bluuebunny/crossref_metadata_2025 huggingface dataset:
LOW-INTENSIVE LASER irradiation OF BLOOD IN COMPLEX THERAPY IN PATIENTS WITH ISCHEMIC STROKE (a review)
Authors: Маслов А.С. , Новиков А.Е. , Основина И.П. , Алексеева Н.В. , Пахрова О.А.
Published: February 2021

Церебральный инсульт остается важной медико-социальной проблемой, представляющей угрозу жизни и здоровью населения всего мира. Гемореологические параметры составляют доказанный независимый фактор риска развития и тяжести течения острых нарушений мозгового кровообращения по ишемическому типу. Перспективным направлением в реабилитационном процессе пациентов с данной цереброваскулярной патологией является изучение и поиск новых препаратов и немедикаментозных способов воздействия, оказывающих положительное влияние на текучесть крови в целом и на её форменные элементы. К таким патогенетически направленным лечебным факторам относится низкоинтенсивное лазерное облучение крови (квантовая или лазерная гемотерапия). Это положение нашло отражение как в современных нормативных документах, так и в клинических рекомендациях и монографиях по рассматриваемой проблеме. Исследователи отмечают высокую эффективность низкоинтенсивного лазерного облучения крови в комплексном лечении больных с ишемическим инсультом, но нет единого мнения относительно сроков и способов применения лазерной гемотерапии, выбора длины волны, режима генерации и определяющих дозу параметров лазерного излучения.

Cerebral stroke remains an important medical and social problem and poses threat to life and health of the world's population. Hemorheological parameters are the proven independent risk factor for development and severity of acute ischemic cerebrovascular disorders. Most advanced rehabilitation trend for patients with this cerebrovascular pathology is investigation and finding of new drugs and non-pharmacological methods that have a positive effect on blood fluidity in general and on blood formed elements. Such pathogenetically directed therapeutic factors include low-intensity laser blood irradiation (quantum or laser hemotherapy). This proposition is reflected both in modern normative documents and in clinical recommendations and monographs. Specialists note the high efficiency of low-intensity laser irradiation of blood in complex treatment of patients with ischemic stroke, but there is no consensus about duration and methods of laser blood therapy application, selection of wavelength, oscillation mode and dose parameters.
RELATIONSHIP OF BLOOD VISCOSITY AND REMODELING OF CARDIOVASCULAR SYSTEM AT ARTERIAL HYPOTENSION IN YOUNG WOMEN
Authors: Агафонова Т.Ю. , Трусов П.В. , Баев В.М. , Кирьянов Д.А. , Камалтдинов М.Р. , Самсонова О.А.
Published: February 2021

Цель исследования: изучить роль вязкости крови в ремоделировании сердечно-сосудистой системы при идиопатической артериальной гипотензии (ИАГ) у молодых женщин (возраст 18-24 года).

Материалы и методы. Обследовано 29 женщин с ИАГ (систолическое артериальное давление – 90-98 мм рт. ст.) и 24 женщины с нормальным артериальным давлением (систолическое артериальное давление – 120-129 мм рт. ст). Выполнен сравнительный анализ корреляционных связей вязкости крови и параметров сердца и периферических сосудов. Для определения вязкости крови в различных участках сердечно-сосудистой системы применялась разработанная авторами формула зависимости вязкости крови от линейной скорости кровотока.

Результаты. При гипотензии выявлены многочисленные отрицательные корреляционные связи вязкости крови в периферических сосудах и клапанах сердца с их структурно-функциональными параметрами.

Заключение. Полученные результаты доказывают влияние вязкости крови на ремоделирование сердца и сосудов через механизм гипероксидазотемии и пойкилоцитоз эритроцитов.

Aim: to study the role of blood viscosity in remodeling of cardiovascular system in idiopathic arterial hypotension (IAH) in young women (age 18-24 years).

Materials and methods. We examined 29 women with IAG (systolic blood pressure – 90-98 mm Hg) and 24 women with normal arterial pressure (systolic blood pressure – 120-129 mm Hg). Comparative analysis of correlations between blood viscosity and parameters of heart and peripheral blood vessels was performed. For determination of blood viscosity in various parts of cardiovascular system we used our own formula (relationship of blood viscosity from linear flow blood velocity).

Results. At hypotension we revealed numerous negative correlations of blood viscosity in peripheral vessels and heart valves with their structural and functional parameters.

Conclusion. Obtained results prove the influence of blood viscosity on remodeling of heart and vessels through the mechanism of hyperoxidazotemia and poikilocytosis of erythrocytes.
NETWORK META-ANALYSIS FOR PARNAPARINE EFFECTIVENESS IN VENOUS THROMBOEMBOLIC PREVENTION IN SURGERY
Authors: Морозов К.М. , Колбин А.С. , Галанкин Т.Л.
Published: February 2021

Цель исследования: сетевой мета-анализ (СМА) рандомизированных контролируемых исследований (РКИ) парнапарина, эноксапарина, надропарина и нефракционированного гепарина (НФГ) в режиме краткосрочных курсов в малых и средних дозах для профилактики венозных тромбоэмболических осложнений (ВТЭО) при хирургических и ортопедических вмешательствах у пациентов с высоким риском тромбоза глубоких вен (ТГВ).

Материалы и методы. Выполнен смешанный СМА 21 РКИ парнапарина, эноксапарина, надропарина и НФГ у хирургических больных с кратковременной (1-2 недели) профилактикой ВТЭО.

Результаты. По сравнению с НФГ применение парнапарина статистически значимо снижало риск развития ТГВ (на 51%) и «больших» кровотечений (на 83%). Эноксапарин и надропарин подобных преимуществ по сравнению с НФГ не продемонстрировали, что вряд ли связано с недостаточной статистической мощностью исследования.

