bluuebunny/crossref_metadata_2025 huggingface dataset:
Community and Collaboration in a Shared Multi-space Office
Authors: Ansio Heli , Käpykangas Sari , Houni Pia
Published: September 2020

Open and shared work environments such as activity-based offices, multi-space offices and co-working spaces have become more popular in recent years. This paper reports the results of a qualitative case study of community and collaboration in a multi-space office shared by six publicly owned companies in Finland. Using interviews (n = 29) and participant observation, the study examines how collaboration and community are understood in the six companies, and how they change during an intervention process. We argue that even though a sense of community, collaboration and synergies are expected to arise from sharing an office space, they do not necessarily emerge spontaneously without effort on the part of management.
El respeto de la autonomía como elemento fundamental en el tratamiento ético de los trastornos de la conducta alimentaria
Authors: Vázquez Parra José Carlos , Martell Espericueta Cassandra Michelle
Published: September 2020

Cuando se habla de trastornos de la conducta alimentaria, es usual pensar en las problemáticas médicas o psicológicas que implican este tipo de patologías. Sin embargo, no se puede negar que estas problemáticas vienen acompañadas de múltiples implicaciones sociales y personales por parte del individuo que se ve afectado, así como de los profesionales de la salud que participan en todo el proceso de atención. Por ende, el objetivo de este artículo es reflexionar sobre la necesidad de hacer un análisis ampliado de la realidad personal y social al momento de atender a pacientes con este tipo de trastornos. Para ello, es fundamental ver más allá de la simple patología médica y procurar que se respete siempre el principio de autonomía como piedra angular de la relación existente entre el médico y el paciente. Como conclusión, se busca que el profesional de la salud que interviene en procesos médicos relacionados con trastornos de la conducta alimentaria considere que la salud del paciente no solo consiste en superar el trastorno, sino también en el estado de bienestar durante el proceso terapéutico y sus implicaciones.
Checkmate to Bioethics?
Authors: Garzón Díaz Fabio Alberto
Published: September 2020

Bioethics, as the first cousin of philosophy, suffers from what philosopher Hegel told us during his lifetime, “When philosophy paints lights and shadows, an aspect of life has grown old, and cannot be rejuvenated, but only understood. Minerva’s owl takes flight only during sundown”. The problem is how to fight an invisible opponent. What to do when your opponent enters your body and kills you from the inside? This pandemic has taken away out trust in the “Other,” even if they are our parents or children, since it turns a simple act of love —a kiss or a hug— into a deadly weapon. No one, not the richest nor the poorest country, was prepared for this. The covid-19 pandemic has put the world in check and proposes a new planetary order. Bioethics must take its most reflective streak, understand the phenomenon, and draw lessons from this heartbreaking experience so that we do not make the same mistakes again that are costing us so many bitter tears and deaths.

I will present in this editorial some points that may help us to continue the debate and possibly reach agreements on how to advance in a post-COVID-19 world. Readers will find too and editorial note on our journals' numeration system.

In the name of the editorial board of Revista Latinoamericana de Bioética and my own, we dedicate this issue to the heroes of this pandemic, the health professionals (doctors, nurses, para- medics, to name just a few) who have risked their lives for the most vulnerable and feeble, those who have suffered the agony of this utterly heartless coronavirus disease.
Aceitação e análise físico-química de mel de Apis mellifera enriquecidos com geleia real
Authors: Batista Fernando Arthur Fernandes , Oliveira Julia Beatriz da Silva Oliveira , Carvalho Leonardo Emmanuel Fernandes de , Mesquita-Carvalho Luciene Xavier
Published: September 2020

O mel é um produto alimentício produzido pelas abelhas Apis mellifera. Assim como a geleia real, o mel é composto por nutrientes que possuem seu valor substancial, e são capazes de propiciar inúmeros benefícios aos usuários que o consomem. A combinação desses dois produtos desenvolveu um ótimo complemento alimentar. Dessa forma, o objetivo do presente trabalho foi verificar a aceitação do mel enriquecido com geleia real, a partir de análises físico-químicas, sensoriais e índices de aceitabilidade. Para isso, foram realizadas diferentes formulações (A com 500 ml de mel e 2,5 g de geleia, e B com 500 ml de mel e 5 g de geleia real), submetidas à análise sensorial (cor, acidez, doçura, impressão e intenção de compra) e físico-química (pH, acidez total, umidade e hidroximetilfurfural), para contribuir no conhecimento das características desse produto. Verificou-se que as amostras de méis enriquecidos com geleia real avaliados sensorialmente A e B apresentam-se estatisticamente similares para os atributos de acidez, doçura, impressão global e intenção de compra. As formulações obtiveram os seguintes índices de aceitabilidade: a amostra A obteve 87, 99 % e a amostra B 88,05 %. Referente aos parâmetros físico químicos avaliados, as amostras encontram-se todas dentro da legislação de qualidade de mel no Brasil, dessa forma, estando aptas para o consumo.
PRODUÇÃO CIENTÍFICA SOBRE PARADA CARDIORRESPIRATÓRIA NOS PERIÓDICOS BRASILEIROS DE ENFERMAGEM: ESTUDO BIBLIOMÉTRICO
Authors: Galindo Neto Nelson Miguel , Sitônio Costa Martins Kilse Uyara , Silva Priscylla Myrelle das Neves , Silva Rute Xavier , Alexandre Ana Carla Silva , Sá Guilherme Guarino de Moura
Published: September 2020

