bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic obstructive pulmonary disease and anemia: clinical manifestations and therapeutic strategy
Authors: Budnevsky A. V. , Provotorov V. M. , Ul’yanova Marina I.
Published: November 2020

Anemia refers to manifestations of systemic infl ammation in chronic obstructive pulmonary disease (COPD) and a factor aggravating the disease. Objective: to study gender characteristics of anemia in patients with COPD, to increase the effectiveness of treatment through the use of pharmacological agents erythropoietin and enteral iron. Materials and methods. The paper presents clinical data on 74 patients with stage II/III COPD and anemiaalong with results of the treatment of 49 patients who received standard therapy in addition to epoetin and Sorbiferdurules. Results. Patients with COPD much morefrequently presented with iron defi ciency anemia (IDA): 63 patients (85.1%) dominated by women (39 or 61.9% ) with men accounting only for 24 or 38.1% of the total. 11 patients (14.9%) had normochromic normocytic anemia with the parameters of anemia of chronic disease. The incidence of IDA in both groups correlated with age; it was largely a moderately severe condition that much more frequently occurred in women (24 out of 39 patients - 61,5%) than in men in whom the mild form of iron defi ciency prevailed (14 of 24 patients - 58,3%). Conclusion. The overall prevalence of anemia concomitant with COPD was estimated at 26.5%. It was documented in44 women (33.7%), i.e. in each third patient. It occurred less frequently in men (30 or 20,7%). The presence of anemia deteriorates conditions of the patients, especially female ones, who more often suffere from shortness of breath, impairedgeneral health status , fatigue, and depression; moreover, they more frequently need hospitalization. Correction of anemia with erythropoietin and iron preparations for the internal use can improve physical endurance of the patients, reduce cough intensity and shortness of breath,promote positive dynamics of physical tolerance for a prolonged period after the completion of antianemic therapy.
National clinicism and its applications
Authors: Fedoseev Gleb B. , Trofimov V. I.
Published: November 2020

Domestic clinicism is a methodology implying the maximum use of diagnostic and therapeutic potential of the physician in combination with the optimal application of laboratory and instrumental techniques for the choice of personified means of pharmaceutical and non-pharmaceutical treatment and prophylaxis of various diseases. It can not be applied under routine working conditions of a district doctor who has only 10-15 min to handle each patient. The currently adopted principle of organization of primary medical care: “the more patients the better”, negatively affects the patients’ health and emotionally discourage doctors.
Obesity and cardiovascular system
Authors: Verbovoy Andrey F. , Pashentseva A. V. , Sharonova L. A.
Published: November 2020

Obesity is a serious medico-social and economic problem. Increased body mass index is associated with a rise in the general mortality rate and mortality due to cardiovascular diseases. In this article, modern views of the influence of obesity on the cardiovascular system are considered.
Evaluation of significance of melatonin
and some atmospheric and heliogeophysical factors for patients with acute coronary syndrome
Authors: Mikhailova Z. D. , Klimkin Pavel F. , Shalenkova M. A. , Manyukova E. T. , Gaidash S. P.
Published: November 2020

Introduction. Changes in melatonin (MT) production affected by earth magnetic field (EMF) were documented, including but not limited to patients with cardiovascular diseases. Thus far, the connection between MT content and atmospheric and heliogeophysical factors with regard to acute coronary syndrome (ACS) patients has not been thoroughly studied and the existing data are controversial. Material and methods. The levels of MT metabolite 6-hydroxymelatonin were measured in urine at night (MTn) and day (MTd) time in 114 ACS and 26 stable angina (SA) patients on days 1-3 of hospital stay. Results. Significant inverse correlation between MTn content and EMF H and D-components (H, D) of EMF was found in ACS patients as well as direct correlation between the MTn levels and solar radiation flux density at a wavelength of 10.7 cm (F-10.7) and the number of sun spots (the Wolf number - W). Significant direct correlation was shown between EMF D-component value, Kp- and Ap- geomagnetic activity indices in ACS patients developing cardiovascular complications. For ACS patients, the risk of development of cardiovascular complications was 1,62 and 1,15 times greater at high Kp- and Ap-indices respectively. Conclusion. Direct connection between MTn level and solar activity factors was observed in ACS patients together with inverse correlation with geomagnetic activity which confirms the influence of heliogeophysical factors on MT production. The risk of developing cardiovascular complications increases at higher Kp-and Ap- indices which proves the effect of heliogeophysical factors on the clinical course of cardiovascular pathology. The MTn content was shown to decrease in winter in these patients.
The frequency and characteristics of cardiovascular pathology in HIV-infected patients (according to aytopsy)
Authors: Golyshko Valentina S. , Snezhitskiy V. A. , Matsiyeueskaya N. V. , Prokopchik N. I.
Published: November 2020