Заключение. При прочих равных условиях парнапарин может рассматриваться в качестве препарата выбора для профилактики ВТЭО в хирургии и ортопедии.

Aim: network meta-analysis (NMA) of randomized controlled trials (RCTs) of parnaparin, enoxaparin, supraparin, and unfractionated heparin (UFH) in the regime of short-term courses in small and medium doses for prophylaxis of venous thromboembolic complications (VTEC) at surgical and orthopedic interventions in patients with high risk of deep vein thrombosis (DVT).

Materials and methods. Mixed CMA of 21 RCTs of parnaparin, enoxaparin, supraparin and UFH was performed in surgical patients with short-term (1-2 weeks) prophylaxis of VTEС.

Results. Parnaparin reduced significantly the odds of DVT (by 51%), and the odds of «large» bleedings (by 83%) compared with UFH. Both enoxaparin and nadroparin did not demonstrate convincing advantages over UFH concerning the efficacy and the safety. This fact is hardly explained due to the insufficient statistical power of the study.

Conclusion. We conclude that when other things being equal, parnaparin exposes better therapeutic profile resulting parnaparin might to be considered first for VTEC prevention in surgery and orthopedics.
APC-RESISTANCE ASSOCIATED WITH FACTOR V LEIDEN GENE MUTATION (GENOTYPE GA): CLINICAL OCCURRENCE IN PREGNANCY
Authors: Николаева М.Г. , Момот А.П. , Сердюк Г.В. , Елыкомов В.А. , Момот К.А. , Ясафова Н.Н.
Published: February 2021

Цель исследования: изучить связь феномена резистентности фактора Vа к активированному протеину С (АПС-резистентность) при носительстве мутации гена FVL (1691) GA с клинической реализацией во время беременности тромботических событий и гестационных осложнений, таких как преэклампсия, задержка развития плода и невынашивание беременности.

Материалы и методы. Проведено проспективное клиническое когортное исследование 1100 беременных. Выделено 2 когорты: основная группа – 500 пациенток с генотипом FVL (1691) GA и группа контроля – 600 женщин с генотипом FVL (1691) GG.

Результаты. Медиана нормализованного отношения (НО) АПС-резистентности в контрольной группе у беременных с генотипом FVL (1691) GG колебалась в диапазоне 1,0→0,86. У беременных – носителей генотипа FVL (1691) GA этот показатель был достоверно ниже – 0,55→0,48 (р < 0,05). У пациенток при НО > 0,5 течение беременности было благоприятным. Более выраженная АПС-резистентность (НО ≤ 0,49) ассоциировалась с гестационными осложнениями.

Заключение. Полученные данные по АПС-резистентности позволяют относить в группу высокого риска по тромботическим и акушерским осложнениям женщин – носительниц мутации фактора V Лейден (1691) не только с генотипом АА, но и с генотипом GA. AПС-резистентность ≤ 0,49 (по показателю НО) при носительстве мутации фактора V Лейден (1691) GA может рассматриваться как прогностический маркер развития гестационных осложнений с наибольшей точностью при сроке 7-8 недель беременности.

Aim: to study during pregnancy the relationship between factor Va resistance to activated protein C (APC-resistance) in carriers of FVL gene mutation (1691) GA with clinical realization of thrombotic events and gestational complications such as preeclampsia, fetal growth retardation and miscarriage.

Materials and methods. A prospective clinical cohort study of 1100 pregnant women was performed. Two cohorts were identified: main group – 500 patients with FVL genotype (1691) GA and control group – 600 women with FVL genotype (1691) GG.

Results. The median of normalized ratio (NR) of APC resistance in the control group with FVL genotype (1691) GG ranged from 1.0→0.86. In pregnant women – the carriers of FVL genotype (1691) GA this parameter was significantly lower – 0.55→0.48 (р < 0.05). In patients with HO > 0.5 the course of pregnancy was favorable. More expressed APS-resistance (НО ≤ 0,49) was associated with gestational complications.

Conclusion. The obtained data on APC-resistance allow to classify women – the carriers of Factor V Leiden (1691) mutation, not only with the AA genotype but also with GA genotype as the group of high risk for thrombotic and obstetric complications. APC resistance ≤ 0.49 (according NR) with the carriage of Factor V Leiden mutation (1691) GA can be considered as a prognostic marker for the development of gestational complications with the greatest accuracy at a period of 7-8 weeks of gestation.
HEMOSTASIOLOGICAL MARKERS FOR REOCCUSION PREDICTION AFTER THROMBOLYTIC THERAPY IN PATIENTS WITH CARDIOEMBOLIC STROKE
Authors: Прохорова И.Н. , Синьков С.В. , Зыбин К.Д.
Published: February 2021

Цель работы: определить прогностическую значимость гемостазиологических параметров в развитии реокклюзии после тромболитической терапии у пациентов с кардиоэмболическим инсультом.

Материалы и методы. Проанализировано лечение 52 пациентов с кардиоэмболическим типом ишемического инсульта, тяжесть которого по шкале NIHSS составляла 10-17 баллов. Данные пациенты попадали в терапевтическое окно, и согласно национальным рекомендациям им был проведен системный тромболизис. Ретроспективно больные были разделены на 2 группы: с эффективным тромболизисом (n = 36) и с признаками реокклюзии (n = 14).

