bluuebunny/crossref_metadata_2025 huggingface dataset:
Gestão de Negócios de Mídia: um meta estudo sobre decisões estratégicas
Authors: Rodrigues Fabiano , Capoano Edson
Published: August 2018

Esta pesquisa consiste em um meta estudo qualitativo para mapear o estado atual dos estudos envolvendo decisões estratégicas em negócios de mídia. As análises se basearam nas publicações do International Journal on Media Management. O meta estudo contemplou amostra de 25 artigos (dentre 61 artigos entre 2013 e 2017). As dimensões de análise foram: relação com a gestão estratégica; objetivos; e tipo de empresa. Como resultados, destaca-se a predominância (72%) de estudos envolvendo decisões sobre modelos de negócio e formas de financiamento. Os estudos retratam diferentes atores desta indústria, como veículos tradicionais, agregadores de mídia, jornais, plataformas de vídeos e notícias. Como contribuição, esta pesquisa avança na literatura sobre media management por meio da sistematização das indagações acadêmicas recentes sobre decisões estratégicas, apresentando categorias de análise para pesquisadores e praticantes da área de jornalismo, comunicação e administração.
Serene Velocity no panorama da arte minimalista
Authors: Duarte Theo Costa
Published: August 2018

No presente artigo analisa-se o filme Serene Velocity (1970), de Ernie Gehr, objetivando-se compreender os modos como apropria e reinventa um conjunto de determinados parâmetros das artes plásticas inusuais no cinema, em uma singular aproximação com o modernismo autorreflexivo das artes visuais e o minimalismo. Propomos assim uma análise formal comparativa do filme com obras e conceitos da escultura minimalista e da pintura modernista de Frank Stella. Entre os principais pontos de contato entre essas tendências artísticas contemporâneas e Serene Velocity encontra-se não somente aqueles mais evidentes, como a simplicidade e proeminência das formas, e a busca pela unidade e regularidade espacial, como também o modo de composição não relacional e serial, a construção autorreflexiva e anti ilusionista, e o deslocamento da ênfase nos significados advindos de um espaço psicológico interior para a própria atividade do espectador no desdobramento perceptivo e de sua compreensão dos elementos convencionados.
ВАКУУМНІ МІКРОХВИЛЬОВІ ТЕХНОГІЇ ПРИ ВИРОБНИЦТВІ ФІТОПРЕПАРАТІВ З ПЛОДІВ ШИПШИН
Authors: Левтринская Юлия Олеговна , Альхурі Юсеф , Голінська Яна Андріївна , Терзієв Сергій Георгійович
Published: August 2018

У даній статті представлено результати досліджень процесів екстрагування у мікрохвильовому полі в умовах зниженого тиску. Об’єктом досліджень обрано плоди шипшини – багаті на термолабільний вітамін С. При екстрагуванні у створеному зразку екстрактора температури не перевищують 50 °С. За таких температур зберігається більше вітаміну С, краще зберігається колір та смак. Проведені лабораторні дослідження підтверджують підвищений вміст вітаміну С у екстракті. У порівнянні з технологіями, які зараз застосовуються на фармацевтичних підприємствах при виробництві екстрактів шипшини створені екстрактор та випарна установка мають ряд переваг: проста конструкція, безпечність, знижені робочі температури, енергетична ефективність. Підвищення виходу екстрактивних речовин можна пояснити особливим протіканням процесу за умов впливу мікрохвильового поля та виникненню явища бародифузії, що значно інтенсифікує перехід компонентів, що містяться у капілярах до екстракту.In this paper are presents the results of studies of extraction processes in a microwave field under conditions of reduced pressure. The object of research are the rose hips – rich in thermolabile vitamin C. According to previous studies, under the action of the microwave field possible reach a significant intensification of extraction processes. This is due to barodiffusion – a phenomenon that occurs in the capillaries of plant material. These principles are the base for innovative facilities designed by our scientific group: a microwave vacuum extractor and a microwave vacuum evaporator. During the sample treatment in an extractor, the temperature does not exceed 50 °C. At these conditions saved more of vitamin C, color and taste are better preserved. The laboratory researches confirm that the high content of vitamin C is present in the extract. Compared to the technologies that are applied be pharmaceutical companies in the production of rose hips extracts and evaporators, they have several advantages: simple design, safety, reduced working temperatures, high energy efficiency, shortening of processes. With microwave extraction it is possible to obtain the extracts that contain non-typical components for aqueous extracts precisely due to barodifusion. So, with the use of one solvent, can be obtained a polyextract on the same installation. These technologies are actual in the first place for the pharmaceutical industry and the market of health food products. The comparison of vacuum microwave and cryoconcentration technologies are performed. It is wellknown that the best way to concentrate products with high vitamin C content is cryoconcentration. Obtained in that research results indicate that the quality of the extract produced in the vacuum microwave evaporator is similarly to cryoconcentrate.
AGE AND EFFECTIVENESS AND SAFETY OF VARIOUS ANTITHROMBOTIC THERAPY VARIANTS IN PATIENTS WITH NONVALVULAR ATRIAL FIBRILLATION
Authors: Shevelev V. I. , Kanorskyi S. G.
Published: August 2018

Aim. To compare effectiveness and safety of warfarin, dabigatran, and clopidogrel therapy as thromboembolism (TE) prevention strategy across the age groups in patients with nonvalvular atrial fibrillation (AF).

Material and methods. The study included 189 patients (110 men and 79 women), aged 65–80 years, with nonvalvular AF. All participants were divided into two groups: Group I (n=126) included patients aged 65–74 years. They were administered warfarin (n=43), in the dose providing the INR levels of 2,0–3,0; dabigatran (n=41) in the dose of 110 mg twice a day; and clopidogrel (n=42) in the dose of 75 mg/d. Group II (n=63) included patients aged 75–80 years. They were administered warfarin (n=22), dabigatran (n=20), and clopidogrel (n=21) in identical doses.

