bluuebunny/crossref_metadata_2025 huggingface dataset:
El sujeto social, desde el postestructuralismo hasta la archivística, en la construcción y usos de la información
Authors: Florez Cortés Carla Cristina , Florez Cortés Sara
Published: February 2021

Este texto reflexiona sobre la visión del sujeto social desde la propuesta del enfoque teórico postestructuralista hasta su consolidación histórica con la perspectiva de la archivística. Relacionar los límites que establecen las ciencias sociales con los estudios sobre el individuo en sociedad, permitió dinamizar la categoría del sujeto, en la actualidad, como interlocutor de estructuras que se modifican según sus necesidades y usos de la información que finalmente, los conducen a registrar sus historias en documentos de archivo, situación que enmarca la profesión archivística.
El uso y dependencia al teléfono celular en estudiantes de licenciatura
Authors: Dorantes Carrión Jeysira Jacqueline , Reyes Estudillo Yaneth
Published: February 2021

En este texto se presentan los resultados de una investigación desarrollada en la Universidad Veracruzana (UV), donde se aplicó un instrumento piloto a 91 estudiantes universitarios que integran seis áreas de conocimiento: Artes, Ciencias Biológico-Agropecuarias, Ciencias de la Salud, Económico-Administrativa, Humanidades y Técnica, en la región de Xalapa. Entre los resultados se destaca que el 99% de los estudiantes en la UV utilizan un teléfono inteligente (smartphone); el 33.67% lo emplean de 4 a 6 horas continuas; el 52% prefieren usarlo en horario nocturno, de 6:00 p. m. a 12:00 a. m.; y el 76% lo ocupan cuando están en su casa.
La ética en las funciones sustantivas del personal académico de la Universidad Veracruzana
Authors: Hákim Krayem Mónica Rubiette , Fortuno Hernández Josefa Carolina , Del Callejo-Canal Diana Donají , Canal-Martínez Margarita Edith
Published: February 2021

Un Código de Ética es una carta de principios interna que guía los fines de la universidad y su finalidad es apoyar a la aplicación justa de las normas y estatutos legales de una institución educativa. De allí el objetivo de este artículo para identificar si los principios del Código de Ética de la Universidad Veracruzana, como referente formal de la conducta y carácter profesional de quienes la integran, se hace presente en la normatividad que rige las funciones sustantivas del personal académico, para otorgarle integridad y confianza a la institución como formadora de estudiantes que se desarrollarán en el ámbito laboral, social, económico y cultural del país con responsabilidad social y ética. Encontramos congruencias importantes y algunos vacíos respecto de las sanciones ante conductas no éticas que se pueden presentar y que pudieran ser un obstáculo en el cumplimiento de la razón de ser de la universidad.
El Plan de Desarrollo Municipal de Bucaramanga 2020-2023 bajo la sombrilla de las nuevas fuerzas del desarrollo
Authors: Corzo Arévalo Daniel
Published: February 2021

El presente estudio analiza el Plan de Desarrollo Municipal (PDM) de Bucaramanga para la gestión 2020-2023, en el marco de la teoría de las nuevas fuerzas de desarrollo propuesta por Vázquez (2005): organización flexible de la producción (OFP), difusión de las innovaciones y del conocimiento (DIC), desarrollo urbano del territorio (DUT) y cambio y adaptación de las instituciones (CAI). Partiendo de una conceptualización del término “desarrollo”, se analizó la relación entre las líneas y proyectos estratégicos del PDM con las cuatro fuerzas del desarrollo. De las cuatro nuevas fuerzas del desarrollo, DUT se reveló como la más relevante, siendo un elemento central de la mayoría de las líneas y proyectos estratégicos en el plan. Las otras tres fuerzas del desarrollo recibieron al menos una mención desde las líneas estratégicas del plan, mientras que los proyectos sólo incluyen OFP y DIC, dejando de lado la fuerza de CAI. La línea estratégica del PDM que apunta al bienestar social no corresponde con ninguna de las fuerzas del desarrollo planteadas por Vázquez (2005). Esto puede asociarse a un sesgo económico de esta teoría, que parece omitir aquellos factores que posibilitan el desarrollo humano.
Why is pollution embodied in Guangdong exports declining? The roles of trading scale, technology and structural changes
Authors:   Guangdong Provincial Academy of Environmental Science, Guangzhou 510045, China, Liang Long-Ni , Wang Ming-Xu ,   Guangdong Provincial Academy of Environmental Science, Guangzhou 510045, China, Siu Weast-Siu ,   Guangdong Provincial Academy of Environmental Science, Guangzhou 510045, China
Published: February 2021

From 2007 to 2017, Guangdong exports grew at an average rate of 9.6%, while the energy consumption and carbon emission embodied in these trades demonstrated a declining trend. Is total real pollution embodied in exports showing the same trend? If so, what accounts for these changes? Prior studies have provided three explanations, producing greater amount of goods (“the scale effect”), adopting cleaner technologies in production processes (“the technology effect”), and producing proportionally more goods that are environmental-friendly (“the structural effect”). Question then arises as which factor is the driving force of such cleanup in the export business? To answer these questions, an EIO-LMDI (Environmental Input-Output and Logarithmic Mean Divisia Index) model is built to conduct a structural decomposition analysis of pollution embodied in Guangdong exports. We calculate that the pollution embodied in Guangdong export fell by 63 to 85 percent, depending on the pollutants. We further conclude that these pollution reductions are primarily driven by the technology advancement, with some industries, including the clothing industry, communications, computers and other electronic equipment, being more sensitive to the changes in technologies than others. The structural effect is more ambiguous. It only contributes to pollution reduction when the industry itself is pollution intensive.
Plejotropowe działanie melatoniny
Authors: Dzierżewicz Zofia , Balwierz Radosław , Marciniak Dominik , Sarecka-Hujar Beata , Delijewski Marcin , Dolińska Barbara
Published: February 2021