Objetivo: analisar a produção científica sobre parada cardiorrespiratória nos periódicos brasileiros de enfermagem. Método: estudo bibliométrico realizado mediante acesso eletrônico aos websites das 14 revistas brasileiras de enfermagem, classificadas na Plataforma Sucupira, para análise dos artigos publicados entre 2010 e 2019. Resultados: foram analisados 18.266 artigos, dos quais 50 foram selecionados para integrar a amostra. Foi possível observar que 50% dos artigos foram publicados em periódicos de extrato Qualis A e 80% das produções foram derivadas da Região Sudeste. Em relação ao tipo de estudo, 54% foram descritivos e 64% quantitativos. Quanto à temática mais investigada, 28% retrataram o conhecimento dos enfermeiros e 22% contemplaram o treinamento da enfermagem sobre parada cardiorrespiratória. Conclusão: a produção científica dos periódicos brasileiros demonstrou predominância de artigos publicados em periódico Qualis A, oriundos da Região Sudeste, do tipo descritivo, quantitativos, que investigaram predominantemente o conhecimento e o treinamento dos profissionais.

Descritores: Parada Cardiorrespiratória. Pesquisa em Enfermagem. Enfermagem. Bibliometria. Assistência de Enfermagem.
ESTRATÉGIAS E INOVAÇÕES TECNOLÓGICAS NO COMBATE À COVID-19: PRODUÇÃO DE MÁSCARAS CIRÚRGICAS
Authors: Guerra Siman Andréia , Batista Barbosa de Sá Diaz Flávia , Muniz Braga Luciene , Dibbern Lopes Correia Marisa , Fernandes Arial Ayres Lilian , Silva Cunha Simone Graziele
Published: September 2020

Objetivo: relatar a experiência de produção de máscaras cirúrgicas por uma comissão de produção de inovação tecnológica. Método: estudo descritivo do tipo relato de experiência. O processo de produção envolveu seis costureiras, uma cortando o tecido-não-tecido hospitalar, uma na máquina Overlock para fazer o acabamento nas laterais e quatro, costurando na máquina Reta. Foi utilizado tecido-não-tecido gramatura de 60, linhas brancas e arame galvanizado encapado. Resultado: a produção chegou a 1.300 máscaras cirúrgicas por dia. Todas passaram pelo teste de qualidade em uma central de distribuição antes de serem encaminhadas aos serviços de saúde. O processo foi gerenciado por duas enfermeiras. Conclusão: a estratégia relatada representou a produção de 63 mil unidades de máscaras cirúrgicas e foi uma maneira alternativa de suprir a demanda de máscaras cirúrgicas nos serviços de saúde, contribuindo para melhorar a segurança dos profissionais de saúde no âmbito da COVID-19.

Descritores: Prevenção & Controle. COVID-19. Infecções por Coronavírus. Gestão de Serviços de Saúde. Equipamento de Proteção Individual.
A An Update of Clinical Characteristics and Chest CT Findings of Coronavirus Disease 2019 (COVID- 19)
Authors: Sah Dr. Shambhu Kumar , Shah Sonali Kumari , Pandit Ram Naresh , Gang Chu Zhi , Li Yongmei
Published: September 2020

Novel coronavirus disease (COVID- 19) is a highly infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This novel virus is mainly transmitted through respiratory droplets and close personal contact, causing recent global public health emergency. COVID- 19 high-risk groups include elderly and immunocompromised patients, patients with preexisting comorbidities such as cardiovascular disease, hypertension, diabetes, respiratory disease, and oncological complications. Chest computed tomography (CT), especially high- resolution CT (HRCT) plays an important role in the early diagnosis, staging and monitoring of patients with COVID- 19 pneumonia. The clinical characteristics and chest CT findings of COVID- 19 are reviewed, including the time course of lung changes on chest CT during recovery and correlation of chest CT and reverse-transcription polymerase chain reaction (RT-PCR) testing in COVID- 19.
Böbrek transplant alıcılarında allograft biyopsisinin histopatolojik değerlendirilmesi ve komplikasyonları: Radyolojik görüntüleme açısından
Authors: ÇEVİK Belma
Published: September 2020

Amaç: Böbrek nakli, son dönem böbrek yetmezliği olan hastaların çoğunda tercih edilen tedavi yöntemi haline gelmiştir. Renal allogreft biyopsisi böbrek nakli disfonksiyonunun tanısında en önemli tekniktir. Bu çalışmada, radyolojik görüntüleme ışığında renal transplant hastalarında histopatolojik değerlendirme ve komplikasyon tipleri ve sıklığının araştırılması amaçlandı.

Gereç ve Yöntemler: Bu retrospektif çalışmada, Ocak 2000 ve Aralık 2007 tarihleri arasında böbrek biyopsisi yapılan renal transplantasyonlu hastaların histopatolojik biyopsi sonuçları, kalsinörin inhibitörü ilaç düzeyi ile toksisite gelişimi arasındaki ilişki açısından değerlendirildi. Ayrıca biyopsi ile ilişkili komplikasyonlar araştırıldı.

