bluuebunny/crossref_metadata_2025 huggingface dataset:
Somatostatin analogues in acromegaly and gastroenteropancreatic neuroendocrine tumours: past, present and future
Authors: Öberg Kjell , Lamberts Steven W J
Published: October 2016

Acromegaly is a hormonal disorder that arises when the pituitary gland secretes excess growth hormone (GH), which in turn stimulates a concomitant increase in serum insulin-like growth factor 1 (IGF-1) levels. Gastroenteropancreatic neuroendocrine tumours (GEP-NET) constitute a heterogeneous group of tumours that can secrete serotonin and a variety of peptide hormones that may cause characteristic symptoms known as carcinoid syndrome or other symptoms and hormonal hypersecretion syndromes depending on the tumour’s site of origin. Current medical therapy for the treatment of acromegaly and GEP-NET involves the administration of somatostatin analogues that effectively suppress excess hormone secretion. After its discovery in 1979, octreotide became the first synthetic biologically stable somatostatin analogue with a short-acting formulation of octreotide introduced into clinical practice in the late 1980s. Lanreotide, another somatostatin analogue, became available in the mid-1990s initially as a prolonged-release formulation administered every 10 or 14 days. Long-acting release formulations of both octreotide (Sandostatin LAR and Novartis) and lanreotide (Somatuline Autogel, Ipsen), based on microparticle and nanoparticle drug-delivery technologies, respectively, were later developed, which allowed for once-monthly administration and improved convenience. First-generation somatostatin analogues remain one of the cornerstones of medical therapy in the management of pituitary and GEP-NET hormone hypersecretion, with octreotide having the longest established efficacy and safety profile of the somatostatin analogue class. More recently, pasireotide (Signifor), a next-generation multireceptor-targeted somatostatin analogue, has emerged as an alternative therapeutic option for the treatment of acromegaly. This review summarizes the development and clinical success of somatostatin analogues.
Front Matter
Authors: Etikonomi Jurnal
Published: October 2016

Front Matter
Tetanus and Occam’s Razor: Almost Forgotten but Not Gone: A Case Report
Authors: Skuby Stephanie O. , Rhee Eunice , Thilo Elizabeth H. , Simões Eric A.F.
Published: October 2016

Tetanus is a rare disease in industrialized countries, largely due to the highly protective effect of immunization. We present a case of tetanus in a formerly preterm infant with myelomeningocele repaired in utero, who presented at 44 days of age with poor feeding, lethargy, and increased tone. His symptoms progressed despite a course of antibiotics for presumed meningitis. At 73 days of age (on 29th day of hospitalization), a clinical diagnosis of tetanus was made based on the presence of risus sardonicus, trismus, and generalized hypertonicity. Consequently, tetanus immune globulin, muscle relaxants, and metronidazole were administered. Five months later, the infant has had complete resolution of the hypertonicity, has regained normal jaw movement and swallowing, and is regaining oral feeding skills. This case involved a delay in diagnosis despite clinical symptoms and signs classic, in retrospect, for tetanus, highlighting the importance of recognizing the constellation of symptoms that should lead us to consider this rare diagnosis.
Establecimiento de la agroindustria palmera en la región del Catatumbo, Norte de Santander (1999 -2010)
Authors: Gutiérrez Montenegro Niyireth Fernanda
Published: October 2016

El artículo busca establecer la evolución del cultivo de la palma de aceite en la región del Catatumbo desde la década de los años noventa hasta el año 2010, analizando el modelo económico nacional, regional y departamental que impulsó este tipo de agroindustrias inmersas en políticas de desarrollo rural. A lo largo del análisis, se intenta demostrar que la evolución del cultivo de palma de aceite en la región, no solo respondió a políticas agrarias de fomento empresarial en el Catatumbo, Norte de Santander, sino a políticas internacionales de erradicación de cultivos de uso ilícito, y del desarrollo de economías extractivas insertadas en el mercado mundial de los agrocombustibles, en donde la economía campesina es desplazada por un nuevo orden de acumulación de capital, enmarcada en las agriculturas comerciales a gran escala.
América Latina fumigada y crisis de las commodities. El caso del glifosato de Monsanto
Authors: Bravo Elizabeth , Naranjo Alexander
Published: October 2016

Las empresas que lucraron del llamado “conceso de las commodities” en América Latina, enfrentan hoy una crisis debido a la caída del precio internacional de productos agrícolas, lo que les ha obligado a reacomodarse. Entre ellas se encuentra la empresa Monsanto, cuyo producto estrella, el herbicida glifosato (del cual la venta está atada a cultivos transgénicos resistentes al herbicida) enfrenta desde hace algunos años una serie de desafíos: con la expiración de su patente, empresas chinas producen masivamente un glifosato genérico más barato; la Agencia Internacional de Investigaciones del Cáncer lo categorizó como un “probable cancerígeno para humanos”,  por lo que varios países han prohibido su uso, y la crisis de las commodities ha hecho caer su consumo. Para enfrentar esta problemática, Monsanto ha desarrollado una serie de iniciativas para salir fortalecida de esta crisis: ampliar su oferta de plaguicidas, establecer megafusiones empresariales, presionar a los gobiernos para que adopten políticas que le favorezca; generando graves impactos en América Latina, región donde más se han expandido los cultivos transgénicos.
Medición del riesgo de suscripción mediante modelos internos en Solvencia II
Authors: Barañano Abasolo Aitor , De La Peña Esteban J. Iñaki , Garayeta Bajo Asier
Published: October 2016

Este trabajo aporta la elaboración del procedimiento para definir un modelo para calcular el riesgo de suscripción en Solvencia II. Para ello, se han utilizado datos de una cartera de multirriesgo, que se han ajustado a la mejor distribución estadística y, sobre esta, se ha aplicado una simulación de Montecarlo, en la que se sustenta el modelo propuesto. Posteriormente, se compara el capital de solvencia de la aproximación determinista de la normativa anterior frente al resultante de aplicar la fórmula estándar del QIS4. Los resultados obtenidos muestran que los capitales necesarios por solvencia para soportar el riesgo de suscripción dependen de la cartera en la que se basan y, por lo tanto, mide correctamente el riesgo.
Indicators of the environmental aspect of spatial order as a tool for the environmental protection in suburban areas
Authors: Mikołajczyk Malwina , Raszka Beata
Published: October 2016

