusi nyata terhadap peningkatan pengetahuan kelompok masyarakat (kader posyandu) Desa Hajimena, tentang pentingnya menjaga kesehatan mulut. Kegiatan pengabdian kepada masyarakat menghasilkan luaran berupa peningkatan pengetahuan Kader Posyandu Desa Hajimena terhadap penggunaan obat kumur (mouthwash) dengan nilai delta (δ) sebesar 19,5; peningkatan persepsi aroma nafas para kader setelah menggunakan obat kumur (mouthwash) dengan nilai delta (δ) sebesar 4,5; Kader Posyandu Desa Hajimena dapat membuat obat kumur alami secara mandiri memanfaatkan bahan dan peralatan sederhana dan terbentuknnya komunitas “HASBALUT” (Hajimena Bebas Bau Mulut). Evaluasi hasil kegiatan adalah masih diperlukannya pengembangan formula lebih lanjut terhadap produk obat kumur (mouthwash) kayu manis (Cinnamomum burmanii) dan daun sirih (Piper betle l.) hasil kegiatan pengabdian masyarakat menggunakan pengawet alami agar dapat digunakan dalam jangka waktu yang lebih lama.
Sleep Apnoea Disorder
Authors: Raut Aishwarya Deepak , Dixit Bharati
Published: March 2020

This article provides research on sleep apnoea. Sleep apnoea is a capable for suspending breath or frequently pausing in period of deep sleep. This symptoms may leads to an unappropriate death that makes it a critical sleeping disorder. Periods of apnoea generally lasts for five seconds or hardly a minute which affects the sleeping pattern due to breathing. This probably happens five times of an hour or even more. Obstructive sleep apnoea (OSA),central sleep apnoea (CSA) and mixed/complex sleep apnoea(MSA) are common three types of apnoea, where mixed/complex sleep apnoea is combination of other two apnoea. Airway obstruction is caused in OSA, while in CSA airway is not blocked, but the brain dosn’t sends proper signals to the muscles that cause instability of the respiratory center. The study includes the sleep disorders, types, cause, signs and symptoms and methods of Sleep Apnoea. Considering the study; it is very much required to detection of sleep apnoea using noninvasive techniques. Machine learning algorithms based detection of sleep apnoea is a feasible solution which provides more than 90% accuracy. The study surveys the similar techniques based on machine learning.
Electrochemical Evaluation of AISI 304 SS and Galvanized Steel in Ternary Ecological Concrete based on Sugar Cane Bagasse Ash and Silica Fume (SCBA-SF) exposed to Na2SO4
Authors: Baltazar-Zamora Miguel Angel , Ariza-Figueroa Hilda , Landa-Ruiz Laura , Croche René
Published: March 2020

In the present research, was studied the electrochemical behavior of AISI 304 stainless steel and Galvanized Steel embedded in Ternary Ecological Concrete made with partial substitution of Portland Cement (PC) by combination of Sugar Cane Bagasse Ash and Silica Fume (SCBA-SF) in 10, 20 and 30% and exposed to a 3.5% solution of Na2SO4 as an aggressive medium. For the design of the concrete mixtures was used ACI 211.1 method. Quality control tests of fresh and hardened concrete were carried out in accordance with the ONNCCE and ASTM standards. The electrochemical evaluation was carried out for a period of 6 months, using the techniques of corrosion potential Ecorr (ASTM C-876-15) and Linear Polarization Resistance-LPR- (ASTM G59) to determine the corrosion rate Icorr. The results indicate that AISI 304 SS has a high corrosion resistance from the curing stage to the end of monitoring, with values of Ecorr lower than -200 mV and negligible corrosion levels with values of Icorr below 0.1 µA/cm2, greater protection is identified in the Ternary Ecological Concrete with replacement of 30% of PC by SCBA-SF.
Treatment Options and Follow-Up among Iraqi Patients with Breast Carcinoma
Authors: Alwan Nada , Shawkat Mena M.
Published: March 2020