Результаты. Через 3 часа после тромболитической терапии у пациентов, у которых впоследствии развилась реокклюзия, в ответ на тромболитическую терапию наблюдалась мощная активация системы гемостаза, проявляющаяся существенным повышением уровня Д-димера и формированием патологически плотного сгустка на тромбоэластограмме. По данным ROC-анализа выявлена хорошая прогностическая точность в отношении развития реокклюзии со стороны концентрации Д-димера (AUROC = 0,766; точка отсечения – значения Д-димера ≥ 0,75 нг/мл) и отличная прогностическая точность со стороны параметра МА тромбоэластограммы (AUROC = 0,903; точка отсечения – значения МА ≥ 48 мм).

Заключение. Для выделения когорты пациентов, которым в связи с высоким риском реокклюзии показано назначение антикогулянтов (антиагрегантов) сразу же после тромболизиса, необходимы дальнейшие исследования.

Aim: to determine the prognostic significance of hemostasiological parameters in the development of reocclusion after thrombolytic therapy in patients with cardioembolic stroke.

Materials and methods. The treatment of 52 patients with cardioembolic type of ischemic stroke (the severity – 10-17 points according NIHSS scale) was analyzed. These patients received systemic thrombolysis according to national guidelines. Retrospectively patients were divided into 2 groups: with effective thrombolysis (n = 36) and with signs of reocclusion (n = 14).

Results. Three hours after thrombolytic therapy in patients with further developed reocclusion powerful hemostasis activation was observed that manifested by a significant increasing of D-dimer level and formation of a pathologically dense clot on thromboelastogram. According to ROC analysis good prognostic accuracy of reocclusion development for D-dimer level (AUROC = 0,766; cut-off point – D-dimer ≥ 0,75ng/ml) and excellent prognostic accuracy for parameter MA of thromboelastogram (AUROC = 0,903; cut-off point – МА ≥ 48 mm) were revealed.

Conclusion. Further studies are needed for identification of patients with high risk of reocclusion who are prescribed the appointment of anticoagulants (antiaggregants) immediately after thrombolysis.
EFFECTIVENESS AND SAFENESS OF LOW MOLECULAR WEIGHT HEPARINS APPLICATION IN CHILDREN WITH RIGHT ATRIUM THROMBOSES
Authors: Жарков П.А. , Ершов Н.М. , Пшонкин А.В.
Published: February 2021

Введение. Тромбозы правого предсердия (ТПП) являются редкой патологией, которая чаще встречается среди новорожденных и детей, перенесших кардиохирургическое вмешательство. Истинная распространенность, а также подходы к лечению ТПП у детей, получающих терапию по поводу злокачественного заболевания, неизвестны.

Цель работы: оценить распространенность ТПП, а также эффективность и безопасность применения низкомолекулярного гепарина (НМГ) у детей с ТПП.

Материалы и методы. Проведен анализ электронной базы данных пациентов в возрасте 0-17 лет. Для оценки динамики размеров тромбов в анализ были включены только пациенты с объективно подтвержденным ТПП, у которых имелось не менее двух эхокардиографических исследований, и которым проводилась терапия НМГ. Оценка случаев кровотечений и тромбоэмболии легочной артерии/артерий (ТЭЛА) проводилась по записям в историях болезни пациентов.

Результаты. Изолированный ТПП или ТПП в комбинации с тромбозами других локализаций был диагностирован у 13,7%, изолированный ТПП – лишь у 5% детей. При проведении антикоагулянтной терапии НМГ отсутствие динамики со стороны размеров тромба наблюдалось в 1 случае, нарастание размеров тромба – в 1 случае, уменьшение размеров тромба или полный лизис – в 13 случаях. За период наблюдения не было выявлено ни одного случая крупных кровотечений и ТЭЛА.

Заключение. ТПП встречаются в 13,7% случаев среди пациентов с тромбозом. Мы считаем применение НМГ эффективным и безопасным методом вторичной антитромботической профилактики у детей с ТПП.

Introduction. Right atrium thromboses (RAT) are rare pathology which is more specific for neonates and children undergoing cardiac surgery. True RAT prevalence as well as approaches to its treatment in children receiving therapy for malignant disease are unknown.

Aim: to assess RAT prevalence as well as effectiveness and safeness of low molecular weight heparin (LMWH) application in children with RAT.

Materials and methods. Electronic hospital database analysis was performed to find patients with objectively confirmed RAT. Children aged 0-17 years old with two or more echocardiographic examinations who received LMWH were included in final analysis. Thrombus size dynamics, the rate of pulmonary embolism (PE) and major bleeding served as effectiveness and safeness endpoints.

Results. Isolated RAT or RAT in combination with thromboses of other localizations was found in 13,7%, isolated RAT – only in 5% of children. Under anticoagulant therapy with LMWH we found no dynamics in clot size – in 1 case, clot size increasing – in 1 case, reduction of clot size or its complete lysis – in 13 cases. There were no cases of major bleeding and PE during LMWH treatment.

Conclusion. RAT occurs in 13,7% of cases among patients with thrombosis. We consider LMWH treatment to be effective and safe method of secondary antithrombotic prophylaxis in children with RAT.
DIAGNOSTIC SIGNIFICANCE OF HEMOSTASIS SCREENING TESTS FOR STAGING OF CERVICAL CANCER
Authors: Сушинская Т.В. , Стуклов Н.И. , Доброхотова Ю.Э.
Published: February 2021

Введение. Рак шейки матки (РШМ) остается одним из самых распространенных онкологических заболеваний органов женской репродуктивной системы и все чаще выявляется в молодом возрасте. В последние годы больным РШМ, не реализовавшим свой репродуктивный потенциал, часто проводят органосохраняющее лечение, важной задачей которого является точность стадирования.
Цель исследования: определение закономерностей изменения рутинных показателей сосудисто-тромбоцитарного и коагуляционного гемостаза у больных РШМ в зависимости от степени распространенности опухолевого процесса и оценка возможности их использования в стадировании РШМ.
Материалы и методы. Показатели гемостаза проанализированы у 200 больных с установленным диагнозом РШМ; у 136 пациентов проведено хирургическое лечение и патологоанатомическое исследование операционного материала.
Результаты. Выявлен достоверный рост содержания фибриногена, значимое повышение уровня растворимых фибрин-мономерных комплексов (РФМК) с увеличением стадии заболевания. Показано, что при высоких значениях фибриногена (свыше 3,0 г/л) и РФМК (свыше 10 мг/100 мл) с большой долей вероятности реальная стадия заболевания выше клинически установленной.
Заключение. Выявленные изменения требуют более тщательного обследования для уточнения истинной распространенности опухолевого процесса при планировании дальнейшего лечения.