The spatial range of the present analysis spans the rural and urban communities of Lower Silesia
region. The aim of the study was to determine the needs in terms of environmental protection
and development, due to environmental resources and equipment in the communal infrastructure. The environmental aspect of spatial order was evaluated. It was assumed that the implementation of the spatial order in the aspect of the environment is done by means of developing
that environment, and especially by the presence / absence of the biotic (natural) elements and
the presence / absence of technical infrastructure (utilities), as well as the proper use thereof.
Analyses were performed using the following indicators: the share of protected areas in the total
area of the community, the share of green areas in the total area of the community, forestation
rates, share of the population using sewage system in the general population of the community,
number of domestic sewage treatment plants and number of septic tanks per 1000 inhabitants,
as well as the total municipal waste per capita. Rural and urban communities were compared.
The data was obtained from GUS (Central Statistical Office), the local data bank. The results allowed for ranking the communities included in the study according to a hierarchy, and grouping
them in the terms of spatial order in the environmental aspect.
Fieldwork approach to determining the extent of agricultural land abandonment — case study
Authors: Czesak Barbara , Cegielska Katarzyna , Cherkes Bohdan , Różycka-Czas Renata , Salata Tomasz
Published: October 2016

Agricultural land abandonment is an elusive phenomenon, as yet not fully defined. Even though
it is common in Polish landscape, there are no measures to date that could quantify the phenomenon. Neither the data from the Central Statistical Office, nor the data from land registers
include information on land abandonment. Therefore, there is a need for a systematic approach
that could quantify and determine the extent of land abandonment.
A fieldwork approach was designed for the purpose, and research was conducted on a test area
of Okocim village in Małopolska region. Vegetation cover that could indicate the existence of
land abandonment on the agricultural areas – such as trees, brushwood, and grass cover – was
examined using a representative sample of 145 test fields.
The fieldwork approach revealed that the extent of land abandonment in the test area is 37%
of all areas officially classified as agricultural, which shows that the scale of the phenomenon is
significant, and that there is a need to develop an approach to provide a more detailed picture of
the distribution of land abandonment.
A method for modeling selected elements of a building based on the data from terrestrial laser scanning
Authors: Głowacka Agnieszka , Pluta Magda
Published: October 2016

Latest reports in subject literature, both Polish and international, testify to significant needs for
the application of 3D models of architectural objects. There are many methods of 3D modeling,
including methods of automatic extraction from point cloud, mesh nets, and manual methods.
Despite being highly time-consuming, the manual methods still provide the best accuracy of
fitting the model into a point cloud, which suggests the possibility of their use for various purposes, including 3D visualization, and architectural inventory taking. This article presents the
methods of manual 3D modeling of the teaching facilities at the University of Agriculture, using
the features of MicroStation V8i. The paper discusses examples of modeling the various elements of a research facility, including architectural details, while giving the exact procedure, as
well as pointing to major causes of possible errors. In addition, the paper presents various levels
of detail within the 3D models, taking into account the requirements of the CityGML standard,
published by the Open Geospatial Consortium.
Climate change and its importance for agricultural production
Authors: Kocur-Bera Katarzyna
Published: October 2016

Agricultural production, which takes place in rural areas, is the sector of the economy, which is
the most dependent on the natural conditions of weather. The climate changes, which are taking
place, and the extreme phenomena, which are their consequence, affect precisely these areas the
most. The content of the present work is the exploration of the definitions of natural variability,
extreme phenomena and disasters, and the analysis of the statistics on natural disasters. In the
final part of the paper, we have indicated, which support instruments for farmers are available in
such events on the part of the State. Climate change is a fact, and unless we realize that, it will be
difficult to take any action allowing us to adapt to the new conditions.
ASPEK BIOLOGI DAN PARAMETER POPULASI IKAN TONGKOL ABU-ABU (Thunnus tonggol) DI PERAIRAN LANGSA DAN SEKITARNYA
Authors: Wagiyo Karsono , Febrianti Endah
Published: October 2016

Ikan tongkol abu-abu (Thunnus tonggol) merupakan salah satu jenis ikan pelagis yang bersifat oseanodromous, bernilai ekonomis tinggi dan hidup pada perairan neritik. Sampai saat ini belum banyak diperoleh hasil penelitian ikan tongkol abu-abu di Selat Malaka, khususnya di Perairan Langsa. Penelitian ini bertujuan untuk mengetahui aspek biologi dan parameter populasi tongkol abu-abu di perairan Langsa. Pengumpulan data dilakukan pada bulan Maret-September 2014. Analisis parameter populasi menggunakan program FAO-ICLARM Stock Assessment Tools (FiSAT). Hasil penelitian parameter biologi ikan tongkol abu-abu di perairan Langsa menunjukkan analisis hubungan panjang-beratnya diperoleh pola pertumbuhan yang bersifat alometrik negatif dengan nilai b = 2,710. Nisbah kelamin jantan terhadap betina sebagai 1,18 :1,0. Dengan uji Chi-square diperoleh rasio tersebut dalam kondisi seimbang. Musim pemijahan ikan betina berlangsung antara bulan Mei-Juni. Pengamatan isi lambung dengan metode index of preponderan diperoleh makanan utama ikan tongkol adalah ikan teri (Stolephorus spp.), diikuti oleh potongan ikan campur dan potongan udang. Panjang pertama kali ikan tongkol yang tertangkap dengan pukat cincin lebih besar dari panjang pertama kali matang gonada (Lc=40,34 cm,FL; > Lm=38,9 cmFL. Analisis parameter populasi ikan tongkol abu-abu diperoleh panjang asimtotik (L ) sebesar 55,65cmFL, laju pertumbuhan (K) sebesar 1,5/tahun. Laju kematian total (Z) sebesar 4,06/tahun, kematian alami (M) sebesar 1,99/tahun dan kematian karena penangkapan (F) sebesar 2,07/per tahun. Laju eksploitasi (E) pada saat ini sebesar 0,51 atau berada dalam tingkat optimal.
KARAKTERISTIK HABITAT IKAN KERAPU DI KEPULAUAN KARIMUN JAWA, JAWA TENGAH
Authors: Mujiyanto Mujiyanto , Syam Amran Ronny
Published: October 2016

