bluuebunny/crossref_metadata_2025 huggingface dataset:
Crowdsourcing Local Knowledge with PPGIS and Social Media for Urban Planning to Reveal Intangible Cultural Heritage
Authors: Nummi Pilvi
Published: March 2018

In participatory urban planning, understanding local stakeholders’ viewpoints is central, and, thus, gathering local knowledge has become a frequent task in planning practice. However, the built cultural heritage is usually evaluated by experts neglecting the values and opinions of citizens. In this study, a crowdsourcing model for assessing local residents’ viewpoints and values related to the built cultural heritage of Nikkilä was developed. The aim was to find out if crowdsourcing with public participation GIS and social media is a functional method for revealing local people’s values, place-based memories and experiences. In the case study, non-professional knowledge was compared with expert knowledge and valuable knowledge about the intangible aspects of the built cultural heritage was reached through place-based memories. Apart from that, social media provided visual representations of place-based experiences and a tool for building a collective memory. Based on the results, it is evident that a multi-method crowdsourcing model can be a functional model for crowdsourcing local knowledge. However, there are several challenges in analysing data and using the knowledge in urban planning.
Genus Skeletocutis (Polyporaceae) in the Ukrainian left bank forest steppe
Authors: Shevchenko M. , Dudka I.
Published: March 2018

Upon review of the reference data and the author's herbarium specimens were recorded five species of the Skeletocutis genus in the Ukrainian Left Bank Forest Steppe. One species, S. brevispora, is a new record for Ukraine, another one, S. carneogrisea, was found for the first time in the Ukrainian Left Bank Forest Steppe. For other two species, S. nivea, S. subincarnata, new localities were found within the studied region.
Не божий дар, а феномен природы
Authors: Ильинский Игорь Михайлович
Published: March 2018

Статья представляет авторское осмысление личности и творчества русского писателя И. А. Бунина. В центре внимания автора — проблема психического состояния гениального творца, в том числе роли наследственности. В основе анализа — теория эвропатологии Г. В. Сегалина, писавшего о патологиях как биологических факторах гениальности.

Анализируются родословная И. А. Бунина, особенности биографии его родителей, самого писателя. Приводятся свидетельства очевидцев, высказывания Бунина о себе, упоминаются факты его жизни.
Социальное государство: исторический генезис и современные модели
Authors: Канарш Григорий Юрьевич
Published: March 2018

В статье поднята ключевая для современного российского общества тема социального государства. Автор обращается к данным социологических исследований, которые свидетельствуют о том, что российское общество не вполне отвечает критериям общества благополучного. С одной стороны, благосостояние российского общества неуклонно увеличивалось на всем протяжении 2000-х и 2010-х годов, однако, с другой стороны, одновременно с этим росли социальные неравенства. В результате российское общество, несмотря на выросший за последние 17 лет уровень зажиточности, характеризуется чрезвычайно высоким уровнем социального расслоения. Это обстоятельство, а также весьма невысокий уровень социальной защищенности российских граждан, по мнению автора статьи, заставляют обратиться к проблеме социального государства.

Автор предлагает использовать сравнительно-исторический подход к анализу формирования социального государства. С его точки зрения, понимание того, какими путями может сформироваться социальное государство в России, предполагает анализ путей его формирования на Западе (Западная Европа и США). В статье анализируются истоки социального государства (проблема пауперизма), исторические способы решения социального вопроса (различные модели социального страхования), а также исследуются основные модели социальной политики (консервативная, либеральная и социал-демократическая).

Основной тезис заключается в том, что социальное государство есть институт, который воплощает в себе практику классового компромисса, готовность господствующих групп поступиться частью своих интересов ради сохранения социальной стабильности. Делается вывод о том, что России ближе социал-демократическая модель социальной политики, однако не все условия для ее реализации имеются в наличии.
Источниковедческие умения аспирантов в аспекте текстовой компетентности
Authors: Косинова Оксана Анатольевна
Published: March 2018

Реформа аспирантуры в российской системе образования подразумевает совершенствование содержания образования и способов преподавания на основе компетентностного подхода. Способность аспирантов самостоятельно осуществлять научно-исследовательскую деятельность рассмотрена как ключевое умение, сообразное цели подготовки кадров высшей квалификации. Способности к критическому анализу и оценке современных научных достижений, генерированию новых идей, к проектированию и осуществлению научных исследований, в том числе междисциплинарных, владение методологией и методами исследования и другие компетенции рассмотрены как компоненты, представляющие собой различные стороны культуры научного исследования.

Текст научной работы выступает и как объект, и как результат познавательной деятельности аспирантов. Авторство в тексте рассматривается в качестве критерия познавательной самостоятельности обучаемых. Языковая компетентность и ее составляющая — текстовая компетентность представляют собой результаты формируемых умений, показатель личностной вовлеченности в научно-исследовательскую работу. Источниковедческие умения рассмотрены на материале дисциплины «Современные информационные и библиотечные ресурсы» как компонент текстовой компетентности обучающихся аспирантуры в единстве: текстовоспринимающей, интерпретационной, текстообразующей.

Раскрытию субъектности аспирантов в учебном взаимодействии способствует система учебных заданий, охватывающая все стороны проявления их индивидуальности. Гносеологический потенциал привлекаемых аспирантами документов раскрывается благодаря формируемым учебным действиям, базирующимся на структуре источниковедческого знания, с одной стороны, и содержательному наполнению самостоятельно выполняемых заданий — с другой. Системность заданий формируется с учетом структуры учебной деятельности, этапности в переходе от воспроизводящей к творческой деятельности, видов текстовой деятельности, структуры источниковедческого знания. Систему умений и навыков в самом общем плане определяют: виды учебной деятельности, объект учебной деятельности, совокупность компетенций.
«Я в детстве заболел…» Арсения Тарковского: интеграция поэтического текста в кинематографический
Authors: Берендеева Мария Сергеевна
Published: March 2018

Статья посвящена исследованию механизма трансформации поэтического текста при его включении в кинематографический на примере одной поэтической цитаты в кинотексте советского кинорежиссера Андрея Тарковского. Цель работы — рассмотреть особенности интеграции стихотворения Арсения Тарковского «Я в детстве заболел…» в кинотекст художественного фильма А. А. Тарковского «Ностальгия».