Melatonin is a hormone synthesized mainly by the pineal gland. Its precursor is the exogenous amino acid L-tryptophan. The basic function of this hormone is the regulation of circadian and seasonal rhythms. As an amphiphilic molecule, melatonin can easily cross biological barriers, which is why its effects can be exerted through a variety of mechanisms. Both in experimental and clinical studies, the cardioprotective effect of melatonin has been demonstrated. Melatonin also plays a role in the regulation of the immune response. In addition, it is particularly effective in inactivating hydroxyl radicals, including the most reactive oxygen radical. Melatonin can inhibit the division of tumor cells by affecting the release of other hormones and substances involved in the process of carcinogenesis. It also limits the process of nerve cell death and adverse changes in the nervous system associated with the etiopathogenesis of Alzheimer’s disease. Melatonin is on the list of OTC preparations (over the counter), medicines available at the pharmacy without a prescription. This paper presents the biosynthesis of melatonin and its metabolism and discusses its physiological and clinical significance in the human body.
Wybrane czynniki ryzyka chorób układu sercowo-naczyniowego związane z miażdżycą tętnic jako problem zdrowotny wśród młodzieży ponadgimnazjalnej
Authors: Chmiel Zdzisława , Hejda Grażyna , Binkowska-Bury Monika
Published: February 2021

Introduction. A World Health Organization (WHO) conference on a “second wave” epidemic of cardiovascular diseases, directly linked to arterial sclerosis (AS), predicts that in 2020 cardiovascular diseases will most likely be the leading cause of death in the world. The development of AS begins in youth and progresses with age. It’s intensity depends on the risk factors involved, such as: smoking, hypertension, obesity and fat and sugar disorders in the body. Aim. The aim of this study was to establish the risk factors of cardiovascular diseases and their existence, among the youth of the upper gymnasium school. Material and methods. The research was conducted using 511 volunteer students from upper and lower gymnasium schools, between 16-19 years of age. Our research methods included: a diagnostic questionnaire, the measurement of blood pressure (BP) and anthropometric measurements. In the statistical study, we used chi-square independence testing, the V-Kramer test and the tau-b Kendall test; the level of changes α = 0.05 – was used. Results. Over a half of the study group (52.5%) was characterised with the lack of recommended physical activity, much more common in girls than boys (p = 0.000), just like smoking (p = 0.009) which was declared by 39.7% of the interviewed youth. In turn, a heightened value of systolic and diastolic pressure occurred more often in boys (19.6%) than in girls (12.1%); (p = 0.000 vs. p = 0.003). Excessive body mass was noted in 15.7% of the respondents, also more often in boys than in girls (p = 0.02), and abdominal obesity occurred in 10.2% of the respondents, with no significant differences between the sexes. 42.3% of the respondents showed one, 29.9% showed two and 18.8% showed three atherosclerosis risk factors. 9.0% of the study group showed 4 and more such risk factors. Accumulation of atherosclerosis risk factors occurred significantly more often in girls than in boys (p = 0.002). Conclusions. In all the respondents at least one atherosclerosis risk factor was found, and in over half of the study group, more frequently in girls than in boys, an accumulation of two or more risk factors was observed. Lack of recommended physical activity was the most frequent atherosclerosis risk factor occurring in the youth.
Kosmetyczne i lecznicze zastosowanie roślin ozdobnych
Authors: Radosz Andżelika , Klasik-Ciszewska Sylwia , Duda-Grychtoł Katarzyna
Published: February 2021

The main theme of this article is the cosmetic and medicinal use of ornamental plants. Its purpose is to present to the reader the beneficial effect of ornamental plants on the skin and the human body. Here you can find information on specific ornamental plants such as Aloe vera, Lavendula angustifolia, Calendula officinalis, Sea-buckthorn (Hippophae rhamnoides) and Rose canina, including their systematics, that is how they come from, what they look like and to which family they belong. The active substances, in which the individual parts of the plants contain the substances responsible for the cosmetic effect, are also described, and a description of the effects of these substances on the condition of the skin is provided. There are also cosmetic recipes that you can do yourself at home using specific raw materials. The article also contains information on the medicinal properties of the plant and its effects on the human body and the precautions to be taken when using the plant. This article seeks to present ornamental plants not only on the basis of their aesthetic qualities, but also on their broad spectrum of cosmetic and therapeutic activities.
Czy warto jeść algi?
Authors: Zdrojewicz Zygmunt , Bieżyński Bartosz , Krajewski Piotr
Published: February 2021

Algae is a very diverse group of aquatic and land organisms that has been used by humans for ages. Nowadays algae are constantly growing in popularity. Thanks to their richness in nutrients and bioactive components (mineral salts, carbohydrates, protein, EFA, vitamins or microelements), they have found use in dietetics and many branches of medicine. Due to an increase of algae-related studies, many biologically active compounds have been discovered. Described as anti-inflammatory, anti-bacterial, anti-viral, anti-allergic or even anti-cancer, marine algae may be used in the treatment of many diseases. Currently one of their main uses is related to obesity but the action of algae is much more than that. The vast number of edible algae species and their biological diversity significantly increase their potential and the growing amount of research they undergo, give us reasons to assume that marine algae can play a big part in “nutrition of the future”. The aim of this study is to present the nutrition value of marine algae and their significance in medical treatment.
Analiza porównawcza postawy uczniów nauczania początkowego Szkoły Podstawowej w Białych Błotach
Authors: Miszewska Agnieszka , Miszewski Waldemar Józef , Głowacka-Mrotek Iwona , Simińska Joanna , Hagner Wojciech
Published: February 2021

