bluuebunny/crossref_metadata_2025 huggingface dataset:
BACTERIAL SUSCEPTIBILITY-RESISTANCE LEVELS OF CHRONIC PYELONEPHRITIS PATHOGENS’, DEPENDING ON EXPRESSION OF DIFFERENT TYPES OF PLASMID-MEDIATED RESISTANCE GENES
Authors: Chub О.І. , Bilchenko O.V. , Teslenko S.V.
Published: June 2018

The aim of the study is to determine the bacterial susceptibility-resistance levels of uropathogens depending on expression of different types of plasmid-mediated resistance genes.

Methods. A cross-sectional study of105 patients with chronic pyelonephritis was carried. Screening for the presence of plasmid-mediated genes was performed by polymerase chain reaction. The antimicrobial susceptibility of isolates was determined by the Kirby Bauer disk diffusion method on Mueller–Hinton agar-containing plates. The size of zone around each antimicrobial disk was interpreted as sensitive, intermediate or resistant.

Results. We demonstrated in vitro significant relationship of the resistance to aminopenicillins, cephalosporins and fluoroquinolones with an appearance of plasmid-mediated extended spectrum p-lactamases (ESBLs) types blaCTX-M, blaTEM, blaSHV and fluoroquinolones resistant genes (PMQR), including QnrA, AAC (6') - Ib-cr, QepA) in bacterial uropathogens. We also demonstrated in vitro significant relationship of the resistance to aminoglycosides with an appearance of plasmid-mediated genes blaCTX-M, QnrA and QepA.

Conclusion. Were established in vitro significant relationships of the resistance to antimicrobials with an appearance of plasmid-mediated resistance genes in uropathogens. Were determined the most effective antibiotics against ESBL and PMQR producers. We have established the algorithm of diagnostic of plasmid-mediated resistance genes in uropathogens, isolated from patients with chronic pyelonephritis.
PECULIARITIES OF CYTOKINES AND THEIR PROGNOSTIC VALUE IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS
Authors: Kolesnyk M. , Driyanska V. , Velichko M. , Drannik G. , Savchenko V.
Published: June 2018

Introduction. Cytokines are important to take part in immunogenesis and progression of glomerulonephritis (GN), therefore the analysis of these indices in dependence of type of GN forms as prognosys results of treatment.

Aim of the work is to determine the peculiarities of pro-inflammatory cytokines (TNFα, MCP-1, IL-17, -18, -23) and anti-inflammatory TGF- β1 and their association with form GN with nephritic syndrome (NS) and possibility use cytokines as prognostic markers.

Materials and methods. Using IFA, the level of the above mentioned cytokines was studied in the blood serum of 117 patients with proliferative (33) and non-proliferative (84) CGN, NS forms. There was also analyzed the changes of these indices in the patients with subsequent clinical laboratory remission (59) and patients without one (58).

Results. The GN, NS patients showed statistically higher level of the pro- inflammatory cytokines – TNFα, MCP-1, IL-17 (with more high indices last one in the proliferative forms of GN, and IL-17 in nonsensitive to immunotherapy patients). High level profibrogenic TGFβ, and the ratio TNFα /TGFβ reflect the prevalence of anti-inflammatory reactions and high activity of monocytes - macrophages and T-helpers17. The positive effect of the treatment associates with the statistically decreased TNFα, MCP-1 and TGFβ1 levels in the patients with proliferative forms GN; the TGFβ1 - for patients with non-proliferative GN forms.

Conclusion. The changes cytokine profiles may be use as predictors of results the immunosuppressive therapy.
MODERNETIOLOGICAND GENDER FEATURESOFMICROBAL SPECTRUMOFURINE IN TEENAGERS WITH URINARYTRACTINFECTIONS
Authors: Bezruk V.V. , Bezruk T.O. , Blinder O.V.
Published: June 2018

In Ukraine the increase of amount of teenagers registers with the infection of the urinary system.

Materials and methods. A bacteriological investigation of urine of324 teenagers is undertaken in the Chernivtsi region. Family and specific belonging of the distinguished stamms in the standards of urine was conducted by the generally accepted microbiological methods.

Results. The dynamic increase ofpercent of selection is educed etiologfc and clinically meaningful stamms among the teenagers of both sexes. Selection ofpercent etiologfc and clinically meaningful stamms among girls–teenagers (3,75% – 18,52%) prevails by comparison to their coevals (1,02% – 12,50%). A negative dynamics is marked in megascopic percent of results of bacteriological investigation of urine (1,46% – 14,81%) in a group «Height it is not educed».

Conclusions. Infections of the urinary system children have the issue of the day of nephrology, and needs complex going near the study of the age–related and gender factors of prevalence of Infections of the urinary system among child’s population of the different age–related groups.
THE LEVEL OF MENTAL STRESS, AND SELF - ESTEEM OFCHILDREN’S HEALTH WITH CHRONIC KIDNEY DISEASE
Authors: Dryl I.S. , Shipko A.F. , Kolfbaeva T.F. , Petrenko L.K. , Zabashta I.V.
Published: June 2018

The most frequent mental changes in children can include increased anxiety, depression, aggression and anger, the existence of which may contribute to the progression of physical illness.

Materials and methods. The study involved 49 children aged 7 to 17 years (mean age 12,7 ± 3,1let) with chronic kidney disease. Further assess psychological stress based on the level of anxiety, aggression, anger, and depression.