В статье рассмотрены основные виды трансформации исходного текста при его цитировании, определены факторы, влияющие на изменение первоначального смысла (место цитаты в структуре кинотекста, механические изменения текста, предтекстовая фоновая информация, способ включения цитаты в кинотекст, визуальное и звуковое сопровождение цитаты). Сцена из фильма «Ностальгия», включающая рассматриваемую цитату, проанализирована в статье с позиции указанных факторов трансформации текста, выявлены следующие параметры цитаты: эпизод с чтением стихотворения «Я в детстве заболел…» в «Ностальгии» является одним из наиболее идейно значимых в фильме, раскрывает образ поэта и вводит различные элементы концепта ОТЕЦ (биографические и культурологические); исходный текст значительно сокращен, присутствуют также отдельные изменения слов; на восприятие стихотворной цитаты оказывает влияние личность поэта (отца режиссера) и актера, исполняющего главную роль; цитата встраивается в текст по звуковому каналу путем небрежного, но мотивированного сюжетом чтения; визуальные образы сопровождения (дерево, вода, храм, огонь, книга) создают дополнительный смысловой уровень эпизода.  
По итогам проведенного исследования можно сделать следующие выводы: переживания лирического героя стихотворения проецируются на героя фильма, соединяющего в себе образы и режиссера, и поэта, воплощающего одновременно архетипы и отца, и сына; сюжет стихотворения в фильме связан с пересечением границы между реальным и сверхреальным измерениями бытия и с предчувствием грядущей жертвенной смерти; а сам эпизод фильма актуализирует сакральные символы, типичные для творчества Андрея Тарковского. Таким образом, стихотворение Арсения Тарковского приобретает в фильме его сына совершенно новое прочтение. 
Интертекстуальность как инструмент моделирования метатекста в творчестве В. Набокова
Authors: Стрельникова Лариса Юрьевна
Published: March 2018

Предметом исследования в статье является интертекстуальность как художественный прием игровой поэтики русского и американского писателя В. Набокова (1899–1977). Определены эстетические особенности интертекстуальности в творчестве писателя, принципы ее художественного воплощения. Анализируются произведения: «Машенька» (1926), «Король, дама, валет» (1928), «Отчаяние» (1930), «Подвиг» (1932), «Дар» (1937).

Интертекстуальность выводит произведение литературы из сферы классического искусства в направлении постмодернистской эстетики и позволяет автору пародийно играть разными культурными кодами, отойти от миметической системы в сферу иррационального искусства. В постмодернизме интертекстуальность становится способом деконструкции произведения, моделирования текста по принципу ризомного разветвления. У такого текста отсутствует единый смысловой источник (корень), поэтому читатель, чтобы получить удовольствие от прочитанного, должен находить интертекстуальные источники. Вовлеченный в интертекстуальную игру художественный текст лишается серьезности, присущей серьезному искусству, и превращается в артефакт, делается театрализованно-зрелищным и комическим.

Интертекстуальность не только реконструирует произведение, но и переводит его в статус пародии — мениппеи с целью унижения и искажения классического канона. Поэтому нельзя говорить, что Набоков использует цитацию для диалога с русской литературой.  Прием интертекстуальности позволяет Набокову создавать тексты-мозаики, в которых парадоксальным образом сосуществуют художественные коды разных произведений, что позволяет ему расширить коммуникативную связь между писателем и читателем, выводя текст из сферы элитарного искусства в направлении игровой избыточности как способ борьбы с приемами реализма.
Религиозно-философское наследие Чже Цонкапы в духовной культуре ойратов
Authors: Эрендженова Юлия Юрьевна
Published: March 2018

В настоящее время в связи с возрождением и развитием буддизма в Калмыкии встает вопрос о происхождении и преемственности буддийской традиции калмыков. Буддийская философия и религиозный культ имели структурирующее значение и влияли на мировоззрение и образ жизни предков калмыков — ойратов. При этом главенствующее место занимала тибетская традиция гелуг, основанная Чже Цонкапой на рубеже XIV–XV вв. Глубинные философские трактаты и сеть монастырей со строгой системой образования составили обширное религиозно-философское наследие Цонкапы. В статье рассматриваются доктринальные основания тибетской буддийской традиции гелуг и их интеграция в духовное пространство ойратов в контексте межкультурного взаимодействия Тибета и ойратских ханств.

В XVII в. в результате вмешательства ойратов традиция гелуг заняла доминирующее положение в Тибете, а буддизм стал национально-государственной религией самих ойратов. Это способствовало консолидации ойратского социума и формированию их культурного пространства на основе буддийской картины мира. Ойратские монахи обучались в гелугпинских монастырях, переводили и распространяли в родных кочевьях философские трактаты Цонкапы, которые, составив теоретическую базу традиции гелуг, разъясняли суть поэтапного совершенствования личности на пути к просветлению и определяли сущностное содержание тантрической ритуальной практики.
На основе данных научных исследований, основополагающих сочинений Чже Цонкапы, исторических хроник, образцов ойратского законодательного и народного творчества автор статьи приходит к выводу, что базовые категории философской традиции гелуг получили отражение в мировоззрении ойратов и способствовали последующему формированию их культуры. В соответствии с учением Цонкапы о совершенствовании личности через практику отречения, сострадания и мудрости ойраты важными считали такие качества, как воздержанность, гуманность, добродетель, справедливость. Буддийская мудрость, которая заключается в осознании взаимообусловленности бытия посредством дискурсивного анализа, согласовывалась с категориями коллективной ответственности, взаимосвязанности, осознанного стремления к обучению и самосовершенствованию, являвшимися духовными регуляторами жизни ойратского общества. Наряду с философским осмыслением учения Цонкапы, которое в основном было доступно духовной и светской элите, большое распространение получила и обрядовая практика.
Ценностные ориентиры в воспитании современной молодежи
Authors: Ситаров Вячеслав Алексеевич
Published: March 2018

Текст выступления автора на пленарном заседании XIV Международной научной конференции «Высшее образование для XXI века: проблемы воспитания», который прошел 14 декабря 2017 г. в Московском гуманитарном университете.