Perairan Kepulauan Karimunjawa merupakan pemasok ikan kerapu bagi wilayah Pantai Utara Jawa. Permintaan dan harga pasar yang sangat tinggi mendorong nelayan lebih intensif dalammelakukan penangkapan ikan kerapu. Kegiatan penangkapan ikan kerapu selama ini dilakukan pada malam hari dengan alat bantu kompresor dan tembak. Kegiatan tersebut merupakan salah satu usaha untuk mendapatkan jumlah tangkapan yang tinggi tanpa memperhatikan kelestarian habitat dasar perairannya. Penelitian bertujuan untukmengetahui keeratan hubungan ikan kerapu dengan karakteristik habitatnya. Metode yang digunakan adalah deskriptif eksploratif. Penelitian dilaksanakan selama 3 tahun (2011; 2012 dan 2013), waktu sampling masing-masing tahun penelitian berdasarkan musim. Pengamatan visual sensus sepanjang garis transek pada dua kedalaman 5-6 m dan 10-11 m. Hasil penelitian menunjukkan habitat ikan kerapu pada kedalaman ±5-6 meter adalah non karang serta substrat mati lainnya. Selain itu, ikan-ikan kerapu cenderung bergerak ke perairan yang lebih dalam. Karakteristik habitat pada kedalaman ±10-11 meter menunjukkan ikan kerapu lebih menyukai dasar perairan dengan habitat karang keras yang didominasi oleh gundukan karangmassive yang membentuk celah atau lubang lubang. Perilaku ikan kerapu bergerak dan berpasangan di tempat yang agak gelap (rendah visibilitas) dengan intensitas cahaya yang rendah. Perbedaan habitat kehidupan ikan kerapu pada kedalaman 5-6 dan 10-11 meter adalah dominasi karang jenis Pavona sp dengan tingkat visibilitas perairan yang rendah.Karimunjawa Islands is a supplier of grouper fish for the north coast of Java. Grouper fishing activities have been carried out fishing done at night with a compressor and shooting aids. Fishing activity is an effort to get the number of catches were high regardless habitat resources of waters. The research aims to determine the correlation grouper fish with habitat characteristics. Method be used is descriptive exploratory method. The research was done in over three years (2011; 2012 and 2013), each sampling of research based on season time. The observations visual census along on line transect at two depths (± 5-6 and ± 10-11 meters). The results showed that habitat in depth ± 5-6 meters, that grouper fish was found in non-reef habitats and other death substrates, as well as show grouper fish tend to move to deeper waters. Characteristics habitats in a depth of ±10-11 meters prefers bottom waters with hard coral habitats with dominated by massive coral mounds are a lot of gaps or holes. Behavior grouper fish move and paired witha low visibility (low intensity of light). Differences habitats of grouper fish life in depth ± 5-6 and ± 10-11 meters is coral dominated by Pavona sp and low visibility of water level.
STRUKTUR KOMUNITAS IKAN DAN TINGKAT TROFIK DI WILAYAH GENANGAN WADUK JATIGEDE PRAINUNDASI, KABUPATEN SUMEDANG-JAWA BARAT
Authors: Warsa Andri , Soewardi Kadarwan , Hariyadi Sigid
Published: October 2016

Waduk Jatigede dibangun dengan membendung Sungai Cimanuk dan  memiliki luas 4.122 ha serta merupakan waduk multifungsi. Tujuan penelitian ini adalah untuk mengetahui struktur komunitas ikan dan pemanfaatan sumber daya makanan oleh beberapa jenis ikan yang terdapat di DAS Cimanuk wilayah genangan Waduk Jatigede pra inundasi. Penelitian dilakukan setiap bulan pada Februari-Mei 2015 setiap bulan pada minggu pertama. Sampel ikan diperoleh dengan menggunakan jaring insang, jala, dan pancing. Percobaan penangkapan dilakukan di Sungai Cialing (inlet), Genteng, Cimanuk dan Cinambo (outlet). Ikan yang tertangkap dipisahkan berdasarkan jenisnya dan diukur panjang total serta ditimbang bobotnya. Untuk analisis kebiasaan makan kebiasaan makan, saluran pencernaan diambil dan diawetkan dengan formalin 4%. Untuk identifikasi contoh ikan diawetkan dengan formalin 10%. Ikan yang tertangkap selama penelitian sebanyak 11 jenis. Ikan yang dominan adalah lalawak dan genggehek. Rasio biomassa-kelimpahan ikan menujukkan bahwa komunitas ikan di Waduk Jatigede sebelum penggenangan dalam kondisi terganggu. Jenis makanan alami yang dimanfaatkan oleh komunitas ikan di Sungai Cimanuk wilayah genangan Waduk Jatigede adalah detritus, krustase, annelida, insekta, moluska, tumbuhan dan fitoplankton.

 

Jatigede Reservoir  was build with damming of Cimanuk River has about  4.122 ha surface area as wel as multi purpose reservoir. The aim of the research is to known the fish community structure and trophic level by fishes community at Cimanuk River arround Jatigede Reservoir pre inudated. The research was carried out in February-May 2015. Fish sample was obtained by using gillnet, hook and cast net. The experimental fishings were setting at Cialing (inlet), Genteng, Cimanuk and Cinambo (outlet). Fish sample were separated according speciesand was measured of total lenght. To the analisys of food habits, digestive tract was preserved using formalin 4%. For identification, fish sample  was preserved using formalin 10%. About 11 fish species were recorded. Dominan fish catches were Barbonymus balleroides and Mystacoleucus marginatus. According to Abundance-Biomass Comparisson, fish community was under pressure (unstable). Natural feeds observed were detritus, crustacea, annelida, insecta, molusca, plant and phytoplankton. 
KESEHATAN TERUMBU KARANG DAN STRUKTUR KOMUNITAS IKAN DI PERAIRAN PANTAI PANGANDARAN, JAWA BARAT
Authors: Hartati Sri Turni , Rahman Arip
Published: October 2016