Results. In assessing the level of anxiety, aggression, anger, and depression in all groups of children prevailed with the average of 73,1 ± 7% to 87,8 ± 5,1% of children in the group. At 24,3 ± 7% of children identified elevated levels of aggression, half of whom had congenital abnormalities of the urinary system. Most children 38 (86,3 ± 5,2%) level of depression was within average. Established cases of depression to improve small, moderate and significant among girls 13,5 ± 1,5years, which amounted to 13,6 ± 5,2% of children.

Conclusions. The most vulnerable are children, particularly girls with chronic kidney disease on the background of congenital anomalies of the urinary system. All children with chronic kidney disease is necessary to evaluate the level of mental strain for the optimization of measures to prevent recurrence of the disease and improve the quality of life ofchildren.
RENAL RISCS IN DETERMINATION OF BRONCHIAL ASTHMA PHENOTYPES
Authors: Semydotska Zh.D. , Cherniacova I.A. , Eremenko G.V.
Published: June 2018

The aim of this investigation was to study acid - secretory renal function and acid - base balance in patients with bronchial asthma in order to optimize the diagnostics and treatment from the pposition of phenotyping.

Materials and methods. In 102 patients with moderate bronchial asthma there was studied the excretion of titratable acids by titration method, excretion ofammonium by Van Slyk - Palmer’s method and acid - base status of the organism in the venous blood by blood gas analyzer 348. Respiratory function was studied on computer spirograph «Microlab 330».

Results. Studied patients were divided into 3 groups according to the disorders of acid - base balance and acidsecretory renal function: 62 patients had respiratory acidosis and a significant increase in the excretion of titratable acid and ammonium; in 28 patients metabolic acidosis and a moderate increase in acid - secretory renal function were ascertained; in 12 patients respiratory alkalosis was found, acid - secretory renal function did not differ significantly from that of healthy persons. The most pronounced bronchial obstruction and bronchial hyperreactivity were observed in patients with respiratory alkalosis. The intravenous infusion of buffered 4.2% solution of sodium hydrocarbonate was included in complex therapy in 14patients with metabolic acidosis. After this treatment marked improvement of bronchial obstruction was established, as well as normalization of BE, pCO,, pO,, increased blood pH, improve control over asthma. The possibility to separate asthma phenotypes (subphenotypes) according to the disorders of the acid - base balance and acid - secretory renal function is discussed.

Conclusions. Monitoring of acid - base status and acid - secretory renal function can be used in patients with asthma to separate phenotypes (subphenotypes) for disease diagnostics and treatment optimization.
CLINICAL AND MORPHOLOGICAL COMPARISON AT NEPHROPATHY IN PATIENTS WITH MICROSCOPIC POLYANGIITIS
Authors: Syniachenko O.V. , Bevzenko T.B. , Diadyk O.O. , Iermolaieva M.V. , Iegudina E.D. , Pomazan D.V.
Published: June 2018

Introduction. Morphological signs of renal pathology in microscopic polyangiitis, their connection with extrarenal manifestations of the disease and urine laboratory parameters, as well as the pathogenesis of such nephropathy remain insufficiently studied, what became the purpose and objectives of this study.

Material and methods. Nephrobiopsy was made 12 patients. The study was performed on microscope «OlumpusBX40», «Olumpus - C3030 - ADU», «Olympus DP - Soft», «Olympus - AX70», «Olympus - DP50».

Results and discussion. Damage of glomeruli, stroma, tubules and vessels was detected without exception in all patients with deposition in the kidney structures of immunoglobulins A, G, M, C3and Clqcomponents of complement that depend on the presence ofcardiac, pulmonary, hepatic, articular and neurological pathologies, and morphological indicators of renal lesion affect the parameters of proteinuria, erythrocythuria, uricosuria, nitrituria and surface physicochemical properties of urine, associated with blood levels ofdifferent antibodies, rheumatoid factor and circulating of immune complexes.

Conclusions. Renal involvement at microscopic polyangiitis affects all morphological structures and indicates the immunecomplex damage of glomeruli, stroma, tubules and vessels.
CLINICAL AND ECONOMIC ANALYSIS OF USING OF LONG ACTION ERYTHROPOES STIMULATED AGENTS FOR THE TREATMENT OF ANEMIA CKD V HD PATIENTS
Authors: Kolesnyk M. , Bezdetko N. , Novakivskyy V.
Published: June 2018

The article describes the ways to cost optimization of anemia treatment CKD - HD patients.

Aims. dinical and economic analysis treatment of Anemia CKD VHD PTS with using long action Erythropoiesis Stimulating Agents (ESA).

Methods. We calculated the true cost of anemia therapy with darbepoetin alfa compared to the methoxypolyethyleneglycol - epoetin beta.

Results. It was established that average cost of therapy with methoxypolyethyleneglycol - epoetin beta was lower than darbepoetin alfa provided declared, wholesale or retail prices of25 - 60%.

Conclusions. The methoxypolyethyleneglycol - epoetin beta haspharmacoeconomics advantages in comparison with the darbepoetin alfa in treatment of anemia CKD V HD patients.
VASCULAR ACCESS OPTIONS AT HEMODIALYSIS THERAPY INITIATION: COMPLICATIONS AND SURVIVAL OF PATIENTS WITH CHRONIC KIDNEY DISEAS STAGE 5 D
Authors: Shifris І.М. , Dudar I.О. , Gonchar I.І. , Krasyuk E.K. , Prusskiy F. О. , Vburhynska I.
Published: June 2018

The annual increasing of dialysis population results tofocus world attention on the problems associated with improving of survival among patients with chronic kidney disease stage VD (CKD VD st.)., decreasing iatrogenic complicationfrequency. HD is the most common method ofrenal replacement therapy (RRT). Several studies haveproven the link between the type ofinitial vascular access, and an morbidity and survival of patients with CKD VD st..