Introduction. Cervical cancer (CC) remains one of the most common cancers of the female reproductive system and is increasingly detected at a young age. In recent years for patients with CC who have not realized their reproductive potential organ-saving treatment often is performed, an important task of which is the accuracy of staging.
Aim: to determine the changes of routine parameters of vascular-platelet and coagulation hemostasis in patients with CC according to the prevalence of tumor process and to assess the possibility of their use in CC staging.
Materials and methods. We analyzed hemostatic parameters in 200 patients with proven CC diagnosis; in 136 patients surgical treatment and pathoanatomical examination of surgical material were performed.
Results. We revealed signifi cant rising of fi brinogen and soluble fi brin-monomer complexes (SFMC) levels in accordance with disease stage increasing. With high probability it was shown that at high fi brinogen (above 3.0 g/L) and SFMC (above 10 mg/100 ml) values the actual disease stage was higher than clinically determined.
Conclusion. Identifi ed changes require detailed examination to clarify the true prevalence of tumor process for planning further treatment.
Enzymatic thrombolisis and «massage» in occlusion of retina veins
Authors: Крылова А.А. , Уразова О.И. , Кривошеина О.И.
Published: February 2021

Введение. На сегодняшний день некоторые аспекты возникновения тромбоза ретинальных вен остаются дискутабельными. Большое количество факторов развития заболевания, отсутствие единой концепции патогенеза обтурации вен сетчатки приводят к неопределенности в тактике ведения пациентов, что снижает качество лечения.
Цель исследования: проанализировать состояние микроциркуляции при окклюзии ретинальных вен на фоне применения «массажа» пораженной вены сетчатки и эпиретинального введения ферментного тромболитика.
Материалы и методы. Обследовано 96 человек (49% мужчин и 51% женщин в возрасте 60,2 ± 1,9 года) с обтурацией ретинальных вен. Пациентам основной группы (n = 47) выполняли «массаж» пораженной вены сетчатки и эпиретинальное введение 500 МЕ рекомбинантной проурокиназы; пациентам группы сравнения (n = 49) однократно вводили эпиретинально 500 МЕ рекомбинантной проурокиназы на фоне традиционной фармакотерапии.
Результаты. Индукция тромболизиса при помощи «массажа» пораженной вены сетчатки на фоне эпиретинального введения ферментного фибринолитика в 2 раза ускоряла восстановление кровотока в ретинальном сосуде и в 1,5 раза сокращала время резорбции отека центральных отделов сетчатки, обеспечивая эффективное (в 1,7 раза) повышение биоэлектрической ретинальной активности.
Заключение. «Массаж» ретинальных вен на фоне ферментного тромболизиса, проведенный в первые 7 дней от начала заболевания, является перспективным методом лечения окклюзии вен сетчатки.

Introduction. Currently some aspects of retinal vein thrombosis remain controversial. A large number of disease development factors, absence of unifi ed pathogenesis conception for retinal veins obturation lead to non-specifi city in tactics of patient management that reduces the quality of treatment.
Aim: to analyze microcirculation in retinal veins occlusion under the «massage» of the aff ected retinal vein and epiretinal administration of thrombolytic enzyme.
Materials and methods. We examined 96 people (49% of men and 51% of women aged 60.2 ± 1.9 years) with obturation of retinal veins. Patients of the main group (n = 47) were treated by «massage» of the aff ected retinal vein and epiretinal administration of recombinant prourokinase (500 IU); patients of the comparison group (n = 47) were treated by traditional pharmacotherapy with single epiretinal injection of recombinant prourokinase (500 IU).
Results. Thrombolysis induction using the «massage» of aff ected retinal vein with epiretinal administration of thrombolytic enzyme accelerated the restoration of blood fl ow in retinal vessel in 2 times and in 1.5 times reduced the resorption time of edema in central retina parts that provided an effective (1.7 times) increasing of bioelectric retinal activity.
Conclusion. «Massage» of retinal vein occlusion with enzymatic thrombolysis conducted in first 7 days from disease onset is a promising method for treatment of retinal vein occlusion.
Review of current normative documentation in healthcare service
Authors: Павлова В.Ю.
Published: February 2021

В настоящее время от практического врача все чаще требуется не только знание клинических вопросов, но и обязательное владение данными нормативной документации. Ранее нормативные документы (федеральные законы, приказы различного уровня) являлись прерогативой организаторов здравоохранения и руководителей медицинских организаций. На протяжении последних лет количество документов значительно увеличилось практическому врачу невозможно отслеживать весь этот поток документов, но при этом незнание нормативных документов имеет очень серьезные последствия различного плана. Кроме того, нормативные документы различного уровня (МЗ РФ, локальные) разрабатываются и утверждаются в большом количестве, но качество их оставляет желать значительно лучшей проработки.