Breast cancer ranks the first among the Iraqi population and the leading cause of cancer related female mortality. In addition to the barriers that impede early detection of that cancer other major challenges include the capacity for effective multimodality treatment. Aim: To review and follow up a sample of Iraqi female patients diagnosed with breast cancer in a main referral center; recording their clinico-pathological characteristics, the offered treatment options and the rate of recurrence. Material and Methods: This retrospective study analyzed the clinical and pathological characteristics of 230 Iraqi female patients histologically diagnosed with breast carcinoma who had reliable valid data related to their demographic, clinical and tumor pathological status. The studied parameters included the age of the patient, marital status, parity, age at first delivery, occupation, history of lactation and hormonal intake, family history of breast and any other cancer, histological type, tumor grade and clinical stage. Hormone receptors (Estrogen and Progesterone) and HER2 over expression contents of the primary tumors were evaluated immunohistochemically. The offered treatment options included surgery, chemotherapy, radiotherapy, hormonal and biological targeted therapy. The rate of recurrence was evaluated after a follow-up period of three years. Results: Only 3.5% of the patients were under the age of 30 years while 39.1% were aged 50 years and over. About 84% were married, 11.3% were nulliparous, 24.9% had their first delivery before the age of 20 years and 56.9% were housewives. History of lactation was reported in 60.4%, whereas history of breast cancer was registered in 17.4%. The most common histological type of breast carcinoma was the infiltrative ductal (86.5%), well differentiated carcinomas were diagnosed in only 5.2%. The rates of positive ER, PR and HER2 tumor contents were 68.3%, 65.7% and 29.6% respectively. Overall 8.3%, 4.3%, 39.6% and 7.8% of the patients were diagnosed at stages I, II, III and IV respectively.  Surgery was the primary treatment modality prescribed to the vast majority (96.1%) of the patients; 88.2% of those underwent modified radical mastectomy and only 3.6% had breast conservative surgery. Whereas 91.7% received chemotherapy, radiotherapy, hormonal and biological therapy were applied on 65.7%, 63.5% and 27.4% respectively. Recurrence of breast carcinoma three years following treatment was displayed among 9.7%; displaying significant direct association with the clinical stages of the disease (p<.05). Conclusions: Breast cancer is still diagnosed at relatively advanced stages at the time of first presentation in Iraq; requesting radical mastectomy. Early detection represents the principal approach to control breast cancer in the near future. Regular long-term follow up through multidisciplinary tumor boards is mandatory to monitor response to therapy and recurrence.
A Curse of Knowledge in Diagnosis of Thalassemia
Authors: Aljasmi Fatma , Denic Srdjan , Souid Abdul-Kader
Published: March 2020

How socioeconomic development affect the diagnosis of thalassemia? Here, we report a couple (husband and wife) from United Arab Emirates (UAE) with microcytic anemia. The parents belong to Arabian tribes with a high prevalence of a- and b-thalassemia. They wanted to have another (sixth) child and their blood counts were investigated before in vitro fertilization. The parents and five children had standard blood tests (complete blood and reticulocyte cell counts, serum ferritin, and hemoglobin analysis) followed by genetic investigations of hemoglobin-a locus 1 and 2.  In addition, the parents had a genetic investigation of hemoglobin-b locus for 22 common variants.  The parents were found to have no abnormality in hemoglobin-b locus.  They had two pathogenic a-globin gene variants: one rare variant in the 3’ prime untranslated region of HBA2 (c.*92A>G; rs63750067) and one common deletion in HBA2 (-a3.7). There were four distinct genotypes: -a3.7 homozygote (mother), c.*92A>G heterozygote (father), double heterozygotes (four children), and -a 3.7 heterozygote (one child).  The couple was cleared for the in vitro fertilization.  In contrast to ‘standard’ approach, the genetic test for thalassemia is controversial. The findings in this family are discussed in the context of recent epidemiologic and genetic studies in the local population. It was concluded that the rapid development in the UAE was accompanied by acquisition of new information about thalassemia which, paradoxically, increased diagnostic uncertainties in the setting of premarital guidance.
Adult Intussusception: Three Cases Reports and Review of the Literature.
Authors: Hajri Amal , Yaqine Karim , El Jai Saad Rifki , Boufettal Rachid , Errguibi Driss , Chehab Farid
Published: March 2020

Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, etiology, and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms and most cases are diagnosed at emergency laparotomy. Treatment entails simple bowel resection in most cases. Reduction of the intussusception before resection is controversial, but there is a shift against this, especially in colonic cases. This paper presents the diagnosis and management of three cases of adult intussusception, in our hospital.
The Correlation Between Asthma Severity and Neutrophil to Lymphocyte Ratio
Authors: Darwesh Meena Abdul-Sattar , Abd Alhaleem Ibtihal Shukri , Al-Obaidy Muhammed Waheeb Salman
Published: March 2020

Background—The prognosis is essential in management and follows up of asthmatic patients. Neutrophil to lymphocyte ratio is considered as the common prognostic marker for many diseases especially the asthma. Aim of study—To assess the relationship between asthma severity and neutrophil to lymphocyte ratio in comparison to healthy controls. Patients and methods—This study is a cross sectional study conducted in Respiratory Consultancy Clinic in Baghdad Teaching Hospital in Medical City during the period from 1st of October, 2018 to 31st of March, 2019 on sample of 50 asthmatic patients and 50 healthy controls. The diagnosis of asthma was confirmed by the supervisor through clinical symptoms, signs, spirometery with reversibility test (according to GINA guideline.). Results—A highly significant difference was observed between asthmatic cases and controls regarding age (p<0.001). A significant association was observed between obesity and asthmatic cases (p=0.001). There was a highly significant association between high neutrophil/lymphocyte ratio and asthmatic cases (p<0.001). The neutrophil/lymphocyte ratio was significantly increased with advanced age, females, severe and uncontrolled asthma. Conclusions—The neutrophil to lymphocyte ratio is useful biomarker in assessment of asthma severity.
Public spaces as a factor of the quality of the urban environment (on the example of the city of Irkutsk)
Authors: Полякова Нина
Published: March 2020

The article describes the relevance of the study of public spaces as an important element of the quality of the urban environment. Successfully functioning public spaces are called upon to solve a number of urban problems, including the social isolation of citizens caused by urbanization processes. The characteristic of public spaces of a particular city is based on an assessment of a set of attributes and related criteria developed by placemaking specialists. It is proved that this complex should reflect not only the general requirements for public spaces, but also the features of the city: the diversity of the socio-ethnic structure of the population, cultural and historical heritage, and the specificity of the existing urban environment. The characteristics of the four most visited public spaces of the provincial Siberian city of Irkutsk are fulfilled: the Kirov square; historical and memorial complex "Jerusalem Mountain "; Municipal Park "Yunost Island"; shopping and entertainment complex "130th quarter". The results showed that the public spaces of the city perform a number of functions with varying degrees of success: best recreational and entertaining, partially creative and the function of storing the “collective memory” of the city. At the same time, the city does not have public spaces that fully meet the objectives of the development of urban society; this applies to both historical and newly created. Their main drawback is the inconsistency with the modern challenge for Irkutsk, namely, the solution to the problem of social inclusion of new citizens. Some measures have been proposed for City management to purposefully strengthen the elements of public spaces that implement the function of involving residents, especially migrants, in the public life of the city.
Dissection of ascending aorta and left main coronary artery after routine percutaneous coronary intervention: a case report
Authors: Daniyarov B.S. , Abdyldaev I.Z. , Chevgun S.D. , Nurbekov K.N. , Cholponbaev D. Ch. , Kaliev T.B. , Borubaev E.E. , Chukubaev M.A.
Published: March 2020