Aim. The aim of this study was to explore the effects of an initial vascular access on morbidity and survival inpatients with CKD VD st., which are treated with hemodialysis.

Materials and methods. In the study 79HDpatients were included. Patients were randomized into twogroups, depending on the type of vascular access at the start of HD treatment: the first group (n = 47) included patients, who started HD treatment through theformed AVF, patients among which central venous catheter (CVC) was usedfor the HD initiation composed the second (n= 32) group.

The endpoints were: the total number of deaths, hospitalizations due to bacterial infections, sepsis, unstable angina and myocardial infarction. All cases that took place from 01.01.2013 to 01.12.2015 year were analyzed. Evaluation of survival wasperformed using the Kaplan-Meier method.

Results. The analysis allowed to state that during analyzed period in total were 24 deaths: in the first group ofpatients - 10 (21.28%), and in the second - 14 (43.75%) cases; p = 0.03299. The survival rate ofpatients was significantly lower with the CVC. The 10-years cumulative proportion surviving was 73% and 40% when using of AMT and CVC, respectively. The relative risks and odds ratio for all-cause hospitalization in the second group ofpatients (26 episodes) were significantly higher compared to thefirstgroup (16 cases): RR = 2,387, (95% Cl: 1,550-3,674) and OR = 8,396 (95% Cl: 2,870-24,559). It was established a significant increasing of the hospitalization incidences both due infectious comorbidity (9/21,43% versus 15/46,9%;p = 0,0085), and cardiovascular diseases (7/16.7% vs. 11/34,37%;p = 0,0427) inpatients with a history ofthe CVC use at the HD initiation, compared withpatients who started treatment through theformed AVF.

Conclusion. Thus, the obtainedfindings suggest that the use of the CVC at the HD initiation has a significant negative effect onprognosis in thepatientpopulation with CKD stage VD.
THE FACTORS INFLUENCING RENAL RECOVERY IN CARDIAC SURGERY ASSOCIATED ACUTE KIDNEY INJURY
Authors: Zakon K. , Romanova V. , Tverdokhlib K. , Dudarenko V. , Arbuzova I. , Radchenko G.
Published: June 2018

Background. In-hospital mortality of cardiac surgery patients with AKI is 3-7 times higher than those without AKI. This prospective observational study was dedicated to evaluate a differential approach of applying continuous and intermittent modalities in CS-AKIpatients on the rate and grade of renalfunction recovery.

Methods. One hundred and six adult cardiac surgery patients admitted hospital in 2008-2011 years, who had AKI and met inclusion criteria were allocated in CRRTorIRRTgroup.

Results. Sixty eight cardiac surgery with AKI patients who needed RRT were discharged from hospital. Among them, recovery of renalfunction was observed in 54 patients (79,4%) and 14 patients (20,6%) remained RRT-depen- dant. Complete recovery of renalfunction was reached in 33 patients (48,5%), while partial was observed in 21 patients (30,9%). Univariate analysis showed that complete recovery of renalfunction in CS-AKI significantly associated with reducing of dopamine dose during thefirst day of RRT (p=0,01) and long-term use of dobutamine (p=0,009). Partial recovery was associated with early dobutamine withdrawal (p=0,005) and absence of MOT (p=0,016), while RRT- dependence at discharge was associated with absence of MOT (p=0,006) and escalation of dopamine dose on thefirst day of RRT (p=0,025). The rate of renal recovery was statistically significantly higher in patients with CS-AKI with MOFthan inpatients with CS-AKI without MOF. In univariate analysis RRT-dependance at discharge of patients with CS-AKI with MOF was statistically significantly associated with arising of dopamine dose during thefirst day of RRT (p=0,006) and no-use of dobutamine at RRT start (p=0,006). Partial recovery was associated with early withdrawal of dobutamine (p=0,038).

Discussion. Frequency of renal recovery inpresented study was higher than in VA/NIHAcute Renal Failure Trial Network study because of differences inpatients'population and corresponds to otherstudies of CS-AKIpatients.

Conclusions. Recovery of renalfunction in CS-AKI patients associated with decreasing dose of dopamine, prolonged use ofdobutamine, illness severity and does not associated with specific RRT modality.
COMPARATIVE EFFICACY OF BLOCKADE OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM WITH COMBINATIONS OF ALISKIREN AND AMLODIPINE, RAMIPRIL AND AMLODIPINE IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Krutikov E. , Chistyakova S. , Gorbatuk V.
Published: June 2018