Bulgular: Toplam 386 hasta çalışmaya dahil edildi ve bu hastalara 843 biyopsi yapıldı. Doku miktarı 812 biyopside (% 96) yeterli, 6 biyopside (% 1) yetersiz ve 27 biyopside (% 3) sınırlı ancak histopatolojik değerlendirme için yeterli bulunmuştur. Akut ret, tübüler epitel hasarı ve kronik allogreft nefropati en sık konulan tanılardı. Biyopsilerin komplikasyonları 4 biyopside makroskopik hematüri (%0.57), 6 biyopside perirenal hematom (% 1) ve 1 biyopside arteriyovenöz fistül (% 0.15) idi.

Sonuç: Böbrek allogreft disfonksiyonunu değerlendirmek için nakil yapılan hastalarda böbrek biyopsisi çok düşük komplikasyon oranına sahip güvenli bir yöntemdir.
Statistical Analysis with Hedonic Pricing Models: Estimation of Real-Estate Values and Anticipation of Housing Price in Beijing, China
Authors: Lyu Haoxuan , Liu Zeyuan
Published: September 2020

On the basis of big data regarding the sold house price in Beijing from 2011 to 2017, this research aims to exhibit a comprehensive and rational deducing progress in character with the justified and formulated variables and visible results to be instrumental in the prediction of housing price in Beijing, and it attributes the dominated factors amongst all dependent variables. In this paper, the hedonic price model is the primary analyzing tool to cope with the intrinsic factors in real-estate estimation and prediction.
The Work We shall be Amidst Organisation and Community
Authors: Capogna Stefania
Published: September 2020

The essay reflects on the topic of technological unemployment, providing a review of scenarios foreseen by some of the most critical studies focusing on possible future developments. By comparing the risks and perspectives according to the impact of the fourth-generation digital revolution, the author develops a prospect of a welfare encompassing work, community and care from a renewed ethos of co-responsibility.
The experience of application of prolonged craniopuncture in acute period of ischemic stroke
Authors: Molchanova Elena Evgenievna
Published: September 2020

The purpose of this research was to study the effect of prolonged craniopuncture on the rate of regression of the neurological deficit, the degree of adaptation to daily life, and the level of motivation among patients in the acute period of ischemic stroke. All patients (60 people) were divided into 2 groups, identical by sex, age and severity of the stroke. In the main group of patients (n=30) prolonged scalp therapy was performed simultaneously with classical acupuncture. The peculiarity of this modification of craniopuncture is the use of seven main areas of the scalp with their symmetrical stimulation and duration of exposure for up to 4 hours. Patients of the control group (n=30) underwent acupuncture in combination with scalp therapy according to the classical method. Assessment of the severity of neurological deficit was carried out on the scale NIHSS, while Barthel ADL index was used to assess the patient's daily live activities after stroke. The level of motivation among the patients was studied by using the questionnaire test Motivation for Success and Motivation for Fear of Failure. Monitoring was carried out on the 1st and 15th day from the start of treatment. In the main group of patients, the reduction in the severity of the neurological deficit occurred on the 15th day according to the data NIHSS scale was 5.0 (64,9%), the Barthel index increased by 31.0 points (55,1%). In the control group, similar indicators were 3.5 (50,7%) (on the NIHSS scale) and 23.5 points (40,5%) (Barthel's index). Both groups of patients experienced an increase in the level of motivation and were already oriented to success, but in the main group, these changes appeared to be more significant. Thus, the use of prolonged craniopuncture significantly accelerates the restoration of lost functions and the adaptation of patients to everyday life, in comparison with the classical method of scalp therapy, and has a beneficial effect on increasing the level of patients motivation.
The experience of functioning of oblast perinatal council of physicians on territory of the Chelyabinskaia oblast
Authors: Moskvitcheva M. G , Sakharova V. V , Semenov Yuriy A. , Boyko I. V
Published: September 2020

The article considers organizational issues of functioning of the oblastnoii perinatal council of physicians related to maintenance of availability of obstetric-gynecologic care of pregnant women on territory of the Chelyabinskaia oblast. The analysis of functioning of oblast perinatal council of physicians “The oblastnoii perinatal center” is presented with purpose of increasing of effectiveness of medical care of pregnant women.
The remote results of laser destruction of proliferating colloidal goiter
Authors: Aleksandrov Yu. K , Semikov Vasiliy I. , Kudachkov V. A , Sokolova E. I
Published: September 2020

The article presents the remote results (time-period more than 1 year) of application of percutaneous laser destruction in treatment of nodular goiter in 164 patients. The reliable decreasing of dimensions and size of nodular formations of thyroid gland in early time-periods with continuation of regression during a year is established. In the following, slight regression was marked during 3,5-5 years. The morphological analysis established that in remote time-periods after percutaneous laser destruction of nodular proliferating colloid goiter the destroyed follicular epithelium and colloid are replaced by connective tissue structures with large amount of collagen guaranteeing long-term predictive result.
The actual problems of immune therapy of pyo-inflammatory diseases
Authors: Zemskova V. A , Zemskov A. M , Zemskov V. M , Zoloedov Vladimir I.
Published: September 2020