Results. In the younger age group, the 6-month treatment with dabigatran (110 mg twice a day), compared to the warfarin treatment, was associated with a similar incidence of ischemic stroke, but a lower risk of major bleeding (4,8% vs. 27,9%; p<0,05). The treatment with clopidogrel prevented stroke as effectively as the therapy with warfarin or dabigatran, and was reasonably safe. In the older age group, there was no significant difference in the incidence of TE and hemorrhagic complications between dabigatran and warfarin groups.

Conclusion. While selecting the antithrombotic therapy strategy in 65–74-year-old patients with nonvalvular AF, dabigatran and clopidogrel could be regarded as an acceptable alternative to warfarin.
LONG-TERM ECONOMIC EFFECTIVENESS OF THE MULTIFACTORIAL CARDIOVASCULAR PREVENTION PROGRAMME IN THE CONTEXT OF PRIMARY HEALTH CARE
Authors: Kalinina A. M. , Kontsevaya A. V. , Deev A. D.
Published: August 2018

Economic effects of the multifactorial cardiovascular prevention programme are analysed in the context of prevention-associated preserved work potential. The programme of multifactorial prevention of cardiovascular disease (CVD) is one of the few Russian controlled studies, which was performed in the primary health care settings, in the population-based middle-aged cohort, and included both the active preventive intervention (5 years) and the end-point follow-up (10 years). This study is a post-hoc analysis employing modern parameters of integrated assessment, such as life-years saved (LYS) and estimated cost-effectiveness of the programme. In the active prevention population, the 5-year intervention saved 52,5 life-years per 1000 participants, with the cumulative 10-year LYS number of 147,4. The programme costs per 1 LYS (85512,4 roubles for 5 years and 41679,3 roubles for 10 years) were significantly lower than the gross domestic product per one worker per year (290000 roubles). The payback of the CVD prevention investment (per 1 rouble invested) reached 2,3 roubles for 5 years and 5,8 roubles for 10 years. Multifactorial medical prevention of CVD is economically effective and justifiable when integrated into the routine practice of primary health care.
POTENTIAL OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS IN THE TREATMENT OF PATIENTS WITH ARTERIAL HYPERTENSION AND CORONARY HEART DISEASE
Authors: Evdokimova A. G. , Evdokimov V. V.
Published: August 2018

For the last 30 years, angiotensin-converting enzyme (ACE) inhibitors have been playing a key role in the management of arterial hypertension (AH) and related cardiovascular disease. This review discusses the mechanisms of action and organo-protective effects of ACE inhibitors. Enalapril is the most extensively studied and widely used in the international clinical practice ACE inhibitor. The authors analyse the results of the studies on enalapril therapy in AH, coronary heart disease (CHD), chronic heart failure, metabolic syndrome, and postmenopause. It has been demonstrated that the combination antihypertensive therapy with a β-adrenoblocker nebivolol, enalapril, and hydrochlorothiazide (such as Berlipril® Plus) is safe and effective in patients with AH and CHD.
PERIPROCEDURAL MYOCARDIAL DAMAGE
Authors: Akinina S. A.
Published: August 2018

Percutaneous coronary intervention (PCI), as a method of myocardial revascularisation, is widely and effectively used for the treatment of coronary heart disease (CHD), with immediate success rates of >90%. Depending on the diagnostic criteria, 5–30% of these patients could develop the signs of periprocedural myocardial damage (PMD) or periprocedural myocardial infarction (PMI). PMD predictors, mechanisms of PMD development, and its specific clinical features play an important role in the PMI prevention. At present, there is no universal agreement on the definition and diagnostics of periprocedural myocardial necrosis and PMI, or on their impact on the clinical outcomes. According to the results of the recent studies, which are presented in this review, the current criteria of PMI might need to be modified, due to the increasingly high sensitivity of the modern threshold levels of troponin.
FLUVASTATIN EFFECTS ON BLOOD CELL AGGREGATION IN PATIENTS WITH ARTERIAL HYPERTENSION AND DYSLIPIDEMIA
Authors: Medvedev I. N. , Skoryatina I. A.
Published: August 2018

Aim.To investigate the effects of fluvastatin on the blood cell aggregation in patients with arterial hypertension (AH) and dyslipidemia (DLP).

Material and methods.The main group (MG) included 32 middle-aged patients with Stage 1–2 AH (Risk 3) and Type IIb DLP. The control group (CG) included 26 healthy middle-aged people. All patients received fluvastatin (40 mg/d in the evening) and enalapril (10 mg twice per day). The assessment of clinical and laboratory parameters was performed at baseline, and after 4, 12, and 52 weeks of the therapy.

Results.In MG patients, the disturbances of blood lipid profile and lipid component of blood cell membranes, together with activation of lipid peroxidation (LP) in blood cell membranes, was associated with an increased aggregation of erythrocytes, platelets, and leukocytes. The 52-week fluvastatin therapy somewhat improved blood lipid profile and reduced LP activity in both plasma and blood cells. However, these parameters failed to reach the levels observed in the CG. The one-year treatment with fluvastatin in the MG reduced, but not completely normalised the aggregation of erythrocytes, platelets, and leukocytes.

Conclusion.Treating patients with AH and DLP with fluvastatin for one year significantly reduces, but not normalises blood cell aggregation.
LEFT VENTRICULAR REMODELLING AND MITRAL VALVE REMODELLING IN CORONARY HEART DISEASE PATIENTS WITH POST-SURGERY PROGRESSION OF MITRAL REGURGITATION
Authors: Buziashvili Yu. I. , Koksheneva I. V. , Khuzurauli E. M. , Arutyunova Ya. E. , Makhmudov Sh. G.
Published: August 2018

The progression of ischemic mitral regurgitation (MR) after coronary arty bypass graft (CABG) surgery remains one of the most complex and still unresolved problems in the treatment of coronary heart disease (CHD).

Aim. To study myocardial function, left ventricular (LV) remodelling, and mitral valve (MV) remodelling in CHD patients with MR progression after isolated CABG or CABG combined with LV reconstructive surgery.

