bluuebunny/crossref_metadata_2025 huggingface dataset:
Mariposas (Lepidoptera: Papilionoidea) de Arequipa, Perú: Lista preliminar con dos nuevos registros para Perú
Authors: Farfán Larico Jackie
Published: December 2018

Se presenta una lista de 74 especies de mariposas diurnas registradas para el Departamento de Arequipa, Perú. Se reporta por primera vez para Perú las especies Strymon flavaria (Ureta 1956) e Hylephila herrerai MacNeill 2002, ambas descritas del norte de Chile. Se suministran datos de distribución local para cada una de las especies. Se brindan comentarios para aquellas especies citadas en la literatura para el Departamento de Arequipa y que fueron excluidas de la presente lista preliminar por errores de identificación y/o ubicación geográfica.
Recusa da vacinação em área urbana do norte de Portugal
Authors: Fonseca Margarida Silva , Varela Maria da Assunção L. N. , Frutuoso Assunção , Pinto Monteiro Maria de Fátima F. R.
Published: December 2018

AIMS: To know the number of vaccine refusals and to investigate the reasons for non-compliance with vaccination by the parents of children and adolescents living in an urban area of northern Portugal.METHODS: A cross-sectional study was carried out with a sample of children/adolescents up to the age of 14 enrolled in health units in a metropolitan area of Porto, Portugal, belonging to the health centers groupings of Porto Ocidental, Porto Oriental, Gaia, Gondomar and Matosinhos, whose parents refused any vaccination of the National Vaccination Program in the period from January 2009 to December 2015. We studied the characterization of the sample and the reasons for vaccine rejection through the application of a questionnaire to parents.RESULTS: We identified 150 cases of children/adolescents to whom the parents refused any vaccine, in a global population of 103,406 children, resulting in a vaccine refusal rate of 0.14%. The highest rate occurred in the Porto Ocidental health centers grouping: 0.31%. Among the 150 cases, 86 parents accepted to respond to the questionnaire, corresponding to an adhesion rate of 64%. The median age of children/adolescents whose parents refused vaccination was seven years; most of them were healthy and had no perinatal problems. All parents were adults, mostly married and female. Most parents had a college degree and were professionally active. The Porto Oriental health centers grouping was the one where the parents who refused vaccines were mostly males, had a higher academic level and were more professionally active. The vaccine with the highest refusal rate was BCG, followed by anti-human papillomavirus and measles, mumps and rubella vaccine. The four main reasons for vaccination refusal by the parents were "vaccines are not a priority", "vaccines are not safe", "indication of the attending physician" and "fear of side effects." The reason for the "indication of the attending physician" was in all cases referred to the BCG vaccine.CONCLUSIONS: In this population the vaccination refusal rate was low; however, based on the results obtained, intervention efforts can be directed towards the families, aiming at combating the arguments without scientific basis and obtaining an unequivocal adhesion to the National Vaccination Program in Portugal.
Recém-nascidos com risco de toxoplasmose congênita, revisão de 16 anos
Authors: Andrade Joana Verdelho , Resende Catarina , Campos Joana , Batista Cristina , Faria Cristina , Figueiredo Cecília , Bastos Vitor , Andrade Nuno , Andrade Isabel
Published: December 2018

AIMS: To analyze the data on pregnancies with risk of congenital toxoplasmosis and to investigate the newborns' outcome, in a level II hospital in Portugal.METHODS: A cross-sectional retrospective study included newborns at risk for congenital toxoplasmosis and their mothers, whose delivery occurred between January 2000 and December 2015. The inclusion criteria were mother with seroconversion to toxoplasmosis during pregnancy or first serum sample with positive specific IgM and IgG. The diagnosis of congenital toxoplasmosis was defined by positive specific IgM at birth and/or polymerase chain reaction positive in amniotic fluid and/or persistence of specific IgG up to 12 months of life. Congenital toxoplasmosis was defined as symptomatic when clinical findings were attributed to the disease. Chi-square or Fisher's exact tests were used to test associations between variables, assuming statistical significance when p <0.05.RESULTS: There were 39,585 live births in the study period and 98 cases with risk of congenital toxoplasmosis were identified, of which 89 completed the follow-up. The prevalence of anti-T. gondii IgG in the pregnant women was 26% (95% confidence interval [CI] 24-27%). Twenty-two cases of congenital toxoplasmosis (5.6 per 10,000 live births, 95%CI 3.5-8.5 per 10,000) were confirmed. Of the 22 newborns, 18 (82%, 95%CI 61-93%) were symptomatic. The most frequent clinical findings were intracranial calcification (64%), hepatomegaly and / or elevation of transaminases (32%) and retinochoroiditis (14%). Cerebral lesions were more frequent when maternal infection was documented in the first and second trimester compared to the third trimester (p=0.018). In 31 cases (35%), the pregnant women were treated from the time of diagnosis until delivery with spiramycin, and no differences were found regarding the rate of vertical transmission or the appearance of clinical manifestations among the newborns of treated and non-treated mothers treated.CONCLUSIONS: The prevalence of congenital toxoplasmosis was higher than that reported in other European countries. The prevalence of intracranial calcifications was higher than that described in the literature, whereas retinochoroiditis and strabismus occurrence was lower. Brain lesions in newborns were more frequent in first- and second-trimester infections. There was no difference in the rate of vertical transmission and in the occurrence of clinical manifestations among newborns whose mothers received spiramycin during gestation and those whose mothers did not receive treatment.
Hesitação/recusa vacinal: um assunto em pauta – Editorial
Authors: Lago Eleonor G.
Published: December 2018