The article considers various clinical models of such pyoinflammatory diseases as deep pyoderma, exacerbation of chronic salpingo-oophoritis, chronic pyelonephritis, implemented to establish determining effect of pathogenesis and possibly basic treatment of pathologic processes on character, intensity of immunopathology, effectiveness and mechanisms of action of pharmacological immune correction.
The neurophysiological aspects of investigation of functional disorders in maxillofacial area
Authors: Sorokina Nataliya D. , Gioeva Yu. A , Selitskiy G. V , Markovtseva M. A
Published: September 2020

Nowadays, problem of rendering of neurological and orthodontic care under occurrence of functional, morphological and aesthetic disorders of maxillofacial area is quite actual because of their significant prevalence in population of Russia. The article presents analysis of publications’ data related to various groups of patients with differentiated types of disorders and pain syndromes of maxillofacial area including subsequent implementation of orthodontic correction. The review presents data of different age groups of both children and adults that is very important in neurophysiological clinic of children age. The presented publications’ data can be used in practical activity of orthodontists and specialists in issues of functional diagnostic.
The activity of renin-angiotensin system in patients with arterial hypertension in population of the Gornaia Shoria
Authors: Mulerova Tatiana A. , Uchasova E. G , Chigisova A. N , Ogarkov M. Yu
Published: September 2020

The study was carried out to investigate characteristics of pathophysiological variants of arterial hypertension depending on activity of plasma renin in indigenous (Shors) and non-indigenous population of the Gornaia Shoria.The clinical epidemiological study was carried out concerning indigenous population of hard-to-reach regions of the Gornaia Shoria. The continuous sampling technique was applied on the basis of nominal lists to select 837 residents of the mentioned villages (513 personf of indigenous population (Shors) and 324 of non-indigenous population). The particular sampling consisted of adult population, including individuals of 18 years and older. The activity of plasma renin was evaluated using test-systems of BRG (Germany). All examined patients were separated in two groups. The first group included patients with arterial hypertension with concentration of plasma renin > 47,85 picograms per ml (development of disease is related to excessive release of renin and activation of renin-angiotensin system). The second group included patients wit arterial hypertension with content of plasma renin < 47,85 picograms per ml (arterial hypertension is related to suppression of release of renin and retention of sodium in organism). The renin - dependent arterial hypertension more was often found among representatives of non-indigenous nationality (89,8 % against 65,5%) and the volume-dependent arterial hypertension - among representatives of indigenous nationality (34,4 % against 10,1%). In the indigenous ethnic group of Shors the renin - dependent arterial hypertension was associated with younger age and expressed structural functional alterations of heart in the form of increased index of myocardium mass of left ventricle. The volume-dependent arterial hypertension was associated with average age and increased indicator of thick- Clinical medicine ness of complex of intima-media. In non-indigenous ethnic group the renin - dependent arterial hypertension was associated with increased level of index of waist/thigh. The volume-dependent arterial hypertension was associated with expressed structural functional alterations of heart in the form of increased index of myocardium mass of left ventricle.
The competence of physicians of medical organizations of pediatric profile in the field of ethical legal issues
Authors: Shmeleva I. A , Konovalov Oleg E. , Polunina N. V
Published: September 2020

The implementation of rights of under age patients in medical institutions to considerable extent is determined by the level of awareness of pediatricians about ethical legal issues related to children and adolescents. The article presents the results of survey of 239 pediatricians about rights of patients and duties of physicians. It is established that respondents are insufficiently informed about ethical legal issues and apply untimely knowledge about legal acts concerning rights of children-patients in their practice. It is established that awareness about ethical legal issues was higher among pediatricians with professional experience less than 10 years since disciplines of biomedical ethics and medical law were included into the program of prediploma training of pediatricians only in last decade. The direct relationship between competence of pediatricians in ethical legal issues and qualification was determined. The most of respondents are convinced in importance of advanced education in ethical and legal issues. It is necessary to include sections intended to increasing of legal competence of pediatricians.
The laparoscopic trans-abdominal pre-peritoneal hernioplasty in case of inguino-scrotal hernia
Authors: Sazhin Aleksandr V. , Klimiashvili A. D , Ivakhov G. B , Kotchiay E.
Published: September 2020

The laparoscopic trans-abdominal pre-peritoneal hernioplasty is an effective technique of treatment of uncomplicated hernia. However, application of this technique at complicated forms (inguinal-scrotal, repeatedly relapsing, strangulated hernias) continues to be a point at issue. The treatment of inguinal-scrotal hernia requires from surgeon availability of considerable experience independently of selected technique. The study was carried out to evaluate reliability and effectiveness of application of trans-abdominal pre-peritoneal hernioplasty under inguinal-scrotal hernia. In municipal clinical hospital № 4 8 operations of hernioplasty was implemented using trans-abdominal pre-peritoneal hernioplasty from 2014 to 2015. The technical intra-operational characteristics of techniques were analyzed. The evaluation of intra-operational and post-operational complications in early post-operational period and after 3 and 6 months after operation was implemented. All hernias were primary and onesided ones and were operated by the same surgeon. The average duration of operation made up to 93.5 min. In no cases the conversion was needed. No severe intra-operational complications were detected. In no case chronic pain and relapsing were detected. The total rate of post-operative complications made up to 12.5%. All patients were satisfied with operation in 3 and 6 months after discharge from the hospital. According the results of study, trans-abdominal pre-peritoneal hernioplasty is an effective technique of treatment of inguinal-scrotal hernias comparative with results of treatment of primary uncomplicated hernias.
The approaches to early diagnostic and correction of nutritive disorders under arterial hypertension combined with chronic obstructive lungs disease
Authors: Shpagina L. A , Gerasimenko Olesya N. , Sukhaterina N. A , Shpagin I. S
Published: September 2020