Material and methods. In total, 101 CHD patients after CABG were included in the analysis.

Results. The mechanisms of MR progression after isolated CABG differ from those after CABG and LV reconstructive surgery. After the former, LV remodelling progresses both locally and globally, while after the latter, the LV remodelling progression is predominantly global. The patients with post-surgery MR progression differ from their peers without MR in terms of all key parameters of MV geometry.

Conclusion. The leading mechanism of MR progression is local and global LV remodelling, which leads to papillary muscle dislocation and MV leaflet tension and restricted motion. The categories of patients with a high risk of post-surgery MR progression are defined.
PREVALENCE OF MULTI-FOCAL ATHEROSCLEROTIC PATHOLOGY ACROSS AGE GROUPS
Authors: Sumin A. N. , Gaifullin R. A. , Bezdenezhnykh A. V. , Korok E. V. , Karpovich A. V. , Ivanov S. V. , Barbarash O. L. , Barbarash L. S.
Published: August 2018

Aim. To compare the prevalence of multi-focal subclinical atherosclerotic pathology and its determinants in cardiovascular surgery patients.

Material and methods. The study included 1018 patients — 825 en and 193 women (mean age 59,0±12,0 years) — who were hospitalised for a planned intervention on coronary or other arteries. Group I (n=542) was aged under 60 years, Group II (n=215) — 60–64 years, Group III (n=141) — 65–69 years, and Group IV (n=120) — 70 years or older. All participants underwent coronary angiography and Doppler ultrasound; peripheral angiography was performed, if necessary. Multi-focal atherosclerosis (MFA) criteria were the presence of stenosis (≥30%) or revascularisation in two or more vascular territories.

Results. Subclinical atherosclerotic pathology of various localisation was observed in 52,3% of the patients. Advanced age was linked to an increase in the MFA prevalence: from 45,8% in Group I to 58,6% in Group II, 58,2% in Group III, and 63,3% in Group IV (p=0,0001). In Group I, MFA was associated with the intermittent claudication syndrome (ICS), decreased body mass index (BMI), increased intima-media thickness (IMT), elevated total cholesterol (TCH). However, in Groups II–IV, the only association observed was between MFA and ICS.

Conclusion. Taking into account the subclinical (hemodynamically insignificant) arterial pathology had resulted in a high prevalence of MFA. Advanced age was associated with a higher MFA prevalence. Other factors linked to MFA were increased IMT, elevated TCH, decreased BMI, and ICS.
DYNAMICS OF CARDIOVASCULAR STATUS AND SERUM MARKERS OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS, TREATED WITH INFLIXIMAB
Authors: Oranskyi S. P. , Eliseeva L. N. , Samorodskaya N. A. , Malkhasyan I. G.
Published: August 2018

Aim. To assess the complex dynamics of the main parameters of cardiovascular status and serum markers of endothelial dysfunction (ED) in patients with rheumatoid arthritis (RA), who were treated with infliximab.

Material and methods. The main group (MG) included 50 patients with seropositive RA, who received a combination of methotrexate and infliximab. The examination took place at baseline, as well as two, six, and 14 weeks after the treatment started. Comparison groups (CG) included healthy volunteers (n=25) and RA patients treated with methotrexate only (n=110). Serum levels of tumor necrosis factor-α (TNO-α), interleukin-10 (IL-10), tissue plasminogen activator (TPA), and von Willebrand factor (vWf) were measured, using ELISA. Left ventricular (LV) function and microvascular status were assessed with echocardiography and laser Doppler flowmetry (LDF), respectively.

Results. The E/A ratio was reduced in all subgroups, and at Week 14 of infliximab therapy, it slightly increased. At baseline, LDF parameters, such as neurogenic arteriole tone and intravascular resistance, were increased. Infliximab therapy was associated with a moderate decline of these parameters. Throughout the study, serum vWf concentration was higher in MG patients than in healthy controls. TPA activity was reduced at baseline (496±173 pg/ml), increasing at Week 14 up to 705±157 pg/ml. Baseline concentrations of TNF-α and UL-10 were substantially elevated (357,1±34 and 453±42 pg/ml, respectively). At Week 6, TNF-α concentration decreased significantly. At Week 14, not only TNF-α level decreased, reaching 94±28 pg/ml, but also the ratio TNF-α/IL-10 decreased (from 0,78±0,5 to 0,4±0,2).

Conclusion. In RA patients, infliximab was highly effective for the functional cytokine dysbalance correction, also demonstrating pleiotropic effects, such as correction of microvascular and endothelial dysfunction.
JUSTIFICATION OF A SYSTEMIC APPROACH IN THE SUDDEN CARDIAC DEATH PREVENTION: A POSSIBLE SOLUTION TO THE PROBLEM OF EXCESSIVE MORTALITY IN RUSSIA (LITERATURE REVIEW) PART I. CARDIOVASCULAR ASPECTS OF EXCESSIVE MORALITY IN RUSSIA: THE STATE OF THE PROBLEM AND POTENTIAL FOR PREVENTION
Authors: Dimov A. S. , Maksimov N. I.
Published: August 2018

The review of the existing evidence on the problem of excessive mortality in Russia has demonstrated that the country is at the initial stage of the irreversible depopulation process. The current healthcare situation, in regard to cardiovascular disease (CVD), does not provide much hope for the effectiveness of existing measures for fatal CVD prevention. It is clear that a large-scale focussed analysis of the clinical and organisational limitations of the existing prevention systems is urgently needed. This discussion should be started in the nearest future.
CLINICO-EPIDEMIOLOGICAL STUDY OF ACUTE CORONARY SYNDROME/ACUTE MYOCARDIAL INFARCTION: DATA FROM THE TASHKENT CITY DISTRICT REGISTER
Authors: Mamutov R. Sh. , Urinov O. , Bekbulatova I. R. , Anarbaeva M. R. , Abidova D. E.
Published: August 2018

Aim. To assess epidemiological characteristics of acute coronary syndrome/acute myocardial infarction (ACS/AMI), using the data from the Tashkent City district register.