Keanekaragaman jenis ikan karang merupakan suatu indikator penting yang dapat menggambarkan perubahan lingkungan perairan karang. Perubahan habitat karang adalah resiko yang mungkin dihadapi sebagai akibat pembangunan.  Penelitian dilakukan di perairan pantai Pangandaran dengan tujuan mengkaji kesehatan terumbu karang dan indeks ekologis komunitas ikan karang. Metode yang digunakan dalam penelitian ini adalah line intercept transect untuk menentukan persen tutupan karang dan metode sensus visual untuk menentukan keanekaragaman ikan karang pada area seluas 250m2. Hasil penelitian menunjukkan kesehatan terumbu karang pada kondisi buruk, tutupan karang hidup 11,4 -20,74%. Teridentifikasi 66 jenis ikan karang dengan kriteria kepadatan sangat jarang (0,59 – 0,91) ind/m2. Indeks kekayaan ikan karang pada kategori baik (4,60-8,68), keanekaragaman jenis ikan karang termasuk dalam kategori sedang (2,57-3,36). Tidak terjadi dominasi jenis ikan karang tertentu (0,05-0,120) dan kemerataan populasi di lokasi penelitian termasuk tinggi (0,81-0,87).

 

Reef fish diversity is a major indicator to expose a current environmental state of coral reefs. Economic developments probably lead to habitat alteration risks. The research was conducted in Pangandaran Beach Waters, Batu Karas, Pananjung Barat, Pananjung Timur. The research objective was,  to assess the reef health, and to fine out several diversity indices of reef fish communities. Methods used for those are a line intercept transect and census visual technique within area of 250 m2. The results showed that all of the area had a poor reef health category(11,4-20,74%), reef fish densities were grouped in very rare areas, especially < 1-5 ind/m2. Richnes indices had a good category(4,60-8,68), shannon diversity indices of reef fish felt in the fair category(2,57-3,36), dominance indices of reef fish felt in the low category(0,05-0,120) and evenness indices were felt in a high category(0,81-0,87).
NENUSILEIDUSIOS SĖKLIDĖS MORFOLOGIJOS, PADĖTIES IR HISTOLOGIJOS SANTYKIS
Authors: Bilius Vytautas , Baltrūnaitė Jūratė , Verkauskas Gilvydas , Puzinas Albertas , Dasevičius Darius , Eidukaitė Audronė , Jankauskienė Augustina , Trainavičius Kęstutis , Hadziselimovic Faruk
Published: October 2016

Reikšminiai žodžiai: kriptorchizmas, prielipas, Ad spermatogonijos, tubulių fertilumo indeksas, nevaisingumas. Darbo tikslas. Nustatyti sėklidės – prielipo santykio ir sėklidės padėties sąsajas su tubulių fertilumo indeksu bei tamsių (Ad) spermatogonijų ir kanalėlių santykiu sergantiems kriptorchizmu pacientams. Tyrimo medžiaga ir metodai. Prospektyvinėje studijoje ištyrėme 57 berniukus, 2013–2015 metais Vilniaus universiteto ligoninės Santariškių klinikų filialo Vaikų ligoninės Urologijos skyriuje operuotus dėl vienpusio kriptorchizmo. Berniukai su abipus nenusileidusiomis sėklidėmis ir įgytu kriptorchizmu nebuvo įtraukti į tyrimą. Orchidopeksijos metu įvertinta nenusileidusios sėklidės – prielipo morfologija ir sėklidės padėtis. Atliktas nenusileidusios sėklidės biopsijos histologinis tyrimas. Bioptatas fiksuotas 2 proc. glutarataldehidu, nudažytas toluidino mėliu ir ištirtas šviesiniu mikroskopu, padidinus 400 kartų. 1 μm storio preparatuose buvo skaičiuojamas tubulių, germinacinių ląstelių ir Ad spermatogonijų skaičius; apskaičiuotas tubulių fertilumo indeksas bei Ad spermatogonijų ir kanalėlių santykis. Statistinė duomenų analizė atlikta SPSS 20.0 statistine programa. Skirtumai laikyti statistiškai reikšmingi, kai p < 0,05. Rezultatai. Pacientų amžiaus vidurkis – 1,42 ± 0,83 metų (nuo 0,58 iki 4,6 m.). Pagal nenusileidusios sėklidės ir jos prielipo santykį sudarytos 4 grupės: (I) normalus sėklidės – prielipo suaugimas 11 (19,3 proc.), (II) suaugimas tik prielipo galva – 22 (38,6 proc.), (III) suaugimas tik prielipo galvos dalimi – 17 (29,8 proc.) ir (IV) visiškas nesuaugimas – 7 (12,3 proc.). Pagal padėtį pacientai pasiskirstė 3 grupėse: (A) nenusileidusi sėklidė pilvo ertmėje 2 (3,5 proc.), (B) kirkšniniame kanale 16 (28,1 proc.) ir (C) ties išoriniu kirkšninio kanalo žiedu 39 (68,4 proc.). Ad spermatogonijų ir kanalėlių santykis buvo didesnis sėklidėse su normaliu komplekso suaugimu ir žemesne nenusileidusios sėklidės padėtimi. Statistiškai reikšmingas šio histologinio rodiklio skirtumas rastas tarp I ir II (p = 0,036), II ir III (p = 0,005), I ir IV (p = 0,027), III ir IV (p = 0,003) bei B ir C (p = 0,02) grupių. Tubulių fertilumo indeksas tarp grupių statistiškai reikšmingai nesiskyrė. Išvados. Ad spermatogonijos, kaip normaliai vykstančio mažojo brendimo rodiklis, turi ryšį su sėklidės – prielipo suaugimo laipsniu. Taip pat germinacinių ląstelių vystymasis, išreikštas Ad spermatogonijų atsiradimu, yra susijęs su nenusileidusios sėklidės padėtimi. Vis dėlto tyrimo rezultatai turėtų būti vertinami atsargiai dėl mažo tiriamųjų skaičiaus ir nenusileidusios sėklidės padėties bei morfologijos aprašymo sudėtingumo.
PERKUTANINIO TRANSHEPATINIO TULŽIES LATAKŲ PIKTYBINIŲ STRIKTŪRŲ STENTAVIMO NEDENGTAIS NITINOLIO SAVAIME IŠSISKLEIDŽIANČIAIS STENTAIS ARTIMIEJI IR ATOKIEJI REZULTATAI
Authors: Pranculis Andrius , Vaičius Artūras , Kievišas Mantas , Kievišienė Lina , Kaupas Rytis Stasys , Dambrauskas Žilvinas
Published: October 2016