Although the advent of childhood vaccination is considered the scientific achievement of the twentieth century with the greatest impact on public health, the issue of vaccine hesitation/refusal continues. The World Health Organization, recognizing the increasing risk of this problem and the need for special attention, has created, within the Strategic Advisory Group of Experts (SAGE) on Immunization, a working group specially focused on the subject, the SAGE Working Group on Vaccine Hesitancy. A recent report from this group concluded that research on the reasons and degree of vaccine hesitation/refusal is important and can help inform and refine the approaches to be implemented at both national and subnational levels. Within this context, Scientia Medica publishes in this issue a survey carried out in a region in the north of Portugal, which identified cases of vaccine refusal in all social classes and investigated their motives.
Os escravos da fazenda jesuítica de São Cristóvão e seus leilões, Rio de Janeiro, 1761-1762
Authors: Amantino Marcia Sueli
Published: December 2018

Esse texto tem como objetivo apresentar a comunidade escrava que vivia na fazenda de São Cristóvão, localizada na capitania do Rio de Janeiro, ao longo de alguns momentos do século XVIII . Serão utilizados três tipos de fontes: 1. a listagem feita em 1759 no momento do sequestro da fazenda, ocasionado pela ordem de expulsão dos religiosos da Companhia de Jesus de Portugal e de seus domínios; 2. uma nova avaliação desses escravos feita em 1761 a partir das denúncias de que os bens estavam se perdendo e os escravos fugindo ou causando tumultos; 3. os registros das arrematações de sua mão de obra nos leilões que ocorreram na praça do Rio de Janeiro entre os anos de 1761 e 1762. Pretende-se com essa análise demonstrar a complexa estrutura familiar que os jesuítas conseguiram estabelecer entre seus cativos e o posterior desmonte dessas unidades familiares após a expulsão dos religiosos e da venda de seus bens. Além disso, busca-se demonstrar que os arrematantes de parte desses escravos eram homens que conviviam com essa comunidade de cativos e, portanto, conheciam previamente a quem estavam arrematando.
El estilo neomedieval veneciano en la historia de la arquitectura chilena (1906-1916)
Authors: Morán José Alberto Moráis
Published: December 2018

Este trabajo analiza la aplicación del término estilístico neomedieval veneciano a ciertos edificios construidos por los arquitectos Ettore Petri, Arnado Barison y Renato Schiavon, en Valparaíso y Viña del Mar (Chile), durante los años 1906 y 1916. Se valora el carácter ambiguo de este concepto asumido por la historiografía, defendiendo la imposibilidad de considerar sus construcciones como meras evocaciones positivistas de la arquitectura medieval de Venecia. Al contrario, se describe un fenómeno más complejo y rico, basado en el uso de modelos edilicios de finales del siglo XIX y principios del XX, contrayendo una visión idealizada de la Edad Media, a partir del conocimiento de los diseños y textos de John Ruskin y Camillo Boito y la inspiración en construcciones medievales fuertemente restauradas. *** O estilo veneziano neo-medieval na história da arquitetura chilena (1906-1916) ***Este artigo analisa a aplicação do termo estilístico neomedieval veneziano a certos edifícios construídos pelos arquitetos Ettore Petri, Arnado Barison e Renato Schiavon, em Valparaíso e Viña del Mar (Chile), nos anos de 1906 e 1916. O caráter ambíguo deste conceito, assumido pela historiografia, é investigado, defendendo a impossibilidade de considerar suas construções como meros evocações positivistas da arquitetura medieval de Veneza. Pelo contrário, é descrito um fenômeno mais complexo e rico, baseado no uso de modelos de construção do final do século XIX e início do século XX. Este fenômeno foi concebido numa visão idealizada da Idade Média, baseada no conhecimento dos desenhos e textos de John Ruskin e Camillo Boito e a inspiração em construções medievais fortemente restauradas.Palavras-chave: neomedieval; gótico veneziano; palácio; Petri; Barison; Schiavon.
Entre suaílis e macuas, mujojos e muzungos: o norte de Moçambique como complexo de interconexões
Authors: Mattos Regiane Augusto de
Published: December 2018

O norte de Moçambique era marcado pela intensa circulação de pessoas, produtos, ideias e saberes no século XIX. Era possível encontrar uma variedade de grupos, tais como suaílis, macuas-imbamelas e namarrais, mujojos e muzungos. Essas categorias sociais revelam formas de classificação e identificação baseadas em diferentes critérios: localização geográfica, religião, aspectos culturais, ocupação, cor, condição econômica e social. O principal objetivo deste artigo é analisar como essas categorias sociais foram construídas historicamente e as conexões culturais e identitárias existentes em torno delas.
Revista Estudos Ibero-Americanos – v. 44, n. 3, 2018
Authors: Maia Tatyana De Amaral , Murari Luciana
Published: December 2018

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Cores, classificações e categorias sociais: os africanos nos impérios ibéricos, séculos XVI a XIX
Authors: Rodrigues Eugénia , Candido Mariana P.
Published: December 2018

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“Diz a preta mina...”: cores e categorias sociais nos processos de divórcio abertos por africanas ocidentais, Rio de Janeiro, século XIX
Authors: Farias Juliana Barreto
Published: December 2018