Material and methods. The data on ACS/AMI among permanent residents of one of the Tashkent City districts were obtained from the following sources: ambulance service database, hospital case histories and discharge reports, ambulatory cards from polyclinics, autopsy records, medico-legal expertise protocols, and death certificates from the civil registration office.

Results. Over one year, 683 ACS/AMI patients were included in the register: 464 (67,9%) men and 219 (32,1%) women. The prevalence of ACS/AMI was 2,1 times higher in men than in women: 67,9% vs. 32,1%, respectively (р<0,01). One-third of the patients had heart failure in their medical history, and more than one-third had AMI earlier (31,2% of men and 26,9% of women). Only in 7,2% of ACS/AMI cases, the volume and quality of prehospital medical care met the required standards. Arterial hypertension (AH) was present in 81,7% of the patients (78,0% of men and 89,5% of women). Stage 2 AH was diagnosed in 15,7%, and Stage 3 AH in 5,4%.

Conclusion. The prevalence of ACS/AMI was 2,1 times higher in men than in women. Women developed ACS/AMI, on average, 10 years later than men. Among ACS/AMI patients, particularly in younger age groups, the prevalence of risk factors was high, while the risk factor awareness was low.
DYNAMICS OF CARDIOVASCULAR RISK FACTOR PREVALENCE IN RYAZAN REGION
Authors: Smirnova E. A.
Published: August 2018

Aim. To investigate the dynamics of the prevalence of cardiovascular disease (CVD) risk factors (RFs) in men and women from a representative sample of the Ryazan Region general population.

Material and methods. As a part of the epidemiological study EPOCH, a cross-sectional standardised screening of a representative sample of the Ryazan Region general population (n=2098) was performed. All respondents underwent a standardised questionnaire survey, anthropometry, and blood pressure (BP) measurement. The examination was repeated 5 years later, in 1760 participants (response rate 83,8%).

Results. Over 5 years, the prevalence of arterial hypertension (AH) in the urban population increased from 34,8% to 39,1% (p<0,05). In the whole sample, AH prevalence remained stable (39,3% and 36,6% at the second and first screening, respectively), similar to the prevalence of diabetes mellitus (DM) (4,5% and 3,4%, respectively). Smoking prevalence in urban women increased from 6,0% to 9,2% (p<0,05) and did not change in men (51,8% in 2002 and 49,6% 5 years later). The prevalence of excessive alcohol consumption decreased from 7,7% to 5,6% (p<0,01), while the prevalence of excessive salt consumption remained the same. Obesity prevalence increased in women (from 23,6% to 28,3%; p<0,001) and only slightly changed in men (11,7% in 2002 and 14,0% 5 years later; p=0,68). Awareness of CVD in family history increased from 46,7% to 59,8% (p<0,001).

Conclusion. In a representative sample of the Ryazan Region general population, the prevalence of CVD RFs remained high over 5 years of the follow-up.
ASSESSMENT OF TOTAL CARDIOVASCULAR RISK AS A PART OF REPEATED MEDICAL EXAMINATION OF EMPLOYEES OF A LARGE INDUSTRIAL ENTERPRISE
Authors: Kalinina A. M. , Shapovalova V. P. , Ryzhov V. M. , Olishevko S. V. , Kondratieva N. V. , Ryzhova T. V. , Khudyakov M. B. , Kiseleva N. V.
Published: August 2018

Aim.To compare the associations between employees’ health groups, defined by the results of the repeated medical examination (RME), and conventional risk factors (RFs) of cardiovascular disease (CVD) or total CVD risk; to justify the need for RME and identify the priorities for its further improvement, in order to prevent CVD among working populations.

Material and methods.The study was performed as a part of a regulation-required RME, at a medical unit serving employees of a large industrial enterprise. A standard examination was combined with the assessment of such CVD RFs as tobacco smoking, alcohol consumption, stress, and body mass index.

Results.The RME data were analysed for 3013 employees (51,8% men and 48,2% women). Mean age of the participants was 45,8±12,5 years (44,8±13,6 years in men and 46,9±11,2 years in women; p0,05); Health Group III to 27,3% (26,0% of men and 28,8% of women; p>0,05); and Health Group IV to 0,3% of both men and women (p>0,05). No participants were assigned Health Group V. The study demonstrated feasibility of an extended medical examination without substantial extra costs. This justifies the inclusion of early CVD RF detection and correction in the RME programme for working populations. Among working-age employees with Health Group I, more than one-third (37,4%) had moderate levels of total CVD risk. Among older age groups, 90% and 10% had moderate and high total CVD risk, respectively.

Conclusion.The results of this analysis can be used for identification of prevention priorities, both for workplace-based and medical unit-based prevention among working populations, as well as for assessment and distribution of the resources required.
COMBINATION ANTIHYPERTENSIVE THERAPY: WHEN THE WHOLE IS GREATER THAN THE SUM OF ITS PARTS
Authors: Taratukhin E. O. , Teplova N. V.
Published: August 2018

The paper discusses the importance of high treatment compliance in the case of long-term or life-long therapy. This problem can be resolved by the use of combination pharmacological treatment, such as the combination of a calcium channel blocker and an ACE inhibitor. Apart from the higher treatment compliance, this combination provides additional metabolic benefits, due to the beneficial metabolic effects of its components.
MECHANISMS OF COMBINED ACTION OF ACE INHIBITORS AND CALCIUM ANTAGONISTS IN ARTERIAL HYPERTENSION
Authors: Astashkin E. I. , Glezer M. G.
Published: August 2018