Reikšminiai žodžiai: piktybinė tulžies latakų obstrukcija, tulžies latakų stentavimas, perkutaninis transhepatinis stentavimas (PTS), nedengti nitinolio savaime išsiskleidžiantys stentai. Perkutaninis transhepatinis tulžies latakų stentavimas (PTS) – tai paliatyvi minimaliai invazyvi procedūra, galinti pašalinti vėžinių ligų sukeltą tulžies latakų obstrukciją. Ši procedūra dažniausiai pasirenkama, kai radikalus chirurginis gydamas dėl naviko išplitimo ar gretutinių ligų negalimas, o endoskopinis stentavimas nesėkmingas arba techniškai neįmanomas. Tikslas. Įvertinti perkutaninio transhepatinio tulžies latakų piktybinių striktūrų stentavimo, atlikto naudojant metalinius (nitinolio) nedengtus savaime išsiskleidžiančius stentus, artimuosius ir atokiuosius rezultatus. Tyrimo medžiaga ir metodai. Nuo 2007 m. iki 2015 m. gegužės mėn. prospektyviai buvo kaupiami ir analizuojami duomenys apie atliekamas PTS procedūras LSMUL KK Chirurgijos ir Gastroenterologijos klinikose. Į tyrimą įtraukta 215 pacientų, kuriems atliktas PTS panaudojant metalinius (nitinolio) nedengtus savaime išsiskleidžiančius stentus. Vertinta, kokios ligos sukėlė tulžies takų obstrukciją, PTS trukmė ir sėkmė, komplikacijos po procedūros, pakartotinių stentavimų dažnis ir priežastys, stento funkcionavimo laikas, išgyvenamumas, bendro bilirubino koncentracijos kraujo serume pokyčiai lyginant koncentraciją prieš procedūrą ir per 2–5 dienas po jos. Proksimalinių latakų striktūros tipas buvo vertinamas pagal Bismutho- Corlette klasifikaciją. Išgyvenamumas analizuotas Kaplano-Meierio metodu. Rezultatai. Techniškai sėkmingos buvo 95,8 proc. visų intervencijų, geras gydomasis efektas pasiektas 82,8 proc. atvejų. Daugiausia striktūrų buvo bendrojo tulžies latako srityje (34,4 proc.). Iš proksimalinių latakų striktūrų dažniausias buvo I striktūros tipas (bendrojo kepenų latako srityje), rečiausias – IV, todėl didžiajai daliai pacientų (73 proc.) užteko vieno stento. Pakartotinis stentavimas atliktas 23 pacientams (10,7 proc.). Dažniausios restentavimo priežastys buvo stento užsikimšimas arba dislokacija, kurios pasireiškė 7 proc. pacientų. Dažniausios komplikacijos – kraujavimas be hemotransfuzijos poreikio, sepsis ir cholangitas. Bendras komplikacijų dažnis siekė 14,4 proc. Bendro bilirubino koncentracija serume 2–5 d. po PTS sumažėjo statistiškai reikšmingai (vidutiniškai per 111,4 μmol/l, p < 0,001). Vidutinė išgyvenamumo trukmė nuo PTS procedūros atlikimo datos buvo 137,4 ± 19,6 d. 30 dienų mirštamumas siekė 14,9 proc., su procedūra susijusių mirčių nebuvo. Išvados. PTS metaliniais nedengtais savaime išsiskleidžiančiais stentais yra efektyvus ir saugus metodas paliatyviai gydant pacientus su intrahepatinių ar ekstrahepatinių tulžies latakų obstrukcija, sukelta lokaliai išplitusių pirminių ar metastatinių navikų.
VAIKŲ ŪMINIO VIDURINĖS AUSIES UŽDEGIMO GYDYMAS TRETINIO LYGIO LIGONINĖS SKUBIOS PAGALBOS SKYRIUJE IR PAGALBA NAMUOSE
Authors: Jakštas Tomas , Lesinskas Eugenijus , Gradauskienė Eglė , Byčkova Jekaterina
Published: October 2016

Reikšminiai žodžiai: ūminis vidurinės ausies uždegimas, otalgija, skubios pagalbos skyrius. Ūminis vidurinis otitas yra viena dažniausių mažų vaikų infekcinių ligų, kuri ypač paplitusi 3 mėnesių–3 metų amžiaus grupėje. 2013 metų lapkričio–2014 metų kovo mėnesiais Vilniaus universiteto ligoninės Santariškių klinikų filialo Vaikų ligoninės priėmimo skyriuje buvo atliekamas tyrimas, siekiant išsiaiškinti vidurinio ausies uždegimo gydymo taktikos pasirinkimą tretinio lygio sveikatos priežiūros įstaigoje bei tėvų pasirenkamus pirmosios pagalbos teikimo būdus. Į tyrimą buvo įtraukta 116 pacientų, kurie atvykę skundėsi ausies skausmu. Apklausiant tėvus apie teiktas pirmosios pagalbos priemones dažniausiai būdavo prisipažįstama, jog jokių priemonių nebuvo imtasi ir skausmui nepraeinant jie atvyko į priėmimo skyrių (N = 50, 43,10 proc.). Kiti tėvai rinkdavosi pagalbą duodami ibuprofeno arba paracetamolio (N = 40, 34,48 proc.). Karščiuojantys vaikai statistiškai reikšmingai dažniau gaudavo antibakterinį gydymą negu nekarščiuojantys (p < 0,01). Esant išpūstam ausies būgneliui, antibakterinis gydymas buvo skiriamas dažniau negu nesant būgnelio išsipūtimui (p < 0,01). Esant nepermatomam ausies būgneliui, antibakterinis gydymas buvo skiriamas dažniau negu esant permatomam ar silpnai permatomam (p < 0,01), o pacientai, kurių timpanograma buvo B tipo, gaudavo antibakterinį gydymą statistiškai reikšmingai dažniau nei esant A ar C tipo timpanogramoms (p < 0,01). Remiantis atlikto tyrimo metu gautais rezultatais galima teigti, jog antibakterinis gydymas pacientams buvo skiriamas motyvuotai ir atitiko naujausias ūminio vidurinio otito gydymo rekomendacijas tretinio lygio gydymo įstaigos priėmimo skyriuje (atsižvelgiant į pacientų amžių, jų simptomų sunkumą ir trukmę). Reikėtų pastebėti, jog didžioji dalis tėvų nesiėmė pirmosios pagalbos veiksmų namuose ir stengėsi atvykti į skubios pagalbos skyrių į budinčio otorinolaringologo konsultaciją
MODERN METHODS OF DEEP VEIN THROMBOSIS DIAGNOSIS: LITERATURE REVIEW
Authors: Zostautiene Indre , Zviniene Kristina , Kiudelis Mindaugas
Published: October 2016