В докладе рассматриваются ценностные аспекты воспитания современной молодежи, обсуждаются социокультурные проблемы и деформации ценностного пространства воспитания. Предложена конструкция источников ценностных ориентаций, включающая социоцентрический, теоцентрический антропоцентрический, этноцентрический, природоцентрический, культуроцентрический и гносеоцентрический пласты, которые могут быть положены в основу воспитательных приоритетов современной студенческой молодежи.
Идеологическая функция культурной политики
Authors: Флиер Андрей Яковлевич
Published: March 2018

В статье излагается авторский взгляд на основные цели и задачи культурной политики. Научная новизна статьи в том, что основные ее положения еще не высказывались в научной литературе с такой определенностью и четкостью. Актуальность статьи заключается в возможности использования ее положений в практике управления культурой и ее регулирования.

Основная цель культурной политики, по мнению автора, состоит во внедрении в массовое сознание господствующей идеологии, причем в наиболее мягкой, ненасильственной форме. Господствующая идеология в современной России — это этатизм (государствоцентризм), реализуемый в сравнительно умеренной форме политической практики. В рамках этой идеологии главная задача культурной политики — обеспечить лояльность большинства населения к власти и ее политической программе.

Население может быть аналитически разделено на четыре группы: активно лояльных, пассивно лояльных, фальшиво лояльных и нелояльных граждан. Основными адресатами культурной политики являются пассивно лояльные люди, которых нужно склонить к электоральной активности и поддержке действующей власти. Главным инструментом воздействия на сознание людей в рамках культурной политики выступают искусство и литература. При этом особый акцент делается на активизацию исторической памяти и чувства патриотизма.

Такая культурная политика не является изобретением нашего времени, а известна из глубин истории, со времен появления первых государств.
To the question of electrophysiological remodeling role in the genesis of ventricular ectopy in patients with postinfarction cardiosclerosis
Authors: Mazur E S , Mazur V V , Jaber H A , Orlov Yu A
Published: March 2018

Aim. To study the character and intensity of relationship between left ventricular dilatation, severity of electrophysiological myocardium remodeling and ectopic ventricular activity in patients with postinfarction cardiosclerosis.

Methods. 46 patients with postinfarction cardiosclerosis were examined (males, average age 57.9 years). All patients underwent echocardiography with detection of end diastolic volume of left ventricle and its ejection fraction, Holter monitoring with determining signal-averaged electrocardiogram and severity of ventricular ectopic activity with calculation of ventricular ectopic activity index. Based on the ejection fraction the patients were divided into two groups. Group 1 included 17 patients with ejection fraction ≥45%, and group 2 - 29 patients with ejection fraction <45%.

Results. Left ventricle ejection fraction in patients from group 2 was lower, and parameters of signal-averaged electrocardiogram were worse than in patients from group 1. Ventricular ectopic activity index in patients from group 2 was 5 times higher than the average index in group 1. According to correlation analysis in the combined group, signal-averaged electrocardiogram parameters more tightly correlated with end diastolic volume than with ventricular ectopic activity index. The latter more tightly correlated with end diastolic volume (r=0.67, p <0.001), than with signal-averaged electrocardiogram parameters. After calculating partial correlation coefficient and excluding the effect of end diastolic volume, correlation coefficients of ventricular ectopic activity index and signal-averaged electrocardiogram parameters became insignificant. The received data put in question the view that electrophysiological remodeling is an independent cause of severity increase of ventricular arrhythmias. More probable is that electrophysiological remodeling and ventricular ectopic activity are related pathogenetically, and correlation between them is determined by the fact that both depend on left ventricle end diastolic volume.

Conclusion. Relation between electrophysiological myocardium remodeling and ectopic ventricular activity in patients with postinfarction cardiosclerosis may depend on severity of left ventricular dilatation.
Study of effectiveness of antiviral drugs (umifenovir, triazavirin) against acute respiratory viral infections
Authors: Tikhonova E P , Kuz'mina T Yu , Andronova N V , Tyushevskaya O A , Elistratova T A , Kuz'min A E
Published: March 2018

Aim. Comparative study of clinical efficacy and safety of antiviral drug triazavirin and umifenovir in the treatment of patients with acute respiratory viral infections and influenza.

Methods. The study included 100 patients aged 18 to 65 years diagnosed with moderate acute respiratory viral infection. Group 1 included 34 patients receiving umifenovir 200 mg 4 times a day for 5 days, and comparison group included 32 patients who received triazavirin 1 capsule (250 mg) 3 times a day for 5 days. Group 3 (control group) included 34 patients not treated with antiviral therapy. Efficacy and safety of the studied antiviral drugs were evaluated based on clinical symptoms in the disease course and were confirmed by adaptive reactions of the organism.

Results. Among patients receiving triazavirin, recovery time and fever, headache and catarrhal syndrome resolution time were less than among patients who received umifenovir. On triazavirin treatment with favorable tolerability, symptomatic medications (antipyretics) were discontinued, and the duration of their use was less, than in patients receiving umifenovir. Evaluation of clinical efficacy of umifenovir and triazavirin for the treatment of acute respiratory viral infections and influenza demonstrated that the drugs effectively reverse the main symptoms of the disease (p <0.05), reduce complications incidence (18.1±2.1% vs. 55.9±3.2%, p <0.05) and contribute to the stabilization of adaptive reactions of the organism in contrast to the results of patients not receiving etiotropic therapy (6.9±2.9% vs. 12.8±2.7, p <0.05). During the use of umifenovir by day 4 and during the use of triazavirin by day 3 intoxication and catarrhal syndromes had been reversed, while in case of the absence of antiviral therapy, 55.8% of patients had continuing intoxication and catarrhal symptoms.