We describe a case of guiding catheter induced dissection of left main coronary artery and ascending aorta. A patient with unstable angina and two-vessel disease underwent drug eluting stents implantation in proximal left anterior descending artery and distal left circumflex artery. Six hours after the procedure of acute occlusive dissection of left main coronary artery with spreading to ascending aorta developed, it was required to do stenting of the left anterior descending and left main coronary arteries and balloon dilatation of left circumflex artery. Despite the initial success of the repeated intervention, total occlusion of left main coronary artery occurred with unsuccessful reopening in catheterization laboratory. Emergency coronary artery bypass surgery was carried out. However, despite the patent anastomosis from left mammary to left anterior descending artery, the patient died.
Results of controlled clinical examination of intraoperative reinfusion of blood, taken from pleural cavity in the slow and fast conditions
Authors: Chyngysheva Jamilya A. , Sabirov Djuraboy M.
Published: March 2020

The controlled clinical examination showed that the decay of erythrocytes and leucocytes under blood reinfusion in experimental control (EC) after intraoperative blood reinfusion (IO RIC) is 35% in slow blood reinfusion, and 48% in fast blood reinfusion. Osmotic resistance is decreased by 3 times. In fast technical exfusion the blood-hemolysis is more than 28%, what needs to be taken into account in carrying out technical IO RIC. According to CCI results, the faster the technical exfusion is done, the more significant is decrease of protein and bilirubin; besides, in both EC and clinical control. There is a higher concentration of K+, residual nitrogen and urea in blood collected during fast technical exfusion. According to CCI results, the number of thrombocytes is reliably decreased, especially due to the fast blood exfusion. The process of aggregation in these conditions is reliably slowing down; besides, in the fast blood exfusion mode it slows down twice in contrast to the controlled one. The period of plasma recalcification is surely  decreased to 40% due  to the high-speed mode of blood exfusion in comparison to the controlled indexes, which is 3 times higher than in the application of the slow blood aspiration.
Possibilities of endobiliary stenting with complex choledocholithiasis
Authors: Yurchenko V.V. , Uzakov O.J.
Published: March 2020

Objective:  To increase the effectiveness and safety of endosurgical treatment of choledocholithiasis.

Methods:  The set goal is achieved by studying the causes of unsatisfactory results of lithoextractions, improving its tactics and technology. Patients with known predictors of the futility of lithoextraction were excluded from the study. Based on the study of other causes of inefficiency namely strangulation of calculi with a basket, progression of obstructive jaundice, the addition of purulent cholangitis or postpapillotomy bleeding some new tactical rules and endosurgical techniques were formulated. Their effectiveness was tested in group of patients.

Results: When comparing the research and control groups, a decrease in the frequency of endosurgical treatment of choledocholithiasis was revealed.

Conclusion: The effectiveness of the proposed tactical principles and technological techniques has been proved.

Key words: endoscopic papillosphinctertomy, endoscopic lithoextraction, obstructive jaundice, purulent cholangitis, postpapillotomy bleeding.
DYNAMICS OF THE INDICATORS OF LUNG DESTRUCTION AND HORMONAL BACKGROUND AS A PREDICTIVE MARKER OF THE EFFECTIVENESS OF MULTIDRUG RESISTANT TUBERCULOSIS TREATMENT
Authors:   Department of Phthisiology and Pulmonology, Kharkiv National Medical University, Shevchenko Olga Stanislavna , Ovcharenko Irina Anatolyevna ,   Department of Phthisiology and Pulmonology, Kharkiv National Medical University, Shvets Olga Nikolaevna ,   Department of Phthisiology and Pulmonology, Kharkiv National Medical University
Published: March 2020