Introduction. This research thesis analyses the screening results of Grade 1 students, beginning their education in 2013, in three consecutive years. Aim. The aim of the thesis was: to establish the incidence of abnormal curvature in the three consecutive years among elementary school students, starting school in 2013; to determine the tendencies in the development of abnormal curvature. Material and methods. The research was conducted in the Primary School in Białe Błota. It is a retrospective thesis, consisting of 120 result specimens of screening of Grade 1 students in School Year 2013/14, 118 results of Grade 2 students in 2014/15 and 119 results of Grade 3 students in 2015/16. Results. The results were presented in one group: all classes (120 students), using general statistics. Within two years of school education, most abnormal curvature occurred in Grade 2. Out of 119 students, only two were of proper curvature. Conclusions. The asymmetries in the frontal plane in most cases were preceded by other abnormal curvature types. The highest percentage refers to spine defects in the sagittal plane and the defects of legs. The most common groups of defects occurring with the two years of school education are asymmetries in the frontal plane and flat-and-claw feet. The analysis of results did not confirm the relation between the number pf sports classes and the development of abnormal curvature. Abnormal curvature developed in a similar way both among children from the sports class and the general classes.
Występowanie obrzęku limfatycznego u kobiet poddanych mastektomii z powodu nowotworu piersi
Authors: Mesyasz Ewa , Milan Magdalena , Juzwiszyn Jan , Maj Agnieszka , Matuszewska Magdalena , Chabowski Mariusz , Janczak Dariusz
Published: February 2021

Introduction. Breast amputation is one of the most debilitating surgery which significantly limits physical, emotional and social functioning. Increasing the level of knowledge on consequences of mastectomy may improve outcomes in breast cancer patients. Aim. The assessment of lymphatic edema on the occurrence of functional limitations in women after mastectomy due to breast cancer. Material and methods. The study included 40 women after mastectomy aged from 40 to 80 years. The study was conducted based on a questionnaire created by authors which included questions about sociodemographic factors and quality of physical and emotional functioning in the social and environmental life. Results. 63% of respondents reported no edema and in 84% of them no respiratory problems were noted; the remaining 16% had breathing difficulties. Regarding women with lymphatic edema (37%), 33% of them confirmed respiratory problems, while 67% denied. Regarding women without lymphatic edema, 37% of them reported pain. 67% of women with lymphatic edema experienced pain at the operation site. Edema occurred more often in young women before 40 years of age (75%). Limited activity in the shoulder girdle joints on the side of operation was the most common in older women above 70 years of age. Conclusions. Women after mastectomy experience different symptoms depending of their age, which should determine varied therapeutic approach. Women below 50 years of age are more sensitive to the occurrence of pain. Physical problems prevail in older women which draws attention to the necessity of intensive nursing care especially in postoperative period. Young women often require psychological support.
KECENDERUNGAN PELANGGARAN PERJANJIAN UTANG PADA PERUSAHAAN KONSTRUKSI DAN PROPERTI DI BEI
Authors: Panjaitan Yunia
Published: February 2021

The importance of debt covenant violation is to minimize the debtholder default risk. The possibility of debtholder’s default risk may be caused by liquidity problems, low profitability, and bad quality of earnings. Hence, this study aims to proof the tendency of debtholder to violate debt covenants by measuring current ratio volatility, return on assets, and earnings quality as independent variables. By using five companies from construction and property sub-sector that listed on Indonesia Stocks Exchange in 2016- 2018, the data are analyzed with multiple linear regression model for panel data. From this study, we can conclude that the impact of return on assets to debt covenant violation is significantly negative, debtholders with poor financial performance have higher potential to do debt covenant violation. However, there is no evidence that debt covenant violation is affected current ratio volatility and earnings quality.
Physical Therapy Management of Older Adults With Hip Fracture
Authors: McDonough Christine M. , Harris-Hayes Marcie , Kristensen Morten Tange , Overgaard Jan Arnholtz , Herring Thomas B. , Kenny Anne M. , Mangione Kathleen Kline
Published: February 2021

Hip fracture is a leading cause of profound morbidity in individuals aged 65 years and older, ranking in the top 10 causes of loss of disability-adjusted life-years for older adults. Worldwide, the number of people with hip fracture is expected to rise significantly due to the aging population and other factors. Physical therapist management is recommended within medical, surgical, and multidisciplinary clinical practice guideline (CPGs) and is considered to be the standard of care in rehabilitation for people with hip fracture. The goal of this CPG was to review the evidence relevant to physical therapist management and to provide evidence-based recommendations for physical therapy diagnosis, prognosis, intervention, and assessment of outcome in adults with hip fracture. J Orthop Sports Phys Ther 2021;51(2):CPG1–CPG81. doi:10.2519/jospt.2021.0301
Exploring Networked Project Coordination in Combined Utility Streetworks
Authors: Léon L olde Scholtenhuis  , Timo Hartmann
Published: February 2021