Aim to study the frequency and structure of the cardiovascular diseases (CVD) deaths from HIV-infected patients. A retrospective analysis of medical records of 346 deaths of HIV-infected patients: 225 (65%) males (95% confidence interval - 95% CI 69,8-58,8) and 121 (35%) women (95% CI 30,1-40,1) at the age of 35.0 [32,0;38,0] years. Autopsy was performed in 150 (43,5%) patients (95% CI 38,2-48,6). GCC is installed in 77 (22.3 %) of 346 cases (95% CI of 18.2-26.9) . While 18 (5,2%) patients (95% CI 3,3-8,1) CVD was the main cause of death in 59 (17,1%) - concomitant diseases (95% CI 13,5-1,4). The structure of the CVD were presented with acute heart failure in 17 (4,9%) autopsy cases (95% CI 3,1-7,7) , hydropericardium - 14 (4.0%) of cases (95% CI 2,4-6,7), coronary heart disease in 14 (4.0%) of cases (95% CI 2,4-6,7), cardiomyopathy in 11 (3,2%) cases (95% CI 1,8-5,6), myocarditis in 10 (2.9%) cases (95% CI 1,6-5,2), infective endocarditis in 4 (1.2%) cases (95% CI 0.5-3.0), chronic pulmonary heart, in 4 (1.2%) cases (95% CI 0.5-3.0), effusion in 3 (0.9%) cases (95% CI 0,3 - 2,5). The defeat of the cardiovascular system in HIV-infected patients in 79,2% of cases were formed against the background of generalized of severe opportunistic infections and diseases. In patients not receiving antiretroviral therapy, have higher rates of death AIDS-associated CVD as compared to that in patients receiving therapy: 3,8% (95% CI 1.9-7,3) and 0 respectively (p=0.05).
Overlap syndromes in hepatic autoimmune
diseases
Authors: Podzolkov V. I. , Dragomiretskaya Natal’ya A. , Volchkova E. V. , Mitrokhina O. I.
Published: November 2020

Autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC) comprise a group of autoimmune hepatic disorders. Sometimes, overlap syndromes occur, e.g. AIH/PBC or AIH/PSC. The authors consider autoimmune hepatic disorders with reference to pathogenesis, clinical picture, diagnostics, and treatment of overlap syndromes.
Women in army and medicine
Authors: Bel’skikh A. N. , Abashin Viktor G. , Shmidt A. A.
Published: November 2020

The data on the participation of women in the armies of various countries are considered in the historical and modern aspect. The focus is made on the Russian army. The article highlights activities of women in command of military units, in combat and in military medicine; the list of the most common military specialties is presented. Peculiar features of female organism are discussed in relation to the conditions of army life. Special attention is given to historical data on women's participation in the delivery of health care in the Russian army, their participation in army institutions and rear hospitals.
Risk factors and peculiarities of clinical course of ulcer disease in employees of antibiotic industry.
Authors: Belousova Irina B. , Mikulyak N. I. , Sheptulin A. A.
Published: November 2020

A total of 62 patients engaged in antibiotic production (main group) and 59 control subjects were examined. Risk factors of ulcer disease in these patients could be dust inhalation, contact with solvents, shift work, and smoking. Patients of the main group had a more severe disease and higher frequency of complications, larger amounts of Helicobacter pylori in the gastric mucosa, its more pronounced morphological changes, slower disappearance of clinical symptoms of exacerbation, and longer period of ulcer scarring. Also, they underwent more severe disorders of humoral immunity than control subjects which might account for the unfavourable clinical picture of their condition.
Metabolic risk factors, as a
trigger mechanism of the disease of the cardiovascular system in different age periods in the adult population.
Authors: Gruzdeva Olga V. , Palicheva E. I. , Maksimov S. A. , Dyleva Yu. A. , Zhilyaeva T. P. , Makarov S. A.
Published: November 2020

Aim - to identify the features of propagation of metabolic CVD risk factors (visceral obesity, hyperglycemia and hypercholesterolemia), depending on the age and sex accessories. Material and methods. As a result of follow-survey 2308 men and women between the ages of 21 to 71 years and older age group 6 is formed. The prevalence of CVD risk factors, as well as hypertension and coronary heart disease, depending on the age and gender characteristics. Determination of serum glucose and total cholesterol (TC) was evaluated using the test systems company «Thermo Fisher Sientific» (Finland). Results. Obesity is equally widespread in young and middle age, but after 40 years have seen a dramatic increase in the prevalence of this factor in women. Hypercholesterolemia is most common in men and women after 50 years, with the greatest increase observed in patients with diabetes and hypertension. At the same time in men with hypercholesterolemia, obesity is recorded at an earlier age, and the prevalence of coronary artery disease is most pronounced in men older age group. Conclusion. Between all the studied risk factors, there is a relationship, and the existing risk factors at a young age, still active when the compensatory system, implemented at a later age the development of critical states in the form of myocardial infarction and stroke.
The role of asymmetric dimethylarginine in the development of arterial
hypertension.
Authors: Podzolkov V. I. , Safronova T. A. , Natkina Dinara U.
Published: November 2020