Conclusion. The results of the study allow defining umifenovir and triazavirin as the first line of defense against acute respiratory viral infections with good efficacy and tolerability of the drugs.
Early and long-term results of surgical treatment of Hirschsprung's disease in children
Authors: Polukhov R S
Published: March 2018

Aim. To assess the safety, functional activity and quality of life of patients with Hirschsprung's disease operated by different methods.

Methods. The study included 86 children operated on for Hirschsprung's disease. Patients were divided into four groups: group 1 - 44 (51.2%) patients underwent Duhamel-Martin procedure; group 2 - 14 (16.3%) patients underwent Soave-Boley procedure; group 3 - 22 (25.6%) patients underwent transanal endorectal resection; and group 4 - 16 (18.6%) patients underwent laparoscopical Soave-Georgeson procedure. The results were comparatively evaluated immediately and one year after the surgery. To assess the quality of life after surgery, a visual questionnaire Peds QLtm 4.0 was used.

Results. Minimal duration of the surgery and related anesthesia was registered in groups 3 and 4, the difference with groups 2 and 3 being statistically significant (p <0.05). Duration of postoperative pain management in group 1 was 3.2±0.7 days, in group 2 - 3.3±0.7 days, while in groups 3 and 4 - 2.5±0.5 days (р ˂0.05). Minimal hospital stay after the surgery was registered in group 4 (9±2 days), which is less than in group 1 by 1.7 times, in group 2 - by 1,5 times (р ˂0.05). The second shortest hospital stay was observed in patients from group 3 (10±2 days): it was 1.4 and 1.3 times shorter tahn in groups 1 and 2, respectively (р ˂0.05). At the assessment of one-year functional results satisfactory results were obtained in group 1 in 20 (45.46%) patients, in group 2 - in 7 (50%), in group 3 - in 12 (54.55%), in group 4 - in 12 (75%) patients. Unfavorable results were observed in group 1 in 6 (13.64%) patients, in group 2 - in 2 (14.29%), in group 3 - in 2 (9.09%), in group 4 - in 0 (0%). The best quality of life according to all parameters was observed among patients from groups 3 and 4 (р ˂0.05).

Conclusion. The quality of life of patients with Hirschsprung's disease after transanal endorectal resection and laparoscopic Soave-Georgeson procedure was higher than after Duhamel-Martin and Soave-Boley procedures; Soave-Boley procedure is preferable due to good regulation of the defecation act by patients.
Biochemical changes in rat muscle tissue with prolonged use of simvastatin
Authors: Vinogradova E V
Published: March 2018

Aim. Analysis of biochemical changes in rat muscle tissue after prolonged use of simvastatin.

Methods. The study was conducted on mongrel male rats. Three groups were identified: control group (intact animals), comparison group (animals with induced hypercholesterolemia not reeciving the drugs), and experimental group (animals with induced hypercholesterolemia receiving simvastatin 0.0012 g/100 g of weight once a day for 2 months as an aqueous suspension through the esophageal probe). Metabolite concentration of glycolysis (pyruvic acid and lactate), activity of antioxidant protection enzymes (reduced glutathione, superoxide dismutase, catalase, glutathione reductase, glutathione peroxidase), titin isoforms and proteolytic fragments of titin and nebulin concentration were determined in the muscles of animals.

Results. After administration of simvastatin to animals with induced hypercholesterolemia, a decrease in the concentration of glycolysis metabolites (pyruvic acid and lactate) compared to comparison group was revealed, as well as multidirectional changes in the activity of antioxidant protection enzymes (decrease in activity of superoxide dismutase, glutathione peroxidase, and glutathione reductase, decreased concentration of reduced glutathione, but catalase activity remained unchanged). The analysis of structural changes in animal muscle tissue after administration of simvastatin revealed a decrease in the concentration of NT- and N2A-titin isoforms and practically complete absence of nebulin compared to the animals from the comparison group. At the same time an increase in the concentration of proteolytic fragments of titin (T2) by 1.3 times was recorded.

Conclusion. The study showed that the basis of myotoxicity of statins in their long-term use is disintegration of enzyme antioxidant processes, as well as tissue hypoxia, leading to destruction of muscle fibers and prevalence of proteolytic processes.
Effect of pivaloyl-substituted pyrrole containing heterocyclic compounds on DNA repair pathways in Ewing sarcoma cells
Authors: Galembikova A R , Boychuk S V , Dunaev P D , Khusnutdinov R R , Zykova S S
Published: March 2018

Aim. To examine deoxyribonucleic acid (DNA) damage repair and cell cycle regulatory mechanisms of Ewing sarcoma cells exposed to pivaloyl-substituted pyrrole containing heterocyclic compounds.

Methods. The study was performed on A673 Ewing sarcoma cell line. The tumor cells were incubated for 48 h in the presence of pivaloyl-substituted pyrrole containing heterocyclic compounds (compounds №20 and №24). Western blot analysis was utilized to examine expression of the markers of DNA single-strand (phosphorylated forms of ATR and Chk1) and double-strand breaks (phosphorylated forms of H2AX, АТМ, DNA-PK, BRCA-1, Chk-2). Analysis of the cell cycle phases was performed by flow cytometry (BD FacsCanto, USA).

Results. Pivaloyl-substituted pyrrole containing heterocyclic compounds substantially increased the expression of histone 2A phosphorylated on serine 138 (γ-H2AX) that indicates DNA damage (double-strand breaks). Under exposure to pivaloyl-substituted pyrrole containing heterocyclic compounds the studied cells increased expression of phosphorylated forms of ATM-kinase and BRCA-1. Also cell cycle disorders leading to substantial G2/M arrest and enhanced apoptosis of tumor cells were observed.