The complex evaluation of food status of patients with arterial hypertension and chronic obstructive disease of lungs was implemented. The patients with combination of arterial hypertension and chronic obstructive disease of lungs are characterized by expressed anomalies of body composition (visceral obesity, surplus of total and extracellular fluid, protein-energy deficiency), dyslipidemia (increasing of level of cholesterol of low density lipoproteins, index of atherogenicity and hypertriglycer-inemia), disorders of protein metabolism (decreasing of total protein and pre-albumin) and adipocytokine status (increasing of concentration of leptin and resistin of blood against the background of decreasing of content of adiponeсtin). The mentioned alterations can promote increasing of cardiovascular risk in patients of this phenotype. The patients received protein formula for enteric nutrition during 21 day in combination with standard therapy. Whereupon, the indices of food status were re-evaluated. In dynamics, amelioration of indices of protein and fat metabolism was established. Hence, it appropriates to prescribe to patients with combination of arterial hypertension and chronic obstructive disease of lungs nutritive support with higher protein products for enteric nutrition.
The rationale application of donor material: original ten years experience, possible ways of development and literature data
Authors: Oganesyan Oganes G. , Yakovleva S. S , Kharlampidi M. P , Grdikanyan A. A
Published: September 2020

Lately, layer-wise keratoplasty became the first operation of choice in case of pathology of cornea. In view of satisfying results of endothelial surgery similar operations are implemented at earlier stages that increases need in donor tissue. With increasing of life span of population, also increases number of patients in need of transplantation of cornea. The number of intact cadaver cornea decreases because of stable increase of surgical interventions on front segment of eye. The present article presents original ten years experience concerning optimization of application of donor tissue and indicate on possibilities of further increasing of number of applied keratoplasties. From 2009 to 2015 in the Helmholtz Moscow research institute of eyes diseases 652 transplantations of cornea were implemented in various modifications: straight-through keratoplasty, transplantation of Descemet's membrane with endothelium (DMEK), deep front layer-wise keratoplasty, endokeratoplasty (DSEK) with various modes of transplant formation and 23 frontal layer-wise keratoplasties. In transplantation were also used eyes of donors with radial keratotomy, after laser keratomileusis and with artificial intra-ocular lens. To implement 652 operations 528 cadaver eyes with average age 41 ± 32,5 years (varying from 21 to 87 years) were required. The number of transplantations increased approximately on 50% at potential up to 75%. The lamellar surgery permits using corneal donor tissue with altered frontal surface and to increase number of transplantations of cornea. The renunciation of application of corneal donor tissue with altered frontal surface is inexpedient.
The effect of educational programs on effectiveness of treatment of arterial hypertension at out-patient stage of medical care rendering
Authors: Melekhov Aleksandr V. , Emelina E. I , Andreeva O. Yu , Gendlin G. E , Sokolovskaya L. V
Published: September 2020

The increasing of effectiveness of treatment of arterial hypertension is a key issue of prevention of complications of this disease. The level of target arterial pressure is achieved far from all patients treated because of arterial pressure. The article presents data concerning 55 individuals with office systolic arterial pressure higher than 140 mm of mercury column who in spite of hypotensive therapy prescribed by physician, demonstrated no achievement of target values of arterial pressure. Out of this group, 24 patients were acquainted with educational program including an hour lecture concerning arterial hypertension, techniques of self-control of arterial pressure, effect of non-pharmaceutical modes of treatment and role of patients themselves in therapy of this diseases. The educational program was ignored by 31 patient. All patients at the start and the completion of examination were measured office arterial pressure, monitored day arterial pressure. Also evaluation of compliance to indicated hypotensive medicinal therapy was carried out. At the second control visit after 1-3 months, in patients who attended the lecture, significant decreasing of arterial pressure was established according both office measurement and data of indices of systolic arterial pressure. Moreover, the same patients developed compliance to applied treatment. No such effects were observed in 31 patients who ignored lecture mentioned above. It is assumed that the important part of activities concerning treatment of patients with arterial hypertension from the very beginning of interaction with physician is to become increasing of awareness of patients about disease, modes of its control, importance of non-medicinal measures, regular pharmacotherapy attended by physician. It is appropriate to actively implement these measures in practical health care considering expressed clinical and social economical effectiveness of educational programs for patients with arterial hypertension.
The role of genetic polymorphisms and growth factors in pathogenesis of urgent and mixed urinary incontinence in women
Authors: Smolnova Tatyana Yu. , Lukyanova D. M
Published: September 2020