The results of numerous studies of recent decades confirm the crucial role of vascular endothelium in regulating vascular homeostasis. A plethora of recent studies have shed light on the clinical significance of endothelial dysfunction in essential hypertension. Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide synthase inhibitor. At present, it is considered as a generally recognized marker of endothelial dysfunction by most researchers. In vitro experiments showed that ADMA inhibits endothelium-dependent arterial relaxation, increases the level of indicators characterizing the degree of oxidative stress in endothelial cells, enhances the synthesis of the superoxide anion radical by endothelial cells. The molecular mechanisms described above, activated with an increase in the concentration of ADMA, cause various disturbances in the function of the cardiovascular system, which gave grounds to consider the level of ADMA as a criterion and risk factor for the development of cardiovascular diseases. Thus, ADMA plays a key role in the development and progression of CVD associated with a spectrum of diseases and pathological conditions characterized by a disturbance in NO production. Despite clinical and experimental confirmation of the relationship between the increase in ADMA in plasma and the development of cardiovascular events, the unambiguous etiopathogenetic role of ADMA in CVD requires further research. In order to accurately answer the question of whether ADMA is an etiological factor or a biological marker of CVD, additional analysis is needed to study the biochemical, genetic and pharmacological aspects of ADMA metabolism, the results of which are presented in this article.
Primary cardiac amyloidosis.
Authors: Demko I. V. , Pelinovskaya L. I. , Soloveva Irina A. , Kraposhina A. Yu. , Gordeeva N. V. , Mosina V. A.
Published: November 2020

Cardiac amyloidosis - the disease which is characterized by deposition of insoluble protein amyloid in intercellular space is one of the most severe implications of systemic amyloidosis. Primary cardiac amyloidosis possesses a wide range of clinical implications that complicates well-timed diagnostics and, respectively, treatment. The long latent current and the adverse forecast do extremely important diagnostics of cardiac amyloidosis at early stages of a disease. The modern concept of pathogenesis and morphology of an amyloidosis is covered in article, the clinical options of a current, diagnostic methods of dysfunction of heart including bio- and immunochemical blood analysis and urine, a complex of tool methods of a research and «the gold standard» of verification of deposits of amyloid - a biopsy of various organs and tissues are described.
Prognostic value of bone density characteristics in patients with
chronic obstructive pulmonary disease.
Authors: Nikitin A. V. , Vasil’eva L. V. , Evstratova Elizaveta F. , Nikitin V. A.
Published: November 2020

The frequency of osteoporosis in patients with chronic obstructive pulmonary disease (COPD) is 2-3 times that in persons of the same age without airway obstruction. Recently, the analysis of bone density under outpatient conditions the quantitative ultrasonometry technique (QUST) has been widely used. We analyzed results of the treatment of 36 patients (14 men and 22 women) aged with COPD 58-72±4,36 years. It was shown the T-criterion values obtained by QUST to characterize spinal pain in COPD patients are much more altered than in healthy subjects; direct correlation between them was documented. Moreover, they related to the duration of the disease and changes in the external respiration function. The possibility to reveal osteoporosis under outpatient conditions with the use of QUST was confirmed.
Inflammation and hemocoagulation
Authors: Bokarev Igor N.
Published: November 2020

Problems of inflammation are extensively studied all over the world. Its mechanisms are known to involve hundreds of factors. The blood coagulation system is a major component of each living organism. This article was designed to analyze the relationship between inflammation and hemocoagulation and discuss definition of the term “low-grade inflammation” with reference to the blood coagulation system.
Personalized medicine in internal medicine
Authors: Kukes V. G. , Marinin V. F. , Olefir Yu. V. , Ramenskaya G. V. , Lazareva N. B. , Smirnov V. V. , Zhuravleva M. V. , Prokofiev A. B. , Shih E. V. , Zhestovskaia A. S. , Rumyantsev N. A. , Mandich D. V. , Goroshko O. A.
Published: November 2020

Personalized medicine - a new direction in medicine, which is based on the study of various biomarkers and the use of new methods of molecular analysis (primarily evaluating the activity of isoenzymes of cytochrome P450), allowing individualized approach to the selection of both the drugs and the selection of the dosing regimen for the purpose of maximize the effectiveness and safety of pharmacotherapy. This personalized medicine is to change the development and use of preventive and curative interventions. Genetic polymorphism isozymes of cytochrome P450 may determine the individual activity of a particular isozyme, and thus, to predict the clinical effectiveness, and in some cases, the risk of adverse reactions. The article is an example of the use of information on the activity of cytochrome P450 in clinical practice in matters of diagnosis, treatment and prevention of diseases. The scheme of the five best-known activity of isoenzymes of cytochrome P450 is shown.
Desialated low density lipoproteins in
human blood
Authors: Ryzhkova A. I. , Karagodin V. P. , Sukhorukov V. N. , Sazonova M. A. , Orekhov A. N.
Published: November 2020

The present article is a review of literature on circulating low-density lipoproteins (LDLP) which can induce accumulation of lipids (mainly, cholesterol), in a SMA(+) cell culture of normal human aortic intima. An attempt was undertaken to resolve the paradox of the absence of both native LDLP influence on intracellular lipid accumulation and modifications of in vitro obtained LDLP in the blood-vascular system. It was showed that atherogenic LDLPs are characterized by a number of changes in carbon, protein and lipid components which can be regarded as multiple modifications of LDLP taking place in human blood plasma. Multiply modified circulating LDLP possess of capacity to interact with various cell membrane receptors differing from B and E receptor, and with proteoglycans. Marked absorption of desiliated LDLPs by the cells simultaneous with a decrease in the degradation of apolipoproteins and cholesterol esters as well as induction of peresterification of free cholesterol leads to intracellular accumulation of esterified cholesterol. Formation of large LDLP-containing complexes especially circulating low-density lipoproteins can stimulate accumulation of lipids by smooth muscle cells of intima. Desiliated LDLPs stimulated cell proliferation and connective tissue matrix synthesis despite cholesterol ester accumulation. In conclusion, the authors of this article found and characterized natural multiply modified LDLPs that can be responsible for the symptoms of atherosclerosis at the cellular level.
Modern approach to therapy of patients with idiopathic pulmonary
fibrosis
Authors: Tsvetkova O. A. , Voronkova O. O. , Buyanova O. E.
Published: November 2020