Partindo de um conjunto de processos de divórcio abertos por africanas ocidentais, conhecidas como pretas (ou negras) minas, no Rio de Janeiro do século XIX, pretendo, neste artigo, discutir como as associações entre cor, condição social. identidades étnicas e certos estereótipos e comportamentos, como as noções de honra e honestidade, pareciam fundamentais – às vezes eram mesmo determinantes – para o desenrolar dessas ações. Nesse processo, observaremos como juízes, padres, advogados, procuradores e também cativos e forros percebiam – e compartilhavam – determinados códigos e signos de identificação das populações africanas que viviam na cidade do Rio.
Calidad de Vida del adulto mayor perteneciente al Programa Gerontológico Social de dos provincias de Ica, Perú 2017
Authors: Jáuregui Meza Angela Isabel
Published: December 2018

Objetivo: Determinar el nivel de calidad de vida de la persona adulta mayor perteneciente al Programa Gerontológico Social de dos provincias de Ica, Perú, en el año 2017. Métodos: El estudio es de tipo no experimental, descriptivo y de corte transversal. La población estuvo constituida por adultos mayores pertenecientes al Programa Gerontológico Social de las provincias de Palpa (n=65) y Nasca (n=30), en el departamento de Ica, Perú. La unidad de análisis fue la persona adulta mayor participante del Programa Gerontológico Social. La calidad de vida se evaluó con el Cuestionario de Salud SF-36. Resultados: El 90 % de los adultos mayores pertenecientes al Programa Gerontológico Social de la provincia de Nasca posee alta calidad de vida según salud mental; mientras el 60 % posee regular calidad de vida según vitalidad. Se encontró que el 81.5 % de las personas adultas mayores pertenecientes al Programa Gerontológico Social de la provincia de Palpa tienen alta calidad de vida según salud mental, pero baja calidad de vida según rol físico (63.1 %). Conclusión: El nivel de calidad de vida de la persona adulta mayor perteneciente al Programa Gerontológico Social de Nasca es mejor que el nivel de calidad de vida de quienes pertenecen al Programa Gerontológico de Palpa
Aproximación a la cohesión social y su relación con la mortalidad evitable en la niñez de Chiapas, México, 2015
Authors: Lizárraga Bustamante Gilberto Martín , Salvatierra Izaba Ernesto Benito , Ochoa Díaz-López Héctor , Zamora Lomelí Carla Beatriz , García Chong Néstor Rodolfo
Published: December 2018

Objetivo: Relacionar los datos de la tasa de mortalidad en la niñez por diarrea y gastroenteritis de presunto origen infeccioso o TMN A(090-099) con el Grado de Cohesión Social (GCS). Métodos: Es un estudio transversal y ecológico para el año 2015. La TMN A(090-099) municipal se calculó con los registros de defunciones del Sistema Nacional en Información en Salud (SINAIS). La aproximación hacia la cohesión social se hizo con base en el Consejo Nacional de Evaluación de la Política de Desarrollo Social (CONEVAL) a través del grado de cohesión social (GCS) municipal. Se calculó una correlación bivariada con la prueba de significancia de Spearman. Se obtuvo la correlación entre la TMN A(090-099) y el GCS. También se hizo un modelo: TMN A(090-099) variable dependiente confrontada con el GCS, el índice de Gini, el índice de rezago social y la no derecho habiencia. Resultados: Existe relación negativa entre el GCS y la TMN A(090-099), con significancia pero débilmente correlacionadas (- 0.320**); la hipótesis se acepta con reservas. El modelo presenta correlación moderada y positiva (R=0.554), la R cuadrada sugiere que el modelo explica casi el 27 % de los casos y el valor Durbin-Watson sugiere que el modelo cubre casi 90 % de los casos estudiados. Discusión: La cohesión social en Chiapas es muy tenue al hacer la aproximación que trató este trabajo. Los datos dan cuenta de que existen municipios con muy alta TMN A(090-099) y baja cohesión social, además de alto grado de rezago social; este escenario predomina, pero es necesario replantear la utilidad del abordaje cualitativo como recomendación encontrada en la literatura.
Comparative analysis of the functional characteristics and motor qualities of students of different generations and body types
Authors: Kolokoltsev M.M. , Iermakov S.S. , Jagiello M.
Published: December 2018

Purpose : the comparative analysis of screening studies of physical fitness and functional condition of young men with different body types (the territory of Baikal region, Russia; the interval of the study is 10 years). Material : First-year students (age 17-18 years; n = 1003; in 2008 - n = 523; in 2017 - n = 480) of Irkutsk National Research Technical University (Pribaikalye, Russia) participated into the research. All students are classified for health reasons to the main medical group (no deviations in health status). All students attended classes in the discipline "Physical Education". It was done the comparative analysis of motor skills; physiometric indicators; the content of muscle, fat and bone mass. Results : It was revealed the significant differences (p <0,05) in the values of the motor test indicators. It was determined “leading” and “lagging” motor qualities of young men with different body types. It was defined decrease of indicators’ values in motor tests in young men in 2017, in comparison with the results of the survey in 2008. The decrease in the values of motor test indicators is more frequently revealed in young men of hypersthenic group (examined in 2017), in comparison with normosthenics and asthenics. There is a deterioration in the majority of the functional characteristics of young men bodies (in 2017) in comparison with 2008 data. Conclusions : University professors (of the discipline - “Physical Education”) should form a predictive database of screening observations on the development of morphofunctional and motor qualities of students with different body types. This will allow to correct the educational process on the physical education of students applying the integrative pedagogical methods and teaching methods.
Effects of stretching before intense exercise training on hematologic and cellular injury indices
Authors: Lotfi N. , Mohamadi S. , Mirzaei-Takmil M.
Published: December 2018