Reikšminiai žodžiai: giliųjų venų trombozė, kompresinis ultragarsinis tyrimas, daugiasluoksnė kompiuterinė tomografija, magnetinis rezonansas, venografija. Venų tromboembolija (VTE) – tai dvi tarpusavyje susijusios patologijos: plaučių embolija (PE) ir giliųjų venų trombozė (GVT). Giliųjų venų trombozė išlieka svarbi sveikatos sistemos problema, kadangi yra susijusi su komplikacijomis, turinčiomis aukštą sergamumo ir mirtingumo rodiklį: ūminė ir lėtinė plaučių embolijos, plautinė hipertenzija ir potrombozinis sindromas. Paprastai GVT prasideda blauzdos venose, bet gali tęstis proksimaliau ir sąlygoti gyvybei pavojingą plaučių emboliją. Klinikinėje praktikoje labai svarbi šios ligos profilaktika ir gydymas, tad aktuali yra ankstyva ir tiksli diagnozė, įvertintant tikslią GVT vietą ir apimtį. Apibendrinus literatūros duomenis, straipsnyje apžvelgiami radiologinės diagnostikos metodai kojų giliųjų venų trombozei nustatyti, radiologinių tyrimų privalumai ir trūkumai.
SPONTANEOUS IMPROVEMENT OF IDIOPATHIC INTRACRANIAL HYPERTENSION DURING PREGNANCY: CASE REPORT AND A SHORT LITERATURE REVIEW
Authors: Randakevičienė Goda , Gleiznienė Rymantė , Nylander Rūta , Laurenčikas Evaldas
Published: October 2016

Reikšminiai žodžiai: idiopatinė, intrakranijinė, hipertenzija, nėštumas, nutukimas. Idiopatinė intrakranijinė hipertenzija yra nežinomos kilmės liga, pasireiškianti padidėjusiu intrakranijiniu slėgiu, optinių diskų patinimu, normalia smegenų skysčio sudėtimi ir normaliu neurologiniu tyrimu. Jaunos ir nutukusios vaisingo amžiaus moterys ypač dažnai serga šia patologija. Anksčiau buvo manoma, kad nėštumas yra vienas šios ligos rizikos veiksnių. Šiame straipsnyje mes pristatome jauną, nutukusią moterį, kuri kreipėsi dėl simptomų, susijusių su padidėjusiu intrakranijiniu slėgiu, ir kuriai buvo diagnozuota idiopatinė intrakranijinė hipertenzija. Jai buvo paskirtas medikamentinis gydymas. Pacientei pastojus, gydymas medikamentais buvo nutrauktas dėl galimo teratogeninio poveikio vaisiui. Nepaisant nutraukto gydymo, intrakranijinis slėgis dar sumažėjo, o klinikiniai simptomai pagerėjo. Nėštumas ir gimdymas buvo be komplikacijų. Pacientei ligos simptomai vėl atsinaujino nutraukus laktaciją. Ligonei buvo atlikta skrandžio padalinimo operacija (gastric bypass) dėl nutukimo. Praėjus šešiems mėnesiams po operacijos, pacientės svoris gerokai sumažėjo, simptomai pranyko, o intrakranijinis slėgis sumažėjo iki normalaus. Mūsų žiniomis, spontanškas idiopatinės intrakranijinės hipertenzijos simptomų pagerėjimas nėra anksčiau aprašytas literatūroje. Straipsnyje taip pat pateikiama trumpa literatūros apžvalga šia tema.
SUNKAUS SEPSIO IR SEPTINIO ŠOKO SUKELTOS ORGANŲ SISTEMŲ DISFUNKCIJOS PREVENCIJA IR GYDYMAS
Authors: Gaižauskas Ernestas , Judickas Šarūnas , Balčiūnas Lukas , Ščupakova Nadežda , Mockutė Lina , Šerpytis Mindaugas , Šipylaitė Jūratė
Published: October 2016

Reikšminiai žodžiai: sunkus sepsis, septinis šokas, plaučius tausojanti ventiliacija, pakaitinė inkstų terapija, stresinės opos. Sepsis – žalingas sisteminis organizmo atsakas į infekciją, sukeliantis daugelio organų sistemų pažeidimą. Sepsio atvejų skaičius kasmet didėja ir pastaraisiais metais aplenkė sergamumą miokardo infarktu. 2007 m. Jungtinėse Amerikos Valstijose sergamumas sunkiu sepsiu pasiekė 343 atvejus 100 000 gyventojų, o sergančiųjų miokardo infarktu skaičius 2008 m. – 208 atvejus 100 000 gyventojų. Deja, nepaisant vis naujų gydymo naujovių, mirtingumas nuo sepsio pasaulyje išlieka didelis – nuo 30 iki 50 atvejų 100 000 gyventojų per metus. Sunkus sepsis pažeidžia daugelį organų sistemų, o jų nepakankamumo derinys – dauginis organų disfunkcijos sindromas – pagrindinė didelio mirštamumo priežastis. Net ir laiku diagnozavus bei pradėjus pradinį gydymą, išlieka didelė organų sistemų pažeidimo rizika. Atsiradus organų pažeidimui, kitas uždavinys – laiku ir tinkamai užtikrinti saugią pažeistų organų sistemų veiklą. Šių principų pritaikymas klinikinėje praktikoje siejamas su mažesniu mirštamumu, hospitalizacijos trukme ir gydymo sąnaudomis. Šios apžvalgos tikslas – pateikti įrodymais pagrįstas sunkaus sepsio ir septinio šoko sukeltos organų sistemų disfunkcijos prevencijos ir gydymo rekomendacijas.
Prevalence of cardiovascular disease risk factors among shipping professionals
Authors: Agaeva K F , Gadzhizade S A
Published: October 2016