Objective: Study of the dynamics of indicators of pulmonary tissue destruction and hormonal background, as a marker for predicting the effectiveness of treatment of multidrug resistant tuberculosis (MDR TB). Methods: The study involved 84 patients with new cases of MDR TB, which were divided into groups with effective (group I) and ineffective (group II) treatment of tuberculosis. The criteria for the effectiveness of treatment of tuberculosis were the cessation of bacterial excretion and the closed cavity destruction. Results: It was found that in patients from group I, the levels of free hydroxyproline were lower than in group II during the first two months of treatment: at the beginning of treatment by 60%, after 2 months of treatment – by 29.4%. In both groups, there was an increase in this indicator during the first 2 months of treatment. The level of protein-bound hydroxyproline was higher in group I by 21.7%. The level of aldosterone in the groups at the beginning of treatment was almost the same. After 2 months of treatment, its level decreased in both groups. However, after 2 months of treatment in group I, its content was lower than in group II by 12.7%. In the course of treatment, the insulin resistance index in patients of both groups decreased to the norm, however, it remained higher in patients of group II (2.4±1.1 vs. 1.6±0.8). At the same time the level of insulin secretion in patients with a favorable course of the disease has decreased almost three times in compared with the baseline data (7.4 vs. 20.1 μU/ml), while in the group of patients with an unfavorable course it decreased only in 2 times (10.3 vs. 22.9 μU/ml). Conclusion: The obtained data allow recommending the study of indicators of carbohydrate metabolism, the reorganization of connective tissue and aldosterone in dynamics as an early marker of effective treatment of MDR TB. Keywords: Multidrug resistant tuberculosis, oral glucose tolerance test, insulin, protein bound hydroxyproline , free hydroxyproline.
SCREENING OF CHRONIC KIDNEY DISEASE IN TAJIKISTAN RESIDENTS
Authors:   Department of General Surgery № 1, Avicenna Tajik State Medical University, Gulov Makhmadshoh Kurbonalievich , Abdulloev Saidkhodzha Murtazoevich ,   Department of Epidemiology, Avicenna Tajik State Medical University
Published: March 2020

Objective: Assessment of the prevalence causes and risk factors for the development of chronic kidney disease (CKD) in the Republic of Tajikistan Methods: Screening of CKD and risk factors for its development among 374 persons in the course of scheduled prophylactic examinations in the urban health centers of Dushanbe city in 2017. The age of residents ranged from 18 to 82 years, averaging 55.2±12.3 years. Of these, 201 (53.7%) were females, 173 (46.3%) were males. The average weight of the examined was 85.9±11.2 kg, height – 168.3±6.92 cm, and body mass index (BMI) – 30.4±3.75. CKD was established on the basis of albuminuria, a reduction in glomerular filtration rate (GFR) and the identification of risk factors. Results: Albuminuria was detected in 63 (16.8%) residents (29 men; 34 women), more often among the age group 45-74 years (46 cases), as well as among patients with the first (n=34) and the second (n=11) degrees of obesity. Increased creatinine level in venous blood was detected in 37 patients with albuminuria (average concentration 165.5±52.5 μmol/l), mainly among people aged 45-74 years (n=23). A decrease in GFR was detected in 18 (9.9% of the total number of the examined) men and 19 (9.9% of the total number of the examined) women. A population-based screening of CKD based on the results of albuminuria, endogenous creatinine, and GFR, and other risk factors allowed us to identify various stages of CKD out of 63 cases of the positive result of albuminuria in 37 cases, which was 9.9%. The first stage of CKD was in 8 (21.6%) patients, the second stage in 15 (40.5%) patients, the third stage in 12 (32.4%) cases, and the fourth stage in 2 (5.4%) cases. Depending on age, CKD prevailed among people aged 45-74 years (62.1%). In young people (18-44 years), it occurred in 9 (24.3%) cases, and in elderly patients (75-90 years) – in 5 (13.5%) cases. Depending on the gender of the surveyed, various stages of CKD occurred in 18 (48.6%) men and 19 (51.4%) women, the diagnosis of CKD among the general population in men was 10.9%, in women – 8.9%. Conclusion: The incidence of CKD among the general population was 9.9%. Diagnosis of CKD is based on the determination of GFR and the detection of albuminuria. For the early diagnosis of CKD and adequate treatment, an algorithm has been proposed that is acceptable both economically and in terms of use in daily clinical practice. Keywords: Chronic kidney disease, screening, albuminuria, glomerular filtration rate, risk factors, prevention.
COMPLEX DIAGNOSTICS AND METHODS OF TREATMENT OF THE SYNDROME OF ENTERAL INSUFFICIENCY IN PATIENTS WITH ACUTE PANCREATITIS
Authors:   Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Ali-Zade Sukhrob Gaffarovich , Nazarov Shokhin Kuvvatovich ,   Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Kholmatov Pulat Kadyrovich ,   Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Dodikhudoev Rakhmatullo Alamshoevich ,   Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
Published: March 2020