Purpose: The aim of the study was to investigate the effect of stretching before intense exercise on hematologic parameters and cell injury. Subjects: The subjects of the present study were 12 adolescent members of the Kurdistan Province futsal team (age: 14.83 ± 0.38 years, height: 173.92 ± 5.90 cm, weight: 63.50 ± 7.94 kg, peak power: 459.42 ± 95.94 watts). The RAST test was used to estimate the anaerobic power and to create the training load. Indexes of blood including white and red blood cells, hemoglobin, hematocrit, platelet and the levels of CK and LDH enzyme activities were measured. Results: The results of the pre and the post tests showed that among hematological parameters and cell damage indexes, the red blood cell and hemoglobin in both groups and the level of LDH in the training group were not significantly changed (p>0.05). Other parameters in the pre-test and post-test measures were statistically changed (p<0.05). Conclusion: Based on the results of the present study, it seems that stretching before intense training decreases the cell damage and side effects of exercise training on the hematological factors.
The maximum oxygen consumption and body structure component of women at the first period of mature age with a different somatotypes
Authors: Miroshnichenko V.M. , Salnykova S.V. , Brezdeniuk O.Y. , Nesterova S.Y. , Sulyma A.S. , Onyshchuk V.E. , Gavrylova N.V.
Published: December 2018

Purpose: the identification of features of the maximum oxygen consumption of women in the first period of mature age and connection with body structure component. Material: 22-35 years old women (n=210) have participated in a research. Results. It was determined that women with endomorphic and mesomorphic somatotype prevail according to the absolute measure VO2 max. They have large body weight and higher percentage content of the muscular component. The women with low body weight and low values of fat component prevail according to a relative measure VO2 max. Large body weight in women of endomorphic, endomorphic and mesomorphic somatotype stipulates low values of a relative measure VO2 max. It is indicated by the high degree of the return correlation between a relative measure VO2 max and body weight. Conclusions. The relative measure VO2 max is considered more informative as its dependence on body weight is leveled. The obtained data indicate the advantage according to a relative measure VO2 max of women with low body weight somatotype (ectomorphic and balanced). Such feature is explained by authentically low percentage content of the fat component in women.
The relationship between watching sport events and spectators’ engagement in physical activities
Authors: Palik M. , Abdi K.
Published: December 2018

Background and Study Aim: The purpose of the present research was to investigate the relationship between watching sport events in stadiums and spectators’ physical activities. Materials and Methods: The population included spectators of basketball, volleyball, and handball in Tehran stadiums, which is estimated to be more than a hundred thousand people. The sample consisted of 384 spectators who were chosen using the Morgan Table in the simple random method, and they filled the questionnaire before the games started. The instrument was a researcher-developed questionnaire whose validity was confirmed by sports management and communication experts. The reliability was obtained to be 0.86 using Cronbach's alpha test. The collected data was analyzed using K-S test, chi-square test, Spearman correlation coefficient (using SPSS software), and confirmatory factor analysis (using LISREL 8.8 software). Results: The results indicated that there is a significant positive relationship between watching sport events in stadiums and spectators’ intention to do physical activities. Also, there was a significant positive relation between effective factors on spectator during watching sport events and doing physical activities. These factors are related to the stadiums, sport events and social interrelation. Conclusions : It seems that watching sport events and the encouraging factors in sporting environment and stadiums promotes physical activity and health. Since the present research focuses on an important social effect of sport events, it can be a start point for researchers to discover if encouraging people to watch sport events is a way to maintain social health.
KESETARAAN GENDER DALAM IJTIHAD HUKUM WARIS DI INDONESIA
Authors: Permana Sugiri
Published: December 2018

AbstractThe discourse on Islamic law has always been the public attention, both from the standpoint of fiqh, as well as other legal side (civil/ common law, customary or feminism). Ijtihad as part of legal reform, is an important part of the dynamics of inheritance law from the time of as-shahabh (the companions) to this day. This paper attempts to describe the development of inheritance law in Indonesia. Some thoughts on equality in inheritance law are part of ijtihad object of legal experts as well as developments in Court decisions.Key words:Fiqh, Ijtihad, Iquality, Renewal, InheritanceAbstrakDiskursus tentang hukum waris Islam selalu menjadi perhatian publik, baik dari sudut pandang fikih, maupun sisi hukum lainnya (hukum Barat, adat atau feminisme). Ijtihad sebagai bagian dari pembaharuan hukum, menjadi bagian penting dalam dinamika hukum waris mulai dari zaman sahabat hingga saat ini. Tulisan ini mencoba men­deskripsi­kan perkembangan hukum waris di Indonesia. Beberapa pemikiran tentang kesetaraan dalam hukum waris menjadi bagian objek ijtihad para ahli hukum termasuk juga perkembangan dalam putusan Pengadilan.Kata Kunci: Fikih, Ijtihad, Kesetaraan, Pembaharuan, Waris
KONTEKSTUALITAS AYAT-AYAT HUKUM WAKAF DI INDONESIA
Authors: Hasanah Neneng
Published: December 2018