Aim. To perform comparative assessment of the prevalence of cardiovascular disease risk factors among the main groups of shipping professionals (captains, their assistants, mechanicians, machinists, electrical officers, and sailors).Methods. Monitoring was conducted by the continuous coverage of males under the age of 40 years, recognized as apparently healthy based on the planned complex preventive examinations in the system of the Azerbaijan State Caspian Shipping Company.Results.The proportion of overweight people (body mass index >25.0 kg/m2) was the highest in the group of captains and their assistants (50.0±6.7%) and the lowest in the group of electrical officers (38.2±5.9%). In the group of captains and their assistants an average weight is significantly higher than that in the group of mechanicians, electrical officers and sailors (pConclusion. Among apparently healthy shipping professionals younger than 40 years in the system of the Azerbaijan State Caspian Shipping Company cardiovascular disease risk factors (overweight and obesity, abdominal obesity, hypercholesterolemia, dyslipidemia ≥32,1%, smoking) are common; the total cardiovascular risk among shipping professionals depends on the type of professional activity (higher among machinists, captains and their assistants, less among the sailors).
Changes in functional activity of the retina after vitrectomy in patients with diabetic retinopathy
Authors: Shahbazova N A
Published: October 2016

Aim. To evaluate the functional state of the retina according to multifocal electroretinography and visual acuity in patients with proliferative diabetic retinopathy before and after vitrectomy.Methods. 18 patients (19 eyes) were examined. Mean age was 57±15 years. All of patients were diagnosed with proliferative diabetic retinopathy complicated by vitreomacular traction syndrome. All the patients underwent vitrectomy. Visual acuity was measured and multifocal electroretinography was performed in all patients before and after surgery.Results. During the optical coherence tomography, retinal profile deformation was revealed. Central retinal thickness was 347±106 microns. The average density of bioelectrical response of the macular area in patients with proliferative diabetic retinopathy complicated by vitreomacular traction, was sharply reduced and amounted to 44.987 nV/deg, in parafoveal area - 14.20 nV/deg. 1 month after vitrectomy averaged density of macular region bioelectrical response slightly increased and amounted to 51.52 nV/deg, in parafoveal area - 18.94 nV/deg. Visual acuity in patients before surgery was in average 0.09 (0.699 LogMAR). 1 month after pars plana vitrectomy visual acuity rose to an average of 0.32 (0.749 LogMAR).Conclusion. In proliferative diabetic retinopathy, retinal thickness is increased, which is accompanied by multifocal electroretinography amplitudes depression; the correlation between morphological parameters of foveal avascular zone and its bioelectric activity was revealed.
Clinical evaluation of mechanism of precipitate labor
Authors: Zhelezova M E , Malceva L I , Zefirova T P
Published: October 2016

Aim. To study the clinical course of pregnancy, labor and features of the structural changes in the cervix in women with precipitate labor.Methods. We observed 186 women who delivered vaginally at 37-41 weeks of gestation. Main (I) group consisted of 146 women with precipitate labor. The comparison group (II) consisted of 40 women with a standard duration of delivery. Morphological and immunohistochemical study of cervical tissue, determining the expression level of collagen genes COL1A2 and SOL3A1 in the cervix and blood of women of studied groups were performed. Material sampling was carried out in the early postpartum period.Results. In absolute majority of cases precipitate labor is not accompanied by intense patrimonial activity. Multiple complications develop during delivery, post-natal and early neonatal periods in 60% of patients with the precipitate labor. Pregnancy in women with a complicated course of precipitate labor occurs amid the infectious disease with predominant localization in the lower genital tract. The results of histological study of cervical tissue show numerous inflammatory changes. The expression levels of collagen genes in women with precipitate labor multifold exceed those in women with physiological duration of delivery.Conclusion. Pathologic outcomes of precipitate labor are caused not by the character of patrimonial activity, but by adverse infectious background; accelerated cervical remodeling plays a key role in the genesis of precipitate labor; high rate of collagen metabolism in these women constitutes the epigenetic realization of the genetic determinants, formed under the influence of a number of exogenous and endogenous factors.
Methods of surgical treatment of bilateral paralytic laryngeal stenosis
Authors: Alimetov A Ch
Published: October 2016

Median stenosis of the larynx, occurring due to paresis or paralysis of the vocal cords, is the most severe pathology in terms of disablement, the treatment complexity and further rehabilitation. Amid the high surgical activity on the organs surrounding larynx, an increase in patients with this pathology is observed. The main surgical approaches in the treatment of bilateral paralytic laryngeal stenosis are described. Two main variants of surgical interventions are emphasized: static - aimed at mechanical expansion of airway lumen, dynamic (functional) - aimed at vocal cord mobility restoration. In considering options aimed at the mechanical expansion of the laryngeal lumen, surgical technique is conventionally used. Most of the authors used removal of the anatomical structures of the larynx to expand its lumen - the vocal cords, arytenoid cartilage, or both at the same time. However, when using these methods, there are possibility of cicatricial changes in violation of the mucosal integrity with recurrent stenosis, eruption of ligatures with the return of the vocal cords in the original position in lateral fixation. In a number of surgical approaches the high invasiveness, technical complexity of execution, as well as the violation of the protective function of the larynx were registered. Among the dynamic methods neuroplasty with an attempt to restore the laryngeal muscles innervation by suturing intersected part of the nerve «end-to-end» and «end-to-side»; myoplasty, when to restore the vocal cords mobility surrounding muscles of the neck were used; neuromuscular plastic, when reinnervation was performed using nerve-muscle flap, were described. The methods are functional, but they have their own disadvantages. The necessity of further search for effective methods of treatment was shown.
Health risk assessment for adolescents depending on environmental factors and lifestyle
Authors: Efimova N V , Myl’nikova I V
Published: October 2016