This review presents the modern views on the effectiveness of water-soluble angiotensin-converting enzyme (ACE) antagonists and calcium antagonists (CA), as monotherapy or as fixed-dose combination therapy, in the treatment of arterial hypertension (AH). The results of the X-ray structural analysis of crystal ACE-lisinopril complexes suggest a highly selective, strong inhibitory effect of lisinopril on various ACE forms of the hormonal renin-angiotensin-aldosterone system and tissue renin-angiotensin systems. The association between specific action mechanisms and therapeutic effects in hypertension is analysed for a third-generation CA amlodipine. The benefits of a fixed-dose combination medication Ekvator (amlodipine 5 mg plus lisinopril 10 mg) in hypertension are described, including its synergetic protective effects.
MODERN POTENTIAL OF MYOCARDIAL INFARCTION TREATMENT IN THE POLYCLINIC SETTINGS (LECTURE)
Authors: Nesterov Yu. I.
Published: August 2018

This lecture, aimed at the primary healthcare practitioners, is focused on the complex rehabilitation and dispanserisation of myocardial infarction (MI) patients in the polyclinic settings. The evidence from the available Russian and international literature, as well as from the original author’s findings, is presented. The section on non-pharmacological MI treatment emphasises the role of risk factor modification. The modern views on the long-term pharmacological recurrence prevention are discussed in detail.
LOW-DENSITY LIPOPROTEIN SUBFRACTIONS AND VARYING DEGREE OF CORONARY STENOSIS
Authors: Ozerova I. N. , Perova N. V. , Metelskaya V. A. , Chernushevich O. I. , Gavrilova N. E.
Published: August 2018

Aim.To investigate whether low and intermediate density lipoprotein (LDL, IDL) subfractions are associated with a degree of angiographically verified coronary atherosclerosis, as well as with other biochemical risk factors of coronary heart disease (CHD), and hypertriglyceridemia (HTG) in particular.

Material and methods.The study included 129 patients (76 men and 53 women), aged 33–75 years, who were referred for coronary angiography. All participants were divided into three groups by the degree of coronary artery (CA) stenosis: 0–20%, 21–70%, and >70%. LDL and IDL subfractions were measured with the Lipoprint LDL System (electrophoresis in 3% polyacrylamide gel).

Results.All groups were similar by the levels of lipid and apoprotein parameters. The levels of high-sensitive C-reactive protein and glucose, as well as HOMA-IR index, were higher in Group 3 patients. In most cases of severe CA stenosis, small dense LDL particles were detected. In HTG patients, higher levels of small dense LDL3 particles were registered only together with the CA stenosis of at least 21–70%.

Conclusion.The findings on lipoprotein subfractions, obtained with the Lipoprint LDL System, have demonstrated that in patients with verified coronary atherosclerosis, there is a link between the levels of more atherogenic small dense LDL3 particles, the degree of CA stenosis, and blood TG levels. The combination of HTG and high LDL3 levels could be considered an additional marker of severe CA atherosclerosis.
ROLE OF GENETIC FACTORS IN THE DEVELOPMENT OF CLOPIDOGREL RESISTANCE AMONG PATIENTS REFERRED FOR PERCUTANEOUS CORONARY INTERVENTIONS
Authors: Matskeplishvili S. T. , Prokhorchuk E. B. , Arutyunova Ya. E. , Koksheneva I. V. , Shakhnazaryan L. S. , Sandukhadze B. R. , Skryabin K. G. , Melerzanov A. V. , Buziashvili Yu. I.
Published: August 2018

Aim. To study the associations between genetic polymorphisms and the development of clopidogrel resistance in patients referred for percutaneous coronary interventions (PCI).

Material and methods. The study included 84 patients with coronary heart disease (CHD), who underwent planned PCI. Dynamic assessment of platelet aggregation was performed using light transmission aggregometry method (two-channel laser analyser Biola-230LA). The role in the development of inadequate suppression of platelet aggregation during the standard-dose dual antiplatelet therapy (DAT) was investigated for the following genes and polymorphic alleles: CYP2C19 (rs4244285*2, rs4986893*3, rs28399504*, rs56337013*5, and rs12248560*17); CYP2C9 (rs1057910*3); CYP3A4 (rs2242480); CYP2B6 (rs3211371 (5*); CYP3A5 (rs28365083*2 and rs776746); and CYP1A2 (rs762551).

Results. The two study groups demonstrated a statistically significant difference in the prevalence of CYP2C19 rs4244285 (2*) polymorphisms, with an increase in GA and AA genotypes and a reduction in the “wild” GG genotype (Χ2 =11,7; р=0,003). The GA genotype was associated with inadequate suppression of platelet aggregation in patients receiving clopidogrel (75 mg/d) and aspirin (300 mg/d; odds ratio 6,27; 95% confidence interval 1,8–21,69). No significant inter-group differences were observed for other polymorphisms (CYP2C9 (rs1057910*3); CYP3A4 (rs2242480); CYP2B6 (rs3211371 (5*)); CYP3A5 (rs28365083*2, rs776746); and CYP1A2 (rs762551)).

Conclusion. The degree of platelet aggregation in patients on DAT is related to their genetic status. The assessment of genetic polymorphisms can facilitate the choice of optimal therapeutic strategies in clopidogrel-resistant patients. Patients with the CYP2C192* polymorphism are in particular need for an additional correction of the antiaggregant treatment scheme.
RISK OF RECURRENT THROMBOTIC EVENTS IN PATIENTS WITH ACUTE CORONARY SYNDROME AND HIGH PLASMA LEVELS OF D-DIMER
Authors: Panina A. V. , Puchinyan N. F. , Dovgalevskyi Ya. P. , Furman N. V. , Dolotovskaya P. V. , Malinova L. I.
Published: August 2018

Aim. To study the association of plasma D-dimer levels and the risk of thrombotic events in patients hospitalised with acute coronary syndrome (ACS).

Material and methods. The study included 70 patients, aged 34-88 years, who were admitted to the Acute Coronary Care Unit with the ACS diagnosis.

Results. During the follow-up period, thrombotic events were registered in 12 patients (17%). Three patients with myocardial infarction (MI) suffered recurrent MI. Nine patients were rehospitalised with the unstable angina (UA) diagnosis. All participants were divided into quartiles by the levels of D-dimer (25% percentile 136 ng/ml; median 1250 ng/ml; and 75% percentile 2930 ng/ml). High plasma levels of D-dimer (third quartile) were associated with a 1,5-fold increase in the risk of recurrent thrombotic events among ACS patients.