Nowadays the doctors practice more and more involves not just the requirement to know clinical issues, but also the mandatory awareness of regulatory documentation. Formerly normative documents (federal laws, orders of different levels) were the prerogative of public health officials and heads of healthcare institutions. In recent years, the number of documents is increasing immensely, so that general practitioner is not able to keep track of all this data flow, although ignorance of normative documents causes various serious consequences. Moreover, regulatory documents at different levels (HМ of RF, local) are developed and ratified in large number meanwhile their quality leaves much to be desired though.
Heparin inhalation in patients with new coronavirus infection (review)
Authors: Воробьева Н.А. , Ройтман Е.В. , Мельничук Е.Ю.
Published: February 2021

Гепарин используется в клинической практике преимущественно как антикоагулянт. Однако спектр его эффектов значительно шире: противовоспалительный, антипролиферативный, гиполипидемический (как прямой, так и посредством повышения активности липопротеинлипазы), антикоагулянтный, противоотечный и др. Именно на противовоспалительное действие гепарина сделан акцент при терапии COVID-19. Одним из патогенетически обоснованных методов профилактики и терапии микрососудистого тромбоза в тканях легких может быть использование ингаляций нефракционированного гепарина, что позволяет реализовать как местное, так и системное действие этого препарата. Терапия ингаляциями гепарина не будет значительно увеличивать риск контаминации вирусом SARS-CoV-2 медицинского персонала при неукоснительном соблюдении стандартов и рекомендуемых мер индивидуальной защиты.

Heparin is considered traditionally as an anticoagulant although it has anti-inflammatory, antiproliferative, hypolipidemic (both direct and by increasing the activity of lipoprotein lipase), anticoagulative, anti-edema effects as well. The anti-inflammatory effect of heparin is in the focus of COVID-19 therapy. Inhaled (nebulized) heparin performs local and systemic effects. This way is pathogenetically justified for the prevention and treatment of microvascular thrombosis in lung tissues. Procedures of heparin inhalation should not significantly increase the risk for medical staff to become infected with SARS-CoV-2 when individual protection is fully observed.
The nature of eculizumab monoclonal antibody and its potential against coronavirus infection COVID‑19
Authors: Кудлай Д.А. , Бакиров Б.А. , Павлов В.Н.
Published: February 2021

В настоящее время серьезной проблемой в мире остается продолжающееся распространение новой коронавирусной инфекции — COVID‑19. Всемирная организация здравоохранения 11.03.2020 объявила о пандемии COVID‑19. Возбудителем заболевания является SARS-CoV‑2 — оболочечный одноцепочечный (+) РНК-вирус из рода бета-коронавирусов. Активация системы комплемента, включая компонент С5а, принимает участие в развитии острого воспалительного процесса в легких, вызванного патогенными вирусами. В ходе доклинических исследований выявлен факт избыточной активации системы комплемента при коронавирусной инфекции. Экулизумаб полностью ингибирует
C5‑опосредованную активность терминального комплекса комплемента, что позволило предположить его эффективность в лечении повреждения легких, тяжелых пневмоний и острого респираторного дистресс-синдрома у больных COVID‑19. Представлены клинические случаи эффективного применения экулизумаба у больных COVID‑19, начиная с первых дней лечения. В настоящее время одобрены клинические исследования эффективности и безопасности
экулизумаба, а также аналогичного комплемент-блокирующего препарата в лечении больных с новой коронавирусной инфекцией.

At present, the continuing spread of a new coronavirus infection, COVID‑19, remains a serious problem in the world. The World Health Organization announced the COVID‑19 pandemic on 11.03.2020. The causative agent of the disease is SARS-CoV‑2, a single-
stranded (+) RNA virus from the genus of beta-coronaviruses. Activation of the complement system, including the C5а component, is involved in the development of acute inflammatory process in the lungs caused by pathogenic viruses. Preclinical
studies have revealed the fact of excessive activation of the complement system in coronavirus infection. Eculizumab completely inhibits the C5‑mediated activity of the terminal complement complex that suggests its effectiveness in the treatment of lung
damage, severe pneumonia, and acute respiratory distress syndrome in COVID‑19 patients. Clinical cases of eculizumab effective use in patients with COVID‑19, starting from the first days of treatment, are presented. Currently, clinical studies of the efficacy
and safety of eculizumab, as well as similar complement-blocking drug in the treatment of patients with a new coronavirus infection have been approved.
The commenting analysis of «Guidelines for Anticoagulation» from Extracorporeal Life Support Organization
Authors: Ройтман Е.В.
Published: February 2021

Экстракорпоральная мембранная оксигенация (ЭКМО) нередко становится методом последней надежды для тяжелых больных с пневмонией. Среди рисков проведения ЭКМО наиболее распространенными закономерно считаются кровотечения и тромбозы. Обзор критически анализирует, как факторы, влияющие на систему свертывания крови при ЭКМО, рассматриваются в документах от Extracorporeal Life Support Organization. Отмечается, что для разработки протоколов, стандартов клинических рекомендаций, содержащих аспекты управления системой гемостаза, профильные специалисты должны привлекать специалистов по патологии гемостаза и специалистов по клинической лабораторной диагностике.