Aim. To assess the risk of developing non-carcinogenic health disorders in adolescents depending on environmental factors and lifestyle.Methods. Calculation of daily doses in inhalation exposure of substances was performed according to the monitoring data of The Federal Service for Hydrometeorology and Environmental Monitoring of Russia (ambient air of Angarsk) in 2003-2014 and the results of the control of impurity levels (formaldehyde, carbon monoxide, nitrogen dioxide, suspended solids) in ambient air, as well as in the air of study rooms and living accommodations, conducted in the laboratory of physical and chemical methods of investigation. The study of the impact of lifestyle factors was performed according to the results social hygienic survey of adolescents. Health problems in adolescents were identified as a result of the medical examination conducted with the participation of the pediatrician, ophthalmologist, otolaryngologist, neurologist, orthopedist, endocrinologist.Results. It has been established that the risk of non-carcinogenic effects for adolescents of industrial city and suburban villages was caused by the presence of formaldehyde and suspended solids, mainly in indoor air. For adolescents living in areas with low exposure, the health risks were associated with the concentration of suspended solids in ambient air and indoor air. The adverse impact of lifestyle factors was observed only in urban adolescents. High relative risk of scoliosis, valgus feet, and flat feet was found for adolescents with insufficient physical activity, myopia - for those with long-term working at a computer.Conclusion. The results are indicative of the specificity of the effects of combined factors (ambient air pollution and lifestyle) on the developing body; adolescents living in the city have higher relative risk of diseases of the upper respiratory tract, musculoskeletal system, visual organs, and autonomic dysfunction syndrome.
Retracted: Experience of cooperation in the creation of hematopoietic stem cells donors registry
Authors: Murzabekova M A , Neredko J S , Marchenko Ya M
Published: October 2016

This article has been retracted.
Aim. To evaluate the experience of participating in the creation of a national registry of hematopoietic stem cells donors.Methods. Potential hematopoietic stem cells donor filled out a questionnaire, after the examination, he was assigned an individual donor code (bar code). The results of typing and questionnaires are placed on the registry of potential hematopoietic stem cells donors. Maintenance of HLA-typed potential hematopoietic stem cells donors registry and the selection of compatible «donor-recipient» pairs in RMSPC «Rosplazma» were performed using a specialized program «Prometheus» (Steiner Ltd., Czech Republic).Results. 484 donors, who were indigenous peoples of Stavropol and Stavropol Krai, as well as representatives of the North Caucasus small nations of different nationalities, were included into the registry for the period from 08.20.2013 to 20.06.2014. Age ranged from 19 to 42 years. As of 31.10.2015, 31 491 potential hematopoietic stem cells donors (54% - female, 46% - male) were included into the registry, 28 509 donors were typed: 24 310 for HLA - A, B, C, and DRB1 loci; 2305 for HLA - A, B, C, DRB1, and DQB1 loci; 1894 for HLA - A, B, and DRB1 loci. The registry has the highest number of A-B-DRB1 typed donors among Russian registries. New HLA-alleles in the Russian populations were revealed in 57 cases for 28 509 typing (1:500).Conclusion. There is a clear need to enhance cooperation of RMSPC «Rosplazma» with all regions of Russia and create unified national registry of hematopoietic stem cells donors with its inclusion in international databases.
Comparative assessment of morbidity of the population above working age in the Russian Federation and Novosibirsk region
Authors: Pogodina V A , Babenko A I , Babenko E A , Gusel’nikova N A
Published: October 2016

Aim. To conduct a comparative analysis of the overall morbidity of the population above working age (55 years for women and 60 years for men) in the Russian Federation and Novosibirsk region according to the data of patient attendance in 2009-2014.Methods. The method of computing the mean value with amplitude of fluctuations by years, the analytical method were used. The data of official statistical compilations: Federal State Statistics Service (Rosstat), «Healthcare in Russia» and «Russian Statistical Yearbook» were analyzed.Results. The difference in increase in the morbidity rate between the Russian Federation (42.4‰), and the Novosibirsk region (85.8‰) was 43.4‰, with difference of 36.0‰ in the value fluctuation amplitude by years. The main differences in the prevalence of diseases in the Russian Federation are characterized by higher rates of musculoskeletal system and connective tissue disorders, diseases of the skin and subcutaneous tissue, urogenital disorders, diseases of the ear and mastoid process (an increase by 23.2; 19.5; 18.9 and 12.8%, respectively), and in the Novosibirsk region - diseases of the blood and blood-forming organs, endocrine disorders, neoplasms, certain infectious diseases, injury and poisoning, digestive system diseases (by 33.3; 28.1; 16.8; 14.9; 13.5 and 11.1%, respectively).Conclusion. Morbidity of the population above working age is higher in the Novosibirsk region; the differences in the indices of morbidity structure between the Russian Federation and the Novosibirsk region were identified.
Self-expanding nitinol stent in combined treatment of bleeding from esophageal varices
Authors: Loginov A V , Mamkeev E Kh , Anisimov A Yu
Published: October 2016

Aim. To assess the capabilities of endoscopic hemostasis using self-expanding nitinol stents as an alternative to balloon tamponade using Sengstaken-Blakemore probe-obturator in the combined treatment program of patients with acute bleeding from esophageal varices.Methods. In 15 of the 266 patients with portal hypertension of various origins and with high risk of rebleeding (or at the height of the latter) endoscopic hemostasis with Danis self-expanding nitinol stents was performed instead of the traditional balloon tamponade using Sengstaken-Blakemore probe-obturator.Results. In all 15 cases, the Danis stent was inserted under intravenous general anesthesia with preservation of spontaneous breathing, using direct laryngoscopy. 5 of the 15 inserted by the manufacturer’s instructions stents (33.3%) migrated into the stomach: 1 did not deploy at all, 4 were in the expanded form. 10 (66.7%) stents were successfully inserted in a standard position in the esophagus without any complications. This was confirmed endoscopically immediately after the delivery device removal. In 2 of 4 patients who was inserted Danis stent at the height of esophageal bleeding, a reliable hemostasis was achieved. In none of the 15 cases, we did not observe any complications associated with the presence of the stent in the esophagus or its removal procedure. 4 of 15 patients (26.7%) died, despite the achieved endoscopic hemostasis, against the background of progressive multiple organ failure.Conclusion. Endoscopic hemostasis in a combined treatment program of patients with bleeding from esophageal varices using Danis self-expanding nitinol stents can be considered as a reasonable alternative to balloon tamponade using Sengstaken-Blakemore probe-obturator.