AbstractWaqf is a form of worship by separating some of our belongings to be used as common property, for the benefit of Muslims or people in general. In order to make waqf’s benefits more applicable and accessible for all, the management must be maximally monitored. With innovative management and intensive supervision, waqf is expected to become productive and empower the mauquf ‘alaih (waqf eligible receiver) and make them independent economically, health and education. With the library research method and content analysis on the interpretation of related al-Quran verses, none explicitly mentions the word waqf. But the Islamic scholars have agreed that infaq and shadaqah jariyah is the essence of waqf. Waqf are long-lasting infaq and shadaqah jariyah, as long as the asset is still used then the reward still flows to `wakif even though he has passed away.Keywords:waqf, productive waqf, Indonesian Waqf Board AbstrakWakaf merupakan satu bentuk ibadah dengan cara memisahkan sebagian harta benda yang kita miliki untuk dijadikan harta milik umum, yang akan diambil manfaatnya bagi kepentingan umat islam atau manusia pada umumnya. Agar keberadaan wakaf dan hasil­nya dapat dirasakan oleh semua lapisan masyarakat, maka pengelolaan dan pengawasannya harus diberdayakan dan diawasi secara maksimal. Dengan cara-cara pengelolaan yang bersifat inovatif dan pengawasan/ monitoring secara intensif yang kemudian wakaf tersebut menjadi produktif sehingga berdaya guna dan menjadikan para mauquf ‘alaih menjadi mandiri secara ekonomi, kesehatan dan pendidikannya.   Dengan metode library research dan content analysis terhadap penafsiran beberapa ayat Al-Quran yang terkait, tidak satupun secara eksplisit menyebutkan kata wakaf. Tetapi para ulama fiqih sudah sepakat bahwa infaq dan shadaqah jariyah yang dimaksud intinya adalah wakaf, karena wakaf adalah infaq dan shadaqah jariyah yang bertahan lama, selama harta tersebut masih digunakan maka pahalanya tetap mengalir kepada`si wakif sekalipun ia sudah meninggal dunia.Kata Kunci:wakaf, wakaf produktif, Badan Wakaf Indonesia
Prevalencia del síndrome de Burnout en residentes de especialidades médicas
Authors: Jácome Sandra Jimena , Villaquiran-Hurtado Andrés Felipe , García Claudia Patricia , Duque Iván Leonardo
Published: December 2018

Introducción: La alta carga de actividades académico asistenciales durante la residencia de medicina, pueden generar un estado de desgaste de tipo ocupacional por causa del estrés psicológico y emocional. Objetivo: Determinar la prevalencia del síndrome de Burnout en residentes de especialidades médicas de una universidad pública en el departamento del Cauca- Colombia. Materiales y Métodos: Estudio descriptivo de corte transversal, realizado en 40 estudiantes de residencia médica, en quienes se estableció la presencia de agotamiento emocional, despersonalización y realización personal, dominios evaluados por el Test Maslach Burnout Inventory Human Services Survey, instrumento que evalúa la prevalencia de síndrome de Burnout. Resultados: En una población de residentes de medicina compuesta por hombres en un 55%, se encontró que la razón de prevalencia del síndrome de Burnout fue del 0,9 y estuvo presente en el 47,5% de los participantes, El 42,5% presentaban cansancio emocional, el 55% presentaron baja despersonalización y solo la mitad reportaron estar en un alto nivel de realización personal, Discusión: La presencia de altos niveles de agotamiento emocional tiene un valor decisorio para  la presencia del síndrome de Burnout en la población de residentes médicos similar a lo reportado en diferentes estudios en médicos y especialistas. Conclusiones: Existe una alta prevalencia de síndrome de Burnout en residentes de medicina con mayor compromiso en el sexo femenino y la edad menor de 35 años.Como citar este artículo: Jácome SJ, Villaquiran-Hurtado A, García CP, Duque IL. Prevalencia del síndrome de Burnout en residentes de especialidades médicas. Rev Cuid. 2019; 10(1): e543. http://dx.doi.org/10.15649/cuidarte.v10i1.543
Nephroprotective strategy in the treatment of hypertension as a modern general medical problem
Authors: Podzolkov V. I. , Bragina A. E. , Ishina T. I. , Bragina L. V. , Vasilyeva L. V.
Published: December 2018

The current population is characterized by a high prevalence of risk factors for the development of chronic kidney disease: hypertension, diabetes, obesity, metabolic syndrome, physical inactivity, smoking. The development of severe complications and a close connection with potentially fatal cardiovascular disorders make this disease a socially and economically significant problem. Treatment of chronic kidney disease in advanced stages belong to nephrologist duties. However, the success of preventive interventions depends on the time of their onset, which makes it relevant to identify the disease. The use of nephroprotective approaches by physicians of different specialties (general practitioners, cardiologists, gerontologists, nephrologists, endocrinologists) can significantly improve the prognosis of both those at risk of developing renal dysfunction and the existing disease. The review presents data on the clinical and laboratory efficacy of angiotensin-renin blocker use, as well as the combination of angiotensin II receptor blockers with calcium antagonists. Using the combination of the angiotensin II receptor blocker irbesartan and amlodipine as an example, we demonstrated the possibilities of nephroprotective therapy in patients with renal dysfunction.
The combination of atrial fibrillation and obstructive sleep apnea — is there a connection?
Authors: Arutyunyan G. G. , Agaltsov M. V. , Davtyan K. V. , Drapkina O. M.
Published: December 2018

The review discusses the issue of the mutual influence of combination of atrial fibrillation (AF) and obstructive sleep apnea (OSA). In individuals with a combination of these pathologies, OSA can influence the easier realization of AF. The presence of respiratory disturbances in sleep reduces the effectiveness of all types of AF treatment (antiarrhythmic, surgical, electrical cardioversion). It is shown, that the treatment of OSA by the method of non-invasive ventilation support (CPAP-therapy) improves the results of catheter treatment of AF in the early postoperative period.
Myocardial perfusion scintigraphy in the diagnostics of takotsubo syndrome
Authors: Abdrakhmanova A. I. , Saifullina G. B. , Amirov N. B.
Published: December 2018