A case of the treatment of a patients with idiopathic pulmonary fibrosis with pirfenidone and nintedanib is reported with reference to the role of these medications in therapy of his condition in the context of modern theory of its pathogenesis.
The influence of gender differences on the
results of treatment of acute myocardial infarction with elevated ST segment (the hospital period)
Authors: Nemik D. B. , Matyushin G. V. , Protopopov A. V. , Shul’min A. V. , Ustyugov S. A.
Published: November 2020

Aim. To evaluate the effect of gender on mortality from acute myocardial infarction with elevated ST segment (STEMI). Materials and methods. In this single-centre retrospective study, we analyzed outcomes of the in-hospital stage of the treatment of 553 men (67,7%) and 263 women (32.3%). 160 women (60,8%) underwent primary percutaneous coronary intervention (pPCI) and 103 pharmacoinvasive strategy (FAST-PCI), (39,2%). The same treatment was given to 295 (53,3%) and 258 (46,7%) men respectively. Patients with “primary medical contact (PMC) - balloon” of less than 60 minutes and “PMC - balloon” symptom” of more than 6 hours were excluded from the study. For the majority of the patients this time interval was on the order of 120 minutes. Results. Mortality in women was significantly higher than in men regardless of the reperfusion strategy: total 15.3 percent (18.1 percent in case of PCCW and 10.9% in case of FIS) in women and 3.1% (5.1% in case of PCCW and 0.8% in case of FIS) in men (p < 0.001). The probability of a lethal outcome in women was 4 times higher (OR 4,4 DI 95% 2,7-7,1).
The prevalence of risk factors of cardiovascular diseases in persons with arterial hypertension exposed to occupational
stress
Authors: Telegina A. I. , Liferov R. A. , Fisun A. Ya. , Makiev R. G. , Gornov V. V. , Pastukhov A. V. , Kirichenko P. Y. , Cherkashin Dmitry V. , Marin A. I. , Filippov V. Y.
Published: November 2020

Based on the literature data and the results of their own research, the authors emphasize the importance of studying adverse effects of high emotional load during stress-induced hypertension and draw attention to the high prevalence of modifiable risk factors of cardiovascular disease among servicemen exposed to occupational stress. It has been shown that lifestyle of hypertensive subjects under heavy stress is characterized by irrational changes in eating behavior, high prevalence of smoking, increased alcohol consumption, and low physical activity. The leading role of long-term emotional stress was demonstrated as an independent risk factor of hypertension in servicemen exposed to long-term occupational psycho-emotional stress. Analysis of the intima-media complex thickness in brachiocephalic arteries, depending on the level of psychosocial stress demonstrated that the group of the examined servicemen with hypertension showed changes that might be due to the development of atherosclerotic process, the response to increased flow, and arterial wall tension at a high level of stress. These changes are unidirectional regardless of the duration of hypertension history. Results of evaluation of the overall risk of developing cardiovascular complications based on the SCORE scale in the servicemen with established and newly diagnosed hypertension under heavy stress suggest its enhancement in the next 10 years which makes necessary implementation of a system of measures for preventing and correcting pathological conditions caused by stressful loads. Stratification of risk factors is essential for early diagnosis of hypertension and the choice of adequate therapy in subjects undergoing high psycho-emotional stress.
Modern principles of antiplatelet antithrombotic therapy
Authors: Popova Lyudmila V.
Published: November 2020

Antiplatelet agents play a key role in preventing the development of atherothrombosis of various location. There are 4 classes of antiplatelet agents having different mechanisms of action. There are peculiarities of their prescription to patients with brain, heart, peripheral artery ischemia as regards their selection, duration of application, etc.
Diagnostic and prognostic role of
markers of inflammation and vascular endothelial growth factor in infectious endocarditis
Authors: Tazina Serafima Ya. , Fedorova T. A. , Semenenko N. A. , Roitman A. P. , Burtsev V. I. , Rybakova M. K.
Published: November 2020

The peculiarities of primary and secondary infective endocarditis (IE) were studied in 62 patients with primary and secondary IE, uncomplicated and complicated disease treated in S. P. Botkin city clinical hospital including analysis of dynamics of tumor necrosis factor α (TNF α), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF) within 3 weeks after the onset of antibiotic therapy. A rise in TNF α and IL-6 levels was shown to correlate with the severity of the disease and the development of infectious-toxic syndrome. Most patients had an increased level of VEGF, a mediator involved in the regulation of inflammation. It was shown that combination of high TNF-α and IL-6 levels with the initially low or gradually increasing VEGF levelsuggests the unfavourable prognosis characteristic of the most heavily diseased anddeceased patients.
Clinical
and diagnostic significance of biochemical markers of myocardial lesions after planned coronary surgery
Authors: Uchasova Evgenya G. , Shilov A. A. , Gruzdeva O. V. , Ganyukov V. I. , Kuz’mina A. A. , Kochergin N. A. , Akbasheva O. E.
Published: November 2020