Conclusion. Pivaloyl-substituted pyrrole containing heterocyclic compounds induced DNA double-strand breaks in A673 Ewing sarcoma cell line; in response to DNA damage in tumor cells, the mechanisms of DNA double-strand breaks repair were activated; despite activation of DNA repair mechanisms, A673 cells underwent cell cycle arrest in the G2/M-phase and apoptosis.
Epidemiologic aspects of breast cancer incidence in Baku
Authors: Vatankha S S
Published: March 2018

Aim. Study of incidence and mortality from breast cancer in different administrative territorial districts of Baku in 2016.

Methods. Statistical report forms №7 were used (reports on malignant neoplasms of the Ministry of Healthcare of Azerbaijan Republic) as well as the database of cancer registry of the National center of oncology of Baku in 2016. Primary incidence index (per 100 000), standardized incidence ratio (per 100 000), prevalence rate (per 100 000), extensive index (% compared to other types of oncologic pathology revealed in Baku in 2016), lethal index (%), crude mortality rate (per 1000), aggressiveness index were calculated.

Results. In the structure of malignant neoplasms in Baku among females, breast cancer takes the first place (extensive index 31.6%). 7.4-fold variation of breast cancer morbidity in different administrative districts was observed (p <0.05) - from 142.4 per 100 000 in Yasamal raion of Baku to 19.1 per 100 000 in Qaradag raion (p <0.05). Variation of prevalence rate was less prominent (3.1 times, p <0.05): from 655.8 per 100 000 in Sabail raion to 209.4 per 100 000 in Binagadin raion. Crude mortality rate was similar in all districts and varied from 0.1 to 0.5 per 1000. More than 30-fold variation of lethal index was observed with the average index in Baku of 17.3%. The more distantly from the center of the city the district is located, the higher the lethal index was (p <0.05). One of the main parameters determining neoplasm prognosis was extension of tumor at the moment of its diagnosis. Among primary patients, those with clinical stages I-II prevailed (59.3%), the proportion of patients with stage III was 22.0%, stage IV - 18.7%. Agressiveness index varied from 0.1 (in Pirallahi raion) to 0.5 (in Binagadin and Sabail raions), the total city index was 0.4. With the growing age, increasing standardized incidence ratio was observed, and its peak value was in the age group 50-59 years (14.5 per 100 000). Generally, in Baku breast cancer incidence among females regardless of their age was 47.7 per 100 000, and it was significantly higher in Baku than generally in the republic (35.0 per 100 000, p <0.001).

Conclusion. The first place in the structure of oncology diseases among female citizens of Baku is taken by breast cancer (31.6%), women aged 50-70 years have the highest risk of the disease; the highest lethal index was reported for females with breast cancer living in the most distant districts of Baku that indicates the necessity for improved preventive activity in those districts.
Reproductive health of women after abdominal delivery living in different regions of the Kyrgyz Republic
Authors: Samigullina A E , Vybornykh V A
Published: March 2018

Aim. Study of somatic and obstetric and gynecologic morbidity of women of the Kyrgyz Republic after Cesarean section.

Methods. Retrospective cohort study was conducted in 2016 in Kyrgyz state medical institute of retraining and advanced training. Three regions of the Kyrgyz Republic were selected: Bishkek, Jalal-Abad and Issyk-Kul regions. 908 pregnant women after abdominal delivery were chosen as the subject of the study and divided into three groups: group 1 (Bishkek) - 305 pregnant women, group 2 (Jalal-Abad region) - 300 females, group 3 (Issyk-Kul region) - 303 females. The age was 15 to 49 years. The incidence of gynecologic and extragenital pathology and complications during previous pregnancies were studied.

Results. Gynecologic pathology in past medical history was revealed in 15.8% of females, while women from group 1 are statistically significantly more likely to have gynecologic diseases than women from group 3. Females from group 2 had gynecologic pathology more rarely. In the structure of gynecologic incidence, sexually transmitted infections take the first place, cervical ectopy takes the second place and uterine fibroids - the third place. Extragenital pathology was detected in 38.2% of pregnant women. In its structure the first ranked place is taken by urinary tract diseases (12.3%), the second one - by infectious and parasitic diseases (11.6%), and the third place - by cardiovascular diseases (3.2%). Pathological course of pregnancy was also more frequent in group 1 than in group 2; there was no significant difference with group 3. Spontaneous abortion interrupted previous pregnancy in 19.8% of women, 5% had premature births, significantly more frequently in group 1, as well as preeclampsia.

Conclusion. The most unfavorable region is the city of Bishkek, female residents of Jalal-Abad region are less susceptible to diseases; in general, gynecologic pathology was revealed in 15.8% of females, extragenital pathology - in 38.2% of pregnant women; pathological course of pregnancy was statistically more frequent in group 1 than in group 2, without significant difference with group 3.
Readmissions for chronic obstructive pulmonary disease in actual clinical practice
Authors: Yakupova A F , Zinnatullina A R , Khamitov R F
Published: March 2018

Aim. Identification of risk factors for readmissions associated with exacerbation of chronic obstructive pulmonary disease followed by identification of possible quality defects in the provision of medical care to patients in the outpatient and hospital stages.

Methods. A retrospective analysis of the medical records of patients with exacerbation of chronic obstructive pulmonary disease admitted twice or more to the therapeutic department of one of the hospitals of Kazan during the period from January 1, 2015 to June 30, 2016.

Results. The risk factors for readmissions were found to be the following: male sex (relative risk 2.29; 95% CI 0.78-6.69; р ˂0.05), age over 70 years (relative risk 2.069; 95% CI 1.01-4.2; р ˂0.05), smoking for more than 40 years (relative risk 5.3; 95% CI 1.6-17.5; р ˂0.05), duration of the disease more than 6 years (relative risk 2.4; 95% CI 0.98-6.18; р ˂0.05), presence of three or more concomitant diseases, primarily cardiovascular pathology (relative risk 13.0; 95% CI 1.89-90.14; р ˂0.05). Important reasons for subsequent exacerbations after discharge from the hospital are patients' nonadherence and defects of the provision of medical care in the hospital.