In the given literary review are discussed the actual problems of diagnosis and treatment of the syndrome of enteral insufficiency, occurs against the background of acute pancreatitis. In patients suffering from acute pancreatitis, up to 80% of cases, enteral insufficiency syndrome (EIS) occurs, aggravating the processes of endotoxicosis. To date, the timely detection of EIS through the use of modern methods of research of detecting disorders is still considered to be influencing disorders of intestinal function. For full diagnosis of EIS are modern laboratory and instrumental studies, such as radiographic, ultrasound, electrogastroenterography, and also the bacteriological research of feces. Prokinetics (ganaton, metoclopramide derivatives, etc.), early intestinal lavage, and cleansing enemas are more often used to stimulate the intestine. It is considered that such a combined application of treatment methods has a great effect against enteroparesis which contributes to the consolation of the results of the EIS in acute pancreatitis. It should be noted that recently a great interest in scientists cause the issues of early enteral probe feeding. It was determined that the best results were the treatment of patients with the use of enteral probe feeding in combination with selective decontamination of the gastrointestinal tract. Thus, therapeutic measures for EIS are aimed at resolving enteroparesis. However, these therapeutic measures need further research as well as aspects of preventing the development of functional bowel disorders. Keywords: Enteral insufficiency syndrome, acute pancreatitis, diagnosis, treatment.
PREGNANCY AND TUBERCULOSIS: PROBLEMS AND THEIR SOLUTIONS
Authors:   Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University, Valdoshova Surmaniso Sharafovna , Dodkhoeva Munavvara Fayzulloevna ,   Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University, Sirodzhidinova Umriniso Yusupovna ,   Department of Phthisiopulmonology, Avicenna Tajik State Medical University
Published: March 2020

The authors analyzing the data of the world literature on tuberculosis, informs that its possible effect on pregnancy and vice versa – pregnancy on the course of tuberculosis in women. The main complications of pregnancy in women suffering from tuberculosis are threatened abortion, development of placental insufficiency and non-intrauterine delay in development fetal birth newborns with low birth weight infants and children with embryotype disease, due to the embryotoxic actions of some anti-tuberculosis drugs in their incorrect assignment. In this regard, there is a need to develop a common tactic of introducing pregnant women, as from the risk groups of action also and already infected with tuberculosis in order to reduce perinatal morbidity and mortality, as well as to prevent intrauterine infection Keywords: Infectious diseases, tuberculosis, pregnancy, outcomes of pregnancy.
FEATURES OF FREE RADICAL OXIDATION AND METABOLIC ACTIVITY OF VASCULAR ENDOTHELIUM IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Authors:   Department of Biochemistry, Avicenna Tajik State Medical University, Saburova Anna Mukhammadievna , Nasyrdzhonova Khursand Rakhimovna ,   Department of Biochemistry, Avicenna Tajik State Medical University, Sharipova Khursand Yodgorovna ,   Department of Propedeutics of Internal Diseases, Avicenna Tajik State Medical University, Kurbanova Masuda Bakievna ,   Department of Biochemistry, Avicenna Tajik State Medical University
Published: March 2020