Conclusion. In ACS patients, plasma D-dimer levels could be regarded as one of the additional risk factors of thrombotic events.
EXPERT CONSENSUS. ROLE OF COMBINATION LIPID-LOWERING THERAPY (SIMVASTATIN/EZETIMIBE 20/10 MG) IN THE CORRECTION OF LIPID METABOLISM DISTURBANCES IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Catapano A. , Shlyakhto E. V. , Martynov A. I. , Oganov R. G. , Kukharchuk V. V. , Shestakova M. V. , Ametov A. S. , Boicov S. A. , Bubnova M. G. , Villevalde S. V. , Galyavich A. S. , Karpov Yu. A. , Kobalava J. D. , Koziolova O. N.
Published: August 2018

Expert Consensus. Role of combination lipid-lowering therapy (simvastatin/ezetimibe 20/10 mg) in the correction of lipid metabolism disturbances in patients with chronic kidney disease.
INSULIN RESISTANCE: GOOD OR BAD? DEVELOPMENT MECHANISMS AND THE ASSOCIATION WITH AGE-RELATED VASCULAR CHANGES
Authors: Boytsov S. A. , Strazhesko I. D. , Akasheva D. U. , Dudinskaya E. N. , Kruglikova A. S. , Tkacheva O. N.
Published: August 2018

The authors discuss the mechanisms of insulin resistance (IR) development; the IR role in the development and progression of the major age-related vascular changes; IR and the transformation of vascular ageing into disease; and IR impact on life expectancy.
ASSESSMENT OF MYOCARDIAL REPERFUSION QUALITY IN PATIENTS WITH ACUTE CORONARY SYNDROME AND ST SEGMENT ELEVATION, BASED ON THE CRITERIA BY THE AMERICAN COLLEGE OF CARDIOLOGY/AMERICAN HEART ASSOCIATION
Authors: Posnenkova O. M. , Kiselev A. R. , Gridnev V. I. , Popova Yu. V. , Dovgalevskyi P. Ya. , Oshchepkova E. V.
Published: August 2018

Aim. To use the criteria by the American College of Cardiology/American Heart Association (ACC/AHA), in order to assess the quality of myocar-dial reperfusion in Russian patients with acute coronary syndrome (ACS) and ST segment elevation (STE-ACS).

Material and methods. We analysed the clinical data of 25682 patients with STE-ACS, who were treated (2010–2011) in Russian hospitals participating in the Russian ACS Registry. The following ACC/AHA indicators (2008) were used: “time to thrombolysis” — the percentage of STE-ACS patients who received thrombolysis within 30 minutes after admission; “time to primary percutaneous coronary intervention (PCI)” — the per-centage of STE-ACS patients in whom primary PCI started within 90 minutes after admission; and “reperfusion” — the percentage of STE-ACS patients who underwent any reperfusion intervention within 12 hours after the chest pain onset.

Results. Among 25682 STE-ACS patients, any reperfusion intervention (PCI and/or thrombolysis, in any order) were performed in 12043 (46,9%). Among 7437 STE-ACS patients who underwent thrombolysis, 5119 (69%) met the inclusion criteria. In this group, the indicator “time to thrombolysis” was met in 3342 patients (65,3%). Among 5405 STEACS patients who underwent PCI, 3993 (73,9%) met the inclusion criteria. In these patients, the indicator “time to primary PCI” was met in 2797 (70%). Finally, among 25135 (97,9%) patients with STE-ACS who were included in the analyses, the indicator “reperfusion” was met in 9800 (38,9%).

Conclusion. The main problem of the health care for Russian patients with STE-ACS is the limited reperfusion coverage. However, the reperfusion quality could be regarded as satisfactory.
COMBINATION THERAPY IN THE MANAGEMENT OF ARTERIAL HYPERTENSION: EFFECTIVENESS OF THE LERCANIDIPINE AND ENALAPRIL COMBINATION
Authors: Minushkina L. O.
Published: August 2018

This review presents the evidence on the benefits of fixed-dose combination therapy for arterial hypertension management. The focus is on the combination of a third-generation dihydropyridine calcium antagonist lercanidipine and an ACE inhibitor enalapril. Lercanidipine is characterised by high vascular selectivity and lipophilicity, good antihypertensive effectiveness, and prolonged, gradually developing therapeutic effects. Literature data on the effectiveness of the lercanidipine-enalapril combination are presented. This combination facilitates a marked reduction in blood pressure levels, which is particularly relevant for elderly patients and patients with diabetes mellitus or obesity. The combination of pharmacologic effects of lercanidipine and enalapril provides additional benefits in terms of organ protection and reduction of adverse effects of the antihypertensive treatment.
NEW PATHOGENETIC FACTORS OF ATHEROSCLEROSIS DEVELOPMENT AND POTENTIAL THERAPEUTIC APPROACHES
Authors: Kalvinsh I. Ya.
Published: August 2018

It has been demonstrated that one of the factors in the pathogenesis of atherosclerosis, with the subsequent development of myocardial infarction (MI), stroke (S), or sudden death (SD), is trimethylaminoxide (TMAO), the end-product of dietary choline, betaine, or carnitine metabolism by intestinal microflora. Simultaneously elevated levels of TMAO and carnitine are associated with a doubled or even tripled risk of MI, S, and SD. Therefore, dietary intake of choline-rich phosphatidylcholine fats and red meats and carnitine-rich dairy is an important risk factor (RF) of atherosclerosis. At the moment, there is no universally accepted therapeutic approach which reduces TMAO and carnitine levels. The only agent which can simultaneously reduce the levels of these two atherosclerosis-associated RFs is a well-known cardio- and cytoprotector Mildronate. Experimental and pilot clinical studies of Mildronate effectiveness in patients with obliterating atherosclerosis suggest the need for further, more detailed clinical trials of Mildronate, for estimation of its efficacy and safety.
IMPLEMENTATION OF EVIDENCE-BASED CLINICAL-AND-MORPHOLOGICAL APPROPRIATE USE CRITERIA FOR CORONARY REVASCULARIZATION IN PATIENTS WITH ACUTE CORONARY SYNDROME IN RUSSIA
Authors: Popova Yu. V. , Posnenkova O. M. , Kiselev A. R. , Gridnev V. I. , Dovgalevsky P. Ya.
Published: August 2018

Aim. To study possibility of using the evidence-based clinical-andmorphological appropriate use criteria for percutaneous coronary interventions (PCIs) for expert evaluation of high-technology procedures implementation in patients with acute coronary syndrome (ACS) in Russia.