The purpose of study. To analyze genetic polymorphisms of receptors of bladder, structural components of intercellular matrix of urinary excretion organs, molecular biochemical mechanisms of regulation of function of bladder and urethra resulting in urinary incontinency. Materials and methods. The analysis of publication data concerning genetic polymorphisms and molecular biochemical mechanisms of development of urinary incontinence in women. The results. The publication data is presented concerning impact of genetic polymorphisms of receptors of detrusor on development of urgent and mixed urinary incontinency in women. The corresponding molecular genetic and biochemical processes underlying detrusor sphincter dyssynergia in women are considered. Conclusion. The urinary incontinence is a multifactorial pathology developing due to alterations at systemic, organic, tissular and cellular levels. Such growth factors as bFGF, TGFβ, CTGF contribute into pathogenesis of urgent and partially mixed urinary incontinency resulting in intensification of unstripped muscle cohesions of detrusor, obstructive miohypertrophy and fibrosis of bladder wall. The altered adrenalin reactivity of urinary excretion ways plays particular role in pathogenesis of urgent component of urinary incontinence. And vice versa, damage of structure of connective tissue in patients with polymorphism COL1A1 or disorder of molecular biochemical mechanism of action of cytokines TGFβ and CTGF provoke insufficiency of sphincter apparatus of urinary excretion ways. The totality of enumerated mechanisms results in development of stress urinary incontinency. The elaboration of individual approach to selection of treatment method requires consideration of mentioned mechanisms of development of urinary incontinence including form and severity of disease.
Effectiveness of a multidisciplinary approach in the rehabilitation treatment of post-stroke patients at the outpatient stage of medical rehabilitation
Authors: Fakhretdinov Vitaly V. , Brynza Natalya S. , Kurmangulov Al’bert A.
Published: September 2020

Background. Current approaches to the rehabilitation of stroke patients are based on the early start of rehabilitation measures, a certain sequence, duration, and, of course, the active participation of the patient and their environment. Recently, the scientific medical community has engaged in a serious discussion on the organization of rehabilitation from the perspective of a multidisciplinary approach.
Aim. To assess the impact of the multidisciplinary approach to the outpatient rehabilitation phase on the main health components in stroke patients.
Materials and methods. An experimental, longitudinal, open study included 60 patients with stroke in the late residual period. The studied patients were classified into groups using stratification randomization: Group 1 30 (50%) patients with high rehabilitation potential, as well as a high degree of personal interest in undergoing the outpatient phase of medical rehabilitation; Group 2 30 (50%) patients who had rehabilitation potential but were, for several reasons, forced to refrain from undergoing the outpatient phase of medical rehabilitation. The duration of the outpatient rehabilitation phase was 14 days: the course of rehabilitation treatment included 10 visits to the rehabilitation department, which operates on the principles of lean manufacturing and a quality management system; 2 days of medical leave; and 2 days of independent work by patients. The multidisciplinary team included a neurologist, physiotherapy physiologist, physical therapy instructor, speech therapist, psychologist, occupational therapist, and a social worker who received special training in medical rehabilitation. As the criteria for assessing the effectiveness of rehabilitation measures during the course of this study, we identified 11 key indicators that allowed us to assess the recovery of neurological deficit, motor functions, possible risk of patients falling, psycho-emotional state, cognitive functions, level of disability, frequency of repeated strokes, number of visits to the clinic place of residence, level of independence, and quality of life of the patient.
Results. When we compared these groups in response to the course of rehabilitation treatment, the patients who passed the outpatient stage achieved a positive result of 91% (a positive response to 10/11 criteria for evaluating effectiveness), while the percentage of response to treatment in the second group was 18% (positive answer for 2/11 criteria for evaluating effectiveness).
Conclusion. To achieve the rehabilitation goals and objectives set for the patient in the late recovery period, it is advisable to conduct the outpatient phase of medical rehabilitation.
Antegrade transhepatic papillodilatation and dislocation of bile stones in duodenum in management of cholelitiasis
Authors: Okhotnikov Oleg I. , Yakovleva M. V , Kalutskiy A. P
Published: September 2020

Endobiliary antegrade stenting by self-expanding stents was performed in 32 patients with unresectable tumors of pancreatobiliary area. Uncoated stents were used in 15 patients with the proximal obstruction of the biliary tree. Uncoated stents prevent the blockade of lobar, segmental and cystic duct. Covered self-expanding stents were used in 17 cases of distal occlusion and obstruction of the peripapillary area. Antegrade stenting drainages of 8Fr were performed in a stepwise manner, consistently performing outside, then outward-internal drainage of the biliary tree, which was transformed into endobiliary stenting. Hybrid endobiliary antegrade stenting, which involves maintaining outward-internal drainage in lumen installed endobiliary stent, was performed in 14 patients. Hybrid antegrade stenting endobiliary allowed to keep endobiliary access to palliative care for all the time, monitor and correct the patency of the stent, by releasing from intraluminal sludge, to carry out a successful reparative stenting “stent to stent” in case of the invasion of tumor or scar tissue in to the lumen of the stent or around of its proximal end.
Oncology Institute of the Republic of Moldova is 55 years (outlines of history)
Authors: Chernat Viktor F.
Published: September 2020