In recent years, percutaneous coronary interventions (PCI) have become the preferred method for the treatment of patients with coronary heart disease. Despite the proven efficacy of PCI, it can be associated with myocardial infarction. Purpose. To study the significance of increased concentration of various biomarkers of myocardial injury for verification of its diagnosis after planned PCI. Materials and methods. The study included 103 subjects who underwent planned myocardial revascularization in the form of PCI. Blood samples for analysis of myocardial necrosis markers (myoglobin, Troponin I, CK-MB) were taken before and 24 hours after PCI. Results. After PCI, the Troponin I content increased in 36 (35%) subjects within the range from 0.05 to 0.25 ng/ml. Troponin I concentration increased in 21 (20.3%) subjects to more than 0.25 n/ml (a higher than 5-fold increase of 99 percentile). CK-MB level increased in 56 subjects up to the 5-fold rise in 99 percentile (<21.5ng/ml) and 3 subjects showed more than 5-fold increase of 99 percentile as compared to the baseline. 37 subjects underwent PCI for the management of technically complicated coronary bed lesions (С and B2 types of coronary arteries’ lesions). In 9 out of the 37 subjects (24.3%), a significant increase in Troponin I level was documented, other 28 (75.7 %) subjects did not experience the 5-fold increase of Troponin I. In 12 (18.2%) patients with morphologically uncomplicated coronary bed anatomy, a significant increase in Troponin I was registered Conclusion. After a planned PC, an increase of Troponin I and CK-MB levels occurs in 55-58% of the patients. A significant 5-fold increase of Troponin I level (without additional criteria of MI diagnosis) occurs more often than a rise in the CK-MB level. A planned PCI is accompanied by elevated Troponin I levels regardless of the complexity of coronary bed lesion.
Thrombocytic activity in patients with arterial hypertension associated with metabolic syndrome
Authors: Medvedev Il’ya N.
Published: November 2020

This work was aimed to elucidate the level of in vitro and in vivo aggregation activity of platelets and the functional significance of individual mechanisms of its regulation in patients with grade III arterial hypertension and metabolic syndrome. The study included 29 adult patients (15 men and 14 women) and 25 clinically healthy subjects of similar age. Biochemical, hematological and statistical methods were used. Marked dyslipidemia was associated with active lipid peroxidation. Plasma thromboxane B2 level was increased by 84,8% while 6-ketoprostaglandin F1α level was decreased by 17,9% and the total amount of NO metabolites by 28,7%. The degree of platelet aggregation and their aggregation with collagen 25,0 and 27,5% lower than the respective control values while the respective indices of their aggregation with ristomycin were 25,7 and 46,4% higher. The degree of platelet aggregation and their aggregation with ADP inducer were 25,7 and 58,4% higher than in control while the platelet-discocyte levels were reduced to 48,6 ± 0,4%. The sum of active platelet forms reached 51,4 ± 0,12% vs 17,9 ± 0,09% in control was, the number of small and large aggregates 18,6 ± 0,08 and 5,4 ± 0,04 per 1000 free platelets respectively vs 2,9 ± 0,06 и 0,2 ± 0,06 in control. Excess platelet activity in the patients was due to their enhanced adhesive and aggregative potential and reduced ability to disaggregate. The most important causs of thrombocytopathy was AH, negative changes in plasma lipid composition, and enhanced lipid peroxidation.
The principles of management of patients with liver cirrhosis complicated by ascites
Authors: Garbuzenko Dmitry V.
Published: November 2020

This review deals with modern principles of management of patients with liver cirrhosis complicated by ascites depending on its clinical manifestations. The search strategy included the use of the PubMed database, the Google Scholar system, Cochrane systematic reviews, and reference lists of individual articles that cover relevant publications for 1986-2016 and match the following key words: liver cirrhosis, portal hypertension, ascites, pathogenesis, diagnostics, treatment. Inclusion criteria were confined to uncomplicated or refractory ascites in patients with liver cirrhosis. The analysis of literature data revealed poor prognosis of this condition and high mortality rate despite progress in its management. A major prerequisite for the successful treatment is stratification of risks of unfavourable outcome and the choice of adequate personalized therapy. The pathogenetically sound prescription of pharmacotherapy and further optimization of minimally invasive methods make it possible to improve the quality of life and survivorship of the patients.
The many faces of the problem of intolerance to gluten.
Authors: Livsan M. A. , Osipenko M. F. , Zayakina Natalya V. , Krolevets T. S.
Published: November 2020

Rising incidence of different variants of gluten intolerance associated with changes in eating behaviorin many countries, changes in the technology of growing and processing crops, new culinary technologies. Until recently, celiac disease, dermatitis herpetiformis and wheat allergy were the only known disease with a proven role of gluten in their pathogenesis. Non-celiac gluten sensitivity (NCGS) - a new syndrome of intolerance to gluten. This pathology can be suspected in patients with persistent intestinal and extra-intestinal symptoms clearly associated with the intake of foods containing gluten, the absence of serological markers of celiac disease or suspected allergy to wheat. The paper presents the current data on the epidemiology, etiology and pathogenesis, clinical features and diagnosis NCGS.
Inhaled glucocorticosteroids in treatment of chronic obstructive pulmonary disease/
Authors: Romanovskikh Anna G. , Belotserkovskaya Yu. G. , Smirnov I. P.
Published: November 2020