Materials and methods. The appropriateness of performed PCI was assessed in patients with ACS, underwent coronary revascularization. The potential need in PCI was determined in ACS patients refused from coronary revascularization. Assessment was performed with the help of ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate Use Criteria for Coronary Revascularization Focused Update (ACCF 2012). Data from 65,912 ACS patients, containing in Russian ACS Registry (2010–2011) were examined.

Results. ACCF 2012 criteria allow to assess the clinical appropriateness of PCI in 79.2% of patients underwent coronary revascularization and to determine the potential need in PCI in 80.6% of patients, refrained from coronary revascularization. Among ACS patients underwent PCI (n=9147), intervention was appropriate in 68.9% of cases. Inappropriate PCI was revealed in 4.6% of cases. Among patients refrained from PCI (n=56765), coronary revascularization was potentially appropriate in 57.9% of cases.

Conclusion. ACCF 2012 clinical-and-morphological criteria allow to judge on appropriateness of performed PCI and to evaluate the potential need in PCI among the most part of Russian ACS patients. In present study coronary revascularization was appropriate in the majority of ACS patients. It was shown possible to use the evidence-based clinical-andmorphological criteria for expert evaluation of high-technology procedures implementation in Russian ACS patients.
THE EFFECTIVENESS OF CARVEDILOL AND EPROSARTAN IN PATIENTS WITH METABOLIC SYNDROME AND CHRONIC HEART FAILURE
Authors: Dashnamirov R. L.
Published: August 2018

Аim. of the study was to assess the effectiveness of carvedilol and eprosartan in addition to the traditional treatment (Nitrosorbid 30mg/day + Digoxin 0.25mg/day + TromboASS 100mg/day + Atorvastatin 20mg/day + Furosemid 40mg/day + Verospiron 50mg/day + Atenolol 12.5–25 mg/day) in patients with metabolic syndrome and chronic heart failure.

Materials and methods. 91 patients with MS and CHF included sharing mentioned criteria. Carvedilol in doses of 6,25 ÷ 25 mg/day and eprosartan in doses of 300 ÷ 600 mg/day were administered in addition to the traditional treatment.

Results. After 12 months of treatment systolic BP decreased by 23.6% and diastolic by 17.2%. Heart rate decreased by 23.1%, and exercise tolerance increased by 22.3%. Dynamics of the presented indicators are statistically significant.

Conclusion. Administration of an alpha-beta blocker carvedilol and angiotensin II receptor blocker eprosartan in the above dosages promote the longest remission of heart failure, improvement in functional class and regression of pathological remodeling.
EARLY HEART DISORDERS IN HYPERTENSIVE PERSONS AS THE RESULTS OF PREVENTIVE EXAMINATION ON INDUSTRIAL ENTERPRISE
Authors: Britov A. N. , Platonova E. M. , Ryzova T. V. , Eliseeva N. A.
Published: August 2018

The article is considered on the questions of pathogenesis, clinic and diagnosis of myocardial disorders, first of all in persons with high blood pressure. Preference of ultrasound cardiography (UC) for detection of concentric and eccentric hypertrophy of left heart ventricle as well as concentric remodeling is shown. Authors claim the principle possibility to use UC methods in the plant out-patient department; it has principal significance for economically active persons. 2557 industrial workers 20–60 years (1492 men and 1065 women) were investigated. Hypertension (140/90 mm Hg or antihypertensive treatment) was diagnosed in 20% — 514 persons. Voltage ECG LVH criteria were found in 142 pts (28%); UC signs of LVH were found in 389 pts (76%). Increase of related thickness of heart walls diagnosed in 412 pts (80%) and increase of Mass myocardial index — in 347 pts (67%), diastolic dysfunction was found in 402 pts (78%). So the exclusive value of modern diagnostic methods including UC is proven which gives the possibility of early diagnostic of prevalent heart disorders in hypertensive industrial workers.
A COMPARISON OF THE MAIN ANTIHYPERTENSIVE DRUGS FROM THE VIEWPOINT OF AORTIC STIFFNESS MODIFICATION IN ARTERIAL HYPERTENSION
Authors: Shupenina E. Yu. , Vasyuk Yu. A. , Khadzegova A. B. , Ivanova S. V. , Nadina E. V. , Khuchinaeva A. M.
Published: August 2018

A plenty of trials confirm the importance of aortic wall stiffness evaluation during estimation of the cardiovascular risk and the need for novel drugs influencing this parameter. Most of hypotensive medications modify arterial wall siffness by one or another way. So the usage of drug combination might be more effective. Insufficient impact of betaadrenoblockers on central artrial pressure is linked to peripheral vasoconstriction. The drugs within this class having vasodilatory properties significantly reduce central aortic pressure.
Simón Rodríguez y la escucha al borde del vacío: lecturas en clave ontológica de la escuela
Authors: Durán Maximiliano Lionel
Published: August 2018