The extracorporeal membrane oxygenation (ECMO) is often the last resort for severe patients with pneumonia. Among the risks of ECMO, bleeding and thrombosis are considered to be the most common. This review analyzes critically how factors affecting blood clotting in ECMO are addressed at documents by Extracorporeal Life Support Organization. In addition it is noted that in order to develop protocols and standards and clinical recommendations containing aspects of hemostasis management, profiled specialists should involve experts on hemostasis and experts on clinical laboratory diagnostics.
The opportunity of dipyridamole using for nonspecific primary prophylaxis against the COVID-19 infection in healthcare staff
Authors: Куртов И.В. , Берман Ю.О. , Никулина Н.А. , Кузнецова Ю.В. , Давыдкин И.Л.
Published: February 2021

Введение. Новая коронавирусная инфекция COVID-19 представляет повышенную опасность инфицирования у медицинских работников. Цель исследования: показать возможность применения дипиридамола у медицинских работников в комплексе мер первичной профилактики новой коронавирусной инфекции COVID-19. Материалы и методы. Наблюдались 33 медицинских работника: 14 человек принимали дипиридамол в дополнение к стандартным методам профилактики; 19 человек, не принимавшие дипиридамол, составили группу сравнения. Результаты. Несмотря на стандартные методы профилактики в многопрофильном стационаре, из 14 сотрудников, принимавших дипиридамол, 5 (35,7%) заболели коронавирусной инфекцией COVID-19 (подтвержденной); интерстициальная пневмония диагностирована у 4 человек. В группе из 19 сотрудников, не принимавших дипиридамол, заболели 13 (68,4%); интерстициальная пневмония была диагностирована у 11 человек. Заключение. Показана возможность применения дипиридамола в качестве дополнительного средства для снижения риска инфицирования новой коронавирусной инфекцией COVID-19.

Background. Healthcare workers are under high risk of the novel coronavirus infection COVID-19. Objectives: to show the opportunity of dipyridamole using within the set of primary prophylaxis measures against the infection of COVID-19. Patients / Methods. We followed up 33 people from medical staff, of them 14 were taking dipyridamole in addition to standard prophylaxis methods; the comparison group consisted of 19 people who did not take dipyridamole. Results. Despite standard prophylaxis in a multidisciplinary hospital, out of 14 staff members who took dipyridamole, 5 (35.7%) catch coronavirus infection COVID-19 (justified); interstitial pneumonia was diagnosed in 4 people. In a group of 19 employees who did not take dipyridamole, 13 (68.4%) fell ill; interstitial pneumonia was diagnosed in 11 people. Conclusions. The opportunity of dipyridamole using has been shown as an additional means to reduce the risk to infect with COVID-19.
REMEDIASI KESALAHAN MENYELESAIKAN SOAL USAHA ENERGI MENGGUNAKAN STRATEGI SYSTEMATIC APPROACH TO PROBLEM SOLVING DI SMA
Authors: Wulandari Wulandari , Sitompul Stepanus Sahala , Mursyid Syukran
Published: February 2021

The aim of this research is to find out the effectiveness of using Systematic Approach Strategy on remedy to reduce the total incorrect results on answering the test on the topic of work and energy on the students at SMA Negeri 1 Batu Ampar. The population in this research are 72 students. Technique of data collection in this research is intact group with 36 students as the sample. The research implements experiment method. The research use limited topic on the test consist of work and energy. Statistic test used in this research is Wilcoxon  with value  = -0.1631, if this results are compared with value  on taraf nyata  = 0.025, it resulted, with the value 0.1631 < 1,96. After analyze found that there are no significant differences on the total incorrect results on answering the test on the topic of work and energy by students at XI MIPA SMA Negeri 1 Batu Ampar before and after remedy. The Conclusion from the results found that the strategy can reduce the total incorrect results of the students answering the test on the topic of work and energy with effectiveness low at the average 11.18%.Keywords: Strategy, Systematic Approach to Problem Solving, Students’ Error, work and energy
PENGEMBANGAN TES DIAGNOSTIK FOUR TIER TEST DILENGKAPI DENGAN SELF-DIAGNOSIS SHEET TENTANG ENERGI DI SMA
Authors: Dendodi Dendodi , S Haratua Tiur Maria , Hamdani Hamdani
Published: February 2021

The purpose of this research is to produce a qualified diagnostic test that can be used to discover students’ misconceptions about energy in high school’s 10th graders. This research uses Research and Development (R&D) with the form of four tier test. The development of diagnostic test uses the adoption of Borg & Gall development steps that has been simplified into seven steps. The inisial design consists of twelve item of test of multiple choices. The trial step of this diagnostic test was done to 35 students in the in the small scale trial, and 91 students in the large scale trial. According to the data analysis, it can be concluded that the developed diagnostic test is qualified of the use to discover students’ misconceptions, because: 1) has higher validity than table validity, 2) has of reliabily of 0,783, 3) all items of the diagnostic can discover students’ misconceptions, 4) has a diffuculty index 0,38, 5) the level of readability of the questions 0,63. The qualified items that worth of use of this test are twelve itemsKeywords: Energy, Four Tier Diagnostic Test, Self-diagnosis Sheet
ANALISIS TINGKAT BERPIKIR DALAM MENYELESAIKAN SOAL GERAK PARABOLA MENGGUNAKAN TAKSONOMI STRUCTURE OF THE OBSERVED LEARNING OUTCOMES (SOLO) SISWA KELAS X MIA SMAN 1 SUNGAI RAYA
Authors: Hartanti Desi , Djudin Tomo , Mursyid Syukran
Published: February 2021