We analyzed the publications about single-photon emission computed tomography in the diagnostics of takotsubo syndrome; the dynamics of testing data are presented on a clinical example. Single-photon emission computed tomography can be used to evaluate perfusion parameters for exclusion of myocardial infarction in uncertain cases. In segments with impaired contractile function, it is possible to detect normal or reduced perfusion. During the acute phase there is a reduced accumulation of radiopharmaceuticals in myocardial segments with impaired function, which coincides with the regional distribution of neuronal activity. Pathological changes may persist for several months, and use of scintigraphy with a radiopharmaceutical may help in cases when the diagnosis was not well-timed established. The method of myocardial scintigraphy in ECG-synchronized tomography allows to simultaneously assess the perfusion and the function of the left ventricle and differentiate such disorder as takotsubo syndrome.
Russian Society of Cardiology position paper on 2018 Guidelines of the European Society of Cardiology/European Society of Arterial Hypertension for the management of arterial hypertension
Authors: Kobalava Zh. D. , Konradi A. O. , Nedogoda S. V. , Arutyunov G. P. , Baranova E. I. , Barbarash O. L. , Villevalde S. V. , Galyavich A. S. , Glezer M. G. , Drapkina O. M. , Kotovskaya Yu. V. , Libis R. A. , Lopatin Yu. M. , Nedoshivin A. O. , Ostroumova O. D. , Ratova L. G. , Tkacheva O. N. , Chazova I. E. , Chesnikova A. I. , Chumakova G. A.
Published: December 2018

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Algorithm of echocardiography in pregnant women
Authors: Gorokhova S. G. , Morozova T. E. , Arakelyants A. A. , Barabanova E. A. , Dyakonova E. G.
Published: December 2018

Pregnancy is a physiological condition that takes a defined period of time in a woman’s life. For nine months, the mother’s heart works under conditions of daily additional load, which is necessary to ensure placental blood flow. In this regard, structural and functional adaptation of the heart develops in a healthy woman with a normal pregnancy. A pregnant woman with some heart diseases is less likely to adapt. That leads to greater susceptibility to stress resulting in pathological changes of pregnancy. In addition, each pregnancy may develop new heart diseases, which in some cases may be relatively innocent, but in others — fatal. In this regard echocardiography (EchoCG) is a necessary procedure for assessing a woman’s health status that needs before bearing a fetus, during and after pregnancy.
Acute coronary syndrome in young patients: clinical features and risk factors
Authors: Ponomarenko I. V. , Sukmanova I. A. , Elykomov V. A.
Published: December 2018

Aim. To study the clinical features and risk factors (RF) associated with the development of acute coronary syndrome (ACS) in young patients.

Material and methods. The study included 474 patients with ACS. Depending on age, patients were divided into 2 groups. The first group consisted of 299 patients of young age (25-44 years), the comparison group consisted of 175 patients of mean and old age (45-74 years). Clinical and anamnestic data, parameters of general clinical and biochemical tests, electrocardiography, echocardiography and coronary angiography were determined in all patients, and polymorphisms in FII G20210-A, FV G1691-A, MTHFR C677-T genes were determined in 116 patients. The control group consisted of 53 healthy volunteers.

Results. ACS in patients <45 years old is most common in men. The number of women with ACS increases as elder patient is. The incidence of myocardial infarction (MI) and unstable angina, ST-elevated MI and non ST-segment elevation MI, Q-wave and non-Q-wave MI had no differences between patients of the younger and older age groups. In younger patients, anterior localization of myocardial infarction was more common, in mean and old patients — posterior. Complications of MI in young patients were less common than in the comparison group. In patients of mean and old ages, acute coronary event was preceded by a clinic of angina, in young patients most often it was the debut of coronary artery disease. It was revealed that single-vessel coronary lesion is more characteristic for young patients, for the elderly patients — two-vessel and multi-vessel. Pathology of the anterior descending coronary artery prevailed in both groups of patients. Most patients in both groups underwent myocardial revascularization. MI as a result of coronary artery thrombosis happened more often in young patients. The most significant RF associated with the ACS development were: increased total cholesterol and low density lipoproteins, decreased high density lipoproteins, increased body mass index, smoking, polymorphism of MTHFR-homozygote, hereditary tainted with smoking, aggravation in combination with F5-homozygote, hereditary tainted in combination with MTHFR-homozygote, hereditary tainted in combination with smoking and MTHFR homozygote.

Conclusion. We identified clinical features and RF, mostly associated with the development of ACS in patients <45 years of age. The results can serve as additional indicators showed the risk of ACS development.
Dynamics of magnesemia levels, structural-functional heart parameters and arrhythmia syndrome features in patients with myocardial infarction and undifferentiated connective tissue dysplasia against the background of drug correction with magnesium
Authors: Miroshnichenko E. P. , Ushakov A. V.
Published: December 2018

Aim.To assess the relationship of serum magnesium levels with the structural-functional heart parameters and the arrhythmic syndrome features in patients with myocardial infarction (MI) and undifferentiated connective tissue dysplasia (UCTD) against the background of drug correction with magnesium.