Chronic obstructive pulmonary disease (COPD) is an urgent problem of modern healthcare. One of the most frequent approaches to the therapy of the COPD remains the appointment of inhaled corticosteroids (ICSs) and long-acting β2-agonists (LABAs) in fixed-dose combinations. At the same time, the role and place of fixed-dose combinations (ICS/LABA) in COPD therapy is currently being actively discussed. The presented article describes the efficacy and safety of fixed-dose combinations (ICS/LABA) in COPD patients, modern approaches to the appointment of ICS/LABA.
Clinical-psychological aspects deficiency syndrome body mass.
Authors: Atamanov Vadim M. , Demicheva T. P. , Ivashova E. S.
Published: November 2020

The authors assessed psychological and clinical manifestations in 30 women: 12 patients with anorexia nervosa and 18 acquired malabsorption. Used the methodology of life-meaningful orientations D. A. Leontiev, the level of depression according to Beck, the level of subjective control in Baino and co-authors.In these diseases characterized by progressive depression, loss of body weight. Patients with anorexia nervosa were characterized by artificially-induced vomiting, reduce the number of meaningful parameters, and maintaining the level of orientation in the manufacturing sector. Acquired malabsorption characterized by diarrhea, decreased life options while maintaining the level of orientations in interpersonal and family spheres.
Management of a patient with terminal chronic heart failure.
Authors: Kosheleva N. A. , Ponomareva Elena Yu. , Sedov D. S.
Published: November 2020

The presented clinical case describes the development of diffuse myocarditis in a 31-year-old man with the outcome of dilated cardiomyopathy and terminal chronic heart failure, resistant to drug therapy that required heart transplantation. Discussed aspects of diagnosis, clinical manifestations, tactics of patient management and indications for heart transplantation.
Breathing tests and their significance in the clinic of internal diseases: the
importance of non-invasive 13C bicarbonate breath test in medical diagnostics.
Authors: Rapoport S. I. , Zyakun A. M. , Shubina Nina A.
Published: November 2020

13C breath tests have been widely developed in the world gastroenterology at the beginning of the 90-ies of the last century. This technique has been used for over 20 years in many developed countries and it has long been a routine and mass procedure. 13C urease breath test for infection Helicobacter pylori detection is the most widely analysis among 13C breath tests. Researchers are developing new 13C-biomarkers and expand the list of available substrates. One of these techniques is a multifunctional 13C bicarbonate breath test. Here is a brief overview of this application.
Complex treatment of
patients with achalasia of cardia and cardiospasm subject to psychosomatic disorders.
Authors: Chernousov A. F. , Khorobrykh T. V. , Vetshev F. P. , Romasenko L. V. , Dulova V. A. , Osminin S. V.
Published: November 2020

Achalasia of cardia and cardiospasm are neuromuscular diseases characterized by functional disorders of the permeability of the esophageal-gastric junction, their prevalence is up to 22% of all diseases of the esophagus. The article presents a series of clinical studies of 114 patients with achalasia of cardia and cardiospasm since 2006. A modified algorithm for the examination and treatment ofpatients with different stages of the disease is presented. The balloon cardiodilation, as the main method of treatment, was carried out by 76 patients. Surgical treatment was performed in 36 patients: 17 patients with stage III performed esophagocardiomyotomy with incomplete fundoplication in the modification of A.F. Chernousov, 19 - with the IV stage transhiatal extirpation of the esophagus with gastroplasty was performed. A group of 26 patients with psychosomatic disorders was selected, who, in addition to traditional surgical treatment, underwent psychotropic therapy. Good immediate and long-term results of complex treatment were obtained. Substantially faster relief of symptoms of dysphagia and other complaintsfrom the gastrointestinal tract was noted, a more persistent and prolonged effect of dilation sessions and a significant improvement in the quality of life compared with patients who did not receive psychotropic drugs. In this group of patients, we did not observe any recurrence of the disease after the dilatation sessions. The control examination (endoscopic and X-ray examination of the upper gastrointestinal tract, manometry) revealed no signs of dysphagia or gastroesophageal reflux in any patient, including among the operated.
Improved accuracy of diagnosis hepatomegaly at computed
tomography.
Authors: Gromov A. I. , Alliua A. L. , Kulberg N. S. , Dulin P. A.
Published: November 2020