In chronological order, there is presented the history of the creation of Oncology Service of the Republic of Moldova. There were mentioned most prominent public health leaders who participated in the creation and functioning of the Oncological service. There are described the main achievements and challenges of the service for the future.
Results of locally advanced laryngopharyngeal and cervical part of esophagus cancers treatment
Authors: Rudyk Andrey N. , Sigal E. I , Burmistrov M. V
Published: September 2020

Issues of locally advanced cancers which involve into the pathological process laryngopharynx and cervical part of esophagus remain to be actual till the present time. Unsatisfactory long-term results lead to the absence of common approaches and clear guidelines on the methods of the treatment choice (radiotherapy, chemoradiation therapy, surgery). Many researchers suppose that the foremost decision is to include surgical component into the treatment schemes of such patients. Main surgical method of the treatment is laryngopharyngectomy or laryngopharyngoesophagectomy. It depends on the extension of cancer. Different kinds of grafts (gastric, jejunal and colon) are used for esophageal reconstrution. The high frequency of complications after surgery, low survival rates are main motives for the search of effective methods of treatment.
Serous ovarian borderline tumors: modern classification and biology
Authors: Davydova Irina Yu. , Kuznetsov V. V , Karseladze A. I , Meshcheryakova L. A
Published: September 2020

In this article there are considered current views on biology of ovarian serous borderline tumors, there is presented a modern histological classification of 2014, which has undergone some changes. Variants of serous borderline tumors are described in terms of morphology, clinical course and prognosis. Also there is discussed the issue of the pathogenesis in the development of ovarian borderline tumors, the contribution of gene mutations in the occurrence of borderline, poorly or well differentiated ovarian tumors. There are described in details features of morphology of serous borderline tumors, the interrelationship of their occurrence and dedifferentiation in dependence on the molecular and genetic deteriorations. In the article there is considered the microinvasive version of the serous borderline tumors and specified criteria for the establishment of this diagnosis. There are given the definition and characterization of micropapillary serous borderline tumors, there is discussed their impact on the course of the disease and prognosis. The issue of terminology is considered in terms of current views and history.
Efficacy of surgical treatment of patients with localized gastrointestinal stromal tumors
Authors: Arkhiri Petr P. , Stilidi I. S , Poddubnaya I. V , Nered S. N , Nikulin M. P , Bokhyan V. Yu , Abu-Khaydar O. B , Peregorodiev I. N , Melikov S. A , Tsymzhitova N. Ts
Published: September 2020

The main method of the treatment of patients with localized and locally advanced gastrointestinal stromal tumors (GIST) currently remains to be surgical, but its effectiveness is limited and determined by the degree of local expansion of the disease and radicality of the surgery. Before the era of the use of tyrosine kinase inhibitors (TKI) in the treatment of GIST patients the overall 5-year survival after radical surgery in the group of patients with size of the tumor larger than 10 cm failed to exceed 20%. For the time present with the comprehensive approach to the treatment indices of survival in these patients have significantly improved. Overall 5-year survival in patients with a high risk of disease progression reaches 93%. The most important prognostic factors in patients with primary localized GIST are: the size of the primary tumor, mitotic index, tumor location, mutation status and the morphological variant of the cellular structure of GIST.
The role of preoperative chemotherapy for colorectal cancer metastases in the liver with the lack of RAS mutations
Authors: Lazarev A. F , Mamontov K. G , Kotelnikov A. G , Khays Sergey L. , Lubennikov V. A
Published: September 2020

Colorectal cancer (CRC) is one of the most common malignancies, occupying the third place in the world among malignant tumors morbidity rate and the 4th place on the causes of death. Every year in the world there are diagnosed more than 1.3 millions of new cases of the disease. The mortality rate continues to be one of the most common causes in the structure of cancer incidence. In Russia, each year there are diagnosed more than 60 thousands of new cases of colorectal cancer. For the last time the incidence increased by 11%, out of them more than 17 thousands patients show newly diagnosed distant metastases. In the absolute majority of cases metastases in the liver are firstly detected in 2-3 years. Liver is the organ- the most commonly affected by metastases. Methods of medicinal treatment of CRC metastases are of great importance and allowed to greatly improve the life expectancy of patients. Median overall survival (OS) is 35-40 months. The one of the last achievement of the modern drug therapy of metastatic CRC was the appearance of the preparation Cetuximab. Blocking of the KRAS gene is a key compartment of the signaling pathways that transmit extracellular growth signals from the surface of the cell to the nucleus. Further signals are transmitted via the cascade into the cellular nucleus, regulating cell growth, proliferation, angiogenesis, invasion and metastasis. Results of the research of PRIME, PEAK and FIRE-3 confirm the advantage of supplement ofpanitumumab or cetuximab to chemotherapy regimens FOLFOX or FOLFIRI in patients with wild-type Ras.
Fertility problems in patients with germ cell tumors
Authors: Zhukovskaya Elena V.
Published: September 2020