Objective: To study the features of free radical oxidation and metabolic activity of the vascular endothelium in patients with chronic obstructive pulmonary disease (COPD). Methods: The results of the examination of 58 patients with COPD aged 28-54 years who were treated at the City Medical Center № 2 named after Academician K.T. Tadzhiev of Dushanbe city. There were 32 men (52.2%), and 26 women (44.8%). Free radical oxidation and the antioxidant system were predetermined by the content of reactive oxygen species (ROS), the amount of malondialdehyde (MDA), and the activity of superoxide dismutase (SOD). The state of the vascular endothelium was assessed by the content of C-reactive protein (CRP), fibrinogen, von Willebrand factor, total cholesterol, LDLP, and HDLP. Results: In patients with COPD in the serum, the intensification of free radical oxidation was noted in the form of an increase in the content of ROS by 30.1%, MDA by 125% and a decrease in SOD activity by 43.2% compared to the control. As a result, there is an imbalance between oxidants and antioxidants with the development of oxidative stress, which plays an important role in the pathogenesis of COPD. A study of the state of the vascular endothelium in patients with COPD revealed an increase in CRP by 16 times, fibrinogen by 61.5%, von Willebrand factor by 33.7%, total cholesterol by 30%, LDLP by 61.5% against a decrease in HDLP by 43.4% compared with control data. A correlation of ROS with fibrinogen (r=0.733817) was noted, which ultimately leads to endothelial dysfunction and the development of thromboembolic complications Conclusion: The course of COPD is accompanied by the development of a systemic inflammatory response, the starter of the mechanism which is oxidative stress, accompanied by an intensification of free radical oxidation, depletion of the antioxidant system. Oxidative stress contributes to damage to the vascular endothelium, the criteria of which are increased levels of CRP, fibrinogen, von Willebrand factor and an atherogenic lipid spectrum disorder (increased LDLP and total cholesterol, along with a decrease in HDLP) Keywords: COPD, free radical oxidation, endothelium, endothelial dysfunction, biochemical studies.
NEW APPROACH IN THE SPINAL DISC HERNIATION TREATMENT
Authors:   Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University, Rakhmonov Khurshed Dzhamshedovich , Berdiev Rustam Namozovich ,   Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University, Ali-Zade Sukhrob Gaffarovich ,   Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
Published: March 2020

Objective: Improve the surgical results of interventions for intervertebral hernias using modern technology Methods: The results of endoscopic surgeries performed by 82 patients were analyzed. All patients studied the clinical and neurological status before and after surgery, as well as CT and MRI. The results of the treatment were assessed by the MacNab scale, the severity of the pain syndrome – by the pain audit scale, and the parameter “quality of life” – by the questionnaire SF36 and the duration of the patient’s temporary disability Results: Assessment of remote postoperative MacNab scores was performed 6 months after surgery. At the same time, 69 (84.1%) patients had an excellent result. In 8 (9.8%) cases, a good result was observed (at the time of discharge, there was a significant decrease in pain syndrome); in 3 (3.7%) cases the result was satisfactory, and in 2 (2.4%) observations there was an unsatisfactory result. At the same time, there was no need to perform reoperation interventions on acute spine pains with the redevelopment of intervertebral hernia. Long-term results of surgical endoscopic interventions in 98.8% of observations showed great efficiency and small injuries. Conclusion: Endoscopic treatment of intervertebral disc hernia in comparison with the traditional open method helps to reduce the time of the operation and the terms of stay of the patient in a hospital and also more acceptable with the cosmetic point of view Keywords: Intervertebral disc hernia, endoscopy, pain syndrome, surgical treatment.
COGNITIVE DYSFUNCTIONS IN PATIENTS OF MIDDLE, ELDERLY AND OLD AGE IN THE LONG-TERM PERIOD AFTER CHOLECYSTECTOMY
Authors:   Department of General Surgery № 1, Avicenna Tajik State Medical University, Gulov Mahmadshoh Kurbonalievich , Safarzoda Abdullo Mumin ,   City Research Center for Resuscitation and Detoxification
Published: March 2020