Objectives: to increase informationvalue of computed tomography (CT) scan in assessing liver size Material and methods. The CT scan of the abdominal cavity of 108 patients from Moscow Radiological information system have been analysed. Measurement of three liver sizes, namely: width, height and thickness. Has been carried out 3D reconstruction of liver has been made on basis of its segmentation in the special module of the multimodal station Philips (IntelliSpase Portal), which permit to determine the organ volume with high accuracy. Results. It is established that in most cases (52%) judgment of liver volume is based on one kraniokaudal dimention of the right lobe. The number offalse positive results in determining the volume of the liver, according to the CT scan is 33.3% (specificity and predictability of the negative result is 60%), which reflects the hepatomegaly’s overdiagnosis. Using this data, it's been revealed that there are 2 sizes whose summation has a strong relation to the volume of the organ among all common linear size: craniocaudal and anteroposterior dimentions of the right lobe (r = 0,85). The most convenient in practice parameter for establishing the fact of a hepatomegaly is determined as the sum of given sizes and borderline value, that is 36 cm, is determined. The usage of this parameter reduces the number of false positive results to 5,6% and raises efficiency indicators of determinating of liver volume (specificity and predictability ofnegative result amount to 93,3%). Formulas for obtaining values of organ volume on the basis of two and three linear sizes of the right lobe liver sizes are developed. Conclusions. At present, there is a tendency of hyperdiagnosis of hepatomegaly, the cause of which is a complex and diverse form of the liver. The usage of the developed parameter that is the sum of the kraniokaudal and front-back the right lobe sizes increases accuracy for establishing the the fact of a hepatomegaly.
Uncontrolled asthma: what is behind it?
Authors: Belotserkovskaya Y. G. , Romanovskikh A. G. , Smirnov I. P. , Sturt E. A.
Published: November 2020

Authors describe the clinical features and causes of severe uncontrolled asthma. Algorithm of evaluation of the patient with persisting clinical symptoms receiving treatment with the highest doses of inhaled corticosteroids in combination with long-acting β­-agonists and/or systemic corticosteroids, should include: a preliminary exclusion of an alternative diagnosis, eliminating the influence of concomitant diseases, preventing exposure to trigger factors, achieving high adherence to prescribed treatment, improving the inhalation techniques. Further steps on the path of regaining control should be aimed at determining phenotype of asthma. Difficulties in achieving control can be expected in patients with severe atopic asthma, late-onset persistent eosinophilic asthma, obesity-related severe nonatopic asthma, neutrophilic asthma.
Clinical significance of neutrophils functional activity in patients
with systemic lupus erythematosus.
Authors: Smirnova E. V. , Krasnova T. N. , Proskurnina E. V. , Mukhin N. A.
Published: November 2020

There is a revival of interest to the role of innate immunity in SLE and neutrophils as its main cellular components. Lupus neutrophils are characterized by impaired phagocytic capabilities, enhanced apoptosis and NETosis, an alternative mechanism ofneutrophil cell death, abnormal clearance ofapoptotic bodies and NETosis products. Therefore, investigation ofpathogenetic processes involving neutrophils is of immense importance, it may help in searching for potential therapeutic targets, understanding the mechanisms of drugs action already used in clinical practice and optimizing the therapeutic regimens by developing predictive factors. Free radical production is one of the crucial neutrophil functions. Thus, the study of neutrophil radical-producing function as a component of their functional status seems expedient. To attain this objective, a new method of luminol-enhanced chemiluminescence with a preliminary two-step stimulation by phorbol-12-myristate-13 acetate and formyl-methionyl-leucyl-phenylalanine was developed. Neutrophil radical-producing activity was evaluated in 46 SLE patients compared to 87 healthy controls. Increased spontaneous production of reactive oxygen species and more pronounced response to the PMA and fMLP effects were found. It was shown by higher specific peak and specific integral neutrophil activity, comparing to the control group. Interleukin-lfi for SLE patients’ neutrophils appeared to be both a pronounced stimulus and a priming agent, it was only a weak priming agent in healthy controls. These results are consistent with research data showing increased functional activity of neutrophils in SLE associated with increased production of pro-inflammatory cytokines, as well as increased production of neutrophil extracellular traps in the absence of additional stimulation, which may be a consequence of cytokine-primed condition.
«Holy doctor» Feofil Gavrylovych Janovskiy: the thorny path to the heights (To the 90th anniversary from the date of death)
Authors: Borodulin Vladimir I. , Vasiliev K. K.
Published: November 2020

Classic domestic clinical medicine academician Theophil Gavrilovich Yanovsky was one of the leaders of the therapeutic elite, established in Russia in the first decades of the XX century. He was famous for his diagnostic skills. So, probably the first of Russian doctors, he put a lifetime diagnosis of pulmonary infarction and described the smell of rotten hay from a patient with tuberculosis and konjunktivalnyj symptom in typhus typhoid. Along with V. P Obraztsov, he created the third scientific center of domestic therapy at the Kiev University of St. Vladimir - after the Military medical Academy in St. Petersburg and the Moscow University. He owns notable scientific works on the problems of bacteriology, tuberculosis, functional diagnosis and treatment of kidney disease, pathology of the digestive system, on improving the methods of direct study of the patient. As an outstanding specialist in resort treatment (at sea, Alpine and local resorts) he was well known not only in Russia but also in Europe. The first of the Soviet clinicians, he was elected academician (in the all-Ukrainian Academy of Sciences). He created a large and bright clinical school; among his students are academicians VN. Ivanov (Kiev), V. H. Vasilenko and B. E. Votchal (Moscow). However, the main reason for the extraordinary popularity of the doctor Was the extremely attractive appearance of this doctor; his life and death became a worthy completion of the national tradition of medical asceticism, the emergence of which is usually associated with the name Of the Moscow “Saint doctor”. The judge of the honor Society of physicians, F. G. Janowski was ready at any time of the day to reliably and free of charge to treat the whole city, and when he died, the whole of Kiev came out to bury him - with white lilies and the funeral service of the Orthodox, Catholic, Protestant and Jewish rites. More so not buried doctors in Russia.
New possibilities for the treatment of enterococcal infectious endocarditis
Authors: Tyurin Vladimir P. , Gudymovich V. G. , Volkova L. V. , Gvozdkov A. L. , Zharkov O. B. , Zhirova L. G. , Mezenova T. V. , Gusaim T. A.
Published: November 2020