Combined utility streetworks involve cable and pipeline owners and authorities that concurrently undertake work in the same physical space. In this networked project setting, ownership fragmentation and lacking formal coordination instruments complicate the integration of multi- stakeholder engineering and construction operations. Boundary spanners have a unique position to pursue integration in this complex system. To understand what it is that constitutes their practices, we explore them through Mintzberg’s seminal framework of informational, interpersonal, and decisional roles. Specifically, we extend the framework to the context of boundary spanning in networked projects by conducting semi- structured interviews with seven boundary spanners of combined utility streetworks: the so- called utility coordinators. Based on open coding of the interview data, we identified 149 performed activities, and twenty- three lower- level management roles (such as involving stakeholders; facilitating formal processes; and, creating a collective memory). Next, axial coding allowed us to tailor Mintzberg’s role model to networked project settings. Based on this, we reflect on how a setting that lacks formal coordination instruments influences the roles that boundary spanners adopt. This empirical study of coordination in networked projects contributes a case to the practice turn literature that calls for explorations of everyday organizational practices in their situated context. Other contributions are the extension of Mintzberg’s framework to networked projects; and, the development of two hypotheses about the position and roles of utility coordinators. Eventually, our findings may help practitioners identify what interpersonal and informational skills they need to improve alignment in loosely connected project networks.
Real Estate’s 21st Century Grand Challenges: The Big Issues and Project Management’s Role
Authors: Andrew Edkins  , Yolande Barnes  , Andrew Grainger  , Paul S. Chinowsky
Published: February 2021

This paper focuses on what real estate comprises, its forms of value in the 21st century and project management’s role and potential in strategic and front- end issues. The broad definition of real estate used is examined through the lens of current challenges and foreseeable major change drivers. Critical realism and engaged scholarship are employed to consider a wide range of primary data generated from multiple practitioner engagement exercises. This process has revealed eight themes that relate to real estate in the 21st century: 1. Digital Disruption, 2. Health and Wellbeing, 3. Learning Environments, 4. Accessible and Affordable Housing, 5. Beyond Placemaking, 6. Resilience, 7. Infrastructure Interfaces, 8. Community Inclusion. The value proposition of this paper is to illustrate the relevance and contribution of project management to real estate and to consider the implications from the proposed set of eight highly relevant, cross- cutting themes. Within the six principal implications identified, we show how project management in the 21st century needs to be more strategically focused and front- end orientated on issues that have been considered beyond the domain of traditional, technocentric and execution- orientated project management. These six implications are presented within the context of two forms of real estatecontext: that real estate which already exists and that real estate yet to becreated. While dominated by engagement with UK expertise, it is anticipated that the paper will be of interest to a global audience.
Riscos cardiovasculares em transgêneros: revisão da literatura
Authors: Sebastião Matheus Loureiro , Accardo Camila de Melo
Published: February 2021

Objetivo: Analisar problemas cardiovasculares em transgêneros em uso de hormônios, realizando uma análise crítica da literatura, destacando os pontos mais pertinentes sobre a saúde desta população. Métodos: Trata-se de uma revisão integrativa de características exploratórias, de natureza qualitativa, utilizando como bases de dados: EBSCO, SCieLO e PUBmed. Resultados: A literatura encontrada converge para risco de eventos tromboembólicos associada ao estrogênio, principalmente em uso de via oral. Porém, não apontam incremento clínico do risco cardiovascular, especificamente, em indivíduos XY. Sobre o uso de testosterona em indivíduos XX, a maioria dos trabalhos analisados concluiu que não existe associação entre o uso e o aumento de riscos cardiovasculares. Agonistas de GnRH que parece possuir implicações cardiovasculares, mas com poucos estudos disponíveis. Aspectos socioeconômicas e comportamentais parecem ser mais importantes, como o uso de tabaco, álcool e condições estressantes de vida. Considerações finais: O uso de hormônios em pessoas transsexuais, respeitando o princípio da beneficência, parece ser recomendável. Porém, o estudo sofre perdas por depender da qualidade dos trabalhos analisados, mas alcança sucesso em analisar, que o processo saúde-doença depende mais de aspectos básicos de saúde púbica e educação em saúde.
Potencialidades e desafios no exercício da preceptoria no estágio curricular supervisionado da graduação em enfermagem
Authors: Nunes Sandra Lúcia Dias , Pinheiro Maria Alzira Rêgo , De Mendonça Ana Elza Oliveira , Da Costa Marcelo Viana , De Araújo Ana Cristina Pinheiro Fernandes
Published: February 2021

RESUMO

Objetivo: Identificar potencialidades e desafios no exercício da preceptoria no estágio curricular supervisionado hospitalar da graduação em Enfermagem. Métodos: Estudo exploratório, descritivo de abordagem quali-quantitativa, realizado de maio a junho de 2018, em um Hospital Universitário do estado do Rio Grande do Norte. A coleta de dados envolveu respostas de um questionário de 21 enfermeiros preceptores. Para análise e interpretação dos dados, seguiram-se três etapas: pré análise das respostas, exploração do material e construção do discurso coletivo. Para análise estatística utilizou-se o software Alceste 4.9. Resultados: As experiências vivenciadas na preceptoria foram percebidas como satisfatórias pelos enfermeiros e os resultados foram agrupados em quatro categorias temáticas: potencialidades, dificuldades, sugestões e experiências. Os desafios identificados relacionaram-se, principalmente, a ausência da capacitação dos profissionais e protocolos para desenvolver a supervisão, a duplicidade de funções durante as atividades do preceptor e a desarticulação entre a instituição de ensino e serviço. Conclusão: A capacidade e a facilidade de comunicação entre preceptores e discentes destacaram-se como potencialidades para o exercício da preceptoria. Já à duplicidade de funções, à desarticulação entre instituição de ensino e serviço configuraram-se como desafios.
Programa “O Brasil Conta Comigo”: experiência de estudantes de enfermagem do Amazonas
Authors: Brasil Vivianne Brandt Pereira , Mota Breno de Souza , Costa Juliana Campelo , Pereira Mirelly Tavares Feitosa , Filho Adamor Cavalcante de Assis , Carvalho Aimée de Queiroz , Rocha Esron Soares Carvalho , De Souza Sineide Santos , Pina Rizioléia Marina Pinheiro
Published: February 2021