Hypertension is one of the most common disease of the cardiovascular system. Important components of a rational antihypertensive therapy are drugs that block the RAAS. The aim of the study was to conduct a comparative evaluation of the effectiveness of blockade of the renin-angiotensin-aldosterone system with drug combinations – aliskiren and amlodipine and combination of ramipril and amlodipine in patients with hypertension and increased body weight. 50 patients with hypertension of stage II, II degree, high and very high risk were involved in the study. Patients were randomized into two groups depending on the received treatment. The first group (25 patients) consisted of patients treated with combined therapy including ramipril and amlodipine, the second group (25 patients) consisted of patients receiving a combination of aliskiren and amlodipine. The control group (25 people) included apparently healthy people. By the 12th week of the study the daily average systolic blood pressure in the first group was 146 (145; 150) mm Hg and 131 (130; 137) mm Hg in the second group, respectively, the daily average diastolic blood pressure was equal to 94 (91; 96) mm Hg in the first group and 81 (80; 82) mm Hg in the second group . By the 12th week of treatment plasma renin levels in the first group was equal to 73 (50; 78) and 15 (14; 27) in the second group, respectively, the level of angiotensin-I in the first group was 6 (4; 7) and 1,4 (1,1; 1,9) in the second group, aldosterone levels in the first group was equal to 134 (132; 145) and 130 (123; 132) in the second group, respectively. It is found that combination of aliskiren and amlodipine have the advantage over the combination of ramipril and amlodipine in achieving of purposeful level of systolic and diastolic blood pressure in patients with hypertension and overweight. The purposeful level of blood pressure reached to 56,6% of patients in group I and 80% of patients in group II to 12th week of the study. Receiving both combinations equally reduces plasma aldosterone levels at the same time receiving a combination of aliskiren and amlodipine accompanied by a decrease in plasma rennin level of 69% and angiotensin-I of 67%, while the combination of ramipril and amlodipine increases of these hormones on 68% and 65% respectively. Thus, using combination of ramipril and amlodipine more effective in patients with low rennin hypertension , patients with normal and high rennin hypertension necessary combination of aliskiren and amlodipine.
REGENERATIVE POSSIBILITIES OF RENAL STEM CELLS
Authors: Geraschenko S. B. , Chaikovsky Yu. B. , Deltsova O. I.
Published: June 2018

Modern data about stem cells of kidney in adults are presented in the review of literature. Sources and peculiarities of stem cells structure and their niches are examined in different kidney compartments – epithelial, vascular and stromal. The aims of kidney regenerative therapy are outlined. Issues of exposure and stimulation of local stem cells, possibilities of exogenous and induced pluripotent cells transplantation and implantation of created on matrix kidney are discussed.
PREDICTION THE MANIFESTATION OF PYELONEPHRITIS IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Zub L.O. , Kulachek V.T.
Published: June 2018

Renal damage in patients with rheumatoid arthritis (RA) is the most frequent and serious among other systemic manifestations and holds a special place in connection with a significant impact on prognosis and approaches to therapy.

Today we know that one of the main possible factors of occurrence and development of RA are external trigger factors, among which the most important factor are infectious, and its pathogenic effect on the body can be done in different ways. Based on the latest scientific evidence on the importance of infectious trigger factors in the manifestation of RA, chronic pyelonephritis among these triggers is one of the leaders. Great interest is also the probability of pyelonephritis manifestation while presence of RA.

The aim: to identify predictors ofpyelonephritis manifestation in patients with rheumatoid arthritis.

Materials and methods. The authors examined 31 patients with RA with presence of chronic pyelonephritis (CP), 31 patients with RA without presence of CP and 20 healthy individuals. Was used clustering and classification methods of Data Mining on indicators of lipid peroxidation of blood and urine, р2–microglobulin blood and urine, immune factors, that defined progressive CKD on the results of our previous studies (IL–1p,IL–10, TGF–р).

Results. Found that patients with diagnosed RA only, mainly are included in the cluster «1» (18patients). Some of them (3 persons) classified as belonging to the cluster «2». Thus, these individuals should have two signs of disease, RA and CP, despite the fact that they have only diagnosed RA. It means that these patients are at risk of developing CP. This analysis gives grounds to consider that RA may be signs of a factor that causes manifestation of CP.

It is proved that the main factor that characterizes the individuals belonging to the cluster of healthy is 2– microglobulin in the urine with the same threshold value, but factor in determining membership of a type of disease is a factor MDA of urine.

Conclusion. The main predictors of pyelonephritis manifestation in patients with rheumatoid arthritis were 2– microglobulin and MDA in urine and TGF– 1 in blood. A new method of diagnosing ofprognostic factors of CP manifestation in patients with RA which is based on cluster and classification analysis makes it possible to establish the interrelation between a diagnosis of RA and caused by it manifestation of CP.
РARTICULAR QUALITIES OF THE RENAL OSMOREGULATORY FUNCTION IN PATIENTS WITH TYPE 2 DIABETES
Authors: Kuznetsova E.S. , Kuznetsova A.S. , Shuhtin V.V. , Gozhenko A.I.
Published: June 2018

The aim of the study was to examine the osmoregulatory state of renal function in patients with type 2 diabetes in a water - salt load with 0,5% NaCl in the amount of 0.5% of body weight.

Materials and methods. The study involved 56patients with insulin - dependent diabetic nephropathy,24 men (42.9%) and 32 women (57.1%), aged from 38 to 81 years. The osmolality was measured by freezing point depression on osmomat 030 - D (USA). Glomerular filtration rate (GFR) was calculated by the formula GFR - EPI with subsequent determination of renal functional reserve.

Results. It demonstrated that renal osmoregulatory function provides effective regulation of osmotic homeostasis even in a reduced amount of nephrons, but as the glomerular filtration rate decreses to 30 ml/min, the excretion of osmotically active substances gradually decrease too.