This This study aims to describe the level of students’ thinking profilein solving parabolic motion problems based on the SOLO taxonomy seen from learning outcomes and gender. This is a survey research without a comparison group. Data collection was done by giving 4 questions to 95class X MIA students at SMAN 1 Sungai Raya, and categorized based on learning outcomes (high, medium, low) and gender (male, female). The level ofstudents’ thinking profile in solving parabolic motion problems based on SOLO taxonomyis 50.52% at the pre-structural level, 11.57% at the uni-structural level, 21.05% at the multi-structural level, 16.84% at relational level , and0% at extended-abstract level. Additionally, students with high learning outcomes reached the uni-structural-relational thinking level, while moderate ones reached the uni-structural-multi-structural level, and low ones reached the uni-structural-pre-structural level. In terms of gender,female students' average percentage of thinking level is 44.2% higher than male students with only 33.6% of the ideal score.Keywords: Thinking Level, SOLO Taxonomy, Parabolic Motion.
META-ANALISIS SKRIPSI MAHASISWA PENDIDIKAN FISIKA FKIP UNTAN TENTANG MODEL PEMBELAJARAN DIRECT INSTRUCTION
Authors: Solihan Teja Putri , Sitompul Stepanus Sahala , Arsyid Syaiful B
Published: February 2021

This meta-analysis aims to determine the effect of research characteristics on the effect size of the direct instruction learning model in the undergraduate thesis of the Physics Education Study Program FKIP UNTAN, published in 2016-2019. This type of research is a survey research with purposive sampling technique consisting of 6 theses. Data collection techniques in this research are documentary studies. The results of undergraduate thesis Physics Education study programs that use the direct instruction learning model obtained an average effect size of 1.00 which high effectiveness categories based on the John Hattie barometer. In this study, there are 2 characteristics of researchers examined, among others: the gender of the researcher and Grade Point Average (GPA) of the researcher. Based on the 2 characteristics of the researchers, it did not have a significant effect on the effect size of the undergraduate students' thesis in the Physics Education study program that uses the direct instruction learning model. In this study there were 13 characteristics of the methodology studied including: research location, school level, sample size, number of classes, number of meetings, material sub-fields, learning tools or media, test reliability coefficient, instrument validity, test forms, forms of research, designs experiments, and data collection tools. Of the 13 characteristics of the methodology, it did not have a significant effect on the effect size of the undergraduate students' thesis in the Physics Education study program that used the direct instruction learning model.Kata Kunci: Meta-analisis, Skripsi, Model Pembelajaran Direct Instruction
Detection of Metabolite-Protein Interactions in Complex Biological Samples by High-Resolution Relaxometry: Towards Interactomics by NMR
Authors: Wang Ziqing , Ghini Veronica , Kaderavek Pavel , Pisano Simone , Zachrdla Milan , Pelupessy Philippe , Kazmierczak Morgan , Marquardsen Thorsten , Tyburn Jean-Max , Bouvignies Guillaume , Parigi Giacomo , Luchinat Claudio , Ferrage Fabien
Published: February 2021

In this manuscript, we introduce an NMR method to investigate the interaction of metabolites and other small molecules with proteins in biological fluids. Our approach, based on high-resolution relaxometry identifies the interaction of small molecules with proteins in blood serum and is used for the quantitative analysis of binding competition in situ.
Incidence of concussions and injuries among quidditch players
Authors: Singh Som Prabh , Nadeau Alexander , Singh Shipra , Shaw Christopher
Published: February 2021

Purpose: To evaluate the rates of concussion and injury in quidditch, a high-contact sport growing in worldwide participation.
Methods: A systematic review of the MEDLINE database was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for all studies reporting on concussion and/or injury rates in quidditch epidemiology.
Results: Five studies were identified that had been published in the last 15 years on the concussion and injury rates among quidditch players worldwide. Each of these five studies included a concussion analysis and two included overall epidemiological rates.
Conclusions: Injury rates seen in the two studies were found to be lower than those seen in other high-contact sports. There is a need to further study concussion symptoms among this understudied population.
Childhood Obesity Interventions by Setting
Authors: Metzger Tai
Published: February 2021

Background: To combat the global health crisis of obesity, many interventions have been implemented, including in children and adolescents. This age range is uniquely important because health behavior continues into adulthood, resulting in lifelong health risks or benefits. This narrative review aims to provide a cross section of the scientific literature regarding obesity interventions by setting, including school-based, daycare-based, home-based, healthcare-based, and digital-based, as well as to highlight gaps in research.
Methods: Articles written in English addressing childhood and adolescent obesity interventions were sought online using PubMed and Google Scholar searches. Although some articles were from a global perspective, the majority focused on children in the United States. This search included reviews, individual studies, and other related papers.
Results: School-based interventions are accessible to many, but there is limited evidence of long-term benefits. Home-based interventions were the only setting to have compelling evidence of long-term benefits, although there are several barriers to participation. Healthcare-based interventions are often successful when specific strategies and unique advantages of healthcare settings are utilized. Digital interventions have limited success now, but show potential for cost-effective scaling up as technology improves.
Conclusion:  The clearest gap in research is the lack of long-term studies, especially of school-based and healthcare-based interventions. Thus, it is imperative that investments are made into studies that include follow-up components continuing at least 1-2 years after the intervention. Additionally, home-based interventions have been more successful during early childhood while school-based interventions tend to be more successful during adolescence.
Mechanism of Genetically-Regulated Response to Bacillus- Calmette Guérin Immunotherapy for Bladder Cancer
Authors: Sam Hakeem , Stevenson Mary M
Published: February 2021