Conclusion. The revealed defects of the quality of medical care indicate the need to intensify the implementation of the federal clinical guidelines for chronic obstructive pulmonary disease in actual medical practice; due to the difficulty of modifying the identified risk factors, the main efforts should be directed at treatment optimization with adherence control, as well as full use of the potential for non-drug treatment in the form of guidelines for maintaining physical activity, early smoking quitting and patients' rehabilitation.
Use of rubber seton in the treatment of anorectal fistulae
Authors: Karpukhin O Yu , Sakulin K A
Published: March 2018

Aim. To determine the efficacy of brand new industrial synthetic material for surgical treatment of patients with complicated anal fistulae and advantages of its use for ligature method of chronic paraproctitis treatment.

Methods. Between 2010 and 2017, 175 patients (average age 47 years) with extra- and transsphincteric fistula were treated with a ligature. The study group consisted of 67 patients treated with rubber seton, comparison group included 108 patients treated with nylon ligature.

Results. The results of clinical use of two seton types for the treatment of rectal fistulae are presented. Rubber thread with circular section as seton was proved to be inexpensive and effective material, advantages of which result from its physical properties. Thus, dissection of muscle tissue due to rubber elasticity becomes more efficient due to the greater reserve of compression than in case of rigid nylon seton, and that reduces the number of contractions. In addition, physical properties of the material, such as its high surface wettability, offer good drainage, and homogeneity of the material not absorbing the fluids, in turn, provides avoidance of the «wick effect» with the spread of infection into the wound. So, the treatment of anorectal fistulae with ligature with the use of rubber seton demonstrates the best therapeutic results and is preferable for patients.

Conclusion. Use of rubber seton in treatment of complicated anal fistulae allows reducing hospital stay, provides better drainage of the surgical wound, and reducing the number of complications and required contractions, thus, minimizing the associated pain syndrome.
Capabilities of single-photon emission computed tomography combined with computed tomography in diagnosis of neck masses
Authors: Maksimova N A , Arzamastseva M A , Agarkova E I , Engibaryan M A
Published: March 2018

Aim. Assessment of the capabilities of planar scanning combined with X-ray computed tomography in the diagnosis of neck masses.

Methods. The study included 9 patients with neck masses examined at Rostov Scientific Research Institute of Oncology. Patients with suspected retrosternal nodal growth and ectopic thyroid gland on clinical and ultrasound examinations received single-photon emission computed tomography combined with computed tomography. The technique included the following stages: (1) planar scanning; (2) volumetric dynamic emission tomography of relevant areas; (3) X-ray spiral computed tomography; (4) archiving, combining scan parameters; (5) post-processing and reconstruction of images and assessment of the results.

Results. Ultrasound study of neck masses in our study did not provide complete evaluation of surrounding anatomical structures due to large size of masses and did not allow identifying the connection between mass lesions and thyroid gland and evaluating relationship between the tumor and trachea, esophagus, great vessels. As a result of our study, with the use of single-photon emission computed tomography combined with computed tomography, among 9 patients with neck masses 5 (55.5%) patients were diagnosed with retrosternal thyroid lesions, 3 (33.3%) - ectopic thyroid gland and 1 (11.2%) - metastasis of neuroendocrine (small cell) carcinoma. 3 (60%) out of 5 patients with retrosternal thyroid lesions had a nodular goiter with retrosternal component and 2 (40%) patients had thyroid cancer with a nodular goiter. Conclusions. A combination of hybrid technologies of single-photon emission computed tomography and computed tomography for the identification of neck masses is a highly informative method providing single-step determination of the lesion location and assessment of its topographic and anatomical relationship with surrounding anatomical structures which allows optimizing the examination and choosing further management strategy.
ÇOCUKLUK ÇAĞI ARAÇ DIŞI TRAFİK KAZALARININ EPİDEMİYOLOJİSİ
Authors: Baskın Embleton Didem , User Neşe Nur , Öztürk Şeyda Nur , Özmutlu Yelda Nur , Üzüm Muammer , Savaş Serkan , Manavlı Bariş
Published: March 2018

AMAÇ: Çocukluk yaş grubunda araç dışı trafik kazalarına ait epidemiyolojik verilerin incelenmesi ve bu kazaları önlemeye yönelik olarak çeşitli risk faktörlerinin belirlenmesi.GEREÇ VE YÖNTEM: Bir üniversite acil servisine başvuran beş yıllık trafik kazası kayıtları içinden 0-18 yaş grubuna ait araç dışı trafik kazaları (ADTK) retrospektif olarak incelendi. Kaza kodları, yaş, cinsiyet, kazanın şehir içinde veya şehir dışında olması, saati, gün, ay, kaza sırasında aile birlikteliği, yaralanan organ sistemleri, hastaneye yatış olup olmadığı, yatan hastaların yatış süreleri ve sonuç kaydedildi. Elde edilen veriler uygun istatistiksel yöntemler kullanılarak değerlendirildiler.BULGULAR: Toplam 272 kayıt incelendi. Cinsiyetlere göre dağılım 178 erkek (%65,4), 94 kız (%34,6) şeklindedir. Aylara göre dağılıma bakıldığında %22,8 ile Eylül ayı kazaların en çok gerçekleştiği ay, %2,9 ile Ocak ve Şubat ayları kazaların en az gerçekleştiği aylar olarak tespit edilmiştir. Verilere göre %16,5 ile Salı günü kazaların en çok gerçekleştiği gün iken, %10,7 ile Cumartesi kazaların en az gerçekleştiği gün olmuştur. En sık kaza görülen saatler 08:00-15:59 (138 çocuk, %50.7) ve 16:00-23:59 saatleri (119 çocuk, %43.8) arasıdır. Kazaların %63.6’sının şehir içinde olduğu, %51.7’sinin çocuk ailesiyle birlikte değilken gerçekleştiği öğrenildi. Toplam 12 hastada kaza sonrası epilepsi, ensefalopati, serebral palsi, işitme kaybı, spastik hemipleji, fasiyal sinir bozukluğu, fleksiyon kısıtlılığı şeklinde kalıcı sakatlıkların oluştuğu, 6 hastanın (%2,2) da kaybedildiği tespit edilmiştir.SONUÇ: Özellikle erkek çocukları Eylül ayında, şehir içinde, mesai saatlerinde daha fazla kazaya maruz kalmıştır. Kazaların artış nedenlerinin ve önleme yollarının saptanabilmesi için ek çalışmalar gerekmektedir
ÇOCUKLUK ÇAĞI ASTIMININ KONTROL VE ŞİDDET DÜZEYİ İLE SERUM ÇİNKO DÜZEYLERİ ARASINDAKİ İLİŞKİ
Authors: Elmas Bahri , Özdemır Öner
Published: March 2018