Conclusion. Osmoregulatory disturbances in the renal function in patients with 2 types diabetes depend both on the reduction in GFR, - and on changes in the functional capacity of nephron's tubules.
INTRADIALYSIS HYPOTENSION: CAUSES, METHODSOFPREVENTION AND WAYS OF CORRECTION
Authors: Mogilnik I.
Published: June 2018

There is a marked increase in the number of patients with chronic kidney disease worldwide. In Ukraine in 2013 its prevalence was 1026,3per 100000population. 7214 patients in total have received a renal replacement therapy; 74% of them had hemodialysis. Statistically, almost 90% of patients on hemodialysis were of a working age. Despite the continuous improvement of the dialysis technologies, mortality among patients remains significantly higher than in general population. In Ukraine, the mortality rate for patients on hemodialysis in 2013 was 8,2%, where cardiovascular complications were the cause ofdeath in 60,5%. Intradialysis episodes of hypotension can lead to myocardial ischemia and vascular thrombosis, which, in turn, are reducing the quality of life and life expectancy, and are significant risk factors for the death. The article describes most common causes, methods of prevention and ways of correction of the most known complications of hemodialysis.
AUTOMATED QUANTIFICATION OF RENAL FIBROSIS WITH SIRIUS RED: IS A ROUTINE METHOD OF THE KIDNEY BIOPSY EVALUATION?
Authors: Nikolaienko O. , Nepomnyashchy V.
Published: June 2018

The Aim of our study was to determine the intra- and interobserver variation of the automated quantitative evaluation if cortical interstitial fibrosis performed on kidney biopsy samples stained with Sirius red compared to conventional approaches.

Materials and methods. The range of fibrosis was evaluated on 15 renal biopsies obtained from adult patients with minimal change nephropathy, focal segmental glomerulosclerosis and membranous nephropathy. Different methods of fibrosis measurement were used: the automated quantification of Sirius red stained areas with and without polarization, the computerized quantification of the fibrotic interstitium on trichrome-stained samples and the visual assessment offibrotic tissues using quantitative and semiquantitative approaches on trkhrome and PAMS-stained slides. The intra- and interobserver variation of these methods was performed.

Results. The quantitative evaluation of interstitial fibrosis with Sirius red stain under both polarized and unpolarized light demonstrated nearly perfect inter- and intraobserver reproducibility (ICC=0,85-0,99). Whereas, visual methods had relatively high variance between observations (ICC=0,48-0,66).

Conclusions. The automated quantification of cortical interstitial fibrosis as performed on renal biopsy samples stained with Sirius red has been shown to be a highly accurate approach that could be used as a routine method of the kidney biopsy evaluation.
PREDICTORS OF PROGRESSION OF CHRONIC PYELONEPHRITIS IN CHILDREN
Authors: Lavrenchuk O. V. , Bagdasarova I. V. , Driyanska V.E. , Korol L.V. , Suslova G.D.
Published: June 2018

Introduction The search for new diagnostic capabilities adverse forecasting of chronic pyelonephritis in children is a pressing issue today. To determine the degree of destruction of renal parenchyma, structural and functional changes in kidney informative study of fermenturiyi, analyze its relationship with albuminuria and profibrozuyuchymy growth factors. The aim was to identify predictors of progression of chronic pyelonephritis in children to assess the level of kidney function in dynamic observation.

Materials and Methods: Pediatric Nephrology at the Department of SI «Institute of Nephrology AMS of Ukraine» at the CST №7 of Kyiv was examined 191 child over 5 years in age from 3 to 17 years.

Results: In the group of children with progressive chronic pyelonephritis relapsing course 2fi-MG urine compared with groups of 2fi-MG there PNhighest level of reliable patients who had not frequent relapses and recovered (p <0.001). To determine infringement tubular renal function, analyzed the $2-MG urine and serum levels with enzyme activity NAG, NAG B and in patients with chronic pyelonephritis and established significant coefficients of paired correlation 2fi-MG serum and urine $2-MG between levels and activity Nag, NagB in urine. Discovered reliable positive correlation between levels of albuminuria and TGF-fi, which is profibrotychnym factor (r = 0,48, p <0.001) and identified a significant increase in its levels in patients with chronic pyelonephritis. Conducted stepwise multiple linear regression analysis revealed a reliable connection between the measure glomerular filtration rate decline per year (which is determined by progression) and $2-MG levels of blood TGF-^, $2-MG in urine, albuminuria and indicators renoscintigraphy - ENPstand% inclusion RFP180 min.

Conclusions. Predictors of progression of pyelonephritis in children are: increased activity of lysosomal enzymes, maintaining elevated levels $2-MG serum and urine regardless of the degree of inflammatory activity in the kidneys and albuminuria
DOPLEROGRAPHIC DESCRIPTION OF RENAL BLOOD SUPPLY DISTURBANCE IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE I-II AND ARTERIAL HYPERTENSION
Authors: Zub L.O. , Novychenko S.D. , Novychenko О.І.
Published: June 2018

The purpose of this work was to investigate renal blood supply disturbance in patients with chronic renal disease stage I-II (pyelonephritis, glomerulonephritis, diabetic nephropathy).

Material and methods. The authors carried out 131 complex ultrasonic investigations using ultrasonic duplex color kidney scanning. 47patients with chronic pyelonephritis (ChPN), 48patients with diabetic nephropathy stage IV (DN) and 36patients with chronic glomerulonephritis (ChGN) were involved into investigation. Each group consisted of 2 subgroups – with arterial hypertension (AH) and without AH. 20 healthy persons were examined as well.