Objetivo: Descrever a experiência vivenciada por estudante de graduação em enfermagem no enfrentamento ao novo coronavírus (COVID-19) por meio do programa do governo federal “O Brasil Conta Comigo”. Relato de Experiência: Trata-se de um estudo qualitativo, de natureza descritiva do tipo relato de experiência, a partir da proposta realizada por Holliday para sistematizar vivências, sobre experiência vivida por acadêmicos de enfermagem durante o período de pandemia do novo coronavírus, no Programa do Governo Federal “O Brasil Conta Comigo”. No que diz respeito a experiência vivenciada pelos acadêmicos, incluem-se o desenvolvimento de ações gerenciais, assistenciais e atividades educativas no âmbito da Atenção Primária à Saúde com contribuição expressiva para o desenvolvimento da formação profissional e acadêmica. Considerações Finais: A experiência vivenciada mostrou-se desafiadora e proporcionou formação diferenciada em enfermagem por promover o aperfeiçoamento de habilidades gerenciais, assistenciais e educativas, favorecendo a formação crítica e reflexiva, por compreender e vivenciar as atribuições do profissional enfermeiro em meio à pandemia do novo coronavírus.
Transculturalidade na enfermagem baseada na teoria de Madeleine Leininger
Authors: Da Silva Elielson Rodrigues , De Alencar Emanoela Barros , Dias Edvalda Alves , Da Rocha Luciano Crispim , De Carvalho Sabrine Canonici Macário
Published: February 2021

Objetivo: Descrever através de uma revisão narrativa a importância do cuidado transcultural baseado na teoria de Madeleine Leininger com inserção na prática do enfermeiro. Revisão Bibliográfica: A Teoria da Diversidade e Universalidade do Cuidado Cultural é a única teoria que tem como enfoque principal o elo entre a cultura, o bem-estar e os cuidados em saúde e no momento atual existem poucos artigos com essa aplicabilidade no Brasil. No entanto, a enfermagem vem empregando esta teoria em vários campos de atuação e vem sendo utilizada em distintas temáticas, o que gera maior relevância para sustentação de sua validação sistemática e continua no país, visto que promove maior conforto ao paciente, preservando sua cultura, religião, etnia e crenças. Considerações Finais: O cuidado transcultural e o processo saúde-doença em enfermagem estão diretamente relacionados com a prática do enfermeiro no ambiente de trabalho, tendo como princípio o respeito pela diversidade cultural de cada indivíduo. Com base nas informações obtidas, a descrição da importância do cuidado transcultural de Leininger, ressalta que, o enfermeiro que insere essa teoria na sua área de trabalho terá mais autonomia na prática do cuidado, trazendo mais conforto ao paciente, preservando a cultura, religião, etnia e crenças do mesmo.
ROLE OF GENETIC POLYMORPHISMS ASSOCIATED WITH THROMBOPHILIA, PROTHROMBOTIC STATE AND FOLATE CYCLE DISTURBANCES IN WOMEN WITH REPRODUCTIVE DISORDERS
Authors: Киселева А. , Бутина Е. , Зайцева Г. , Попонина Е. , Игнатьев С. , Ярыгин Д. , Белоус И.
Published: February 2021

Введение. Причины осложнения беременности достаточно многообразны: хромосомные и генетические нарушения, эндокринопатии, анатомические, инфекционные, иммунные и тромбофилические факторы. До настоящего времени нет четкого представления об истинных составляющих нарушения гестационного процесса.
Материалы и методы. Проведено исследование аллелей, ассоциированных с тромбофилией и протромботическими состояниями, у 629 женщин и генов фолатного обмена у 277 женщин с отягощенным акушерским анамнезом.
Результаты. Проанализирован характер распределения «аллелей риска» у женщин с первичным бесплодием, осложненными родами, неразвивающимися беременностями и у женщин без отягощенного акушерского анамнеза. Представлены данные о частоте встречаемости генетических мутаций, ассоциированных с тромбофилией (F2, F5), протромботическими состояниями (F7, F13, FGB, ITGA-2, ITGB-3, PAI-1) и нарушениями фолатного обмена (MTFFR, MTR, MTRR) у женщин с репродуктивными расстройствами. Заключение. Обнаружены статистически значимые различия в частоте распределения гетерозиготной формы полиморфизма ITGB3 у женщин с первичным бесплодием и осложненными родами в сравнении с женщинами без репродуктивных неудач. Влияние других полиморфных генов, ассоциированных с тромбофилией, протромботическими состояниями и нарушениями фолатного обмена, на наступление, течение и исход беременности не подтверждено.

Introduction. The causes of pregnancy complications are quite multiformous: chromosomal and genetic disorders, endocrinopathies, anatomical, infectious, immune and thrombophilic factors. Until now there is no clear understanding of true components of gestational disorders.
Materials and methods. We studied alleles associated with thrombophilia and prothrombotic conditions (in 629 women) and folate metabolism genes (in 277 women) with burdened obstetrical anamnesis.
Results. The distribution of «risk alleles» in women with primary infertility, complicated delivery, non-developing pregnancy and at women without aggravated obstetric history was analyzed. Data about incidence of genetic mutations associated with thrombophilia (F2, F5), prothrombotic states (F7, F13, FGB, ITGA-2, ITGB-3, PAI-1) and folate metabolism disturbances (MTFFR, MTR, MTRR) in women with reproductive disorders are presented.
Conclusion. Statistically signifi cant diff erences in distribution rate of heterozygous form of ITGB3 polymorphism in women with primary infertility and complicated delivery in comparison with women without reproductive failures were found. Impact of other polymorphic genes associated with thrombophilia, prothrombotic states and disturbances of folate metabolism to onset, gestation course and outcome of pregnancy was not proved.
SIGNS OF THROMBOTIC READINESS IN PATIENTS WITH STABLE ANGINA PECTORIS AFTER CORONARY BYPASS SURGERY
Authors: Морова Н. , Цеханович В. , Никитин Н. , Файль И.
Published: February 2021