In this study, we investigated host response to Bacillus-Calmette Guérin (BCG) immunotherapy using the murine MM45T bladder tumor cell line. BALB/c (Bcgs allele) and BALB/c.CD2 (CD2) (Bcgr allele) mice were seeded subcutaneously with MM45T cells. Treatment began on day 7 with intra-tumor injections of BCG. Significant decreases in tumor growth in BALB/c (p < 0.05) but not in the CD2 (p = NS) mice were observed 6, 10 and 14 days following treatment. Investigation of the mechanism(s) underlining the difference in the response between the two strains of mice revealed key points, namely: (i) Intraperitoneal injection of BCG led to a significant increase (p < 0.05) in the number of cells recovered 14 days later by peritoneal lavage (in million cells: 5.1 ± 0.7 vs 9.5 ± 0.3 in BALB/c and 5.3 ± 0.4 vs 7.0 ± 0.4 in CD2, PBS vs BCG). (ii) Compositional analysis of the lavages following BCG injection indicated a significant increase in the lymphocyte/macrophage ratio in BALB/c mice as compared to CD2 mice (p < 0.05). (iii) Activated peritoneal macrophage production of nitric oxide (NO) was significantly lower (p < 0.05) in BALB/c than in CD2 (26.8 ± 1.6 vs 38.3 ± 0.7 uM of nitrite respectively) when challenged with lipopolysaccharide. (iv) No difference in the in vitro cytotoxicity against MM45T cells was observed between BALB/c and CD2 macrophages. Our results suggest that differences in the composition of monocytes infiltrating the site of BCG treatment and in the release of substances such as NO by macrophages may be key determinants of the response to BCG immunotherapy for bladder cancer.
Joining the Fight against Poverty: Open Invitation from the International Poverty and Health Network to All Health Professionals
Authors: Heath Iona , Haines Andy
Published: February 2021

N/A
The Use of Fibrinolytic Therapy in Acute Ischemic Events
Authors: Del Duca Danny
Published: February 2021

The loss of tissue perfusion represents the pathological basis underlying acute cerebrovascular events. The occlusion of the brain's blood supply by intravascular thrombotic and/or atherosclerotic phenomena results in a disruption in tissue oxygen and glucose delivery. This inevitably impairs the cell's capacity to synthesize ATP. Despite initial attempts to maintain consistent ATP stores through anaerobic glycolysis and adenosine release, the starving tissue experiences loss of membrane ionic gradients, secondary to the inactivation of the Na+/K+ ATPase pump. A significant increase in intracellular calcium concentration is triggered by the activation of voltage- gated calcium channels, the activation of ligand-gated calcium channels, and by the inactivation of the Na+/Ca+ exchanger. In addition, massive release of the main excitatory, inhibitory, and monoamine neurotransmitters (many of which become excitotoxins at high concentration) is also observed. The above excitatory transmitters, such as glutamine, for example, play an important role in the over-stimulation of the NMDA receptor, which in turn promotes excessive calcium influx (1). The cytotoxic effects of calcium are associated with the activation of lipases, proteases, and endonucleases, as well as xanthine oxidase and neuronal NO synthase, capable of either direct or indirect destruction of cellular structures (2).
Molecular Cloning and Expression of Human Regulators of G-Protein Signaling 4, 5, and 16
Authors: Athiviraham Aravind
Published: February 2021

N/A
Historical Footprints: MJM Past and Present
Authors: Han Kathy , Labos Christopher
Published: February 2021

N/A
The Evidence Supporting a Systematic Approach to the Care of the Injured Patient:From Prevention to Rehabilitation
Authors: Liberman Moishe , Mulder David S. , Sampalis John S.
Published: February 2021

N/A
Arterialised Capillary Blood Gases in Accident and Emergency Department Patients - a Reliable Alternative to Arterial Sampling?
Authors: Shakur Faheem , Mason Suzanne
Published: February 2021

OBJECTIVES: Many patients with respiratory complaints who present to the Accident & Emergency (A & E) department have an arterial blood gas analysis performed at some point. It is our belief that there is no difference between arterial and capillary blood gas values in patients presenting to the A & E department. It is also anticipated that body temperature and blood pressure may play a part, so these will also be reported and associations will be investigated. METHODS: Patients who require arterial blood gas analysis at any stage during their stay in the A & E department at the Northern General hospital of Sheffield are eligible for inclusion in the study. In total there were 32 patients. PROCEDURE:Transvasin cream was applied to the ear lobe to improve local blood flow by dilating the capillaries. When ten minutes have elapsed after the application of the Transvasin cream, a capillary sample is taken from the ear lobe by the researchers. CONCLUSION: From the t-tests conducted, no significant difference was seen between the arterial and capillary blood gas samples for the parameters pO2 and O2 saturation. However, for pCO2, pH and [HCO3] there were significant differences observed. This result seems to disagree with the findings of most other studies that have so far shown stronger correlations generally for pH, pCO2 and bicarbonate, than for oxygen measuring parameters.
Evidence for Maternal Style Among Adult Female Dolphins When Sharing Pectoral Fin Contacts with Their Calves
Authors: Dudzinski Kathleen M. , Ribic Christine A. , Manitzas Hill Heather M. , Bolton Teresa T.
Published: February 2021

Adult bottlenose dolphins share pectoral fin contacts (PFC) to manage their social relationships but less is known about how mothers share PFC with their calves. Using a dataset collected over 16 years, we analyzed how 10 matrilines, including three second generation female dolphins in a maternal role, used PFC with their pre-weaned calves. Mothers had different rates of initiation with their calves forming a continuum from those initiating few contacts (15%) to those initiating more (44%). For mothers with all-aged calves, the lateral side was contacted the most to start interactions with mothers contacting body parts at a similar rate. All mothers assumed the same posture regardless of their role as initiator or receiver, with horizontal the most prevalent posture. Two maternal styles were found for PFC: high and low use of PFC. Within the high PFC group, there was individual variation that was related to calf sex. Even though evidence of maternal style was confirmed in PFC exchanges between adult female dolphins and their calves, the number of PFC shared between these kin was only ~9% of all documented PFC contacts (N = 4,345) over 16 years, suggesting that other forms of tactile contact may be more important within the confines of the mother-offspring relationship in delphinids.