Resumen Simón Rodríguez crea, en 1826, una escuela completamente novedosa en la ciudad de Chuquisaca. Por primera vez en América, los niños y las niñas de las distintas castas son incluidos en un mismo salón de clases en calidad de iguales. A lo largo de su obra, Rodríguez hace referencia a esa escuela inédita en el continente americano con el nombre de educación popular. Dicha escuela se caracterizó por el despliegue axiomático de un principio igualitario. A diferencia de otros proyectos escolares latinoamericanos, cuyo objetivo final era generar, en el mejor de los casos, ciertas condiciones de igualdad entre la población escolar, la escuela de Rodríguez parte de la igualdad como su condición de posibilidad. En este trabajo, se intentará pensar un componente particular de la escuela popular: el maestro. Para ello, se dividirá el artículo en tres partes. En la primera, se desarrollará un análisis de las categorías ontológicas y metaontológicas de Alain Badiou. En esa sección del trabajo, se presentarán brevemente las categorías de situación, estado de la situación, vacío y acontecimiento. En la segunda, se expondrá la reapropiación de esas categorías por Alejandro Cerletti. Dicho autor realiza una relectura de las categorías badiouanas en clave educativa. La última parte consistirá en el análisis del concepto de maestro implícito en la escuela popular de Simón Rodríguez, en función de las categorías trabajadas en las dos primeras secciones. Esa sección demostrará que el maestro popular es aquel que acompaña a los niños y a las niñas a través de un proceso de atención centrado en la escucha al borde del vacío.
Práticas de desenho e saberes geométricos nos manuais escolares do século XIX
Authors: Silva Maria Célia Leme da
Published: August 2018

Resumo O artigo analisa as diferentes práticas de desenho no processo de escolarização de saberes geométricos presentes nos manuais escolares do século XIX e discute as diferenças entre os manuais traduzidos e a produção brasileira. A pergunta que norteia a análise é: como as práticas de desenho participam do processo de escolarização dos saberes geométricos? Os manuais revelam a presença de duas abordagens distintas para a escolarização de saberes geométricos: o desenho à mão livre e o desenho geométrico, com instrumentos. Apesar de as traduções de manuais estrangeiros propagarem marcas do método intuitivo, em que o desenho à mão livre escolariza os saberes geométricos, tal proposta não prevalece nas produções brasileiras, que se caracterizam pelo desenho geométrico de figuras previamente definidas, de modo que os saberes geométricos sustentam a prática do desenho.
O ensino de literatura e a negatividade do literário
Authors: Cechinel André
Published: August 2018

Resumo Em contraste com os pressupostos teóricos “humanos” ou “pós-humanos” acerca da literatura e de seu lugar institucional, o presente ensaio propõe-se a estabelecer uma leitura “negativa” ou “improdutiva” do ensino literário. Para tanto, o texto divide-se em dois momentos fundamentais: primeiro, examina a temporalidade que a literatura exige, quando do contato efetivo com os objetos; a seguir, o ensaio volta-se para o processo de “saída de si” que a literatura inaugura, quando da entrega à especificidade dos artefatos. Em suma, defender uma leitura “negativa” da literatura não significa esvaziá-la de qualquer dimensão ética; pelo contrário, a “negatividade” do literário responde a uma tarefa política urgente para o tempo presente.
Avaliando a qualidade dos serviços para a infância: uma abordagem participativa
Authors: Giandomenico Isabella Di , Picchio Mariacristina , Musatti Tullia
Published: August 2018

Resumo Serviços educacionais para a infância apresentam certas características específicas que têm consequências importantes para a escolha da abordagem teórica e dos procedimentos para avaliação da sua qualidade. Serão expostas nesta contribuição algumas dessas características e analisadas suas consequências. Apresenta-se aqui o sistema de avaliação da qualidade dos serviços educacionais para a infância desenvolvido e testado em várias cidades italianas, discutindo a abordagem teórica e descrevendo os procedimentos. O sistema inclui a participação das várias partes interessadas na avaliação e se baseia na documentação escrita da experiência de crianças e pais no serviço, produzida, analisada e discutida pelos operadores nas reuniões de colegiado. A avaliação está incluída na atual atividade profissional dos operadores e objetiva implementar suas habilidades de reflexão e introduzir intervenções de inovação nos serviços.
Efeito da eletroestimulação no nervo tibial posterior para bexiga hiperativa em mulheres: revisão sistemática
Authors: Rufino Priscila Thaís Santos de Oliveira , Leme Ana Paula Cardoso Batista Paes
Published: August 2018

INTRODUÇÃO: A bexiga hiperativa é uma condição que tem como principal causa a hiperatividade do músculo detrusor e que afeta muitas mulheres. Tem origem idiopática quando não está vinculada a outra patologia. Em contrapartida, quando possui origem neurogênica, tem como causas alterações neurológicas associadas ao mecanismo da micção. Os tratamentos utilizados para a bexiga hiperativa são medicamentoso, fisioterapia e terapia comportamental. Um dos métodos utilizados na fisioterapia é a eletroestimulação do nervo tibial posterior (PTNS), cujo objetivo é impossibilitar a contração involuntária do músculo detrusor de forma exacerbada. OBJETIVO: Identificar o efeito do uso da eletroestimulação percutânea no nervo tibial posterior como forma de tratamento em mulheres com diagnóstico de bexiga hiperativa associada à perda urinária. MATERIAIS E MÉTODOS: Uma revisão sistemática de literatura, que utilizou artigos de ensaios clínicos randomizados encontrados na base de dados Cochrane. A busca dos artigos foi realizada por dois revisores no período compreendido entre agosto e outubro de 2017, realizada de seguinte forma (Urinary Bladder, Overactive AND Tibial nerve AND Transcutaneous Electric Nerve Stimulation). RESULTADOS: Foram encontrados 17 artigos; destes, 4 foram selecionados. As variáveis dos artigos analisados foram noctúria, urgência miccional, qualidade de vida, frequência urinária. O PTNS apresentou-se como um método eficaz para o controle da frequência urinária, a noctúria e a incontinência urinária de urgência. CONCLUSÃO: O tratamento através da eletroestimulação percutânea no nervo tibial posterior (PTNS) torna-se um método eficaz, para o controle da frequência urinária, a noctúria e a incontinência urinária de urgência, garantindo a melhora dos sintomas da bexiga hiperativa referida pelos pacientes.