Введение. После коронарного шунтирования (КШ) все больные получают антиагрегантную терапию; несмотря на это тромбоз коронарных шунтов является основной проблемой коронарной хирургии.
Цель работы. Выявить лабораторные признаки протромботической готовности у больных, перенесших операцию КШ по поводу стабильной стенокардии напряжения.
Материалы и методы. Обследовано 47 мужчин (в возрасте 57,9H±H1,2 лет), страдавших стабильной стенокардией напряжения, через неделю после операции коронарного шунтирования (КШ). Отбор проб крови для исследования гемостаза осуществляли через 7–8 дней после операции, через 5 дней после отмены гепарина.
Результаты. По сравнению с группой из 26 здоровых мужчин у пациентов с ишемической болезнью сердца установлено существенное повышение содержания фибриногена (более чем в 2 раза), растворимых фибрин-мономерных комплексов (почти в 20 раз), Д-димеров (в 6 раз). Выявлены признаки активации сосудисто-тромбоцитарного гемостаза в виде значительного увеличения уровня фактора Виллебранда; у 29 пациентов из 47 обнаружен волчаночный антикоагулянт; у 27 пациентов найдены лабораторные признаки резистентности к ацетилсалициловой кислоте.
Заключение. Пациенты, перенесшие плановую операцию КШ, в раннем послеоперационном периоде имеют признаки протромботической готовности.

Introduction. All patients receive antiplatelet therapy after coronary bypass surgery (CBS); nonetheless thrombosis of coronary bypass grafts is the main problem of coronary surgery.
The aim of study: to identify laboratory signs of prothrombotic readiness in patients with stable angina pectoris undergoing CBS.
Materials and methods. We examined 47 men (57,9H±H1,2 years old) with stable angina pectoris one week after CBS. Hemostasis blood parameters were measured 7–8 days after surgery, 5 days after heparin withdrawal.
Results. Compared with group of 26 healthy men in patients with ischemic heart disease we found signifi cantly elevated levels of fibrinogen (more than 2-fold), soluble fibrin monomer complexes (almost 20 times), D-dimers (by 6 times). Considerable increasing of von Willebrand factor level was revealed as a sign of vascular-platelet hemostasis activation; in 29 (from 47)
patients lupus anticoagulant was detected; in 27 patients laboratory signs of resistance to acetylsalicylic acid were found.
Conclusion. Patients after planned CBS have signs of prothrombotic readiness in early postoperative period.
LOW MOLECULAR WEIGHT HEPARINS AND FONDAPARINUX IN THERAPY OF ANTIPHOSPHOLIPID SYNDROME: LABORATORY CONTROL AND APPLICATION
Authors: Середавкина В. , Решетняк М. , Насонов Л.
Published: February 2021

Лечение антифосфолипидного синдрома (АФС) — это пожизненная первичная и вторичная профилактика тромбозов. В связи с появлением новых антикоагулянтов вопрос выбора антитромботической терапии стал более сложным.
В статье рассматривается оптимизация подбора антикоагулянтов при АФС с позиции патогенеза болезни в зависимости от имеющихся факторов риска и коморбидности. Освещены достоинства и показания к регулярному контролю анти-Ха активности плазмы у больных первичным и вторичным АФС.

Therapy of antiphospholipid syndrome (APS) is a lifelong primary and secondary prophylaxis of thromboses. Due to appearance of new anticoagulants question of antithrombotic therapy choosing became more complicated. Optimization of anticoagulants selection at APS according pathogenesis, existing risk factors and comorbidity is discussed. Advantages and indications
for regular monitoring of plasma anti-Xa activity at patients with primary and secondary APS are presented.
PROTHROMBIN COMPLEX CONCENTRATES AS A TOOL OF PATIENT’S BLOOD MANAGEMENT
Authors: Буланов А.
Published: February 2021

Настоящая работа посвящена обсуждению актуального места и перспектив применения в клинической практике современных препаратов плазмы крови — концентратов протромбинового комплекса (КПК). Будучи комбинированными гемостатическими препаратами, КПК за более чем 50 лет клинического стажа проделали целую эволюцию, которая коснулась и их состава, показаний к применению, безопасности. Базовое предназначение КПК — реверсия эффекта кумаринов — расширена до неотложной коррекции нарушений гемостаза, связанных с дефицитом витамина К различного происхождения, коррекции гемостаза при посттравматической коагулопатии, печеночной коагулопатии, периоперационного гемостаза. Множество вопросов, касающихся использования КПК, обсуждаемых специалистами, говорят о потенциальных перспективах данных препаратов. В России зарегистрированы три препарата КПК: протромплекс, октаплекс и коаплекс.