Results. Scantyintrarenal blood flow which is characterized with a decrease of maximal systolic (Vs), minimal diastolic blood velocity(Vd), as well as a decrease of indices of the averaged, according to time, maximal blood velocity (TAMX) and volumetric blood velocity (Vvol) and an increase of index resistance (IR) have been revealed in patients with chronic renal disease (ChRD) stage I-II with the presence of AH stage II. Indices of the vascular renal blood flow under study correlated with the main factors of ChRD progression – glomerular filtration rate (GFR) and daily proteinuria.

Conclusion. Reliable Vs, Vd, TAMX and Vvol decrease and a reliable IR increase may be considered as early noninvasive criteria of ChRD progression with the presence of AH stage II.
THE FEATURES OE CLINICAL AND LABORATORY DIAGNOSIS OF FABRY DISEASE
Authors: Pichkur N O.
Published: June 2018

The aim of the study was to determine the clinical features and molecular genetic patterns of patients with Fabry disease (FD) to optimize the diagnostic stepwise.

Object and methods. The comparison of clinical features was performed and the activity of lysosomal enzyme a–galactosidase A in the peripheral blood leukocyte homogenate was studied in 120 male with the neuropathic pain or acroparesthesia who contacted the Center of Orphan Diseases of NSCH “Ohmatdyt” in years 2002–2016. The cascade family screening (in 8 people) at low enzyme levels and molecular genetic analysis for the presence of mutations in the GLA gene were performed.

Results. The activity of –galactosidase A was decreased (range 0.5–12.6 nM/mg/h with median 2.0 nM/mg/h) in nine cases (7.5%). All these patients had additional clinical signs (angiokeratoma, hypertrophic cardiomyopathy, coarse facial features, and compromised family tree). The diagnosis of FD were confirmed by the molecular genetic analysis in the GLA gene; there were identified two new mutations (p.739 740delAA and C.945 946delinsTTGA). The other mutations in 6 out of 8 examined families were revealed by the screening of the first kinship degree female relatives, but the activity of –galactosidase A in leukocytes was only reduced in 4 of them.

Conclusion. The multisystem lesions and the difference in the clinical signs of FD complicate the timely formulation of diagnosis. Selective screening among patients with renal insufficiency, cardiac pathology, and ischemic stroke in the anamnesis increases the possibility of FD diagnosis. Cascade family screening of FD patients relatives is highly effective in identification new patients with non–classical form of FD. Inclusion in the selective group of persons with chronic diseases, compromised pedigree, acroparesthesia and additional FD probable clinical signs reduces the range ofpatients for further high–cost testing and optimizes the diagnosis of FD.
А PROBLEM OF ACUTE KIDNEY INJURY IN CHILDREN TODAY
Authors: Lavrenchuk O.
Published: June 2018

In this survey of contemporary foreign literature presents the results of recent studies on acute kidney damage in children. Present modern system of stratification by severity degrees ofacute kidney injury and their comparison (RIFLE and AKIN – criteria). For this reason recently there has been a great surge of interest in identifying biomarkers ofacute and chronic kidney injury which help to detect early pathological changes in kidneys, to differentiate the injury of different parts of the nephron, to accurately determine the stage of the process, to assess the severity of inflammation and fibrogenesis intensity. The most important new markers which are currently studied include KIM–1, VEGF–А, L–FABP, TGF–b1, NGAL and NAG. This review highlights the results of major recent studies in this area.
ESTUDO SOBRE AS BOAS PRÁTICAS DE FABRICAÇÃO NA INDÚSTRIA DE MEDICAMENTOS VETERINÁRIOS
Authors: Bispo Leonardo Rafael , Gasparotto Angelita Moutin Segoria
Published: June 2018

Na economia e no cenário econômico mundial, as empresas que processam e produzem medicamentos veterinários estão aumentando suas lucratividades e suas receitas conforme se adequam a um fator muito importante na produção de fármacos-veterinários, que é a qualidade nos seus processos e serviços. Neste ambiente, a concorrência por melhorias vem alcançando níveis de eficiência muito altos em relação às metodologias de qualidade. Uma organização que se adapta a essas necessidades cada vez mais é cobrada por órgãos vigentes e regulamentadores que, sem dúvida, não pode ficar sem essas adequações importantes. Tais órgãos têm a competência de manter estes padrões e estabelecerem as organizações padrões que sugerem a melhoria dos processos e produtos destinados a esse segmento. O artigo mostra as etapas de implantação em uma indústria de medicamentos veterinários, seus processos em meio à metodologia aplicada e seus desafios. Cabe salientar que os objetivos que as boas práticas de fabricação (BPF) seguem seus padrões em todo o fluxo operacional, desde o fornecimento de matérias primas até o produto acabado para os setores de expedição e logística.
Pengaruh Teknik Pernapasan Buteyko terhadap ACT
Authors: Sutrisna Marlin , Pranggono Emmy H , Kurniawan Titis
Published: June 2018

This study aims to determine the effect of buteyko breathing technique on asthma control test.The quasi experimental study with the pretest and post test one group design approach involved 14 patients with asthma selected from the Lung Polyclinic of Dr. Hasan Sadikin Bandung with consecutive sampling. Asthma control was collected using time series ACT. The collected data were analyzed descriptively and inferentially with the scale of significance p smaller than 0.05.The results showed a significantly higher mean difference between ACT scores after buteyko breathing technique 19.79 more or less 1.47 with ACT score at week III 17.50 moe or less 1.78 week II 12.64 more or less 1.82, week I 9.57 more or less 1.95, and pretest 7.64 more or less 1.82. Post hoc analysis found the fourth week post test score 19.79 more or less 1.47 significantly better than post test week III 17.50 more or less 1.78, week II 12.64 more or less 1.82, week I 9.57 more or less 1.95, and pretest 7.64 more or less 1.82 in improving asthma control. It was concluded that there was an effect of buteyko breathing technique on asthma control test. Thus, the results of this study become important as a study material for nurses at the Hospital in an effort to increase asthma control test.