This review highlights some of the aspects of the fertility in patients with germ cell tumors. This problem appears to be the very actual problem because of the possible impact not only anticancer therapy, but the tumor itself, coming from the human gonadal germ cells on the fertility. The individual histological types have been characterized by age and gender features. In patients with germ cell tumors, infertility is more common than in patients with other malignancies. Feasibility of the germ cell sampling procedure: the sperm and possibly, ovum, before the treatment in order to preserve the reproductive function of cured patients.
MUTATIONAL STATUS AND SOME CLINICO-MORPHOLOGICAL FEATURES OF CUTANEOUS MELANOMA
Authors: Mazurenko N. N , Tsyganova I. V , Lushnikova A. A , Anurova O. A , Ponkratova D. A , Vikhrova A. N , Utyashev I. A
Published: September 2020

Cutaneous melanoma is characterized by molecular heterogeneity. The work is devoted to the analysis of mutational status of genes involved in MAPK signaling in primary and metastatic cutaneous melanoma for the detection of tumor sensitivity to the specific targeted therapy as well as possible links of genetic alterations in cutaneous melanoma with some clinical and morphological features. BRAF, NRAS and KIT mutations were found in 60.6%, 13.8% and 1% of cutaneous melanoma cases correspondingly. Mutational status of cutaneous melanoma is differed depending on tumor localization, chronic UV insolation and patients’ age. Thus the rate of the BRAF mutation in melanomas of trunk and extremities (64.7%) was higher than in melanomas of face and head (42.8%). The rate of BRAF mutation was shown to be not associated with pigmentation and tumor growth while NRAS mutation frequency in amelanotic melanoma was lower and in noddle melanoma - higher if compared with pigmented cutaneous melanoma in the radial growth phase. The trend in the association of mutations with melanoma histological type was shown for the first time, the highest rate of BRAF mutation was found in epithelioid melanoma. The obtained results are important for the treatment of cutaneous melanoma as mutational status determines the sensitivity of metastatic melanoma to specific targeted therapy in patients with BRAF, NRAS and KIT mutations.
SOME FEATURES OF CHOLESTASIS IN CANCER PATIENTS IN THE COURSE O THE IMPAIRMENT OF LIVER FUNCTIONAL RESERVES
Authors: Okhotnikov O. I , Yakovleva M. V , Grigoriev S. N , Pakhomov V. I
Published: September 2020

Purpose. To discuss the possible causes of discrepancies in results of laboratory and X-ray methods of diagnostics of surgical cholestasis without a concomitant dilatation of the bile ducts, as well as features of X-ray-surgical tactics in such cases. Material and methods. In 2015-2016, 271 percutaneous transhepatic cholangiostomies were performed, including 23 cases - on unexpanded bile ducts, 7 these cancer patients with the laboratory evidence of cholestasis. The criteria for the absence of dilatation of the intrahepatic bile ducts were considered as not only an obvious non-visualized biliary tree on ultrasound, but also the diameter of the peripheral intrahepatic bile ducts less than 2 mm, which must be significantly less than similar peripheral branches of the portal vein. Results.Outside bile-outflow was effective, but only in two cases it provided the relief due to cholestasis performance. In 3 cases, blood bilirubin levels decreased by more than half of the initial ones. 5 out of 7 patients after external drainage of unexpanded bile ducts had evident signs of the liver failure. Two patients with malignant lesions of the biliary tree and baseline bilirubinemia over 450 umol/L died because of progressive liver failure. Conclusion. Mechanical jaundice corresponds to the concept of surgical cholestasis, which is associated with surgical diseases stipulating the violation of the outflow of bile and requires biliary decompression. By reducing the functional reserves of liver surgical cholestasis may not be accompanied by the significant expansion of the bile duct, which can be considered as a predictor of hepatic failure, which nevertheless requires cholangiostomy.
TRANSDERMAL FENTANYL: PHARMACOLOGICAL ASPECTS OF THERAPY IN CANCER PATIENTS. PART 2. APPLICATION FEATURES OF TRANSDERMAL FENTANYL FORMULATIONS
Authors: Sidorov Aleksander V.
Published: September 2020

Second part of the article summarizes factors influencing transdermal phentanyl pharmacokinetics. Data obtained from genetic studies of factors that could explain the individual variability in fentanyl activity are given. Main aspects of transdermal fentanyl administration with regard to the dosage, patch application and efficacy assessment as well as adverse effects and drug interactions are reviewed. Besides the most common medication errors related to transdermal opioid are analyzed.
CLINICAL EXPERIENCE OF THE USE OF PD-1 INHIBITOR IN PATIENTS WITH NON-CELL LUNG CANCER WITH METASTATIC DAMAGE OF KIDNEYS AND ADRENALS
Authors: Sarantseva Ksenya A. , Yudin D. I , Okruzhnova M. A , Laktionov K. P
Published: September 2020

Non-small cell lung cancer (NSCLC) is the leading cause of death from cancer worldwide. Despite the success over recent years in the treatment of NSCLC it has not yet been able to achieve good long-term survival. A new promising direction of NSCLC treatment in the second line is the use of immunotherapy by inhibitors of immune control points. This group of drugs radically changed the outlook on the prognosis of patients with disseminated NSCLC progressing on previous platinum-containing chemotherapy. The article presents the results of a clinical trial program for nivolumab and the analysis of clinical cases of its application in NSCLC patients with metastatic damage of the kidneys and adrenal glands.