This article presents the discussion of actual place and future application in clinical practice of innovative plasma preparations — prothrombin complex concentrates (PCCs). PCCs are combined hemostatic drugs; for more than 50 years of clinical experience their composition, indications for use and safety have evolved. The basic purpose of PCCs is the reversion of coumarins effect; it’s expanded to the urgent correction of coagulation disorders associated with vitamin K deficiency of different origin, correction of hemostasis in post-traumatic coagulopathy, liver coagulopathy, perioperative hemostasis. Experts discuss a lot of questions concerning PCCs usage; they talk about the potential prospects of these drugs. Three PCCs preparations are registered in Russias: protronix, octaplex and coaplex.
HEMORRAGIC COMPLICATIONS IN PATIENTS WITH ISCHEMIC HEART DISEASE AFTER PLANNED PERCUTANEOUS CORONARY INTERVENTIONS
Authors: Гуськова Е.В. , Комаров А.Л. , Самко А.Н. , Панченко Е.П.
Published: February 2021

Введение. Антитромбоцитарная терапия является основой медикаментозного лечения больных с различными проявлениями атеротромбоза. Совместный прием аспирина и блокатора P2Y12-рецепторов способствует более сильному ингибированию функции тромбоцитов и снижению риска тромботических осложнений по сравнению с монотерапией, но неизбежно ведет к увеличению числа различных кровотечений.

Цель исследования: изучение распространенности и клинических факторов риска кровотечений (по классификации BARC) у больных стабильной ишемической болезнью сердца (ИБС) после плановых чрескожных коронарных вмешательств (ЧКВ).

Материалы и методы. Обследовано 188 больных (средний возраст 61,4 ± 10,7 лет) со стабильной ИБС, подвергнутых плановому ЧКВ. Все больные получали стандартную антитромботическую, гиполипидемическую, антиангинальную и гипотензивную терапию и наблюдались в течение всего периода приема двойной антитромбоцитарной терапии (ДАТТ) – в среднем 1,1 ± 0,3 года.

Результаты. Показано, что малые (BARC 1) кровотечения возникают у половины пациентов, длительно получающих двойную антитромбоцитарную терапию, и не связаны с появлением больших (BARC 3-5) кровотечений.

Заключение. У больных с малыми (BARC 1) кровотечениями не было отмечено ни одного тромбоза стента, что может отражать эффективно проводимую антитромбоцитарную терапию.

The aim: to study the incidence and clinical risk factors of bleeding events (according to BARC classification) in patients with ischemic heart disease (IHD) after planned percutaneous coronary intervention (PCI).

Materials and methods. We examined 188 patients (mean age 61,4 ± 10,7 years) with IHD undergoing planned PCI. All patients received standard antithrombotic, hypolipidemic, antianginal and antihypertensive therapy and were monitored during the entire period of double antiplatelet therapy (DAPT) – an average of 1,1 ± 0,3 years.

Results. It was shown that small (BARC 1) bleedings occurred in half of patients under long-term antiplatelet therapy and were not associated with the occurrence of large (BARC 3-5) bleedings.

Conclusion. In patients with small (BARC 1) bleedings no cases of stent thrombosis were noted that can prove the effectiveness of DAPT.
FREQUENCY ASSESSMENT OF KEY HEMOSTATIC GENES POLYMORPHISMS AND OF FOLATE METABOLISM GENES IN PATIENTS WITH ISCHEMIC HEART DISEASE
Authors: Шкода О.С. , Шилова А.Н. , Козырева В.С. , Шевченко В.П.
Published: February 2021

Цель исследования: оценить частоту встречаемости некоторых ключевых генов-кандидатов и их возможный вклад в развитие ишемической болезни сердца (ИБС) у пациентов г. Новосибирска и Новосибирской области.
Материалы и методы. Обследован 391 пациент с ИБС и 449 условно здоровых доноров. Исследовали частоту встречаемости полиморфизмов ключевых генов системы гемостаза — F2: 20210 G > A, F5: 1691 G > A (Arg506Gln), F7: 10976 G > A (Arg353Gln), F13A1: 103G > T (Val34Leu), FGB: –455 G > A, ITGA2: 807 C > T (Phe224Phe), ITGB3: 1565 T > C (Leu33Pro), SERPINE1 (PAI-1): –675 5G > 4G и генов метаболизма фолиевой кислоты — MTHFR: 677 C > T (Ala222Val), MTHFR: 1298 A > C (Glu429Ala), MTR: 2756 A > G (Asp919Glu), MTRR: 66 A > G (Ile22Met).
Результаты. При анализе не обнаружено различий в частоте встречаемости всех исследованных генетических полиморфизмов между больными ИБС и условно здоровыми донорами.
Заключение. Обнаружено, что носительство мутации Лейдена повышает риск развития инфаркта миокарда (OR = 6,9) в возрасте до 55 лет.

Aim: to estimate the frequency occurrence of some key genes and their possible infl uence on the development of ischemic heart disease (IHD) in patients in Novosibirsk and Novosibirsk Region.
Materials and methods. We examined 391 patients with IHD and 449 relatively healthy donors. We investigated frequency of key hemostatic gene polymorphisms — F2: 20210 G > A, F5: 1691 G > A (Arg506Gln), F7: 10976 G > A (Arg353Gln), F13A1: 103G > T (Val34Leu), FGB: –455 G > A, ITGA2: 807 C > T (Phe224Phe), ITGB3: 1565 T > C (Leu33Pro), SERPINE1 (PAI-1): –675 5G > 4G and of folate metabolism genes — MTHFR: 677 C > T (Ala222Val), MTHFR: 1298 A > C (Glu429Ala), MTR: 2756 A > G (Asp919Glu), MTRR: 66 A > G (Ile22Met).
Results. Analysis revealed no diff erences in frequency of all tested gene polymorphisms between patients with IHD and relatively healthy donors.
Conclusion. It was found what presence of Leiden mutation increased risk of myocardial infarction (OR = 6,9) older than 55 years.
INTERACTION OF THROMBOLYTIC PROTEINASES COMPLEX LONGOLITIN AND ITS PRODUCER — MYCELIAL FUNGUS ARTHROBOTRYS LONGA — WITH ANTITHROMBOTIC DRUG PIYAVIT
Authors: Шаркова Т.С. , Павлова И.Б. , Подорольская Л.В.
Published: February 2021