AMAÇ: Çocukluk çağı astımı multifaktöriyel bir hastalıktır. Patogenezinde anti-inflamatuvar ve anti-oksidan ajanların önemli rol oynadığı bilinir. Bununla birlikte anti oksidan çinko gibi eser elementlerin rolü ile ilgili farklı görüşler mevcuttur. Bizim çalışmamızın amacı astım kontrol ve şiddeti ile serum çinko düzyleri arasındaki ilişkiyi belirlemekti.GEREÇ VE YÖNTEM: Çalışmaya Temmuz 2014 ile Nisan 2015 tarihleri arasında 3-17 yaş arası astım tanısı almış 56 hasta ve 26 sağlıklı çocuk alındı. Astım kontrol düzeyleri GINA 2014 kriterlerine göre belirlendi. Serum çinko düzeyleri atomic absorbsiyon spektroskopi metodu ile çalışıldı. Yapılabilen hastalara solunum fonksiyon testleri uygulandı.BULGULAR: Astım ve kontrol grubu serum çinko düzeyleri arasında anlamlı fark bulunmadı. Serum çinko düzeyleri tam kontrollü astım grubuna göre kısmi kontrollü astım grubunda anlamlı şekilde yüksek bulundu (p=0.023). Astım kontrol düzeyi ile serum çinko düzeyleri arasında anlamlı negative korelasyon izlendi (r: -0.437, p=0.001). FVC %80 altında olan grupta serum çinko düzeyleri anlamlı şekilde yüksek bulundu (p=0.001). Astım şiddet düzeyine göre serum çinko düzeyleri arasında fark bulunmadı (p=0.228). Astım şiddeti ile serum çinko düzeyleri arasında anlamlı korelasyon saptanmadı (r=0.168, p=0.217).SONUÇ: Serum çinko düzeyleri çocuklarda astım kontrolü ile ilişkili idi. Serum çinko düzeyleri astım kontrol düzeylerini belirlemede diğer parametrelere destekleyici olarak düşünülebilir.
KOLONOSKOPİDE ÇEKAL POLİP İMAJI VEREN İNVERTE APENDİKS GÜDÜĞÜ
Authors: Kozan Ramazan
Published: March 2018

Çekumda kitle imajına yol açabilen inverte apendiks güdüğü apendektominin oldukça nadir komplikasyonlarından biridir. Kolonoskopide apendiks invajinasyonu veya inverte güdük polip ya da tümör görünümü vererek yanıltıcı olabilmektedir. Bu nedenden dolayı biyopsiden geniş rezeksiyona kadar değişen çeşitli tedaviler uygulandığı görülmektedir. Kolonoskopik tanı konulan hasta sayısı oldukça az olup kolonoskopik tedavi yaklaşımları olası peritonit riski göz önünde tutularak seçilmiş hastalarda uygulanabilir. Bu yazıda snare polipektomi sonrası tanı konulan, kolonoskopide çekal polip imajı veren inverte apendiks güdüğü olgusu sunulmuştur. Özellikle apendiks orifisi düzeyine lokalize lezyonlarda inverte güdük ya da intussepsiyon ihtimalinin akılda tutulması gerektiği, kolonoskopik yaklaşım ile tedavinin de seçenekler arasında olabileceği vurgulanmak istenmiştir.
ÇOCUK VE SANAL ORTAM
Authors: Topçu Seda
Published: March 2018

Son yıllarda çocukların bilgisayar ve internet ortamına dahil olmaları, elektronik medya cihazlarının giderek genişleyen çeşitliliği ile artmıştır. Çocuklar bu dünyayı; bilgiye erişim, iletişim, dijital oyunlar, sosyal medya kullanımı gibi alanlarda sıkça kullanmaktadır. Dünyada olduğu gibi ülkemizde de internet kullanan nüfusu giderek artan hızda çocuklar oluşturmaktadır. Bu kadar hızlı gelişen ve değişen bir ortama kendi yaşlarına özgü gelişim özellikleri olan çocukların uyum sağlaması bir takım zorluklar içerebilmektedir. Çocukların internet ve bilgisayar kullanımını kontrol etme ihtiyacı bir çok çalışmada araştırılmıştır. Hızla değişen sanal dünyaya uyum sağlamak güçlükler içermekte, bu yüzden çocukların ekran maruziyeti konusunda önemli ve hassas düzenlemeler belirli aralıklarla güncellenmelidir. Sanal dünyaya uyum sürecinde çocukların gelişimlerini desteklemek önemlidir. Ayrıca çocuklar, sanal dünyayı, fiziksel ve bilişsel yeteneklerine en az zararı olacak şekilde kullanmaları gerekmektedir. İnternet farklı yaş gruplarında farklı şekillerde kullanılmaktadır. Çocuğun sağlıklı bilişsel ve fiziksel gelişimi için, uygun süre ve içerikte kullanımı önerilmektedir. Özellikle okul öncesi dönemde internet ve bilgisayar kullanımının süre ve içerik olarak kontrolü önem taşırken, adölesan dönemde ebeveyn kontrolü daha önemli hale gelebilir. İnternetin aşırı kullanımı ve ayrı kalındığında yoksunluk bulgularının görülmesi olarak tanımlanan internet bağımlılığı en çok adölesan dönemde görülmektedir. Çocuğa yönelik kötü muamele olarak tanımlanan çocuk istismarı, gerçek hayatta olduğu kadar sanal dünyada da karşılaşılan bir sorundur. Bu durumu öngörmek ve bu durumdan çocuklarını korumak öncelikle ebeveynlerin sorumluluğundadır. İnternetin riskleri ön görülebildiğinde, internetin zararlı etkilerini önlemek mümkün olabilmektedir. Sağlıklı çocuk izleminde, klinisyenler çocuğun bilgisayar ve internet kullanımı sırasında karşılaşabileceği riskler konusunda ailelere bilgi vermeli ve bu konuda ailelerin bilgi ve farkındalıklarını artırmalıdır.
Gebelikte Depresyon ve Anksiyete Artar mı?
Authors: KAYA ZAMAN Ferda , ÖZKAN Nurşah , TOPRAK Dilek
Published: March 2018