Material and methods.The study included 112 patients with Q-wave MI. Group I (n=22) consisted of patients with MI and UCTD, who, in addition to the standard basic therapy, from 1st day of IM took the magnesium drug. Group II (n=30) — patients with MI and UCTD who received only basic therapy. Group III (n=60) — patients with MI without UCTD who received standard basic therapy. The control group (n=32) — patients without cardiovascular pathology and without UCTD. For assessment we used clinical and phenotypic examinations, echocardiography and daily monitoring of the electrocardiogram, determination of serum magnesium level in the course of MI.

Results.We observed a decrease in serum magnesium level in patients with MI in all study groups on the 1st day of MI. Moreover, this tendency persisted for 28 days in the II and III groups. In the first group of patients against the background of the medical correction, an increase in the magnesium level was observed by the 28th day of MI. MI patients with UCTD revealed a more pronounced increase of left ventricular cavity dimensions, a decrease in its pumping ability. We also noted a tendency to a less pronounced increase in the left ventricular mass index compared with the group of patients with MI without UCTD. In addition, the development of MI in patients with UCTD compared with patients without UCTD is characterized by a higher frequency of paroxysmal supraventricular rhythm disturbances and paroxysmal ventricular tachycardia. Magnesium addition to MI treatment in patients with UCTD reduces the frequency of supraventricular arrhythmias.

Conclusion.In patients with MI, which occur on the background of UCTD, the initially existing hypomagnesaemia is associated with the development of a disadaptive version of the post-infarction cardiac remodeling. Magnesium use in patients with MI and UCTD helps to reduce the severity of hypomagnesaemia and the frequency of supraventricular cardiac rhythm disorders.
Comorbidity of chronic heart failure and chronic obstructive pulmonary disease: features of pathogenesis, clinic and diagnostics
Authors: Tokmachev R. E. , Mukhortova M. S. , Budnevsky A. V. , Tokmachev E. V. , Ovsyannikov E. S.
Published: December 2018

This article discusses the epidemiology of chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD). CHF and COPD are characterized by high prevalence and high mortality, especially when they are combined. The article analyzes the general mechanisms of formation of these diseases: the relationship of COPD with cardiovascular diseases is explained by common risk factors, including smoking, physical inactivity, improper feeding and genetic predisposition. The leading role in the pathogenesis of pathologies is played by the activation and maintenance of systemic inflammation. Article presents the features of the clinical picture and the direction of the diagnostics in case of suspected combined pathology, the possibilities of modern laboratory and instrumental research methods. Diagnostics of comorbidity of CHF and COPD may be difficult, given the above common risk factors, some common pathogenesis mechanisms and similar clinical symptoms. However the caution regarding the comorbidity of the studied conditions, as well as a thorough clinical examination and the appointment of the necessary additional research methods, can reduce the number of diagnostic mistakes and improve the prognosis in such patients.
What “new” factors should be considered when assessing cardiovascular risk?
Authors: Smirnova M. D. , Barinova I. V. , Fofanova T. V. , Blankova Z. N. , Svirida O. N. , Ageev F. T. , Boytsov S. A.
Published: December 2018

One of the causes of high mortality from cardiovascular diseases is the lack of effective measures for the primary and secondary prevention of cardiovascular complications (CCO), due to the difficulty of timely identification risk factors (RF) and individuals with a high individual risk of CCO. This is especially true for patients from low/mean risk. This group is heterogeneous. Often, clinical manifestations of atherosclerosis occur for the first time without “classical” RF. Possible factors that increase the risk of developing cardiovascular diseases and CCO, are: heart rate, increased formation of advanced glycation endproducts, disorders of bone mineral metabolism, thyroid function, low adherence to therapy, psychosocial factors and climatic features. This review is devoted to the analysis of the evidence base of the influence of these “new” CCO RF and the individual patient prognosis.
Ambulatory pulse wave monitoring: current and future. Opinion paper of Russian Experts
Authors: Kotovskaya Yu. V. , Rogoza A. N. , Orlova Ya. A. , Posokhov I. N.
Published: December 2018

The predictive value of vascular biomarkers such as pulse wave velocity (PWV), central arterial pressure (CAP), and augmentation index (AIx), obtained through pulse wave analysis (PWA) in resting conditions, has been documented in a variety of patient groups and populations. There are appropriate recommendations on their clinical use in clinical practice guidelines of various scientific societies. Operator-independent methods are currently available for estimating vascular biomarkers also in ambulatory conditions. The acceptable accuracy and reproducibility of ambulatory PWA makes it be a promising tool for evaluating vascular biomarkers in daily-life conditions. This approach may provide an opportunity to further improve the early cardiovascular screening in subjects at risk. However, there is no sufficient evidence to support the routine clinical use of PWA in ambulatory conditions at the moment. In particular, long-term outcome studies are needed to show the predictive value of ambulatory PWV, CAP and AIx values.
Review of "Becoming Who We Are: Politics and Practical Philosophy in the Work of Stanley Cavell" by Andrew Norris
Authors: Ritter Eric Joseph
Published: December 2018

Review of Becoming Who We Are: Politics and Practical Philosophy in the Work of Stanley Cavell by Andrew Norris.
Estratégia Saúde da Família, um forte modelo de Atenção Primária à Saúde que traz resultados
Authors: Macinko James , Mendonça Claunara Schilling
Published: December 2018