Цель исследования: изучение взаимодействия комплекса протеолитических ферментов препарата лонголитин из анаморфного гриба Arthrobotrys longa с антикоагулянтным и антитромботическим препаратом пиявитом.
Материалы и методы. Препарат пиявит смешивали в разных разведениях с различными концентрациями лонголитина и определяли фибринолитическую активность (ФА) смеси. В другой серии опытов пиявит добавляли в погруженную культуру гриба-продуцента. По окончании эксперимента в пробах культуральной жидкости (КЖ) определяли ФА. Антикоагулянтные свойства КЖ измеряли методом рекальцификации и записи тромбоэластограммы при добавлении КЖ к плазме крови здоровых интактных крыс.
Результаты. В опытах in vitro пиявит дозозависимо угнетал ФА лонголитина до полного ее подавления при концентрации 16 мг/мл. Добавление пиявита к культуре гриба-продуцента вызывало усиление биосинтеза препарата с увеличением ФА. КЖ при этом обладала высокой антикоагулянтной активностью. Время рекальцификации и показатель R тромбоэластограммы в КЖ были статистически достоверно удлинены, увеличивалась и антиполимеризационная активность КЖ.
Заключение. Совместное применение двух антитромботических средства (лонголитина и пиявита) в исследовании in vitro привело к уменьшению фибринолитических, а значит, и тромболитических свойств лонголитина. Таким образом, одновременное использование этих препаратов требует осторожности.

Aim: to study the interaction of Longolitin (complex of proteolytic enzymes from anamorphic fungus Arthrobotrys longa) with anticoagulative and antithrombotic drug Piyavit.
Materials and methods. We mixed diff erent dilutions of Piyavit with various concentrations of Longolitin and determined fibrinolytic activity (FA) of the mixture. In other experimental series we added Piyavit to submerged culture of the fungus-producer. At the end of the experiment we determined FA in culture liquid samples (CL). Anticoagulative properties of CL were measured by recalcification method and thromboelastograms recording with CL addition to blood plasma of healthy intact rats.
Results. In in vitro experiments Piyavit dose-dependently inhibited FA of Longolitin until it’s completely suppression at concentration of 16 mg/ml. Piyavit addition to the culture of fungus-producer caused the enhancement of drug biosynthesis with FA increasing. At the same time CL had a high anticoagulative activity. Recalcifi cation time and parameter R of thromboelastogram in CL were statistically signifi cant elongated, also CL anti-polymerization activity increased.
Conclusion. Combined application of two antithrombotic agents (Longolitin and Piyavit) in in vitro study led to decreasing of fibrinolytic, and so thrombolytic properties of Longolitine. Thus, the simultaneous use of these drugs requires caution. Adding piyavit to the culture of the producer fungus led to an increase in the biosynthesis of the preparation. Thus, caution is needed at simultaneous using of these drugs.
Use of high-altitude climate in therapy of childrenwith idiopathic thrombocytopenic purpura in Kyrgyz Republic
Authors: Маматов С.М. , Эсенгелди А.К. , Махмануров А.А.
Published: February 2021

Введение. Вопрос о дальнейшем совершенствовании базисной терапии идиопатической тромбоцитопенической пурпуры (ИТП) по-прежнему широко обсуждается специалистами и является предметом оживленных дискуссий.
Цель исследования: изучить динамику геморрагического синдрома и количества тромбоцитов у детей с ИТП в процессе высокогорной климатотерапии и оценить эффективность воздействия высокогорной гипоксии на течение болезни.
Материалы и методы. В исследование включено 24 ребенка с хронической ИТП в возрасте от 5 до 14 лет (средний возраст — 10,25 ± 1,43 года) с длительностью заболевания от 4 до 8 лет. Для лечения детей поднимали на высокогорную базу Туя-Ашу (перевал Туя-Ашу, 3200 м над уровнем моря). Продолжительность лечения в высокогорье составляла 40 дней.
Результаты. К концу срока пребывания в горах значительно уменьшались проявления геморрагического синдрома, полностью купировался анемический синдром, количество тромбоцитов достоверно увеличивалось с минимума 22,1 × 109/л до максимума 108,4 × 109/л.
Заключение. Из 22 детей, получивших высокогорную климатотерапию, у 2 детей достигнута полная и у 15 — частичная ремиссия. У 4 детей улучшение клинико-гематологических показателей носило временный характер, и отсутствие эффекта зарегистрировано у 1 ребенка. Ремиссия достигнута у 77% больных детей.

Introduction. Further improvement of the basic therapy of idiopathic thrombocytopenic purpura (ITP) is still widely discussedby specialists and is the subject of lively discussions.
Aim: to study the dynamics of hemorrhagic syndrome and platelet count in children with ITP in the process of high-altitude climatotherapy and assess the eff ectiveness of high-altitude hypoxia exposure on the course of the disease.
Materials and methods. The study included 24 children with chronic ITP aged 5 to 14 years (mean age — 10.25 ± 1.43 years) with disease duration from 4 to 8 years. For treatment children were raised to Tuya-Ashu high-altitude base (mountain pass Tuya Ashu, 3200 m above sea level). The duration of treatment in highlands was 40 days.
Results. By the end of the treatment, the manifestations of hemorrhagic syndrome decreased signifi cantly, the anemic syndrome completely stopped, the platelet count increased significantly from minimum of 22.1 × 109/L to maximum of 108.4 × 109/L.
Conclusion. High-altitude climatotherapy received 22 children, 2 children had complete remission and 15 — part remission. In 4 children the improvement of clinical and hematological parameters was temporal, and the absence of eff ect was registered in 1 child. Remission was achieved in 77% of ill children.