Keywords: ACT, Breathing Technique, Bronchial Asthma, Buteyko
Pengalaman Ibu dalam Merawat Bayi Preterm yang Pernah dirawat di Ruang Neonatus Intensive Care Unit Kota Bengkulu
Authors: Padila Padila , Amin Muhammad , Rizki Rizki
Published: June 2018

The purpose of this study was to to explore mothers experience in caring for preterm infants who had been treated in the NICU in Bengkulu. This study used a qualitative design with in depth interviews using open ended questions as a guide. The study was conducted in a patients home in a fairly comfortable space. The sample consisted of five mothers. Data were analyzed using Collaizi method. The results obtained are six themes, namely the mothers description of the characteristics of preterm infants, the cause of preterm birth, the mothers experience in preterm baby care at home, the support the mother receives in preterm infant care, mothers self-coping in the care of preterm infants and reactions mother during caring for preterm baby. The conclusion that can be taken is that mothers experience in caring for preterm baby who had been treated in NICU room of Bengkulu City should be able to pay attention to some obstacles or challenges that need to be considered during home treatment. In general, the mother is able to pass a period of sadness and grief in treating preterm infants or low birth weight.

Keywords:Phenomenology, Mothers Experience,Preterm.
Faktor Faktor yang Mempengaruhi Perilaku Lansia dalam Mengikuti Senam Lansia di Wilayah Kerja Puskesmas
Authors: Novianti Novianti , Mariana Dina
Published: June 2018

This study aimed to determine the factors that influence the behavior of the elderly in participating in gymnastics for elderly in Jalan Gedang Health Center in Bengkulu City, 2016. This study was an analytical study using cross sectional design. The population were all elderly at gymnastics in Jalan Gedang health center totaled 50 people, with a total sample of 33 people, and were taken using accidental sampling technique. Data collection was done by direct interview using a questionnaire. The data were analyzed using univariate and bivariate analysis with chi square test at α 5 percent. The results showed that most respondents 60.6 percent had less knowledge, most respondents 51.5 percent got lower family support, almost half of respondents 36.4 percent had low motivation, almost half of respondents 42.4 percent behave not active in participating in gymnastics for elderly, and the results of the chisquare value of ρ 0.040, 0.000 and 0.001 showed no relationship between knowledge, family support and motivation to the behavior of the elderly in participating in gymnastics in Jalan Gedang health center in Bengkulu City 2016. Knowledge, family support, and motivation are very important for the elderly in order to follow gymnastics actively, because gymnastics is very useful for maintaining health.

Keywords: Awareness, Behavior, Family Support, and Motivation
Five-year results of a clinical pilot study utilizing a pedicle-lengthening osteotomy for the treatment of lumbar spinal stenosis
Authors: Mlyavykh Sergey , Ludwig Steven C. , Kepler Christopher K. , Anderson D. Greg
Published: June 2018

OBJECTIVE

Lumbar spinal stenosis (LSS) is a common condition that leads to significant disability, particularly in the elderly. Current therapeutic options have certain drawbacks. This study evaluates the 5-year clinical and radiographic results of a minimally invasive pedicle-lengthening osteotomy (PLO) for symptomatic LSS.

METHODS

A prospective, single-arm, clinical pilot study was conducted involving 20 patients (mean age 61.7 years) with symptomatic LSS treated by a PLO procedure at 1 or 2 lumbar levels. All patients had symptoms of neurogenic claudication or radiculopathy secondary to LSS, and had not improved after a minimum 6-month course of nonoperative treatment. Eleven patients had a Meyerding grade I degenerative spondylolisthesis in addition to LSS. Clinical outcomes were measured using the Oswestry Disability Index, Zürich Claudication Questionnaire, 12-Item Short Form Health Survey, and a visual analog scale for back and leg pain. Procedural variables, neurological outcomes, adverse events, and radiological imaging (plain radiographs and CT scans) were collected at the 1.5-, 3-, 6-, 9-, 12-, 24-, and 60-month time points.

RESULTS

The PLOs were performed through percutaneous incisions, with minimal blood loss in all cases. There were no operative complications. Four adverse events occurred during the follow-up period. Statistically significant improvement was observed in each of the outcome instruments and maintained over the 5-year follow-up period. Imaging studies, reviewed by an independent radiologist, showed no evidence of device subsidence, migration, breakage, or heterotopic ossification. Thin-slice CT scans documented healing of the osteotomy site in all patients at the 6-month time point and an increase of 115% in the mean cross-sectional area of the spinal canal.