This study was designed to analyze results of daptomycin therapy in 7 patients with enterococcal infectious endocarditis caused by Enterococcus faecium in two of them. Mean duration of therapy was 36.7 days. 70% of the strains proved resistant to gentamycin, 40% showed resistance to penicillin antibiotics, and 14.3% to vancomycin. Three patients suffered prosthetic valve endocarditis, six had elevated presepsin level (up to 768.8 pg/ml). 28,6% of the patients underwent valve prosthetic surgery. Hospital lethality was 14,3%. The effectiveness of ampicillin plus ceftriaxone treatment of gentamycin-resistant enterococci is discussed. Recommendation for the antibacterial treatment of enterococcal infectious endocarditis (ESC 2015) are provided.
Sanciones por violencia patrimonial debido al impago de la obligación de alimentos
Authors: Ibarra Sánchez Camilo Andrés
Published: November 2020

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El derecho al trabajo en el contexto de los derechos humanos
Authors: Restrepo Domínguez Manuel Humberto
Published: November 2020

El libro, resultado de un proceso de investigación posdoctoral, presenta una lectura de la realidad a partir de un enfoque de derechos humanos con pensamiento crítico, y a través de categorías de la economía política, como el salario, la plusvalía y el desgaste de energía, revela la complejidad y modos de acción del capital sostenido con la guerra, que degrada la vida humana, a la vez que produce el vaciamiento de conceptos, significados y sentidos e inventa las crisis para recomponer la acumulación.
RECEPTIONS AND METHODS IN TEACHING CHINESE STUDENTS OF RUSSIAN SPOKEN SPEECH
Authors:   South-West university, China, Boldyreva Elena M.
Published: November 2020

The article examines the problems and methods of teaching russian spoken speech at a chinese university, taking into account the ethnocultural characteristics of the chinese audience and the specifics of the chinese student education system. A system of methods and approaches is justified, which contributes to the effective mastery of russian spoken speech. The article describes the features of the chinese audience, complicating the mastery of russian spoken speech in the RCT lesson. The principles and exercises proposed in the article contribute to the organization of such an educational process that will ensure the achievement of a high level of communicative competence of chinese students, the author considers certain didactic techniques that allow achieving a high level of formation of foreign-language communicative competence, neutralization of passion and psychological barrier («psychological counseling», debates, «brainstorming», «fun pictures», comic dialogues, thematic autostoritelling, «black box», «director himself», roleplaying games, «lexical physical education», etc.). The article notes that the main way to overcome this is to use means, methods and techniques in the process of training based on the pedagogical impact of humor, the use of which should become an integral component of the process of teaching chinese students of oral speech and be consistently implemented in all aspects of this process: in the speech behavior of the teacher, in the selection of didactic material, in the typology of the proposed tasks. The author justifies the concept of lessons in colloquial speech as an «encyclopedia of life» and the need to expand the outlook of students by providing them with new information from the field of «background knowledge», not only aimed at expanding the lexical base, but also containing interesting information about psychological and cultural phenomena.
ФОРМИРОВАНИЕ КОМПЕТЕНЦИИ САМООРГАНИЗАЦИИ В ПРОЦЕССЕ ПОДГОТОВКИ БУДУЩЕГО СПЕЦИАЛИСТА ИТ-СФЕРЫ
Authors:   Nizhny Tagil State SocioPedagogical Institute, Grebneva Dariya M. , Vaseva Elena S. ,   Nizhny Tagil State SocioPedagogical Institute, Buzhinskaya Nadezhda V. ,   Nizhny Tagil state sociopedagogical institute
Published: November 2020

Currently, there is a tendency of increasing employers' interest in employing specialists capable of working remotely. The ability to organize the work of employees remotely has a number of advantages for the employer: saving costs associated with maintaining the workplace, providing staff to remote or hard-to-reach areas (branches). Russian legislation is also aimed at regulating labor relations in this area. These factors determine the relevance of the targeted training of a future IT specialist for remote work. The purpose of this study is to determine the content and organizational conditions for the process of preparing a future IT specialist for remote work. The article highlights the stages of remote work that can be implemented in the process of training a future IT specialist: choosing a set of interaction tools, agreeing on the goal of work and choosing forms for presenting intermediate results by stages of solving a problem, planning work, choosing a solution, solving a problem, present results, self-assessment. It is concluded that the willingness to work remotely is determined by the presence of personality skills in the field of self-organization. The components of the competence of self-organization are shown as applied to IT specialists in the aspect of the indicated stages of organizing remote work. Formation indicators are proposed for all components. The proposed structure of activities was applied in teaching the course «Web technologies» to students enrolled in the direction 09.03.03 «Applied Informatics». Simulation of the situation of future professional activity was implemented in the context of distance learning during the coronavirus pandemic, which made it possible to create the most realistic conditions for remote work. The obtained results showed that the presented system of organizing the educational process and assessing the ability to perform work remotely can be successfully used when students perform professionally oriented tasks.