RESUMO Este artigo revisa e sintetiza evidências sobre o impacto da Estratégia Saúde da Família (ESF) a partir do marco conceitual de sistemas de saúde da Organização Mundial da Saúde, o qual agrega os conceitos de acesso, proteção financeira, qualidade dos serviços, eficiência no sistema, impacto na saúde e equidade. Os resultados sugerem que a ESF contribuiu para a melhoria em todos esses indicadores, com alguns efeitos no acesso e equidade com resultados quase chegando aos níveis observados nos países da Organização para Cooperação e Desenvolvimento Econômico. Embora ainda haja bastante espaço para melhorias, a evidência é clara de que a ESF é uma abordagem poderosa e eficaz para a organização da atenção primária à saúde no Brasil.
Atributos essenciais da Atenção Primária à Saúde: resultados nacionais do PMAQ-AB
Authors: Lima Juliana Gagno , Giovanella Ligia , Fausto Márcia Cristina Rodrigues , Bousquat Aylene , Silva Edcarlos Vasconcelos da
Published: December 2018

RESUMO A concepção de uma Atenção Primária à Saúde (APS) abrangente e sua qualidade podem ser avaliadas por meio da efetivação dos atributos: primeiro contato, longitudinalidade, abrangência/integralidade e coordenação. O artigo teve por objetivo analisar a consecução dos atributos da APS na prática das equipes, na perspectiva dos profissionais e usuários, comparando-se os resultados do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), entre os ciclos 1 e 2. Estudo quantitativo, com identificação das equipes participantes dos dois ciclos e operacionalização dos atributos da APS por meio da seleção de variáveis PMAQ-AB pertinentes a cada atributo. Foram comparados os resultados nacionais de 12.680 Unidades Básicas de Saúde (UBS), 15.668 equipes e 58.517 usuários. Apenas parte dos atributos apresentou melhorias do ciclo 1 para o ciclo 2. Os melhores resultados foram primeiro contato e integralidade, confirmando gradual constituição da UBS como serviço de porta de entrada acessível, com escopo diversificado de ações, ainda que insuficientes. Os atributos com pior avaliação foram longitudinalidade, com baixa continuidade e qualidade da relação profissional-paciente; e coordenação, por dificuldades de acesso às consultas especializadas e insuficientes registros compartilhados.
Inovação e utilidade: Avaliação Externa do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica
Authors: Uchôa Severina Alice da Costa , Martiniano Claudia Santos , Queiroz Ana Angélica Rêgo de , Bay Júnior Osvaldo de Goes , Nascimento Wezila Gonçalves do , Diniz Ítalo Vinícius Albuquerque , Hartz Zulmira Maria de Araújo
Published: December 2018

RESUMO O objetivo deste estudo foi avaliar a utilidade da Avaliação Externa do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, considerado uma inovação. Trata-se de pesquisa avaliativa da Avaliação Externa do PMAQ-AB na percepção de sujeitos que vivenciaram a condução dessa avaliação por meio de estudo de caso qualitativo. Os dados foram coletados por meio de entrevista semiestruturada e de grupo focal on-line, e analisados por meio da análise de conteúdo de Bardin. Observou-se envolvimento dos interessados com pactuação em diferentes esferas da gestão nacional, envolvimento processual entre Departamento de Atenção Básica e Instituições de Ensino e Pesquisa, abrangência nacional facilitada com recurso de Tecnologia da Informação, negociação da logística in loco com gestores municipais. Verificou-se credibilidade científica dos avaliadores; a relação entre gestor nacional e instituições de pesquisa não se mostrou conflituosa; as instituições desvelaram conflitos entre gestores e Equipes de Atenção Básica sobre destinação dos recursos provenientes do PMAQ. Constatou-se grande escopo das informações sobre estrutura, processos e resultados; capilaridade e acesso aos resultados. Conclui-se que, na ótica dos participantes do estudo, a Avaliação Externa mostrou-se inovadora e útil à indução da melhoria da qualidade da Atenção Básica.
Complexidade e potencialidade do trabalho dos Agentes Comunitários de Saúde no Brasil contemporâneo
Authors: Barreto Ivana Cristina de Holanda Cunha , Pessoa Vanira Matos , Sousa Maria de Fátima Antero de , Nuto Sharmenia de Araújo Soares , Freitas Roberto Wagner Junior Freire de , Ribeiro Kelen Gomes , Vieira-Meyer Anya Pimental Gomes Fernandes , Andrade Luiz Odorico Monteiro de
Published: December 2018

RESUMO O objetivo deste artigo foi analisar o escopo de práticas dos Agentes Comunitários de Saúde (ACS) relacionando-o à situação social e de saúde, bem como os elementos facilitadores e os limitantes. Trata-se de um estudo transversal de abordagem mista, e estratégia explanatória sequencial, realizado em quatro municípios do Ceará. No estudo quantitativo, a amostra de 160 ACS foi aleatória com instrumento estruturado. No qualitativo, realizou-se seis grupos focais e entrevistas. Prevaleceram, na amostra, mulheres (139; 86,9%), casadas (111; 69,4%), com renda familiar maior ou igual a 2 salários mínimos (102; 63,7%), nível técnico incompleto (68; 42,5%), da zona urbana (114; 71,3%), atuando como ACS há menos de 10 anos (93; 58,2%). As principais atividades foram visitação domiciliar de grupos prioritários e cadastramento de famílias. Evidenciou-se a complexidade do trabalho, que inclui ações de promoção e vigilância à saúde como pré-natal, imunizações, hipertensão, diabetes, cuidado com idosos, entre outros. Como limitantes das práticas, identificaram-se: deficiência da formação técnica, suporte reduzido no trabalho e violência. Como potencializadores: educação permanente e gestão participativa. O escopo de práticas dos ACS é complexo e abrangente, incluindo a articulação de políticas públicas no território, o que se constitui em uma potencialidade para promoção da saúde de comunidades vulneráveis.