Objective: To study the state of cognitive dysfunction in patients of middle, elderly and old age in the long-term period after cholecystectomy Methods: A study conducted on the state of cognitive dysfunctions in 306 patients with cholelithiasis, operated on at the City Clinical Emergency Hospital for the period 2012 to 2017. Long-term results studied at 12 and 24 months after cholecystectomy. Depending on age, the subjects divided into 3 groups: middle, elderly, and old (senile) age. The study included a standardized neurological examination on a brief scale of neuropsychological testing, «Examination of mental status» and a quantitative assessment of the «Drawing watches» test; cognitive impairment determined by the performance of attention «The arrangement of numbers according to the method of Wexler». In addition, the following tests conducted distribution and switching of attention according to Schulte; selectivity of attention by Munsterberg; Bourdon correction method and intellectual liability assessment Results: 26 (25.4%) middle-aged patients diagnosed with mild cognitive dysfunction. In 28 (27.4%) elderly patients, cognitive impairment characterized by the presence of a moderate degree of cognitive dysfunction. In 39 (38.2%) patients of senile age, cognitive impairment manifested by the inability to memorize new information, as well as to reproduce the information that was already available that however did not lead to social deadaptation. Conclusion: Operative-anesthetic trauma has a negative impact on the state of cognitive functions in elderly and senile patients with a non-burdened neuropsychiatric history in the late postoperative period after cholecystectomy. The prevalence of cognitive impairment in the late postoperative period after cholecystectomy diagnosed in 27.4% of elderly patients and in 38.2% of old patients. The clinical picture of late postoperative cognitive dysfunction in the patients observed and expressed in a decrease in mental performance, attention, memory, distribution and switching of attention, concentration rate and accuracy, and intellectual liability, which was the cause of their social discomfort and reducing the quality of life. Keywords: Age-related cognitive dysfunctions , cholelithiasis, cholecystectomy.
LEVELS OF MALONIC DIALDEHYDE AND SUPEROXIDE DISMUTASE IN CHILDREN FROM A ZONE WITH HEIGHTENED RADIATION BACKGROUND
Authors:   Department of Pediatric Diseases № 1, Avicenna Tajik State Medical University, Badalova Zebo Abdulkhayrovna , Dodkhoev Jamshed Saidboboevich ,   Department of Pediatric Diseases № 1, Avicenna Tajik State Medical University, Saburova Anna Mukhammadievna ,   Department of Biochemistry, Avicenna Tajik State Medical University
Published: March 2020

Objective: To study the content of superoxide dismutase (SOD) and malonic dialdehyde (MDA) in the blood of children by the influence of heightened radiation background. Methods: The levels of MDA and SOD in the blood were determined in 20 newborns and in 60 to 3-5 years old children living in the area of high radiation background. The control group included 80 children and newborns living in areas with a natural radiation background. The content of MDA was determined by the method of I.D. Stalnaya, and the level of SOD – by the method of reduction of nitro-blue tetrazole in serum. Results: Levels of MDA in children living in conditions with a natural radiation background, were: newborns – 0.065±0.003 μmol/l; 3 years old children – 0.073±0.003 μmol/l; children 4 years old – 0.065±0.003 μmol/l; children 5 years old – 0.060±0.002 μmol/l. At the same time, in children living in conditions of heightened radiation background, the level of MDA was higher, with the greatest level among newborns – 0.879±0.025 μmol/l. In children 3, 4 and 5 years, this values were 0.301±0.025; 0.338±0.027 and 0.671±0.049 μmol/l, accordingly. The content of SOD in children living in conditions with a normal natural radiation background was as follows: newborns – 12.7±0.2 c. u./l; children 3 years old – 13.1±0.1 c. u./l; children 4 years old – 13.4±0.1 c. u./l; children 5 years old – 13.1±0.1 c. u./l. At the same time, in children living in conditions of heightened radiation background, considerably low levels of SOD were detected: newborns – 11.5±0.2 c. u./l; children 3 years old – 11.7±0.1 c. u./l; children 4 years old – 11.5±0.1 c. u./l; children 5 years old – 11.5±0.1 c. u./l. Conclusion: The results of conducted research revealed the presence of oxidative stress and imbalance of the pro- and antioxidant systems in children living in conditions of heightened radiation background Keywords: Superoxide dismutase, malonic dialdehyde, radiation, children.