CONCLUSIONS

Treatment of patients with symptomatic LSS with a PLO procedure provided substantial enlargement of the area of the spinal canal and favorable clinical results for both disease-specific and non–disease-specific outcome measures at all follow-up time points out to 5 years. Future research is needed to compare this technique to alternative therapies for LSS.
Prediction of recovery from supplementary motor area syndrome after brain tumor surgery: preoperative diffusion tensor tractography analysis and postoperative neurological clinical course
Authors: Oda Kazunori , Yamaguchi Fumio , Enomoto Hiroyuki , Higuchi Tadashi , Morita Akio
Published: June 2018

OBJECTIVE

Previous studies have suggested a correlation between interhemispheric sensorimotor networks and recovery from supplementary motor area (SMA) syndrome. In the present study, the authors examined the hypothesis that interhemispheric connectivity of the primary motor cortex in one hemisphere with the contralateral SMA may be important in the recovery from SMA syndrome. Further, they posited that motor cortical fiber connectivity with the SMA is related to the severity of SMA syndrome.

METHODS

Patients referred to the authors’ neurological surgery department were retrospectively analyzed for this study. All patients with tumors involving the unilateral SMA region, without involvement of the primary motor area, and diagnosed with SMA syndrome in the postoperative period were eligible for inclusion. Preoperative diffusion tensor imaging tractography (DTT) was used to examine the number of fiber tracts (NFidx) connecting the contralateral SMA to the ipsilateral primary motor area via the corpus callosum. Complete neurological examination had been performed in all patients in the pre- and postoperative periods. All patients were divided into two groups: those who recovered from SMA syndrome in ≤ 7 days (early recovery group) and those who recovered in ≥ 8 days (late recovery group). Differences between the two groups were assessed using the Student t-test and the chi-square test.

RESULTS

Eleven patients (10 men, 1 woman) were included in the study. All patients showed transient postoperative motor deficits because of SMA syndrome. Tractography data revealed NFidx from the contralateral SMA to the ipsilateral primary motor area via the corpus callosum. The mean tumor volume (early 27.87 vs late 50.91 cm3, p = 0.028) and mean NFidx (early 8923.16 vs late 4726.4, p = 0.002) were significantly different between the two groups. Fisher exact test showed a significant difference in the days of recovery from SMA syndrome between patients with an NFidx > 8000 and those with an NFidx < 8000.

CONCLUSIONS

Diffusion tensor imaging tractography may be useful for predicting the speed of recovery from SMA syndrome. To the authors’ knowledge, this is the first DTT study to identify interhemispheric connectivity of the SMA in patients with brain tumors.
Assessment of blood flow velocities and venous pressures using a dual-sensor guidewire in symptomatic dural sinus stenoses
Authors: Lenck Stéphanie , Vallée Fabrice , Civelli Vittorio , Saint-Maurice Jean-Pierre , Nicholson Patrick , Hong Alex , Houdart Emmanuel
Published: June 2018

Lateral venous sinus stenoses have been associated with idiopathic intracranial hypertension and venous pulsatile tinnitus. Venous pressure measurement is traditionally performed to assess the indications for stenting in patients with idiopathic intracranial hypertension. However, its reliability has recently been questioned by many authors. The dual-sensor guidewire was first developed for advanced physiological assessment of fractional and coronary flow reserves in coronary artery stenoses. It allows measurement of both venous pressure and blood flow velocities. The authors used this device in 14 consecutively treated patients to explore for symptomatic lateral sinus stenosis. They found that venous blood flow was significantly accelerated inside the stenotic lesion. This acceleration, as well as the pulsatile tinnitus, resolved in all patients following stent placement. According to the authors’ results, this guidewire can be helpful for establishing an indication for stenting in patients with pulsatile tinnitus and idiopathic intracranial hypertension.
Full-endoscopic uniportal decompression in disc herniations and stenosis of the thoracic spine using the interlaminar, extraforaminal, or transthoracic retropleural approach
Authors: Ruetten Sebastian , Hahn Patrick , Oezdemir Semih , Baraliakos Xenophon , Merk Harry , Godolias Georgios , Komp Martin
Published: June 2018

OBJECTIVE

Surgery for thoracic disc herniation and spinal canal stenosis is comparatively rare and often challenging. Individual planning and various surgical techniques and approaches are required. The key factors for selecting the technique and approach are anatomical location, consistency of the pathology, general condition of the patient, and the surgeon’s experience. The objective of the study was to evaluate the technical implementation and outcomes of a full-endoscopic uniportal technique via the interlaminar, extraforaminal, or transthoracic retropleural approach in patients with symptomatic disc herniation and stenosis of the thoracic spine, taking specific advantages and disadvantages and literature into consideration.

METHODS

Between 2009 and 2015, decompression was performed in 55 patients with thoracic disc herniation or stenosis using a full-endoscopic uniportal technique via an interlaminar, extraforaminal, or transthoracic retropleural approach. Imaging and clinical data were collected during follow-up examinations for 18 months.

RESULTS

Sufficient decompression was achieved in the full-endoscopic uniportal technique. One patient required revision due to secondary bleeding, and another exhibited persistent deterioration on myelopathy. No other serious complications were observed. All but one patient experienced regression or improvement of their symptoms.

CONCLUSIONS

The full-endoscopic uniportal technique with an interlaminar, extraforaminal, or transthoracic retropleural approach was found to be a sufficient and minimally invasive method. To cover the entire range of thoracic disc herniations and stenosis within the criteria named, all full-endoscopic approaches are required.