GEBELİKTE
DEPRESYON VE ANKSİYETE ARTAR MI?

 

ÖZET

 

AMAÇ:            Bu
çalışmanın amacı; gebelerdeki anksiyete ve depresyon seviyelerini, üreme
çağındaki gebe olmayan kadınların seviyeleriyle mukayese etmek ve
sosyodemografik özelliklerindeki korelasyonları incelemektir. GEREÇ ve YÖNTEM:            Çalışmaya Gazi Osman Paşa Taksim
Eğitim ve Araştırma Hastanesi Kadın Hastalıkları Doğum Polikliniği ile Gebe
Polikliniğine başvuran, 15-49 yaş arası doğurganlık çağındaki 50 gebe ve 50
gebe olmayan kadın dâhil edilmiştir. Çalışmaya alınan katılımcılara
sosyodemografik sorgulama için tarafımızca hazırlanan anket formu, Beck
Anksiyete Envanteri (BAE) ve Beck Depresyon Envanteri (BDE) uygulanmıştır.
Sonuçlar istatistiksel olarak analiz edilmiştir. BULGULAR:            Gebe
grubun Beck depresyon ve anksiyete puanları kontrol grubundan istatistiksel
olarak anlamlı şekilde yüksek saptanmıştır. Ayrıca gebe grupta gebelik
dönemlerine göre Beck depresyon ve anksiyete puanları arasında istatistiksel
olarak anlamlı farklılık bulunmaktadır (p<0,05); 3. Trimester grubunun puanı
1. Trimester grubundan anlamlı şekilde yüksek saptanmıştır (p:0,017).  SONUÇ:Sonuç olarak bulgularımız gebeliğin tüm
trimesterlerinde, özellikle de 3. trimesterde depresyon ve anksiyete
düzeylerinin arttığını, yasam kalitesinin düştüğünü göstermektedir. Gebelik
sırasında depresif semptomlar, özellikle depresyonun psikolojik semptomları
ciddiye alınmalıdır ve gebeliğin normal bir parçası olarak değerlendirilip
gözden kaçırılmamalıdır.    Anahtar Kelimeler: Gebelik, Anksiyete, Depresyon,
Sosyodemografik özellikler, Tedavi
Ankara İli Akyurt Bölgesindeki Gebelerde Demir Eksikliği Anemisi Prevalansı ve Demir Eksikliğine Sebep Olan Faktörler
Authors: Küçükceran Hatice , Ayhan Başer Duygu , Ağadayı Ezgi , Demir Alsancak Aybüke , Kahveci Rabia
Published: March 2018

Amaç: Bu
çalışma, Ankara İli Akyurt bölgesindeki gebelerde anemi sıklığını ve etkileyen
faktörleri belirlemek amacıyla yapılmıştır.Gereç ve Yöntem: Tamamlayıcı
olarak yapılan araştırmamızı, 01.03.2016-01.04.2016 tarihleri arasında Ankara
ili Akyurt bölgesinde yaşayan, mevcut 7 tane aile hekimliği birimine kayıtlı, çalışmamıza
katılmayı kabul eden 200 gebe oluşturmuştur. Bilinen hematolojik veya kronik
hastalığı olan, çoğul gebeliğe sahip gebeler çalışma dışı bırakılmıştır. Çalışmaya
katılmayı kabul eden gebelere, literatür bilgilerine dayanarak hazırlamış
olduğumuz anket formu telefon görüşmesi esnasında okunarak gebelerin cevapları
not edilmiştir. Gebelerin trimesterine göre uyumlu hemoglobin ve hematokrit
değeri retrospektif olarak Akyurt Devlet Hastanesi sistemine bakılarak not
edilmiştir.Bulgular:
Gebelerin yaş ortalaması 26.84 ±5.64 (min: 16;max:42) olarak saptandı. Gebeler
gebelik haftasına göre 3 gruba ayrıldı. Gebelerin %12.5’i (n=25) 1. trimester (1-14
hafta), %41.5’i (n=83) 2. trimester (15-27 hafta),  %46’sı (n=92) 3. trimesterde (28-40 hafta)
olarak tespit edildi. Gebelerin 1, 2 ve 3.trimesterlere göre anemi oranları
sırasıyla % 5.7,  %  8.8 ve % 14.9 bulunmuştur. Tüm gebelere
bakıldığında ise gebelerin % 13.15‘inin anemik olduğu saptanmıştır. Gebelerin
anemi durumu ile çay, kırmızı et ve sakatat tüketimi arasında istatistiksel
olarak anlamlı bir farklılık bulunmaktadır (p<0.05). Gebelerin anemi durumu
ile 2 yıl aradan daha sık aralıkta gebe kalma durumu arasında istatistiksel
olarak anlamlı bir farklılık saptanmıştır (p<0.05).

Sonuç: Gebelikte anemi önemli ve sık görülen
bir problem olup; gebelerin çoğu bu problemin yeterince farkında değildir.
Anemi gebeliğin daha sorunlu geçmesine neden olabilir. Gebelik öncesinde anemi
varsa bu problemin önceden düzeltilmesi ve gebelikte de yakın takip edilmesi
önerilebilir.